North American Registry of Midwives (NARM) Practice Exam

After delivering 30 seconds of chest compression to a newborn, what should the caregiver do next?

1. Continue compressions for another 30 seconds

2. Pause and evaluate the heart rate for 6 seconds

3. Administer medications

4. Initiate resuscitation protocol

The correct answer is: Pause and evaluate the heart rate for 6 seconds

Following 30 seconds of chest compressions on a newborn, the appropriate next step is to pause and evaluate the heart rate for 6 seconds. This action is crucial as it allows the caregiver to assess whether the interventions have been effective in restoring circulation and heart function. Monitoring the heart rate after chest compressions gives immediate feedback on the newborn's cardiac status. A heart rate below 60 beats per minute indicates that further resuscitation efforts are necessary, whereas a heart rate above 60 suggests that the child is responding positively to the chest compressions and that resuscitation may need to be continued or adjusted accordingly. In neonatal resuscitation, regular assessment of the heart rate is a core element of the protocol, as it guides the caregiver's next steps, including whether to continue with compressions or begin additional interventions. This methodical approach helps ensure that interventions are targeted and effective, thus improving outcomes for the newborn. The other actions may be important in various contexts but do not immediately follow the initial 30 seconds of chest compressions as a priority in neonatal resuscitation. The focus should remain on immediate heart assessment to guide further action.