RNC-NIC EXAM STUDY GUIDE QUESTIONS
WITH CORRECT ANSWERS 2026
◉ A term infant is now 24 hours old and rooming in with the
mother. The infant was delivered by cesarean section due to
maternal arrest of labor. Apgar scores are 7 at 1 minute and 8 at 5
minutes. Membranes ruptured 12 hours before delivery and were
meconium stained. Prenatal group B streptococcus screen at 36
weeks was negative. Maternal temperature before delivery was 37.9°
C (100.2° F). Beginning shift assessment reveals color slightly pale;
decreased peripheral pulses and perfusion in lower extremities;
difficulty getting baby to latch for breast-feeding; slightly lethargic;
and respiratory rate 80 breaths per minute sustained with no
grunting, flaring, or retractions. Based on the assessment, the nurse
should carry out which of the following interventions? Answer:
Notify the pediatric provider and transfer the infant to the special
care nursery for observation under a radiant warmer, with the
possible diagnosis of coarctation of the aorta
Coarctation of the aorta has the classic finding of decreased
perfusion and pulses in the lower extremities. These infants can
develop temperature instability and poor feeding. Congenital heart
disease should be suspected when infants present with an increase
in respiratory rate in the absence of any other respiratory signs of
distress and cyanosis. The physician should be notified immediately
and the infant transferred to the nursery for further evaluation and
stabilization
,◉ Cephalohematoma Answer: is a collection of blood between the
periosteum and the skull that does not cross the suture line. It may
enlarge during the 24 hours after birth and may take several months
to resolve. These infants are at a higher risk for developing
hyperbilirubinemi
◉ Subgaleal Hemorrhage Answer: happens when emissary veins in
the scalp rupture, allowing blood to pool between the skull's
periosteum and galea aponeurotica
◉ Caput Succedaneum Answer: is caused from pressure on the fetal
skull by the cervix during labor. A common characteristic of a caput
succedaneum is pitting edema that extends across the suture lines.
Edema generally resolves within a few days
◉ Craniosynostosis Answer: Premature closure of the cranial suture
with a palpable suture line
◉ After the resuscitation of a term infant delivered after a motor
vehicle accident, the infant is noted to be pale with an oxygen
saturation of 95%. The blood pressure is 34/22 mm Hg with a mean
of 28 mm Hg. The tone is diminished, and the blood glucose level is
30 mg/dl. The first action at this time would be to: Answer: give 30
ml normal saline
,Pallor despite adequate oxygenation, hypotension, and hypotonia
are all signs of hypovolemic shock. Normal saline is the preferred
fluid to correct hypovolemia and facilitate tissue perfusion
◉ Erythroblastosis Fetalis Answer: a potentially life-threatening
blood disorder that occurs when a mother's immune system attacks
her fetus's red blood cells:
The disorder occurs when a fetus inherits blood group factors that
the mother doesn't have, such as the Rh factor. This can happen
during pregnancy when the fetus's blood comes into contact with
the mother's
◉ Kleihauer-Betke test Answer: identifies fetal cells in the maternal
blood. Although the Kelihauer-Betke test can be useful in
determining whether the mother needs RhIgG, it will not determine
the infant's condition at the time of delivery.
◉ Choanal atresia Answer: a rare, life-threatening condition that
occurs when the nasal passage is blocked by tissue or bone,
preventing a baby from breathing properly
◉ A term infant is born via normal spontaneous vaginal delivery.
The infant is noted to be cyanotic when quiet but pinks up when
crying. The most likely diagnosis for this infant is: Answer: Choanal
atresia
, commonly presents with cyanosis upon delivery that resolves with
crying due to the blockage of one or both nares.
◉ Despite continuous positive pressure ventilation via an
endotracheal tube, a newborn is persistently cyanotic. The heart rate
remains less than 100 beats per minute. Breath sounds can be heard
over both the lung fields and the stomach. The stomach is distended.
Most likely, the endotracheal tube is: Answer: in the esophagus
Signs of inadvertent esophageal intubation include hearing breath
sounds over the stomach, seeing abdominal distension, and a poor
response to resuscitation
◉ The use of epinephrine in neonatal resuscitation for bradycardia
less than 60 beats per minute is recommended: Answer: following
initial steps, 30 seconds of effective ventilations and 60 seconds of
chest compressions
The most effective means of correcting bradycardia in the neonate is
effective ventilation. However, if the heart rate remains less than 60
beats per minute, current literature supports the use of epinephrine
following 30 seconds of effective ventilation (preferably through an
endotracheal tube) with 100% oxygen and 60 seconds of chest
compressions
WITH CORRECT ANSWERS 2026
◉ A term infant is now 24 hours old and rooming in with the
mother. The infant was delivered by cesarean section due to
maternal arrest of labor. Apgar scores are 7 at 1 minute and 8 at 5
minutes. Membranes ruptured 12 hours before delivery and were
meconium stained. Prenatal group B streptococcus screen at 36
weeks was negative. Maternal temperature before delivery was 37.9°
C (100.2° F). Beginning shift assessment reveals color slightly pale;
decreased peripheral pulses and perfusion in lower extremities;
difficulty getting baby to latch for breast-feeding; slightly lethargic;
and respiratory rate 80 breaths per minute sustained with no
grunting, flaring, or retractions. Based on the assessment, the nurse
should carry out which of the following interventions? Answer:
Notify the pediatric provider and transfer the infant to the special
care nursery for observation under a radiant warmer, with the
possible diagnosis of coarctation of the aorta
Coarctation of the aorta has the classic finding of decreased
perfusion and pulses in the lower extremities. These infants can
develop temperature instability and poor feeding. Congenital heart
disease should be suspected when infants present with an increase
in respiratory rate in the absence of any other respiratory signs of
distress and cyanosis. The physician should be notified immediately
and the infant transferred to the nursery for further evaluation and
stabilization
,◉ Cephalohematoma Answer: is a collection of blood between the
periosteum and the skull that does not cross the suture line. It may
enlarge during the 24 hours after birth and may take several months
to resolve. These infants are at a higher risk for developing
hyperbilirubinemi
◉ Subgaleal Hemorrhage Answer: happens when emissary veins in
the scalp rupture, allowing blood to pool between the skull's
periosteum and galea aponeurotica
◉ Caput Succedaneum Answer: is caused from pressure on the fetal
skull by the cervix during labor. A common characteristic of a caput
succedaneum is pitting edema that extends across the suture lines.
Edema generally resolves within a few days
◉ Craniosynostosis Answer: Premature closure of the cranial suture
with a palpable suture line
◉ After the resuscitation of a term infant delivered after a motor
vehicle accident, the infant is noted to be pale with an oxygen
saturation of 95%. The blood pressure is 34/22 mm Hg with a mean
of 28 mm Hg. The tone is diminished, and the blood glucose level is
30 mg/dl. The first action at this time would be to: Answer: give 30
ml normal saline
,Pallor despite adequate oxygenation, hypotension, and hypotonia
are all signs of hypovolemic shock. Normal saline is the preferred
fluid to correct hypovolemia and facilitate tissue perfusion
◉ Erythroblastosis Fetalis Answer: a potentially life-threatening
blood disorder that occurs when a mother's immune system attacks
her fetus's red blood cells:
The disorder occurs when a fetus inherits blood group factors that
the mother doesn't have, such as the Rh factor. This can happen
during pregnancy when the fetus's blood comes into contact with
the mother's
◉ Kleihauer-Betke test Answer: identifies fetal cells in the maternal
blood. Although the Kelihauer-Betke test can be useful in
determining whether the mother needs RhIgG, it will not determine
the infant's condition at the time of delivery.
◉ Choanal atresia Answer: a rare, life-threatening condition that
occurs when the nasal passage is blocked by tissue or bone,
preventing a baby from breathing properly
◉ A term infant is born via normal spontaneous vaginal delivery.
The infant is noted to be cyanotic when quiet but pinks up when
crying. The most likely diagnosis for this infant is: Answer: Choanal
atresia
, commonly presents with cyanosis upon delivery that resolves with
crying due to the blockage of one or both nares.
◉ Despite continuous positive pressure ventilation via an
endotracheal tube, a newborn is persistently cyanotic. The heart rate
remains less than 100 beats per minute. Breath sounds can be heard
over both the lung fields and the stomach. The stomach is distended.
Most likely, the endotracheal tube is: Answer: in the esophagus
Signs of inadvertent esophageal intubation include hearing breath
sounds over the stomach, seeing abdominal distension, and a poor
response to resuscitation
◉ The use of epinephrine in neonatal resuscitation for bradycardia
less than 60 beats per minute is recommended: Answer: following
initial steps, 30 seconds of effective ventilations and 60 seconds of
chest compressions
The most effective means of correcting bradycardia in the neonate is
effective ventilation. However, if the heart rate remains less than 60
beats per minute, current literature supports the use of epinephrine
following 30 seconds of effective ventilation (preferably through an
endotracheal tube) with 100% oxygen and 60 seconds of chest
compressions
