1. Which of the following is NOT an antepartum risk factor that increases the potential that a newborn may require resuscitation?
A) Preeclampsia
B)
... [Show More] Prolapsed cord
C) Polyhydramnios
D) Multiple gestations
B) Prolapsed cord
2. The risk of newborn complications is HIGHEST if the amniotic sac:
A) encases the baby's face at birth.
B) is still intact at the time of birth.
C) contains thin, brown amniotic fluid.
D) ruptured more than 18 hours before birth.
D) ruptured more than 18 hours before birth.
3. Which of the following events is a critical part of fetal transition?
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 arteriosis
A) Diversion of blood flow to the fetus's lungs
4. Causes of delayed fetal transition include all of the following, EXCEPT:
A) acidosis.
B) hypothermia.
C) birth at 41 weeks.
D) meconium aspiration.
C) birth at 41 weeks.
5. A newborn born between ___ and ___ weeks of gestation is described as term.
A) 36, 38
B) 38, 42
C) 40, 42
D) 42, 44
B) 38, 42
6. A delay in clamping the umbilical cord and keeping the baby below the level of the placenta can result in fetal:
A) anemia.
B) hypovolemia.
C) exsanguination.
D) polycythemia.
D) polycythemia.
7. While preparing equipment for newborn resuscitation, which of the following items is/are NOT considered optional?
A) Pulse oximeter
B) Cardiac monitor
C) Endotracheal tubes
D) Laryngeal mask airway
C) Endotracheal tubes
8. Which of the following statements regarding the Apgar score is correct?
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.
D) A newborn with a heart rate of greater than 80 beats/min would be assigned a score of 2 on the Apgar score.
A) If resuscitation is necessary, the Apgar score is completed to determine the result of the resuscitation.
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:
A) 2.
B) 3.
C) 4.
D) 5.
A) 2.
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:
A) 5.
B) 6.
C) 7.
D) 8.
D) 8.
11. If a newborn does not respond to the initial steps of resuscitation, the need for further intervention is based upon:
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.
B) respiratory effort, pulse rate, and color.
12. The initial steps of newborn resuscitation include:
A) free-flow oxygen.
B) proper positioning.
C) assessment of pulse rate.
D) positive-pressure ventilation.
B) proper positioning.
13. If you feel 13 pulsations in a 6-second time frame, the newborn's heart rate is approximately:
A) 30 beats/min.
B) 60 beats/min.
C) 90 beats/min.
D) 130 beats/min.
D) 130 beats/min.
14. The MOST common etiology for bradycardia in a newborn is:
A) severe hypoxia.
B) untreated acidosis.
C) occult hypovolemia.
D) increased vagal tone
A) severe hypoxia.
15. A newborn with central cyanosis, adequate respirations, and a heart rate of 120 beats/min should initially be treated with:
A) continued observation only.
B) high-flow oxygen via mask.
C) free-flow oxygen at 5 L/min.
D) positive-pressure ventilation.
C) free-flow oxygen at 5 L/min.
16. Choanal atresia is defined as a:
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.
C) bony or membranous obstruction of the nose
17. An oropharyngeal airway would MOST likely be indicated for a newborn with:
A) gasping respirations.
B) Pierre Robin sequence.
C) a diaphragmatic hernia.
D) prolonged periods of apnea.
B) Pierre Robin sequence.
18. A newborn with a pulse rate of 80 beats/min:
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.
D) requires immediate positive-pressure ventilation
19. The MOST common device used to provide positive-pressure ventilation to a newborn in the prehospital setting is a:
A) T-piece resuscitator.
B) self-inflating bag-mask device.
C) flow-inflating bag-mask device.
D) manually triggered ventilator.
B) self-inflating bag-mask device
20. Common causes of respiratory distress in the newborn include:
A) mucous obstruction of the nose.
B) unrecognized metabolic alkalosis.
C) persistent pulmonary hypotension.
D) maternal use of a narcotic analgesic
A) mucous obstruction of the nose
21. Compared to subsequent breaths, the first few positive-pressure breaths delivered to a distressed newborn:
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.
C) may necessitate manual disabling of the pop-off valve.
22. The correct positive-pressure ventilation rate for an apneic newborn is:
A) 12 to 20 breaths/min.
B) 20 to 30 breaths/min.
C) 30 to 40 breaths/min.
D) 40 to 60 breaths/min.
D) 40 to 60 breaths/min
23. The MOST common reasons for ineffective bag-mask ventilations in the newborn are:
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.
B) inadequate mask-to-face seal and incorrect head position.
24. Endotracheal intubation is clearly indicated in the newborn if:
A) its heart rate is improving, but only because of adequate ventilations and chest compressions.
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.
B) meconium is present in the amniotic fluid and the newborn is limp and has a heart rate of 70 beats/min
25. What size and type of laryngoscope blade is recommended for use in a full-term newborn?
A) No. 1, straight
B) No. 2, straight
C) No. 1, curved
D) No. 2, curved
A) No. 1, straight
26. When suctioning the newborn's oropharynx to clear secretions prior to intubation, it is MOST important to:
A) limit suctioning to 15 seconds.
B) use a flexible suction catheter.
C) monitor the newborn's heart rate.
D) assess pulse oximetry and capnography.
C) monitor the newborn's heart rate.
27. Signs of a diaphragmatic hernia include all of the following, EXCEPT:
A) a scaphoid or concave abdomen.
B) bilaterally absent breath sounds.
C) noted increased work of breathing.
D) audible bowel sounds in the chest.
B) bilaterally absent breath sounds
28. After inserting an orogastric tube in a newborn, you should:
A) leave the 20-mL syringe attached.
B) perform intubation within 2 minutes.
C) connect the tube to continuous suction.
D) leave the tube open to allow air to vent.
D) leave the tube open to allow air to vent.
29. Chest compressions are indicated in the newborn if its heart rate remains less than ____ beats/min despite effective positive-pressure ventilations for ____ seconds.
A) 80, 30
B) 60, 30
C) 60, 60
D) 80, 60
B) 60, 30
30. When performing chest compressions on a newborn, you should:
A) compress the chest one third the anteroposterior depth of the chest.
B) use the two-finger compression technique if two rescuers are present.
C) reassess the newborn's heart rate after every 60 seconds of compressions.
D) deliver 120 compressions and 40 ventilations during any 60-second period.
A) compress the chest one third the anteroposterior depth of the chest.
31. If a newborn requires epinephrine and peripheral venous access is unsuccessful, you should:
A) cannulate the umbilical vein.
B) insert an IO catheter.
C) perform intubation immediately.
D) inject the drug directly into a vein.
A) cannulate the umbilical vein
32. Epinephrine is indicated during newborn resuscitation if:
A) the heart rate does not increase above 80 beats/min after 30 to 60 seconds of effective positive-pressure ventilation.
B) the newborn is bradycardic and thick secretions are hindering your ability to provide effective positive-pressure ventilations.
C) the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions.
D) profound central cyanosis persists despite 30 seconds of effective positive-pressure ventilation with 100% supplemental oxygen.
C) the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions.
33. The recommended IV dose and concentration of epinephrine for the newborn is:
A) 0.01 mg/kg, 1:1,000.
B) 0.3 to 1 mL/kg, 1:10,000.
C) 0.01 to 0.03 mg/kg, 1:1,000.
D) 0.1 to 0.3 mL/kg, 1:10,000.
D) 0.1 to 0.3 mL/kg, 1:10,000
34. Signs of hypovolemia in the newborn include all of the following, EXCEPT:
A) persistent pallor.
B) weak central pulses.
C) persistent acrocyanosis.
D) persistent bradycardia.
C) persistent acrocyanosis
35. If hypovolemia is suspected or confirmed, you should administer ____ mL of normal saline to a 6-pound newborn over a period of ____.
A) 18, 10 to 20 minutes
B) 27, 5 to 10 minutes
C) 33, 10 to 20 minutes
D) 55, 5 to 10 minutes
B) 27, 5 to 10 minutes
36. How much naloxone should you give to a 6.5-pound newborn with respiratory depression secondary to maternal narcotic administration?
A) 0.3 mg
B) 0.4 mg
C) 0.5 mg
D) 0.6 mg
A) 0.3 mg
37. Naloxone is NOT recommended for use in newborns:
A) who weigh less than 5.5 lbs.
B) who are born to narcotic-addicted mothers.
C) unless the umbilical vein has been cannulated.
D) with shallow breathing and persistent bradycardia.
B) who are born to narcotic-addicted mothers.
38. A shift of heart tones and severe respiratory distress despite positive-pressure ventilations is indicative of:
A) a pneumothorax.
B) a diaphragmatic hernia.
C) Pierre Robin sequence.
D) a pericardial tamponade.
A) a pneumothorax
39. A newborn is at GREATEST risk for meconium aspiration if he or she:
A) is large for his or her gestational age.
B) requires positive-pressure ventilations.
C) has respiratory depression at the time of birth.
D) is born at more than 42 weeks' gestation.
D) is born at more than 42 weeks' gestation.
40. In contrast to primary apnea, secondary apnea:
A) is characterized by profound tachycardia.
B) commonly follows a brief period of hypoxia.
C) is usually unresponsive to stimulation alone.
D) necessitates immediate endotracheal intubation.
C) is usually unresponsive to stimulation alone. [Show Less]