RNC NIC EXAM ACTUAL EXAM 2026 | REGISTERED NURSE CERTIFIED
IN NEONATAL INTENSIVE CARE EXAM | COMPLETE QUESTIONS AND
CORRECT ANSWERS | UPDATED VERSION
Question 1
An amniocentesis can be performed late in pregnancy for what primary purpose?
A) To screen for chromosomal abnormalities.
B) To assess fetal lung maturity.
C) To determine the sex of the fetus.
D) To test for maternal infections.
E) To measure alpha-fetoprotein levels.
Correct Answer: B) To assess fetal lung maturity.
Rationale: While amniocentesis is commonly used for genetic screening in the second
trimester, it is also used later in pregnancy to analyze the amniotic fluid for markers of fetal
lung maturity, such as the Lecithin/Sphingomyelin (L/S) ratio, to help decide the timing of a
preterm delivery.
Question 2
Maternal thrombocytopenia during pregnancy can increase the risk of what condition in the
newborn?
A) Hypoglycemia
B) Hypocalcemia
C) Jaundice and petechiae
D) Respiratory distress
E) Hyperthermia
Correct Answer: C) Jaundice and petechiae
Rationale: Maternal thrombocytopenia can lead to a low platelet count in the infant. This
increases the infant's risk of bleeding, which can manifest as petechiae, bruising, and
prolonged bleeding from procedures. The breakdown of extravasated red blood cells from this
bleeding can lead to hyperbilirubinemia (jaundice).
,Question 3
What is the most common intrauterine infection in newborns?
A) Rubella
B) Syphilis
C) HIV
D) Cytomegalovirus (CMV)
E) Group B Streptococcus (GBS)
Correct Answer: D) Cytomegalovirus (CMV)
Rationale: CMV is the most frequently occurring congenital viral infection. While most infants
are asymptomatic at birth, it can lead to significant long-term sequelae, most commonly
hearing and vision loss.
Question 4
Which of the following maternal conditions is an absolute contraindication for breastfeeding?
A) Cytomegalovirus (CMV) infection
B) Hepatitis B infection
C) Active tuberculosis
D) HIV/AIDS infection
E) Active herpes simplex lesions on the breast
Correct Answer: D) HIV/AIDS infection
Rationale: In developed countries where safe alternatives are available, maternal HIV
infection is considered an absolute contraindication to breastfeeding because the virus can be
transmitted to the infant through breast milk.
Question 5
A newborn of an HIV-positive mother presents with poor weight gain, enlarged lymph nodes, an
enlarged liver and spleen, and repeated oral thrush. These are signs of:
A) Cytomegalovirus (CMV)
B) Congenital syphilis
C) Neonatal HIV infection
,D) Fetal alcohol syndrome
E) Neonatal abstinence syndrome
Correct Answer: C) Neonatal HIV infection
Rationale: These are classic signs of a compromised immune system in an infant, characteristic
of a symptomatic congenital HIV infection. Repeated or persistent fungal infections like oral
thrush are a key indicator.
Question 6
What is the most common bacterial sexually transmitted infection that can cause conjunctivitis
and late-onset pneumonia in the neonate?
A) Gonorrhea
B) Syphilis
C) Chlamydia
D) Group B Strep
E) E. coli
Correct Answer: C) Chlamydia
Rationale: Chlamydia trachomatis is the most common bacterial STI. It is a frequent cause of
ophthalmia neonatorum (conjunctivitis) in the first few weeks of life and a characteristic
afebrile pneumonia that presents later, at 3-4 months of age.
Question 7
Oligohydramnios is a known risk factor for which of the following neonatal complications?
A) Macrosomia
B) Polycythemia
C) Pulmonary hypoplasia
D) Esophageal atresia
E) Hydrops fetalis
Correct Answer: C) Pulmonary hypoplasia
Rationale: Amniotic fluid is crucial for fetal lung development as the fetus "breathes" the fluid
, in and out, which helps the airways expand. A lack of amniotic fluid (oligohydramnios) leads
to inadequate lung development, or pulmonary hypoplasia.
Question 8
Potter sequence is a constellation of findings that begins with bilateral renal agenesis. What is
the direct consequence of the lack of fetal kidneys?
A) Polyhydramnios
B) Severe oligohydramnios
C) Fetal tachycardia
D) Congenital heart defects
E) Hydrops fetalis
Correct Answer: B) Severe oligohydramnios
Rationale: After the first trimester, fetal urine is the primary component of amniotic fluid. If
the kidneys do not develop (renal agenesis), the fetus cannot produce urine, leading to a
severe or complete lack of amniotic fluid (anhydramnios/oligohydramnios).
Question 9
An ultrasound showing polyhydramnios would lead the clinician to suspect which of the
following fetal anomalies?
A) Renal agenesis
B) A cardiac defect with increased pulmonary blood flow
C) A gastrointestinal obstruction, such as esophageal atresia
D) A neural tube defect
E) Placental insufficiency
Correct Answer: C) A gastrointestinal obstruction, such as esophageal atresia
Rationale: The fetus normally swallows amniotic fluid, which is then absorbed. If there is a
high GI obstruction (like esophageal or duodenal atresia), the fetus cannot swallow the fluid,
leading to an excessive accumulation (polyhydramnios).
Question 10
The risk of neonatal infection following premature rupture of membranes (PROM) is directly
IN NEONATAL INTENSIVE CARE EXAM | COMPLETE QUESTIONS AND
CORRECT ANSWERS | UPDATED VERSION
Question 1
An amniocentesis can be performed late in pregnancy for what primary purpose?
A) To screen for chromosomal abnormalities.
B) To assess fetal lung maturity.
C) To determine the sex of the fetus.
D) To test for maternal infections.
E) To measure alpha-fetoprotein levels.
Correct Answer: B) To assess fetal lung maturity.
Rationale: While amniocentesis is commonly used for genetic screening in the second
trimester, it is also used later in pregnancy to analyze the amniotic fluid for markers of fetal
lung maturity, such as the Lecithin/Sphingomyelin (L/S) ratio, to help decide the timing of a
preterm delivery.
Question 2
Maternal thrombocytopenia during pregnancy can increase the risk of what condition in the
newborn?
A) Hypoglycemia
B) Hypocalcemia
C) Jaundice and petechiae
D) Respiratory distress
E) Hyperthermia
Correct Answer: C) Jaundice and petechiae
Rationale: Maternal thrombocytopenia can lead to a low platelet count in the infant. This
increases the infant's risk of bleeding, which can manifest as petechiae, bruising, and
prolonged bleeding from procedures. The breakdown of extravasated red blood cells from this
bleeding can lead to hyperbilirubinemia (jaundice).
,Question 3
What is the most common intrauterine infection in newborns?
A) Rubella
B) Syphilis
C) HIV
D) Cytomegalovirus (CMV)
E) Group B Streptococcus (GBS)
Correct Answer: D) Cytomegalovirus (CMV)
Rationale: CMV is the most frequently occurring congenital viral infection. While most infants
are asymptomatic at birth, it can lead to significant long-term sequelae, most commonly
hearing and vision loss.
Question 4
Which of the following maternal conditions is an absolute contraindication for breastfeeding?
A) Cytomegalovirus (CMV) infection
B) Hepatitis B infection
C) Active tuberculosis
D) HIV/AIDS infection
E) Active herpes simplex lesions on the breast
Correct Answer: D) HIV/AIDS infection
Rationale: In developed countries where safe alternatives are available, maternal HIV
infection is considered an absolute contraindication to breastfeeding because the virus can be
transmitted to the infant through breast milk.
Question 5
A newborn of an HIV-positive mother presents with poor weight gain, enlarged lymph nodes, an
enlarged liver and spleen, and repeated oral thrush. These are signs of:
A) Cytomegalovirus (CMV)
B) Congenital syphilis
C) Neonatal HIV infection
,D) Fetal alcohol syndrome
E) Neonatal abstinence syndrome
Correct Answer: C) Neonatal HIV infection
Rationale: These are classic signs of a compromised immune system in an infant, characteristic
of a symptomatic congenital HIV infection. Repeated or persistent fungal infections like oral
thrush are a key indicator.
Question 6
What is the most common bacterial sexually transmitted infection that can cause conjunctivitis
and late-onset pneumonia in the neonate?
A) Gonorrhea
B) Syphilis
C) Chlamydia
D) Group B Strep
E) E. coli
Correct Answer: C) Chlamydia
Rationale: Chlamydia trachomatis is the most common bacterial STI. It is a frequent cause of
ophthalmia neonatorum (conjunctivitis) in the first few weeks of life and a characteristic
afebrile pneumonia that presents later, at 3-4 months of age.
Question 7
Oligohydramnios is a known risk factor for which of the following neonatal complications?
A) Macrosomia
B) Polycythemia
C) Pulmonary hypoplasia
D) Esophageal atresia
E) Hydrops fetalis
Correct Answer: C) Pulmonary hypoplasia
Rationale: Amniotic fluid is crucial for fetal lung development as the fetus "breathes" the fluid
, in and out, which helps the airways expand. A lack of amniotic fluid (oligohydramnios) leads
to inadequate lung development, or pulmonary hypoplasia.
Question 8
Potter sequence is a constellation of findings that begins with bilateral renal agenesis. What is
the direct consequence of the lack of fetal kidneys?
A) Polyhydramnios
B) Severe oligohydramnios
C) Fetal tachycardia
D) Congenital heart defects
E) Hydrops fetalis
Correct Answer: B) Severe oligohydramnios
Rationale: After the first trimester, fetal urine is the primary component of amniotic fluid. If
the kidneys do not develop (renal agenesis), the fetus cannot produce urine, leading to a
severe or complete lack of amniotic fluid (anhydramnios/oligohydramnios).
Question 9
An ultrasound showing polyhydramnios would lead the clinician to suspect which of the
following fetal anomalies?
A) Renal agenesis
B) A cardiac defect with increased pulmonary blood flow
C) A gastrointestinal obstruction, such as esophageal atresia
D) A neural tube defect
E) Placental insufficiency
Correct Answer: C) A gastrointestinal obstruction, such as esophageal atresia
Rationale: The fetus normally swallows amniotic fluid, which is then absorbed. If there is a
high GI obstruction (like esophageal or duodenal atresia), the fetus cannot swallow the fluid,
leading to an excessive accumulation (polyhydramnios).
Question 10
The risk of neonatal infection following premature rupture of membranes (PROM) is directly
