Neonatal Resuscitation Program (NRP) Practice Questions and Answers Rated A
1. what is expected Gestational age, (preterm <38 wks,
term 38-41 wks or post-term >41 wks)
2. what is amniotic fluid color (only clear good),
Questions to ask prior to birth 3. what's number of babies expected (twins mebbe
more),
4. are any additional risk factors (GDM, miscarriages,
preeclampsia, etc.)
When to clamp umbilical cord 30-60 seconds after birth for VIGOROUS newborn
1. Is the baby term, (if no, bring baby to warmer)
2. does the baby have good muscle tone, (flaccid/extend-
ed extremities are bad)
Things to look for after birth
3. is the baby breathing or crying? (if no crying, observe
chest for breathing ettorts. if vigorous crying, return to
mom)
1. Warm,
2. position airway,
5 initial steps of care 3. clear secretions if needed,
4. dry,
5. stimulate
Flow rate for free-flow O2 administration 10lpm
O2 level for free-flow O2 administration 30%
Suction setting for newborn 80-100mmHg
gestation <36wks or >41wks, pre-eclampsia and eclamp-
sia, maternal HTN, poly and oligohydramnios, fetal hy-
Antepartum risk factors
drops, macrosomia and IGR, fetal malformations or
anomalies, no prenatal care.
Emergency c-section, vacuum assisted delivery, breech
Inpartum or abnormal presentation, category II or III, maternal
anesthesia, mag, or narcs, prolapse cord, shoulder dys-
, Neonatal Resuscitation Program (NRP) Practice Questions and Answers Rated A
Apnea, tachypnea, bradycardia, tachycardia, decreased
Abnormal transition signs and symptoms
muscle tone, low SpO2, hypotension
Preductal SpO2 at 1 min 60-65%
Preductal SpO2 at 2 min 65-70%
Preductal SpO2 at 3 min 70-75%
Preductal SpO2 at 4 min 75-80%
Preductal SpO2 at 5 min 80-85%
Preductal SpO2 at 10 min 85-95%
Where to put pulse oximeter on newborn Right hand or wrist (preductal)
Requirements for CPAP on newborn HR >100bpm and spontaneous respirations
Listen with stethoscope on left side chest for 6 seconds,
Best way to determine HR
multiply by 10
If suctioning, do you suction the mouth or nose first? Mouth
Apnea, gasping, HR<100bpm, SpO2 low despite free-flow
Indications for PPV
O2 or CPAP
Clear secretions, position yourself at baby's head, position
Preparation for PPV
baby's head and neck
Rate for administering PPV breaths 40-60bpm or "breathe, two, three, breathe..."
Proper PIP setting 20-25cmH2O
Proper PEEP setting 5cmH20
O2 flow rate for PPV 10lpm
O2 concentration for PPV (>35wk gestation) 21%
O2 concentration for PPV (<35wk gestation) 21-30%
1. what is expected Gestational age, (preterm <38 wks,
term 38-41 wks or post-term >41 wks)
2. what is amniotic fluid color (only clear good),
Questions to ask prior to birth 3. what's number of babies expected (twins mebbe
more),
4. are any additional risk factors (GDM, miscarriages,
preeclampsia, etc.)
When to clamp umbilical cord 30-60 seconds after birth for VIGOROUS newborn
1. Is the baby term, (if no, bring baby to warmer)
2. does the baby have good muscle tone, (flaccid/extend-
ed extremities are bad)
Things to look for after birth
3. is the baby breathing or crying? (if no crying, observe
chest for breathing ettorts. if vigorous crying, return to
mom)
1. Warm,
2. position airway,
5 initial steps of care 3. clear secretions if needed,
4. dry,
5. stimulate
Flow rate for free-flow O2 administration 10lpm
O2 level for free-flow O2 administration 30%
Suction setting for newborn 80-100mmHg
gestation <36wks or >41wks, pre-eclampsia and eclamp-
sia, maternal HTN, poly and oligohydramnios, fetal hy-
Antepartum risk factors
drops, macrosomia and IGR, fetal malformations or
anomalies, no prenatal care.
Emergency c-section, vacuum assisted delivery, breech
Inpartum or abnormal presentation, category II or III, maternal
anesthesia, mag, or narcs, prolapse cord, shoulder dys-
, Neonatal Resuscitation Program (NRP) Practice Questions and Answers Rated A
Apnea, tachypnea, bradycardia, tachycardia, decreased
Abnormal transition signs and symptoms
muscle tone, low SpO2, hypotension
Preductal SpO2 at 1 min 60-65%
Preductal SpO2 at 2 min 65-70%
Preductal SpO2 at 3 min 70-75%
Preductal SpO2 at 4 min 75-80%
Preductal SpO2 at 5 min 80-85%
Preductal SpO2 at 10 min 85-95%
Where to put pulse oximeter on newborn Right hand or wrist (preductal)
Requirements for CPAP on newborn HR >100bpm and spontaneous respirations
Listen with stethoscope on left side chest for 6 seconds,
Best way to determine HR
multiply by 10
If suctioning, do you suction the mouth or nose first? Mouth
Apnea, gasping, HR<100bpm, SpO2 low despite free-flow
Indications for PPV
O2 or CPAP
Clear secretions, position yourself at baby's head, position
Preparation for PPV
baby's head and neck
Rate for administering PPV breaths 40-60bpm or "breathe, two, three, breathe..."
Proper PIP setting 20-25cmH2O
Proper PEEP setting 5cmH20
O2 flow rate for PPV 10lpm
O2 concentration for PPV (>35wk gestation) 21%
O2 concentration for PPV (<35wk gestation) 21-30%
