RNC NIC EXAM SCRIPT 2026 FULL
SOLUTION QUESTIONS AND ANSWERS
GRADED A+
⩥ How does a Diaphragmatic Hernia present?
Answer: Cyanosis, tachypnea, tachycardia, lack of breath sounds on side
of hernia, bowel sounds heard in chest.
⩥ What should be avoided if a Diaphragmatic Hernia is suspected?
Answer: Bag/Mask Ventilation (pushes air into the intestines and further
compresses the lungs and heart). If infant need respiratory support,
intubate.
⩥ A Scaphoid Abdomen is the classic appearance of an infant with
which congenital disorder?
Answer: Diaphragmatic Hernia
⩥ What is the Compression/Ventilation rate when performing Chest
Compressions?
Answer: 90 compressions and 30 ventilations per minute
⩥ When is Epinephrine indicated during a resuscitation?
,Answer: After 30 sec of effective PPV at 100% fiO2, followed by 30 sec
of coordinated chest compressions and ventilations.
⩥ When are Volume Expanders indicated during a resuscitation?
Answer: When the infant with a history or exam consistent with blood
loss fails to response to epinephrine.
⩥ What is a prenatal form of heart failure that is almost always caused
by Fetal Anemia?
Answer: Hydrops Fetalis
⩥ How does Hydrops Fetalis present?
Answer: Generalized edema and fluid in 2 compartmental spaces like
pleural or pericardial effusion and ascites.
⩥ What are usually the first indicators of Hydrops in utero?
Answer: Polyhydramnios and measuring LGA, with subsequent
ultrasound revealing ascites, pleural effusion, pericardial effusion or skin
edema.
⩥ What two procedures should you anticipate upon delivery for an
infant with suspected Hydrops?
Answer: Intubation and a Thoracentesis to drain the intrapleural fluid.
, ⩥ Name some disease processes that can cause severe Upper Airway
Obstructions.
Answer: Pierre Robin Sequence, Laryngomalacia, and Vocal Cord
Paralysis. Children born with congenital craniofacial, pharyngeal, or
laryngeal abnormalities are at an increased risk for severe upper airway
obstruction.
⩥ What is Laryngomalacia characterized by?
Answer: Inspiratory stridor and increases with agitation
⩥ What occurs when the cartilage in the windpipe has not developed
properly and causes a collapse of the airway when breathing?
Answer: Congenital Tracheomalacia. Instead of being rigid, the walls of
the trachea are floppy.
⩥ How does Tracheomalacia present?
Answer: Expiratory Stridor which may improve with prone positioning
⩥ What common intervention in the NICU is associated with the
complication of Tracheal Stenosis?
Answer: Endotracheal Intubation. Trauma during intubation,
manipulation of the tube while intubated, and length of intubation all
contribute to scar tissue forming, resulting in a narrowing of the trachea.
SOLUTION QUESTIONS AND ANSWERS
GRADED A+
⩥ How does a Diaphragmatic Hernia present?
Answer: Cyanosis, tachypnea, tachycardia, lack of breath sounds on side
of hernia, bowel sounds heard in chest.
⩥ What should be avoided if a Diaphragmatic Hernia is suspected?
Answer: Bag/Mask Ventilation (pushes air into the intestines and further
compresses the lungs and heart). If infant need respiratory support,
intubate.
⩥ A Scaphoid Abdomen is the classic appearance of an infant with
which congenital disorder?
Answer: Diaphragmatic Hernia
⩥ What is the Compression/Ventilation rate when performing Chest
Compressions?
Answer: 90 compressions and 30 ventilations per minute
⩥ When is Epinephrine indicated during a resuscitation?
,Answer: After 30 sec of effective PPV at 100% fiO2, followed by 30 sec
of coordinated chest compressions and ventilations.
⩥ When are Volume Expanders indicated during a resuscitation?
Answer: When the infant with a history or exam consistent with blood
loss fails to response to epinephrine.
⩥ What is a prenatal form of heart failure that is almost always caused
by Fetal Anemia?
Answer: Hydrops Fetalis
⩥ How does Hydrops Fetalis present?
Answer: Generalized edema and fluid in 2 compartmental spaces like
pleural or pericardial effusion and ascites.
⩥ What are usually the first indicators of Hydrops in utero?
Answer: Polyhydramnios and measuring LGA, with subsequent
ultrasound revealing ascites, pleural effusion, pericardial effusion or skin
edema.
⩥ What two procedures should you anticipate upon delivery for an
infant with suspected Hydrops?
Answer: Intubation and a Thoracentesis to drain the intrapleural fluid.
, ⩥ Name some disease processes that can cause severe Upper Airway
Obstructions.
Answer: Pierre Robin Sequence, Laryngomalacia, and Vocal Cord
Paralysis. Children born with congenital craniofacial, pharyngeal, or
laryngeal abnormalities are at an increased risk for severe upper airway
obstruction.
⩥ What is Laryngomalacia characterized by?
Answer: Inspiratory stridor and increases with agitation
⩥ What occurs when the cartilage in the windpipe has not developed
properly and causes a collapse of the airway when breathing?
Answer: Congenital Tracheomalacia. Instead of being rigid, the walls of
the trachea are floppy.
⩥ How does Tracheomalacia present?
Answer: Expiratory Stridor which may improve with prone positioning
⩥ What common intervention in the NICU is associated with the
complication of Tracheal Stenosis?
Answer: Endotracheal Intubation. Trauma during intubation,
manipulation of the tube while intubated, and length of intubation all
contribute to scar tissue forming, resulting in a narrowing of the trachea.
