NCC Neonatal Intensive Care Nursing
(RNC-NIC) Exam 2025/2026 – Verified
Questions with Correct Answers and
Explanations
Question 1
A preterm neonate at 32 weeks gestation is receiving mechanical ventilation for respiratory
distress syndrome (RDS). Which parameter should be monitored to assess adequate
oxygenation?
A. Pulse oximetry saturation
B. Arterial blood gas (ABG) pH
C. End-tidal CO2
D. Mean arterial pressure
Correct Answer: A
Rationale: Pulse oximetry is the primary non-invasive method to monitor oxygenation in
neonates with RDS, targeting SpO2 of 90-95% to balance oxygen delivery and prevent
hyperoxia per NRP guidelines.
Question 2
A 28-week preterm infant develops necrotizing enterocolitis (NEC). What is the initial
management?
A. Immediate surgical resection
B. Discontinue enteral feeds and start antibiotics
C. Increase enteral feeding volume
D. Administer probiotics
Correct Answer: B
Rationale: NEC management includes bowel rest (NPO), broad -spectrum antibiotics (e.g.,
ampicillin, gentamicin), and IV fluids to stabilize the infant, per AAP guidelines.
Question 3
A neonate with a 1-minute Apgar score of 3 requires resuscitation. What is the first action?
A. Administer epinephrine
B. Start chest compressions
,C. Provide positive pressure ventilation (PPV)
D. Suction the airway
Correct Answer: C
Rationale: Per NRP, PPV is initiated for Apgar <4 or HR <100 bpm to establish ventilation, the
priority in neonatal resuscitation.
Question 4
A 34-week neonate exhibits jitteriness and poor feeding. Blood glucose is 35 mg/dL. What is the
appropriate intervention?
A. Observe and recheck in 1 hour
B. Administer IV dextrose 10% bolus
C. Offer formula feeding
D. Start insulin infusion
Correct Answer: B
Rationale: Hypoglycemia (<40 mg/dL in preterm) requires IV D10W bolus (2 mL/kg) to
prevent neurologic sequelae, followed by maintenance infusion.
Question 5
Which electrolyte imbalance is most common in preterm infants receiving loop diuretics for
chronic lung disease?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B
Rationale: Loop diuretics (e.g., furosemide) increase potassium excretion, leading to
hypokalemia, requiring supplementation and monitoring.
Question 6
A neonate with patent ductus arteriosus (PDA) shows bounding pulses and a continuous murmur.
What medication is first-line?
A. Digoxin
B. Ibuprofen
C. Propranolol
D. Furosemide
Correct Answer: B
, Rationale: Ibuprofen (or indomethacin) inhibits prostaglandin synthesis to close a
hemodynamically significant PDA, per neonatal pharmacology standards.
Question 7
A 30-week neonate on phototherapy for hyperbilirubinemia develops loose stools. What is the
most likely cause?
A. Sepsis
B. NEC
C. Phototherapy effect
D. Formula intolerance
Correct Answer: C
Rationale: Phototherapy increases insensible water loss and bile excretion, often causing
transient loose stools; monitor hydration status.
Question 8
What is the target oxygen saturation range for a preterm infant at 28 weeks to prevent
retinopathy of prematurity (ROP)?
A. 85-90%
B. 90-95%
C. 95-100%
D. 80-85%
Correct Answer: B
Rationale: Maintaining SpO2 at 90-95% reduces ROP risk while ensuring adequate
oxygenation, per AAP and NICHD recommendations.
Question 9
A neonate with meconium aspiration syndrome (MAS) develops persistent pulmonary
hypertension (PPHN). What is the initial management?
A. Inhaled nitric oxide
B. High-frequency oscillatory ventilation
C. Surfactant replacement
D. ECMO
Correct Answer: A
Rationale: Inhaled nitric oxide is first-line for PPHN to promote pulmonary vasodilation,
improving oxygenation per neonatal critical care protocols.
(RNC-NIC) Exam 2025/2026 – Verified
Questions with Correct Answers and
Explanations
Question 1
A preterm neonate at 32 weeks gestation is receiving mechanical ventilation for respiratory
distress syndrome (RDS). Which parameter should be monitored to assess adequate
oxygenation?
A. Pulse oximetry saturation
B. Arterial blood gas (ABG) pH
C. End-tidal CO2
D. Mean arterial pressure
Correct Answer: A
Rationale: Pulse oximetry is the primary non-invasive method to monitor oxygenation in
neonates with RDS, targeting SpO2 of 90-95% to balance oxygen delivery and prevent
hyperoxia per NRP guidelines.
Question 2
A 28-week preterm infant develops necrotizing enterocolitis (NEC). What is the initial
management?
A. Immediate surgical resection
B. Discontinue enteral feeds and start antibiotics
C. Increase enteral feeding volume
D. Administer probiotics
Correct Answer: B
Rationale: NEC management includes bowel rest (NPO), broad -spectrum antibiotics (e.g.,
ampicillin, gentamicin), and IV fluids to stabilize the infant, per AAP guidelines.
Question 3
A neonate with a 1-minute Apgar score of 3 requires resuscitation. What is the first action?
A. Administer epinephrine
B. Start chest compressions
,C. Provide positive pressure ventilation (PPV)
D. Suction the airway
Correct Answer: C
Rationale: Per NRP, PPV is initiated for Apgar <4 or HR <100 bpm to establish ventilation, the
priority in neonatal resuscitation.
Question 4
A 34-week neonate exhibits jitteriness and poor feeding. Blood glucose is 35 mg/dL. What is the
appropriate intervention?
A. Observe and recheck in 1 hour
B. Administer IV dextrose 10% bolus
C. Offer formula feeding
D. Start insulin infusion
Correct Answer: B
Rationale: Hypoglycemia (<40 mg/dL in preterm) requires IV D10W bolus (2 mL/kg) to
prevent neurologic sequelae, followed by maintenance infusion.
Question 5
Which electrolyte imbalance is most common in preterm infants receiving loop diuretics for
chronic lung disease?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B
Rationale: Loop diuretics (e.g., furosemide) increase potassium excretion, leading to
hypokalemia, requiring supplementation and monitoring.
Question 6
A neonate with patent ductus arteriosus (PDA) shows bounding pulses and a continuous murmur.
What medication is first-line?
A. Digoxin
B. Ibuprofen
C. Propranolol
D. Furosemide
Correct Answer: B
, Rationale: Ibuprofen (or indomethacin) inhibits prostaglandin synthesis to close a
hemodynamically significant PDA, per neonatal pharmacology standards.
Question 7
A 30-week neonate on phototherapy for hyperbilirubinemia develops loose stools. What is the
most likely cause?
A. Sepsis
B. NEC
C. Phototherapy effect
D. Formula intolerance
Correct Answer: C
Rationale: Phototherapy increases insensible water loss and bile excretion, often causing
transient loose stools; monitor hydration status.
Question 8
What is the target oxygen saturation range for a preterm infant at 28 weeks to prevent
retinopathy of prematurity (ROP)?
A. 85-90%
B. 90-95%
C. 95-100%
D. 80-85%
Correct Answer: B
Rationale: Maintaining SpO2 at 90-95% reduces ROP risk while ensuring adequate
oxygenation, per AAP and NICHD recommendations.
Question 9
A neonate with meconium aspiration syndrome (MAS) develops persistent pulmonary
hypertension (PPHN). What is the initial management?
A. Inhaled nitric oxide
B. High-frequency oscillatory ventilation
C. Surfactant replacement
D. ECMO
Correct Answer: A
Rationale: Inhaled nitric oxide is first-line for PPHN to promote pulmonary vasodilation,
improving oxygenation per neonatal critical care protocols.
