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NEONATAL INTENSIVE CARE (NICU) NURSING EXAM
– HIGH-RISK NEWBORNS 2026-27 LATEST VERSION
Exam Structure
• Total Questions: 100
• Format: Multiple Choice (Single Best Answer)
• Level: University / RN–BSN / Post-RN / NICU specialization
• Time: 120–150 minutes
Introduction
This exam assesses nursing knowledge and decision-making in the care of high-risk newborns in
the Neonatal Intensive Care Unit (NICU). It focuses on:
• Assessment of high-risk neonates – vital signs, gestational age, weight, and APGAR
scoring
• Respiratory care – oxygen therapy, CPAP, ventilators, and surfactant administration
• Cardiovascular support – monitoring for congenital heart defects, hypotension, and
shock
• Thermoregulation and fluid/electrolyte management – incubator use, IV fluids, and
nutrition
• Infection prevention – neonatal sepsis, antibiotic use, and NICU isolation protocols
• Neurodevelopmental care – handling, stimulation, and family-centered care
• Emergency interventions – neonatal resuscitation and management of complications
The exam uses scenario-based questions to evaluate critical thinking, adherence to NICU
protocols, and evidence-based practice in caring for high-risk neonates.
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Question & Answer Format
• Four options (A–D)
• One correct answer per question
• Each question includes a rationale referencing NICU
standards and neonatal care guidelines.
SECTION I: ASSESSMENT & INITIAL STABILIZATION (Q1–30)
Q1.
A newborn is delivered at 28 weeks gestation. What is the
priority assessment in the first minutes of life?
A. Respiratory effort, heart rate, APGAR score
B. Weight and length only
C. Eye color and reflexes
D. Feeding readiness
Correct Answer: A
Rationale: Preterm neonates are at high risk for respiratory
distress and bradycardia; initial assessment focuses on vital
functions and APGAR.
Q2.
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A high-risk newborn has a heart rate of 80 bpm immediately
after birth. Appropriate action:
A. Begin resuscitation with positive pressure ventilation
B. Observe only
C. Give oral glucose
D. Swaddle and monitor
Correct Answer: A
Rationale: Heart rate <100 bpm indicates need for ventilation
per Neonatal Resuscitation Program (NRP) guidelines.
Q3.
A newborn shows grunting, nasal flaring, and chest retractions.
Likely condition:
A. Respiratory distress syndrome (RDS)
B. Hypoglycemia
C. Hyperbilirubinemia
D. Neonatal sepsis
Correct Answer: A
Rationale: Classic signs of RDS in preterm infants; requires
oxygen support and possible surfactant therapy.
Q4.
, 4
A preterm infant is placed in an incubator. The main goal is:
A. Maintain thermoregulation and prevent hypothermia
B. Observe behavior only
C. Restrict feeding
D. Limit bonding
Correct Answer: A
Rationale: Preterm neonates cannot regulate temperature;
incubators prevent hypothermia and conserve energy.
Q5.
APGAR score at 1 minute is 5. Next step:
A. Continue monitoring and provide necessary interventions
(oxygen, stimulation)
B. Immediately discharge
C. Perform full resuscitation without assessment
D. Only feed the newborn
Correct Answer: A
Rationale: APGAR <7 requires assessment and support;
interventions depend on respiratory and cardiovascular status.
Q6.
A high-risk newborn with cyanosis despite oxygen therapy:
A. Evaluate for congenital heart defect or persistent pulmonary
NEONATAL INTENSIVE CARE (NICU) NURSING EXAM
– HIGH-RISK NEWBORNS 2026-27 LATEST VERSION
Exam Structure
• Total Questions: 100
• Format: Multiple Choice (Single Best Answer)
• Level: University / RN–BSN / Post-RN / NICU specialization
• Time: 120–150 minutes
Introduction
This exam assesses nursing knowledge and decision-making in the care of high-risk newborns in
the Neonatal Intensive Care Unit (NICU). It focuses on:
• Assessment of high-risk neonates – vital signs, gestational age, weight, and APGAR
scoring
• Respiratory care – oxygen therapy, CPAP, ventilators, and surfactant administration
• Cardiovascular support – monitoring for congenital heart defects, hypotension, and
shock
• Thermoregulation and fluid/electrolyte management – incubator use, IV fluids, and
nutrition
• Infection prevention – neonatal sepsis, antibiotic use, and NICU isolation protocols
• Neurodevelopmental care – handling, stimulation, and family-centered care
• Emergency interventions – neonatal resuscitation and management of complications
The exam uses scenario-based questions to evaluate critical thinking, adherence to NICU
protocols, and evidence-based practice in caring for high-risk neonates.
,2
Question & Answer Format
• Four options (A–D)
• One correct answer per question
• Each question includes a rationale referencing NICU
standards and neonatal care guidelines.
SECTION I: ASSESSMENT & INITIAL STABILIZATION (Q1–30)
Q1.
A newborn is delivered at 28 weeks gestation. What is the
priority assessment in the first minutes of life?
A. Respiratory effort, heart rate, APGAR score
B. Weight and length only
C. Eye color and reflexes
D. Feeding readiness
Correct Answer: A
Rationale: Preterm neonates are at high risk for respiratory
distress and bradycardia; initial assessment focuses on vital
functions and APGAR.
Q2.
,3
A high-risk newborn has a heart rate of 80 bpm immediately
after birth. Appropriate action:
A. Begin resuscitation with positive pressure ventilation
B. Observe only
C. Give oral glucose
D. Swaddle and monitor
Correct Answer: A
Rationale: Heart rate <100 bpm indicates need for ventilation
per Neonatal Resuscitation Program (NRP) guidelines.
Q3.
A newborn shows grunting, nasal flaring, and chest retractions.
Likely condition:
A. Respiratory distress syndrome (RDS)
B. Hypoglycemia
C. Hyperbilirubinemia
D. Neonatal sepsis
Correct Answer: A
Rationale: Classic signs of RDS in preterm infants; requires
oxygen support and possible surfactant therapy.
Q4.
, 4
A preterm infant is placed in an incubator. The main goal is:
A. Maintain thermoregulation and prevent hypothermia
B. Observe behavior only
C. Restrict feeding
D. Limit bonding
Correct Answer: A
Rationale: Preterm neonates cannot regulate temperature;
incubators prevent hypothermia and conserve energy.
Q5.
APGAR score at 1 minute is 5. Next step:
A. Continue monitoring and provide necessary interventions
(oxygen, stimulation)
B. Immediately discharge
C. Perform full resuscitation without assessment
D. Only feed the newborn
Correct Answer: A
Rationale: APGAR <7 requires assessment and support;
interventions depend on respiratory and cardiovascular status.
Q6.
A high-risk newborn with cyanosis despite oxygen therapy:
A. Evaluate for congenital heart defect or persistent pulmonary
