NRP Megacode Scenario 5
By Lisa Wright, MHA, RRT-NPS | Medically reviewed by Mark Dzwonkiewicz, FP-C, LI on December 5, 2024
Quiz Summary
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Question 1 of 14
1. Question
Dr. Jacoby’s patient has delivered a 3.6 kg infant born at 39 weeks. When delivered, the baby boy is flaccid and is not breathing or crying.You warm, dry, stimulate, position the airway, and suction the baby. He still is not breathing, but you auscultate for a heart beat and note that the heart rate is 56 bpm.
1. You know that a normal heart rate for a newly born baby is:
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Question 2 of 14
2. Question
The infant has gasping respirations. You reposition the infant and begin positive pressure ventilation using a bag-mask device at a rate of 50 breaths per minute with an oxygen concentration of 21%.Another team member applies a pulse oximeter and a cardiac monitor.
After you provide PPV for 15 seconds, you instruct the team to do a quick assessment of the newborn.
2. The most significant finding of successful resuscitation of this infant is:
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Question 3 of 14
3. Question
The team member doing the assessment announces that the chest is rising, and the heart rate is still at 56 bpm.As the resuscitation team leader, you go through the MR. SOPA interventions to improve ventilation and increase the heart rate. After an additional 15 seconds of PPV, the team reports that the infant’s heart rate has not changed.
3. You know that the next intervention you must do is:
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Question 4 of 14
4. Question
As you prepare for endotracheal tube insertion, you instruct the team to begin chest compressions.4. The correct rate for chest compressions for an infant is:
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Question 5 of 14
5. Question
As chest compressions and PPV continue, you intubate the infant and increase the oxygen concentration to 100%.5. After intubation, the chest compression to ventilation ratio should be:
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Question 6 of 14
6. Question
The team is providing PPV with visible chest rise in coordination with the chest compressions.At the end of 60 seconds, the team stops CPR and looks at the ECG monitor to determine the heart rate. The heart rate on the monitor is still 56 bpm.
6. At this point, the team should:
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Question 7 of 14
7. Question
7. While CPR is in progress, your next best intervention is to direct the team to:
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Question 8 of 14
8. Question
8. The preferred route for administration of medications in the newly born population is:
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Question 9 of 14
9. Question
9. The medications that can be administered through an IO site include:
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Question 10 of 14
10. Question
The umbilical cord is still clamped. The team leader determines the umbilical vein will be the route for the vascular access.The person who will insert the umbilical catheter assembles the equipment and asks the team to stop compressions.
10. The first step in the insertion process is to:
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Question 11 of 14
11. Question
You clean the umbilical cord and cut the umbilical cord approximately 2 cm above the baby’s skin line in preparation for inserting the umbilical catheter.11. When looking at the cut end of the umbilical cord, you know that the umbilical vein is at the:
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Question 12 of 14
12. Question
You insert the umbilical catheter into the vein until you see blood return into the tubing. The team continues compressions and PPV.The team has epinephrine with a concentration of 1:10,000.
12. As team leader, you know that the correct dosage for epinephrine via the umbilical vein is:
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Question 13 of 14
13. Question
You give the initial dose of epinephrine and flush the stopcock with normal saline.One minute after giving the epinephrine and continuing CPR, you ask the team to pause compressions so you can see the heart rate on the cardiac monitor. You note that the heart rate has not increased. You order CPR and ventilations to resume. You order a second dose of epinephrine.
13. Epinephrine can be repeated every:
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Question 14 of 14
14. Question
You give the second dose of epinephrine and flush the stopcock with normal saline.One minute after giving the epinephrine and continuing CPR, you ask the team to pause compressions so that you can see the heart rate on the cardiac monitor. You note that the heart rate is still less than 60 bpm.
14. Additional considerations of things that might be affecting heart rate include:
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NRP Megacode Scenario 5 Video
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