2022 NRP PRACTICE EXAM QUESTIONS AND ANSWERS ALL SOLVED SOLUTION. Rated A

2022 NRP PRACTICE EXAM QUESTIONS AND ANSWERS ALL SOLVED SOLUTION Your team has provided face-mask PPV with chest movement for 30 seconds. When is placement of an endotracheal tube strongly recommended? a. The baby's ...

2022 NRP PRACTICE EXAM QUESTIONS AND ANSWERS ALL SOLVED SOLUTION Your team has provided face-mask PPV with chest movement for 30 seconds. When is placement of an endotracheal tube strongly recommended? a. The baby's heart rate remains less than 100 bpm and is not increasing. b. The baby's heart rate is between 60 and 100 bpm and the heart rate is increasing. c. The baby's heart rate is >100 bpm and the baby is beginning to breathe. d. The baby's heart rate is >100 bpm and oxygen saturation is less than the target range. -Ans-a During a delivery, when and where should a person with intubation skills be available? a. In the hospital and immediately available b. In the delivery room or operating room at every birth c. Available on call at home d. Available on call from a remote area of the hospital -Ans-a What are the primary methods of confirming endotracheal tube placement within the trachea? a. Continued central cyanosis and no mist in the tube b. Auscultation of bilateral breath sounds and no air entry heard over the abdomen c. Demonstration of exhaled carbon dioxide (CO2) and a rapidly increasing heart rate d. Absence of crying and no abdominal distension -Ans-c You are resuscitating a critically ill newborn whose heart rate is 20 bpm. The baby has been intubated and the endotracheal tube insertion depth is correct. You can see chest movement with PPV and hear bilateral breath sounds, but the colorimetric CO2 detector does not turn yellow. What is the likely reason for this? a. The endotracheal tube is not in the trachea. b. Excessive ventilation pressure. c. Epinephrine contamination. d. Low cardiac output. -Ans-d According to the Textbook of Neonatal Resuscitation, 8th edition algorithm, at what point during resuscitation is a cardiac monitor recommended to assess the baby's heart rate? a. After chest compressions are performed for at least 2 minutes b. When an alternative airway is inserted c. Immediately after epinephrine is administered d. Anytime pulse oximetry is used to assess oxygen saturation -Ans-b What size laryngoscope blade is recommended to intubate a preterm newborn with an estimated gestational age of 32 weeks (estimated birth weight of 1.4 kg)? a. 2b. 1 c. 0 d. 00 -Ans-c Even brief interruptions of chest compressions may significantly reduce their effectiveness, but it is also important to assess the need to continue chest compressions. What is the preferred way to assess the heart rate during chest compressions? a. Briefly interrupt chest compressions every 30 seconds to auscultate the heart rate. b. Briefly interrupt chest compressions and palpate the brachial pulse. c. Briefly interrupt chest compressions every 60 seconds to assess the heart rate using the cardiac monitor. d. Briefly interrupt chest compressions to palpate the umbilical cord. -Ans-c Your team is resuscitating a newborn at birth. The heart rate is low and the baby has poor perfusion. Which is the preferred method to assess the heart rate? a. Cardiac monitor b. Pulse oximeter c. CO2 detector d. Direct auscultation -Ans-a When are chest compressions indicated? a. When the heart rate is less than 80 bpm b. When the heart rate remains less than 60 bpm after at least 30 seconds of PPV that moves the chest, preferably through an alternative airway c. When the heart rate remains less than 100 bpm after 30 seconds of PPV that moves the chest preferably through an alternative airway d. When the heart rate remains less than 100 bpm despite PPV with 100% oxygen - Ans-b After 60 seconds of PPV coordinated with chest compressions, the cardiac monitor indicates a heart rate of 70 beats per minute. What is your next action? a. Stop chest compressions and continue PPV. b. Continue chest compressions and continue PPV. c. Stop chest compressions and stop PPV. d. Administer epinephrine while continuing chest compressions and PPV with 100% oxygen. -Ans-a What is the recommended depth of chest compressions? a. One-third of the anterior-posterior diameter of the chest b. One-fourth of the anterior-posterior diameter of the chest c. Half of the anterior-posterior diameter of the chest d. Two-thirds of the anterior-posterior diameter of the chest -Ans-a During chest compressions, which of the following is correct?a. To coordinate compressions and ventilations, the compressor calls out Breathe-twothree; breathe-two-three.... b. The compression to ventilation ratio is 15 compressions:2 ventilations. c. Most babies who require chest compressions will also require volume expander. d. To coordinate compressions and ventilations, the compressor calls out one-and-twoand-three-and-breathe-and.... -Ans-d Your team is resuscitating a newborn whose heart rate remains less than 60 bpm despite effective PPV and 60 seconds of chest compressions. You have administered epinephrine intravenously. According to the Textbook of Neonatal Resuscitation, 8th edition, what volume of normal saline flush should you administer? a. 0.5 mL b. 1 mL c. 3 mL d. 5 mL -Ans-c According to the Textbook of Neonatal Resuscitation, 8th edition, what is the suggested initial dose for IV epinephrine (0.1 mg/1 mL=1 mg/10 mL)? a. 0.02 mg/kg (equal to 0.2 mL/kg) b. 0.05 mg/kg (equal to 0.5 mL/kg c. 0.1 mg/kg (equal to 1.0 mL/kg) d. 0.3 mg/kg (equal to 3.0 mL/kg) -Ans-a When is the administration of a volume expander indicated during newborn resuscitation? a. The baby's heart rate is not increasing and there are signs of shock or a history of acute blood loss. b. The baby's heart rate is increasing but the color remains poor. c. The baby's heart rate is increasing but there is a history of acute blood loss. d. The baby's heart rate is >160 bpm but there are no spontaneous respirations. -Ans-a Your team is caring for a term newborn whose heart rate is 50 bpm after receiving effective ventilation, chest compressions, and intravenous epinephrine administration. There is a history of acute blood loss around the time of delivery. You administer 10 mL/kg of normal saline (based on the newborn's estimated weight). At what rate should this be administered? a. Over 1 to 2 minutes b. Over 5 to 10 minutes c. Over 15 to 20 minutes d. Over 20 to 25 minutes -Ans-b How soon after administration of intravenous epinephrine should you pause compressions and reassess the baby's heart rate? a. 10 to 15 seconds b. 30 seconds c. 60 secondsd. 90 seconds -Ans-c You are called to the birth of a newborn at 30 weeks gestation. As you prepare your equipment, what concentration of oxygen will you use initially if PPV is required? a. 21% to 30% b. 40% c. 60% d. 100% -Ans-a A baby is born at 26 weeks gestation. The initial steps of care, including gentle stimulation, have been completed and the baby is nearly 1-minute old. The baby is not breathing. What is the most appropriate next step? a. Begin CPAP at 5 cm H2O. b. Begin PPV by mask. c. Stimulate more vigorously to initiate breathing. d. Administer free-flow oxygen. -Ans-b Choose the appropriate step(s) to prepare for the birth of a newborn <32 weeks gestation. a. Prepare a size 1 laryngoscope and size 3.5-mm endotracheal tube in case intubation is required b. Decrease the delivery room temperature to approximately 65˚F to 66˚F (18.3˚C to 18.8˚C). c. Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, a hat, and a skin temperature sensor. d. Set the oxygen blender to 100% the flowmeter to 15 L/min and the suction to 100 mm Hg. -Ans-c A term newborn was born via emergency cesarean section in the setting of fetal bradycardia. The baby was limp and bradycardic at birth and was intubated at 6 minutes after birth for persistent apnea. The cord blood gas demonstrates a severe metabolic acidosis, and the physical examination is consistent with hypoxic-ischemic encephalopathy (HIE). Which of the following is the most appropriate intervention for this newborn? a. Admit the newborn to a center with capability to perform therapeutic hypothermia. b. Maintain a body temperature >38˚C to avoid cold stress after resuscitation. c. Initiate formula feeding promptly to avoid electrolyte abnormalities. d. Administer 100% oxygen and sodium bicarbonate to prevent pulmonary hypertension. -Ans-a A term baby was vigorous at birth but