Genuine and Real NCC-RNC-NIC Nursing Certification 2023 Practice Test PDF Dumps Questions and Answers
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High Grade and Valuable Preparation Stuff 
 
   College Admission
  
RNC-NIC
 Neonatal Intensive Care Nursing certification exam
 
 
 
 
 
 
 
 
 
 
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Question: 1 
   
Which of the following is a cause of direct hyperbilirubinemia in the neonate? 
 
A. Wilson disease 
B. Autoimmune hepatitis 
C. Extrahepatic biliary atresia (EBA) 
 
Answer: C     
 
Explanation: 
EBA is a cause of direct hyperbilirubinemia in the neonate. EBA is either the complete or partial absence 
of the bile duct that connects the liver to the duodenum, resulting in cholestasis as bile accumulates in 
the liver. This results in jaundice and liver scarring. Indications of EBA are usually obvious within 2 to 6 
weeks: stools are clay-colored, and hepatomegaly is present. Surgical intervention is necessary, but 
some children may have dysfunction of the liver and may eventually require a liver transplant. 
Question: 2 
   
For gastroesophageal reflux in the preterm neonate, what does the American Academy of Pediatrics 
(AAP) recommend? 
 
A. No specific treatment Correct 
B. H2-receptor blockers 
C. Proton pump inhibitors 
 
Answer: A     
 
Explanation: 
According to AAP recommendations, gastroesophageal reflux is normal in preterm neonates and 
requires no specific treatment because the condition will resolve as the neonate matures. If the 
neonate's postmenstrual age (PMA [the gestational age plus the postnatal age]) is greater than 32 
weeks, it is safe to position the neonate supine for sleep. Prokinetic agents (e.g., metoclopramide) are 
ineffective. H2-receptor blockers (e.g., famotidine, ranitidine) may increase the risk of NEC and 
infections, and proton pump inhibitors (e.g., omeprazole) are ineffective and pose the same risks as H2-
receptor blockers. 
Question: 3 
   
For a neonate that suffered birth asphyxia with signs of syndrome of inappropriate secretion of 
antidiuretic hormone (SIADH), what does treatment typically include? 
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A. Increased hydration 
B. Increased sodium 
C. Fluid restriction 
 
Answer: C     
 
Explanation: 
For a neonate that suffered birth asphyxia with signs of SIADH, treatment typically includes restriction of 
fluids to less than 60 mL/kg/day for 2 to 3 days because of the risk of cerebral edema. Birth asphyxia can 
result in increased levels of arginine vasopressin, the antidiuretic hormone, causing hyponatremia and 
retention of fluids. Although sodium may be administered to counter other causes of hyponatremia, it is 
not recommended for SIADH because fluid restriction usually reverses the condition. 
Question: 4 
   
Shock in the neonate is characterized by hypotension, hypoperfusion, and which of the following? 
 
A. Respiratory acidosis 
B. Metabolic acidosis 
C. Metabolic alkalosis 
 
Answer: B     
 
Explanation: 
Shock in the neonate is characterized by hypotension, hypoperfusion (i.e., cyanosis, delayed capillary 
refill). and metabolic acidosis. Tachycardia occurs as a compensatory response. Causes may include 
congenital heart disease, sepsis, hemorrhage with acute blood loss, and adrenal insufficiency. Early 
recognition and treatment are critical. Inotropes and vasopressor drugs that are used for shock include 
dopamine, dobutamine, epinephrine, norepinephrine, vasopressin, hydrocortisone, and milrinone. 
Question: 5 
   
If a term neonate develops vasodilation and sweating in response to hyperthermia, what can this result 
in? 
 
A. Hypotension and dehydration 
B. Hypertension and dehydration 
C. Hypotension and peripheral edema 
 
Answer: A     
 
Explanation: 
If a term neonate develops vasodilation and sweating in response to hyperthermia, this can result in 
hypotension and dehydration because of increased insensible water loss. The neonate may need extra 
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fluids to compensate and volume expanders to increase the BP. If the core temperature elevates, the 
neonate may experience seizures and apnea, so cardiopulmonary monitoring is essential. The neonate 
may require ventilation for apnea. 
Question: 6 
   
If a neonate is on continuous positive airway pressure (CPAP) but is gasping and bradycardic, what is the 
appropriate action? 
 
A. Increase positive end-expiratory pressure (PEEP) 
B. Decrease PEEP 
C. Intubate and ventilate  
 
Answer: C     
 
Explanation: 
If a neonate is on CPAP but is gasping and bradycardic, this indicates the need to intubate and ventilate 
because the infant is in respiratory distress and the CPAP is not providing adequate oxygenation. 
Intubation and mechanical ventilation, however, increase the risk of damage to the lungs through 
volutrauma (such as overdistension of alveoli) and barotrauma (such as rupture of alveoli and air 
leakage into the pleural space). The intubated neonate is at increased risk of developing 
bronchopulmonary dysplasia and chronic lung disease. 
Question: 7 
   
If a fungal infection occurs under an ostomy appliance, treatment includes which of the following? 
 
A. Barrier powder 
B. Nystatin powder 
C. Leaving tissue exposed to the air without the appliance 
 
Answer: B     
 
Explanation: 
If a fungal infection occurs under an ostomy appliance, treatment includes applying nystatin powder. If 
leakage occurs under an appliance, the warm, moist environment will be conducive to fungal infections, 
such as candidiasis. Leaving the skin open to the air without an appliance may increase the chance of 
further infection from contact with the effluent. Nystatin powder may be applied, slightly dampened 
with a fingertip, and then dried to provide a barrier layer. 
Question: 8 
   
The probe for temperature monitoring should be resited at least every 
 
A. 4 hours 
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B. 8 hours  
C. 24 hours 
 
Answer: B     
 
Explanation: 
The probe for temperature monitoring should be resited at least every 8 hours or more often if needed 
for repositioning. Care must be taken that the probe is not between the skin and the mattress because 
this may increase the temperature and cause pressure and irritation of the skin. The probe should be 
placed on the right abdomen (the liver area) or on the flank areas. The probe should not be placed over 
areas where brown fat accumulates (i.e., in the kidneys, neck, scapula, back, axillae) because the 
temperature will not be accurate. 
Question: 9 
   
What is eviscerated bowel without a peritoneal covering characteristic of? 
 
A. Omphalocele 
B. Intestinal atresia 
C. Gastroschisis 
 
Answer: C     
 
Explanation: 
Gastroschisis is extrusion of the nonrotated midgut through the abdominal wall to the right of the 
umbilicus with no peritoneal membrane covering the matted, thickened loops of intestine. The 
abnormality is usually small, but the stomach and almost all of the small and large intestines can 
protrude. Because the intestines float in amniotic fluid, there may be severe damage to the intestines 
with bowel atresia and ischemia. Gastroschisis is usually diagnosed with fetal ultrasound and is obvious 
at birth. Complications include hypothermia and fluid and electrolyte loss. 
Question: 10  
   
If a neonate has subdural hemorrhage, what would it most likely have resulted from? 
 
A. Postnatal trauma 
B. Tearing of dural sinuses during labor 
C. Vertical molding of the head during labor 
 
Answer: C     
Explanation: 
If a neonate has subdural hemorrhage (i.e., bleeding between the dura and arachnoid mater), it most 
likely resulted from vertical molding of the head during labor. Epidural hemorrhage (i.e., bleeding 
between the dura and the skull) rarely occurs in neonates; subarachnoid hemorrhage (i.e., bleeding 
between the arachnoid mater and the pia mater) is the most common. Instrumental delivery (i.e., 
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vacuum/forceps assisted) and Cesarean section during active labor increase the risk of hemorrhage, as 
does preterm birth. 
 
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