RNC-NIC CERTIFICATION SCRIPT 2026
QUESTIONS WITH SOLUTIONS
GRADED A+
◍ renal ultrasound using doppler flow.
Answer: noninvasive, looks at renal flow velocity patterns.
◍ acute kidney failure (renal- intrinsic/parenchymal).
Answer: congenital renal abnormalities, inflammation/ infection (syphills,
toxoplasmosis), vascular (thrombosis/DIC), uncorrected hypo perfusion
leading to ischemia, nephrotoxins (ahminoglycosides, indomethacin, and
amphotericin b).
◍ Renal thrombosis.
Answer: a clot in the vein that drains blood from the kidneys. Hematuria
often is the first presenting sign. Polycythemia, dehydration, seen with IDM,
cyanotic congenital heart disease.
◍ Renal agenesis (potter sequence).
Answer: bilateral renal genesis due to failure of the ureteric bud to divide.
Urine formation does not occur, resulting in low or absent amniotic fluid
volumes. associated with abnormal genital development, gI defects,
agrthogryposis. Most infants die the first few days bc of associated lung
hypoplasia.
◍ Inguinal Hernia.
Answer: most common surgical problem in infancy. small intestine and
gonads pass through the open processes vaginalis. In the female, the
herniation may occur into the soft tissue of the labia. can lead to
incarceration and necrosis of the herniated tissue.
◍ pulmonary atresia (test q).
, Answer: the absence of the pulmonary valve, which in turn prohibits blood
flow from the right ventricle into the pulmonary artery and essentially to the
lungs
◍ total fluid goal calculation.
Answer: first 10kg x100mlsecond 10-20 kg x 50mlfor each kg after 20kg
x20ml
◍ urine output calculation.
Answer: divide urine amount in mL by child's weight in kg, then divide by
hours the urine was from
◍ TPN (total parenteral nutrition) complications.
Answer: -pneumothorax during insertion of triple lumen catheter (TLC)-air
embolism-catheter displacement-clotted catheter line
(altipase)-sepsis-hyperglycemia/rebound hypoglycemia-fluid volume
overload
◍ PGE given what to look out for?.
Answer: apnea
◍ SIRS (systemic inflammatory response syndrome).
Answer: widespread inflammation that can occur in infection, trauma,
shock, ect. May result from or lead to MODS. Most frequently associated
with sepsis.
◍ SIRS signs and symptoms.
Answer: Fever >/= 100.4 or </= 96.8Tachypnea RR (>20)Tachycardia
>90Elevated WBCs >12,000Low WBCs <4,000 or >10% bandsAltered
Mental StatusHyperglycemia- glucose >140 mg/dL
◍ Infant in pain described,.
Answer: give morphine prn
◍ Frequent trach plugging means.
Answer: the baby needs more humidity.
◍ Cold stress and the newborn.
, Answer: Chemical thermogenesis by releasing NOREPINEPHRINE.
◍ Subgaleal hemorrhage.
Answer: bleeding into the subgaleal compartment (nape of neck) RISK
WITH VACCUM ASSISTED DELIVERIES.
◍ S/S of subgaleal hemorrhage.
Answer: boggy scalp, pallor, tachycardia, and increasing head circumference
are early S/S. apnea or tachypnea, hypotension, and signs of hypovolemic
shock. Because the shearing of the emissary vein happens during delivery,
these signs can rapidly develop within minutes to hours after birth.
◍ MRSOPA.
Answer: Mask adjustmentReposition airway-try PPV and reassess chest
movementSuction mouth and noseOpen mouth and lift jaw forward-try
PPVIncrease pressure in 5-10 increments maximum of 40-try
PPVAlternative Airway- place ET tubeTry PPV assess chest and lung
sounds
◍ A term infant presents at birth with tachypnea and increased work of
breathing. The infant’s oxygen saturation is 78% to 80% despite being given
100% oxygen. Congenital heart disease is suspected. Which of the following
defects is most likely to cause these symptoms?A:Aortic
stenosisB:Coarctation of the aortaC:Transposition of the great vessels.
Answer: C. Transposition of the great vessels occurs when the aorta arises
from the right ventricle and the pulmonary artery arises from the left
ventricle. Marked cyanosis is a presenting feature of transposition because
the aorta carries deoxygenated blood from the right ventricle to the systemic
circulation.
◍ An asymmetric Moro reflex is suggestive.
Answer: of a brachial plexus injury, as is the classic waiter's tip hand and
arm position. Shoulder dystocia places the infant at increased risk of Erb
palsy, an injury to the brachial plexus. With Erb palsy, the Moro reflex is
asymmetrical and the arm and wrist are positioned in what is referred to as
waiter's tip.
, ◍ The Ortolani test is used in conjunction with the Barlow test to assess for.
Answer: developmental dysplasia of the hip.
◍ small, recessed mandible, cleft palate, and a tongue, which is displaced to
the rear of the mouth at birth. These findings are suggestive of.
Answer: Infants with Pierre Robin sequence have significant mandibular
hypoplasia which results in a posteriorly located tongue and cleft palate.
◍ tonic-clonic seizure.
Answer: stiffening and repetitive jerking.stiffening-jerking; a major motor
seizure involving all muscle groups; previously termed grand mal (big bad)
seizure
◍ Neonatal myoclonus manifests as.
Answer: episodes of repetitive jerking or jitteriness that does not stop with
passive restraint.
◍ Galant reflex, also known as the truncal incurvation reflex.
Answer: tested by placing the infant in ventral suspension and applying
pressure along the edge of the thoracic spine. The infant's pelvis should flex
toward the side of the spine that is stimulated. It does not test muscle
strength of the lower limbs.
◍ The stepping reflex is elicited by.
Answer: supporting the infant under the arms and placing a foot on the edge
of a firm surface. When the reflex is intact, the infant will support his weight
and make a stepping motion.
◍ A positive Babinski reflex occurs.
Answer: when the foot undergoes plantar flexion after stimulation of the
sole. It does not test muscle strength.
◍ The harlequin sign.
Answer: A rare color change that occurs between the longitudinal halves of
the newborn's body, such that the dependent half is noticeably pinker than
the superior half when the newborn is placed on one side; it is of no
QUESTIONS WITH SOLUTIONS
GRADED A+
◍ renal ultrasound using doppler flow.
Answer: noninvasive, looks at renal flow velocity patterns.
◍ acute kidney failure (renal- intrinsic/parenchymal).
Answer: congenital renal abnormalities, inflammation/ infection (syphills,
toxoplasmosis), vascular (thrombosis/DIC), uncorrected hypo perfusion
leading to ischemia, nephrotoxins (ahminoglycosides, indomethacin, and
amphotericin b).
◍ Renal thrombosis.
Answer: a clot in the vein that drains blood from the kidneys. Hematuria
often is the first presenting sign. Polycythemia, dehydration, seen with IDM,
cyanotic congenital heart disease.
◍ Renal agenesis (potter sequence).
Answer: bilateral renal genesis due to failure of the ureteric bud to divide.
Urine formation does not occur, resulting in low or absent amniotic fluid
volumes. associated with abnormal genital development, gI defects,
agrthogryposis. Most infants die the first few days bc of associated lung
hypoplasia.
◍ Inguinal Hernia.
Answer: most common surgical problem in infancy. small intestine and
gonads pass through the open processes vaginalis. In the female, the
herniation may occur into the soft tissue of the labia. can lead to
incarceration and necrosis of the herniated tissue.
◍ pulmonary atresia (test q).
, Answer: the absence of the pulmonary valve, which in turn prohibits blood
flow from the right ventricle into the pulmonary artery and essentially to the
lungs
◍ total fluid goal calculation.
Answer: first 10kg x100mlsecond 10-20 kg x 50mlfor each kg after 20kg
x20ml
◍ urine output calculation.
Answer: divide urine amount in mL by child's weight in kg, then divide by
hours the urine was from
◍ TPN (total parenteral nutrition) complications.
Answer: -pneumothorax during insertion of triple lumen catheter (TLC)-air
embolism-catheter displacement-clotted catheter line
(altipase)-sepsis-hyperglycemia/rebound hypoglycemia-fluid volume
overload
◍ PGE given what to look out for?.
Answer: apnea
◍ SIRS (systemic inflammatory response syndrome).
Answer: widespread inflammation that can occur in infection, trauma,
shock, ect. May result from or lead to MODS. Most frequently associated
with sepsis.
◍ SIRS signs and symptoms.
Answer: Fever >/= 100.4 or </= 96.8Tachypnea RR (>20)Tachycardia
>90Elevated WBCs >12,000Low WBCs <4,000 or >10% bandsAltered
Mental StatusHyperglycemia- glucose >140 mg/dL
◍ Infant in pain described,.
Answer: give morphine prn
◍ Frequent trach plugging means.
Answer: the baby needs more humidity.
◍ Cold stress and the newborn.
, Answer: Chemical thermogenesis by releasing NOREPINEPHRINE.
◍ Subgaleal hemorrhage.
Answer: bleeding into the subgaleal compartment (nape of neck) RISK
WITH VACCUM ASSISTED DELIVERIES.
◍ S/S of subgaleal hemorrhage.
Answer: boggy scalp, pallor, tachycardia, and increasing head circumference
are early S/S. apnea or tachypnea, hypotension, and signs of hypovolemic
shock. Because the shearing of the emissary vein happens during delivery,
these signs can rapidly develop within minutes to hours after birth.
◍ MRSOPA.
Answer: Mask adjustmentReposition airway-try PPV and reassess chest
movementSuction mouth and noseOpen mouth and lift jaw forward-try
PPVIncrease pressure in 5-10 increments maximum of 40-try
PPVAlternative Airway- place ET tubeTry PPV assess chest and lung
sounds
◍ A term infant presents at birth with tachypnea and increased work of
breathing. The infant’s oxygen saturation is 78% to 80% despite being given
100% oxygen. Congenital heart disease is suspected. Which of the following
defects is most likely to cause these symptoms?A:Aortic
stenosisB:Coarctation of the aortaC:Transposition of the great vessels.
Answer: C. Transposition of the great vessels occurs when the aorta arises
from the right ventricle and the pulmonary artery arises from the left
ventricle. Marked cyanosis is a presenting feature of transposition because
the aorta carries deoxygenated blood from the right ventricle to the systemic
circulation.
◍ An asymmetric Moro reflex is suggestive.
Answer: of a brachial plexus injury, as is the classic waiter's tip hand and
arm position. Shoulder dystocia places the infant at increased risk of Erb
palsy, an injury to the brachial plexus. With Erb palsy, the Moro reflex is
asymmetrical and the arm and wrist are positioned in what is referred to as
waiter's tip.
, ◍ The Ortolani test is used in conjunction with the Barlow test to assess for.
Answer: developmental dysplasia of the hip.
◍ small, recessed mandible, cleft palate, and a tongue, which is displaced to
the rear of the mouth at birth. These findings are suggestive of.
Answer: Infants with Pierre Robin sequence have significant mandibular
hypoplasia which results in a posteriorly located tongue and cleft palate.
◍ tonic-clonic seizure.
Answer: stiffening and repetitive jerking.stiffening-jerking; a major motor
seizure involving all muscle groups; previously termed grand mal (big bad)
seizure
◍ Neonatal myoclonus manifests as.
Answer: episodes of repetitive jerking or jitteriness that does not stop with
passive restraint.
◍ Galant reflex, also known as the truncal incurvation reflex.
Answer: tested by placing the infant in ventral suspension and applying
pressure along the edge of the thoracic spine. The infant's pelvis should flex
toward the side of the spine that is stimulated. It does not test muscle
strength of the lower limbs.
◍ The stepping reflex is elicited by.
Answer: supporting the infant under the arms and placing a foot on the edge
of a firm surface. When the reflex is intact, the infant will support his weight
and make a stepping motion.
◍ A positive Babinski reflex occurs.
Answer: when the foot undergoes plantar flexion after stimulation of the
sole. It does not test muscle strength.
◍ The harlequin sign.
Answer: A rare color change that occurs between the longitudinal halves of
the newborn's body, such that the dependent half is noticeably pinker than
the superior half when the newborn is placed on one side; it is of no
