HISTORY 940Neonatal Resuscitate Program Questions

HISTORY 940Neonatal Resuscitate Program Questions Neonatal Resuscitate Program Lesson 1: Overview and Principles of Resuscitation 1. You have determined that a baby needs resuscitation at birth. What are the initial steps of resuscitation? A. Provide warmth, position head to open the airway, dry and stimulate B. Provide warmth, position head to open airway, evaluate heart rate C. Position to open the airway, dry and stimulate, evaluate heart rate D. Provide warmth, evaluate color and respiration, evaluate heart rate 2. After the initial steps in resuscitation, a newborn is apneic with the heart less than 100 beats per minute. What is the most important and effective action to take in resuscitation for this baby? a. Ventilate the lungs b. Perform chest compression c. Give epinephrine d. Give supplemental oxygen 3. You have called to a newborn at birth which 3 questions should you ask first for the need of resuscitation? a. Is the baby warm? Does the baby have good tone? Is the baby full term? b. Is amniotic fluid clear? Is baby breathing or crying? Is the baby low birth weight? c. Is the baby of term gestation? Breathing or crying? Good tone? d. Is the baby pink? Breathing or crying? Amniotic fluid clear? 4. After several hours of labor with failure to progress, baby born via C-section. Cries at birth and vigorous but slightly dusky appearance at 2-3 minutes of age. How long may take this normal baby to reach 90% of oxygen saturation? a. 5 minutes b. 2 minutes c. 1 minutes d. 10 minutes 5. A C-section is performed under General Anesthesia because of prior maternal back surgery after birth, newborn is making some respiratory effort but heart rate drops below 100 beats per minute. What difficulty in transition can occurred after birth? a. Increase blood pressure from the transition of blood from the placenta b. Inadequate ventilation because of baby poor respiratory effort c. Constriction of blood vessels in lungs because of excess oxygen administration d. Less blood flow to the lungs if baby cry vigorously. 6. Your hospital has several people skilled in neonatal resuscitation. Most of them have work away from delivery room and you alone are there at this time. When should you recruit additional help? a. When after birth, you determine that the baby requires intubation or other procedures b. When you learn it is a birth of multiple gestation to care for the additional baby. c. When after birth, obstetrician or labour nurse suggest that you need additional help. d. When you anticipate the likely need for more advanced resuscitation based on present of any known prenatal risk factor. 7. Your hospital is planning NRP training and is trying to decide who should be included. For every delivery who should be available? a. Someone capable of initiating resuscitation should be present at every delivery and available to care for baby b. Someone capable of initiating resuscitation should be present if risk factor indentified c. Someone should be identified at every delivery as the person to call for help for the baby d. Someone skilled in neonatal resuscitation should be available at the hospital to be called for deliveries. 8. A newborn requires resuscitation and you have begun positive pressure ventilation and chest compression. Which 3 signs are used to evaluate the effectiveness of your action and the need to continue some aspect of support? a. Respiration, muscle tone and heart rate b. Blood pressure, assessment of oxygenation and heart rate c. Respiration, blood pressure , assessment of oxygenation d. Respiration, heart rate, assessment of oxygenation 9. Baby is born 34 weeks, despite initial steps, baby is apneic and heart rate is 70 beats per minute. What step should be taken next? a. Administer C-PAP, place an oximeter probe on right hand/wrist, evaluate color and tone b. Administer free flow oxygen, place an oximeter probe on right hand/wrist, reevaluate in 30 seconds c. Provide additional tactile stimulation, evaluate color and tone, reevaluate in 30 seconds d. Begin positive pressure ventilation, place an oximeter probe on right hand/wrist, reevaluate in 30 seconds. 10. Full term newborn apneic after birth, fails to respond to tactile stimulation. Newborn in secondary apnea usually respond with an increase with heart rate after which intervention? a. Effective positive pressure ventilation b. Increasingly vigorous tactile stimulation c. Chest compression rate 30 per minute d. Administration of free flow 100% oxygen 11. A prenatal class is learning about labor and birth. Approximately what percent of newborn require some assistance to begin breathing at birth? a. 5% b. 30% c. 10% d. 1% 12. A caregiver states that he can always predict which baby needs help at birth. You disagree because you know that percent of newborns require initial assessment to determine whether resuscitation is required. a. 100% b. 50% c. 10% d. 1% Lesson 2: Initial Steps of Resuscitation 1. Which statement accurately describe the role of oxygen in newborn resuscitation. a. It is reasonable to expect most babies to have pre-ductal saturation (SpO2) of more than 90% by 3 minutes of age. b. Most newborn resuscitation should begin with 100% oxygen c. Newborn with secondary apnea can be expected to resume normal respiration with the application of free flow oxygen d. Free flow oxygen may be administered using an oxygen mask held close to the baby face 2. What statement best describes normal transitional physiology at the time of birth? a. Oxygen saturation rises to at least 90% by 2 minute of age b. Baby may take as long as 10 minutes after birth to increase their oxygen saturation to greater than 90% c. Oxygen saturation is unreliable and 100% oxygen is often required immediately after birth. d. Evaluation of skin color is a reliable of the baby transition 3. A baby is a born with meconium stained amniotic fluid. The baby has normal muscle tone and respiratory effect at heart rate of 120 beats per minute. What is the appropriate action? a. Mild chest physiotherapy b. Supplemental oxygen c. Clearance of secretions from the mouth and nose with the bulb syringe d. Intubation and suction in trachea. 4. Which statement describes best practice for using the pulse oximeter? a. Once the oximeter is placed in a pre-ductal location, begin resuscitation with 100% oxygen and titrate downwards. b. The probe attached to the instrument prior to attaching it to the baby, to ensure the most rapid acquisition of signals. c. Combination of appropriately placed oximeter and knowledge of minute by minute normal oxygen targets should guide resuscitation d. Probe should be placed in a reliable post-ductal location to guide the application of supplemental oxygen in a newborn. 5. What is the best way to determine if a baby needs supplemental oxygen? a. Send ABG and evaluate partial pressure of oxygen b. Determine color of newborn chest and abdomen, monitor for central cyanosis c. Place an oximeter on baby right hand/ wrist d. Determine the color of newborn hand and feet. 6. During resuscitation of newborn, you palpate umbilical cord and count 10 beats over 6 seconds of period. What heart rate do you report? a. 60 beats per minute b. 100 beats per minute c. 30 beats per minute d. 120 beats per minute 7. What is the most effect maneuver to establish normal breathing in a baby with secondary apnea? a. Application of positive pressure ventilation b. Administration of free-flow oxygen c. Flicking of soles of feet. d. Gentle rubbing the back. 8. What is the best technique for removing secretions from the mouth and nose of a newborn who requires resuscitation? a. Suction the mouth or nose first b. Suction the mouth before the nose c. Suction the nose before the mouth d. Suction vigorously and deeply to clear secretions. 9. What is the appropriate technique to stimulate a baby to breathe? a. Vigorously rubbing the back b. Application of mild ocular pressure c. Slapping of flicking the soles of the feet d. Holding the baby upside down and gently patting the buttocks 10. You are at a delivery of a baby born through meconium-stained amniotic fluid. What is the correct indication for intubation and suctioning the trachea at birth? a. The baby has poor tone and respiratory effort. b. The baby is not pink by 1 minute of life c. The meconium is thick d. The baby has wet-sounding lungs. 11. You are at the resuscitation of a newborn who is gasping and has a heart rate of 90 beats per minute. What is the most important action you can take? a. Assist ventilation b. Provide chest compression c. Apply mild chest physiotherapy d. Provide free-flow oxygen. 12. During a recitation of a newborn, what is the ideal head position? a. The baby shoulder be prone, with the head turned to the left. b. The neck should be slightly flexed c. The neck should be mild extended d. The baby should be prone, with the head turned to the right. Lesson 3: Use of Resuscitation Devices for Positive-Pressure Ventilation 1. You are giving positive ventilation to a premature newborn. In your delivery room booth a flow- inflating bag and a T-piece resuscitator are available for use. Both devices can be effectively used to provide positive-pressure ventilation. What advantage does the T-piece resuscitator have over the flow-inflating bag? a. Has an adjustable valve to regulate the amount of continuous positive airway pressure or positive end-expiratory pressure. b. Can be used to deliver continuous positive airway pressure. c. Delivers more consistent, reliable pressures with each breath. d. Reliably deliver 100% oxygen. 2. You are part of a team resuscitating a premature newborn. Shortly after birth, the baby developed apnea followed by bradycardia. Positive-pressure ventilation with a bag and mask had not resulted in an improvement. You communicate to the team that you remember potential corrective steps, using the acronym MR SOPA. Despite taking the first 4 corrective steps, M-R-S-O, there is still no chest rate. You recommend that your team consider a. P: Provide more oxygen, A: Ask for help b. P: Pressure increase, A: Airway Alternative c. P: Push chest (compressions), A: Airway alternative d. P: Pressure increase, A: Add drugs (epinephrine) 3. A baby is born in the hospital lobby as his mother waited for admission. He is apneic, despite tactile stimulation, drying and bulb suctioning. You have brought a self-inflating bag to birth. What should your next step be? a. Calls for someone to bring 100% oxygen tank and oximeter to the patient before starting positive pressure ventilation b. Start positive-pressure ventilation using room air and transport the baby to a care area. c. Quickly transport the baby to a care area, and start positive-pressure ventilation with blended oxygen and monitor with an oximeter. d. Monitor the heart rate, if it slows, begin positive-pressure ventilation with room air. 4. You attend the birth of a newborn with another caretaker. The baby is born limp and apneic. Despite initial steps, you are required to provide the newborn with positive-pressure ventilation. At the same time, you team member should a. Listen for breath sounds begin chest compressions and prepare for intubation and medications b. Apply the pulse oximeter probe to the right hand or wrist, take over ventilations and increase the heat on the radiant warmer c. Apply the pulse oximeter probe to any extremity, increase the oxygen concentration to 100% and call for additional help d. Apply the pulse oximeter probe to the right hand or wrist, listen for a rising heart rate and watch for rising oxygen saturations. 5. A full term newborn is apneic at birth and requires positive-pressure ventilation. What concentration of oxygen should be used during resuscitation? a. Room air should be used for resuscitation of full-term newborns, independent of color or oxygen saturation.