Neonatal Resuscitation Program (NRP) practice Questions and
Answers Graded A+
Questions to ask prior to birth - -1. what is eclampsia, maternal HTN, poly and
expected Gestational age, (preterm <38 wks, oligohydramnios, fetal hydrops, macrosomia and
term 38-41 wks or post-term >41 wks) IGR, fetal malformations or anomalies, no
2. what is amniotic fluid color (only clear good), prenatal care.
3. what's number of babies expected (twins
mebbe more),
4. are any additional risk factors (GDM, Inpartum - -Emergency c-section, vacuum
miscarriages, preeclampsia, etc.) assisted delivery, breech or abnormal
presentation, category II or III, maternal
anesthesia, mag, or narcs, prolapse cord,
When to clamp umbilical cord - -30-60 shoulder dystocia, meconium staining, bleeding,
seconds after birth for VIGOROUS newborn placental abruption, chorioamnionitis
Things to look for after birth - -1. Is the Abnormal transition signs and symptoms - -
baby term, (if no, bring baby to warmer) Apnea, tachypnea, bradycardia, tachycardia,
2. does the baby have good muscle tone, decreased muscle tone, low SpO2, hypotension
(flaccid/extended extremities are bad)
3. is the baby breathing or crying? (if no crying,
observe chest for breathing efforts. if vigorous Preductal SpO2 at 1 min - -60-65%
crying, return to mom)
Preductal SpO2 at 2 min - -65-70%
5 initial steps of care - -1. Warm,
2. position airway,
3. clear secretions if needed, Preductal SpO2 at 3 min - -70-75%
4. dry,
5. stimulate
Preductal SpO2 at 4 min - -75-80%
Flow rate for free-flow O2 administration - -
10lpm Preductal SpO2 at 5 min - -80-85%
O2 level for free-flow O2 administration - - Preductal SpO2 at 10 min - -85-95%
30%
Where to put pulse oximeter on newborn - -
Suction setting for newborn - -80- Right hand or wrist (preductal)
100mmHg
Requirements for CPAP on newborn - -HR
Antepartum risk factors - -gestation >100bpm and spontaneous respirations
<36wks or >41wks, pre-eclampsia and
1/8
, Neonatal Resuscitation Program (NRP) practice Questions and
Answers Graded A+
Ventilation of the lungs
Best way to determine HR - -Listen with
stethoscope on left side chest for 6 seconds, Meaning of "MR. SOPA" - -Mask
multiply by 10 adjustment, reposition head, suction airway, open
mouth, pressure, alternative airway
If suctioning, do you suction the mouth or nose
first? - -Mouth If a baby does not begin breathing in response to
stimulation, you should assume they are in
_______ apnea. - -Secondary
Indications for PPV - -Apnea, gasping,
HR<100bpm, SpO2 low despite free-flow O2 or (At the initiation of respiratory compromise,
CPAP newborns experience an initial period of
attempted rapid breathing followed by primary
apnea. Primary apnea results in a reduced
Preparation for PPV - -Clear secretions, oxygen saturation, resulting in a lower heart rate.
position yourself at baby's head, position baby's Stimulation will usually assist a newborn in the
head and neck 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
Rate for administering PPV breaths - -40-
help, and the newborn require positive-pressure
60bpm or "breathe, two, three, breathe..."
ventilation.)
Proper PIP setting - -20-25cmH2O Which device should be readily available as a
backup wherever resuscitation may be needed,
in case a compressed gas source fails? - -
Proper PEEP setting - -5cmH20 Self-inflating bag
(Unlike other bag-mask ventilation methods, self-
O2 flow rate for PPV - -10lpm 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
O2 concentration for PPV (>35wk gestation) - to 40 cm H2O of pressure. This makes them the
-21% only method usable when compressed gas
sources are not available. It's important to note
that for newborns who have not yet taken their
O2 concentration for PPV (<35wk gestation) - first breath, occlusion of the pop-off valve may be
-21-30% necessary to generate sufficient pressure to
inflate the nonaerated lungs. However, care must
be taken to avoid overinflation and creation of a
Single most important step in NRP is... - - pulmonary air leak.)
2/8
Answers Graded A+
Questions to ask prior to birth - -1. what is eclampsia, maternal HTN, poly and
expected Gestational age, (preterm <38 wks, oligohydramnios, fetal hydrops, macrosomia and
term 38-41 wks or post-term >41 wks) IGR, fetal malformations or anomalies, no
2. what is amniotic fluid color (only clear good), prenatal care.
3. what's number of babies expected (twins
mebbe more),
4. are any additional risk factors (GDM, Inpartum - -Emergency c-section, vacuum
miscarriages, preeclampsia, etc.) assisted delivery, breech or abnormal
presentation, category II or III, maternal
anesthesia, mag, or narcs, prolapse cord,
When to clamp umbilical cord - -30-60 shoulder dystocia, meconium staining, bleeding,
seconds after birth for VIGOROUS newborn placental abruption, chorioamnionitis
Things to look for after birth - -1. Is the Abnormal transition signs and symptoms - -
baby term, (if no, bring baby to warmer) Apnea, tachypnea, bradycardia, tachycardia,
2. does the baby have good muscle tone, decreased muscle tone, low SpO2, hypotension
(flaccid/extended extremities are bad)
3. is the baby breathing or crying? (if no crying,
observe chest for breathing efforts. if vigorous Preductal SpO2 at 1 min - -60-65%
crying, return to mom)
Preductal SpO2 at 2 min - -65-70%
5 initial steps of care - -1. Warm,
2. position airway,
3. clear secretions if needed, Preductal SpO2 at 3 min - -70-75%
4. dry,
5. stimulate
Preductal SpO2 at 4 min - -75-80%
Flow rate for free-flow O2 administration - -
10lpm Preductal SpO2 at 5 min - -80-85%
O2 level for free-flow O2 administration - - Preductal SpO2 at 10 min - -85-95%
30%
Where to put pulse oximeter on newborn - -
Suction setting for newborn - -80- Right hand or wrist (preductal)
100mmHg
Requirements for CPAP on newborn - -HR
Antepartum risk factors - -gestation >100bpm and spontaneous respirations
<36wks or >41wks, pre-eclampsia and
1/8
, Neonatal Resuscitation Program (NRP) practice Questions and
Answers Graded A+
Ventilation of the lungs
Best way to determine HR - -Listen with
stethoscope on left side chest for 6 seconds, Meaning of "MR. SOPA" - -Mask
multiply by 10 adjustment, reposition head, suction airway, open
mouth, pressure, alternative airway
If suctioning, do you suction the mouth or nose
first? - -Mouth If a baby does not begin breathing in response to
stimulation, you should assume they are in
_______ apnea. - -Secondary
Indications for PPV - -Apnea, gasping,
HR<100bpm, SpO2 low despite free-flow O2 or (At the initiation of respiratory compromise,
CPAP newborns experience an initial period of
attempted rapid breathing followed by primary
apnea. Primary apnea results in a reduced
Preparation for PPV - -Clear secretions, oxygen saturation, resulting in a lower heart rate.
position yourself at baby's head, position baby's Stimulation will usually assist a newborn in the
head and neck 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
Rate for administering PPV breaths - -40-
help, and the newborn require positive-pressure
60bpm or "breathe, two, three, breathe..."
ventilation.)
Proper PIP setting - -20-25cmH2O Which device should be readily available as a
backup wherever resuscitation may be needed,
in case a compressed gas source fails? - -
Proper PEEP setting - -5cmH20 Self-inflating bag
(Unlike other bag-mask ventilation methods, self-
O2 flow rate for PPV - -10lpm 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
O2 concentration for PPV (>35wk gestation) - to 40 cm H2O of pressure. This makes them the
-21% only method usable when compressed gas
sources are not available. It's important to note
that for newborns who have not yet taken their
O2 concentration for PPV (<35wk gestation) - first breath, occlusion of the pop-off valve may be
-21-30% necessary to generate sufficient pressure to
inflate the nonaerated lungs. However, care must
be taken to avoid overinflation and creation of a
Single most important step in NRP is... - - pulmonary air leak.)
2/8
