RNC-NIC ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED
A+
◍ amniocentesis.
Answer: needle puncture of the amniotic sac to withdraw amniotic fluid for
analysis- screens for chromosomal abnormalities- typically performed early
in 2nd trimester (15-20 wks), more accurate >20 wks d/t chromosomal
presence in fluid- *also can be used later in pregnancy to assess fetal lung
maturity*- often recommended for AMA
◍ Neonatal Side Effects of Maternal Administration of Magnesium Sulfate
include:
A. Hypertonia
B. Hypoglycemia
C. Respiratory Depression.
Answer: C. Respiratory Depression
◍ Analyze the following blood gas value:pH 7.11, CO2 65, HCO3 17
A. Compensated metabolic acidosis
B. Uncompensated metabolic acidosis
C. Uncompensated mixed respiratory & metabolic acidosis.
Answer: C. Uncompensated mixed respiratory & metabolic acidosis
◍ thrombocytopenia (maternal).
Answer: - a generally benign maternal medical complication that is due to
hemodilution (increased RBCs)- may be associated with hypertensive
conditions r/t pregnancy- may be associated with s/s of bleeding in the
infant
◍ risks of maternal thrombocytopenia.
, Answer: can result in:- increased risk of bleeding in the mother, especially
during the delivery- *bleeding in the infant (oozing from umbilical cord,
prolonged bleeding from heel sticks, bruising, *petechiae
◍ You are obtaining labs for a newborn who was born 2 days ago. Which of
the following elevated lab values indicate physiologic hyperbilirubinemia.
A. Elevated glucose
B. Elevated Direct Bilirubin
C. Elevated Indirect Bilirubin.
Answer: C. Elevated Indirect Bilirubin
◍ Newborns with hyperglycemia in utero are at risk for
A. Being born small for their gestational age
B. Gastroschisis
C. Respiratory Distress Syndrome.
Answer: C. Respiratory Distress Syndrome
◍ Analyze the following blood gas value:pH 7.38, CO2 27, HCO3 16
A. Compensated metabolic acidosis
B. Compensated respiratory acidosis
C. Uncompensated metabolic acidosis.
Answer: A. Compensated metabolic acidosis
◍ What's the difference between NIPPV and CPAP?
A. CPAP & NIPPV are essentially the same except CPAP is delivered with
a mask and NIPPV is delivered with prongs
B. CPAP provides constant distending pressure whereas NIPPV only
provides intermittent breaths without constant distending pressure
C. CPAP provides constant distending pressure whereas NIPPV provides
constant distending pressure with peak intervals above to mimic tidal
volumes.
Answer: C. CPAP provides constant distending pressure whereas NIPPV
provides constant distending pressure with peak intervals above to mimic
tidal volumes
◍ neonatal petechiae.
, Answer: - must consider hyperbilirubinemia/jaundice (breakdown of RBCs)-
also associated with maternal thrombocytopenia
◍ You are caring for a newborn who is small for their gestational age, has
hepatomegaly, and "blueberry muffin spots". This is most likely due to
A. Congential viral infection
B. Neonatal alloimmune thrombocytopenia
C. Traumatic delivery.
Answer: A. Congential viral infection
◍ Functional closure of the ductus arteriosus occurs as a result of
A. fibrosis of the ductal muscle
B. increased arterial oxygen
C. increased left atrial pressure.
Answer: B. increased arterial oxygen
◍ cytomegalovirus (CMV).
Answer: - *most common intrauterine infection*- transmitted by exposure to
infected blood or body fluids- majority of infants asymptomatic at birth, but
5-15% have later sequelae (most commonly hearing and vision loss)
◍ contraindication for breastfeeding.
Answer: - maternal HIV/AIDS infection - *HIV/AIDS can be spread
through breastfeeding*
◍ A premature neonate has been consistently engaging in hand-to-mouth
movements. The nurse should
A. provide a time out for care giving activities
B. recognize these behaviors as a form of self consolation
C. swaddle and hold the infant for awhile.
Answer: B. recognize these behaviors as a form of self consolation
◍ signs of HIV in newborn.
Answer: - poor weight gain- *repeated fungal mouth infections* (thrush)-
enlarged lymph nodes- enlarged liver/spleen- neurologic problems- multiple
bacterial infections, including pneumonia
, ◍ chlamydia.
Answer: - *most common bacterial sexually transmitted infection*-
treatment: erythromycin
◍ After six hours of IV calcium replacement, the serum calcium level of a
neonate remains below normal. Which of the following laboratory values
should be obtained as the next step in evaluating the neonate's condition?
A. Serum magnesium
B. Serum phosphorus
C. Urine calcium.
Answer: A. Serum magnesium
◍ The primary etiology of transient tachypnea of the newborn is thought to be
A. asphyxia at birth
B. retained lung fluid
C. surfactant deficiency.
Answer: B. retained lung fluid
◍ signs/symptoms of neonatal chlamydia.
Answer: - conjunctivitis in first few weeks- late-onset: pneumonia at 3-4
months- otitis media- gastroenteritis
◍ oligohydramnios.
Answer: - AF volume <1 L at 36 weeks, <800 mL at term- can lead to
pulmonary hypoplasia d/t amniotic fluid's role in fetal pulmonary
development- *may be related to Potter sequence/renal agenesis* because
AF is largely made up of fetal urine (no urine if the baby has no kidneys)-
*can lead to hypoplastic lungs*- can also lead to IUGR and positional
deformities (baby can't move well)
◍ A 1300 g neonate wearing only a diaper is placed in a single walled
incubator with an inside temperature of 35oC (95o F). By what method is
the neonate most likely to experience heat loss?
A. Convection
B. Evaporation
QUESTIONS WITH ANSWERS GRADED
A+
◍ amniocentesis.
Answer: needle puncture of the amniotic sac to withdraw amniotic fluid for
analysis- screens for chromosomal abnormalities- typically performed early
in 2nd trimester (15-20 wks), more accurate >20 wks d/t chromosomal
presence in fluid- *also can be used later in pregnancy to assess fetal lung
maturity*- often recommended for AMA
◍ Neonatal Side Effects of Maternal Administration of Magnesium Sulfate
include:
A. Hypertonia
B. Hypoglycemia
C. Respiratory Depression.
Answer: C. Respiratory Depression
◍ Analyze the following blood gas value:pH 7.11, CO2 65, HCO3 17
A. Compensated metabolic acidosis
B. Uncompensated metabolic acidosis
C. Uncompensated mixed respiratory & metabolic acidosis.
Answer: C. Uncompensated mixed respiratory & metabolic acidosis
◍ thrombocytopenia (maternal).
Answer: - a generally benign maternal medical complication that is due to
hemodilution (increased RBCs)- may be associated with hypertensive
conditions r/t pregnancy- may be associated with s/s of bleeding in the
infant
◍ risks of maternal thrombocytopenia.
, Answer: can result in:- increased risk of bleeding in the mother, especially
during the delivery- *bleeding in the infant (oozing from umbilical cord,
prolonged bleeding from heel sticks, bruising, *petechiae
◍ You are obtaining labs for a newborn who was born 2 days ago. Which of
the following elevated lab values indicate physiologic hyperbilirubinemia.
A. Elevated glucose
B. Elevated Direct Bilirubin
C. Elevated Indirect Bilirubin.
Answer: C. Elevated Indirect Bilirubin
◍ Newborns with hyperglycemia in utero are at risk for
A. Being born small for their gestational age
B. Gastroschisis
C. Respiratory Distress Syndrome.
Answer: C. Respiratory Distress Syndrome
◍ Analyze the following blood gas value:pH 7.38, CO2 27, HCO3 16
A. Compensated metabolic acidosis
B. Compensated respiratory acidosis
C. Uncompensated metabolic acidosis.
Answer: A. Compensated metabolic acidosis
◍ What's the difference between NIPPV and CPAP?
A. CPAP & NIPPV are essentially the same except CPAP is delivered with
a mask and NIPPV is delivered with prongs
B. CPAP provides constant distending pressure whereas NIPPV only
provides intermittent breaths without constant distending pressure
C. CPAP provides constant distending pressure whereas NIPPV provides
constant distending pressure with peak intervals above to mimic tidal
volumes.
Answer: C. CPAP provides constant distending pressure whereas NIPPV
provides constant distending pressure with peak intervals above to mimic
tidal volumes
◍ neonatal petechiae.
, Answer: - must consider hyperbilirubinemia/jaundice (breakdown of RBCs)-
also associated with maternal thrombocytopenia
◍ You are caring for a newborn who is small for their gestational age, has
hepatomegaly, and "blueberry muffin spots". This is most likely due to
A. Congential viral infection
B. Neonatal alloimmune thrombocytopenia
C. Traumatic delivery.
Answer: A. Congential viral infection
◍ Functional closure of the ductus arteriosus occurs as a result of
A. fibrosis of the ductal muscle
B. increased arterial oxygen
C. increased left atrial pressure.
Answer: B. increased arterial oxygen
◍ cytomegalovirus (CMV).
Answer: - *most common intrauterine infection*- transmitted by exposure to
infected blood or body fluids- majority of infants asymptomatic at birth, but
5-15% have later sequelae (most commonly hearing and vision loss)
◍ contraindication for breastfeeding.
Answer: - maternal HIV/AIDS infection - *HIV/AIDS can be spread
through breastfeeding*
◍ A premature neonate has been consistently engaging in hand-to-mouth
movements. The nurse should
A. provide a time out for care giving activities
B. recognize these behaviors as a form of self consolation
C. swaddle and hold the infant for awhile.
Answer: B. recognize these behaviors as a form of self consolation
◍ signs of HIV in newborn.
Answer: - poor weight gain- *repeated fungal mouth infections* (thrush)-
enlarged lymph nodes- enlarged liver/spleen- neurologic problems- multiple
bacterial infections, including pneumonia
, ◍ chlamydia.
Answer: - *most common bacterial sexually transmitted infection*-
treatment: erythromycin
◍ After six hours of IV calcium replacement, the serum calcium level of a
neonate remains below normal. Which of the following laboratory values
should be obtained as the next step in evaluating the neonate's condition?
A. Serum magnesium
B. Serum phosphorus
C. Urine calcium.
Answer: A. Serum magnesium
◍ The primary etiology of transient tachypnea of the newborn is thought to be
A. asphyxia at birth
B. retained lung fluid
C. surfactant deficiency.
Answer: B. retained lung fluid
◍ signs/symptoms of neonatal chlamydia.
Answer: - conjunctivitis in first few weeks- late-onset: pneumonia at 3-4
months- otitis media- gastroenteritis
◍ oligohydramnios.
Answer: - AF volume <1 L at 36 weeks, <800 mL at term- can lead to
pulmonary hypoplasia d/t amniotic fluid's role in fetal pulmonary
development- *may be related to Potter sequence/renal agenesis* because
AF is largely made up of fetal urine (no urine if the baby has no kidneys)-
*can lead to hypoplastic lungs*- can also lead to IUGR and positional
deformities (baby can't move well)
◍ A 1300 g neonate wearing only a diaper is placed in a single walled
incubator with an inside temperature of 35oC (95o F). By what method is
the neonate most likely to experience heat loss?
A. Convection
B. Evaporation
