RNC NIC LATEST UPDATE EXAM
2026
GIR Calculation - answer- (%dextrose x IV rate) / (6 x wt in kg)
I/T ratio - answer- %Metas + Bands / %Metas + Bands + Segs
I/T ratio greater than >0.2 to >.25 suggestive of infection
>0.8 associated with shock
GIR - answer- 6-8mcg/kg/min caloric intake
D10 Bolus - answer- 2mL/kg
Fluid Volume Bolus - answer- 10mL/kg
Term Parenteral Fluid Requirement - answer- 80mL/kg/day
Enteral 100-150 mlk/kg/day
Preterm Parenteral Fluid Requirement - answer- 120
Enteral 150-200ml/kig/day
,Absolute Neutrophil COUNT - answer- WBC x (%) Segmented neutrophils + band
neutrophils + metamyelocytes
Example. 15,000 x 35 segs + 15 bands + 3 metas (turns into percent)
15,000 x .53 = 7950
ANC <1800 suggestive of infection
Normal Range
Mature WBCs - answer- Poly, Segs, Neutrophils
Immature WBCs - answer- Meta, Bands, Stabs
Congenital CMV infection - answer- congenital infection include: intrauterine growth
restriction, hepatosplenomegaly, jaundice, purpura, pneumonitis, microcephaly, hydrocephalus,
intracerebral calcifications, hearing loss, chorioretinitis, and optic atrophy.
Endotracheal Measurement - answer- 6 + wt in kg
Proper placement on an endotracheal tube is midway between the thoracic inlet and the carina.
Polyethelane Wrap for Infant < 29 weeks - answer- Dry infants head only
Place infant in bag, from neck down
Remove bag once infant is in an NTE and humidified environment
,UAC Placement - answer- High Placement T6-T9
Low Placement L3-L4
UVC Placement - answer- 1 to 2cm above the diaghragm
Low Lying 2-4cm in the cord
Chest Tube Placement - answer- Mid Clavicular line with distal chest tube hole inside the
thoracic space
lecithin/sphingomyelin (L/S) ratio - answer- An L/S ratio greater than 2:1 is considered to
indicate fetal lung maturity.
Anatomic events Five stages of lung development - answer- 1. Embryonic development
(weeks 1 to 5). The endoderm-derived embryonic foregut provides a single lung bud that begins
to divide ventrocaudally through the mesenchyme surrounding the foregut. The pulmonary vein
develops and extends to join the lung bud. The trachea develops at the end of the embryonic
period. There are three divisions on the right side and two on the left side that will eventually
become the lobes of the lungs.
2. Pseudoglandular period (weeks 6 to 16). All conducting airways are formed. Cartilage
appears; main bronchi are formed; demarcation of major lobes occurs; formation of new
bronchi is complete; capillary bed is formed with connecting bronchial blood supply; no
connection made with terminal air sacs. The lung at this time undergoes 14 more generations of
branching and the formation of the terminal bronchioles. The lung resembles an exocrine organ
because of surrounding loose mesenchymal tissues, hence the name pseudoglandular .
3. Canalicular period (weeks 16 to 26). Formation of gas-exchanging acinar units (i.e.,
respiratory units). The appearance of glycogen-rich cuboidal cells and inclusions for surface-
active material storage are seen; capillaries invade terminal airway walls; type II alveolar
epithelial cells appear. Airway changes from glandular to tubular and increases in length and
diameter. Vascular system proliferates and the capillaries are now closer to the epithelium-
, conducting airways. Respiratory bronchioles that will participate in gas exchange can be
differentiated.
4. Terminal sac period (weeks 26 to birth). Around week 26 alveolar sacs are formed; air-blood
surface area is limited for gas exchange; and type II cells are unable to release surfactant in
sufficient quantity to maintain air breathing. Capillary loops increase; type II cells cluster at
alveolar ducts, beco
IUGR asymmetrical - answer- Weight low for Gestation Age
Head Sparing (less restriction on brain growth)
Old man appearance
Appear wasted, thin
Results from: Poor Placental function
Maternal Hypertension*
Smoking
IUGR Symmetric - answer- Lower weight, height, length, and head circumference for
gestational age
Results from intrauterine viral infection, chromosomal genetic abnormalities, long standing
disease
Prostaglandin E1 (alprostadil) - answer- Prevent premature closure of the PDA
Side Effects: Apnea, hypotension, hyperthermia, bradycardia
Indomethicin (NSAID - answer- 1. Hypoglycemia
2026
GIR Calculation - answer- (%dextrose x IV rate) / (6 x wt in kg)
I/T ratio - answer- %Metas + Bands / %Metas + Bands + Segs
I/T ratio greater than >0.2 to >.25 suggestive of infection
>0.8 associated with shock
GIR - answer- 6-8mcg/kg/min caloric intake
D10 Bolus - answer- 2mL/kg
Fluid Volume Bolus - answer- 10mL/kg
Term Parenteral Fluid Requirement - answer- 80mL/kg/day
Enteral 100-150 mlk/kg/day
Preterm Parenteral Fluid Requirement - answer- 120
Enteral 150-200ml/kig/day
,Absolute Neutrophil COUNT - answer- WBC x (%) Segmented neutrophils + band
neutrophils + metamyelocytes
Example. 15,000 x 35 segs + 15 bands + 3 metas (turns into percent)
15,000 x .53 = 7950
ANC <1800 suggestive of infection
Normal Range
Mature WBCs - answer- Poly, Segs, Neutrophils
Immature WBCs - answer- Meta, Bands, Stabs
Congenital CMV infection - answer- congenital infection include: intrauterine growth
restriction, hepatosplenomegaly, jaundice, purpura, pneumonitis, microcephaly, hydrocephalus,
intracerebral calcifications, hearing loss, chorioretinitis, and optic atrophy.
Endotracheal Measurement - answer- 6 + wt in kg
Proper placement on an endotracheal tube is midway between the thoracic inlet and the carina.
Polyethelane Wrap for Infant < 29 weeks - answer- Dry infants head only
Place infant in bag, from neck down
Remove bag once infant is in an NTE and humidified environment
,UAC Placement - answer- High Placement T6-T9
Low Placement L3-L4
UVC Placement - answer- 1 to 2cm above the diaghragm
Low Lying 2-4cm in the cord
Chest Tube Placement - answer- Mid Clavicular line with distal chest tube hole inside the
thoracic space
lecithin/sphingomyelin (L/S) ratio - answer- An L/S ratio greater than 2:1 is considered to
indicate fetal lung maturity.
Anatomic events Five stages of lung development - answer- 1. Embryonic development
(weeks 1 to 5). The endoderm-derived embryonic foregut provides a single lung bud that begins
to divide ventrocaudally through the mesenchyme surrounding the foregut. The pulmonary vein
develops and extends to join the lung bud. The trachea develops at the end of the embryonic
period. There are three divisions on the right side and two on the left side that will eventually
become the lobes of the lungs.
2. Pseudoglandular period (weeks 6 to 16). All conducting airways are formed. Cartilage
appears; main bronchi are formed; demarcation of major lobes occurs; formation of new
bronchi is complete; capillary bed is formed with connecting bronchial blood supply; no
connection made with terminal air sacs. The lung at this time undergoes 14 more generations of
branching and the formation of the terminal bronchioles. The lung resembles an exocrine organ
because of surrounding loose mesenchymal tissues, hence the name pseudoglandular .
3. Canalicular period (weeks 16 to 26). Formation of gas-exchanging acinar units (i.e.,
respiratory units). The appearance of glycogen-rich cuboidal cells and inclusions for surface-
active material storage are seen; capillaries invade terminal airway walls; type II alveolar
epithelial cells appear. Airway changes from glandular to tubular and increases in length and
diameter. Vascular system proliferates and the capillaries are now closer to the epithelium-
, conducting airways. Respiratory bronchioles that will participate in gas exchange can be
differentiated.
4. Terminal sac period (weeks 26 to birth). Around week 26 alveolar sacs are formed; air-blood
surface area is limited for gas exchange; and type II cells are unable to release surfactant in
sufficient quantity to maintain air breathing. Capillary loops increase; type II cells cluster at
alveolar ducts, beco
IUGR asymmetrical - answer- Weight low for Gestation Age
Head Sparing (less restriction on brain growth)
Old man appearance
Appear wasted, thin
Results from: Poor Placental function
Maternal Hypertension*
Smoking
IUGR Symmetric - answer- Lower weight, height, length, and head circumference for
gestational age
Results from intrauterine viral infection, chromosomal genetic abnormalities, long standing
disease
Prostaglandin E1 (alprostadil) - answer- Prevent premature closure of the PDA
Side Effects: Apnea, hypotension, hyperthermia, bradycardia
Indomethicin (NSAID - answer- 1. Hypoglycemia
