NRP 8TH EDITION QUIZ ANSWERS PART 1 2026/2027
Actual Exam – Complete Questions & Detailed
Rationales – Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Initial Steps of Newborn Resuscitation | Q1 – Q10
Section 2 | Positive Pressure Ventilation | Q11 – Q20
Section 3 | Endotracheal Intubation & Airway Devices | Q21 – Q30
Section 4 | Chest Compressions & Medications | Q31 – Q40
Section 5 | Special Situations & Post-Resuscitation Care | Q41 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
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SECTION 1: INITIAL STEPS OF NEWBORN RESUSCITATION Q1 – Q10
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Question 1 of 50
A 38-week gestation infant is born via spontaneous vaginal delivery to a mother with no
risk factors. The neonate is placed skin-to-skin and begins to cry vigorously at 15
seconds of life. The nurse notes the infant is pink with good tone and a heart rate of 150
bpm. What is the most appropriate next step in management?
A. Clamp the cord immediately and move the infant to the radiant warmer
B. Perform routine suctioning of the mouth and nose with a bulb syringe
C. Allow the infant to remain on the mother's chest and continue routine newborn care
D. Begin intermittent positive pressure ventilation with a bag and mask
C ✓ CORRECT
Correct Answer: C
Rationale: The NRP algorithm classifies this infant as vigorous with normal respirations,
good tone, and a heart rate greater than 100 bpm, so routine newborn care is
,appropriate without intervention. Option A is incorrect because delayed cord clamping
is recommended for vigorous infants, and moving the infant away from the mother is
unnecessary. The NRP 8th edition emphasizes supporting physiologic transition and
keeping mother and infant together when no resuscitation is needed.
Question 2 of 50
A term infant is delivered precipitously in the emergency department. The infant is limp,
apneic, and pale with a heart rate of 80 bpm. The team has completed the initial steps
of drying, positioning, clearing the airway, and stimulating. The heart rate remains 80
bpm. What is the most appropriate immediate action?
A. Begin chest compressions at a ratio of 3:1
B. Initiate positive pressure ventilation with room air
C. Administer intravenous epinephrine at 0.1 mL/kg of 1:10,000
D. Continue tactile stimulation for an additional 30 seconds
B ✓ CORRECT
Correct Answer: B
Rationale: An apneic or gasping infant with a heart rate below 100 bpm after initial
steps requires immediate positive pressure ventilation, which is the most important and
effective intervention in neonatal resuscitation. Option A is incorrect because chest
compressions are only indicated if the heart rate remains below 60 bpm after 30
seconds of effective ventilation. The NRP algorithm prioritizes ventilation before
compressions or medications.
Question 3 of 50
During a delivery room resuscitation of a 34-week preterm infant, the team has dried
and positioned the infant, suctioned the mouth and nose, and provided gentle tactile
,stimulation. The infant remains apneic with a heart rate of 90 bpm. Which initial oxygen
concentration should be used for positive pressure ventilation?
A. 21% oxygen (room air)
B. 30% oxygen
C. 60% oxygen
D. 100% oxygen
B ✓ CORRECT
Correct Answer: B
Rationale: The NRP 8th edition recommends starting positive pressure ventilation with
21% oxygen for term infants and 30% oxygen for preterm infants less than 35 weeks
gestation, then titrating based on pulse oximetry. Option A is incorrect because room air
is reserved for term infants; preterm infants have immature antioxidant defenses and
require slightly higher initial oxygen to avoid both hypoxia and hyperoxia. Pulse oximetry
should be applied within the first minute to guide oxygen titration.
Question 4 of 50
A 41-week gestation infant is born via cesarean section for nonreassuring fetal heart
tones. The infant is limp, apneic, and covered in thick meconium-stained fluid. The team
has completed initial steps including positioning and clearing the airway. The heart rate
is 70 bpm. What is the most appropriate next step?
A. Perform deep suctioning of the trachea with an endotracheal tube before any
ventilation
B. Initiate positive pressure ventilation without routine tracheal suctioning
C. Provide tactile stimulation for 60 seconds to encourage spontaneous breathing
D. Administer surfactant via endotracheal tube immediately
B ✓ CORRECT
Correct Answer: B
, Rationale: The NRP 8th edition no longer recommends routine tracheal suctioning for
nonvigorous infants with meconium-stained amniotic fluid; instead, positive pressure
ventilation should be initiated if the infant is apneic or bradycardic after initial steps.
Option A reflects an outdated practice that can cause delays in ventilation and increase
the risk of bradycardia. Effective ventilation remains the priority, and intubation should
only be performed if bag-mask ventilation is ineffective.
Question 5 of 50
A team is preparing for the delivery of a 28-week gestation infant. The mother received
a full course of antenatal steroids. What is the recommended target temperature for this
infant within the first hour after birth?
A. 36.0°C to 36.5°C
B. 36.5°C to 37.5°C
C. 37.5°C to 38.0°C
D. 38.0°C to 38.5°C
B ✓ CORRECT
Correct Answer: B
Rationale: The NRP 8th edition and neonatal thermoregulation guidelines recommend
maintaining a newborn's axillary temperature between 36.5°C and 37.5°C to reduce
morbidity and mortality, with particular attention to preterm infants who are at highest
risk for hypothermia. Option A is incorrect because temperatures below 36.5°C are
associated with increased risks of hypoglycemia, respiratory distress, and mortality. The
delivery team should use a combination of radiant warmers, plastic wrap, and warmed
humidified gases to achieve this target.
Question 6 of 50
Actual Exam – Complete Questions & Detailed
Rationales – Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Initial Steps of Newborn Resuscitation | Q1 – Q10
Section 2 | Positive Pressure Ventilation | Q11 – Q20
Section 3 | Endotracheal Intubation & Airway Devices | Q21 – Q30
Section 4 | Chest Compressions & Medications | Q31 – Q40
Section 5 | Special Situations & Post-Resuscitation Care | Q41 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
══════════════════════════════════════
SECTION 1: INITIAL STEPS OF NEWBORN RESUSCITATION Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 38-week gestation infant is born via spontaneous vaginal delivery to a mother with no
risk factors. The neonate is placed skin-to-skin and begins to cry vigorously at 15
seconds of life. The nurse notes the infant is pink with good tone and a heart rate of 150
bpm. What is the most appropriate next step in management?
A. Clamp the cord immediately and move the infant to the radiant warmer
B. Perform routine suctioning of the mouth and nose with a bulb syringe
C. Allow the infant to remain on the mother's chest and continue routine newborn care
D. Begin intermittent positive pressure ventilation with a bag and mask
C ✓ CORRECT
Correct Answer: C
Rationale: The NRP algorithm classifies this infant as vigorous with normal respirations,
good tone, and a heart rate greater than 100 bpm, so routine newborn care is
,appropriate without intervention. Option A is incorrect because delayed cord clamping
is recommended for vigorous infants, and moving the infant away from the mother is
unnecessary. The NRP 8th edition emphasizes supporting physiologic transition and
keeping mother and infant together when no resuscitation is needed.
Question 2 of 50
A term infant is delivered precipitously in the emergency department. The infant is limp,
apneic, and pale with a heart rate of 80 bpm. The team has completed the initial steps
of drying, positioning, clearing the airway, and stimulating. The heart rate remains 80
bpm. What is the most appropriate immediate action?
A. Begin chest compressions at a ratio of 3:1
B. Initiate positive pressure ventilation with room air
C. Administer intravenous epinephrine at 0.1 mL/kg of 1:10,000
D. Continue tactile stimulation for an additional 30 seconds
B ✓ CORRECT
Correct Answer: B
Rationale: An apneic or gasping infant with a heart rate below 100 bpm after initial
steps requires immediate positive pressure ventilation, which is the most important and
effective intervention in neonatal resuscitation. Option A is incorrect because chest
compressions are only indicated if the heart rate remains below 60 bpm after 30
seconds of effective ventilation. The NRP algorithm prioritizes ventilation before
compressions or medications.
Question 3 of 50
During a delivery room resuscitation of a 34-week preterm infant, the team has dried
and positioned the infant, suctioned the mouth and nose, and provided gentle tactile
,stimulation. The infant remains apneic with a heart rate of 90 bpm. Which initial oxygen
concentration should be used for positive pressure ventilation?
A. 21% oxygen (room air)
B. 30% oxygen
C. 60% oxygen
D. 100% oxygen
B ✓ CORRECT
Correct Answer: B
Rationale: The NRP 8th edition recommends starting positive pressure ventilation with
21% oxygen for term infants and 30% oxygen for preterm infants less than 35 weeks
gestation, then titrating based on pulse oximetry. Option A is incorrect because room air
is reserved for term infants; preterm infants have immature antioxidant defenses and
require slightly higher initial oxygen to avoid both hypoxia and hyperoxia. Pulse oximetry
should be applied within the first minute to guide oxygen titration.
Question 4 of 50
A 41-week gestation infant is born via cesarean section for nonreassuring fetal heart
tones. The infant is limp, apneic, and covered in thick meconium-stained fluid. The team
has completed initial steps including positioning and clearing the airway. The heart rate
is 70 bpm. What is the most appropriate next step?
A. Perform deep suctioning of the trachea with an endotracheal tube before any
ventilation
B. Initiate positive pressure ventilation without routine tracheal suctioning
C. Provide tactile stimulation for 60 seconds to encourage spontaneous breathing
D. Administer surfactant via endotracheal tube immediately
B ✓ CORRECT
Correct Answer: B
, Rationale: The NRP 8th edition no longer recommends routine tracheal suctioning for
nonvigorous infants with meconium-stained amniotic fluid; instead, positive pressure
ventilation should be initiated if the infant is apneic or bradycardic after initial steps.
Option A reflects an outdated practice that can cause delays in ventilation and increase
the risk of bradycardia. Effective ventilation remains the priority, and intubation should
only be performed if bag-mask ventilation is ineffective.
Question 5 of 50
A team is preparing for the delivery of a 28-week gestation infant. The mother received
a full course of antenatal steroids. What is the recommended target temperature for this
infant within the first hour after birth?
A. 36.0°C to 36.5°C
B. 36.5°C to 37.5°C
C. 37.5°C to 38.0°C
D. 38.0°C to 38.5°C
B ✓ CORRECT
Correct Answer: B
Rationale: The NRP 8th edition and neonatal thermoregulation guidelines recommend
maintaining a newborn's axillary temperature between 36.5°C and 37.5°C to reduce
morbidity and mortality, with particular attention to preterm infants who are at highest
risk for hypothermia. Option A is incorrect because temperatures below 36.5°C are
associated with increased risks of hypoglycemia, respiratory distress, and mortality. The
delivery team should use a combination of radiant warmers, plastic wrap, and warmed
humidified gases to achieve this target.
Question 6 of 50
