Neonatology: resuscitation: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neonatology: resuscitation

Sample item

A newborn is not breathing and has a heart rate of 50 per minute despite 30 seconds of effective ventilation with a bag and mask. What is the next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Start chest compressions at a ratio of 3 compressions to 1 breath

In newborn resuscitation, effective ventilation is the priority. If the heart rate remains below 60 per minute after 30 seconds of effective ventilation, chest compressions are begun at a 3:1 compression to ventilation ratio, using the two-thumb encircling technique. Adrenaline is given if the heart rate stays below 60 after a further 60 seconds.

Option by option

  • A. Give intravenous adrenaline immediately without compressions

    Adrenaline follows compressions and ventilation, not before them.

  • B. Start chest compressions at a ratio of 3 compressions to 1 breath (correct)

    Correct. Compressions are added when the heart rate is below 60 despite effective ventilation.

  • C. Continue ventilation only for another 5 minutes

    Persisting bradycardia needs compressions, not more ventilation alone.

  • D. Intubate and give sodium bicarbonate

    Bicarbonate is not a routine part of initial neonatal resuscitation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Start chest compressions at a ratio of 3 compressions to 1 breath. In newborn resuscitation, effective ventilation is the priority.

Why is "Give intravenous adrenaline immediately without compressions" not the answer?

Adrenaline follows compressions and ventilation, not before them.

Why is "Continue ventilation only for another 5 minutes" not the answer?

Persisting bradycardia needs compressions, not more ventilation alone.

Why is "Intubate and give sodium bicarbonate" not the answer?

Bicarbonate is not a routine part of initial neonatal resuscitation.

What concept does this question test?

It tests Neonatology: resuscitation in Pediatrics. If the heart rate remains below 60 per minute after 30 seconds of effective ventilation, chest compressions are begun at a 3:1 compression to ventilation ratio, using the two-thumb encircling technique. Adrenaline is given if the heart rate stays below 60 after a further 60 seconds.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neonatology: resuscitation?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.