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1. A newborn is apneic and has a heart rate of 80 bpm after birth.
What is the first appropriate action?
A. Begin chest compressions
B. Start positive pressure ventilation
C. Administer epinephrine
D. Give oxygen by nasal cannula
Answer: B
Rationale: Positive pressure ventilation is the most critical first
step when a newborn is apneic or has a heart rate <100 bpm, as
most neonatal resuscitation cases are due to inadequate
ventilation.
2. A term newborn is born with poor tone and no respirations. After
initial steps, the heart rate remains 60 bpm. What is indicated
next?
A. Continue stimulation
B. Start chest compressions with coordinated ventilation
C. Give IV fluids
D. Intubate and observe
Answer: B
, Rationale: Chest compressions are indicated when heart rate
remains below 60 bpm despite effective ventilation.
3. What is the recommended compression-to-ventilation ratio in
neonatal resuscitation?
A. 15:2
B. 30:2
C. 3:1
D. 5:1
Answer: C
Rationale: The neonatal resuscitation ratio is 3 compressions to
1 ventilation to prioritize effective oxygenation.
4. What is the primary cause of bradycardia in the newly born
infant?
A. Hypovolemia
B. Hypothermia
C. Inadequate ventilation
D. Sepsis
Answer: C
Rationale: In newborns, bradycardia is most commonly caused
by inadequate ventilation leading to hypoxia.
5. A newborn requires PPV. What is the preferred initial oxygen
concentration for a term infant?
A. 21%
B. 30%
C. 50%
D. 100%
Answer: A
Rationale: Term infants should start PPV with room air (21%
oxygen) and titrate based on oxygen saturation.
, 6. When should chest compressions be started in a newborn?
A. Heart rate <100 bpm
B. Heart rate <80 bpm
C. Heart rate <60 bpm despite ventilation
D. Apnea regardless of heart rate
Answer: C
Rationale: Chest compressions are initiated when HR remains
below 60 bpm despite adequate ventilation.
7. Which device is most appropriate for providing initial PPV in most
newborns?
A. Endotracheal tube
B. Nasal cannula
C. Bag-mask device
D. Non-rebreather mask
Answer: C
Rationale: A bag-mask device is commonly used for initial
positive pressure ventilation.
8. What is the most important initial step immediately after birth?
A. Intubation
B. Drying and stimulation
C. Chest compressions
D. Oxygen administration
Answer: B
Rationale: Initial steps include drying, warming, positioning, and
stimulating the newborn.
9. A newborn has meconium-stained fluid and is vigorous at birth.
What is the next step?
A. Immediate intubation
B. Suction below cords