NEW UPDATE QUESTION AND ANSWERS NRP 7TH EDITION
PART 1 SECTION 1 (2022)
A baby is born at term with a bilateral cleft lip and palate and a very small mandible. She requires
positive-pressure ventilation because she is not breathing. You are unable to achieve a seal with bag and
mask. Which intervention is indicated?
- CORRECT ANSWER Insert a laryngeal mask
You are at the resuscitation of a newborn who is gasping and has a heart rate of 60 beats per minute.
What is the most important action you can take?
- CORRECT ANSWER Provide positive-pressure ventilation
What size (internal diameter) endotracheal tube should be used to intubate a newborn with an
estimated gestational age of 26 weeks (estimated birth weight of 800 g)?
- CORRECT ANSWER 2.5 mm
Your team attends an emergency cesarean delivery of a term baby because of chorioamnionitis,
meconium-stained amniotic fluid, and fetal heart rate decelerations. At delivery, the newborn is term as
expected, with very poor tone and he is not breathing (apneic). You quickly perform initial steps, but the
newborn is still not breathing. What is the most appropriate next step of resuscitation?
- CORRECT ANSWER Start positive-pressure ventilation and check heart rate response after 15 seconds
During the resuscitation of a newborn, you auscultate the apical pulse and count 10 beats over a 6
second period. What heart rate do you report to your team?
- CORRECT ANSWER 100 beats per minute
You are part of a team preparing for the birth of a baby who has meconium-stained fluid and a category
III fetal heart rate tracing. A person skilled in endotracheal intubation should be
- CORRECT ANSWER Present at the birth.
You are at a delivery of a baby born through meconium-stained amniotic fluid, and the baby is not
vigorous. What steps should be taken immediately after birth? - CORRECT ANSWER The baby should be
brought to the radiant warmer for initial steps of newborn care.
, What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after
initial steps?
- CORRECT ANSWER Administration of positive-pressure ventilation that inflates the lungs
A newborn of 34 weeks' gestation is not breathing (apneic) at birth, does not respond to initial steps and
requires positive-pressure ventilation. What concentration of oxygen should be used as you begin
positive-pressure ventilation?
- CORRECT ANSWER 21 - 30% oxygen
You have started positive-pressure ventilation for a newborn because her heart rate is low
(bradycardia). What is the most important indicator of successful positive-pressure ventilation?
- CORRECT ANSWER A rising heart rate
A baby requires positive-pressure ventilation because she is not breathing (apneic), but she soon
establishes spontaneous respirations and a heart rate over 100 beats per minute. Her oxygen saturation
is lower than the target level when in room air, so you provide free-flow oxygen. Which of the following
devices cannot reliably deliver free-flow oxygen?
- CORRECT ANSWER Mask of self-inflating bag
Which statement best describes normal transitional physiology at the time of birth?
- CORRECT ANSWER Babies may take as long as 10 minutes after birth to increase their oxygen
saturation to greater than 90%.
A baby is born at 34 weeks' gestation. After the initial steps of resuscitation, the baby is not breathing
(apneic). What are the next steps?
- CORRECT ANSWER Initiative positive-pressure ventilation, place a pulse oximeter sensor on the right
hand or wrist, evaluate heart rate.
A full-term baby is born by emergency cesarean delivery because of fetal bradycardia (Category III fetal
heart rate tracing). The baby is limp and not breathing after initial steps. What is the next step in the
resuscitation process?
- CORRECT ANSWER Initiate positive-pressure ventilation and check for increasing heart rate
PART 1 SECTION 1 (2022)
A baby is born at term with a bilateral cleft lip and palate and a very small mandible. She requires
positive-pressure ventilation because she is not breathing. You are unable to achieve a seal with bag and
mask. Which intervention is indicated?
- CORRECT ANSWER Insert a laryngeal mask
You are at the resuscitation of a newborn who is gasping and has a heart rate of 60 beats per minute.
What is the most important action you can take?
- CORRECT ANSWER Provide positive-pressure ventilation
What size (internal diameter) endotracheal tube should be used to intubate a newborn with an
estimated gestational age of 26 weeks (estimated birth weight of 800 g)?
- CORRECT ANSWER 2.5 mm
Your team attends an emergency cesarean delivery of a term baby because of chorioamnionitis,
meconium-stained amniotic fluid, and fetal heart rate decelerations. At delivery, the newborn is term as
expected, with very poor tone and he is not breathing (apneic). You quickly perform initial steps, but the
newborn is still not breathing. What is the most appropriate next step of resuscitation?
- CORRECT ANSWER Start positive-pressure ventilation and check heart rate response after 15 seconds
During the resuscitation of a newborn, you auscultate the apical pulse and count 10 beats over a 6
second period. What heart rate do you report to your team?
- CORRECT ANSWER 100 beats per minute
You are part of a team preparing for the birth of a baby who has meconium-stained fluid and a category
III fetal heart rate tracing. A person skilled in endotracheal intubation should be
- CORRECT ANSWER Present at the birth.
You are at a delivery of a baby born through meconium-stained amniotic fluid, and the baby is not
vigorous. What steps should be taken immediately after birth? - CORRECT ANSWER The baby should be
brought to the radiant warmer for initial steps of newborn care.
, What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after
initial steps?
- CORRECT ANSWER Administration of positive-pressure ventilation that inflates the lungs
A newborn of 34 weeks' gestation is not breathing (apneic) at birth, does not respond to initial steps and
requires positive-pressure ventilation. What concentration of oxygen should be used as you begin
positive-pressure ventilation?
- CORRECT ANSWER 21 - 30% oxygen
You have started positive-pressure ventilation for a newborn because her heart rate is low
(bradycardia). What is the most important indicator of successful positive-pressure ventilation?
- CORRECT ANSWER A rising heart rate
A baby requires positive-pressure ventilation because she is not breathing (apneic), but she soon
establishes spontaneous respirations and a heart rate over 100 beats per minute. Her oxygen saturation
is lower than the target level when in room air, so you provide free-flow oxygen. Which of the following
devices cannot reliably deliver free-flow oxygen?
- CORRECT ANSWER Mask of self-inflating bag
Which statement best describes normal transitional physiology at the time of birth?
- CORRECT ANSWER Babies may take as long as 10 minutes after birth to increase their oxygen
saturation to greater than 90%.
A baby is born at 34 weeks' gestation. After the initial steps of resuscitation, the baby is not breathing
(apneic). What are the next steps?
- CORRECT ANSWER Initiative positive-pressure ventilation, place a pulse oximeter sensor on the right
hand or wrist, evaluate heart rate.
A full-term baby is born by emergency cesarean delivery because of fetal bradycardia (Category III fetal
heart rate tracing). The baby is limp and not breathing after initial steps. What is the next step in the
resuscitation process?
- CORRECT ANSWER Initiate positive-pressure ventilation and check for increasing heart rate
