2025 NRP PRACTICE EXAM QUESTIONS AND ANSWERS

When coordinating positive-pressure ventilation with chest compressions, how many events are performed each minute? - 30 breaths, 90 compressions What is the ideal depth of chest compressions for a newborn? - One-third of the anterior-posterior diameter of the chest A newborn requires complex resuscitation. You have intubated and are administering positive-pressure ventilation and chest compressions. Which 3 signs are used to evaluate the effectiveness of your actions, and the need to continue one or both of these measures? - Respirations, heart rate, oxygen saturation For a newborn weighing 1 kg, what dose of 1:10,000 (0.1 mg/mL) concentration of intravenous epinephrine is indicated? - 0.1 mL You are in the delivery room caring for a preterm newborn at 27 weeks' gestation. The baby's: -5 minutes old and breathing spontaneously -heart rate is 120 beats per minute -oxygen saturation is 90% in room air -respirations are labored. Which of the following is an appropriate action? - Administer CPAP at 5 cm H20 pressure A baby required ventilation and chest compressions. After 60 seconds of chest compressions, the electronic cardiac monitor indicates a heart rate of 70 beats per minute. What is your next action? - Stop chest compressions; continue positive-pressure ventilation. When a newborn has a high risk of mortality and there is a significant burden of morbidity among survivors, what should be included in your discussion with the parents’ concerning options for resuscitation? - The option of providing comfort care can be considered. What do you expect to happen after administration of a dose of intravenous epinephrine during a resuscitation? - The heart rate will increase about 1 minute after administration. What time frame should be used to administer intravenous epinephrine? - Rapid push, as quickly as possible When are chest compressions indicated? - When the heart rate remains less than 60 beats per minute after 30 seconds of positive-pressure ventilation that moves the chest, preferably through an alternative airway. In most cases, who is (are) the usual and appropriate surrogate decision maker(s) for a newborn? - The newborn's parents Which of the following statements is true? - Intravenous administration of epinephrine results in reliable and effective absorption. What is the preferred method for assessing heart rate during chest compressions? - Electronic cardiac (ECG) monitoring Which of the following may be associated with delayed cord clamping in vigorous preterm newborns? - Decreased need for blood transfusions A baby's heart rate does not increase after intubation and the breath sounds are louder on the right side than the left side of the chest. Which of the following is a common cause of asymmetric breath sounds in an intubated baby? - Endotracheal tube inserted too deep During resuscitation, a baby is responding to positive-pressure ventilation with a rapidly increasing heart rate. Her heart rate and oxygen saturation suddenly worsen. She has decreased breath sounds on the left side and transillumination also reveals a bright glow on the left side. What is the most likely cause of this distress? - Left-sided pneumothorax Which statement best describes the ethical principle(s) that guide the resuscitation of a newborn? - The approach to decisions in the newborn should be guided by the same principles used for adults and older children. You are in the delivery room caring for a preterm newborn at 27 weeks' gestation. Resuscitation has been completed and the baby is ready to be transported to the neonatal intensive care unit. Which of the following is a true statement about the baby's subsequent care? - Monitor blood glucose levels because of the risk of hypoglycemia after birth. Which of the following is true about a pneumothorax in the newborn? - Positive-pressure ventilation increases the risk of pneumothorax A baby born at 36 weeks' gestation was apneic after birth and required positive-pressure ventilation and oxygen supplementation in the delivery room. He continues to require supplemental oxygen after birth. Which of the following statements is true? - His blood glucose level should be checked soon after resuscitation and then at regular intervals until stable and normal. Which of the following is the best indication for volume expansion after resuscitative efforts that included intubation, chest compressions, and IV epinephrine? - The baby's heart rate remains 50 beats per minute after resuscitative efforts and pulses are weak. A laboring woman received a narcotic medication for pain relief 1 hour before delivery. The baby does not have spontaneous respirations and does not improve with stimulation. Your first priority is to - Start positive-pressure ventilation Which of the following is true about the preparation and resources needed for a very preterm birth? - Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, and a hat. After chest compressions with coordinated ventilations are started, the heart rate should be assessed: - After 60 seconds How soon after administration of intravenous epinephrine should you pause compressions and reassess the baby's heart rate? - 1 minute