Page 1 of 98
RELIAS RN NICU NURSING CORE CONCEPTS PRACTICE
EXAM BANK: 150 QUESTIONS WITH DETAILED
RATIONALES
Nursing / Neonatology
Exam coverage:-
❖ Neonatal Transition & Thermoregulation:
❖ Respiratory System:
❖ Cardiovascular System:
❖ Neurologic System:
❖ Gastrointestinal System:
❖ Metabolic & Endocrine:
❖ Hematologic System:
❖ Infectious Diseases:
❖ Renal & Fluids:
❖ Genetics & Congenital Anomalies:
❖ General NICU Nursing Care:
QUESTIONS :
SECTION 1: NEONATAL TRANSITION & THERMOREGULATION
1. Which type of heat loss occurs when a newborn is placed on
a cold scale?
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A) Evaporation
B) Radiation
C) Convection
D) Conduction
CORRECT ANSWER: D
Conduction is heat loss through direct contact with cold
surfaces. Preterm infants are at highest risk for conductive heat
loss due to their large surface-area-to-body-weight ratio and
thin skin. Prevention includes using pre-warmed blankets and
radiant warmers.
2. A nurse notices that a preterm infant's axillary temperature is
96.5°F (35.8°C). What is the priority nursing action?
A) Place the infant under a radiant warmer
B) Notify the healthcare provider
C) Administer a warm bath
D) Document the finding and reassess in 1 hour
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CORRECT ANSWER: A
Hypothermia is a critical concern in preterm infants who lack
adequate brown fat stores and have immature thermoregulatory
systems. The priority is to actively warm the infant using a
radiant warmer or incubator to prevent further heat loss and
associated complications such as hypoglycemia and respiratory
distress.
3. The primary mechanism of heat production in neonates is:
A) Shivering
B) Brown fat metabolism (nonshivering thermogenesis)
C) Sweating
D) Increased metabolic rate from feeding
CORRECT ANSWER: B
Nonshivering thermogenesis through brown fat metabolism is
the primary mechanism of heat production in neonates,
particularly in preterm infants who have limited brown fat
stores.
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4. The primary reason for administering surfactant to a
premature neonate is to:
A) Increase glucose regulation
B) Improve lung compliance and oxygenation
C) Promote gastrointestinal maturity
D) Prevent sepsis
CORRECT ANSWER: B
Surfactant reduces surface tension in the alveoli, improving
oxygenation and compliance in premature lungs.
5. A 28-week gestation infant is 12 hours old and receiving CPAP.
Which assessment finding indicates worsening respiratory
status?
A) Heart rate 155 bpm
B) Grunting on expiration
C) Oxygen saturation 92%
D) Mild subcostal retractions
RELIAS RN NICU NURSING CORE CONCEPTS PRACTICE
EXAM BANK: 150 QUESTIONS WITH DETAILED
RATIONALES
Nursing / Neonatology
Exam coverage:-
❖ Neonatal Transition & Thermoregulation:
❖ Respiratory System:
❖ Cardiovascular System:
❖ Neurologic System:
❖ Gastrointestinal System:
❖ Metabolic & Endocrine:
❖ Hematologic System:
❖ Infectious Diseases:
❖ Renal & Fluids:
❖ Genetics & Congenital Anomalies:
❖ General NICU Nursing Care:
QUESTIONS :
SECTION 1: NEONATAL TRANSITION & THERMOREGULATION
1. Which type of heat loss occurs when a newborn is placed on
a cold scale?
, Page 2 of 98
A) Evaporation
B) Radiation
C) Convection
D) Conduction
CORRECT ANSWER: D
Conduction is heat loss through direct contact with cold
surfaces. Preterm infants are at highest risk for conductive heat
loss due to their large surface-area-to-body-weight ratio and
thin skin. Prevention includes using pre-warmed blankets and
radiant warmers.
2. A nurse notices that a preterm infant's axillary temperature is
96.5°F (35.8°C). What is the priority nursing action?
A) Place the infant under a radiant warmer
B) Notify the healthcare provider
C) Administer a warm bath
D) Document the finding and reassess in 1 hour
, Page 3 of 98
CORRECT ANSWER: A
Hypothermia is a critical concern in preterm infants who lack
adequate brown fat stores and have immature thermoregulatory
systems. The priority is to actively warm the infant using a
radiant warmer or incubator to prevent further heat loss and
associated complications such as hypoglycemia and respiratory
distress.
3. The primary mechanism of heat production in neonates is:
A) Shivering
B) Brown fat metabolism (nonshivering thermogenesis)
C) Sweating
D) Increased metabolic rate from feeding
CORRECT ANSWER: B
Nonshivering thermogenesis through brown fat metabolism is
the primary mechanism of heat production in neonates,
particularly in preterm infants who have limited brown fat
stores.
, Page 4 of 98
4. The primary reason for administering surfactant to a
premature neonate is to:
A) Increase glucose regulation
B) Improve lung compliance and oxygenation
C) Promote gastrointestinal maturity
D) Prevent sepsis
CORRECT ANSWER: B
Surfactant reduces surface tension in the alveoli, improving
oxygenation and compliance in premature lungs.
5. A 28-week gestation infant is 12 hours old and receiving CPAP.
Which assessment finding indicates worsening respiratory
status?
A) Heart rate 155 bpm
B) Grunting on expiration
C) Oxygen saturation 92%
D) Mild subcostal retractions
