RNC-NIC FINAL PAPER EXAM QUESTIONS
WITH SOLUTIONS 2026
◉ caput succedanenum. Answer: - hemorrhagic edema that
**crosses suture line**
- evident at birth; looks like soft swelling with discoloration (usually
looks like a bruise/red, blue, purple)
- does not grow in size
- may develop hyperbilirubinemia (bleeding/bruising --> jaundice)
◉ preauricular sinuses/pit. Answer: - **often associated with renal
abnormalities and 2-vessel cord**
- could also be skin tags (more common)
◉ cystic hygroma. Answer: - fluid-filled sacs that results from a
blockage in the lymphatic system
- **may require immediate intubation or emergent tracheotomy in
the delivery room**
- ENT typically present at delivery
- some cases resolve, leading to webbed neck, edema, and
lymphangioma
,◉ murmurs. Answer: - abnormal heart sound **due to turbulent
blood flow**
- e.g. turbulence due to blood flowing in the wrong direction, at the
wrong velocity, in the wrong vessel, etc.
◉ hymenal tag. Answer: - a *normal* urogenital finding in some
female newborns that *will recede on its own*
◉ cysts along spinal column. Answer: - any of these soft tissue
masses or findings *could indicate spinal defects, such as spina
bifida occulta*
- **if present, assess for other signs, such as muscle tone and
movement of LEs, anal wink, distended bladder, etc.**
◉ erythema toxicum neonatorum. Answer: - **benign newborn
rash**
- looks like small white or yellow pinpoint papules with an
erythematous base, usually appearing in the 2nd or 3rd DOL
- **contains Eosinophils**
◉ hyperpigmented macule, aka "Mongolian spot". Answer: - **large
gray or blue-green patches of skin, usually found on the buttocks,
flanks, or shoulders**
- often seen in darker skinned newborns
,◉ transient neonatal pustular melanosis. Answer: - lesions similar to
milia but present at birth and will rupture within 48 hours after
birth, leaving small, hyperpigmented macules
- **contains neutrophils**
◉ strawberry hemangioma. Answer: - benign bright red, raised
tumor consisting of dilated blood vessels
- can appear on head, neck, trunk, or extremities
- often recede spontaneously within 6-12 months
- if very large, may lead to airway obstruction when located on the
neck
- **typically get larger over ~first 6 months, then get smaller**
◉ neonatal eye drainage. Answer: - **does not always mean
infection, especially in cases where the drainage is either clear or
cloudy white**
- **consider other causes, such as a blocked lacrimal (tear) duct**
- may benefit from warm compresses/lacrimal massage
◉ cephalohematoma. Answer: - a subperiosteal collection of blood
that overlies a cranial bone that **does NOT extend across the
suture line**
- usually unilateral, but may be bilateral
, - overlying scalp is not discolored; swelling may not be apparent for
several hours to days after birth
- does not transilluminate
◉ choanal atresia. Answer: - membranous or bony complete nasal
obstruction in the neonate
- may be associated with Apert, Treacher Collins, Down, or Crouzon
Syndromes or with CHARGE association
- **classic presentation: cyanotic when at rest or when eating (when
mouth is closed/occluded), but pink when crying (mouth is open)**
- **check nasal patency with a small-bore NG tube passed on one
side, then the other**
- oral airway, may need intubation until surgical repair
◉ most important risk factor for ROP. Answer: -
**immaturity/prematurity**
- oxygen exposure is less important
◉ ROP stage I. Answer: - mildest stage of ROP, feature is a
demarcation line: border between optic (posterior) vascular and
peripheral avascular retina
WITH SOLUTIONS 2026
◉ caput succedanenum. Answer: - hemorrhagic edema that
**crosses suture line**
- evident at birth; looks like soft swelling with discoloration (usually
looks like a bruise/red, blue, purple)
- does not grow in size
- may develop hyperbilirubinemia (bleeding/bruising --> jaundice)
◉ preauricular sinuses/pit. Answer: - **often associated with renal
abnormalities and 2-vessel cord**
- could also be skin tags (more common)
◉ cystic hygroma. Answer: - fluid-filled sacs that results from a
blockage in the lymphatic system
- **may require immediate intubation or emergent tracheotomy in
the delivery room**
- ENT typically present at delivery
- some cases resolve, leading to webbed neck, edema, and
lymphangioma
,◉ murmurs. Answer: - abnormal heart sound **due to turbulent
blood flow**
- e.g. turbulence due to blood flowing in the wrong direction, at the
wrong velocity, in the wrong vessel, etc.
◉ hymenal tag. Answer: - a *normal* urogenital finding in some
female newborns that *will recede on its own*
◉ cysts along spinal column. Answer: - any of these soft tissue
masses or findings *could indicate spinal defects, such as spina
bifida occulta*
- **if present, assess for other signs, such as muscle tone and
movement of LEs, anal wink, distended bladder, etc.**
◉ erythema toxicum neonatorum. Answer: - **benign newborn
rash**
- looks like small white or yellow pinpoint papules with an
erythematous base, usually appearing in the 2nd or 3rd DOL
- **contains Eosinophils**
◉ hyperpigmented macule, aka "Mongolian spot". Answer: - **large
gray or blue-green patches of skin, usually found on the buttocks,
flanks, or shoulders**
- often seen in darker skinned newborns
,◉ transient neonatal pustular melanosis. Answer: - lesions similar to
milia but present at birth and will rupture within 48 hours after
birth, leaving small, hyperpigmented macules
- **contains neutrophils**
◉ strawberry hemangioma. Answer: - benign bright red, raised
tumor consisting of dilated blood vessels
- can appear on head, neck, trunk, or extremities
- often recede spontaneously within 6-12 months
- if very large, may lead to airway obstruction when located on the
neck
- **typically get larger over ~first 6 months, then get smaller**
◉ neonatal eye drainage. Answer: - **does not always mean
infection, especially in cases where the drainage is either clear or
cloudy white**
- **consider other causes, such as a blocked lacrimal (tear) duct**
- may benefit from warm compresses/lacrimal massage
◉ cephalohematoma. Answer: - a subperiosteal collection of blood
that overlies a cranial bone that **does NOT extend across the
suture line**
- usually unilateral, but may be bilateral
, - overlying scalp is not discolored; swelling may not be apparent for
several hours to days after birth
- does not transilluminate
◉ choanal atresia. Answer: - membranous or bony complete nasal
obstruction in the neonate
- may be associated with Apert, Treacher Collins, Down, or Crouzon
Syndromes or with CHARGE association
- **classic presentation: cyanotic when at rest or when eating (when
mouth is closed/occluded), but pink when crying (mouth is open)**
- **check nasal patency with a small-bore NG tube passed on one
side, then the other**
- oral airway, may need intubation until surgical repair
◉ most important risk factor for ROP. Answer: -
**immaturity/prematurity**
- oxygen exposure is less important
◉ ROP stage I. Answer: - mildest stage of ROP, feature is a
demarcation line: border between optic (posterior) vascular and
peripheral avascular retina
