RELIAS RN NICU NURSING CORE CONCEPTS RN EXAM 2 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
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
🟢 B. Acceleration of fetal lung maturity
🔴 RATIONALE: Antenatal corticosteroids, such as betamethasone, are administered to accelerate fetal lung
maturity by stimulating surfactant production. The optimal regimen involves two doses given 24 hours apart,
with effects peaking between 24 hours and 7 days after administration .
,Question 2
Which of the following best describes thermoregulation in a preterm infant?
A. Efficient due to brown fat stores
B. Enhanced by immature skin
C. Poor due to large surface area and thin skin
D. Maintained by shivering
🟢 C. Poor due to large surface area and thin skin
🔴 RATIONALE: Preterm infants are at high risk for heat loss due to a large surface area-to-body-weight ratio,
thin skin, and decreased subcutaneous fat. They also have limited brown fat stores for non-shivering
thermogenesis, making them unable to effectively maintain their body temperature .
Question 3
What is the purpose of administering surfactant therapy to a neonate?
A. Treat sepsis
B. Improve cardiac output
C. Decrease surface tension in the lungs
D. Promote liver function
🟢 C. Decrease surface tension in the lungs
🔴 RATIONALE: Surfactant is a substance that reduces alveolar surface tension, preventing alveolar collapse at
end-expiration. Administering exogenous surfactant improves lung compliance, reduces the work of breathing,
and enhances oxygenation in preterm infants with Respiratory Distress Syndrome (RDS) .
,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
🟢 B. Platelet count of 50,000/mm³
🔴 RATIONALE: While leukocytosis, elevated CRP, and neutrophilia can support a diagnosis of infection, severe
thrombocytopenia (platelets <100,000/mm³) is a more specific indicator of disseminated infection, especially in
the context of maternal chorioamnionitis. The platelet count of 50,000/mm³ is critically low and concerning for
sepsis .
Question 5
Which electrolyte abnormality is most likely in infants receiving prolonged diuretic therapy?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hypermagnesemia
🟢 A. Hypokalemia
🔴 RATIONALE: Loop and thiazide diuretics act on the renal tubules to promote sodium and water excretion
but also increase the excretion of potassium. Prolonged use can lead to significant hypokalemia, which can
cause cardiac arrhythmias and other complications .
, Question 6
A 29-week preterm infant is delivered 48 hours after the mother received only one dose of betamethasone. The
infant develops severe respiratory distress. The nurse understands that:
A. Two doses given 24 hours apart are optimal for surfactant production
B. A single dose provides equivalent benefit to two doses
C. Betamethasone has no effect on lung maturity
D. The infant should have received dexamethasone instead
🟢 A. Two doses given 24 hours apart are optimal for surfactant production
🔴 RATIONALE: The optimal regimen for antenatal corticosteroids is two doses administered 24 hours apart. A
single dose provides partial benefit but is less effective than the full course for accelerating fetal lung maturity .
Question 7
What is the preferred method for enteral feeding in a preterm infant with an immature suck-swallow-breathe
reflex?
A. Oral syringe
B. Breastfeeding
C. Gavage feeding
D. Cup feeding
🟢 C. Gavage feeding
🔴 RATIONALE: Gavage feeding (orogastric or nasogastric) is the preferred method for preterm infants who lack
the neuromuscular coordination to suck, swallow, and breathe safely. It ensures adequate nutrition is delivered
directly to the stomach while avoiding the risk of aspiration associated with oral feeding .
ANSWERS) PLUS RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
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
🟢 B. Acceleration of fetal lung maturity
🔴 RATIONALE: Antenatal corticosteroids, such as betamethasone, are administered to accelerate fetal lung
maturity by stimulating surfactant production. The optimal regimen involves two doses given 24 hours apart,
with effects peaking between 24 hours and 7 days after administration .
,Question 2
Which of the following best describes thermoregulation in a preterm infant?
A. Efficient due to brown fat stores
B. Enhanced by immature skin
C. Poor due to large surface area and thin skin
D. Maintained by shivering
🟢 C. Poor due to large surface area and thin skin
🔴 RATIONALE: Preterm infants are at high risk for heat loss due to a large surface area-to-body-weight ratio,
thin skin, and decreased subcutaneous fat. They also have limited brown fat stores for non-shivering
thermogenesis, making them unable to effectively maintain their body temperature .
Question 3
What is the purpose of administering surfactant therapy to a neonate?
A. Treat sepsis
B. Improve cardiac output
C. Decrease surface tension in the lungs
D. Promote liver function
🟢 C. Decrease surface tension in the lungs
🔴 RATIONALE: Surfactant is a substance that reduces alveolar surface tension, preventing alveolar collapse at
end-expiration. Administering exogenous surfactant improves lung compliance, reduces the work of breathing,
and enhances oxygenation in preterm infants with Respiratory Distress Syndrome (RDS) .
,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
🟢 B. Platelet count of 50,000/mm³
🔴 RATIONALE: While leukocytosis, elevated CRP, and neutrophilia can support a diagnosis of infection, severe
thrombocytopenia (platelets <100,000/mm³) is a more specific indicator of disseminated infection, especially in
the context of maternal chorioamnionitis. The platelet count of 50,000/mm³ is critically low and concerning for
sepsis .
Question 5
Which electrolyte abnormality is most likely in infants receiving prolonged diuretic therapy?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hypermagnesemia
🟢 A. Hypokalemia
🔴 RATIONALE: Loop and thiazide diuretics act on the renal tubules to promote sodium and water excretion
but also increase the excretion of potassium. Prolonged use can lead to significant hypokalemia, which can
cause cardiac arrhythmias and other complications .
, Question 6
A 29-week preterm infant is delivered 48 hours after the mother received only one dose of betamethasone. The
infant develops severe respiratory distress. The nurse understands that:
A. Two doses given 24 hours apart are optimal for surfactant production
B. A single dose provides equivalent benefit to two doses
C. Betamethasone has no effect on lung maturity
D. The infant should have received dexamethasone instead
🟢 A. Two doses given 24 hours apart are optimal for surfactant production
🔴 RATIONALE: The optimal regimen for antenatal corticosteroids is two doses administered 24 hours apart. A
single dose provides partial benefit but is less effective than the full course for accelerating fetal lung maturity .
Question 7
What is the preferred method for enteral feeding in a preterm infant with an immature suck-swallow-breathe
reflex?
A. Oral syringe
B. Breastfeeding
C. Gavage feeding
D. Cup feeding
🟢 C. Gavage feeding
🔴 RATIONALE: Gavage feeding (orogastric or nasogastric) is the preferred method for preterm infants who lack
the neuromuscular coordination to suck, swallow, and breathe safely. It ensures adequate nutrition is delivered
directly to the stomach while avoiding the risk of aspiration associated with oral feeding .
