The need for positive-pressure ventilation lasting more than a few minutes
  • Which of the following is an indication for endotracheal intubation?
  • A 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 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 are unable to achieve a seal with bag and mask. Which intervention is indicated?
  • 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?
Present at the birth.
  • 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 in endotracheal intubation should be
  • You have been called to attend a birth and are the only healthcare provider responsible for the management of the newborn in the room. When should you first call for additional help?
  • You are at the resuscitation of a newborn who is gasping and has a heart rate of 60 beats per minute. What is the most important action you can take?
  • You have started positive-pressure ventilation for a newborn because her heart rate is low (bradycardia). What is the most important indicator of successful positive-pressure ventilation?
Initiative positive-pressure ventilation, place a pulse oximeter sensor on the right hand or wrist, evaluate heart rate.
  • 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 are unable to achieve a seal with bag and mask. Which intervention is indicated?
  • 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 baby is born at 34 weeks' gestation. After the initial steps of resuscitation, the baby is not breathing (apneic). What are the next steps?
  • Which of the following is an indication for endotracheal intubation?
Initiate positive-pressure ventilation and check for increasing heart rate
  • 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 baby is born at 34 weeks' gestation. After the initial steps of resuscitation, the baby is not breathing (apneic). What are the next steps?
  • Which of the following is an indication for endotracheal intubation?
  • 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 are unable to achieve a seal with bag and mask. Which intervention is indicated?
21 - 30% oxygen
  • You have started positive-pressure ventilation for a newborn because her heart rate is low (bradycardia). What is the most important indicator of successful positive-pressure ventilation?
  • 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 in endotracheal intubation should be
  • A baby requires positive-pressure ventilation because she is not breathing (apneic), but she soon establishes spontaneous respirations and a heart rate over 100 beats per minute. Her oxygen saturation is lower than the target level when in room air, so you provide free-flow oxygen. Which of the following devices cannot reliably deliver free-flow oxygen?
  • 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?
Someone capable of initiating neonatal resuscitation should be present at every delivery whose only responsibility is management of the newborn.
  • Which statement describes recommended practice when using a pulse oximeter in the delivery room?
  • Your hospital is planning Neonatal Resuscitation Program® training and trying to decide who should be included.
  • You have determined a baby needs resuscitation at birth. What are the initial steps of newborn care?
  • You have been called to attend a birth and are the only healthcare provider responsible for the management of the newborn in the room. When should you first call for additional help?
Insert a laryngeal mask
  • A 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 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 are unable to achieve a seal with bag and mask. Which intervention is indicated?
  • 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?
  • Which of the following is an indication for endotracheal intubation?
Start positive-pressure ventilation and check heart rate response after 15 seconds
  • 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 initial steps, but the newborn is still not breathing. What is the most appropriate next step of resuscitation?
  • You are at the resuscitation of a newborn who is gasping and has a heart rate of 60 beats per minute. What is the most important action you can take?
  • You are at a delivery of a baby born through meconium-stained amniotic fluid, and the baby is not vigorous. What steps should be taken immediately after birth?
  • You are called to attend to a newborn at birth. At the time the baby is delivered, which 3 questions should you ask to evaluate whether the baby can stay with his mother or be moved to the radiant warmer for further assessment?
Place the pulse oximeter sensor on the right hand and use the minute specific oxygen saturation target to guide oxygen supplementation.
  • What is the recommended way to determine if a baby requires supplemental oxygen in the delivery room?
  • Which statement describes recommended practice when using a pulse oximeter in the delivery room?
  • You have determined a baby needs resuscitation at birth. What are the initial steps of newborn care?
  • Which statement best describes normal transitional physiology at the time of birth?
Gently rub the baby's back or extremities
  • What is the appropriate technique to stimulate a baby to breathe?
  • Which statement best describes normal transitional physiology at the time of birth?
  • What is the recommended way to determine if a baby requires supplemental oxygen in the delivery room?
  • What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after initial steps?
Babies may take as long as 10 minutes after birth to increase their oxygen saturation to greater than 90%.
  • You have determined a baby needs resuscitation at birth. What are the initial steps of newborn care?
  • What is the recommended way to determine if a baby requires supplemental oxygen in the delivery room?
  • Which statement describes recommended practice when using a pulse oximeter in the delivery room?
  • Which statement best describes normal transitional physiology at the time of birth?
Mask of self-inflating bag
  • A baby requires positive-pressure ventilation because she is not breathing (apneic), but she soon establishes spontaneous respirations and a heart rate over 100 beats per minute. Her oxygen saturation is lower than the target level when in room air, so you provide free-flow oxygen. Which of the following devices cannot reliably deliver free-flow oxygen?
  • 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?
  • During the resuscitation of a newborn, you auscultate the apical pulse and count 10 beats over a 6 second period. What heart rate do you report to your team?
  • 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 initial steps, but the newborn is still not breathing. What is the most appropriate next step of resuscitation?
They should be able to maintain situational awareness.
  • You are at a delivery of a baby born through meconium-stained amniotic fluid, and the baby is not vigorous. What steps should be taken immediately after birth?
  • After the initial steps of newborn care, a baby is apneic. What is the most important and effective action to take in the resuscitation of this baby?
  • What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after initial steps?
  • Effective team functioning is critical in ensuring the best performance. Which of these characteristics is critical in team leaders?
Administration of positive-pressure ventilation that inflates the lungs
  • Effective team functioning is critical in ensuring the best performance. Which of these characteristics is critical in team leaders?
  • What is the appropriate technique to stimulate a baby to breathe?
  • What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after initial steps?
  • What is the recommended way to determine if a baby requires supplemental oxygen in the delivery room?
30 seconds
  • What is the appropriate technique to stimulate a baby to breathe?
  • The steps of intubation should ideally be completed within which duration?
  • 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?
  • What is the recommended way to determine if a baby requires supplemental oxygen in the delivery room?
Provide warmth, position head and neck to open the airway, clear secretions from the airway if needed, dry, stimulate
  • You have been called to attend a birth and are the only healthcare provider responsible for the management of the newborn in the room. When should you first call for additional help?
  • You have determined a baby needs resuscitation at birth. What are the initial steps of newborn care?
  • Your hospital is planning Neonatal Resuscitation Program® training and trying to decide who should be included.
  • You are at the resuscitation of a newborn who is gasping and has a heart rate of 60 beats per minute. What is the most important action you can take?
A rising heart rate
  • 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 in endotracheal intubation should be
  • You have started positive-pressure ventilation for a newborn because her heart rate is low (bradycardia). What is the most important indicator of successful positive-pressure ventilation?
  • You are at the resuscitation of a newborn who is gasping and has a heart rate of 60 beats per minute. What is the most important action you can take?
  • You have been called to attend a birth and are the only healthcare provider responsible for the management of the newborn in the room. When should you first call for additional help?
2.5 mm
  • 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)?
  • During the resuscitation of a newborn, you auscultate the apical pulse and count 10 beats over a 6 second period. What heart rate do you report to your team?
  • After the initial steps of newborn care, a baby is apneic. What is the most important and effective action to take in the resuscitation of this baby?
  • You have started positive-pressure ventilation for a newborn because her heart rate is low (bradycardia). What is the most important indicator of successful positive-pressure ventilation?
Place an oximeter sensor on the baby's right hand or wrist and assess oxygen saturation.
  • What is the recommended way to determine if a baby requires supplemental oxygen in the delivery room?
  • What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after initial steps?
  • What is the appropriate technique to stimulate a baby to breathe?
  • Which statement describes recommended practice when using a pulse oximeter in the delivery room?
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