RNC-NIC Exam Study Guide Newest
2024/25 with complete solution
Correct ETT placement - T1-T2 ii ii ii ii ii ii ii
level of claviclesii ii
Correct UVC placement - T 8-9
ii ii ii ii ii ii ii ii
0.5-1 cm above diaphragm
ii ii ii
Tip in inf. vena cava
ii ii ii ii
Correct UAC placement - Low-L3-4
ii ii ii ii ii ii ii
Below renal arteries ii ii
High-T6-10
Correct PICC placement - T3-5
ii ii ii ii ii ii ii
Lower 1/3 of s. Vena cava ii ii ii ii ii
ii Normal weight loss of preterm infant - 10-15%
ii ii ii ii ii ii ii ii ii
Healthy term infant requires how many kcal/kg/day for normal growth? - 100-120
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
kcal/kg/day
ii
ii Formula to calculate GIR - ml/kg/day x %dextrose ➗1.44ii ii ii ii ii ii ii ii ii ii
ii Normal GIR - 4-6 ml/kg/min initially May go as high as 12
ii ii ii ii ii ii ii ii ii ii ii ii ii
Anomalies associated with esophageal atresia - SGA
ii ii ii ii ii ii ii ii ii
VATER synd. ii ii
-vertebral
ii
-imperf anus
ii ii
-renal dysplasia
ii ii
Increased risk of mec plug? - -premature
ii ii ii ii ii ii ii ii ii
-IDM
-small left colon ii ii
-cystic fibrosis ii
Signs of pyloric stenosis - Distended stomach on x-ray with little or no gas below
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
duodenum
ii
Can palpate "olive"
ii ii
Present at 2 to 3 weeks of life with Bile stained vomiting
ii ii ii ii ii ii ii ii ii ii ii
ii Normal temp range axillary - 36.5 to 37.4°C
ii ii ii ii ii ii ii ii ii
, TTN vs RDS - Usually requires less than 40% FI O2
ii ii ii ii ii ii ii ii ii ii ii ii ii
Improves quicker ii
Larger lung volumes ii ii
Natural diuresis occurs at_____________ hours of age as condition improves - 48-72
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
hours
ii
ii Prolonged rupture of membranes - Greater than 18 hours ii ii ii ii ii ii ii ii ii ii
ii Difference in PaO2 of________ or greater documents ductal shunting - 15%ii ii ii ii ii ii ii ii ii ii ii ii
ii With PPHN goal is to keep PaO2 ________or > - 50
ii ii ii ii ii ii ii ii ii ii ii ii
Signs and symptoms of MAS - Chest hyperinflated on x-ray
ii ii ii ii ii ii ii ii ii ii ii ii
Low PaO2 with O2 given
ii ii ii ii
Air leaks
ii
Prone to PPHN ii ii
Treatment of micrognathia - Prone positioning
ii ii ii ii ii ii ii ii ii
Oral airway placement
ii ii
Trach in rare cases ii ii ii
Generally mandibular growth "catches up" by 6 to 12 months ii ii ii ii ii ii ii ii ii
Surgery if significant compromise ii ii ii
Micrognathia associated with - Pierre Robin syndrome
ii ii ii ii ii ii ii ii ii
Trisomy 18 ii
Trisomy 21 ii
Cri-du-chat syndrome ii
Causes of pulmonary hemorrhage - Prematurity
ii ii ii ii ii ii ii ii
Erythroblastosis
Intracranial hemorrhage ii
Asphyxia
Aspiration
Heart diagnosis, PDA ii ii
Sepsis
Hypothermia
Surfactant replacement ii
Treatment of pulmonary hemorrhage - Vent and use PEEP to decrease bleeding
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
Transfused PRBC's as needed ii ii ii
Treat clotting problems
ii ii
Assess and treat PDA ii ii ii
Treat underlying disease processes
ii ii ii
, Apneic event - Cessation of respiration for 20 seconds, or less if accompanied by
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
cyanosis, pallor, decreased tone, bradycardia
ii ii ii ii ii
Causes pulmonary hypoplasia - 1) conditions that limit lung growth (CCAM, DH)
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
2) oligohydramnios (thoracic compression)
ii ii ii
3) associated congenital malformations (Potters, phrenic nerve absence)
ii ii ii ii ii ii ii
ii Normal blood gas results - ph 7.35-7.45 ii ii ii ii ii ii ii ii
PaCO2 35-45 ii
PaO2 50-80 ii
HCO3 22-26 ii
BE -2 to +2 ii ii ii
Vent Setting VT (tidal volume) - -Primary factor affecting oxygenation and ventilation
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
-should be 4-5 ml/kg ii ii ii
Vent Settings
ii ii
-To increase ventilation - Increase rate
ii ii ii ii ii ii ii
Vent settings
ii ii
-to increase oxygenation - Increase FiO2, PEEP, or VT
ii ii ii ii ii ii ii ii ii ii
Inclusion criteria for ECMO - 1) GA > 34 weeks
ii ii ii ii ii ii ii ii ii ii ii ii
2) BE > 2000 grams
ii ii ii ii
3) reversible lung disease
ii ii ii
4) no lethal anomalies or brain injuries
ii ii ii ii ii ii
5) IVH Gr 2 or <
ii ii ii ii ii
6) no significant bleeding issues
ii ii ii ii
Vent Setting Rate - Set rate at 30-40/minute for respiratory failure
ii ii ii ii ii ii ii ii ii ii ii ii ii
Set rate at 20-30/minute for no respiratory failure
ii ii ii ii ii ii ii
Adjust to maintain PCO2 40-50 ii ii ii ii
Rate >40/minute can lead to air trapping
ii ii ii ii ii ii
Vent setting PIP - Determines VT and affects PaO2
ii ii ii ii ii ii ii ii ii ii ii
Determined by weight, GA, lung compliance, & airway resistance ii ii ii ii ii ii ii ii
20 is appropriate for most preterm infants
ii ii ii ii ii ii
Look at chest wall movement ii ii ii ii
Vent Setting PEEP - Physiologic PEEP is about 2cm
ii ii ii ii ii ii ii ii ii ii ii
Usually set at 4-7cm ii ii ii
>7 can cause air leaks
ii ii ii ii
2024/25 with complete solution
Correct ETT placement - T1-T2 ii ii ii ii ii ii ii
level of claviclesii ii
Correct UVC placement - T 8-9
ii ii ii ii ii ii ii ii
0.5-1 cm above diaphragm
ii ii ii
Tip in inf. vena cava
ii ii ii ii
Correct UAC placement - Low-L3-4
ii ii ii ii ii ii ii
Below renal arteries ii ii
High-T6-10
Correct PICC placement - T3-5
ii ii ii ii ii ii ii
Lower 1/3 of s. Vena cava ii ii ii ii ii
ii Normal weight loss of preterm infant - 10-15%
ii ii ii ii ii ii ii ii ii
Healthy term infant requires how many kcal/kg/day for normal growth? - 100-120
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
kcal/kg/day
ii
ii Formula to calculate GIR - ml/kg/day x %dextrose ➗1.44ii ii ii ii ii ii ii ii ii ii
ii Normal GIR - 4-6 ml/kg/min initially May go as high as 12
ii ii ii ii ii ii ii ii ii ii ii ii ii
Anomalies associated with esophageal atresia - SGA
ii ii ii ii ii ii ii ii ii
VATER synd. ii ii
-vertebral
ii
-imperf anus
ii ii
-renal dysplasia
ii ii
Increased risk of mec plug? - -premature
ii ii ii ii ii ii ii ii ii
-IDM
-small left colon ii ii
-cystic fibrosis ii
Signs of pyloric stenosis - Distended stomach on x-ray with little or no gas below
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
duodenum
ii
Can palpate "olive"
ii ii
Present at 2 to 3 weeks of life with Bile stained vomiting
ii ii ii ii ii ii ii ii ii ii ii
ii Normal temp range axillary - 36.5 to 37.4°C
ii ii ii ii ii ii ii ii ii
, TTN vs RDS - Usually requires less than 40% FI O2
ii ii ii ii ii ii ii ii ii ii ii ii ii
Improves quicker ii
Larger lung volumes ii ii
Natural diuresis occurs at_____________ hours of age as condition improves - 48-72
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
hours
ii
ii Prolonged rupture of membranes - Greater than 18 hours ii ii ii ii ii ii ii ii ii ii
ii Difference in PaO2 of________ or greater documents ductal shunting - 15%ii ii ii ii ii ii ii ii ii ii ii ii
ii With PPHN goal is to keep PaO2 ________or > - 50
ii ii ii ii ii ii ii ii ii ii ii ii
Signs and symptoms of MAS - Chest hyperinflated on x-ray
ii ii ii ii ii ii ii ii ii ii ii ii
Low PaO2 with O2 given
ii ii ii ii
Air leaks
ii
Prone to PPHN ii ii
Treatment of micrognathia - Prone positioning
ii ii ii ii ii ii ii ii ii
Oral airway placement
ii ii
Trach in rare cases ii ii ii
Generally mandibular growth "catches up" by 6 to 12 months ii ii ii ii ii ii ii ii ii
Surgery if significant compromise ii ii ii
Micrognathia associated with - Pierre Robin syndrome
ii ii ii ii ii ii ii ii ii
Trisomy 18 ii
Trisomy 21 ii
Cri-du-chat syndrome ii
Causes of pulmonary hemorrhage - Prematurity
ii ii ii ii ii ii ii ii
Erythroblastosis
Intracranial hemorrhage ii
Asphyxia
Aspiration
Heart diagnosis, PDA ii ii
Sepsis
Hypothermia
Surfactant replacement ii
Treatment of pulmonary hemorrhage - Vent and use PEEP to decrease bleeding
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
Transfused PRBC's as needed ii ii ii
Treat clotting problems
ii ii
Assess and treat PDA ii ii ii
Treat underlying disease processes
ii ii ii
, Apneic event - Cessation of respiration for 20 seconds, or less if accompanied by
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
cyanosis, pallor, decreased tone, bradycardia
ii ii ii ii ii
Causes pulmonary hypoplasia - 1) conditions that limit lung growth (CCAM, DH)
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
2) oligohydramnios (thoracic compression)
ii ii ii
3) associated congenital malformations (Potters, phrenic nerve absence)
ii ii ii ii ii ii ii
ii Normal blood gas results - ph 7.35-7.45 ii ii ii ii ii ii ii ii
PaCO2 35-45 ii
PaO2 50-80 ii
HCO3 22-26 ii
BE -2 to +2 ii ii ii
Vent Setting VT (tidal volume) - -Primary factor affecting oxygenation and ventilation
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
-should be 4-5 ml/kg ii ii ii
Vent Settings
ii ii
-To increase ventilation - Increase rate
ii ii ii ii ii ii ii
Vent settings
ii ii
-to increase oxygenation - Increase FiO2, PEEP, or VT
ii ii ii ii ii ii ii ii ii ii
Inclusion criteria for ECMO - 1) GA > 34 weeks
ii ii ii ii ii ii ii ii ii ii ii ii
2) BE > 2000 grams
ii ii ii ii
3) reversible lung disease
ii ii ii
4) no lethal anomalies or brain injuries
ii ii ii ii ii ii
5) IVH Gr 2 or <
ii ii ii ii ii
6) no significant bleeding issues
ii ii ii ii
Vent Setting Rate - Set rate at 30-40/minute for respiratory failure
ii ii ii ii ii ii ii ii ii ii ii ii ii
Set rate at 20-30/minute for no respiratory failure
ii ii ii ii ii ii ii
Adjust to maintain PCO2 40-50 ii ii ii ii
Rate >40/minute can lead to air trapping
ii ii ii ii ii ii
Vent setting PIP - Determines VT and affects PaO2
ii ii ii ii ii ii ii ii ii ii ii
Determined by weight, GA, lung compliance, & airway resistance ii ii ii ii ii ii ii ii
20 is appropriate for most preterm infants
ii ii ii ii ii ii
Look at chest wall movement ii ii ii ii
Vent Setting PEEP - Physiologic PEEP is about 2cm
ii ii ii ii ii ii ii ii ii ii ii
Usually set at 4-7cm ii ii ii
>7 can cause air leaks
ii ii ii ii
