, CCRN NEONATAL PRACTICE EXAM PROVIDED WITH COMPLETE
&VERIFIED QUESTIONS AND ANSWERS WITH WELL-EXPLAINED
RATIONALES -2025/2026- UPDATED VERSION& FULLY COVERED
Question 1
At what gestational week do the kidneys begin formation in a developing fetus?
A) 3 weeks
B) 5 weeks
C) 8 weeks
D) 12 weeks
CORRECT ANSWERB
Rationale: Kidney formation begins at 5 weeks gestation as the metanephros develops.
Question 2
A preterm infant born at 26 weeks gestation will have complete nephrogenesis at what postnatal
age?
A) At birth
B) 4 weeks
C) 9 weeks*
D) 26 weeks
CORRECT ANSWERC
Rationale: Nephrogenesis completes at 35 weeks gestation, so 35 minus 26 equals 9 weeks postnatal
age.
Question 3
Prenatally, what percentage of cardiac output reaches the fetal kidneys?
A) 1-2%
B) 4-6%*
C) 8-10%
,D) 15-20%
CORRECT ANSWERB
Rationale: Fetal renal blood flow is only 4-6% of cardiac output due to high placental vascular
resistance.
Question 4
A term newborn at 1 week of life will have what percentage of cardiac output directed to the
kidneys?
A) 4-6%
B) 8-10%*
C) 15%
D) 25%
CORRECT ANSWERBRationale: After birth, renal perfusion increases to 8-10% of cardiac output
as systemic vascular resistance rises.
Question 5
Which laboratory test is the best indicator of glomerular filtration rate in a neonate?
A) BUN
*B) Creatinine*
C) Cystatin C
D) Urine specific gravity
CORRECT ANSWER B*Rationale: Creatinine is the standard laboratory indicator of glomerular
filtration rate in newborns.
Question 6
True or false: Preterm infants have reduced proximal and distal tubule sodium reabsorption
compared to term infants.
*A) True*
B) False
, CORRECT ANSWER A *Rationale: Premature infants have immature tubular function, leading to
reduced sodium reabsorption in both proximal and distal tubules.
Question 7
A 28-week preterm infant under a radiant warmer receiving phototherapy is at risk for increased
loss of what type of fluid?
A) Urinary loss
*B) Insensible water loss*
C) GI loss
D) Third spacing
CORRECT ANSWER B*Rationale: Radiant warmers and phototherapy increase transepidermal
water loss, a major cause of insensible water loss.
Question 8
What is the number one cause of insensible water loss in the neonatal intensive care unit?
A) Phototherapy
B) Respiratory distress
*C) Severe prematurity*
D) NG drainage
CORRECT ANSWER C*Rationale: Severe prematurity causes the greatest insensible water loss
due to immature skin barrier function.*
Question 9
Which intervention will help decrease insensible water loss in an extremely preterm infant
immediately after delivery?
A) Radiant warmer without cover
*B) Plastic wrap at delivery*
C) Frequent bathing
D) Open crib
CORRECT ANSWER B*Rationale: Plastic wrap at delivery reduces transepidermal water loss, as
do humidity and servo-controlled isolettes.
&VERIFIED QUESTIONS AND ANSWERS WITH WELL-EXPLAINED
RATIONALES -2025/2026- UPDATED VERSION& FULLY COVERED
Question 1
At what gestational week do the kidneys begin formation in a developing fetus?
A) 3 weeks
B) 5 weeks
C) 8 weeks
D) 12 weeks
CORRECT ANSWERB
Rationale: Kidney formation begins at 5 weeks gestation as the metanephros develops.
Question 2
A preterm infant born at 26 weeks gestation will have complete nephrogenesis at what postnatal
age?
A) At birth
B) 4 weeks
C) 9 weeks*
D) 26 weeks
CORRECT ANSWERC
Rationale: Nephrogenesis completes at 35 weeks gestation, so 35 minus 26 equals 9 weeks postnatal
age.
Question 3
Prenatally, what percentage of cardiac output reaches the fetal kidneys?
A) 1-2%
B) 4-6%*
C) 8-10%
,D) 15-20%
CORRECT ANSWERB
Rationale: Fetal renal blood flow is only 4-6% of cardiac output due to high placental vascular
resistance.
Question 4
A term newborn at 1 week of life will have what percentage of cardiac output directed to the
kidneys?
A) 4-6%
B) 8-10%*
C) 15%
D) 25%
CORRECT ANSWERBRationale: After birth, renal perfusion increases to 8-10% of cardiac output
as systemic vascular resistance rises.
Question 5
Which laboratory test is the best indicator of glomerular filtration rate in a neonate?
A) BUN
*B) Creatinine*
C) Cystatin C
D) Urine specific gravity
CORRECT ANSWER B*Rationale: Creatinine is the standard laboratory indicator of glomerular
filtration rate in newborns.
Question 6
True or false: Preterm infants have reduced proximal and distal tubule sodium reabsorption
compared to term infants.
*A) True*
B) False
, CORRECT ANSWER A *Rationale: Premature infants have immature tubular function, leading to
reduced sodium reabsorption in both proximal and distal tubules.
Question 7
A 28-week preterm infant under a radiant warmer receiving phototherapy is at risk for increased
loss of what type of fluid?
A) Urinary loss
*B) Insensible water loss*
C) GI loss
D) Third spacing
CORRECT ANSWER B*Rationale: Radiant warmers and phototherapy increase transepidermal
water loss, a major cause of insensible water loss.
Question 8
What is the number one cause of insensible water loss in the neonatal intensive care unit?
A) Phototherapy
B) Respiratory distress
*C) Severe prematurity*
D) NG drainage
CORRECT ANSWER C*Rationale: Severe prematurity causes the greatest insensible water loss
due to immature skin barrier function.*
Question 9
Which intervention will help decrease insensible water loss in an extremely preterm infant
immediately after delivery?
A) Radiant warmer without cover
*B) Plastic wrap at delivery*
C) Frequent bathing
D) Open crib
CORRECT ANSWER B*Rationale: Plastic wrap at delivery reduces transepidermal water loss, as
do humidity and servo-controlled isolettes.
