Ohio Neonatal Resuscitation Program
(NRP) Instructor Practice Exam Questions
And Correct Answers (Verified Answers)
Plus Rationales |2026 Q&A | Instant
Download Pdf
1. Which of the following is the correct sequence of the initial steps
immediately after birth for an infant who is not breathing?
A. Dry, suction, warm, stimulate
B. Dry, warm, stimulate, position airway, suction if needed
C. Clamp cord, dry, intubate, stimulate
D. Stimulate, suction, warm, intubate
Rationale: The initial steps are to provide warmth, dry, stimulate,
position the airway, and suction only if needed.
2. For a term newborn requiring positive-pressure ventilation (PPV),
what initial FiO₂ does NRP recommend starting with?
A. 100% O₂
, B. 50% O₂
C. Room air (≈21% O₂)
D. 30% O₂ for all term infants
Rationale: For term and late-preterm infants, initiate PPV with room
air and titrate oxygen based on pre-ductal SpO₂.
3. When should chest compressions be started on a newborn?
A. Immediately at birth if apneic
B. After 15 seconds of unsuccessful stimulation
C. If heart rate remains <60/min despite 30 seconds of effective
ventilation
D. Only after epinephrine administration
Rationale: Chest compressions begin when the heart rate stays
<60/min after at least 30 seconds of effective ventilation.
4. What is the recommended compression:ventilation ratio for neonatal
resuscitation?
A. 15:2
B. 5:1
C. 3:1 (90 compressions : 30 breaths per minute)
D. 30:2
Rationale: NRP recommends a 3:1 ratio to achieve ~120 events/min
(90 compressions + 30 inflations).
5. Which technique is preferred for chest compressions on a term
neonate?
, A. One-hand heel compressions
B. Two-finger method only
C. Two-thumb encircling hands technique
D. Sternal rub compressions
Rationale: The two-thumb encircling hands technique provides more
consistent coronary and cerebral perfusion in neonates.
6. What is the recommended IV dose range of epinephrine for neonatal
resuscitation (1:10,000)?
A. 0.1–0.3 mg/kg
B. 0.5–1.0 mg/kg
C. 0.01–0.03 mg/kg (0.1–0.3 mL/kg of 1:10,000)
D. 0.001–0.003 mg/kg
Rationale: The recommended IV/IO dose is 0.01–0.03 mg/kg; higher
doses are not routinely recommended.
7. If epinephrine must be given via endotracheal tube (ETT), the typical
recommended dose is:
A. 0.001–0.005 mg/kg
B. 0.05–0.1 mg/kg
C. 0.5 mg/kg
D. 1 mg/kg
Rationale: ETT doses are larger (0.05–0.1 mg/kg) because systemic
absorption is less reliable than IV/IO.
, 8. During resuscitation, a newborn’s heart rate is 40/min despite good
ventilation and compressions. Next best step:
A. Stop compressions and observe
B. Give volume bolus immediately
C. Administer epinephrine (after ensuring IV/IO access and adequate
ventilation/compressions)
D. Give naloxone
Rationale: If HR <60/min despite adequate ventilation/compressions,
give epinephrine; assess volume only if hypovolemia suspected.
9. Which is true regarding delayed cord clamping (DCC) in vigorous term
infants?
A. It should always be avoided
B. It should be performed only after 5 minutes
C. Clamping after 30–60 seconds (or longer if feasible) benefits
placental transfusion
D. It increases need for resuscitation in all infants
Rationale: DCC for 30–60 seconds (or up to 1–2 minutes when
feasible) provides placental transfusion benefits unless
contraindicated.
10. Which device is recommended to provide controlled positive-
pressure ventilation for newborns during initial resuscitation?
A. Bag with room air only and no PEEP
B. T-piece resuscitator (provides consistent pressure and PEEP)
(NRP) Instructor Practice Exam Questions
And Correct Answers (Verified Answers)
Plus Rationales |2026 Q&A | Instant
Download Pdf
1. Which of the following is the correct sequence of the initial steps
immediately after birth for an infant who is not breathing?
A. Dry, suction, warm, stimulate
B. Dry, warm, stimulate, position airway, suction if needed
C. Clamp cord, dry, intubate, stimulate
D. Stimulate, suction, warm, intubate
Rationale: The initial steps are to provide warmth, dry, stimulate,
position the airway, and suction only if needed.
2. For a term newborn requiring positive-pressure ventilation (PPV),
what initial FiO₂ does NRP recommend starting with?
A. 100% O₂
, B. 50% O₂
C. Room air (≈21% O₂)
D. 30% O₂ for all term infants
Rationale: For term and late-preterm infants, initiate PPV with room
air and titrate oxygen based on pre-ductal SpO₂.
3. When should chest compressions be started on a newborn?
A. Immediately at birth if apneic
B. After 15 seconds of unsuccessful stimulation
C. If heart rate remains <60/min despite 30 seconds of effective
ventilation
D. Only after epinephrine administration
Rationale: Chest compressions begin when the heart rate stays
<60/min after at least 30 seconds of effective ventilation.
4. What is the recommended compression:ventilation ratio for neonatal
resuscitation?
A. 15:2
B. 5:1
C. 3:1 (90 compressions : 30 breaths per minute)
D. 30:2
Rationale: NRP recommends a 3:1 ratio to achieve ~120 events/min
(90 compressions + 30 inflations).
5. Which technique is preferred for chest compressions on a term
neonate?
, A. One-hand heel compressions
B. Two-finger method only
C. Two-thumb encircling hands technique
D. Sternal rub compressions
Rationale: The two-thumb encircling hands technique provides more
consistent coronary and cerebral perfusion in neonates.
6. What is the recommended IV dose range of epinephrine for neonatal
resuscitation (1:10,000)?
A. 0.1–0.3 mg/kg
B. 0.5–1.0 mg/kg
C. 0.01–0.03 mg/kg (0.1–0.3 mL/kg of 1:10,000)
D. 0.001–0.003 mg/kg
Rationale: The recommended IV/IO dose is 0.01–0.03 mg/kg; higher
doses are not routinely recommended.
7. If epinephrine must be given via endotracheal tube (ETT), the typical
recommended dose is:
A. 0.001–0.005 mg/kg
B. 0.05–0.1 mg/kg
C. 0.5 mg/kg
D. 1 mg/kg
Rationale: ETT doses are larger (0.05–0.1 mg/kg) because systemic
absorption is less reliable than IV/IO.
, 8. During resuscitation, a newborn’s heart rate is 40/min despite good
ventilation and compressions. Next best step:
A. Stop compressions and observe
B. Give volume bolus immediately
C. Administer epinephrine (after ensuring IV/IO access and adequate
ventilation/compressions)
D. Give naloxone
Rationale: If HR <60/min despite adequate ventilation/compressions,
give epinephrine; assess volume only if hypovolemia suspected.
9. Which is true regarding delayed cord clamping (DCC) in vigorous term
infants?
A. It should always be avoided
B. It should be performed only after 5 minutes
C. Clamping after 30–60 seconds (or longer if feasible) benefits
placental transfusion
D. It increases need for resuscitation in all infants
Rationale: DCC for 30–60 seconds (or up to 1–2 minutes when
feasible) provides placental transfusion benefits unless
contraindicated.
10. Which device is recommended to provide controlled positive-
pressure ventilation for newborns during initial resuscitation?
A. Bag with room air only and no PEEP
B. T-piece resuscitator (provides consistent pressure and PEEP)
