NRP 2026 Practice Exam Test Bank: 200 Questions, Verified Answers & Rationales (8th & 9th Editions)

NRP 2026 Practice Exam Test Bank: 200 Questions,
Verified Answers & Rationales (8th & 9th Editions)




Question 1

A mother delivers a full-term newborn who is floppy, apneic, and has a heart rate of 80
bpm. What is the immediate first action the resuscitation team should perform after
drying and stimulating the infant?

 A) Administer free-flow oxygen at 100%
 B) Initiate Positive-Pressure Ventilation (PPV)
 C) Secure an endotracheal tube
 D) Initiate chest compressions at a 3:1 ratio

, CORRECT ANSWER: B
EXPLANATION: According to current neonatal resuscitation algorithms, if a newborn
remains apneic, gasping, or has a heart rate below 100 bpm after initial steps
(warming, drying, stimulating, positioning airway), the immediate next action is to
initiate positive-pressure ventilation (PPV) within the first 60 seconds of life.
Question 2

During the pre-delivery briefing, the team prepares for a delivery at 34 weeks gestation.
What is the appropriate initial oxygen concentration setting on the blender for this
newborn?

 A) 21% oxygen
 B) 21% to 30% oxygen
 C) 40% to 60% oxygen
 D) 100% oxygen
CORRECT ANSWER: B
EXPLANATION: For preterm newborns less than 35 weeks of gestation, neonatal
resuscitation guidelines state that initial positive-pressure ventilation (PPV) should be
initiated with an oxygen concentration of 21% to 30%. The oxygen concentration is
subsequently adjusted based on preductal pulse oximeter readings and target limits.
Question 3

You are performing positive-pressure ventilation on a newborn, but there is no chest rise
and the heart rate is not improving. You begin the MR. SOPA protocol. What does the
"S" in MR. SOPA stand for?

 A) Stimulate the newborn vigorously
 B) Suction the mouth and nose
 C) Start chest compressions
 D) Secure an advanced airway
CORRECT ANSWER: B
EXPLANATION: The MR. SOPA acronym represents corrective ventilation steps. M =
Mask adjustment, R = Reposition airway, S = Suction mouth and nose, O = Open
mouth, P = Pressure increase, A = Alternative airway. Suctioning the mouth then the
nose ensures a clear airway before increasing inflation pressure.

, Question 4

A team is performing chest compressions on a newborn whose heart rate remains below
60 bpm despite 30 seconds of effective PPV. What is the correct compression-to-
ventilation ratio for neonatal CPR?

 A) 15 compressions to 2 ventilations
 B) 30 compressions to 2 ventilations
 C) 3 compressions to 1 ventilation
 D) 5 compressions to 1 ventilation
CORRECT ANSWER: C
EXPLANATION: Neonatal advanced life support requires a 3:1 ratio of compressions
to ventilations to optimize both coronary artery perfusion and minute ventilation. This
cycle yields 90 compressions and 30 ventilations per minute, totaling 120 structural
events per minute.
Question 5

During a resuscitation event, where should the pulse oximeter probe be placed on the
newborn to accurately assess preductal oxygen saturation?

 A) Right wrist or right hand palm
 B) Left wrist or left hand palm
 C) Either the right or left foot
 D) Directly over the apical chest wall
CORRECT ANSWER: A
EXPLANATION: The preductal oxygen saturation reflects blood moving to the heart
and brain before it mixes with deoxygenated ductal shunting. The right upper extremity
(right hand or wrist) is the only reliable structural site for preductal pulse oximetry
monitoring.
Question 6

A newborn is born via emergency cesarean section due to placental abruption. After 60
seconds of chest compressions coordinated with PPV using 100% oxygen, the heart rate
remains 45 bpm. What is the recommended first dose of intravenous Epinephrine?

 A) 0.1 to 0.3 mg/kg

,  B) 0.01 to 0.03 mg/kg
 C) 0.5 to 1.0 mg/kg
 D) 0.05 to 0.1 mg/kg
CORRECT ANSWER: B
EXPLANATION: The recommended intravenous (IV) or intraosseous (IO) dose of
Epinephrine in neonatal resuscitation is 0.01 to 0.03 mg/kg (equivalent to 0.1 to 0.3
mL/kg of a 1:10,000 solution). The endotracheal route requires a higher dose (0.05 to
0.1 mg/kg), but IV/IO remains the preferred, highly effective route.
Question 7

What is the maximum pressure that should be initially applied when performing the "P"
(Pressure increase) stage of MR. SOPA using a flow-inflating or self-inflating bag for a
term infant?

 A) 20 cm H2O
 B) 30 cm H2O
 C) 40 cm H2O
 D) 60 cm H2O
CORRECT ANSWER: C
EXPLANATION: When increasing breath delivery pressure during the ventilation
corrective steps (MR. SOPA), increments should be gradual. The maximum
recommended pressure with a face mask during these corrective breaths for a term
infant is 40 cm H2O, to mitigate risks of barotrauma or pneumothorax.
Question 8

A newborn infant requires chest compressions. What is the preferred technical method for
delivering chest compressions according to standard guidelines?

 A) Two-finger technique over the middle third of the sternum
 B) Two-thumb encircling hands technique over the lower third of the sternum
 C) Palm-press method over the mid-sternal area
 D) Three-finger technique over the upper sternal margin
CORRECT ANSWER: B
EXPLANATION: The two-thumb encircling hands technique is the preferred method
because it generates higher coronary perfusion pressure, produces more consistent