RNC-NIC EXAM VERSION 1&2 2025/2026 WITH
ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED ANSWERS WITH
RATIONALES |CURRENTLY TESTING
QUESTIONS AND SOLUTIONS|ALREADY
GRADED A+|NEWEST|BRAND NEW
VERSION!!|GUARANTEED PASS
VERSION 1
A full-term neonate is admitted to the NICU for evaluation of suspected transposition of the
great arteries. Approximately 16 hours after birth, the patient exhibits a sudden deterioration in
oxygen saturations and central cyanosis is present. This patient has MOST LIKELY experienced:
Closure of the pulmonary ductus arteriosus (PDA)
Pulmonary hypoperfusion
Pulmonary embolus
Aortic atresia
Closure of the pulmonary ductus arteriosus (PDA)
Feedback
Functional closure of the PDA usually occurs within the first 24 hours in full-term neonates.
When transposition of the great arteries is present, the pulmonary ductal circulation may
need to be kept open until the defect is corrected.CONTENT AREA: Assess & Manage
Pathophysiologic States
A 7-day old 28-week female infant with a history of RDS is now on room air. The infant is having
recurrent episodes of apnea and bradycardia, irritability, and emesis associated with her
feedings. Which of the following pathophysiologic processes may be causing her clinical
manifestations?
Necrotizing enterocolitis
Tracheoesophageal reflux
Gastroesophageal reflux
Malrotation of the duodenum
1|Page
,Gastroesophageal reflux
Feedback
Gastroesophageal reflux is the passage of gastric contents into the esophagus. This occurs
commonly in newborn infants and is especially common in those born prematurely. Signs of
reflux include irritability, apnea and bradycardia, emesis, failure to thrive, feeding or sleeping
problems, chronic respiratory disorders, esophagitis, hematemesis, and back arching.
You are caring for a 2-day old, 26-week 950 g male infant. The infant is on the ventilator related
to a diagnosis of respiratory distress syndrome (RDS). At 1230, he becomes very irritable,
waving his arms and legs, and appears pale. At this time, you must increase his percentage of
inspired oxygen to maintain his oxygen saturation greater than 90%. You check the infant's
glucose and check a CBC with a provider order. The glucose is 250 and the Hct is 23. What
physiologic complication could the infant be experiencing?
Bacterial meningitis
Intraventricular hemorrhage
Multifocal seizures
Post hemorrhagic hydrocephalus
Intraventricular hemorrhage
Feedback
Clinical signs of an intraventricular hemorrhage include apnea, bradycardia, anemia, seizures,
poor muscle tone, decreased activity, irritability or lethargy, and bugling fontanel. This infant
is experiencing anemia, irritability or possible seizures, an increase in oxygen requirement and
a high glucose indicating his body is stressed.
When examining the neonate, which of the below assessment findings would NOT be in
indicator of increased intracranial pressure?
Bulging over the infant's sutures
Sutures that are widely spaced apart
Increasing head circumference measurement
Increasing abdominal girth measurement
Increasing abdominal girth measurement
Feedback
Bulging over the infant's sutures, sutures that are widely spaced apart, and increasing head
circumference measurements are all signs of increasing intracranial pressure. These are all
caused by an increase in fluid volume and swelling in the brain. To make room for the extra
fluid, the skull spreads apart at the sutures. Bulging would also be able to be felt at the
sutures. These changes would all cause in increase in the head circumference. An increasing
abdominal girth would be from a gastrointestinal event and not a neurological event.
2|Page
,Being a nurse preceptor is contributing to a work environment that is conducive to the
education of healthcare professionals. This is an example of which neonatal nursing standard?
Education
Leadership
Evidenced Based Practice
Resource Utilization
Education
Feedback
The neonatal registered nurse should work to maintain current clinical knowledge for their
specialty area.
An infant is diagnosed with acute renal failure. All of the following medications may worsen this
condition EXCEPT:
Ceftazidime (Fortaz)
Indomethacin (Indocin)
Furosemide (Lasix)
Heparin
Heparin
Feedback
NSAIDs (e.g., indomethacin), aminoglycosides (e.g., gentamycin), cephalosporins, furosemide,
thiazide diuretics, and amphotericin are all potentially nephrotoxic, especially when used in
combination with each other. Heparin, while primarily excreted by the kidneys, is not
nephrotoxic. Dose should be adjusted based on individual renal clearance.
A 41-week-gestation infant was delivered without complications, but was admitted to the NICU
for further evaluation of suspected craniosynostosis. Which of the following assessment findings
MOST closely correlates to this condition?
Intraventricular hemorrhage
Hydrocephalus
Caput medusae
Misshapen head
Misshapen head
Feedback
Craniosynostosis is the early fusion of cranial sutures. Signs include a misshapen head that
does not resolve within a few days of birth, absence of one or more fontanelles, and a raised
hard ridge along affected sutures.
3|Page
, Analyzing quality data to identify opportunities for improving nursing practice and care delivery
is which neonatal nursing standard?
Quality of Practice
Leadership
Diagnosis
Outcomes Identification
Quality of Practice
Feedback
The neonatal registered nurse must contribute to quality nursing practice according to their
specialty specific scope and standards of practice. This includes analyzing quality data to
identify opportunities for improvement.
A 33-week-gestation neonate has not responded to routine resuscitation efforts. The nurse
notes decreased breath sounds on the left and a scaphoid abdomen. The nurse should prepare
for:
Extracorporeal membrane oxygenation (ECMO) cannulation
Cardiac massage and cannulation of an umbilical vein for medication administration
Immediate intubation and insertion of a chest tube on the left side
Immediate intubation and insertion of an orogastric tube
Immediate intubation and insertion of an orogastric tube
Feedback
A scaphoid abdomen with decreased left-sided breath sounds is highly indicative of a
diaphragmatic hernia. Immediate intubation and insertion of an orogastric tube will provide
optimal ventilation while decompressing the stomach to maximize left-sided lung inflation.
A 30-week male infant was admitted to the Neonatal ICU with acute cyanosis. His initial blood
gas showed a PaO2 of 50 on 45% FiO2. He was placed on an FiO2 of 100%. A repeat arterial
blood gas was obtained 10 minutes later that revealed a Neonatal ICU with acute cyanosis. His
initial blood gas showed a PaO2 of 50 on 45% FiO2. He was placed on an FiO2 of 100%. A repeat
arterial blood gas was obtained 10 minutes later that revealed a PaO2 of 53. Based on these
findings, his cyanosis is most likely caused by?
Respiratory Distress Syndrome
Meconium Aspiration Syndrome
Cyanotic Heart Defect
Transient Tachypnea of the Newborn
Cyanotic Heart Defect
Feedback
4|Page
ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED ANSWERS WITH
RATIONALES |CURRENTLY TESTING
QUESTIONS AND SOLUTIONS|ALREADY
GRADED A+|NEWEST|BRAND NEW
VERSION!!|GUARANTEED PASS
VERSION 1
A full-term neonate is admitted to the NICU for evaluation of suspected transposition of the
great arteries. Approximately 16 hours after birth, the patient exhibits a sudden deterioration in
oxygen saturations and central cyanosis is present. This patient has MOST LIKELY experienced:
Closure of the pulmonary ductus arteriosus (PDA)
Pulmonary hypoperfusion
Pulmonary embolus
Aortic atresia
Closure of the pulmonary ductus arteriosus (PDA)
Feedback
Functional closure of the PDA usually occurs within the first 24 hours in full-term neonates.
When transposition of the great arteries is present, the pulmonary ductal circulation may
need to be kept open until the defect is corrected.CONTENT AREA: Assess & Manage
Pathophysiologic States
A 7-day old 28-week female infant with a history of RDS is now on room air. The infant is having
recurrent episodes of apnea and bradycardia, irritability, and emesis associated with her
feedings. Which of the following pathophysiologic processes may be causing her clinical
manifestations?
Necrotizing enterocolitis
Tracheoesophageal reflux
Gastroesophageal reflux
Malrotation of the duodenum
1|Page
,Gastroesophageal reflux
Feedback
Gastroesophageal reflux is the passage of gastric contents into the esophagus. This occurs
commonly in newborn infants and is especially common in those born prematurely. Signs of
reflux include irritability, apnea and bradycardia, emesis, failure to thrive, feeding or sleeping
problems, chronic respiratory disorders, esophagitis, hematemesis, and back arching.
You are caring for a 2-day old, 26-week 950 g male infant. The infant is on the ventilator related
to a diagnosis of respiratory distress syndrome (RDS). At 1230, he becomes very irritable,
waving his arms and legs, and appears pale. At this time, you must increase his percentage of
inspired oxygen to maintain his oxygen saturation greater than 90%. You check the infant's
glucose and check a CBC with a provider order. The glucose is 250 and the Hct is 23. What
physiologic complication could the infant be experiencing?
Bacterial meningitis
Intraventricular hemorrhage
Multifocal seizures
Post hemorrhagic hydrocephalus
Intraventricular hemorrhage
Feedback
Clinical signs of an intraventricular hemorrhage include apnea, bradycardia, anemia, seizures,
poor muscle tone, decreased activity, irritability or lethargy, and bugling fontanel. This infant
is experiencing anemia, irritability or possible seizures, an increase in oxygen requirement and
a high glucose indicating his body is stressed.
When examining the neonate, which of the below assessment findings would NOT be in
indicator of increased intracranial pressure?
Bulging over the infant's sutures
Sutures that are widely spaced apart
Increasing head circumference measurement
Increasing abdominal girth measurement
Increasing abdominal girth measurement
Feedback
Bulging over the infant's sutures, sutures that are widely spaced apart, and increasing head
circumference measurements are all signs of increasing intracranial pressure. These are all
caused by an increase in fluid volume and swelling in the brain. To make room for the extra
fluid, the skull spreads apart at the sutures. Bulging would also be able to be felt at the
sutures. These changes would all cause in increase in the head circumference. An increasing
abdominal girth would be from a gastrointestinal event and not a neurological event.
2|Page
,Being a nurse preceptor is contributing to a work environment that is conducive to the
education of healthcare professionals. This is an example of which neonatal nursing standard?
Education
Leadership
Evidenced Based Practice
Resource Utilization
Education
Feedback
The neonatal registered nurse should work to maintain current clinical knowledge for their
specialty area.
An infant is diagnosed with acute renal failure. All of the following medications may worsen this
condition EXCEPT:
Ceftazidime (Fortaz)
Indomethacin (Indocin)
Furosemide (Lasix)
Heparin
Heparin
Feedback
NSAIDs (e.g., indomethacin), aminoglycosides (e.g., gentamycin), cephalosporins, furosemide,
thiazide diuretics, and amphotericin are all potentially nephrotoxic, especially when used in
combination with each other. Heparin, while primarily excreted by the kidneys, is not
nephrotoxic. Dose should be adjusted based on individual renal clearance.
A 41-week-gestation infant was delivered without complications, but was admitted to the NICU
for further evaluation of suspected craniosynostosis. Which of the following assessment findings
MOST closely correlates to this condition?
Intraventricular hemorrhage
Hydrocephalus
Caput medusae
Misshapen head
Misshapen head
Feedback
Craniosynostosis is the early fusion of cranial sutures. Signs include a misshapen head that
does not resolve within a few days of birth, absence of one or more fontanelles, and a raised
hard ridge along affected sutures.
3|Page
, Analyzing quality data to identify opportunities for improving nursing practice and care delivery
is which neonatal nursing standard?
Quality of Practice
Leadership
Diagnosis
Outcomes Identification
Quality of Practice
Feedback
The neonatal registered nurse must contribute to quality nursing practice according to their
specialty specific scope and standards of practice. This includes analyzing quality data to
identify opportunities for improvement.
A 33-week-gestation neonate has not responded to routine resuscitation efforts. The nurse
notes decreased breath sounds on the left and a scaphoid abdomen. The nurse should prepare
for:
Extracorporeal membrane oxygenation (ECMO) cannulation
Cardiac massage and cannulation of an umbilical vein for medication administration
Immediate intubation and insertion of a chest tube on the left side
Immediate intubation and insertion of an orogastric tube
Immediate intubation and insertion of an orogastric tube
Feedback
A scaphoid abdomen with decreased left-sided breath sounds is highly indicative of a
diaphragmatic hernia. Immediate intubation and insertion of an orogastric tube will provide
optimal ventilation while decompressing the stomach to maximize left-sided lung inflation.
A 30-week male infant was admitted to the Neonatal ICU with acute cyanosis. His initial blood
gas showed a PaO2 of 50 on 45% FiO2. He was placed on an FiO2 of 100%. A repeat arterial
blood gas was obtained 10 minutes later that revealed a Neonatal ICU with acute cyanosis. His
initial blood gas showed a PaO2 of 50 on 45% FiO2. He was placed on an FiO2 of 100%. A repeat
arterial blood gas was obtained 10 minutes later that revealed a PaO2 of 53. Based on these
findings, his cyanosis is most likely caused by?
Respiratory Distress Syndrome
Meconium Aspiration Syndrome
Cyanotic Heart Defect
Transient Tachypnea of the Newborn
Cyanotic Heart Defect
Feedback
4|Page
