NRP 8th Edition Test Questions and Answers Already Graded A

NRP 8th Edition Test Questions and Answers Already Graded A Your team has provided face-mask PPV with chest movement for 30 seconds. When is placement of an endotracheal tube strongly recommended? -ANS The baby's heart rate remains less than 100 bpm and is not increasing. During a delivery, when and where should a person with intubation skills be available? -ANS In the hospital and immediately available What are the primary methods of confirming endotracheal tube placement within the trachea? -ANS Demonstration of exhaled carbon dioxide (CO2) and a rapidly increasing heart rate You are resuscitating a critically ill newborn whose heart rate is 20 bpm. The baby has been intubated and the endotracheal tube insertion depth is correct. You can see chest movement with PPV and hear bilateral breath sounds, but the colorimetric CO2 detector does not turn yellow. What is the likely reason for this? -ANS Low cardiac output. According to the Textbook of Neonatal Resuscitation, 8th edition algorithm, at what point during resuscitation is a cardiac monitor recommended to assess the baby's heart rate? -ANS When an alternative airway is inserted What size laryngoscope blade is recommended to intubate a preterm newborn with an estimated gestational age of 32 weeks (estimated birth weight of 1.4 kg)? -ANS 0 Even brief interruptions of chest compressions may significantly reduce their effectiveness, but it is also important to assess the need to continue chest compressions. What is the preferred way to assess the heart rate during chest compressions? -ANS Briefly interrupt chest compressions every 60 seconds to assess the heart rate using the cardiac monitor. Your team is resuscitating a newborn at birth. The heart rate is low and the baby has poor perfusion. Which is the preferred method to assess the heart rate? -ANS Cardiac monitor When are chest compressions indicated? -ANS When the heart rate remains less than 60 bpm after at least 30 seconds of PPV that moves the chest, preferably through an alternative airway After 60 seconds of PPV coordinated with chest compressions, the cardiac monitor indicates a heart rate of 70 beats per minute. What is your next action? -ANS Stop chest compressions and continue PPV. What is the recommended depth of chest compressions? -ANS One-third of the anterior-posterior diameter of the chest During chest compressions, which of the following is correct? -ANS To coordinate compressions and ventilations, the compressor calls out one-and-two-and-three-and-breathe-and.... Your team is resuscitating a newborn whose heart rate remains less than 60 bpm despite effective PPV and 60 seconds of chest compressions. You have administered epinephrine intravenously. According to the Textbook of Neonatal Resuscitation, 8th edition, what volume of normal saline flush should you administer? -ANS 3 mL According to the Textbook of Neonatal Resuscitation, 8th edition, what is the suggested initial dose for IV epinephrine (0.1 mg/1 mL=1 mg/10 mL)? -ANS 0.02 mg/kg (equal to 0.2 mL/kg) When is the administration of a volume expander indicated during newborn resuscitation? -ANS The baby's heart rate is not increasing and there are signs of shock or a history of acute blood loss. Your team is caring for a term newborn whose heart rate is 50 bpm after receiving effective ventilation, chest compressions, and intravenous epinephrine administration. There is a history of acute blood loss around the time of delivery. You administer 10 mL/kg of normal saline (based on the newborn's estimated weight). At what rate should this be administered? -ANS Over 5 to 10 minutes How soon after administration of intravenous epinephrine should you pause compressions and reassess the baby's heart rate? -ANS 60 seconds You are called to the birth of a newborn at 30 weeks gestation. As you prepare your equipment, what concentration of oxygen will you use initially if PPV is required? -ANS 21% to 30% A baby is born at 26 weeks gestation. The initial steps of care, including gentle stimulation, have been completed and the baby is nearly 1-minute old. The baby is not breathing. What is the most appropriate next step? -ANS Begin PPV by mask. Choose the appropriate step(s) to prepare for the birth of a newborn 32 weeks gestation. -ANS Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, a hat, and a skin temperature sensor A term newborn was born via emergency cesarean section in the setting of fetal bradycardia. The baby was limp and bradycardic at birth and was intubated at 6 minutes after birth for persistent apnea. The cord blood gas demonstrates a severe metabolic acidosis, and the physical examination is consistent with hypoxic-ischemic encephalopathy (HIE). Which of the following is the most appropriate intervention for this newborn? -ANS Admit the newborn to a center with capability to perform therapeutic hypothermia. A term baby was vigorous at birth but receives CPAP for 3 minutes after birth for grunting respirations. The baby is now 15 minutes old, breathing comfortably in room air, and bonding with their mother. The team plans for the baby to room-in with their mother. What immediate decision needs to be made regarding post-resuscitation care? -ANS Identify who will continue to monitor the baby in the mother's room. A baby's heart rate does not increase after intubation and the breath sounds are louder on the right side than on the left side of the chest. Which of the following is a common cause of asymmetric breath sounds in an intubated baby? -ANS Endotracheal tube inserted into the right mainstem bronchus