NRP Post-Resuscitation Care and NICU Stabilization 1 — Questions and Answers
Question 1: After successful resuscitation, which vital sign parameter requires the closest monitoring in the immediate post-resuscitation period?
- Heart rate and SpO₂ (Correct answer)
- Temperature only
- Blood pressure exclusively
- Urine output alone
Correct answer: Heart rate and SpO₂
Heart rate and oxygen saturation are the primary indicators of ongoing cardiorespiratory stability after neonatal resuscitation.
Question 2: What blood glucose level requires treatment in a post-resuscitation neonate?
- Below 40–45 mg/dL (Correct answer)
- Below 60 mg/dL
- Below 80 mg/dL
- Below 30 mg/dL only if symptomatic
Correct answer: Below 40–45 mg/dL
Hypoglycemia (blood glucose below 40–45 mg/dL) after resuscitation requires treatment because the recovering brain is highly sensitive to low glucose.
Question 3: What is the risk of administering high-concentration oxygen for prolonged periods to a recovering neonate?
- Oxidative stress, free radical injury, and retinopathy of prematurity (Correct answer)
- Only hypocapnia from over-ventilation
- Hyperkalemia due to cell breakdown
- Prolonged hyperoxia has no documented harm
Correct answer: Oxidative stress, free radical injury, and retinopathy of prematurity
Prolonged hyperoxia generates reactive oxygen species that damage the brain, lungs, eyes, and other organs in neonates.
Question 4: Which complication of birth asphyxia affects multiple organ systems after initial resuscitation?
- Hypoxic-ischemic encephalopathy (HIE) — brain, kidney, heart, liver, and gut injury (Correct answer)
- Isolated respiratory failure only
- Polycythemia affecting only the blood
- Cardiac arrhythmia as the sole complication
Correct answer: Hypoxic-ischemic encephalopathy (HIE) — brain, kidney, heart, liver, and gut injury
HIE from birth asphyxia is a multisystem disorder; the brain suffers the most but kidneys, heart, liver, and intestines are also commonly injured.
Question 5: What is the role of continuous positive airway pressure (CPAP) in post-resuscitation management of preterm infants?
- Supports lung recruitment and reduces need for intubation in spontaneously breathing preterm infants (Correct answer)
- Replaces PPV during active resuscitation
- Delivers medications directly to the lungs
- Used only after extubation from mechanical ventilation
Correct answer: Supports lung recruitment and reduces need for intubation in spontaneously breathing preterm infants
CPAP maintains positive airway pressure during spontaneous breathing, recruits alveoli, and reduces atelectasis in preterm infants after stabilization.
Question 6: What is the purpose of a post-resuscitation blood gas in a newborn who required PPV or compressions?
- To assess acid-base status, oxygenation, and ventilation adequacy (Correct answer)
- Only to confirm intubation placement
- To measure glucose and electrolytes
- Blood gas is not indicated after resuscitation
Correct answer: To assess acid-base status, oxygenation, and ventilation adequacy
A blood gas reveals the degree of acidosis, hypoxia, and CO₂ retention, guiding ongoing ventilatory and hemodynamic management.
