1. A newborn of 34 weeks’ gestation is not breathing (apneic) at birth, does not respond to initial steps and requires positive pressure ventilation. What concentration of oxygen should be used as you begin positive pres
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1. A newborn of 34 weeks’ gestation is not breathing (apneic) at birth, does not respond to initial steps and requires positive pressure ventilation. What concentration of oxygen should be used as you begin positive pressure ventilation?
a. 30 to 50% oxygen
b. 50 to 70% oxygen
c. 100% oxygen
d. 21 to 30% oxygen
2. What size (internal diameter) endotracheal tube should be used to intubate a newborn with an estimated gestational age of 26 weeks (estimated birth weight of 800 g)?
a. 4.0 mm
b. 3.5 mm
c. 3.0 mm
d. 2.5 mm
3. You are called to attend a newborn at birth. At the time of the baby is delivered, which three question should you ask to evaluate whether the baby can stay with his mother or be moved to the radiant warmer for further assessment?
a. Is the baby warm? Does the baby have good tone? Is the baby full-term?
b. Is the baby term? Does the baby have a good muscle tone? Is the baby breathing or crying?
c. Is amniotic fluid clear? Is the baby breathing or crying? Is the baby of low birth weight?
d. Is the baby pink? Is the baby breathing or crying? Is the amniotic fluid clear?
4. What is the appropriate technique to stimulate a baby to breathe?
a. Gently rub the baby’s back or extremities
b. Hold the baby upside down and gently pat the buttocks
c. Vigorously suction the oropharynx with a bulb syringe
d. Apply free flow of oxygen to the baby’s face
5. What is the preferred technique for removing secretions from the mouth and nose of a newborn who requires resuscitation?
a. Suction deeply to clear secretions
b. Suction the mouth before the nose
c. Suction vigorously to clear secretions
d. Suction the nose before the mouth
6. You have determined a baby needs resuscitation at birth. What are the initial steps of newborn care?
a. Position had to open the airway, dry, stimulate, evaluate the baby’s color
b. Provide warmth, position head and neck to open the airway, clear secretions from the airway if needed, dry, stimulate
c. Provide warmth, position had to open airway, evaluate the baby’s color
d. Provide warmth, clear secretions with a suction catheter, evaluate the babies color, and evaluate heart rate
7. Hey baby is born at 34 weeks gestation. After the initial steps of resuscitation, the baby is not breathing (apneic). What are the next steps?
a. Administer free flow oxygen, place a pulse oximeter sensor on the right-hand or wrist, evaluate heart rate
b. Administer CPAP, place the pulse oximeter sensor on the right hand or wrist, evaluate color and tone
c. Initiate positive pressure ventilation, place a pulse oximeter sensor on the right hand or wrist, evaluate heart rate
d. Provide additional tactile stimulation, evaluate color and tone, evaluate heart rate
8. A baby is born at term with a bilateral cleft lip and palate and a very small mandible. She requires positive pressure ventilation because she is not breathing. You’re unable to achieve a seal with bag and mask. Which intervention is indicated?
a. Insert a laryngeal mask
b. Administer CPAP
c. Place an orogastric tube
d. Attempt endotracheal intubation multiple times
9. A full-term baby is born by emergency cesarean delivery because of fetal bradycardia (category III fetal heart rate tracing). The baby is limp and not breathing after initial steps. What is the next step in the resuscitation process?
a. Provide free flow oxygen, and chest compressions
b. Initiate positive pressure ventilation and check the increasing heart rate
c. Initiate chest compressions using the 2-thumb technique
d. Continue stimulating the baby for an additional 30 seconds
10. Which statement best describes normal transitional physiology at the time of birth?
a. The oxygen saturation normally rises to at least 90% by 2 minutes of age
b. Babies may take as long as 10 minutes after birth to increase her oxygen saturation to greater than 90%
c. Visual assessments of cyanosis is an reliable indicator of the babies oxygen saturation
d. Oxygen saturation by pulse oximetry is unreliable in the newborn and 100% oxygen is recommended immediately after birth
11. Which statement describes recommended practice when using a pulse oximeter in the delivery room?
a. Place the pulse oximeter sensor on the right-hand and use the minute specific oxygen saturation target to guide oxygen supplementation
b. Placed the pulse oximeter sensor on the right foot and adjust the oxygen saturation to achieve 100% oxygen saturation
c. Place the pulse oximeter sensor on the right hand and adjust oxygen concentration to achieve 100% oxygen saturation
d. Place a pulse oximeter sensor on the right foot and use the minute specific oxygen saturation target to guide oxygen supplementation
12. What is the recommended way to determine if a baby require supplemental oxygen in the delivery room?
a. Assess the color of the baby’s hands and feet
b. Assess the color of the baby’s chest and abdomen, and monitored for central cyanosis
c. Place an oximeter sensor on the baby’s right hand or wrist and assess oxygen saturation
d. Send an arterial blood gas, and evaluate the partial pressure of oxygen
13. The steps of intubation should ideally be completed within which duration?
a. 30 seconds
b. 90 seconds
c. 60 seconds
d. 40 seconds
14. You are part of a team preparing for the birth of a baby who has meconium stained fluid and a category III fetal heart rate tracing. A person skilled and endotracheal intubation should be
a. Not necessary if a team member knows how to place a laryngeal mask
b. Called in from home when the baby is born and then requires intubation
c. Present at the birth
d. Available from a remote location in the hospital
15. Your team attends an emergency cesarean delivery of a term baby because of chorioamnionitis, meconium stained amniotic fluid, and fetal heart rate decelerations. At delivery, the newborn is term as expected, with very poor tone and he is not breathing (apneic). You quickly perform the initial steps, but the baby is still not breathing. What is the most appropriate next step of resuscitation?
a. Intubate and administer 0.05 mg/kg of endotracheal epinephrine
b. Start positive pressure ventilation and check heart rate response after 15 seconds
c. Start cardiac compressions coordinated 3:1 with the ventilations, and prepared insert an umbilical venous catheter
d. Immediately intubate and suction the trachea
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