NRP Preterm Infant Resuscitation

Question 1

What is the most important intervention for preventing heat loss in a preterm infant less than 32 weeks gestation in the delivery room?

Accepted Answer

Placing the infant in a polyethylene plastic wrap or bag without drying

Answer

Warm blankets and vigorous drying

Answer

Using a radiant warmer set to the highest temperature

Answer

Giving the infant directly to the parent for skin-to-skin contact

Question 2

What initial PEEP (positive end-expiratory pressure) is recommended when providing positive-pressure ventilation to a preterm infant?

Accepted Answer

5 cmH2O

Answer

0 cmH2O (no PEEP)

Answer

10 cmH2O

Answer

15 cmH2O

Question 3

When should surfactant therapy be considered for a preterm infant during delivery room management?

Accepted Answer

For intubated preterm infants with respiratory distress syndrome who require ventilatory support

Answer

For all preterm infants regardless of breathing effort

Answer

Only if the infant's SpO2 is below 85% despite PPV

Answer

Only after 6 hours of CPAP failure in the NICU

Question 4

What is the target axillary temperature for a preterm infant in the delivery room according to NRP guidelines?

Accepted Answer

36.5–37.5°C

Answer

35.0–36.0°C

Answer

37.5–38.5°C

Answer

38.0–39.0°C

Question 5

Why is a preterm infant at increased risk for intraventricular hemorrhage (IVH) during delivery room resuscitation?

Accepted Answer

Preterm infants have fragile germinal matrix vessels that are vulnerable to fluctuations in cerebral blood flow

Answer

Preterm infants have a larger brain volume that is more susceptible to pressure

Answer

Preterm infants receive more medication during resuscitation, which increases bleeding risk

Answer

Preterm infants have thinner skull bones that allow external compression during delivery

Question 6

Which of the following resuscitation approaches is most appropriate for a spontaneously breathing 28-week preterm infant with mild respiratory distress?

Accepted Answer

CPAP with 5–6 cmH2O starting pressure and oxygen titrated to SpO2 targets

Answer

Immediate intubation and surfactant administration

Answer

PPV with 100% oxygen via mask

Answer

Observation only with supplemental oxygen by nasal cannula