CPR Neonatal Resuscitation

Question 1

According to the Neonatal Resuscitation Program (NRP), what is the first step when a newborn is delivered?

Accepted Answer

Provide warmth, dry and stimulate, position and clear airway if needed, and assess the newborn's condition

Answer

Immediately clamp and cut the umbilical cord

Answer

Begin chest compressions

Answer

Administer epinephrine

Question 2

At what heart rate threshold does the NRP recommend initiating positive-pressure ventilation (PPV) in a newborn?

Accepted Answer

Below 100 beats per minute with labored breathing or apnea

Answer

Below 60 beats per minute

Answer

Below 80 beats per minute

Answer

Below 120 beats per minute

Question 3

What is the recommended initial oxygen concentration for PPV in term (≥37 weeks) newborns during resuscitation?

Accepted Answer

21% oxygen (room air)

Answer

100% oxygen

Answer

40% oxygen

Answer

60% oxygen

Question 4

What is the recommended compression-to-ventilation ratio for neonatal CPR?

Accepted Answer

3:1 (90 compressions and 30 breaths per minute)

Answer

30:2

Answer

15:2

Answer

5:1

Question 5

When should chest compressions be initiated in neonatal resuscitation?

Accepted Answer

When the heart rate remains below 60 bpm despite 30 seconds of adequate PPV

Answer

When the heart rate is below 100 bpm

Answer

Immediately upon birth if the Apgar score is low

Answer

When cyanosis is present

Question 6

What is the APGAR score and what does it assess in newborns?

Accepted Answer

It is a 5-category scoring system (Appearance, Pulse, Grimace, Activity, Respiration) scored at 1 and 5 minutes of life

Answer

It measures blood glucose, pH, and oxygen levels in newborns

Answer

It predicts long-term neurological outcome with accuracy

Answer

It is used to determine when to start or stop neonatal resuscitation

Question 7

In NRP, what is meant by the 'Golden Minute'?

Accepted Answer

The first 60 seconds after birth in which initial assessment and PPV (if needed) should be completed

Answer

The first minute of life, during which the Apgar score determines treatment

Answer

The 1-minute window for umbilical cord clamping

Answer

The time from birth to delivery of the first medication

Question 8

What is the preferred technique for neonatal chest compressions according to current NRP guidelines?

Accepted Answer

Two-thumb encircling technique with hands encircling the chest

Answer

Two-finger technique using index and middle fingers

Answer

Heel of one hand on the sternum

Answer

Fist compression technique

Question 9

What is the first-line medication for persistent bradycardia in neonatal resuscitation despite effective PPV and compressions?

Accepted Answer

Epinephrine 0.01-0.03 mg/kg IV/IO (1:10,000 solution)

Answer

Atropine 0.02 mg/kg IV

Answer

Sodium bicarbonate 2 mEq/kg IV

Answer

Adenosine 0.1 mg/kg IV

Question 10

What special resuscitation consideration applies to meconium-stained amniotic fluid when the newborn is born vigorous?

Accepted Answer

Routine initial steps without routine tracheal suctioning; only suction the trachea if the newborn is non-vigorous and has airway obstruction

Answer

Immediate deep tracheal suctioning regardless of newborn's condition

Answer

Administer antibiotics immediately

Answer

Delay resuscitation until meconium is cleared