NRP 7th Edition Exam Section 1

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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?

100 beats per min

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?

21 - 30% oxygen

The steps of intubation should ideally be completed within which duration?

30 seconds

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?

A rising heart rate

What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after initial steps?

Administration of positive-pressure ventilation that inflates the lungs

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%

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

What is the appropriate technique to stimulate a baby to breathe?

Gently rub the baby's back or extremities

A full-term baby is born in the hospital lobby. He is not breathing (apneic), despite positioning his head in sniffing position, clearing his airway, drying, and providing tactile stimulation. You have emergency equipment including a self-inflating bag. You should start positive-pressure ventilation

Immediately

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?

Initiate positive-pressure ventilation and check for increasing heart rate

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?

Initiative positive-pressure ventilation, place a pulse oximeter sensor on the right hand or wrist, evaluate heart rate

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?

Insert a laryngeal mask

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 term? Does the baby have good muscle tone? Is the baby breathing or crying?

What is the recommended way to determine if a baby requires supplemental oxygen in the delivery room?

Place an oximeter sensor on the baby's right hand or wrist and assess oxygen saturation

Statement describes recommended practice when using a pulse oximeter in the delivery room

Place the pulse oximeter sensor on the right hand and use the minute specific oxygen saturation target to guide oxygen supplementation

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

Present at birth

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

You have determined a baby needs resuscitation at birth. What are the initial steps of newborn care?

Provide warmth, position head and neck to open the airway, clear secretions from the airway if needed, dry, stimulate

Your hospital is planning Neonatal Resuscitation Program® training and trying to decide who should be included. For every delivery, what is the minimum requirement for care of the newborn at birth?

Someone capable of initiating neonatal resuscitation should be present at every delivery whose only responsibility is management of the newborn

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?

Start positive-pressure ventilation and check heart rate response after 15 seconds

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?

The baby should be brought to the radiant warmer for initial steps of newborn care

A full-term newborn has a heart rate less than 60 beats per minute despite 30 seconds of positive-pressure ventilation that moves the chest. Your team plans to intubate. Which of the following is a true statement regarding the procedure?

The baby should be positioned on a flat surface with the neck slightly extended

The following is an indication for endotracheal intubation

The need for positive-pressure ventilation lasting more than a few minutes

Effective team functioning is critical in ensuring the best performance. Which of these characteristics is critical in team leaders?

They should be able to maintain situational awareness

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?

What is the gestational age?


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