neonatal care

Question 1

All of the following are antepartum risk factors that increase the potential that a newborn may require resuscitation, EXCEPT:

Select one:

a. preeclampsia.
b. prolapsed cord.
c. polyhydramnios
d. multiple gestations.

Answer 1

b. prolapsed cord.

Question 2

The risk of newborn complications is HIGHEST if the amniotic sac:

Select one:

a. encases the baby’s face at birth.
b. s still intact at the time of birth.
c. contains thin, brown amniotic fluid.
d. ruptured more than 18 hours before birth.

Answer 2

d. ruptured more than 18 hours before birth.

Question 3

Which of the following events is a critical part of fetal transition?

Select one:

a. Diversion of blood flow to the fetus’s lungs
b. An acute increase in intrapulmonary pressure
c. Fetal lung expansion within 5 minutes after birth
d. Blood flow diversion across the ductus arteriosus

Answer 3

a. Diversion of blood flow to the fetus’s lungs

Question 4

Causes of delayed fetal transition include all of the following, EXCEPT:

Select one:

a. acidosis.
b. hypothermia.
c. birth at 41 weeks.
d. meconium aspiration.

Answer 4

c. birth at 41 weeks.

Question 5

A newborn born between ___ and ___ weeks of gestation is
described as term.

Select one:

a. 36, 38
b. 38, 42
c. 40, 42
d. 42, 44

Answer 5

b. 38, 42

Question 6

A delay in clamping the umbilical cord and keeping the baby below the level of the placenta can result in fetal:

Select one:

a. anemia.
b. hypovolemia.
c. exsanguination.
d. polycythemia.

Answer 6

d. polycythemia.

Question 7

While preparing equipment for newborn resuscitation, which of the following items is/are NOT considered optional?

Select one:

a. Pulse oximeter Incorrect
b. Cardiac monitor
c. Endotracheal tubes
d. Laryngeal mask airway

Answer 7

c. Endotracheal tubes

Question 8

Which of the following statements regarding the Apgar score is correct?

Select one:

a. If resuscitation is necessary, the Apgar score is completed to determine the result of the resuscitation
b. The Apgar score is determined on the basis of the newborn’s condition at 2 and 10 minutes after birth.
c. If resuscitation is needed, it should commence immediately after you obtain the 1-minute Apgar score. Incorrect
d. A newborn with a heart rate of greater than 80 beats/min would be assigned a score of 2 on the Apgar score.

Answer 8

a. If resuscitation is necessary, the Apgar score is completed to determine result of the resuscitation.

Question 9

According to the Apgar score, a newborn with a heart rate of 80 beats/min and slow, irregular breathing should receive a combined score of:

Select one:

a. 2
b. 3
c. 4
d. 5

Answer 9

a. 2

Question 10

An infant born with a pink body and blue extremities, a pulse rate of 90 beats/min, a strong cry, and active movement should be assigned an initial Apgar score of:

Select one:

a. 5
b. 6
c. 7
d. 8

Answer 10

d. 8

Question 11

If a newborn does not respond to the initial steps of resuscitation, the need for further intervention is based upon:

Select one:

a. pulse rate, activity, and appearance.
b. respiratory effort, pulse rate, and color.
c. appearance, skin color, and muscle tone.
d. respirations, appearance, and muscle tone.

Answer 11

b. respiratory effort, pulse rate, and color.

Question 12

The initial steps of newborn resuscitation include:

Select one:

a. free-flow oxygen.
b. proper positioning.
c. assessment of pulse rate.
d. positive pressure ventilation.

Answer 12

b. proper positioning.

Question 13

If you feel 13 pulsations in a 6-second time frame, the newborn’s heart rate is approximately:

Select one:

a. 30 beats/min.
b. 60 beats/min.
c. 90 beats/min.
d. 130 beats/min.

Answer 13

d. 130 beats/min.

Question 14

The MOST common etiology for bradycardia in a newborn is:

Select one:

a. severe hypoxia.
b. untreated acidosis.
c. occult hypovolemia.
d. increased vagal tone.

Answer 14

a. severe hypoxia.

Question 15

A newborn with central cyanosis, adequate respirations, and a heart rate of 120 beats/min should initially be treated with:

Select one:

a. continued observation only.
b. high-flow oxygen via mask
c. free-flow oxygen at 5 L/min.
d. positive pressure ventilation.

Answer 15

c. free-flow oxygen at 5 L/min.

Question 16

Choanal atresia is defined as a:

Select one:

a. small chin that causes a posteriorly positioned tongue.
b. condition in which high-flow oxygen causes blindness.
c. bony or membranous obstruction of the back of the nose.
d. condition in which the occipital skull is abnormally large.

Answer 16

c. bony or membranous obstruction of the back of the nose.

Question 17

An oropharyngeal airway would MOST likely be indicated for a newborn with:

Select one:

a. gasping respirations.
b. Pierre Robin sequence.
c. a diaphragmatic hernia.
d. prolonged periods of apnea.

Answer 17

b. Pierre Robin sequence.

Question 18

A newborn with a pulse rate of 80 beats/min:

Select one:

a. requires ventilations and chest compressions.
b. should be treated with 0.02 mg/kg of atropine.
c. is likely under the influence of maternal opiates.
d. requires immediate positive pressure ventilation.

Answer 18

d. requires immediate positive pressure ventilation.

Question 19

The MOST common device used to provide positive pressure ventilation to a newborn in the prehospital setting is a:

Select one:

a. T-piece resuscitator.
b. self-inflating bag-mask device.
c. flow-inflating bag-mask device.
d. manually triggered ventilator.

Answer 19

b. self-inflating bag-mask device.

Question 20

Common causes of respiratory distress in the newborn include:

Select one:

a. mucous obstruction of the nose.
b. unrecognized metabolic alkalosis.
c. persistent pulmonary hypotension.
d. maternal use of a narcotic analgesic.

Answer 20

a. mucous obstruction of the nose.

Question 21

Compared to subsequent breaths, the first few positive pressure breaths delivered to a distressed newborn:

Select one:

a. should provide a volume equal to 40 to 45 mm Hg.
b. should make the chest rise significantly.
c. may necessitate manual disabling of the pop-off valve.
d. generally require a significantly lower volume of air.

Answer 21

c. may necessitate manual disabling of the pop-off valve.

Question 22

The correct positive pressure ventilation rate for an apneic newborn is:

Select one:

a. 12 to 20 breaths/min.
b. 20 to 30 breaths/min.
c. 30 to 40 breaths/min.
d. 40 to 60 breaths/min.

Answer 22

d. 40 to 60 breaths/min.

Question 23

The MOST common reasons for ineffective bag-mask ventilations in the newborn are:

Select one:

a. equipment malfunction and a ventilation rate that is too rapid.
b. inadequate mask-to-face seal and incorrect head position.
c. hyperflexion of the newborn’s head and thick mucous plugs.
d. pneumothorax and a face mask that is too large for the infant.

Answer 23

c. hyperflexion of the newborn’s head and thick mucous plugs.

Question 24

Endotracheal intubation is clearly indicated in the newborn if:

Select one:

a. its heart rate is improving, but only because of adequate ventilations and chest compressions. Incorrect
b. meconium is present in the amniotic fluid and the newborn is limp and has a heart rate of 70 beats/min.
c. central cyanosis is persistent despite the administration of free-flow oxygen for 30 to 45 seconds.
d. a small, 27-gauge IV line is present and epinephrine is required to treat refractory bradycardia.

Answer 24

b. meconium is present in the amniotic fluid and the newborn is limp and has a heart rate of 70 beats/min.

Question 25

What size and type of laryngoscope blade is recommended for use in a full-term newborn?

Select one:

a. No. 1, Miller
b. No. 2, Miller
c. No. 1, MacIntosh
d. No. 2, MacIntosh

Answer 25

a. No. 1, Miller