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NRP LESSONS 1-9||2025-2026||QUESTIONS WITH CORRECT VERIFIED ANSWERS. A+ GRADE, Exams of Pediatrics

University of California-San FranciscoPediatrics

NRP LESSONS 1-9||2025-2026||QUESTIONS WITH CORRECT VERIFIED ANSWERS. A+ GRADE

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NRP LESSONS 1-9||2025-2026||QUESTIONS WITH
CORRECT VERIFIED ANSWERS. A+ GRADE
LESSON 1: OVERVIEW AND PRINCIPLES OF RESUSCITATION
1. You have determined that a baby needs resuscitation at birth. What are the initial steps of
resuscitation?
A. Provide warmth, position head to open the airway, dry and stimulate
B. Provide warmth, position head to open airway, evaluate heart rate
C. Position to open the airway, dry and stimulate, evaluate heart rate
D. Provide warmth, evaluate color and respiration, evaluate heart rate
2. After the initial steps in resuscitation, a newborn is apneic with the heart less than 100 beats per
minute. What is the most important and effective action to take in resuscitation for this baby?
a. Ventilate the lungs
b. Perform chest compression
c. Give epinephrine
d. Give supplemental oxygen
3. You have called to a newborn at birth which 3 questions should you ask first for the need of
resuscitation?
a. Is the baby warm? Does the baby have good tone? Is the baby full term?
b. Is amniotic fluid clear? Is baby breathing or crying? Is the baby low birth weight?
c. Is the baby of term gestation? Breathing or crying? Good tone?
d. Is the baby pink? Breathing or crying? Amniotic fluid clear?
4. After several hours of labor with failure to progress, baby born via C-section. Cries at birth and
vigorous but slightly dusky appearance at 2-3 minutes of age. How long may take this normal
baby to reach 90% of oxygen saturation?
a. 5 minutes
b. 2 minutes
c. 1 minutes
d. 10 minutes
5. A C-section is performed under General Anesthesia because of prior maternal back surgery after
birth, newborn is making some respiratory effort but heart rate drops below 100 beats per
minute. What difficulty in transition can occurred after birth?
a. Increase blood pressure from the transition of blood from the placenta
b. Inadequate ventilation because of baby poor respiratory effort
c. Constriction of blood vessels in lungs because of excess oxygen administration
d. Less blood flow to the lungs if baby cry vigorously.
6. Your hospital has several people skilled in neonatal resuscitation. Most of them have work away
from delivery room and you alone are there at this time. When should you recruit additional
help?
a. When after birth, you determine that the baby requires intubation or other procedures
b. When you learn it is a birth of multiple gestation to care for the additional baby.
c. When after birth, obstetrician or labour nurse suggest that you need additional help.
d. When you anticipate the likely need for more advanced resuscitation based on present
of any known prenatal risk factor.
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Download NRP LESSONS 1-9||2025-2026||QUESTIONS WITH CORRECT VERIFIED ANSWERS. A+ GRADE and more Exams Pediatrics in PDF only on Docsity!

NRP LESSONS 1- 9 ||2025-2026||QUESTIONS WITH

CORRECT VERIFIED ANSWERS. A+ GRADE

LESSON 1: OVERVIEW AND PRINCIPLES OF RESUSCITATION

  1. You have determined that a baby needs resuscitation at birth. What are the initial steps of resuscitation? A. Provide warmth, position head to open the airway, dry and stimulate B. Provide warmth, position head to open airway, evaluate heart rate C. Position to open the airway, dry and stimulate, evaluate heart rate D. Provide warmth, evaluate color and respiration, evaluate heart rate
  2. After the initial steps in resuscitation, a newborn is apneic with the heart less than 100 beats per minute. What is the most important and effective action to take in resuscitation for this baby? a. Ventilate the lungs b. Perform chest compression c. Give epinephrine d. Give supplemental oxygen
  3. You have called to a newborn at birth which 3 questions should you ask first for the need of resuscitation? a. Is the baby warm? Does the baby have good tone? Is the baby full term? b. Is amniotic fluid clear? Is baby breathing or crying? Is the baby low birth weight? c. Is the baby of term gestation? Breathing or crying? Good tone? d. Is the baby pink? Breathing or crying? Amniotic fluid clear?
  4. After several hours of labor with failure to progress, baby born via C-section. Cries at birth and vigorous but slightly dusky appearance at 2-3 minutes of age. How long may take this normal baby to reach 90% of oxygen saturation? a. 5 minutes b. 2 minutes c. 1 minutes d. 10 minutes
  5. A C-section is performed under General Anesthesia because of prior maternal back surgery after birth, newborn is making some respiratory effort but heart rate drops below 100 beats per minute. What difficulty in transition can occurred after birth? a. Increase blood pressure from the transition of blood from the placenta b. Inadequate ventilation because of baby poor respiratory effort c. Constriction of blood vessels in lungs because of excess oxygen administration d. Less blood flow to the lungs if baby cry vigorously.
  6. Your hospital has several people skilled in neonatal resuscitation. Most of them have work away from delivery room and you alone are there at this time. When should you recruit additional help? a. When after birth, you determine that the baby requires intubation or other procedures b. When you learn it is a birth of multiple gestation to care for the additional baby. c. When after birth, obstetrician or labour nurse suggest that you need additional help. d. When you anticipate the likely need for more advanced resuscitation based on present of any known prenatal risk factor.
  1. Your hospital is planning NRP training and is trying to decide who should be included. For every delivery who should be available? a. Someone capable of initiating resuscitation should be present at every delivery and available to care for baby b. Someone capable of initiating resuscitation should be present if risk factor indentified c. Someone should be identified at every delivery as the person to call for help for the baby d. Someone skilled in neonatal resuscitation should be available at the hospital to be called for deliveries.
  2. A newborn requires resuscitation and you have begun positive pressure ventilation and chest compression. Which 3 signs are used to evaluate the effectiveness of your action and the need to continue some aspect of support? a. Respiration, muscle tone and heart rate b. Blood pressure, assessment of oxygenation and heart rate c. Respiration, blood pressure , assessment of oxygenation d. Respiration, heart rate, assessment of oxygenation
  3. Baby is born 34 weeks, despite initial steps, baby is apneic and heart rate is 70 beats per minute. What step should be taken next? a. Administer C-PAP, place an oximeter probe on right hand/wrist, evaluate color and tone b. Administer free flow oxygen, place an oximeter probe on right hand/wrist, reevaluate in 30 seconds c. Provide additional tactile stimulation, evaluate color and tone, reevaluate in 30 seconds d. Begin positive pressure ventilation, place an oximeter probe on right hand/wrist, reevaluate in 30 seconds.
  4. Full term newborn apneic after birth, fails to respond to tactile stimulation. Newborn in secondary apnea usually respond with an increase with heart rate after which intervention? a. Effective positive pressure ventilation b. Increasingly vigorous tactile stimulation c. Chest compression rate 30 per minute d. Administration of free flow 100% oxygen
  5. A prenatal class is learning about labor and birth. Approximately what percent of newborn require some assistance to begin breathing at birth? a. 5% b. 30% c. 10% d. 1%
  6. A caregiver states that he can always predict which baby needs help at birth. You disagree because you know that percent of newborns require initial assessment to determine whether resuscitation is required. a. 100% b. 50% c. 10% d. 1%

b. Administration of free-flow oxygen c. Flicking of soles of feet. d. Gentle rubbing the back.

  1. What is the best technique for removing secretions from the mouth and nose of a newborn who requires resuscitation? a. Suction the mouth or nose first b. Suction the mouth before the nose c. Suction the nose before the mouth d. Suction vigorously and deeply to clear secretions.
  2. What is the appropriate technique to stimulate a baby to breathe? a. Vigorously rubbing the back b. Application of mild ocular pressure c. Slapping of flicking the soles of the feet d. Holding the baby upside down and gently patting the buttocks
  3. You are at a delivery of a baby born through meconium-stained amniotic fluid. What is the correct indication for intubation and suctioning the trachea at birth? a. The baby has poor tone and respiratory effort. b. The baby is not pink by 1 minute of life c. The meconium is thick d. The baby has wet-sounding lungs.
  4. You are at the resuscitation of a newborn who is gasping and has a heart rate of 90 beats per minute. What is the most important action you can take? a. Assist ventilation b. Provide chest compression c. Apply mild chest physiotherapy d. Provide free-flow oxygen.
  5. During a recitation of a newborn, what is the ideal head position? a. The baby shoulder be prone, with the head turned to the left. b. The neck should be slightly flexed c. The neck should be mild extended d. The baby should be prone, with the head turned to the right.

LESSON 3: USE OF RESUSCITATION DEVICES FOR POSITIVE-PRESSURE VENTILATION

  1. You are giving positive ventilation to a premature newborn. In your delivery room booth a flow- inflating bag and a T-piece resuscitator are available for use. Both devices can be effectively used to provide positive-pressure ventilation. What advantage does the T-piece resuscitator have over the flow-inflating bag? a. Has an adjustable valve to regulate the amount of continuous positive airway pressure or positive end-expiratory pressure. b. Can be used to deliver continuous positive airway pressure. c. Delivers more consistent, reliable pressures with each breath. d. Reliably deliver 100% oxygen.
  2. You are part of a team resuscitating a premature newborn. Shortly after birth, the baby developed apnea followed by bradycardia. Positive-pressure ventilation with a bag and mask had not resulted in an improvement. You communicate to the team that you remember potential corrective steps, using the acronym MR SOPA. Despite taking the first 4 corrective steps, M-R-S-O, there is still no chest rate. You recommend that your team consider a. P: Provide more oxygen, A: Ask for help b. P: Pressure increase, A: Airway Alternative c. P: Push chest (compressions), A: Airway alternative d. P: Pressure increase, A: Add drugs (epinephrine)
  3. A baby is born in the hospital lobby as his mother waited for admission. He is apneic, despite tactile stimulation, drying and bulb suctioning. You have brought a self-inflating bag to birth. What should your next step be? a. Calls for someone to bring 100% oxygen tank and oximeter to the patient before starting positive pressure ventilation b. Start positive-pressure ventilation using room air and transport the baby to a care area. c. Quickly transport the baby to a care area, and start positive-pressure ventilation with blended oxygen and monitor with an oximeter. d. Monitor the heart rate, if it slows, begin positive-pressure ventilation with room air.
  4. You attend the birth of a newborn with another caretaker. The baby is born limp and apneic. Despite initial steps, you are required to provide the newborn with positive-pressure ventilation. At the same time, you team member should a. Listen for breath sounds begin chest compressions and prepare for intubation and medications b. Apply the pulse oximeter probe to the right hand or wrist, take over ventilations and increase the heat on the radiant warmer c. Apply the pulse oximeter probe to any extremity, increase the oxygen concentration to 100% and call for additional help d. Apply the pulse oximeter probe to the right hand or wrist, listen for a rising heart rate and watch for rising oxygen saturations.
  5. A full term newborn is apneic at birth and requires positive-pressure ventilation. What concentration of oxygen should be used during resuscitation? a. Room air should be used for resuscitation of full-term newborns, independent of color or oxygen saturation.

hand. It is providing a reading as you administer supplemental oxygen. What level of oxygen saturation should you try to achieve? a. Adjust your oxygen to keep the saturation at the level at which the baby appears pink to the team. b. Adjust the oxygen level to achieve the target levels for oxygen saturation according to the baby’s age in minutes c. Adjust the oxygen level to ensure that the saturation level is always 90% or greater. d. Adjust the oxygen level to keep the saturation levels between 85% to 95%

  1. You are giving positive-pressure ventilation to a baby because he is apneic and bradycardiac. What is the most important indicator of successful positive-pressure ventilation? a. A rising heart rate b. Audible and bilateral breath sound c. Chest rise with each breath d. Improvement in tone and movement
  2. You attend the birth of a neonate at 30 weeks’ gestation who needs respiratory support. What concentration of oxygen should be used in the resuscitation of a preterm baby? a. Start with a concentration somewhat higher than room air and adjust to keep oxygen saturations in target range b. Start with room air and adjust to keep oxygen saturations in target range. c. Start with 100% oxygen and adjust to keep oxygen saturations in target range. d. Start with 100% and adjust concentration based on color.

LESSON 4: CHEST COMPRESSIONS

  1. When chest compression are indicated, you should also consider a. Immediately administrating epinephrine b. Increasing the temperature setting of the radiant warmer c. Endotracheal intubation, in not ready done d. Repositioning the baby’s head
  2. When administrating chest compressions and ventilation, the heart rate should be assessed a. After 120 events b. When spontaneous respirations return c. Every 45 to 60 seconds d. Every 30 seconds
  3. When coordinating positive-pressure ventilation with chest compressios, how many events are performed each minute? a. 30 breaths, 90 compressions b. 60 breaths, 120 compressions c. 60 breaths, 60 compressions d. 40 breaths, 80 compressions
  4. Your team begins administrating chest compressions to a newborn. Correct technique includes which of the following? a. Ventilate whenever possible b. Thumbs or fingers remain in contact with the chest at all times. c. Compressions depth is on forth the diameter of the chest d. 2:1 ratio of compressions to breaths is being used.
  5. What is the depth of chest compressions for a newborn? a. Half the antero-posterior diameter of the chest. b. One fourth the antero-posterior diameter of the chest c. Two thirds the antero-posterior diameter of the chest. d. One third the antero-posterior diameter of the chest.
  6. Your team begins administrating chest compressions to a newborn. Correct technique includes which of the following? a. A 2:1 ratio compressions to breaths is being used b. Compression depth is one-fourth the diameter of the chest. c. Thumbs or fingers are lifted off the chest during the relaxation phase d. Chest compressions and ventilation are well coordinated.
  7. What is the appropriate position on this baby to apply chest compressions? (rib picture) a. C b. B c. A d. D
  8. What is the preferred technique for chest compressions? a. Fist technique b. 2 - thumb technique c. Heel-of-hand technique d. 2 - finger technique

LESSON 5: ENDOTRACHEAL INTUBATION AND LARYNGEAL MASK AIRWAY INSERTION

  1. You are part of the team resuscitating a baby who has meconium-stained fluid. A person experienced in endotracheal intubation should be a. Immediately available to join the resuscitation team to assist at every delivery b. No necessary if another team member knows how to place a laryngeal mask airway c. Called in from home when a baby is born and requires intubation d. Called from an office near the hospital.
  2. You are practicing the use of an algorithm to direct the sequence of interventions to correct ventilation. In which situation will the placement of a laryngeal mask airway be useful? a. When a newborn has facial or upper airway malformations and is breathing comfortably. b. When a term new born with thick meconium has respiratory depression at birth. c. When a 30 - week preterm newborn requires surfactant in the delivery room. d. When positive-pressure ventilation with a face mask fails to achieve effective ventilation and intubation is not possible.
  3. During an intubation, you have a very clear view of the hypopharynx. Which of the following is the correct way to lift the tongue out of the way in order to expose the pharyngeal area? a. A upwards b. Teeth support
  4. What size (internal diameter) endotracheal tube should be used to intubate a newborn with an estimated gestational age of 20 weeks (estimated birth weight of 800g) a. 3.5mm b. 3.0mm c. 2.5mm d. 2.0mm
  5. You are certain whether you have successfully intubated a newborn. Which of the following is an indication that endotracheal tube is correctly placed in the trachea and not in the esophagus? a. Continued cyanosis and bradycardia b. Carbon dioxide detector indicates the presence of expired carbon dioxide c. No vapor(mist) is detected in the endotracheal tube d. Air is heard entering the stomach.
  6. You have successfully intubated a newborn with an estimated 35-week gestational age newborn and an estimated birth weight of 2kg. What is the correct tip-to-lip depth of tube insertion to correct placement in the mid-trachea? a. 7cm b. 9cm c. 8cm d. 6cm
  7. What size laryngoscope blade should be used in intubate a newborn with an estimated gestational age of 30 weeks (estimated birth weight of 1200g) a. 2 b. 0 c. 1

d. 00

  1. A full-term newborn has a heart rate less than 60 beats per minute despite 30 seconds of bag- mask ventilation. Your team plans to intubate. Which of the following is a true statement regarding the procedure? a. The endotracheal tube should be slowly pushed through closed vocal cords b. The intubation procedure should ideally be completed in 40 seconds c. The laryngoscope may be held in the left or right hand for intubation. d. The newborn’s head should be positioned in a sniffing position to intubation.
  2. Which of the following is an indication for intubation? a. The presence of thick meconium in a vigorous newborn who must be suctioned. b. An estimated gestational age of less than 28 weeks. c. The need to administer continuous positive airway pressure d. The need for positive-pressure ventilation lasting beyond a few minutes.
  3. What is the approximate period within which one should ideally be able to intubate a newborn? a. 30 seconds b. 40 seconds c. 20 seconds d. 20 seconds
  4. What size (internal diameter) endotracheal tube should you use when intubating a newborn of 30 weeks gestation with a birth weight of 1200g? a. 4.0mm b. 3.5mm c. 3.0mm d. 2.5mm
  5. During an intubation, you want to be sure that you are going to enter the trachea. Which of the following is the glottis? a. Epiglottis b. Vocal node c. Glottis d. Vocal cord

endotracheal tube placement and secure the tube. The heart rate continues to be 30 beats per minute. You provide 45 to 60 seconds of coordinated compressions and ventilations with no improvement in heart rate. You decide to administer epinephrine and a team member places an umbilical venous catheter. What does of 1:10,000 concentration epinephrine will best result in return of spontaneous circulation? a. 0.5ml epinephrine via endotracheal administration b. 0.1ml epinephrine via endotracheal administration c. 0.5ml epinephrine via intravenous administration d. 0.1ml epinephrine via intravenous administration

  1. A 32-week gestational age baby is delivered following 50% abruption and has not responded to the initial steps of resuscitation, 30 seconds of positive-pressure ventilation with chest movement, or 45 to 60 seconds of cardiac compressions coordinatd with positive pressure ventilation in a 3:1 ratio. A dose of epinephrine is administered. The epinephrine should be administered over the following time frame. a. Over 1 to 2 minutes b. Over 5 to 10 minutes c. Rapid push as quickly as possible. d. Over 3 to 5 minutes
  2. You are called to an emergency cesarean delivery of a term baby because of chorioamnionitis meconium stained amniotic fluid and late decelerations that are not recovering. You call for help. At delivery the newborn is apneic with very poor tone, meconium staining and grey color. You quickly intubate and suction for meconium; none is obtained below the cords. You reposition the baby, dry and stimulate but the newborn remains apneic with a heart rate of 40 beats per minute. What is the most appropriate next step of resuscitation? a. Start cardiac compressions coordinated 3:1 with ventilation b. Initiate effect positive – pressure ventilation for 30 seconds and reassess the heart rate c. Intubate and administer 0.05mg/kg of endotracheal epinephrine d. Continue rubbing the back of the baby with a towel to increase stimulation
  3. Which fluid is not reasonable choice for volume expansion? a. O Rh-negative blood b. Ringer’s lactate c. Normal saline d. Placental blood drawn through umbilical cord.
  4. A 34-week gestational age baby is delivered following prolonged premature rupture of membrane and cord prolapsed. The newborn has not responded to the initial steps of resuscitation, 30 seconds of positive pressure ventilation with chest rise, or 45 to 60 seconds of cardiac compression coordinated with positive pressure ventilation in a 3:1 ratio. You decide to administer intravenous epinephrine. Which vessel in the drawing should be used? a. A b. B c. C d. B and C ( two arteries)
  5. A 32-week gestational age baby is delivered following prolonged rupture of membranes and cord prolapsed. The newborn has not responded to initial stage of resuscitation, 30 seconds of

positive-pressure ventilation with chest movement, or 40 to 60 seconds of cardiac compressions coordinated with positive pressure ventilation in a 3:1 ratio. An umbilical venous catheter is placed. a. 10 to 11cm b. Just far enough to get blood return c. Two thirds of the shoulder-to-umbilical distance d. 1 to 2 cm into the insertion site of the umbilical vein.

  1. A 32-week gestational age baby is delivered following prolonged rupture of membranes and cord prolapsed. The newborn has not responded to initial stage of resuscitation, 30 seconds of positive-pressure ventilation with chest movement, or 40 to 60 seconds of cardiac compressions coordinated with positive pressure ventilation in a 3:1 ratio. A dose of epinephrine is administered. a. Increase heart rate via increased inotropy b. Increase heart rate via improved coronary perfusion pressure via its peripheral vasoconstriction c. Increase heart rate via increased chronotropy d. Increase heart rate via increased pulmonary vasoconstriction
  2. Which of the following medication may be used during the first several minutes of neonatal resuscitation? a. Atropine b. Epinephrine c. Calcium d. Sodium bicarbonate

d. The diagnosis of congenital heart disease in these babies can almost always be establish in delivery room.

  1. A new born requires resuscitative efforts for the first 15 minutes following birth. What are common complications in newborns who require prolonged or substantial resuscitation? a. Pulmonary hypertension, hypoglycemia, metabolic alkalosis b. Systemic hypertension, hypoglycemia, hypothermia c. Hypoglycemia, metabolic alkalosis, hypothermia d. Pulmonary hypertension, hypoglycemia, hypothermia
  2. Remembering the MR SOPA acronym helps our team correct problems with ventilation. Which of the following steps are included in MR SOPA? a. Mouth opened, repeat stimulation, saturation check b. Mask seal ensured, repeat stimulation and suction the airway c. Mask seal ensured, reposition head of baby, suction of the airway d. Mouth opened, reposition head, saturation check
  3. During positive-pressure ventilation of a newborn, the breath sounds suddenly become inaudible on one side of the chest. Which of the following statement is true? a. Prior to evacuating a pneumothorax, the baby should be positioned with affected side (with the pneumothorax) placed superior. b. In the delivery room, a pneumothorax should only be evacuated from 4th^ intercostals space in the midclavicular line c. In the delivery room, a pneumothorax should only be evacuated from 2nd^ intercostals space in the anterior axillary line. d. Prior to evacuating a pneumothorax, the baby should be positioned with the affected side (with pneumothorax) placed inferior.
  4. While resuscitating a term newborn, you observe that baby has severe respiratory distress and a usually flat abdomen, with no air entry on the left side. Which of the following is the most likely diagnosis? a. Pulmonary hypoplasia b. Pierre robin syndrome c. Left choanal atresia d. Congenital diaphragmatic hernia
  5. A baby is unable to breath adequately after birth. Which of the following statements is true? a. Pulmonary hypoplasia is rarely associated with pneumothorax b. Hypoplastic lungs are easily ventilated with low inflation pressures c. Severe pulmonary hypoplasia usually in incompatible with survival d. Pulmonary hypoplasia may result from any cause of polyhydramnios
  6. A baby under your care has severe respiratory distress after birth, but can be easily ventilated with positive-pressure ventilation by mask. How can you test for choanal atresia? a. Attempt to pass an endotracheal tube through each naris into the posterior pharynx b. Place a carbon dioxide detector over each of the nares c. Attempt to pass a suction catheter through each naris into the posterior pharynx d. Obtain lateral skull radiographs to determine patency of the nares.

LESSON 8: RESUSCITATION OF BABIES BORN PRETERM

  1. A premature baby has required resuscitation. Which of the following statements about subsequent care is false? a. Management should include monitoring and controlling blood glucose b. Feedings should be initiated cautiously while maintaining intravenous nutrition c. Antibiotic therapy is rarely indicated as infection is unlikely d. The baby should be monitored for apnea and bradycardia during the stabilization period
  2. Which of the following procedures may decrease the risk of brain injury in premature newborn during and after resuscitation? a. Administer hypertonic intravenous fluid boluses. b. Place the newborn in the Trendelenburg position c. Avoid excessive airway pressure d. Ensure that the newborn in kept hyperthermic.
  3. You are in the delivery room caring for preterm newborn at 28 weeks gestation. The baby was intubated for poor respiratory effort and you are providing positive-pressure ventilation. You initially started with 30% oxygen (0.30 FiO2). The newborn has a pulse oximeter on the right wrist; after 10 minute, oxygen saturation is 80% and not rising. Which of the following is an appropriate action? a. Insert an orogastric tube b. Ventilate without positive end-expiratory pressure c. Move the pulse oximeter to the baby’s left wrist d. Increase the oxygen concentration
  4. What resources are needed to prepare for preterm birth? a. Additional means to maintain body temperature should be prepare, such as reclosable polyethylene bags and portable warming pad. b. Additional trained personnel should be requested, including someone with expertise performing endotracheal intubation c. A pulse oximeter and an oxygen blender should be available in the delivery room d. All of these.
  5. You are in the delivery room caring for a preterm newborn at 27 weeks gestation. The baby’s mother had a fever and chorioamnionitis. Resuscitation has been completed and the baby is ready to be transported to the neonatal intensive care unit. Which of the following is true statement about the baby’s subsequent care a. Supplemental oxygen should be provided to maintain the baby’s oxygen saturation equal to or above 98% b. Enteral feedings should be started immediately and advanced rapidly to ensure adequate nutrition. c. Blood glucose levels should be monitored because glycogen stores may be rapidly depleted after resuscitation d. Antibiotics are not included because the risk of infection if low following preterm birth.
  6. You have been called to attend the birth of a baby at 25 weeks gestation with an estimated fetal weight of 750g. Which of the following practices may decrease this newborn’s risk of neurologic injury?
  1. You have been called to attend the birth of a baby at 25 weeks gestation, with an estimated fetal weight of 750g. Which of the following is a true statement about the preparation and resources needed for this preterm baby? a. A size 1 laryngoscope and size 3.5mm endotracheal tube should be prepared for the initial intubation attempt, in the event that the baby has respiratory distress b. The delivery room temperature should be decreased to approximately 65oF to 66oF (18.3oC to 18.8oC) to avoid hyperthermia c. A compressed air source, oxygen blender and pulse oximeter should be in the room and available for immediate use. d. Personnel skilled in intubation and umbilical catheter placement may be on call at home or in another area of the hospital.

Lesson 9: Ethics and Care at the End of Life

  1. You are counselling a set of 17 year-old parents, whose baby is about to born at 23 weeks’ gestation. You have explained that survival is unlikely and that in the event of survival the likelihood of severe long term morbidity is high. The parents may firmly request that everything be done, starting with resuscitation at birth. How might you answer them? a. You explain that your first obligation is to do no harm and given the statistics, you will not begin resuscitation b. You tell them you are glad the made this choice because federal law requires you to do this anyway c. You assure them as the parents, they are the appropriate voice for their baby and you will support their wishes. d. You tell them because they are younger than the legal voting age, they are not able to make final decisions and you will take that responsibility.
  2. When a fetus viability is thought to be marginal and there is a high rate of morbidity, what should be included in your discussion with the parents concerning options for resuscitation? a. An ethics consultation must be requested in order to make a decision b. No resuscitation will be started under any circumstances c. The resuscitation team will make the appropriate decision after birth d. The option of comfort care only can be considered
  3. In most cases who is (are) the usual and appropriate surrogate decision maker(s) for a newborn? a. The delivering obstetrician. b. The parents c. The members of the resuscitation team. d. The hospital chaplain.
  4. You are called to the birth of a newborn weighing 385g and gestational age of just under 23 weeks, a birth weight that is associated with almost certain early death and nearly universal rate of severe morbidity among the rare survivors. Which action is appropriate? a. Attempts at resuscitation can be delayed for up to five minutes to allow time to determine whether the baby might respond. b. Attempts at resuscitation should only be done after consultation with the hospital ethics committee. c. Attempt at resuscitation are not indicated under these circumstances, care should focus on comfort alone d. Attempts at resuscitation are indicated and expected if your team is called to birth.
  5. You are called to counsel the parents of a fetus who is believe to be at the lower limits of viability and whose birth is imminent. What should you tell the parents when they ask you how decisions about resuscitation are made? a. The decision agreed to before birth may need to be modified based on the condition of the baby after birth and the postnatal gestational age assessment. b. You will categorically honor and follow whatever decision – to initiate or withhold resuscitation – you reach together prior to birth. c. You offer to bring an ultrasonographer to the birth so that the baby can be immediately assessed for presence of an intracranial hemorrhage, to guide decisions.