NICU EXAMS SCRIPT 2025/2026 QUESTIONS AND
SOLUTIONS RANKED A+
✔✔What are nursing considerations for apnea of prematurity? - ✔✔-Evaluate for
infection or respiratory compromise that may be causing apnea, not just prematurity
-Tx: Respiratory support and caffeine
-Nursing documentation of events is important
✔✔What should the nurse understand about ECMO? - ✔✔-Extracoporeal membrane
oxygenation
-Prolonged cardiopulmonary bypass that provides cardiorespiratory support for infants
in REVERSIBLE (key for candidacy), profound respiratory and/or cardiac failure
-Associated conditions: RDS, MAS, PPHN, CDH, sepsis
✔✔What are the two different types of ECMO? - ✔✔-Venoarterial (VA)
-Venvenous (VV)
✔✔What are contraindications for ECMO? - ✔✔-Gestational age <34 weeks
-Weight <2kg
-Severe IVH
-Irreversible lung disease
-Irreversible severe neuro abnormally (i.e. severe head bleed, as ECMO is heparinized)
-Severe congenital anomalies
✔✔What are acyanotic congenital heart abnormalities? - ✔✔-PDA
-VSD
-ASD
-A-V canal
-Coarctation of the aorta
-Hypoplastic left heart
✔✔What are cyanotic congenital heart abnormalities? - ✔✔-Transposition of the greater
vessels
-Tetralogy of Fallot
-Pulmonary stenosis
-Truncus arteriosus
✔✔How is critical congenital heart disease (CCHD) measured? - ✔✔-Pulse ox on upper
and lower extremities and looking for a gradient
-Mandatory for all nurseries
✔✔What is a PDA and the sx? - ✔✔-Patent ductus arteriosus after birth
-Sx: Murmur, cardiomegaly, bounding pulses, active precordium, widened pulse
pressure
, ✔✔What are complications of PDA? - ✔✔-Congestive heart failure
-Feeding intolerance (not enough oxygenation for increased energy demand)
-Respiratory distress (poor oxygenation)
✔✔What is the management of a PDA? - ✔✔-Fluid restriction
-PEEP
-Indomethacin and ibuprofen to vasoconstrict and close up PDA
-Surgical ligation if meds are unsuccessful
✔✔What should the nurse understand about gastroschisis? - ✔✔-Abdominal wall defect
-Defect placed to the right of the umbilicus
-NOT covered by a sac
-May include stomach and small and large intestines
-Bowel is thickened, edmatous, and inflamed
-Not usually associated with other anomalies
-Slowly pushed back in
✔✔What should the nurse understand about omphaloceles? - ✔✔-Abdominal wall
defect
-Herniation of abdominal viscera into umbilical cord and usually covered with peritoneal
sac
-May include stomach, liver, spleen, and intestine
-Associated with cardiac, neuro, GU, skeletal, and chromosome anomalies
-Often left to granulate over and fix when child is older
✔✔What should the nurse understand about necrotizing enterocolitis? - ✔✔-Disease
process leading to bowel necrosis
✔✔What are the risk factors of necrotizing enterocolitis? - ✔✔-Perinatal hypoxemia
-Polycythemia
-Prematurity
-Formula or hyperosmolar feeds
-Abnormal bacterial colonization
-Congenital heart defect
✔✔What are the sx of necrotizing enterocolitis? - ✔✔-Apnea
-Lethargy
-Abdominal distention
-Feeding intolerance
-Emesis
-Bloody stools
-Abdominal wall erythema
-Hypotension
-Metabolic acidosis
-DIC
SOLUTIONS RANKED A+
✔✔What are nursing considerations for apnea of prematurity? - ✔✔-Evaluate for
infection or respiratory compromise that may be causing apnea, not just prematurity
-Tx: Respiratory support and caffeine
-Nursing documentation of events is important
✔✔What should the nurse understand about ECMO? - ✔✔-Extracoporeal membrane
oxygenation
-Prolonged cardiopulmonary bypass that provides cardiorespiratory support for infants
in REVERSIBLE (key for candidacy), profound respiratory and/or cardiac failure
-Associated conditions: RDS, MAS, PPHN, CDH, sepsis
✔✔What are the two different types of ECMO? - ✔✔-Venoarterial (VA)
-Venvenous (VV)
✔✔What are contraindications for ECMO? - ✔✔-Gestational age <34 weeks
-Weight <2kg
-Severe IVH
-Irreversible lung disease
-Irreversible severe neuro abnormally (i.e. severe head bleed, as ECMO is heparinized)
-Severe congenital anomalies
✔✔What are acyanotic congenital heart abnormalities? - ✔✔-PDA
-VSD
-ASD
-A-V canal
-Coarctation of the aorta
-Hypoplastic left heart
✔✔What are cyanotic congenital heart abnormalities? - ✔✔-Transposition of the greater
vessels
-Tetralogy of Fallot
-Pulmonary stenosis
-Truncus arteriosus
✔✔How is critical congenital heart disease (CCHD) measured? - ✔✔-Pulse ox on upper
and lower extremities and looking for a gradient
-Mandatory for all nurseries
✔✔What is a PDA and the sx? - ✔✔-Patent ductus arteriosus after birth
-Sx: Murmur, cardiomegaly, bounding pulses, active precordium, widened pulse
pressure
, ✔✔What are complications of PDA? - ✔✔-Congestive heart failure
-Feeding intolerance (not enough oxygenation for increased energy demand)
-Respiratory distress (poor oxygenation)
✔✔What is the management of a PDA? - ✔✔-Fluid restriction
-PEEP
-Indomethacin and ibuprofen to vasoconstrict and close up PDA
-Surgical ligation if meds are unsuccessful
✔✔What should the nurse understand about gastroschisis? - ✔✔-Abdominal wall defect
-Defect placed to the right of the umbilicus
-NOT covered by a sac
-May include stomach and small and large intestines
-Bowel is thickened, edmatous, and inflamed
-Not usually associated with other anomalies
-Slowly pushed back in
✔✔What should the nurse understand about omphaloceles? - ✔✔-Abdominal wall
defect
-Herniation of abdominal viscera into umbilical cord and usually covered with peritoneal
sac
-May include stomach, liver, spleen, and intestine
-Associated with cardiac, neuro, GU, skeletal, and chromosome anomalies
-Often left to granulate over and fix when child is older
✔✔What should the nurse understand about necrotizing enterocolitis? - ✔✔-Disease
process leading to bowel necrosis
✔✔What are the risk factors of necrotizing enterocolitis? - ✔✔-Perinatal hypoxemia
-Polycythemia
-Prematurity
-Formula or hyperosmolar feeds
-Abnormal bacterial colonization
-Congenital heart defect
✔✔What are the sx of necrotizing enterocolitis? - ✔✔-Apnea
-Lethargy
-Abdominal distention
-Feeding intolerance
-Emesis
-Bloody stools
-Abdominal wall erythema
-Hypotension
-Metabolic acidosis
-DIC
