Neonatal–Perinatal Medicine (Form
301) Exam With Actual Questions &
Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/2026
/Latest Update/Instant Download Pdf
1. A 28-week gestation infant is born with poor respiratory effort and a
heart rate of 80 bpm at 1 minute. After warming and clearing the airway,
what is the next immediate step in resuscitation?
A. Begin chest compressions
B. Give IV epinephrine
C. Start positive-pressure ventilation with a T-piece or bag-mask
D. Intubate and suction the trachea
E. Give surfactant immediately
C. Start positive-pressure ventilation with a T-piece or bag-mask
PPV is indicated when the heart rate is <100 bpm or the infant has
inadequate respiratory effort; it often corrects bradycardia caused by
respiratory failure.
2. Which finding most strongly predicts the development of
bronchopulmonary dysplasia (BPD) in a very preterm infant?
A. Maternal chorioamnionitis
B. Need for supplemental oxygen at 36 weeks postmenstrual age
C. Prolonged mechanical ventilation and oxygen exposure in the first 2
weeks of life
D. Early postnatal corticosteroid use
E. Positive blood culture in the first week
C. Prolonged mechanical ventilation and oxygen exposure in the first 2
, weeks of life
Duration and intensity of ventilator and oxygen support are the
primary drivers of lung injury that leads to BPD.
3. A term newborn develops progressive cyanosis that does not improve
with 100% oxygen; pre- and post-ductal saturations differ by 10%. The
most likely diagnosis is:
A. Transient tachypnea of the newborn (TTN)
B. Persistent pulmonary hypertension of the newborn (PPHN)
C. Meconium aspiration syndrome
D. Congenital diaphragmatic hernia
E. Neonatal pneumonia
B. Persistent pulmonary hypertension of the newborn (PPHN)
A differential between pre- and post-ductal oxygen saturation and poor
response to oxygen suggest right-to-left shunting from elevated
pulmonary vascular resistance, typical of PPHN.
4. Which maternal condition is most strongly associated with neonatal
hypoglycemia at birth?
A. Maternal hypothyroidism
B. Maternal diabetes mellitus (poorly controlled)
C. Maternal asthma
D. Maternal hypertension controlled with labetalol
E. Maternal iron deficiency anemia
B. Maternal diabetes mellitus (poorly controlled)
Maternal hyperglycemia causes fetal hyperinsulinemia; after birth, loss
of maternal glucose leads to neonatal hypoglycemia.
5. A full-term newborn has an apgar score of 2 at 1 minute and 7 at 5
minutes. Which statement is correct about long-term prognosis?
A. All infants with 1-minute Apgar <3 develop cerebral palsy
B. A 5-minute Apgar of 7 predicts severe neurodevelopmental
impairment
C. Improved Apgar from 1 to 5 minutes suggests better short-term
prognosis but does not exclude later problems
D. Apgar scores are diagnostic of hypoxic–ischemic encephalopathy (HIE)
E. A single low Apgar mandates long-term neurologic testing
, C. Improved Apgar from 1 to 5 minutes suggests better short-term
prognosis but does not exclude later problems
Apgar is a quick clinical score for immediate status; recovery by 5
minutes is reassuring but not wholly predictive of long-term outcome.
6. For neonatal resuscitation, when are chest compressions indicated?
A. If heart rate <100 bpm after 30 seconds of effective ventilation
B. Immediately at birth for all preterm infants
C. If heart rate <60 bpm despite 30 seconds of effective ventilation
D. For apnea without bradycardia
E. Only after giving epinephrine
C. If heart rate <60 bpm despite 30 seconds of effective ventilation
Current neonatal resuscitation guidelines recommend starting
compressions when HR remains <60 bpm after adequate ventilation.
7. A preterm infant (32 weeks) develops apnea of prematurity. Which
medication is first-line therapy?
A. Phenobarbital
B. Caffeine citrate
C. Doxapram
D. Theophylline inhalation
E. Naloxone
B. Caffeine citrate
Caffeine is preferred for apnea of prematurity due to efficacy, longer
half-life, and better safety profile compared with alternatives.
8. A neonate has total serum bilirubin 18 mg/dL at 72 hours; the infant is
38 weeks GA and clinically well. Which is the most appropriate next
step?
A. Exchange transfusion immediately
B. Start phototherapy if level exceeds threshold based on age and risk
factors
C. Administer IV immunoglobulin (IVIG) immediately
D. Observe without treatment
E. Start rifampin
B. Start phototherapy if level exceeds threshold based on age and risk
factors
, Treatment thresholds depend on postnatal age and risk factors;
phototherapy is first-line for elevated unconjugated bilirubin that
meets treatment criteria.
9. Which organism is the most common cause of early-onset neonatal
sepsis in many parts of the world?
A. Staphylococcus aureus
B. Listeria monocytogenes
C. Group B Streptococcus (GBS)
D. Escherichia coli
E. Klebsiella pneumoniae
C. Group B Streptococcus (GBS)
GBS remains a leading cause of early-onset neonatal sepsis; E. coli is
also important, especially in very low birth weight infants.
10.A 26-week preterm infant is intubated at birth for respiratory distress.
Which action most reliably reduces the risk of intraventricular
hemorrhage (IVH)?
A. Early aggressive enteral feeding
B. Avoiding fluctuations in cerebral blood flow — gentle handling and
appropriate ventilation
C. Rapid correction of low sodium
D. High tidal volume ventilation
E. Routine postnatal corticosteroids
B. Avoiding fluctuations in cerebral blood flow — gentle handling and
appropriate ventilation
Preterm IVH risk is linked to unstable cerebral blood flow; minimizing
rapid physiologic changes reduces risk.
11.In a newborn with suspected hypoxic–ischemic encephalopathy (HIE),
what is the recommended window to start therapeutic hypothermia?
A. Within 6 hours of birth
B. Within 24 hours of birth
C. Only after MRI confirms injury
D. At any time during the first week
E. Only if seizure activity is present
A. Within 6 hours of birth
301) Exam With Actual Questions &
Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/2026
/Latest Update/Instant Download Pdf
1. A 28-week gestation infant is born with poor respiratory effort and a
heart rate of 80 bpm at 1 minute. After warming and clearing the airway,
what is the next immediate step in resuscitation?
A. Begin chest compressions
B. Give IV epinephrine
C. Start positive-pressure ventilation with a T-piece or bag-mask
D. Intubate and suction the trachea
E. Give surfactant immediately
C. Start positive-pressure ventilation with a T-piece or bag-mask
PPV is indicated when the heart rate is <100 bpm or the infant has
inadequate respiratory effort; it often corrects bradycardia caused by
respiratory failure.
2. Which finding most strongly predicts the development of
bronchopulmonary dysplasia (BPD) in a very preterm infant?
A. Maternal chorioamnionitis
B. Need for supplemental oxygen at 36 weeks postmenstrual age
C. Prolonged mechanical ventilation and oxygen exposure in the first 2
weeks of life
D. Early postnatal corticosteroid use
E. Positive blood culture in the first week
C. Prolonged mechanical ventilation and oxygen exposure in the first 2
, weeks of life
Duration and intensity of ventilator and oxygen support are the
primary drivers of lung injury that leads to BPD.
3. A term newborn develops progressive cyanosis that does not improve
with 100% oxygen; pre- and post-ductal saturations differ by 10%. The
most likely diagnosis is:
A. Transient tachypnea of the newborn (TTN)
B. Persistent pulmonary hypertension of the newborn (PPHN)
C. Meconium aspiration syndrome
D. Congenital diaphragmatic hernia
E. Neonatal pneumonia
B. Persistent pulmonary hypertension of the newborn (PPHN)
A differential between pre- and post-ductal oxygen saturation and poor
response to oxygen suggest right-to-left shunting from elevated
pulmonary vascular resistance, typical of PPHN.
4. Which maternal condition is most strongly associated with neonatal
hypoglycemia at birth?
A. Maternal hypothyroidism
B. Maternal diabetes mellitus (poorly controlled)
C. Maternal asthma
D. Maternal hypertension controlled with labetalol
E. Maternal iron deficiency anemia
B. Maternal diabetes mellitus (poorly controlled)
Maternal hyperglycemia causes fetal hyperinsulinemia; after birth, loss
of maternal glucose leads to neonatal hypoglycemia.
5. A full-term newborn has an apgar score of 2 at 1 minute and 7 at 5
minutes. Which statement is correct about long-term prognosis?
A. All infants with 1-minute Apgar <3 develop cerebral palsy
B. A 5-minute Apgar of 7 predicts severe neurodevelopmental
impairment
C. Improved Apgar from 1 to 5 minutes suggests better short-term
prognosis but does not exclude later problems
D. Apgar scores are diagnostic of hypoxic–ischemic encephalopathy (HIE)
E. A single low Apgar mandates long-term neurologic testing
, C. Improved Apgar from 1 to 5 minutes suggests better short-term
prognosis but does not exclude later problems
Apgar is a quick clinical score for immediate status; recovery by 5
minutes is reassuring but not wholly predictive of long-term outcome.
6. For neonatal resuscitation, when are chest compressions indicated?
A. If heart rate <100 bpm after 30 seconds of effective ventilation
B. Immediately at birth for all preterm infants
C. If heart rate <60 bpm despite 30 seconds of effective ventilation
D. For apnea without bradycardia
E. Only after giving epinephrine
C. If heart rate <60 bpm despite 30 seconds of effective ventilation
Current neonatal resuscitation guidelines recommend starting
compressions when HR remains <60 bpm after adequate ventilation.
7. A preterm infant (32 weeks) develops apnea of prematurity. Which
medication is first-line therapy?
A. Phenobarbital
B. Caffeine citrate
C. Doxapram
D. Theophylline inhalation
E. Naloxone
B. Caffeine citrate
Caffeine is preferred for apnea of prematurity due to efficacy, longer
half-life, and better safety profile compared with alternatives.
8. A neonate has total serum bilirubin 18 mg/dL at 72 hours; the infant is
38 weeks GA and clinically well. Which is the most appropriate next
step?
A. Exchange transfusion immediately
B. Start phototherapy if level exceeds threshold based on age and risk
factors
C. Administer IV immunoglobulin (IVIG) immediately
D. Observe without treatment
E. Start rifampin
B. Start phototherapy if level exceeds threshold based on age and risk
factors
, Treatment thresholds depend on postnatal age and risk factors;
phototherapy is first-line for elevated unconjugated bilirubin that
meets treatment criteria.
9. Which organism is the most common cause of early-onset neonatal
sepsis in many parts of the world?
A. Staphylococcus aureus
B. Listeria monocytogenes
C. Group B Streptococcus (GBS)
D. Escherichia coli
E. Klebsiella pneumoniae
C. Group B Streptococcus (GBS)
GBS remains a leading cause of early-onset neonatal sepsis; E. coli is
also important, especially in very low birth weight infants.
10.A 26-week preterm infant is intubated at birth for respiratory distress.
Which action most reliably reduces the risk of intraventricular
hemorrhage (IVH)?
A. Early aggressive enteral feeding
B. Avoiding fluctuations in cerebral blood flow — gentle handling and
appropriate ventilation
C. Rapid correction of low sodium
D. High tidal volume ventilation
E. Routine postnatal corticosteroids
B. Avoiding fluctuations in cerebral blood flow — gentle handling and
appropriate ventilation
Preterm IVH risk is linked to unstable cerebral blood flow; minimizing
rapid physiologic changes reduces risk.
11.In a newborn with suspected hypoxic–ischemic encephalopathy (HIE),
what is the recommended window to start therapeutic hypothermia?
A. Within 6 hours of birth
B. Within 24 hours of birth
C. Only after MRI confirms injury
D. At any time during the first week
E. Only if seizure activity is present
A. Within 6 hours of birth
