NRP Oxygen Administration and Monitoring

Question 1

What initial concentration of oxygen is recommended when starting positive-pressure ventilation for a term infant during neonatal resuscitation?

Accepted Answer

21% oxygen (room air)

Answer

100% oxygen

Answer

40% oxygen

Answer

30% oxygen

Question 2

Where should the pulse oximetry probe be placed during neonatal resuscitation to measure preductal oxygen saturation?

Accepted Answer

Right hand or wrist

Answer

Left hand or wrist

Answer

Either foot

Answer

The forehead

Question 3

What is the target preductal SpO2 at 5 minutes of life for a newborn undergoing resuscitation, according to NRP guidelines?

Accepted Answer

80–85%

Answer

60–65%

Answer

70–75%

Answer

95–100%

Question 4

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

Accepted Answer

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

Answer

100% oxygen causes bradycardia by stimulating vagal receptors in the lung

Answer

100% oxygen decreases pulmonary vascular resistance too rapidly, causing cardiac failure

Answer

100% oxygen interferes with pulse oximetry accuracy

Question 5

What should the resuscitation team do if a newborn's SpO2 is consistently above the NRP target range during resuscitation?

Accepted Answer

Wean the supplemental oxygen (FiO2) to bring SpO2 back into the target range

Answer

Increase the respiratory rate to remove the excess oxygen

Answer

Add PEEP to the ventilation circuit

Answer

Do nothing — SpO2 above target is always beneficial

Question 6

For a preterm infant less than 35 weeks gestation requiring resuscitation, what starting oxygen concentration does NRP recommend?

Accepted Answer

21–30%

Answer

21% (room air)

Answer

50%

Answer

100%