NRP 7th Edition Part 1 Section 2 | Neonatal Resuscitation Latest Summer 2026/2027 | Verified Answers
NRP 7th Edition | Part 1 Section 2
Neonatal Resuscitation Program
Practice Questions, Verified Answers & Detailed Solutions
80 Comprehensive Questions across 8 NRP Competency Domains
Aligned with NRP 7th Edition Summer 2026/2027 Updates
Exam Overview & Study Strategy
This practice exam is aligned with the NRP 7th Edition Part 1 Section 2 provider course content. It contains 80
multiple-choice questions spanning eight competency domains: positive pressure ventilation principles and practice;
ventilation correction and troubleshooting (MR SOPA, DOPES); alternative airways and advanced airway management
(LMA, ETT, tube confirmation); continuous positive airway pressure and oxygen management; chest compressions and
circulatory support; medications and volume expansion; special considerations and complex scenarios; and
post-resuscitation care, teamwork, and documentation. Approximately 70% of items are scenario-based and 30% test direct
recall of NRP 7th Edition algorithms, parameters, and equipment specifications. Each item provides the verified answer
with a step-by-step rationale that explains why the correct option is right and why the distractors represent common NRP
exam pitfalls.
How to Use This Practice Exam
Step 1: Take each section under timed conditions (allow ~1 minute per question) to simulate the actual NRP Part 1 Section
2 exam experience. Step 2: After completing a section, review the rationale for every question, including those answered
correctly, to identify misconceptions and reinforce algorithm-based reasoning. Step 3: Track competency performance by
recording items missed under their competency tag; revisit only those competency clusters in the next study round. Step 4:
Use the paired-concept study notes (PPV vs. CPAP, MR SOPA vs. DOPES, IV vs. ET epinephrine route, self-inflating vs.
T-piece resuscitator) to consolidate commonly confused concepts before exam day.
Section Topic Q Range Items
1 PPV Principles and Practice Q1-Q12 12
2 Ventilation Correction (MR SOPA, DOPES) Q13-Q24 12
3 Alternative Airways (LMA, ETT, Confirmation) Q25-Q36 12
4 CPAP and Oxygen Management Q37-Q46 10
5 Chest Compressions and Circulatory Support Q47-Q56 10
6 Medications and Volume Expansion Q57-Q65 9
7 Special Considerations & Complex Scenarios Q66-Q73 8
8 Post-Resuscitation Care, Teamwork, Documentation Q74-Q80 7
TOTAL 80
Page 1 | NRP 7th Edition Part 1 Section 2 Preparation | Z.ai Neonatal Education
,NRP 7th Edition Part 1 Section 2 | Neonatal Resuscitation Latest Summer 2026/2027 | Verified Answers
Section 1: Positive Pressure Ventilation (PPV) Principles and Practice
Q1: A newborn at 38 weeks gestation has just been delivered and is not crying. The heart rate is 80
beats per minute, the infant is breathing but with shallow, irregular respirations, and central
cyanosis is present. What is the most appropriate first intervention according to the NRP 7th
Edition algorithm?
A. Continue to observe and provide tactile stimulation for an additional 60 seconds.
B. Begin positive pressure ventilation (PPV) at 40-60 breaths per minute. [CORRECT]
C. Begin chest compressions immediately because the heart rate is below 100 bpm.
D. Administer supplemental oxygen via blow-by at 100%.
Correct Answer: B
Rationale: According to the NRP 7th Edition, PPV is indicated when the infant is apneic or gasping, has a heart rate below 100
bpm despite tactile stimulation, or has persistent central cyanosis with labored breathing. This infant's heart rate of 80 bpm and
inadequate respirations are clear indications for PPV. Option A is incorrect because further stimulation alone is insufficient when
HR is below 100. Option C is incorrect because compressions require HR below 60 bpm AND effective PPV first. Option D is
incorrect because oxygen alone does not address the inadequate ventilation causing the bradycardia. NRP 7th Edition reference:
Algorithm Step 5 - PPV indicated for HR <100 after stimulation.
Cognitive Level: Application | Competency: Identify PPV indications
Q2: When delivering positive pressure ventilation (PPV) to a newborn, what is the recommended
rate of breaths per minute?
A. 20-30 breaths per minute
B. 30-40 breaths per minute
C. 40-60 breaths per minute [CORRECT]
D. 60-80 breaths per minute
Correct Answer: C
Rationale: The NRP 7th Edition specifies a PPV rate of 40-60 breaths per minute, which approximates one breath every 1-1.5
seconds. This rate provides adequate ventilation without overdistending the lungs or causing stacked breaths. Option A is too
slow to adequately ventilate a newborn. Option B is below the recommended range. Option D would deliver excessive breaths
and risk hypocarbia, decreased venous return, and potential lung injury. NRP 7th Edition reference: PPV delivered at 40-60
breaths/min; coordinated with chest compressions at 3:1 ratio (30 breaths + 90 compressions = 120 events/min).
Cognitive Level: Recall | Competency: Recall PPV rate
Page 2 | NRP 7th Edition Part 1 Section 2 Preparation | Z.ai Neonatal Education
, NRP 7th Edition Part 1 Section 2 | Neonatal Resuscitation Latest Summer 2026/2027 | Verified Answers
Q3: A team is preparing for a high-risk delivery where PPV may be required. Which PPV device is
most appropriate when the operator is inexperienced or when no compressed gas source is
reliably available?
A. Flow-inflating (anesthesia) bag
B. Self-inflating bag with a reservoir [CORRECT]
C. T-piece resuscitator
D. Mask continuous positive airway pressure (CPAP) device only
Correct Answer: B
Rationale: A self-inflating bag with a reservoir is the most appropriate device when operator experience is limited or no
compressed gas source is available, because it reinflates automatically and does not require a gas source to deliver a breath. The
reservoir is required to deliver high oxygen concentrations (up to 90-100%); without a reservoir, the bag delivers approximately
30-40% oxygen. Option A is incorrect because flow-inflating bags require a compressed gas source and operator skill to maintain
a seal. Option C is incorrect because T-piece resuscitators require a compressed gas source. Option D is incorrect because CPAP
alone does not provide PPV. NRP 7th Edition reference: Equipment for PPV - self-inflating bag works without gas source;
reservoir needed for high O2 concentration.
Cognitive Level: Application | Competency: Select appropriate PPV device
Q4: Which PPV device provides the most consistent peak inspiratory pressure (PIP) and positive
end-expiratory pressure (PEEP) and is especially useful for preterm infants requiring precise
pressure control?
A. Self-inflating bag without reservoir
B. Self-inflating bag with reservoir
C. Flow-inflating bag
D. T-piece resuscitator [CORRECT]
Correct Answer: D
Rationale: The T-piece resuscitator provides the most consistent and precise control of both PIP and PEEP, making it especially
suitable for preterm infants where precise pressure delivery reduces the risk of volutrauma. It requires a compressed gas source
and blender. Option A and B are incorrect because self-inflating bags provide less precise PIP and limited PEEP control. Option
C is incorrect because flow-inflating bags can deliver PEEP but require operator skill to maintain consistent pressure. NRP 7th
Edition reference: T-piece resuscitators (e.g., Neopuff) provide consistent PIP/PEEP, beneficial for preterm infants requiring
controlled ventilation.
Cognitive Level: Recall | Competency: Compare PPV device characteristics
Page 3 | NRP 7th Edition Part 1 Section 2 Preparation | Z.ai Neonatal Education
NRP 7th Edition | Part 1 Section 2
Neonatal Resuscitation Program
Practice Questions, Verified Answers & Detailed Solutions
80 Comprehensive Questions across 8 NRP Competency Domains
Aligned with NRP 7th Edition Summer 2026/2027 Updates
Exam Overview & Study Strategy
This practice exam is aligned with the NRP 7th Edition Part 1 Section 2 provider course content. It contains 80
multiple-choice questions spanning eight competency domains: positive pressure ventilation principles and practice;
ventilation correction and troubleshooting (MR SOPA, DOPES); alternative airways and advanced airway management
(LMA, ETT, tube confirmation); continuous positive airway pressure and oxygen management; chest compressions and
circulatory support; medications and volume expansion; special considerations and complex scenarios; and
post-resuscitation care, teamwork, and documentation. Approximately 70% of items are scenario-based and 30% test direct
recall of NRP 7th Edition algorithms, parameters, and equipment specifications. Each item provides the verified answer
with a step-by-step rationale that explains why the correct option is right and why the distractors represent common NRP
exam pitfalls.
How to Use This Practice Exam
Step 1: Take each section under timed conditions (allow ~1 minute per question) to simulate the actual NRP Part 1 Section
2 exam experience. Step 2: After completing a section, review the rationale for every question, including those answered
correctly, to identify misconceptions and reinforce algorithm-based reasoning. Step 3: Track competency performance by
recording items missed under their competency tag; revisit only those competency clusters in the next study round. Step 4:
Use the paired-concept study notes (PPV vs. CPAP, MR SOPA vs. DOPES, IV vs. ET epinephrine route, self-inflating vs.
T-piece resuscitator) to consolidate commonly confused concepts before exam day.
Section Topic Q Range Items
1 PPV Principles and Practice Q1-Q12 12
2 Ventilation Correction (MR SOPA, DOPES) Q13-Q24 12
3 Alternative Airways (LMA, ETT, Confirmation) Q25-Q36 12
4 CPAP and Oxygen Management Q37-Q46 10
5 Chest Compressions and Circulatory Support Q47-Q56 10
6 Medications and Volume Expansion Q57-Q65 9
7 Special Considerations & Complex Scenarios Q66-Q73 8
8 Post-Resuscitation Care, Teamwork, Documentation Q74-Q80 7
TOTAL 80
Page 1 | NRP 7th Edition Part 1 Section 2 Preparation | Z.ai Neonatal Education
,NRP 7th Edition Part 1 Section 2 | Neonatal Resuscitation Latest Summer 2026/2027 | Verified Answers
Section 1: Positive Pressure Ventilation (PPV) Principles and Practice
Q1: A newborn at 38 weeks gestation has just been delivered and is not crying. The heart rate is 80
beats per minute, the infant is breathing but with shallow, irregular respirations, and central
cyanosis is present. What is the most appropriate first intervention according to the NRP 7th
Edition algorithm?
A. Continue to observe and provide tactile stimulation for an additional 60 seconds.
B. Begin positive pressure ventilation (PPV) at 40-60 breaths per minute. [CORRECT]
C. Begin chest compressions immediately because the heart rate is below 100 bpm.
D. Administer supplemental oxygen via blow-by at 100%.
Correct Answer: B
Rationale: According to the NRP 7th Edition, PPV is indicated when the infant is apneic or gasping, has a heart rate below 100
bpm despite tactile stimulation, or has persistent central cyanosis with labored breathing. This infant's heart rate of 80 bpm and
inadequate respirations are clear indications for PPV. Option A is incorrect because further stimulation alone is insufficient when
HR is below 100. Option C is incorrect because compressions require HR below 60 bpm AND effective PPV first. Option D is
incorrect because oxygen alone does not address the inadequate ventilation causing the bradycardia. NRP 7th Edition reference:
Algorithm Step 5 - PPV indicated for HR <100 after stimulation.
Cognitive Level: Application | Competency: Identify PPV indications
Q2: When delivering positive pressure ventilation (PPV) to a newborn, what is the recommended
rate of breaths per minute?
A. 20-30 breaths per minute
B. 30-40 breaths per minute
C. 40-60 breaths per minute [CORRECT]
D. 60-80 breaths per minute
Correct Answer: C
Rationale: The NRP 7th Edition specifies a PPV rate of 40-60 breaths per minute, which approximates one breath every 1-1.5
seconds. This rate provides adequate ventilation without overdistending the lungs or causing stacked breaths. Option A is too
slow to adequately ventilate a newborn. Option B is below the recommended range. Option D would deliver excessive breaths
and risk hypocarbia, decreased venous return, and potential lung injury. NRP 7th Edition reference: PPV delivered at 40-60
breaths/min; coordinated with chest compressions at 3:1 ratio (30 breaths + 90 compressions = 120 events/min).
Cognitive Level: Recall | Competency: Recall PPV rate
Page 2 | NRP 7th Edition Part 1 Section 2 Preparation | Z.ai Neonatal Education
, NRP 7th Edition Part 1 Section 2 | Neonatal Resuscitation Latest Summer 2026/2027 | Verified Answers
Q3: A team is preparing for a high-risk delivery where PPV may be required. Which PPV device is
most appropriate when the operator is inexperienced or when no compressed gas source is
reliably available?
A. Flow-inflating (anesthesia) bag
B. Self-inflating bag with a reservoir [CORRECT]
C. T-piece resuscitator
D. Mask continuous positive airway pressure (CPAP) device only
Correct Answer: B
Rationale: A self-inflating bag with a reservoir is the most appropriate device when operator experience is limited or no
compressed gas source is available, because it reinflates automatically and does not require a gas source to deliver a breath. The
reservoir is required to deliver high oxygen concentrations (up to 90-100%); without a reservoir, the bag delivers approximately
30-40% oxygen. Option A is incorrect because flow-inflating bags require a compressed gas source and operator skill to maintain
a seal. Option C is incorrect because T-piece resuscitators require a compressed gas source. Option D is incorrect because CPAP
alone does not provide PPV. NRP 7th Edition reference: Equipment for PPV - self-inflating bag works without gas source;
reservoir needed for high O2 concentration.
Cognitive Level: Application | Competency: Select appropriate PPV device
Q4: Which PPV device provides the most consistent peak inspiratory pressure (PIP) and positive
end-expiratory pressure (PEEP) and is especially useful for preterm infants requiring precise
pressure control?
A. Self-inflating bag without reservoir
B. Self-inflating bag with reservoir
C. Flow-inflating bag
D. T-piece resuscitator [CORRECT]
Correct Answer: D
Rationale: The T-piece resuscitator provides the most consistent and precise control of both PIP and PEEP, making it especially
suitable for preterm infants where precise pressure delivery reduces the risk of volutrauma. It requires a compressed gas source
and blender. Option A and B are incorrect because self-inflating bags provide less precise PIP and limited PEEP control. Option
C is incorrect because flow-inflating bags can deliver PEEP but require operator skill to maintain consistent pressure. NRP 7th
Edition reference: T-piece resuscitators (e.g., Neopuff) provide consistent PIP/PEEP, beneficial for preterm infants requiring
controlled ventilation.
Cognitive Level: Recall | Competency: Compare PPV device characteristics
Page 3 | NRP 7th Edition Part 1 Section 2 Preparation | Z.ai Neonatal Education
