RNC-NIC Exam (Complete) | Questions
And Answers | Latest Exam 2026-2027
| 100% Guaranteed Pass | Already
Graded A+
amniocentesis -ANSWER needle puncture of the amniotic sac to withdraw amniotic fluid
for analysis
- screens for chromosomal abnormalities
- typically performed early in 2nd trimester (15-20 wks), more accurate >20 wks d/t
chromosomal presence in fluid
- **also can be used later in pregnancy to assess fetal lung maturity**
- often recommended for AMA
thrombocytopenia (maternal) -ANSWER - a generally benign maternal medical
complication that is due to hemodilution (increased RBCs)
- may be associated with hypertensive conditions r/t pregnancy
- may be associated with s/s of bleeding in the infant
risks of maternal thrombocytopenia -ANSWER can result in:
- increased risk of bleeding in the mother, especially during the delivery
- **bleeding in the infant (oozing from umbilical cord, prolonged bleeding from heel
sticks, bruising, **petechiae
neonatal petechiae -ANSWER - must consider hyperbilirubinemia/jaundice (breakdown of
RBCs)
- also associated with maternal thrombocytopenia
cytomegalovirus (CMV) -ANSWER - **most common intrauterine infection**
- transmitted by exposure to infected blood or body fluids
- majority of infants asymptomatic at birth, but 5-15% have later sequelae (most
commonly hearing and vision loss)
contraindication for breastfeeding -ANSWER - maternal HIV/AIDS infection
- **HIV/AIDS can be spread through breastfeeding**
signs of HIV in newborn -ANSWER - poor weight gain
- **repeated fungal mouth infections** (thrush)
- enlarged lymph nodes
- enlarged liver/spleen
- neurologic problems
- multiple bacterial infections, including pneumonia
,chlamydia -ANSWER - **most common bacterial sexually transmitted infection**
- *treatment: erythromycin*
signs/symptoms of neonatal chlamydia -ANSWER - conjunctivitis in first few weeks
- late-onset: pneumonia at 3-4 months
- otitis media
- gastroenteritis
oligohydramnios -ANSWER - AF volume <1 L at 36 weeks, <800 mL at term
- can lead to pulmonary hypoplasia d/t amniotic fluid's role in fetal pulmonary
development
- **may be related to Potter sequence/renal agenesis** because AF is largely made up
of fetal urine (no urine if the baby has no kidneys)
- **can lead to hypoplastic lungs**
- can also lead to IUGR and positional deformities (baby can't move well)
Potter sequence (renal agenesis) -ANSWER - **Renal agenesis -> oligohydramnios ->
severe pulmonary hypoplasia**
- association of defects beginning w/ bilateral renal agenesis d/t failure of the ureteric
bud to divide
- urine formation does not occur --> low or absent amniotic fluid volumes
- fetal structures are compressed
- associated defects: abnormal genital dev., leg deformities, GI defects, arthrohyposis,
pulmonary hypoplasia
- *most infants will die within the first several days; often d/t associated lung hypoplasia*
hydramnios or polyhydramnios -ANSWER - AF volume >2L
- **may be due to GI obstructions (e.g. esophageal atresia, duodenal to anal atresia) d/t
the baby being unable to swallow amniotic fluid, so the AF keeps building up in utero **
- also can be d/t tight nuchal cord or neurologic defects which may also obstruct or
impair fetal swallowing
PROM -ANSWER - premature rupture of membranes, before the onset of labor
- **risk of infection if directly proportional to the duration of ROM**
- **after 24 hours of ROM, the risk of infection escalates significantly**
PPROM -ANSWER - preterm premature rupture of membranes, PROM occurring before
37 weeks
- does not necessarily lead to the onset of labor if it occurs too early, but after 24 hours
of ROM, the risk of infection escalates
- **risk of infection if directly proportional to the duration of ROM**
maternal serum alpha fetaprotein (MSAFP) -ANSWER - aka triple or quad screen
- test during pregnancy that measures a major fetal protein produced in the fetal liver at
>22 wks that is present in the mother's blood
,- maternal blood test that is a clue for some fetal anomalies, generally between 15-22
wks, optimally at 16-18 wks
- **elevated levels may be indicative of neural tube defects (not diagnostic, but is a
clue)**
- low levels associated with Trisomy 21
Lecithin/Sphingomyelin (L/S) ratio -ANSWER - test of amniotic fluid to assess fetal lung
maturity
- may help determine lung maturity to see when to deliver prematurely if necessary
- **normal: greater or equal to ~2**
- <2 indicates immature lungs, <1.5 is associated with a high risk of RDS
fetal heart rate (FHR) decelerations -ANSWER - defined as a fetal heart rate decrease of
at least 15 bpm that lasts longer than 2 min. but less than 10 min.
cause of early decelerations -ANSWER **head compression**
cause of variable decelerations -ANSWER **cord compression**
cause of late decelerations -ANSWER **hypoxemia or placental insufficiency**
fetal tachycardia -ANSWER - fetal HR >160 for 10 or more min.
- sustained 170s-180s **think infection**
- also could be caused by acute hypoxemia/hypoxia, maternal fever, maternal anxiety,
maternal hyperthyroidism
effects of maternal magnesium sulfate on newborn -ANSWER - tocolytic medication that
can be used for neuroprotection in preterm labor that can cause **neuromuscular or
respiratory depression in the newborn**
effects of maternal prostaglandin inhibitors in newborn -ANSWER - tocolytic medications
such as indomethacin that puts the fetus at risk of premature ductal closure in utero,
pulmonary HTN, and altered renal function if given to mother
effects of maternal betaminetics in newborn -ANSWER - tocolytic medications such as
terbutaline that can cause **hypoglycemia in the newborn due to hyperinsulinemia**
(baby's pancreas produces too much insulin, thus lowering blood glucose)
risks of vacuum assisted delivered -ANSWER - can case cephalohematoma, retinal
hemorrhage, and intracranial hemorrhage (rarely); consider **hyperbilirubinemia** -->
may show as bruising and bleeding
transillumination -ANSWER - tool used for newborn physical exam that is a fiberoptic light
source attached to the end of a long, flexible tube
- fluid- or air-filled structures will transmit the light (light up), e.g. hydroceles, severe
hydrocephalus, pneumothorax
, -**solid masses will NOT light up/transmit light, e.g. tumors, testicular torsion**
red reflex -ANSWER - **reflex due to light reflecting off the interior lining of the eye
(fundus)**
- shows as a bright orange-red or pale/gray in darker skinned newborns
- absent or disrupted reflex could be congenital cataracts, glaucoma, or retinoblastoma
acrocyanosis -ANSWER - **blue/pale discoloration of hands and feet, normal in the first
48 hours of life**
general pallor/cyanosis -ANSWER - blue/pale discoloration outside of the first 48 hours of
life or outside of just the hands/feet that may be due to anemia, hypoxemia, or shock
how to differentiate between cyanosis and ecchymosis (bruising) -ANSWER - **assess
the ability of the skin to blanch**
- **ecchymosis (bruising) will NOT blanch**
jaundice/icterus -ANSWER - **yellow discoloration of the skin d/t hyperbilirubinemia**
- **ALWAYS an abnormal finding in the FIRST 24 HOURS OF LIFE**
general safe temperature range -ANSWER 36 to 37.5 degrees C (96.8 to 99.5 degrees F)
craniotabes -ANSWER - **aka congenital cranial osteoporosis, defined as a softening of
the skull bones**
- can occur in up to 1/3 of all newborns and can be a normal finding, especially in
preemies
- **soft areas of the skull (especially along the suture line) can pop in and out like a ping
pong ball
- **mostly found along the occipital and parietal bones
caput succedanenum -ANSWER - hemorrhagic edema that **crosses suture line**
- evident at birth; looks like soft swelling with discoloration (usually looks like a
bruise/red, blue, purple)
- does not grow in size
- may develop hyperbilirubinemia (bleeding/bruising --> jaundice)
preauricular sinuses/pit -ANSWER - **often associated with renal abnormalities and 2-
vessel cord**
- could also be skin tags (more common)
cystic hygroma -ANSWER - fluid-filled sacs that results from a blockage in the lymphatic
system
- **may require immediate intubation or emergent tracheotomy in the delivery room**
- ENT typically present at delivery
- some cases resolve, leading to webbed neck, edema, and lymphangioma
And Answers | Latest Exam 2026-2027
| 100% Guaranteed Pass | Already
Graded A+
amniocentesis -ANSWER needle puncture of the amniotic sac to withdraw amniotic fluid
for analysis
- screens for chromosomal abnormalities
- typically performed early in 2nd trimester (15-20 wks), more accurate >20 wks d/t
chromosomal presence in fluid
- **also can be used later in pregnancy to assess fetal lung maturity**
- often recommended for AMA
thrombocytopenia (maternal) -ANSWER - a generally benign maternal medical
complication that is due to hemodilution (increased RBCs)
- may be associated with hypertensive conditions r/t pregnancy
- may be associated with s/s of bleeding in the infant
risks of maternal thrombocytopenia -ANSWER can result in:
- increased risk of bleeding in the mother, especially during the delivery
- **bleeding in the infant (oozing from umbilical cord, prolonged bleeding from heel
sticks, bruising, **petechiae
neonatal petechiae -ANSWER - must consider hyperbilirubinemia/jaundice (breakdown of
RBCs)
- also associated with maternal thrombocytopenia
cytomegalovirus (CMV) -ANSWER - **most common intrauterine infection**
- transmitted by exposure to infected blood or body fluids
- majority of infants asymptomatic at birth, but 5-15% have later sequelae (most
commonly hearing and vision loss)
contraindication for breastfeeding -ANSWER - maternal HIV/AIDS infection
- **HIV/AIDS can be spread through breastfeeding**
signs of HIV in newborn -ANSWER - poor weight gain
- **repeated fungal mouth infections** (thrush)
- enlarged lymph nodes
- enlarged liver/spleen
- neurologic problems
- multiple bacterial infections, including pneumonia
,chlamydia -ANSWER - **most common bacterial sexually transmitted infection**
- *treatment: erythromycin*
signs/symptoms of neonatal chlamydia -ANSWER - conjunctivitis in first few weeks
- late-onset: pneumonia at 3-4 months
- otitis media
- gastroenteritis
oligohydramnios -ANSWER - AF volume <1 L at 36 weeks, <800 mL at term
- can lead to pulmonary hypoplasia d/t amniotic fluid's role in fetal pulmonary
development
- **may be related to Potter sequence/renal agenesis** because AF is largely made up
of fetal urine (no urine if the baby has no kidneys)
- **can lead to hypoplastic lungs**
- can also lead to IUGR and positional deformities (baby can't move well)
Potter sequence (renal agenesis) -ANSWER - **Renal agenesis -> oligohydramnios ->
severe pulmonary hypoplasia**
- association of defects beginning w/ bilateral renal agenesis d/t failure of the ureteric
bud to divide
- urine formation does not occur --> low or absent amniotic fluid volumes
- fetal structures are compressed
- associated defects: abnormal genital dev., leg deformities, GI defects, arthrohyposis,
pulmonary hypoplasia
- *most infants will die within the first several days; often d/t associated lung hypoplasia*
hydramnios or polyhydramnios -ANSWER - AF volume >2L
- **may be due to GI obstructions (e.g. esophageal atresia, duodenal to anal atresia) d/t
the baby being unable to swallow amniotic fluid, so the AF keeps building up in utero **
- also can be d/t tight nuchal cord or neurologic defects which may also obstruct or
impair fetal swallowing
PROM -ANSWER - premature rupture of membranes, before the onset of labor
- **risk of infection if directly proportional to the duration of ROM**
- **after 24 hours of ROM, the risk of infection escalates significantly**
PPROM -ANSWER - preterm premature rupture of membranes, PROM occurring before
37 weeks
- does not necessarily lead to the onset of labor if it occurs too early, but after 24 hours
of ROM, the risk of infection escalates
- **risk of infection if directly proportional to the duration of ROM**
maternal serum alpha fetaprotein (MSAFP) -ANSWER - aka triple or quad screen
- test during pregnancy that measures a major fetal protein produced in the fetal liver at
>22 wks that is present in the mother's blood
,- maternal blood test that is a clue for some fetal anomalies, generally between 15-22
wks, optimally at 16-18 wks
- **elevated levels may be indicative of neural tube defects (not diagnostic, but is a
clue)**
- low levels associated with Trisomy 21
Lecithin/Sphingomyelin (L/S) ratio -ANSWER - test of amniotic fluid to assess fetal lung
maturity
- may help determine lung maturity to see when to deliver prematurely if necessary
- **normal: greater or equal to ~2**
- <2 indicates immature lungs, <1.5 is associated with a high risk of RDS
fetal heart rate (FHR) decelerations -ANSWER - defined as a fetal heart rate decrease of
at least 15 bpm that lasts longer than 2 min. but less than 10 min.
cause of early decelerations -ANSWER **head compression**
cause of variable decelerations -ANSWER **cord compression**
cause of late decelerations -ANSWER **hypoxemia or placental insufficiency**
fetal tachycardia -ANSWER - fetal HR >160 for 10 or more min.
- sustained 170s-180s **think infection**
- also could be caused by acute hypoxemia/hypoxia, maternal fever, maternal anxiety,
maternal hyperthyroidism
effects of maternal magnesium sulfate on newborn -ANSWER - tocolytic medication that
can be used for neuroprotection in preterm labor that can cause **neuromuscular or
respiratory depression in the newborn**
effects of maternal prostaglandin inhibitors in newborn -ANSWER - tocolytic medications
such as indomethacin that puts the fetus at risk of premature ductal closure in utero,
pulmonary HTN, and altered renal function if given to mother
effects of maternal betaminetics in newborn -ANSWER - tocolytic medications such as
terbutaline that can cause **hypoglycemia in the newborn due to hyperinsulinemia**
(baby's pancreas produces too much insulin, thus lowering blood glucose)
risks of vacuum assisted delivered -ANSWER - can case cephalohematoma, retinal
hemorrhage, and intracranial hemorrhage (rarely); consider **hyperbilirubinemia** -->
may show as bruising and bleeding
transillumination -ANSWER - tool used for newborn physical exam that is a fiberoptic light
source attached to the end of a long, flexible tube
- fluid- or air-filled structures will transmit the light (light up), e.g. hydroceles, severe
hydrocephalus, pneumothorax
, -**solid masses will NOT light up/transmit light, e.g. tumors, testicular torsion**
red reflex -ANSWER - **reflex due to light reflecting off the interior lining of the eye
(fundus)**
- shows as a bright orange-red or pale/gray in darker skinned newborns
- absent or disrupted reflex could be congenital cataracts, glaucoma, or retinoblastoma
acrocyanosis -ANSWER - **blue/pale discoloration of hands and feet, normal in the first
48 hours of life**
general pallor/cyanosis -ANSWER - blue/pale discoloration outside of the first 48 hours of
life or outside of just the hands/feet that may be due to anemia, hypoxemia, or shock
how to differentiate between cyanosis and ecchymosis (bruising) -ANSWER - **assess
the ability of the skin to blanch**
- **ecchymosis (bruising) will NOT blanch**
jaundice/icterus -ANSWER - **yellow discoloration of the skin d/t hyperbilirubinemia**
- **ALWAYS an abnormal finding in the FIRST 24 HOURS OF LIFE**
general safe temperature range -ANSWER 36 to 37.5 degrees C (96.8 to 99.5 degrees F)
craniotabes -ANSWER - **aka congenital cranial osteoporosis, defined as a softening of
the skull bones**
- can occur in up to 1/3 of all newborns and can be a normal finding, especially in
preemies
- **soft areas of the skull (especially along the suture line) can pop in and out like a ping
pong ball
- **mostly found along the occipital and parietal bones
caput succedanenum -ANSWER - hemorrhagic edema that **crosses suture line**
- evident at birth; looks like soft swelling with discoloration (usually looks like a
bruise/red, blue, purple)
- does not grow in size
- may develop hyperbilirubinemia (bleeding/bruising --> jaundice)
preauricular sinuses/pit -ANSWER - **often associated with renal abnormalities and 2-
vessel cord**
- could also be skin tags (more common)
cystic hygroma -ANSWER - fluid-filled sacs that results from a blockage in the lymphatic
system
- **may require immediate intubation or emergent tracheotomy in the delivery room**
- ENT typically present at delivery
- some cases resolve, leading to webbed neck, edema, and lymphangioma
