NRP 7TH EDITION
You have been called to attend a birth and are the only healthcare provider responsible for the
management of the newborn in the room. When should you first call for additional help?
Before birth, when you have identified the presence of a perinatal risk factor that increases the
likelihood of requiring neonatal resuscitation.
After birth, when you determine the baby requires positive-pressure ventilation.
After birth, when the obstetrician or labor nurse suggests you need additional help.
After birth, when you determine the baby requires intubation. ans: Before birth, when you have
identified the presence of a perinatal risk factor that increases the likelihood of requiring neonatal
resuscitation.
You are called to attend to a newborn at birth. At the time the baby is delivered, which 3 questions
should you ask to evaluate whether the baby can stay with his mother or be moved to the radiant
warmer for further assessment?
Is the baby pink? Is the baby breathing or crying? Is the amniotic fluid clear?
Is the amniotic fluid clear? Is the baby breathing or crying? Is the baby of low birth weight?
Is the baby warm? Does the baby have good tone? Is the baby full-term?
Is the baby term? Does the baby have good muscle tone? Is the baby breathing or crying? ans: Is the
baby term? Does the baby have good muscle tone? Is the baby breathing or crying?
What size laryngoscope blade should be used to intubate a newborn with an estimated gestational age
of 30 weeks (estimated birth weight of 1,200 g)?
2
00
0
1 ans: 0
Which statement best describes normal transitional physiology at the time of birth?
Babies may take as long as 10 minutes after birth to increase their oxygen saturation to greater than
90%.
Visual assessment of cyanosis is a reliable indicator of the baby's oxygen saturation.
The oxygen saturation normally rises to at least 90% by 2 minutes of age.
Oxygen saturation by pulse oximetry is unreliable in the newborn, and 100% oxygen is recommended
immediately after birth. ans: Babies may take as long as 10 minutes after birth to increase their oxygen
saturation to greater than 90%.
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?
, Attempt endotracheal intubation multiple times
Insert a laryngeal mask
Administer CPAP
Place an orogastic tube ans: Insert a laryngeal mask
Four pre-birth questions should be asked to assess perinatal risk and determine who should be present
at the birth. Which is one of the questions?
Is this her first baby?
Are membranes ruptured?
What is the estimated fetal weight?
What is the gestational age? ans: What is the gestational age?
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?
Provide positive-pressure ventilation
Provide free-flow oxygen
Provide chest compressions
Apply CPAP ans: Provide positive-pressure ventilation
What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after
initial steps?
Continued rubbing of the back
Administration of positive-pressure ventilation that inflates the lungs
Administration of free-flow oxygen
Application of CPAP ans: Administration of positive-pressure ventilation that inflates the lungs
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?
60 beats per minute
30 beats per minute
100 beats per minute
120 beats per minute ans: 100 beats per minute
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?
Immediately intubate and suction the trachea
Start positive-pressure ventilation and check heart rate response after 15 seconds
You have been called to attend a birth and are the only healthcare provider responsible for the
management of the newborn in the room. When should you first call for additional help?
Before birth, when you have identified the presence of a perinatal risk factor that increases the
likelihood of requiring neonatal resuscitation.
After birth, when you determine the baby requires positive-pressure ventilation.
After birth, when the obstetrician or labor nurse suggests you need additional help.
After birth, when you determine the baby requires intubation. ans: Before birth, when you have
identified the presence of a perinatal risk factor that increases the likelihood of requiring neonatal
resuscitation.
You are called to attend to a newborn at birth. At the time the baby is delivered, which 3 questions
should you ask to evaluate whether the baby can stay with his mother or be moved to the radiant
warmer for further assessment?
Is the baby pink? Is the baby breathing or crying? Is the amniotic fluid clear?
Is the amniotic fluid clear? Is the baby breathing or crying? Is the baby of low birth weight?
Is the baby warm? Does the baby have good tone? Is the baby full-term?
Is the baby term? Does the baby have good muscle tone? Is the baby breathing or crying? ans: Is the
baby term? Does the baby have good muscle tone? Is the baby breathing or crying?
What size laryngoscope blade should be used to intubate a newborn with an estimated gestational age
of 30 weeks (estimated birth weight of 1,200 g)?
2
00
0
1 ans: 0
Which statement best describes normal transitional physiology at the time of birth?
Babies may take as long as 10 minutes after birth to increase their oxygen saturation to greater than
90%.
Visual assessment of cyanosis is a reliable indicator of the baby's oxygen saturation.
The oxygen saturation normally rises to at least 90% by 2 minutes of age.
Oxygen saturation by pulse oximetry is unreliable in the newborn, and 100% oxygen is recommended
immediately after birth. ans: Babies may take as long as 10 minutes after birth to increase their oxygen
saturation to greater than 90%.
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?
, Attempt endotracheal intubation multiple times
Insert a laryngeal mask
Administer CPAP
Place an orogastic tube ans: Insert a laryngeal mask
Four pre-birth questions should be asked to assess perinatal risk and determine who should be present
at the birth. Which is one of the questions?
Is this her first baby?
Are membranes ruptured?
What is the estimated fetal weight?
What is the gestational age? ans: What is the gestational age?
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?
Provide positive-pressure ventilation
Provide free-flow oxygen
Provide chest compressions
Apply CPAP ans: Provide positive-pressure ventilation
What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after
initial steps?
Continued rubbing of the back
Administration of positive-pressure ventilation that inflates the lungs
Administration of free-flow oxygen
Application of CPAP ans: Administration of positive-pressure ventilation that inflates the lungs
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?
60 beats per minute
30 beats per minute
100 beats per minute
120 beats per minute ans: 100 beats per minute
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?
Immediately intubate and suction the trachea
Start positive-pressure ventilation and check heart rate response after 15 seconds
