Quiz 1: Failure to breathe at birth and resuscitation

Question 1

How many infants breathe well at birth?

50%
75%
80%
90%

Answer 1

90%

Question 2

Which vital sign is included in the Apgar score?

Temperature
Heart rate
Meconium staining
Oedema

Answer 2

Heart rate

Question 3

Most newborn infants that breathe well after delivery should have:

Pink hands at birth
Pink feet at birth
Pink hands and feet by 1 minute
A pink tongue by 1 minute

Answer 3

A pink tongue by 1 minute

Question 4

A normal Apgar score at 1 minute is:

Above 10
7–10
3–7
Less than 3

Answer 4

7–10

Question 5

The Apgar score at 1 minute should be determined:

In all newborn infants

Only when there have been signs of fetal distress

Only if the infant does not breathe well after birth

Only if the infant needs mask ventilation

Answer 5

In all newborn infants

Question 6

What is the value of the 1 minute Apgar score?

It predicts brain damage.

It confirms fetal hypoxia.

It is used to assess the infant’s clinical condition at birth.

It is used to assess gestational age.

Answer 6

It is used to assess the infant’s clinical condition at birth.

Question 7

What is the value of a 5 minute Apgar score?

It is used to define ‘failure to breathe at birth’.

It is used to assess the success or failure of resuscitation.

It helps to decide whether further resuscitation is hopeless.

It accurately predicts whether the infant will develop cerebral palsy.

Answer 7

It is used to assess the success or failure of resuscitation.

Question 8

In which of the following situations would you anticipate that the infant will need resuscitation at birth?

Caesarean section under general anaesthesia

Caesarean section under epidural anaesthesia

Mother had pethidine 8 hours before delivery

Mother received nitrous oxide during the second stage of labour

Answer 8

Caesarean section under general anaesthesia

Question 9

All the equipment for basic resuscitation is needed:

In operating theatres only
In level 2 hospitals only
In level 3 hospitals only
In all hospitals and clinics where infants are delivered

Answer 9

In all hospitals and clinics where infants are delivered

Question 10

If an infant does not breathe immediately after birth, what do you do first?

Stimulate the infant by drying it.

Start chest compressions.

Cool the infant.

Give naloxone by intramuscular injection.

Answer 10

Stimulate the infant by drying it.

Question 11

Which staff members need to be able to resuscitate infants:

Doctors only

Midwives only

Doctors and senior midwives only

All staff who conduct deliveries

Answer 11

All staff who conduct deliveries

Question 12

After being well dried which infants should have their mouth and pharynx suctioned:

Preterm infants

Infants born by Caesarean section

Infants that fail to breathe well

All newborn infants

Answer 12

Infants that fail to breathe well

Question 13

Which infants should be resuscitated with oxygen?

Infants who fail to respond to good bag and mask ventilation

Preterm infants

Meconium stained infants

All infants

Answer 13

Infants who fail to respond to good bag and mask ventilation

Question 14

An infant who cannot be adequately ventilated with bag and mask should:

Be intubated and ventilated.

Be given chest compressions.

Be given adrenaline.

Receive no further resuscitation as it has probably suffered brain damage.

Answer 14

Be intubated and ventilated.

Question 15

Which of the following rates is recommended for ventilating a newborn infant?

20 breaths per minute

40 breaths per minute

80 breaths per minute

140 breaths per minute

Answer 15

40 breaths per minute

Question 16

Naloxone (Narcan) reverses the respiratory depression caused by:

Barbiturates
General anaesthesia
Diazepam (Valium)
Pethidine and morphine

Answer 16

Pethidine and morphine

Question 17

The infant’s chance of survival is poor if:

The 1 minute Apgar score is low.

The 5 minute Apgar score is low.

The 20 minute Apgar score is low.

The infant needs to be intubated and ventilated.

Answer 17

The 20 minute Apgar score is low.

Question 18

If an infant is heavily meconium stained at delivery:

It is important to stimulate respiration before suctioning the airways.

The mouth should be suctioned before the shoulders are delivered.

The mouth should only be suctioned after the infant is completely delivered.

Only the nose should be suctioned.

Answer 18

The mouth should be suctioned before the shoulders are delivered.

Question 19

Which size of catheter should be used to suction a meconium-stained infant at birth?

F 3.5
F 5
F 6
F 10

Answer 19

F 10

Question 20

Severe hypoxia before delivery causing fetal distress:

Will always result in stillbirth or neonatal death.

May cause transient or permanent brain damage.

Does not damage the heart and kidneys.

Is an indication not to resuscitate the infant at birth.

Answer 20

May cause transient or permanent brain damage.