NRP 8TH EDITION TEST REVIEW AND
SOLUTIONS 2026
◉ If a baby does not begin breathing in response to stimulation, you
should assume they are in _______ apnea. 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?.
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?. 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?. 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
SOLUTIONS 2026
◉ If a baby does not begin breathing in response to stimulation, you
should assume they are in _______ apnea. 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?.
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?. 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?. 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
