NRP 8th Edition Exam Questions
Marking Scheme New Update
What is the single most important and effective step in neonatal resuscitation? - Answer
-Ventilation of the newborn's lungs
Abnormal Transition Findings - Answer --Irregular Breathing, absent breathing, or rapid
breathing
-Slow or fast heart rate
-Decreased Muscle Tone
-Pale Skin or Blue Skin
-Low oxygen saturation
-Low blood pressure
NRP algorithm- First Step - Answer -Antenatal Counselling
Team Debriefing
Equipment Check
After the birth of the baby, what do you ask? - Answer -1. Term Gestation?
2. Good Tone?
3. Breathing or crying?
FIVE INITIAL STEPS:
If you answer NO to any of the three questions (term, tone, breathing) what do you do?
- Answer -Warm
Dry
Stimulate
Position airway
Suction if needed
Apnea or gasping? HR <100bpm= NO with laboured breathing/cyanosis - Answer -
Position airway, suction if needed
Pulse oximeter
Oxygen if needed
Consider CPAP
Apnea or gasping? HR <100bpm= YES - Answer -PPV
Pulse Oximeter
Consider Cardiac Monitor
HR STILL less than 100bpm= YES - Answer -Ensure adequate ventilation
Consider ETT or laryngeal mask
Cardiac Monitor
, HR <60 bpm? - Answer -ETT or laryngeal mask
Chest compressions
Coordinate PPV-100% oxygen
UVC
HR STILL <60 bpm? - Answer -IV Epinephrine every 3-5 minutes
If still less than 60, consider hypovolemia or pneumothorax
Rapid Evaluation - Answer -Determine if the newborn can remain with the mother or
should be moved to the radiant warmer for further evaluation
REVIEW: Three questions you ask during rapid evaluation? - Answer -1. Term?
2. Good Muscle Tone?
3. Breathing/crying?
If the answer is NO to any of these, baby should be brought to radiant warmer.
Airway - Answer -Perform the initial steps to establish an open Airway and support
spontaneous respiration
Breathing - Answer -PPV is provided to assist Breathing for babies with apnea or
bradycardia
Circulation - Answer -If severe bradycardia persists despite assisted ventilation,
Circulation is supported by performing chest compressions coordinated with PPV
Drug - Answer -If severe bradycardia persists despite assisted ventilation and
coordinated chest compressions, the Drug Epinephrine is administered as coordinated
PPV and chest compressions continue
What are the 4 pre-birth questions to ask the provider before every delivery? - Answer -
1. Expected Gestational Age
2. Is the amniotic fluid clear?
3. Are there any additional Risk Factors?
4. What is our umbilical cord management plan?
Equipment Check- Warm - Answer --Preheated radiant warmer
-Towels/Blankets
-Temp Sensor/sensor cover
-Hat
-Plastic Wrap (<32 weeks)
-Thermal Mattress (<32 weeks)
Equipment Check- Clear the airway - Answer --Bulb Syringe
-10F or 12F Suction catheter attached to wall suction set at 80-100mm Hg
Marking Scheme New Update
What is the single most important and effective step in neonatal resuscitation? - Answer
-Ventilation of the newborn's lungs
Abnormal Transition Findings - Answer --Irregular Breathing, absent breathing, or rapid
breathing
-Slow or fast heart rate
-Decreased Muscle Tone
-Pale Skin or Blue Skin
-Low oxygen saturation
-Low blood pressure
NRP algorithm- First Step - Answer -Antenatal Counselling
Team Debriefing
Equipment Check
After the birth of the baby, what do you ask? - Answer -1. Term Gestation?
2. Good Tone?
3. Breathing or crying?
FIVE INITIAL STEPS:
If you answer NO to any of the three questions (term, tone, breathing) what do you do?
- Answer -Warm
Dry
Stimulate
Position airway
Suction if needed
Apnea or gasping? HR <100bpm= NO with laboured breathing/cyanosis - Answer -
Position airway, suction if needed
Pulse oximeter
Oxygen if needed
Consider CPAP
Apnea or gasping? HR <100bpm= YES - Answer -PPV
Pulse Oximeter
Consider Cardiac Monitor
HR STILL less than 100bpm= YES - Answer -Ensure adequate ventilation
Consider ETT or laryngeal mask
Cardiac Monitor
, HR <60 bpm? - Answer -ETT or laryngeal mask
Chest compressions
Coordinate PPV-100% oxygen
UVC
HR STILL <60 bpm? - Answer -IV Epinephrine every 3-5 minutes
If still less than 60, consider hypovolemia or pneumothorax
Rapid Evaluation - Answer -Determine if the newborn can remain with the mother or
should be moved to the radiant warmer for further evaluation
REVIEW: Three questions you ask during rapid evaluation? - Answer -1. Term?
2. Good Muscle Tone?
3. Breathing/crying?
If the answer is NO to any of these, baby should be brought to radiant warmer.
Airway - Answer -Perform the initial steps to establish an open Airway and support
spontaneous respiration
Breathing - Answer -PPV is provided to assist Breathing for babies with apnea or
bradycardia
Circulation - Answer -If severe bradycardia persists despite assisted ventilation,
Circulation is supported by performing chest compressions coordinated with PPV
Drug - Answer -If severe bradycardia persists despite assisted ventilation and
coordinated chest compressions, the Drug Epinephrine is administered as coordinated
PPV and chest compressions continue
What are the 4 pre-birth questions to ask the provider before every delivery? - Answer -
1. Expected Gestational Age
2. Is the amniotic fluid clear?
3. Are there any additional Risk Factors?
4. What is our umbilical cord management plan?
Equipment Check- Warm - Answer --Preheated radiant warmer
-Towels/Blankets
-Temp Sensor/sensor cover
-Hat
-Plastic Wrap (<32 weeks)
-Thermal Mattress (<32 weeks)
Equipment Check- Clear the airway - Answer --Bulb Syringe
-10F or 12F Suction catheter attached to wall suction set at 80-100mm Hg
