NEONATAL RESUSCITATION PROGRAM
2025 (NRP) QUESTIONS AND DETAILED
CORRECT ANSWERS | VERIFIED
ANSWERS
Meaning of "MR. SOPA" Correct Answer Mask
adjustment, reposition head, suction airway, open mouth,
pressure, alternative airway
If a baby does not begin breathing in response to
stimulation, you should assume they are in _______
apnea. Correct Answer Secondary
(At the initiation of respiratory compromise, newborns
experience an initial period of attempted rapid
breathing followed by primary apnea. Primary apnea
results in a reduced oxygen saturation, resulting in a
lower heart rate. Stimulation will usually assist a
newborn in the required respiratory transition,
however if a newborn does not start breathing
immediately following stimulation, he/she is likely
experiencing secondary apnea. Further stimulation
will not help, and the newborn require positive-
pressure ventilation.)
Which device should be readily available as a backup
wherever resuscitation may be needed, in case a
compressed gas source fails? Correct Answer Self-
inflating bag
,(Unlike other bag-mask ventilation methods, self-
inflating bags reinflate when released due to a
pressure-release, or pop-off valve. Valves are typically
set by the manufacturer to release at 30 to 40 cm H2O
of pressure. This makes them the only method usable
when compressed gas sources are not available. It's
important to note that for newborns who have not yet
taken their first breath, occlusion of the pop-off valve
may be necessary to generate sufficient pressure to
inflate the nonaerated lungs. However, care must be
taken to avoid overinflation and creation of a
pulmonary air leak.)
Where should pressure be applied when performing
compressions on the newborn? Correct Answer Lower
third of the sternum
(Chest compressions on the newborn should apply
pressure to the lower one-third of the sternum,
typically in line with the nipples. Downward pressure
should be applied perpendicular to the chest wall to
depress the sternum about one-third of the
anteroposterior diameter of the chest, followed by
release of pressure to allow for refilling of the heart.
Providers should avoid direct pressure to the xiphoid,
which can result in liver injury.)
During resuscitation of a newborn, you've establish
adequate ventilation with an endotracheal tube and your
colleague has begun chest compressions for a heart rate
, under 60 bpm. Nevertheless, after 60 seconds, the heart
rate has not increased. What is the most appropriate next
step in management? Correct Answer Administer
epinephrine.
(A persistent heart rate under 60 beats per minute
despite chest compressions and adequate ventilation,
is indication for epinephrine administration.
Epinephrine should only be initiated after establishing
adequate ventilation to avoid myocardial injury, as it
increases myocardial oxygen consumption and
workload. Guidelines recommend IV epinephrine at a
dose of 0.01 to 0.03 mg/kg at a dilution of 1:10,000.
Epinephrine can be given every 3 to 5 minutes with
the heart rate below 60 bpm.)
Air that leaks from inside the lung and collects in the
pleural space is called a ________. Correct Answer
Pneumothorax
(A pneumothorax is air present between the parietal
and visceral pleura. Pneumothorax in infants may be
asymptomatic, however respiratory distress can
manifest as tachypnea, pallor and cyanosis. Early
indication of pneumothorax can often be a rapid
reduction in QRS voltage on EKG. Physical exam
findings can include an asymmetric chest larger on
the side of pathology, decreased breath sounds on
that side, and a point of maximal impulse shift away
from that side.)
2025 (NRP) QUESTIONS AND DETAILED
CORRECT ANSWERS | VERIFIED
ANSWERS
Meaning of "MR. SOPA" Correct Answer Mask
adjustment, reposition head, suction airway, open mouth,
pressure, alternative airway
If a baby does not begin breathing in response to
stimulation, you should assume they are in _______
apnea. Correct Answer Secondary
(At the initiation of respiratory compromise, newborns
experience an initial period of attempted rapid
breathing followed by primary apnea. Primary apnea
results in a reduced oxygen saturation, resulting in a
lower heart rate. Stimulation will usually assist a
newborn in the required respiratory transition,
however if a newborn does not start breathing
immediately following stimulation, he/she is likely
experiencing secondary apnea. Further stimulation
will not help, and the newborn require positive-
pressure ventilation.)
Which device should be readily available as a backup
wherever resuscitation may be needed, in case a
compressed gas source fails? Correct Answer Self-
inflating bag
,(Unlike other bag-mask ventilation methods, self-
inflating bags reinflate when released due to a
pressure-release, or pop-off valve. Valves are typically
set by the manufacturer to release at 30 to 40 cm H2O
of pressure. This makes them the only method usable
when compressed gas sources are not available. It's
important to note that for newborns who have not yet
taken their first breath, occlusion of the pop-off valve
may be necessary to generate sufficient pressure to
inflate the nonaerated lungs. However, care must be
taken to avoid overinflation and creation of a
pulmonary air leak.)
Where should pressure be applied when performing
compressions on the newborn? Correct Answer Lower
third of the sternum
(Chest compressions on the newborn should apply
pressure to the lower one-third of the sternum,
typically in line with the nipples. Downward pressure
should be applied perpendicular to the chest wall to
depress the sternum about one-third of the
anteroposterior diameter of the chest, followed by
release of pressure to allow for refilling of the heart.
Providers should avoid direct pressure to the xiphoid,
which can result in liver injury.)
During resuscitation of a newborn, you've establish
adequate ventilation with an endotracheal tube and your
colleague has begun chest compressions for a heart rate
, under 60 bpm. Nevertheless, after 60 seconds, the heart
rate has not increased. What is the most appropriate next
step in management? Correct Answer Administer
epinephrine.
(A persistent heart rate under 60 beats per minute
despite chest compressions and adequate ventilation,
is indication for epinephrine administration.
Epinephrine should only be initiated after establishing
adequate ventilation to avoid myocardial injury, as it
increases myocardial oxygen consumption and
workload. Guidelines recommend IV epinephrine at a
dose of 0.01 to 0.03 mg/kg at a dilution of 1:10,000.
Epinephrine can be given every 3 to 5 minutes with
the heart rate below 60 bpm.)
Air that leaks from inside the lung and collects in the
pleural space is called a ________. Correct Answer
Pneumothorax
(A pneumothorax is air present between the parietal
and visceral pleura. Pneumothorax in infants may be
asymptomatic, however respiratory distress can
manifest as tachypnea, pallor and cyanosis. Early
indication of pneumothorax can often be a rapid
reduction in QRS voltage on EKG. Physical exam
findings can include an asymmetric chest larger on
the side of pathology, decreased breath sounds on
that side, and a point of maximal impulse shift away
from that side.)
