NRP 9th Edition Test Bank (Latest 2026) | 200 Real Exam Q&As with Verified Explanations

NRP 9th Edition Test Bank (Latest 2026) |
200 Real Exam Q&As with Verified
Explanations




Question 1 (Initial Assessment)
A baby is born at 39 weeks gestation via spontaneous vaginal delivery. What are the three
initial assessment questions the neonatal resuscitation team must ask immediately after birth
to determine if the newborn can remain with the mother for routine care?

 A) Is the fluid clear? Is the baby pink? Is there a good heart rate?
 B) Is the baby term? Does the baby have good muscle tone? Is the baby breathing or crying?
 C) What is the Apgar score? Is the baby breathing? Is the placenta intact?
 D) Is the baby crying? Is the birth weight over 2500g? Is the fluid clear?

, VERIFIED ANSWER: B) Is the baby term? Does the baby have good muscle tone? Is the
baby breathing or crying?
EXPLANATION: According to the NRP 9th Edition guidelines, the three rapid assessment
questions asked immediately at birth are: 1) Is the infant term? 2) Does the infant have
good muscle tone? 3) Is the infant breathing or crying? If the answer to all three is 'Yes',
the baby can remain with the mother for routine initial care and skin-to-skin contact.




Question 2 (Initial Steps of Care Sequence)
A newborn is born limp and apneic at 36 weeks. The team moves the infant to the radiant
warmer. What is the correct sequence of the initial steps of newborn care?

 A) Warm, dry, stimulate, position the airway, suction if necessary.
 B) Position the airway, suction if necessary, dry, stimulate, warm.
 C) Warm, position the airway, suction if necessary, dry, stimulate.
 D) Stimulate, warm, dry, position the airway, suction if necessary.
VERIFIED ANSWER: C) Warm, position the airway, suction if necessary, dry, stimulate.
EXPLANATION: The correct logical sequence for the initial steps of neonatal care under
a radiant warmer is to provide warmth, position the head/airway to a neutral 'sniffing'
position, suction the mouth then nose ONLY if there is airway obstruction or meconium,
followed by thoroughly drying the skin and providing tactile stimulation to initiate
breathing.




Question 3 (Initial Assessment - Meconium Management)
A baby is born at 38 weeks gestation through thick, meconium-stained amniotic fluid. The
infant is limp, has poor respiratory effort, and a heart rate of 90 bpm. According to the NRP
9th Edition guidelines, what is the most appropriate initial action?



,  A) Perform immediate endotracheal intubation and deep tracheal suctioning before
the baby takes a breath.
 B) Bring the infant to the radiant warmer, dry, stimulate, position the airway, and
clear the mouth and nose with a bulb syringe if obstructed.
 C) Initiate immediate positive pressure ventilation (PPV) with 100% oxygen using a
T-piece resuscitator.
 D) Administer a fluid bolus of 10 mL/kg of Normal Saline through the umbilical vein.



VERIFIED ANSWER: B) Bring the infant to the radiant warmer, dry, stimulate, position
the airway, and clear the mouth and nose with a bulb syringe if obstructed.
EXPLANATION: NRP 9th Edition maintains that routine endotracheal intubation and
suctioning for non-vigorous infants born through meconium-stained fluid is no longer
recommended. The initial steps of care (warming, positioning, clearing the airway if
obstructed, drying, and stimulating) should be performed first under the radiant warmer. If
the infant remains non-vigorous or apneic after these steps, positive pressure ventilation
(PPV) must be initiated immediately.


Question 4 (Positive Pressure Ventilation - Initial Oxygen Titration)
A late preterm infant born at 35 weeks gestation is apneic at birth and fails to respond to
initial drying and tactile stimulation. The resuscitation team prepares to initiate positive
pressure ventilation (PPV). What is the correct initial fraction of inspired oxygen (



FiO2cap F i cap O sub 2
𝐹𝑖𝑂2
) settings required for this infant?



 A) 21% oxygen (room air)
 B) 30% oxygen
 C) 40% oxygen
 D) 100% oxygen


, VERIFIED ANSWER: A) 21% oxygen (room air)
EXPLANATION: For newborns born at or greater than 35 weeks gestation who require
positive pressure ventilation (PPV), resuscitation should begin using 21% oxygen (room
air). For premature infants born at less than 35 weeks gestation, the initial



FiO2cap F i cap O sub 2
𝑭𝒊𝑶𝟐
window is 21% to 30%. Oxygen concentration should subsequently be titrated based on
pre-ductal pulse oximetry targets.


Question 5 (Positive Pressure Ventilation - Cadence and Rate)
The resuscitation team is administering positive pressure ventilation (PPV) to a newborn via
a face mask. To ensure a delivery rate of 40 to 60 breaths per minute, which rhythmic clinical
cadence should the team leader call out?



 A) "Breathe, two, three, four... Breathe, two, three, four..."
 B) "Breathe, squeeze, release... Breathe, squeeze, release..."
 C) "Breathe, two, three... Breathe, two, three..."
 D) "Squeeze, release... Squeeze, release..."



VERIFIED ANSWER: C) "Breathe, two, three... Breathe, two, three..."
EXPLANATION: To maintain the targeted neonatal ventilation rate of 40 to 60 breaths
per minute during positive pressure ventilation, clinicians utilize the rhythmic verbal cue
"Breathe, two, three... Breathe, two, three...". Squeezing or delivering pressure occurs on
the word "Breathe" and release occurs during the count of "two, three."


Question 6 (Ventilation Corrective Steps - MR. SOPA Sequence)
During the administration of positive pressure ventilation (PPV) to a term infant, the team
notes that the heart rate is not increasing and there is no visible chest rise. The team begins
the MR. SOPA corrective ventilation sequence. What are the first two actions that must be
completed simultaneously?