Pediatric Nursing NGN Practice Exam
47 Questions with Rationales | Prematurity, Genetics, Oncology, Infection and Inflammatory
Conditions
Every question is written in NGN style with a full rationale in the green box. Cover the box, answer first, then
check your reasoning.
Part 1: Prematurity and the At-Risk Newborn
Question 1
Respiratory distress syndrome in a premature infant is primarily caused by:
A. Too much surfactant
B. Surfactant deficiency from lung immaturity
C. Infection alone
D. A congenital heart defect
Answer: B
Why: Premature lungs lack adequate surfactant, so the alveoli collapse and breathing becomes difficult,
producing respiratory distress syndrome.
Question 2
Which factor increases a premature infant's risk for retinopathy of prematurity?
A. Low oxygen levels
B. Prolonged exposure to high supplemental oxygen
C. Hypothermia
D. Jaundice
Answer: B
Why: High supplemental oxygen over time can damage the developing retinal vessels, so oxygen is carefully
titrated in preterm infants.
Question 3
Which early signs suggest necrotizing enterocolitis in a preterm infant?
A. Increased appetite
B. Feeding intolerance, abdominal distension, and bloody stools
C. Steady weight gain
D. Hyperthermia
Answer: B
Why: Necrotizing enterocolitis presents with feeding intolerance, a distended abdomen, and bloody stools as
the bowel becomes inflamed and injured.
For personal study use only — not for redistribution. Page 1
, Question 4
Why are premature infants at higher risk for cold stress?
A. They have more brown fat
B. They have less subcutaneous and brown fat and a large surface area relative to body weight
C. They shiver excessively
D. They sweat too much
Answer: B
Why: Preterm infants have little insulating fat, limited brown fat, and a high surface-area-to-weight ratio, so
they lose heat quickly.
Question 5
Apnea of prematurity is generally defined as a respiratory pause:
A. Longer than 20 seconds, or shorter if accompanied by bradycardia or cyanosis
B. Of 5 seconds
C. Of any length
D. Only longer than 2 minutes
Answer: A
Why: Apnea of prematurity is a pause over 20 seconds, or a shorter pause associated with bradycardia or
cyanosis, due to an immature respiratory center.
Question 6
What is a key benefit of kangaroo (skin-to-skin) care for a preterm infant?
A. It increases infection risk
B. It promotes thermoregulation, bonding, and more stable vital signs
C. It reduces oxygenation
D. It has no measurable benefit
Answer: B
Why: Skin-to-skin contact helps stabilize temperature, heart rate, and breathing while supporting bonding and
breastfeeding.
Part 2: Genetic Disorders, Cystic Fibrosis and Sickle Cell Disease
Question 7
Cystic fibrosis is inherited in which pattern?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked
D. A chromosomal trisomy
Answer: B
Why: Cystic fibrosis is autosomal recessive, so a child must inherit a defective gene from both parents.
For personal study use only — not for redistribution. Page 2
47 Questions with Rationales | Prematurity, Genetics, Oncology, Infection and Inflammatory
Conditions
Every question is written in NGN style with a full rationale in the green box. Cover the box, answer first, then
check your reasoning.
Part 1: Prematurity and the At-Risk Newborn
Question 1
Respiratory distress syndrome in a premature infant is primarily caused by:
A. Too much surfactant
B. Surfactant deficiency from lung immaturity
C. Infection alone
D. A congenital heart defect
Answer: B
Why: Premature lungs lack adequate surfactant, so the alveoli collapse and breathing becomes difficult,
producing respiratory distress syndrome.
Question 2
Which factor increases a premature infant's risk for retinopathy of prematurity?
A. Low oxygen levels
B. Prolonged exposure to high supplemental oxygen
C. Hypothermia
D. Jaundice
Answer: B
Why: High supplemental oxygen over time can damage the developing retinal vessels, so oxygen is carefully
titrated in preterm infants.
Question 3
Which early signs suggest necrotizing enterocolitis in a preterm infant?
A. Increased appetite
B. Feeding intolerance, abdominal distension, and bloody stools
C. Steady weight gain
D. Hyperthermia
Answer: B
Why: Necrotizing enterocolitis presents with feeding intolerance, a distended abdomen, and bloody stools as
the bowel becomes inflamed and injured.
For personal study use only — not for redistribution. Page 1
, Question 4
Why are premature infants at higher risk for cold stress?
A. They have more brown fat
B. They have less subcutaneous and brown fat and a large surface area relative to body weight
C. They shiver excessively
D. They sweat too much
Answer: B
Why: Preterm infants have little insulating fat, limited brown fat, and a high surface-area-to-weight ratio, so
they lose heat quickly.
Question 5
Apnea of prematurity is generally defined as a respiratory pause:
A. Longer than 20 seconds, or shorter if accompanied by bradycardia or cyanosis
B. Of 5 seconds
C. Of any length
D. Only longer than 2 minutes
Answer: A
Why: Apnea of prematurity is a pause over 20 seconds, or a shorter pause associated with bradycardia or
cyanosis, due to an immature respiratory center.
Question 6
What is a key benefit of kangaroo (skin-to-skin) care for a preterm infant?
A. It increases infection risk
B. It promotes thermoregulation, bonding, and more stable vital signs
C. It reduces oxygenation
D. It has no measurable benefit
Answer: B
Why: Skin-to-skin contact helps stabilize temperature, heart rate, and breathing while supporting bonding and
breastfeeding.
Part 2: Genetic Disorders, Cystic Fibrosis and Sickle Cell Disease
Question 7
Cystic fibrosis is inherited in which pattern?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked
D. A chromosomal trisomy
Answer: B
Why: Cystic fibrosis is autosomal recessive, so a child must inherit a defective gene from both parents.
For personal study use only — not for redistribution. Page 2
