NRP 8TH EDITION 2026 REVISION EXAM PAPER
QUESTIONS AND ANSWERS GUARANTEE A+
✔✔If a baby if apneic, gasping or has a HR less than 100 bpm after the initial steps of
resuscitation, what do you do immediately? - ✔✔Begin PPV Immediately
✔✔If the newborn is not breathing after these initial steps, PPV begins immediately
within how long after birth? - ✔✔within 60 seconds!
✔✔How do you estimate a newborns heart rate: - ✔✔Count the number of breast in 6
seconds & multiply by 10
✔✔At least how many qualified people should be present to solely manage the baby if
risk factors are present? - ✔✔Answer: Two
✔✔If a newborn is not breathing or the HR is less than 100 bpm, you should being PPV
within how soon after birth? - ✔✔60 seconds
✔✔If the baby is not vigorous and the HR is difficult to auscultate, what should you do?
- ✔✔Connect a pulse oximeter or cardiac monitor
✔✔For babies >35 weeks gestation, start PPV with fiO2 at what? - ✔✔21% oxygen
✔✔For preterm babies < 35 weeks gestation, start PPV with fiO2 of what? - ✔✔21-30%
oxygen
✔✔Oxygen saturation goals: - ✔✔-Oxygen saturation goals are listed on the target
oxygen saturation table
-It may take 1-2 minutes for pulse ox to display a reliable signal
-If the baby has a very low HR or poor perfusion, pulse ox may not work or have a
reliable signal
-Increasing the oxygen concentration used for PPV may not help if the lungs are not
being inflated
✔✔Which block of the NRP algorithm helps you determine if the baby can stay with the
mother or should be moved to the radiant warmer for further evaluation? - ✔✔Rapid
evaluation
✔✔Self inflating bag vs T-piece resuscitator - ✔✔Self inflating bag
-PIP is determined by how hard you squeeze the bag
,-Self inflating bags are not used to give PEEP, you can add a PEEP valve but it is not
always reliable
-CPAP cannot be given
✔✔What is an advantage of the T-piece resuscitator vs the self inflating bag? - ✔✔T-
piece deliveries the breath at the same pressure each time- advantage over a self-
inflating bag/flow inflating bag where the pressure varies by the insonsitent squeezing
pressure of the operators hand
✔✔What is the correct ventilation rate when providing PPV? - ✔✔40-60 breaths/min
✔✔When providing PPV to a term newborn, what peak inspiratory pressure should you
start with? - ✔✔20-25 cm H20
✔✔It can be difficult ot deliver PEEP with a self-inflating bag. A T-piece resuscitator
delivers consistent inspiratory pressure & PEEP. WHat does the PEEP help achieve?
SATA
-Removes fluid
-Stable lung inflation
-prevents air spaces from collapsing during exhalation
-Maintains thermoregulation - ✔✔-Removes fluid
-Stable lung inflation
-prevents air spaces from collapsing during exhalation
✔✔If the baby is breathing after initial steps, you should assess and monitor the HR. It
should be at least what bpm? - ✔✔100 bpm
✔✔After the first 15 seconds of PPV, you do the first HR assessment. The HR is not
increasing and the chest is not moving. What should you do? - ✔✔Being MR. SOPA
ventilation corrective steps immediately
✔✔After starting PPV, when do you do your first HR assessment? - ✔✔15 seconds
✔✔What is the rate and rhythm for ventilated breaths? - ✔✔40-60 bpm
using the waltzing rhythm
breathe 2, 3 breath 2, 3
✔✔What is the ideal PIP rate to ventilate baby with PPV? - ✔✔Start with a PIP of 20-25
cm H20
, Full term infants may require 30-40 cm H20 for their first few breaths to infalte the lungs,
then need less pressure to maintain chest movement
✔✔How do you know if you are giving adequate breaths during PPV? - ✔✔Should see
a gentle rise and fall of chest
✔✔What do you do if you cannot get a good seal on the mask? - ✔✔Try a 2 hand
technique
-hold mask against face with thumb & first finger
-place other 3 fingers of each hand under boney angle of jaw and lift the jaw forward
-Hold head in sniffing position
-2nd person gives breaths
-3rd person monitors HR and chest movement
✔✔CO2 detector - ✔✔-placed between mask and inflator bag
-detects if lungs are inflating
-Should change yellow by 8-10 breaths indicating ventilation that inflate lungs
✔✔How does PEEP help maintain stable lung inflation? - ✔✔-removes fluid
-prevents air spaces fron collasping during exhalation
✔✔Where do you place pulse ox? - ✔✔Rt hand or wrist
✔✔During PPV, HR is increasing what do you do? - ✔✔Continue PPV for another 15
seconds
Assess HR
you do not need to do PPV corrective steps to attain chest movement if HR is
increasing
✔✔During PPV, if the HR is no increasing but the chest is moving, what do you do? -
✔✔Continue PPV and assess in 15 seconds
✔✔During PPV, what do you do if the HR is not increasing and the chest is not moving?
- ✔✔Being MR. SOPA ventilation corrective steps immediately
QUESTIONS AND ANSWERS GUARANTEE A+
✔✔If a baby if apneic, gasping or has a HR less than 100 bpm after the initial steps of
resuscitation, what do you do immediately? - ✔✔Begin PPV Immediately
✔✔If the newborn is not breathing after these initial steps, PPV begins immediately
within how long after birth? - ✔✔within 60 seconds!
✔✔How do you estimate a newborns heart rate: - ✔✔Count the number of breast in 6
seconds & multiply by 10
✔✔At least how many qualified people should be present to solely manage the baby if
risk factors are present? - ✔✔Answer: Two
✔✔If a newborn is not breathing or the HR is less than 100 bpm, you should being PPV
within how soon after birth? - ✔✔60 seconds
✔✔If the baby is not vigorous and the HR is difficult to auscultate, what should you do?
- ✔✔Connect a pulse oximeter or cardiac monitor
✔✔For babies >35 weeks gestation, start PPV with fiO2 at what? - ✔✔21% oxygen
✔✔For preterm babies < 35 weeks gestation, start PPV with fiO2 of what? - ✔✔21-30%
oxygen
✔✔Oxygen saturation goals: - ✔✔-Oxygen saturation goals are listed on the target
oxygen saturation table
-It may take 1-2 minutes for pulse ox to display a reliable signal
-If the baby has a very low HR or poor perfusion, pulse ox may not work or have a
reliable signal
-Increasing the oxygen concentration used for PPV may not help if the lungs are not
being inflated
✔✔Which block of the NRP algorithm helps you determine if the baby can stay with the
mother or should be moved to the radiant warmer for further evaluation? - ✔✔Rapid
evaluation
✔✔Self inflating bag vs T-piece resuscitator - ✔✔Self inflating bag
-PIP is determined by how hard you squeeze the bag
,-Self inflating bags are not used to give PEEP, you can add a PEEP valve but it is not
always reliable
-CPAP cannot be given
✔✔What is an advantage of the T-piece resuscitator vs the self inflating bag? - ✔✔T-
piece deliveries the breath at the same pressure each time- advantage over a self-
inflating bag/flow inflating bag where the pressure varies by the insonsitent squeezing
pressure of the operators hand
✔✔What is the correct ventilation rate when providing PPV? - ✔✔40-60 breaths/min
✔✔When providing PPV to a term newborn, what peak inspiratory pressure should you
start with? - ✔✔20-25 cm H20
✔✔It can be difficult ot deliver PEEP with a self-inflating bag. A T-piece resuscitator
delivers consistent inspiratory pressure & PEEP. WHat does the PEEP help achieve?
SATA
-Removes fluid
-Stable lung inflation
-prevents air spaces from collapsing during exhalation
-Maintains thermoregulation - ✔✔-Removes fluid
-Stable lung inflation
-prevents air spaces from collapsing during exhalation
✔✔If the baby is breathing after initial steps, you should assess and monitor the HR. It
should be at least what bpm? - ✔✔100 bpm
✔✔After the first 15 seconds of PPV, you do the first HR assessment. The HR is not
increasing and the chest is not moving. What should you do? - ✔✔Being MR. SOPA
ventilation corrective steps immediately
✔✔After starting PPV, when do you do your first HR assessment? - ✔✔15 seconds
✔✔What is the rate and rhythm for ventilated breaths? - ✔✔40-60 bpm
using the waltzing rhythm
breathe 2, 3 breath 2, 3
✔✔What is the ideal PIP rate to ventilate baby with PPV? - ✔✔Start with a PIP of 20-25
cm H20
, Full term infants may require 30-40 cm H20 for their first few breaths to infalte the lungs,
then need less pressure to maintain chest movement
✔✔How do you know if you are giving adequate breaths during PPV? - ✔✔Should see
a gentle rise and fall of chest
✔✔What do you do if you cannot get a good seal on the mask? - ✔✔Try a 2 hand
technique
-hold mask against face with thumb & first finger
-place other 3 fingers of each hand under boney angle of jaw and lift the jaw forward
-Hold head in sniffing position
-2nd person gives breaths
-3rd person monitors HR and chest movement
✔✔CO2 detector - ✔✔-placed between mask and inflator bag
-detects if lungs are inflating
-Should change yellow by 8-10 breaths indicating ventilation that inflate lungs
✔✔How does PEEP help maintain stable lung inflation? - ✔✔-removes fluid
-prevents air spaces fron collasping during exhalation
✔✔Where do you place pulse ox? - ✔✔Rt hand or wrist
✔✔During PPV, HR is increasing what do you do? - ✔✔Continue PPV for another 15
seconds
Assess HR
you do not need to do PPV corrective steps to attain chest movement if HR is
increasing
✔✔During PPV, if the HR is no increasing but the chest is moving, what do you do? -
✔✔Continue PPV and assess in 15 seconds
✔✔During PPV, what do you do if the HR is not increasing and the chest is not moving?
- ✔✔Being MR. SOPA ventilation corrective steps immediately
