[RNC-NIC REVIEW SET] COMPLETE EXAM QUESTIONS AND
VERIFIED ANSWERS | 2026–2027 LATEST UPDATE |
GUARANTEED PASS | DETAILED RATIONALES | FULL STUDY
GUIDE | EXAM PREP | PRACTICE TEST | CERTIFICATION
PREPARATION
1. A neonatal intensive care nurse is caring for a premature infant born at 30 weeks' gestation.
Which assessment finding most strongly indicates respiratory distress syndrome (RDS)?
A. Bounding pulses and flushed skin
B. Expiratory grunting and nasal flaring
C. Hyperactive bowel sounds
D. Bilateral pedal edema
Correct Answer: B. Expiratory grunting and nasal flaring
Rationale:
Expiratory grunting and nasal flaring are classic early signs of respiratory distress syndrome in
premature infants. These findings reflect increased work of breathing and efforts to maintain alveolar
expansion. The other options are not characteristic indicators of RDS.
2. A newborn develops jaundice within the first 12 hours after birth. What is the nurse's priority
concern?
A. Physiologic jaundice
B. Breastfeeding-associated jaundice
C. Pathologic hyperbilirubinemia
D. Delayed meconium passage
Correct Answer: C. Pathologic hyperbilirubinemia
Rationale:
Jaundice appearing within the first 24 hours of life is considered pathologic and requires prompt
evaluation. Early-onset jaundice may indicate hemolysis, infection, or another serious condition.
Physiologic jaundice typically appears after the first day of life.
3. During resuscitation of a newborn, which action should occur immediately after providing
warmth and positioning the airway if the infant remains apneic?
A. Begin positive-pressure ventilation
B. Administer epinephrine
C. Start chest compressions
D. Insert an umbilical venous catheter
Correct Answer: A. Begin positive-pressure ventilation
Rationale:
Positive-pressure ventilation is the most important intervention for an apneic newborn. Effective
ventilation often corrects bradycardia and poor oxygenation. Chest compressions and medications
are considered only if ventilation alone is insufficient.
,4. Which maternal condition places a newborn at highest risk for hypoglycemia?
A. Gestational diabetes mellitus
B. Seasonal allergies
C. Mild anemia
D. Rh-positive blood type
Correct Answer: A. Gestational diabetes mellitus
Rationale:
Infants of diabetic mothers often produce excess insulin in response to maternal hyperglycemia and
are therefore at increased risk for neonatal hypoglycemia after delivery. The other maternal
conditions are not primary risk factors.
5. A nurse is evaluating pain in a mechanically ventilated neonate. Which assessment tool is most
appropriate?
A. Glasgow Coma Scale
B. APGAR Scale
C. N-PASS
D. Braden Scale
Correct Answer: C. N-PASS
Rationale:
The Neonatal Pain, Agitation, and Sedation Scale (N-PASS) is specifically designed to assess pain and
sedation in neonates, including ventilated infants. The other scales serve different clinical purposes.
6. A preterm infant receiving oxygen therapy suddenly develops increased work of breathing and
asymmetrical chest movement. Which complication should the nurse suspect first?
A. Necrotizing enterocolitis
B. Patent ductus arteriosus
C. Pneumothorax
D. Sepsis
Correct Answer: C. Pneumothorax
Rationale:
Sudden respiratory deterioration with asymmetrical chest movement suggests pneumothorax. This
condition can occur in infants receiving respiratory support and requires rapid recognition and
intervention.
7. Which finding is most consistent with patent ductus arteriosus (PDA) in a premature infant?
A. Harsh systolic murmur with weak pulses
B. Continuous machinery-like murmur
C. Absent peripheral pulses
D. Severe cyanosis relieved by crying
Correct Answer: B. Continuous machinery-like murmur
, Rationale:
A continuous machinery-like murmur is a hallmark sign of PDA. Additional findings may include
bounding pulses and widened pulse pressure due to left-to-right shunting of blood.
8. A nurse caring for a neonate with suspected sepsis should recognize that which symptom may
be an early indicator of infection?
A. Temperature instability
B. Polyuria
C. Hyperactivity
D. Hypertension
Correct Answer: A. Temperature instability
Rationale:
Temperature instability is a common early sign of neonatal sepsis. Newborns often exhibit subtle
symptoms rather than overt signs of infection, making careful assessment essential.
9. What is the primary purpose of surfactant administration in premature infants?
A. Increase systemic blood pressure
B. Enhance gastrointestinal motility
C. Reduce alveolar surface tension
D. Stimulate red blood cell production
Correct Answer: C. Reduce alveolar surface tension
Rationale:
Surfactant decreases alveolar surface tension, preventing alveolar collapse and improving gas
exchange. It is a cornerstone therapy for respiratory distress syndrome.
10. Which nursing intervention best supports developmental care in the NICU?
A. Keeping lights on continuously
B. Minimizing unnecessary stimulation
C. Frequent repositioning every 15 minutes
D. Avoiding parental involvement
Correct Answer: B. Minimizing unnecessary stimulation
Rationale:
Developmental care focuses on reducing stress and promoting neurodevelopment. Limiting excessive
noise, light, and handling helps support physiologic stability and growth.
11. A newborn's blood glucose level is 32 mg/dL. Which action is most appropriate initially?
A. Reassess in four hours
B. Encourage feeding if clinically stable
C. Restrict fluids
D. Administer diuretics
Correct Answer: B. Encourage feeding if clinically stable
VERIFIED ANSWERS | 2026–2027 LATEST UPDATE |
GUARANTEED PASS | DETAILED RATIONALES | FULL STUDY
GUIDE | EXAM PREP | PRACTICE TEST | CERTIFICATION
PREPARATION
1. A neonatal intensive care nurse is caring for a premature infant born at 30 weeks' gestation.
Which assessment finding most strongly indicates respiratory distress syndrome (RDS)?
A. Bounding pulses and flushed skin
B. Expiratory grunting and nasal flaring
C. Hyperactive bowel sounds
D. Bilateral pedal edema
Correct Answer: B. Expiratory grunting and nasal flaring
Rationale:
Expiratory grunting and nasal flaring are classic early signs of respiratory distress syndrome in
premature infants. These findings reflect increased work of breathing and efforts to maintain alveolar
expansion. The other options are not characteristic indicators of RDS.
2. A newborn develops jaundice within the first 12 hours after birth. What is the nurse's priority
concern?
A. Physiologic jaundice
B. Breastfeeding-associated jaundice
C. Pathologic hyperbilirubinemia
D. Delayed meconium passage
Correct Answer: C. Pathologic hyperbilirubinemia
Rationale:
Jaundice appearing within the first 24 hours of life is considered pathologic and requires prompt
evaluation. Early-onset jaundice may indicate hemolysis, infection, or another serious condition.
Physiologic jaundice typically appears after the first day of life.
3. During resuscitation of a newborn, which action should occur immediately after providing
warmth and positioning the airway if the infant remains apneic?
A. Begin positive-pressure ventilation
B. Administer epinephrine
C. Start chest compressions
D. Insert an umbilical venous catheter
Correct Answer: A. Begin positive-pressure ventilation
Rationale:
Positive-pressure ventilation is the most important intervention for an apneic newborn. Effective
ventilation often corrects bradycardia and poor oxygenation. Chest compressions and medications
are considered only if ventilation alone is insufficient.
,4. Which maternal condition places a newborn at highest risk for hypoglycemia?
A. Gestational diabetes mellitus
B. Seasonal allergies
C. Mild anemia
D. Rh-positive blood type
Correct Answer: A. Gestational diabetes mellitus
Rationale:
Infants of diabetic mothers often produce excess insulin in response to maternal hyperglycemia and
are therefore at increased risk for neonatal hypoglycemia after delivery. The other maternal
conditions are not primary risk factors.
5. A nurse is evaluating pain in a mechanically ventilated neonate. Which assessment tool is most
appropriate?
A. Glasgow Coma Scale
B. APGAR Scale
C. N-PASS
D. Braden Scale
Correct Answer: C. N-PASS
Rationale:
The Neonatal Pain, Agitation, and Sedation Scale (N-PASS) is specifically designed to assess pain and
sedation in neonates, including ventilated infants. The other scales serve different clinical purposes.
6. A preterm infant receiving oxygen therapy suddenly develops increased work of breathing and
asymmetrical chest movement. Which complication should the nurse suspect first?
A. Necrotizing enterocolitis
B. Patent ductus arteriosus
C. Pneumothorax
D. Sepsis
Correct Answer: C. Pneumothorax
Rationale:
Sudden respiratory deterioration with asymmetrical chest movement suggests pneumothorax. This
condition can occur in infants receiving respiratory support and requires rapid recognition and
intervention.
7. Which finding is most consistent with patent ductus arteriosus (PDA) in a premature infant?
A. Harsh systolic murmur with weak pulses
B. Continuous machinery-like murmur
C. Absent peripheral pulses
D. Severe cyanosis relieved by crying
Correct Answer: B. Continuous machinery-like murmur
, Rationale:
A continuous machinery-like murmur is a hallmark sign of PDA. Additional findings may include
bounding pulses and widened pulse pressure due to left-to-right shunting of blood.
8. A nurse caring for a neonate with suspected sepsis should recognize that which symptom may
be an early indicator of infection?
A. Temperature instability
B. Polyuria
C. Hyperactivity
D. Hypertension
Correct Answer: A. Temperature instability
Rationale:
Temperature instability is a common early sign of neonatal sepsis. Newborns often exhibit subtle
symptoms rather than overt signs of infection, making careful assessment essential.
9. What is the primary purpose of surfactant administration in premature infants?
A. Increase systemic blood pressure
B. Enhance gastrointestinal motility
C. Reduce alveolar surface tension
D. Stimulate red blood cell production
Correct Answer: C. Reduce alveolar surface tension
Rationale:
Surfactant decreases alveolar surface tension, preventing alveolar collapse and improving gas
exchange. It is a cornerstone therapy for respiratory distress syndrome.
10. Which nursing intervention best supports developmental care in the NICU?
A. Keeping lights on continuously
B. Minimizing unnecessary stimulation
C. Frequent repositioning every 15 minutes
D. Avoiding parental involvement
Correct Answer: B. Minimizing unnecessary stimulation
Rationale:
Developmental care focuses on reducing stress and promoting neurodevelopment. Limiting excessive
noise, light, and handling helps support physiologic stability and growth.
11. A newborn's blood glucose level is 32 mg/dL. Which action is most appropriate initially?
A. Reassess in four hours
B. Encourage feeding if clinically stable
C. Restrict fluids
D. Administer diuretics
Correct Answer: B. Encourage feeding if clinically stable
