NRP 8th Edition Questions and Answers
(2024/2025)(Verified Answers)
1. Rapid evaluation
Determines if the baby can stay with the mother for routine care or should be brought to the radiant
warmer
2. Airway
The initial steps open the airway and support spontaneous respiration
3. Breathing
Assist breathing with positive pressure ventilation if the baby is apneic, gasping, or bradycardic. CPAP
or oxygen may be appropriate for labored breathing or low oxygen sats
4. circulation
perform chest compressions coordinated with PPV if severe bradycardia persists despite effective
assisted ventilation
5. Drug
Administer epinephrine if severe bradycardia persists despite PPV and coordinated chest
compressions
What type of shunting occurs before birth?
right to left
What are the alveoli expanded and filled with before birth?
fluid
What does the placenta supply before birth?
oxygen and carries out CO2 (removed by mother's lungs
Where does the most highly oxygenated blood go in the fetus?
the brain and heart
What are the pulmonary vessels that will carry blood to the alveoli like after birth?
tightly constricted
Pulmonary resistance is (high/low) in the fetal lungs.
high
What does the first breath of air (oxygen 21%) allow the lungs to do?
relax and dilate the pulmonary blood vessels
As blood flows to the lungs and the baby's o2 level increases, what occurs in the heart?
, 2 openings in the heart used for fetal circulation start to close and the blood can flow from the right
side into the lungs (the right to left shunting gradually resolves)
Where can the oxygenated blood from the baby's lungs flow once the right to left shunting resolves?
to the left side of the heart
What does assessing perinatal right before birth help to identify?
which newborns are likely to require resuscitation
What are the 4 pre-birth questions to determine if you have assembled the necessary personnel and
equipment?
- expected gestational age
- amniotic fluid color
- additional risk factors
- umbilical cord management plan
What are the perinatal risk factors?
- gestational age less than 36 0/7 weeks
- gestational age greater than or equal to 41 0/7 weeks
- preeclampsia or eclampsia
- maternal hypertension
- multiple gestation
- fetal anemia
- polyhydramnios
- fetal hydrops
- fetal macrosomia
- intrauterine growth restriction
- significant fetal malformations or anomalies
- no prenatal care
- emergency C section delivery
- forceps or vacuum-assisted delivery
- breech or abnormal presentation
- category II or III fetal heart rate pattern
- maternal general anesthesia
- maternal magnesium therapy
- placental abruption
- intrapartum bleeding
- chorioamnionitis
- opioids administered to mother within 4 hours of delivery
- shoulder dystocia
- meconium-stained amniotic fluid
- prolapsed umbilical cord
Who should attend every birth?
at least 1 qualified person skilled in the initial steps of newborn care and positive pressure ventilation
whose only responsibility is management of the baby
Who should attend the birth if risk factors are present?
at least 2 qualified people to solely manage the baby
(2024/2025)(Verified Answers)
1. Rapid evaluation
Determines if the baby can stay with the mother for routine care or should be brought to the radiant
warmer
2. Airway
The initial steps open the airway and support spontaneous respiration
3. Breathing
Assist breathing with positive pressure ventilation if the baby is apneic, gasping, or bradycardic. CPAP
or oxygen may be appropriate for labored breathing or low oxygen sats
4. circulation
perform chest compressions coordinated with PPV if severe bradycardia persists despite effective
assisted ventilation
5. Drug
Administer epinephrine if severe bradycardia persists despite PPV and coordinated chest
compressions
What type of shunting occurs before birth?
right to left
What are the alveoli expanded and filled with before birth?
fluid
What does the placenta supply before birth?
oxygen and carries out CO2 (removed by mother's lungs
Where does the most highly oxygenated blood go in the fetus?
the brain and heart
What are the pulmonary vessels that will carry blood to the alveoli like after birth?
tightly constricted
Pulmonary resistance is (high/low) in the fetal lungs.
high
What does the first breath of air (oxygen 21%) allow the lungs to do?
relax and dilate the pulmonary blood vessels
As blood flows to the lungs and the baby's o2 level increases, what occurs in the heart?
, 2 openings in the heart used for fetal circulation start to close and the blood can flow from the right
side into the lungs (the right to left shunting gradually resolves)
Where can the oxygenated blood from the baby's lungs flow once the right to left shunting resolves?
to the left side of the heart
What does assessing perinatal right before birth help to identify?
which newborns are likely to require resuscitation
What are the 4 pre-birth questions to determine if you have assembled the necessary personnel and
equipment?
- expected gestational age
- amniotic fluid color
- additional risk factors
- umbilical cord management plan
What are the perinatal risk factors?
- gestational age less than 36 0/7 weeks
- gestational age greater than or equal to 41 0/7 weeks
- preeclampsia or eclampsia
- maternal hypertension
- multiple gestation
- fetal anemia
- polyhydramnios
- fetal hydrops
- fetal macrosomia
- intrauterine growth restriction
- significant fetal malformations or anomalies
- no prenatal care
- emergency C section delivery
- forceps or vacuum-assisted delivery
- breech or abnormal presentation
- category II or III fetal heart rate pattern
- maternal general anesthesia
- maternal magnesium therapy
- placental abruption
- intrapartum bleeding
- chorioamnionitis
- opioids administered to mother within 4 hours of delivery
- shoulder dystocia
- meconium-stained amniotic fluid
- prolapsed umbilical cord
Who should attend every birth?
at least 1 qualified person skilled in the initial steps of newborn care and positive pressure ventilation
whose only responsibility is management of the baby
Who should attend the birth if risk factors are present?
at least 2 qualified people to solely manage the baby
