NRP Chest Compressions and Cardiac Resuscitation 2 — Questions and Answers
Question 1: How is the 3:1 compression-to-ventilation ratio delivered in practice?
- Three compressions followed by a brief pause for one ventilation, repeated continuously (Correct answer)
- Three compressions while simultaneously delivering a breath
- Three compressions, then three breaths
- Alternate compressions and ventilations every 15 seconds
Correct answer: Three compressions followed by a brief pause for one ventilation, repeated continuously
The provider performs three rapid compressions followed by a brief pause during which the ventilator delivers one effective breath.
Question 2: How often should the heart rate be assessed during chest compressions?
- Every 60 seconds (Correct answer)
- Every 15 seconds
- Every 5 minutes
- Continuously by pulse oximetry only
Correct answer: Every 60 seconds
Heart rate should be reassessed every 60 seconds during chest compressions to determine response to resuscitation.
Question 3: When should chest compressions be stopped?
- When heart rate rises above 60 bpm (Correct answer)
- When SpO₂ reaches 90%
- After epinephrine is given
- After 2 minutes regardless of response
Correct answer: When heart rate rises above 60 bpm
Chest compressions are discontinued when the heart rate rises above 60 bpm, at which point PPV alone may sustain circulation.
Question 4: What should be done if cardiac monitoring (ECG) is unavailable during compressions?
- Assess heart rate by auscultation or palpation of the umbilical pulse (Correct answer)
- Rely solely on SpO₂ trends
- Assess color and tone as surrogates
- Continue compressions for a full 5 minutes before assessing
Correct answer: Assess heart rate by auscultation or palpation of the umbilical pulse
In the absence of a cardiac monitor, heart rate can be assessed by auscultation with a stethoscope or palpation of the umbilical cord base.
Question 5: Why is an endotracheal tube preferred over a mask when chest compressions are required?
- It provides a secure airway and more reliable ventilation during coordinated compressions (Correct answer)
- It allows higher oxygen concentrations than a mask
- It prevents gastric distension better than a mask
- It is required by NRP protocol for all compressions
Correct answer: It provides a secure airway and more reliable ventilation during coordinated compressions
An ETT secures the airway, prevents mask leak, and ensures effective ventilation that is synchronized with compressions.
Question 6: What is cardiac monitoring's role during neonatal resuscitation with chest compressions?
- Provides rapid, accurate heart rate assessment to guide resuscitation decisions (Correct answer)
- Replaces the need for pulse oximetry
- Indicates when to give epinephrine based on waveform
- Is required before compressions can begin
Correct answer: Provides rapid, accurate heart rate assessment to guide resuscitation decisions
A three-lead cardiac monitor provides continuous, accurate heart rate data faster than pulse oximetry during compressions.
