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Relias RN NICU Nursing Core Concepts Exam –
ACTUAL QUESTIONS AND ANSWERS LATEST
UPDATE THIS YEAR
Relias RN NICU Nursing Core Concepts RN Exam – Coverage Summary & 200 Exam-Relevant Questions
Based on the National Certification Corporation (NCC) exam blueprint for neonatal intensive care
nursing (RNC-NIC), the Relias RN NICU Core Concepts exam assesses advanced knowledge required for
high-risk newborn care . The following content areas are typically covered:
Exam Coverage Summary
Domain Key Topics
Antepartum & Maternal risk factors, antenatal corticosteroids, prolonged rupture of membranes,
Intrapartum chorioamnionitis, gestational diabetes, preeclampsia
Transition to Neonatal resuscitation (NRP), APGAR scoring, initial stabilization, thermoregulation, delaye
Extrauterine Life cord clamping
Respiratory distress syndrome (RDS), transient tachypnea (TTN), pneumothorax, meconium
Respiratory System
aspiration syndrome (MAS), bronchopulmonary dysplasia (BPD), apnea of prematurity
Patent ductus arteriosus (PDA), congenital heart defects (e.g., ductal-dependent lesions),
Cardiovascular System
persistent pulmonary hypertension (PPHN), hypotension management
Intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), hypoxic-ischemic
Neurologic System
encephalopathy (HIE), therapeutic hypothermia, seizures
Necrotizing enterocolitis (NEC), feeding intolerance, gastroschisis, omphalocele, bilious asp
Gastrointestinal System
gavage feeding
Hypoglycemia, hyperbilirubinemia (physiologic vs. pathologic), phototherapy, congenital
Metabolic & Endocrine
hypothyroidism, calcium disorders
Hematologic System Anemia of prematurity, polycythemia, thrombocytopenia, vitamin K deficiency bleeding (VK
Neonatal sepsis (early-onset vs. late-onset), Group B Streptococcus (GBS) prophylaxis,
Infectious Diseases
meningitis, congenital infections (CMV, toxoplasmosis)
Renal & Fluids Dehydration, fluid overload, hyponatremia, hyperkalemia, acute kidney injury (AKI)
Genetics & Congenital Common chromosomal disorders (Down syndrome, Trisomy 13/18), abdominal wall defects
Anomalies (gastroschisis, omphalocele), diaphragmatic hernia
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Domain Key Topics
Surfactant therapy, caffeine citrate (apnea of prematurity), indomethacin/ibuprofen (PDA
Pharmacology
closure), prostaglandin E1 (ductal-dependent lesions)
Parental bonding, kangaroo care (skin-to-skin), discharge planning, care of the late preterm
Family-Centered Care
infant
NICU safety protocols, developmental care, pain assessment (Neonatal Infant Pain Scale - N
Professional Practice
ethical/legal issues
)
Antepartum & Intrapartum (Questions 1-15)
Question 1: A nurse is caring for a 34-week gestation infant whose mother received two doses of
betamethasone 24 hours apart 5 days prior to delivery. What is the primary expected outcome of this
antenatal corticosteroid administration?
A) Prevention of intraventricular hemorrhage (IVH)
B) Acceleration of fetal lung maturity
C) Treatment of maternal hypertension
D) Prevention of neonatal sepsis
Answer: B
Antenatal corticosteroids (betamethasone or dexamethasone) accelerate fetal lung maturity by
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stimulating surfactant production, reducing the incidence and severity of respiratory distress syndrome
(RDS) in preterm infants .
Question 2: A mother with premature rupture of membranes (PROM) for 36 hours delivers a 38-week
infant. The infant develops respiratory distress shortly after birth. What is the most likely diagnosis?
A) Congenital pneumonia
B) Transient tachypnea of the newborn (TTN)
C) Meconium aspiration syndrome
D) Spontaneous pneumothorax
Answer: B
Prolonged rupture of membranes does not increase the risk of TTN. TTN is more common after cesarean
section without labor. This infant has a normal gestational age and PROM, so infection should be ruled
out, but pneumonia typically presents later or with sepsis findings .
Question 3: A nurse is reviewing the maternal history of a term newborn admitted to the NICU for
respiratory distress. Which maternal history finding is most consistent with transient tachypnea of the
newborn (TTN)?
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A) Gestational diabetes
B) Prolonged rupture of membranes (18 hours)
C) Cesarean section without labor
D) Maternal fever during labor
Answer: C
TTN is commonly seen in infants born by cesarean section, especially without labor, because the lack of
thoracic compression during vaginal delivery leaves more fetal lung fluid remaining in the lungs .
Question 4: An infant is born at 32 weeks gestation to a mother with chorioamnionitis. Which laboratory
finding in the infant would be most concerning for early-onset sepsis?
A) White blood cell count of 22,000/mm³
B) Platelet count of 50,000/mm³
C) C-reactive protein (CRP) of 2 mg/dL
D) Absolute neutrophil count of 8,000/mm³
Answer: B
*Severe thrombocytopenia (platelets <100,000/mm³) is a concerning sign for neonatal sepsis. While
Relias RN NICU Nursing Core Concepts Exam –
ACTUAL QUESTIONS AND ANSWERS LATEST
UPDATE THIS YEAR
Relias RN NICU Nursing Core Concepts RN Exam – Coverage Summary & 200 Exam-Relevant Questions
Based on the National Certification Corporation (NCC) exam blueprint for neonatal intensive care
nursing (RNC-NIC), the Relias RN NICU Core Concepts exam assesses advanced knowledge required for
high-risk newborn care . The following content areas are typically covered:
Exam Coverage Summary
Domain Key Topics
Antepartum & Maternal risk factors, antenatal corticosteroids, prolonged rupture of membranes,
Intrapartum chorioamnionitis, gestational diabetes, preeclampsia
Transition to Neonatal resuscitation (NRP), APGAR scoring, initial stabilization, thermoregulation, delaye
Extrauterine Life cord clamping
Respiratory distress syndrome (RDS), transient tachypnea (TTN), pneumothorax, meconium
Respiratory System
aspiration syndrome (MAS), bronchopulmonary dysplasia (BPD), apnea of prematurity
Patent ductus arteriosus (PDA), congenital heart defects (e.g., ductal-dependent lesions),
Cardiovascular System
persistent pulmonary hypertension (PPHN), hypotension management
Intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), hypoxic-ischemic
Neurologic System
encephalopathy (HIE), therapeutic hypothermia, seizures
Necrotizing enterocolitis (NEC), feeding intolerance, gastroschisis, omphalocele, bilious asp
Gastrointestinal System
gavage feeding
Hypoglycemia, hyperbilirubinemia (physiologic vs. pathologic), phototherapy, congenital
Metabolic & Endocrine
hypothyroidism, calcium disorders
Hematologic System Anemia of prematurity, polycythemia, thrombocytopenia, vitamin K deficiency bleeding (VK
Neonatal sepsis (early-onset vs. late-onset), Group B Streptococcus (GBS) prophylaxis,
Infectious Diseases
meningitis, congenital infections (CMV, toxoplasmosis)
Renal & Fluids Dehydration, fluid overload, hyponatremia, hyperkalemia, acute kidney injury (AKI)
Genetics & Congenital Common chromosomal disorders (Down syndrome, Trisomy 13/18), abdominal wall defects
Anomalies (gastroschisis, omphalocele), diaphragmatic hernia
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Domain Key Topics
Surfactant therapy, caffeine citrate (apnea of prematurity), indomethacin/ibuprofen (PDA
Pharmacology
closure), prostaglandin E1 (ductal-dependent lesions)
Parental bonding, kangaroo care (skin-to-skin), discharge planning, care of the late preterm
Family-Centered Care
infant
NICU safety protocols, developmental care, pain assessment (Neonatal Infant Pain Scale - N
Professional Practice
ethical/legal issues
)
Antepartum & Intrapartum (Questions 1-15)
Question 1: A nurse is caring for a 34-week gestation infant whose mother received two doses of
betamethasone 24 hours apart 5 days prior to delivery. What is the primary expected outcome of this
antenatal corticosteroid administration?
A) Prevention of intraventricular hemorrhage (IVH)
B) Acceleration of fetal lung maturity
C) Treatment of maternal hypertension
D) Prevention of neonatal sepsis
Answer: B
Antenatal corticosteroids (betamethasone or dexamethasone) accelerate fetal lung maturity by
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stimulating surfactant production, reducing the incidence and severity of respiratory distress syndrome
(RDS) in preterm infants .
Question 2: A mother with premature rupture of membranes (PROM) for 36 hours delivers a 38-week
infant. The infant develops respiratory distress shortly after birth. What is the most likely diagnosis?
A) Congenital pneumonia
B) Transient tachypnea of the newborn (TTN)
C) Meconium aspiration syndrome
D) Spontaneous pneumothorax
Answer: B
Prolonged rupture of membranes does not increase the risk of TTN. TTN is more common after cesarean
section without labor. This infant has a normal gestational age and PROM, so infection should be ruled
out, but pneumonia typically presents later or with sepsis findings .
Question 3: A nurse is reviewing the maternal history of a term newborn admitted to the NICU for
respiratory distress. Which maternal history finding is most consistent with transient tachypnea of the
newborn (TTN)?
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A) Gestational diabetes
B) Prolonged rupture of membranes (18 hours)
C) Cesarean section without labor
D) Maternal fever during labor
Answer: C
TTN is commonly seen in infants born by cesarean section, especially without labor, because the lack of
thoracic compression during vaginal delivery leaves more fetal lung fluid remaining in the lungs .
Question 4: An infant is born at 32 weeks gestation to a mother with chorioamnionitis. Which laboratory
finding in the infant would be most concerning for early-onset sepsis?
A) White blood cell count of 22,000/mm³
B) Platelet count of 50,000/mm³
C) C-reactive protein (CRP) of 2 mg/dL
D) Absolute neutrophil count of 8,000/mm³
Answer: B
*Severe thrombocytopenia (platelets <100,000/mm³) is a concerning sign for neonatal sepsis. While
