NEONATAL RESUSCITATION PROGRAM (NRP) EXAM
PREDICTION 2026 EDITION Q&A
A term newborn is born through meconium-stained amniotic fluid. The
baby is limp, apneic, and has a heart rate of 80 bpm. What is the most
appropriate next step in management?
A. Suction the trachea immediately using an endotracheal tube
B. Begin positive pressure ventilation (PPV) immediately
C. Administer intravenous epinephrine right away
D. Perform chest compressions before any ventilation
Correct Answer: B
Explanation: According to NRP 8th edition guidelines, routine tracheal
suctioning for meconium-stained infants is no longer recommended. If
the baby is not vigorous (apneic, limp, HR <100), the priority is to begin
PPV immediately. Suctioning delays ventilation and can worsen
bradycardia.
What is the recommended initial oxygen concentration for resuscitating
a term newborn at birth?
A. 100% oxygen
B. 50% oxygen
C. 21% oxygen (room air)
D. 30% oxygen
Correct Answer: C
Explanation: NRP 8th edition recommends starting term and late
preterm newborns (≥35 weeks) with 21% oxygen (room air). Oxygen
should be titrated based on preductal pulse oximetry targets. Starting
,with 100% oxygen is no longer recommended due to oxidative stress
concerns.
A preterm infant born at 28 weeks gestation requires resuscitation.
What is the most critical intervention to prevent hypothermia during
resuscitation?
A. Place the infant under a preheated radiant warmer only
B. Wrap the infant in a plastic bag or wrap up to the neck without drying
C. Dry the infant thoroughly and place under warming lights
D. Use a thermal mattress alone without additional warming
Correct Answer: B
Explanation: For infants <32 weeks gestation, NRP guidelines
recommend placing the infant in a plastic bag or wrap up to the neck
without drying to prevent evaporative heat loss, while also using a
preheated radiant warmer and thermal mattress. This significantly
reduces hypothermia risk.
What is the正确 (correct) ratio of chest compressions to ventilations
during neonatal resuscitation?
A. 3:1 (3 compressions to 1 breath)
B. 15:2 (15 compressions to 2 breaths)
C. 30:2 (30 compressions to 2 breaths)
D. 5:1 (5 compressions to 1 breath)
Correct Answer: A
Explanation: NRP recommends a 3:1 ratio (90 compressions and 30
breaths per minute) for neonatal resuscitation when the heart rate
,remains <60 bpm despite effective ventilation. This ratio optimizes
coronary perfusion while maintaining adequate oxygenation.
During resuscitation, a newborn's heart rate remains at 50 bpm after 60
seconds of effective positive pressure ventilation and chest
compressions. What is the next appropriate step?
A. Continue chest compressions for another 60 seconds
B. Administer intravenous epinephrine
C. Increase the oxygen concentration to 100%
D. Administer a volume expander immediately
Correct Answer: B
Explanation: When heart rate remains <60 bpm after 60 seconds of
effective PPV and chest compressions, epinephrine should be
administered. The recommended IV dose is 0.01-0.03 mg/kg (0.1-0.3
mL/kg of 1:10,000 concentration).
What is the preferred method for assessing heart rate during neonatal
resuscitation when chest compressions are being performed?
A. Palpating the umbilical cord
B. Auscultating the precordium with a stethoscope
C. Using a 3-lead ECG cardiac monitor
D. Feeling the femoral pulse
Correct Answer: C
Explanation: NRP 8th edition recommends using a 3-lead ECG cardiac
monitor for heart rate assessment during resuscitation, especially when
chest compressions are needed, as it provides the most accurate and
rapid heart rate detection. Auscultation is secondary.
, What is the recommended depth of chest compressions in a newborn?
A. At least one-third the anterior-posterior diameter of the chest
(approximately 4 cm)
B. Exactly 2 cm deep
C. One-half the anterior-posterior diameter of the chest
D. Shallow compressions that barely depress the sternum
Correct Answer: A
Explanation: NRP guidelines specify compressing at least one-third the
AP diameter of the chest (approximately 4 cm in most newborns) to
achieve adequate circulation while minimizing injury risk.
A newborn is born at 36 weeks gestation. The baby is breathing, has
good tone, but the heart rate is 90 bpm. What is the most appropriate
intervention?
A. Immediate intubation
B. Start chest compressions
C. Provide positive pressure ventilation
D. Continue monitoring and provide warmth
Correct Answer: C
Explanation: For a newborn with heart rate <100 bpm despite
spontaneous breathing, positive pressure ventilation is indicated to
improve oxygenation and increase heart rate. Chest compressions are
only started if HR remains <60 bpm after effective PPV.
What is the recommended initial dose of IV epinephrine during
neonatal resuscitation?
PREDICTION 2026 EDITION Q&A
A term newborn is born through meconium-stained amniotic fluid. The
baby is limp, apneic, and has a heart rate of 80 bpm. What is the most
appropriate next step in management?
A. Suction the trachea immediately using an endotracheal tube
B. Begin positive pressure ventilation (PPV) immediately
C. Administer intravenous epinephrine right away
D. Perform chest compressions before any ventilation
Correct Answer: B
Explanation: According to NRP 8th edition guidelines, routine tracheal
suctioning for meconium-stained infants is no longer recommended. If
the baby is not vigorous (apneic, limp, HR <100), the priority is to begin
PPV immediately. Suctioning delays ventilation and can worsen
bradycardia.
What is the recommended initial oxygen concentration for resuscitating
a term newborn at birth?
A. 100% oxygen
B. 50% oxygen
C. 21% oxygen (room air)
D. 30% oxygen
Correct Answer: C
Explanation: NRP 8th edition recommends starting term and late
preterm newborns (≥35 weeks) with 21% oxygen (room air). Oxygen
should be titrated based on preductal pulse oximetry targets. Starting
,with 100% oxygen is no longer recommended due to oxidative stress
concerns.
A preterm infant born at 28 weeks gestation requires resuscitation.
What is the most critical intervention to prevent hypothermia during
resuscitation?
A. Place the infant under a preheated radiant warmer only
B. Wrap the infant in a plastic bag or wrap up to the neck without drying
C. Dry the infant thoroughly and place under warming lights
D. Use a thermal mattress alone without additional warming
Correct Answer: B
Explanation: For infants <32 weeks gestation, NRP guidelines
recommend placing the infant in a plastic bag or wrap up to the neck
without drying to prevent evaporative heat loss, while also using a
preheated radiant warmer and thermal mattress. This significantly
reduces hypothermia risk.
What is the正确 (correct) ratio of chest compressions to ventilations
during neonatal resuscitation?
A. 3:1 (3 compressions to 1 breath)
B. 15:2 (15 compressions to 2 breaths)
C. 30:2 (30 compressions to 2 breaths)
D. 5:1 (5 compressions to 1 breath)
Correct Answer: A
Explanation: NRP recommends a 3:1 ratio (90 compressions and 30
breaths per minute) for neonatal resuscitation when the heart rate
,remains <60 bpm despite effective ventilation. This ratio optimizes
coronary perfusion while maintaining adequate oxygenation.
During resuscitation, a newborn's heart rate remains at 50 bpm after 60
seconds of effective positive pressure ventilation and chest
compressions. What is the next appropriate step?
A. Continue chest compressions for another 60 seconds
B. Administer intravenous epinephrine
C. Increase the oxygen concentration to 100%
D. Administer a volume expander immediately
Correct Answer: B
Explanation: When heart rate remains <60 bpm after 60 seconds of
effective PPV and chest compressions, epinephrine should be
administered. The recommended IV dose is 0.01-0.03 mg/kg (0.1-0.3
mL/kg of 1:10,000 concentration).
What is the preferred method for assessing heart rate during neonatal
resuscitation when chest compressions are being performed?
A. Palpating the umbilical cord
B. Auscultating the precordium with a stethoscope
C. Using a 3-lead ECG cardiac monitor
D. Feeling the femoral pulse
Correct Answer: C
Explanation: NRP 8th edition recommends using a 3-lead ECG cardiac
monitor for heart rate assessment during resuscitation, especially when
chest compressions are needed, as it provides the most accurate and
rapid heart rate detection. Auscultation is secondary.
, What is the recommended depth of chest compressions in a newborn?
A. At least one-third the anterior-posterior diameter of the chest
(approximately 4 cm)
B. Exactly 2 cm deep
C. One-half the anterior-posterior diameter of the chest
D. Shallow compressions that barely depress the sternum
Correct Answer: A
Explanation: NRP guidelines specify compressing at least one-third the
AP diameter of the chest (approximately 4 cm in most newborns) to
achieve adequate circulation while minimizing injury risk.
A newborn is born at 36 weeks gestation. The baby is breathing, has
good tone, but the heart rate is 90 bpm. What is the most appropriate
intervention?
A. Immediate intubation
B. Start chest compressions
C. Provide positive pressure ventilation
D. Continue monitoring and provide warmth
Correct Answer: C
Explanation: For a newborn with heart rate <100 bpm despite
spontaneous breathing, positive pressure ventilation is indicated to
improve oxygenation and increase heart rate. Chest compressions are
only started if HR remains <60 bpm after effective PPV.
What is the recommended initial dose of IV epinephrine during
neonatal resuscitation?
