RNC-NIC Neonatal Intensive Care Nurse Basic 2 — Questions and Answers
Question 1: A term neonate has a heart rate of 90 bpm immediately after birth. What is the priority action?
- Provide supplemental oxygen via mask
- Begin positive pressure ventilation (Correct answer)
- Start chest compressions
- Administer epinephrine
Correct answer: Begin positive pressure ventilation
A heart rate below 100 bpm after birth requires immediate positive pressure ventilation per NRP guidelines.
Question 2: Which acid-base disturbance is most commonly seen in a neonate with severe respiratory distress syndrome?
- Metabolic alkalosis
- Respiratory alkalosis
- Respiratory acidosis (Correct answer)
- Mixed metabolic and respiratory alkalosis
Correct answer: Respiratory acidosis
RDS causes CO2 retention due to alveolar collapse, resulting in respiratory acidosis.
Question 3: A preterm neonate at 28 weeks gestation is placed in a radiant warmer. Which intervention best prevents transepidermal water loss?
- Increase warmer temperature
- Apply a polyethylene plastic wrap (Correct answer)
- Administer IV fluids at 100 mL/kg/day
- Place the infant in a prone position
Correct answer: Apply a polyethylene plastic wrap
Polyethylene plastic wraps significantly reduce transepidermal water loss in extremely preterm infants.
Question 4: Which finding on a chest X-ray is most consistent with meconium aspiration syndrome?
- Diffuse ground-glass opacities
- Hyperinflation with patchy infiltrates (Correct answer)
- Cardiomegaly with pleural effusions
- Bilateral white-out appearance
Correct answer: Hyperinflation with patchy infiltrates
MAS typically shows hyperinflation with coarse, asymmetric patchy infiltrates due to air trapping and atelectasis.
Question 5: A neonate born at 35 weeks receives phototherapy for jaundice. The nurse notes a bronze discoloration of the skin and dark urine. This finding indicates:
- Physiologic jaundice resolving normally
- Bronze baby syndrome from phototherapy (Correct answer)
- Severe hemolytic disease
- Biliary atresia
Correct answer: Bronze baby syndrome from phototherapy
Bronze baby syndrome is a rare complication of phototherapy occurring primarily in neonates with conjugated hyperbilirubinemia.
Question 6: Which electrolyte abnormality is most commonly associated with early-onset seizures in a term neonate?
- Hyponatremia
- Hyperkalemia
- Hypoglycemia (Correct answer)
- Hypercalcemia
Correct answer: Hypoglycemia
Hypoglycemia is a leading cause of early neonatal seizures and must be checked and corrected promptly.
Question 7: A NICU nurse is assessing a neonate for patent ductus arteriosus. Which clinical finding is most characteristic?
- Systolic murmur at the lower left sternal border
- Continuous machine-like murmur at the upper left sternal border (Correct answer)
- Diastolic murmur at the apex
- Fixed split S2
Correct answer: Continuous machine-like murmur at the upper left sternal border
PDA produces a continuous machine-like murmur best heard at the upper left sternal border due to shunting between the aorta and pulmonary artery.
RNC-NIC Neonatal Intensive Care Nurse Basic 2
A term neonate has a heart rate of 90 bpm immediately after birth.
What is the priority action?