NRP Study Guide 2026

Everything you need to pass the NRP exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.

📋 NRP Exam Format at a Glance

Questions

90 min

Time Limit

80%

Passing Score

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📚 NRP Topics to Study (45)

Ethical Considerations · 11 cards Medication Administration · 11 cards Thermoregulation and Temperature Management · 7 cards Thermoregulation and Temperature Management · 7 cards Thermoregulation and Temperature Management · 7 cards Airway Management and Intubation · 6 cards Airway Management and Intubation · 6 cards Airway Management and Intubation · 6 cards Chest Compressions and Cardiac Resuscitation · 6 cards Chest Compressions and Cardiac Resuscitation · 6 cards Chest Compressions and Cardiac Resuscitation · 6 cards Documentation and Family Communication · 6 cards Documentation and Family Communication · 6 cards Ethical Considerations in Neonatal Resuscitation · 6 cards Ethical Considerations in Neonatal Resuscitation · 6 cards Initial Assessment and Stabilization · 6 cards Initial Assessment and Stabilization · 6 cards Initial Assessment and Stabilization · 6 cards Medication Administration · 6 cards Medication Administration · 6 cards Neonatal Physiology and Birth Transition · 6 cards Neonatal Physiology and Birth Transition · 6 cards Neonatal Physiology and Birth Transition · 6 cards Oxygen Administration and Monitoring · 6 cards Oxygen Administration and Monitoring · 6 cards Positive Pressure Ventilation · 6 cards Positive Pressure Ventilation · 6 cards Positive Pressure Ventilation · 6 cards Post-Resuscitation Care and NICU Stabilization · 6 cards Post-Resuscitation Care and NICU Stabilization · 6 cards

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✍️ Sample NRP Questions & Answers

1. What is the endotracheal dose of epinephrine if IV/IO access is unavailable during neonatal resuscitation?

✓ 0.05–0.1 mg/kg (0.5–1 mL/kg of 1:10,000 solution)

The endotracheal dose of epinephrine is 0.05–0.1 mg/kg (0.5–1 mL/kg of 1:10,000 solution) — significantly higher than the IV/IO dose — because absorption via the pulmonary route is unreliable.

2. What is the normal fetal oxygen saturation (SpO2) via pulse oximetry in the minutes immediately after birth for a term infant?

✓ SpO2 of 60–65% at 1 minute, rising gradually to 85–95% by 10 minutes

NRP provides target SpO2 ranges for the first 10 minutes of life. At 1 minute, 60–65% is normal; it rises gradually as pulmonary circulation is established, reaching 85–95% by 10 minutes.

3. What device is used to precisely control the fraction of inspired oxygen (FiO2) delivered during neonatal resuscitation?

✓ Oxygen blender

An oxygen blender allows precise mixing of oxygen and air to deliver any FiO2 from 21–100%, enabling titration based on pulse oximetry during resuscitation.

4. Why is 100% oxygen harmful in neonatal resuscitation, and what specific risk does it pose?

✓ 100% oxygen generates excess reactive oxygen species (free radicals), causing oxidative injury to organs including the brain and lungs

Hyperoxia generates excess reactive oxygen species (free radicals), leading to oxidative stress that can injure immature tissues including the brain, lungs, and retina. This is particularly harmful in preterm infants whose antioxidant defenses are underdeveloped.

5. What is the primary physiological change that must occur in the lungs immediately after birth for successful transition to extrauterine life?

✓ Replacement of lung fluid with air and establishment of functional residual capacity

At birth, the fluid-filled lungs must be cleared and air must replace the fluid to establish functional residual capacity (FRC), enabling effective gas exchange for the first time.

6. In which clinical scenario would it be appropriate to use 100% oxygen during neonatal resuscitation despite NRP's standard recommendation to start at lower FiO2?

✓ An infant receiving CPR for heart rate below 60 bpm despite PPV

NRP recommends considering 100% oxygen during active CPR for heart rate below 60 bpm, as the priority in cardiac arrest is maximizing oxygen delivery. Wean as quickly as possible once circulation is restored.

🎯 Free NRP Practice Tests

Ethical Considerations · 11 questions Medication Administration · 11 questions Thermoregulation and Temperature Management · 7 questions Thermoregulation and Temperature Management · 7 questions Thermoregulation and Temperature Management · 7 questions Neonatal Physiology and Birth Transition · 6 questions Initial Assessment and Stabilization · 6 questions Medication Administration · 6 questions Medication Administration · 6 questions Initial Assessment and Stabilization · 6 questions

📖 NRP Guides & Articles

Your NRP Study Path

1. Learn with Flashcards → 2. Drill Practice Tests → 3. Take the Full Exam Simulation

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