NRP 7th Edition Section 1 / Part 1 Exam
Questions & Answers — All Correct • 2026/2027 Updated Content
Neonatal Resuscitation Program Provider Course
75 Questions Across 9 Domains • Cognitive Mix: 40% Recall, 45% Application, 15% Analysis • 70% Scenario-Based, 30%
Direct Recall • Verified Answers + NRP 7th Edition Rationales
Each question is followed by four options (A–D), one verified correct answer marked [CORRECT], the correct answer letter,
and a 2–4 sentence rationale integrating NRP 7th Edition algorithm sequence, physiologic rationale, and clinical application.
Section 1: NRP Foundations and Program Overview (NRP History, 7th
Edition Updates, & Program Structure)
Q1: Which organizations jointly sponsor the Neonatal Resuscitation Program (NRP)?
A. American Heart Association (AHA) and American Academy of Pediatrics (AAP) [CORRECT]
B. American Nurses Association (ANA) and American College of Obstetricians
C. World Health Organization and Centers for Disease Control
D. Joint Commission and Institute for Healthcare Improvement
Correct Answer: A
Rationale: NRP is co-sponsored by the American Academy of Pediatrics (AAP) and the American Heart Association
(AHA), with the first edition released in 1987. The program standardizes neonatal resuscitation education across disciplines.
The 7th Edition (released 2016, with subsequent reaffirmations through 2026/2027 continuing to guide current practice)
emphasizes a simplified algorithm, mastery learning, and team-based simulation. Options B, C, and D list other influential
but incorrect sponsoring bodies.
Q2: Which of the following is a major change introduced in the NRP 7th Edition that remains a defining
feature of current 2026/2027 practice?
A. Routine intubation and tracheal suctioning for all non-vigorous meconium-stained infants.
B. Delayed cord clamping for at least 30-60 seconds for vigorous term and preterm infants who do not require
resuscitation, with a simplified algorithm, initial oxygen concentrations stratified by gestational age, and a
team-based, mastery-learning educational approach. [CORRECT]
C. Use of 100% oxygen for all newborns requiring resuscitation regardless of gestational age.
D. Eliminating the use of pulse oximetry and end-tidal CO2 monitoring.
Correct Answer: B
Rationale: Key 7th Edition updates that remain current include delayed cord clamping (30-60 seconds) for vigorous term
and preterm infants not requiring resuscitation, the new rapid evaluation questions (Term? Good tone? Breathing or crying?),
starting oxygen concentration stratified by gestational age (21% for ≥35 weeks; 21%-30% for <35 weeks), routine suctioning
only when obstruction is suspected, and T-piece resuscitator use. Option A was abandoned in the 7th Edition. Option C is
incorrect — oxygen is now titrated. Option D is incorrect — monitoring is emphasized.
NRP 7th Edition Section 1 / Part 1 Exam | Questions & Answers | 2026/2027 Page 1
, Q3: A learner preparing for NRP 7th Edition Section 1 asks how the 7th Edition differs from the 6th
regarding initial steps. Which response is most accurate?
A. The 7th Edition adds 60 seconds of routine intubation for every newborn.
B. The 7th Edition simplifies initial steps into 60 seconds of warming, positioning the head in a neutral sniffing
position, clearing the airway only if needed, drying, and stimulating — and replaces the older Apgar-based
decision tree with the rapid evaluation of Term, Tone, and Breathing. [CORRECT]
C. The 7th Edition requires 5 minutes of stimulation before any ventilatory support.
D. The 7th Edition eliminates the need for warming newborns.
Correct Answer: B
Rationale: The 7th Edition reorganized initial newborn care into a streamlined 60-second Golden Minutes approach: provide
warmth, position head in neutral sniffing position, clear airway only if needed (no routine suctioning), dry, and stimulate.
The rapid evaluation uses three questions — Term? Good muscle tone? Breathing or crying? — to determine whether the
infant can stay with the mother or needs initial steps. Option A, C, and D contradict current NRP guidelines.
Q4: According to NRP 7th Edition educational standards continuing in 2026/2027, which learning approach
has replaced traditional time-based lecture instruction?
A. Self-study only with no simulation component.
B. Mastery-based learning with simulation and debriefing, in which learners complete online pre-course
modules before attending a hands-on simulation and skills session. [CORRECT]
C. Group lectures of 8 hours duration.
D. Watch an instructor perform resuscitation once without any hands-on practice.
Correct Answer: B
Rationale: The NRP 7th Edition introduced a flipped-classroom, mastery-learning model: learners complete an online
pre-course assessment and modules, then attend an instructor-led simulation and skills session focused on competency,
communication, and debriefing. This shift reflects adult learning theory and the evidence that simulation-based mastery
learning improves resuscitation performance. Options A, C, and D do not reflect current NRP educational structure.
Q5: Approximately what percentage of newborns require some resuscitation beyond routine initial steps at
birth, and what percentage require extensive resuscitation including chest compressions and medications?
A. 50% require resuscitation; 25% require compressions and medications.
B. Approximately 10% require some assistance with breathing; less than 1% require extensive resuscitation
with chest compressions and medications. [CORRECT]
C. 1% require any resuscitation; 50% require compressions.
D. 100% require PPV; 50% require medications.
Correct Answer: B
Rationale: NRP epidemiology: approximately 10% of newborns require some assistance with breathing at birth, and fewer
than 1% require advanced resuscitation including chest compressions, medications, or intubation. This epidemiology
underscores the importance of preparation — most resuscitations are ventilation-only events. Options A, C, and D overstate
the frequency substantially. Knowing these statistics helps teams calibrate training emphasis.
NRP 7th Edition Section 1 / Part 1 Exam | Questions & Answers | 2026/2027 Page 2
, Q6: For NRP 7th Edition provider status continuing into 2026/2027, which statement about certification
requirements is correct?
A. Certification is valid for life after one course.
B. NRP provider status requires successful completion of the online examination and a hands-on
skills/simulation component; the provider card is typically valid for 2 years. [CORRECT]
C. Certification requires only watching a video.
D. Certification requires completion of a doctoral degree in neonatology.
Correct Answer: B
Rationale: NRP provider status requires both successful completion of the online examination (taken before the live course)
and a hands-on simulation and skills performance component with an NRP instructor. The provider card is valid for 2 years,
after which renewal requires a new online exam and skills session. Options A, C, and D misrepresent the requirements.
Q7: The NRP algorithm is best characterized as which of the following?
A. A rigid, step-by-step protocol that must be followed in identical fashion for every newborn regardless of context.
B. A framework that organizes the rapid assessment and escalating interventions — from initial steps through
ventilation, compressions, and medications — based on the infant's physiologic response at each step.
[CORRECT]
C. An algorithm used only for term infants.
D. An algorithm that begins with chest compressions.
Correct Answer: B
Rationale: The NRP algorithm is a sequential, response-based framework — at each step the team assesses the infant's
response (heart rate, breathing, tone) and either escalates to the next intervention or continues current therapy. It is not rigid:
clinical judgment and contextual factors modify application. The algorithm begins with rapid evaluation and initial steps, not
compressions. It applies to both term and preterm infants. Understanding the algorithm's response-based logic is essential for
NRP Section 1 mastery.
Q8: Which of the following statements most accurately reflects the historical evolution of neonatal
resuscitation guidance leading to NRP 7th Edition?
A. NRP was first developed in 2020 with the COVID-19 pandemic.
B. NRP began in 1987 as a joint AAP/AHA program and has been revised periodically, with the 7th Edition
reflecting contemporary evidence on oxygen management, delayed cord clamping, thermoregulation, and
team-based simulation training. [CORRECT]
C. NRP originated as a pediatric basic life support course with no neonatal content.
D. NRP was developed by the Joint Commission for hospital accreditation.
Correct Answer: B
Rationale: NRP was launched in 1987 by AAP and AHA and is periodically revised to reflect emerging evidence. The 7th
Edition incorporated major evidence updates — including oxygen titration by gestational age, delayed cord clamping,
simplified initial steps, and educational transformation to mastery learning — that remain current in 2026/2027 practice.
Understanding this historical arc clarifies why some older practices (e.g., routine intubation for meconium) are no longer
recommended.
Section 2: Neonatal Resuscitation Science and Physiology (Transition at
Birth, Asphyxia, & Resuscitation Physiology)
NRP 7th Edition Section 1 / Part 1 Exam | Questions & Answers | 2026/2027 Page 3
Questions & Answers — All Correct • 2026/2027 Updated Content
Neonatal Resuscitation Program Provider Course
75 Questions Across 9 Domains • Cognitive Mix: 40% Recall, 45% Application, 15% Analysis • 70% Scenario-Based, 30%
Direct Recall • Verified Answers + NRP 7th Edition Rationales
Each question is followed by four options (A–D), one verified correct answer marked [CORRECT], the correct answer letter,
and a 2–4 sentence rationale integrating NRP 7th Edition algorithm sequence, physiologic rationale, and clinical application.
Section 1: NRP Foundations and Program Overview (NRP History, 7th
Edition Updates, & Program Structure)
Q1: Which organizations jointly sponsor the Neonatal Resuscitation Program (NRP)?
A. American Heart Association (AHA) and American Academy of Pediatrics (AAP) [CORRECT]
B. American Nurses Association (ANA) and American College of Obstetricians
C. World Health Organization and Centers for Disease Control
D. Joint Commission and Institute for Healthcare Improvement
Correct Answer: A
Rationale: NRP is co-sponsored by the American Academy of Pediatrics (AAP) and the American Heart Association
(AHA), with the first edition released in 1987. The program standardizes neonatal resuscitation education across disciplines.
The 7th Edition (released 2016, with subsequent reaffirmations through 2026/2027 continuing to guide current practice)
emphasizes a simplified algorithm, mastery learning, and team-based simulation. Options B, C, and D list other influential
but incorrect sponsoring bodies.
Q2: Which of the following is a major change introduced in the NRP 7th Edition that remains a defining
feature of current 2026/2027 practice?
A. Routine intubation and tracheal suctioning for all non-vigorous meconium-stained infants.
B. Delayed cord clamping for at least 30-60 seconds for vigorous term and preterm infants who do not require
resuscitation, with a simplified algorithm, initial oxygen concentrations stratified by gestational age, and a
team-based, mastery-learning educational approach. [CORRECT]
C. Use of 100% oxygen for all newborns requiring resuscitation regardless of gestational age.
D. Eliminating the use of pulse oximetry and end-tidal CO2 monitoring.
Correct Answer: B
Rationale: Key 7th Edition updates that remain current include delayed cord clamping (30-60 seconds) for vigorous term
and preterm infants not requiring resuscitation, the new rapid evaluation questions (Term? Good tone? Breathing or crying?),
starting oxygen concentration stratified by gestational age (21% for ≥35 weeks; 21%-30% for <35 weeks), routine suctioning
only when obstruction is suspected, and T-piece resuscitator use. Option A was abandoned in the 7th Edition. Option C is
incorrect — oxygen is now titrated. Option D is incorrect — monitoring is emphasized.
NRP 7th Edition Section 1 / Part 1 Exam | Questions & Answers | 2026/2027 Page 1
, Q3: A learner preparing for NRP 7th Edition Section 1 asks how the 7th Edition differs from the 6th
regarding initial steps. Which response is most accurate?
A. The 7th Edition adds 60 seconds of routine intubation for every newborn.
B. The 7th Edition simplifies initial steps into 60 seconds of warming, positioning the head in a neutral sniffing
position, clearing the airway only if needed, drying, and stimulating — and replaces the older Apgar-based
decision tree with the rapid evaluation of Term, Tone, and Breathing. [CORRECT]
C. The 7th Edition requires 5 minutes of stimulation before any ventilatory support.
D. The 7th Edition eliminates the need for warming newborns.
Correct Answer: B
Rationale: The 7th Edition reorganized initial newborn care into a streamlined 60-second Golden Minutes approach: provide
warmth, position head in neutral sniffing position, clear airway only if needed (no routine suctioning), dry, and stimulate.
The rapid evaluation uses three questions — Term? Good muscle tone? Breathing or crying? — to determine whether the
infant can stay with the mother or needs initial steps. Option A, C, and D contradict current NRP guidelines.
Q4: According to NRP 7th Edition educational standards continuing in 2026/2027, which learning approach
has replaced traditional time-based lecture instruction?
A. Self-study only with no simulation component.
B. Mastery-based learning with simulation and debriefing, in which learners complete online pre-course
modules before attending a hands-on simulation and skills session. [CORRECT]
C. Group lectures of 8 hours duration.
D. Watch an instructor perform resuscitation once without any hands-on practice.
Correct Answer: B
Rationale: The NRP 7th Edition introduced a flipped-classroom, mastery-learning model: learners complete an online
pre-course assessment and modules, then attend an instructor-led simulation and skills session focused on competency,
communication, and debriefing. This shift reflects adult learning theory and the evidence that simulation-based mastery
learning improves resuscitation performance. Options A, C, and D do not reflect current NRP educational structure.
Q5: Approximately what percentage of newborns require some resuscitation beyond routine initial steps at
birth, and what percentage require extensive resuscitation including chest compressions and medications?
A. 50% require resuscitation; 25% require compressions and medications.
B. Approximately 10% require some assistance with breathing; less than 1% require extensive resuscitation
with chest compressions and medications. [CORRECT]
C. 1% require any resuscitation; 50% require compressions.
D. 100% require PPV; 50% require medications.
Correct Answer: B
Rationale: NRP epidemiology: approximately 10% of newborns require some assistance with breathing at birth, and fewer
than 1% require advanced resuscitation including chest compressions, medications, or intubation. This epidemiology
underscores the importance of preparation — most resuscitations are ventilation-only events. Options A, C, and D overstate
the frequency substantially. Knowing these statistics helps teams calibrate training emphasis.
NRP 7th Edition Section 1 / Part 1 Exam | Questions & Answers | 2026/2027 Page 2
, Q6: For NRP 7th Edition provider status continuing into 2026/2027, which statement about certification
requirements is correct?
A. Certification is valid for life after one course.
B. NRP provider status requires successful completion of the online examination and a hands-on
skills/simulation component; the provider card is typically valid for 2 years. [CORRECT]
C. Certification requires only watching a video.
D. Certification requires completion of a doctoral degree in neonatology.
Correct Answer: B
Rationale: NRP provider status requires both successful completion of the online examination (taken before the live course)
and a hands-on simulation and skills performance component with an NRP instructor. The provider card is valid for 2 years,
after which renewal requires a new online exam and skills session. Options A, C, and D misrepresent the requirements.
Q7: The NRP algorithm is best characterized as which of the following?
A. A rigid, step-by-step protocol that must be followed in identical fashion for every newborn regardless of context.
B. A framework that organizes the rapid assessment and escalating interventions — from initial steps through
ventilation, compressions, and medications — based on the infant's physiologic response at each step.
[CORRECT]
C. An algorithm used only for term infants.
D. An algorithm that begins with chest compressions.
Correct Answer: B
Rationale: The NRP algorithm is a sequential, response-based framework — at each step the team assesses the infant's
response (heart rate, breathing, tone) and either escalates to the next intervention or continues current therapy. It is not rigid:
clinical judgment and contextual factors modify application. The algorithm begins with rapid evaluation and initial steps, not
compressions. It applies to both term and preterm infants. Understanding the algorithm's response-based logic is essential for
NRP Section 1 mastery.
Q8: Which of the following statements most accurately reflects the historical evolution of neonatal
resuscitation guidance leading to NRP 7th Edition?
A. NRP was first developed in 2020 with the COVID-19 pandemic.
B. NRP began in 1987 as a joint AAP/AHA program and has been revised periodically, with the 7th Edition
reflecting contemporary evidence on oxygen management, delayed cord clamping, thermoregulation, and
team-based simulation training. [CORRECT]
C. NRP originated as a pediatric basic life support course with no neonatal content.
D. NRP was developed by the Joint Commission for hospital accreditation.
Correct Answer: B
Rationale: NRP was launched in 1987 by AAP and AHA and is periodically revised to reflect emerging evidence. The 7th
Edition incorporated major evidence updates — including oxygen titration by gestational age, delayed cord clamping,
simplified initial steps, and educational transformation to mastery learning — that remain current in 2026/2027 practice.
Understanding this historical arc clarifies why some older practices (e.g., routine intubation for meconium) are no longer
recommended.
Section 2: Neonatal Resuscitation Science and Physiology (Transition at
Birth, Asphyxia, & Resuscitation Physiology)
NRP 7th Edition Section 1 / Part 1 Exam | Questions & Answers | 2026/2027 Page 3
