NRP Ethical Considerations in Neonatal Resuscitation 2

Question 1

According to NRP guidelines, when is it appropriate to withhold resuscitation in the delivery room?

Accepted Answer

When gestational age is confirmed at less than 22 weeks or birth weight is less than 400g

Answer

When the family requests it regardless of gestational age

Answer

When the infant appears cyanotic at birth

Answer

When the obstetrician recommends withholding resuscitation

Question 2

What does the NRP recommend regarding informed consent for resuscitation in the delivery room?

Accepted Answer

Consent is implied in emergency situations; prenatal counseling when possible is preferred

Answer

Written consent must be obtained from parents before every delivery room resuscitation

Answer

Consent is only required for extremely preterm infants

Answer

Consent is required only when stopping resuscitation, not for starting it

Question 3

Which gestational age range is considered a 'gray zone' requiring individualized decision-making according to NRP?

Accepted Answer

22–25 weeks

Answer

20–22 weeks

Answer

25–28 weeks

Answer

28–30 weeks

Question 4

When should a resuscitation team consider discontinuing resuscitative efforts in a newborn?

Accepted Answer

If there is no detectable heart rate after 10 minutes of complete and adequate resuscitation

Answer

After 5 minutes of unsuccessful resuscitation regardless of cause

Answer

As soon as the heart rate falls below 60 bpm despite resuscitation

Answer

After the first round of epinephrine fails to restore circulation

Question 5

In the context of neonatal resuscitation, what is the principle of 'non-maleficence'?

Accepted Answer

Avoid interventions that are more likely to cause harm than benefit

Answer

Always provide the maximum level of resuscitation available

Answer

Ensure family members are present during all resuscitation efforts

Answer

Document every intervention to protect the team from liability

Question 6

How should a resuscitation team handle a situation where parents' wishes conflict with the medical team's assessment of the infant's best interest?

Accepted Answer

Engage in open communication, involve ethics consultation if needed, and seek consensus

Answer

Always defer entirely to parental wishes as they are the legal decision-makers

Answer

Proceed with full resuscitation regardless of parental wishes to avoid liability

Answer

Follow the most senior physician's recommendation without further discussion