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University of Pennsylvania
(Pennsylvania)
NCC National Certification Corporation
NCC Registered Nurse Certified in Neonatal
Intensive Care Nursing RNC-NIC Exam
Course Title and Number: NCC Registered Nurse Certified in Neonatal Intensive Care Nursing RNC-NIC Exam Exam Title: Board Exam Exam Date: Exam 2024- 2025 Instructor: [Insert Instructor’s Name] Student Name: [Insert Student’s Name] Student ID: [Insert Student ID]
Examination
180 minutes
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📧 Hybridgrades101@gmail.com NCC National Certification Corporation 2024-2025 NCC Registered Nurse Certified in Neonatal Intensive Care Nursing RNC-NIC Watson and Robynre Review Exam Questions and Answers | 100% Pass Guaranteed | Graded A+ | Read All Instructions Carefully and Answer All the Questions Correctly Good Luck: - A patient who is G2P2 at 33 weeks' gestation arrives at the triage unit complaining of regular uterine contractions. Her pregnancy history includes a preterm delivery at 34 weeks. Prior to examining her, the nurse performs electronic fetal monitoring and obtains a complete history. The patient reports no bleeding and no rupture of membranes. She has had no vaginal examinations or sexual activity for more than 24 hours. The biochemical marker useful in this situation for predicting pre-term birth is: a. cervical ferritin b. fetal fibronectin c. corticotropin-releasing hormone d. placental alpha-microglobulin-1 - Answer>> b. fetal fibronectin fetal fibronectin (fFN) is uncommonly present in cervicovaginal secretion in the late second and early third trimesters. fFN is an extracellular glycoprotein and is Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com Premature rupture of membranes is one of the most common complications of pregnancy resulting in a newborn's admission to the NICU. A bedside immunoassay test, AmniSure ROM, is simple, easy to perform, rapid (5- minutes), and minimally invasive. This test identifies a placental glycoprotein that is abundant in amniotic fluid but present in lower concentrations in maternal blood and cervicovaginal secretions. Prolactin is responsible for priming the breast tissue in preparation for lactation. Alpha-fetoprotein is assessed to indentify neural tube defects (high) and Down's Syndrome (low). Fetal Fibronectin is an extracellular glycoprotein that is thought to act as an adhesive between the fetal membranes and uterine wall and is a biomarker for predicting preterm birth. When electric fetal monitoring is used, the BEST indicator of fetal oxygenation status during labor is: a. fetal heart rate baseline within the normal range b. moderate fetal heart rate variability c. absence of decelerations of the fetal heart rate d. presence of accelerations in the fetal heart rate - Answer>> b. moderate fetal heart rate variability Moderate fetal heart rate (FHR) variability is strongly associated with an arterial umbilical cord pH higher than 7.15. Normal FHR variability provides reassurance about Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com fetal status and the absence of metabolic acidemia. FHR variability is the sign most predictive of fetal well-being. The most important single FHR characteristic variability. FHR baseline is 110 to 160 bpm regardless of gestational age. Decelerations are a reflection of head compression, umbilical cord compression, or a transient interruption of in oxygen transfer. Accelerations are highly predictive of the absence of fetal metabolic acidemia and form the basis of the nonstress test. They occur in association with fetal movement. The biophysical profile (BPP) is currently the primary method for evaluating fetal well-being through the assessment of various activities that are controlled by the central nervous system and are sensitive to oxygenation. The five variable included in the BPP are: a. fetal tone, fetal breathing, fetal movement, non-stress test, and amniotic fluid volume b. fetal movement, fetal tone, nonstress test, amniotic fluid index, and fetal position c. fetal tone, fetal position, amniotic fluid volume, fetal heart rate, and fetal activity d. fetal heart rate, fetal movement, nonstress test, amniotic fluid volume, and fetal tone - Answer>> a. fetal tone, fetal breathing, fetal movement, non-stress test, and amniotic fluid volume Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com Patients who are at low risk for developing gestational diabetes (<25 years, normal weight, member of an ethnic group with low prevalence of diabetes, no diabetes in a first-degree relative, no history of abnormal glucose tolerance, and no history of poor obstetric outcome) are tested between 24 to 28 weeks' gestation. Patients with risk factors (>35 years, BMI>30, history of gestational diabetes, delivery of an LGA infant, polycystic ovarian syndrome, strong family history of diabetes) should receive a plasma glucose screening at their first prenatal visit followed by one at 24 to 28 weeks. When women give birth sitting upright, which of the following indicators show lower values in Cord Blood? a. pH b. PCO c. PO d. Base Excess - Answer>> b. PCO Values of PCO2 are lower when women give birth to an upright position than when they give birth in the Supine position. A supine position during labor should be avoided to prevent maternal hypotension and to enhance uteroplacental blood flow to keep the fetal pH within normal limits. values of pH, are higher in women who give birth in the upright position. A normal pH, po2, and pco should reflect a normal base excess. Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com Which test is most reliable in predicting fetal lung maturity in the infant of a diabetic mother? a. Fetal lung maturity test b. Phosphatidylglycerol level c. Lamellar body count d. Lecithin - Answer>> b. Phosphatidylglycerol level The major factor influencing pulmonary maturity in the infants of diabetic mothers is glucose control. And mothers with good control, fetal lung maturation is not delayed. Phosphatidylglycerol (PG) enhances the spread a phospholipid on Eli and its presence indicates an advanced state of fetal lung development and function. The fetal lung maturity test reports and milligrams of surfactant per gram of albumin.The AmnioSTAT Is the test that is used and uses 55 mg of surfactant/gram albumin as "mature." Lamellar bodies are lamellated phospholipids that represent a storage form of surfactant. The size of lamellar bodies is similar to that of platelets, so a lamellar body count can be obtained rapidly with the use of a platelet channel of a hEmatology analyzer. The fetal lung maturity cut off is suggested to be 50,000 microliters. the lecithin/sphingomyelin ratio is best used in combination Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com a. Polyhydramnios b. Late decelerations c. Variable decelerations d. Decreased fetal heart rate variability - Answer>> c. Variable decelerations Amnioinfusion has been used to attempt to resolve variable heart rate decelerations by correcting umbilical cord compression as a result of oligohydramnios. During amnioinfusion, normal saline or lactated ringer solution is infused into the uterus either by gravity flow or through an infusion pump. Amnioinfusion may assist with oligohydramnios (amniotic fluid index<5cm) to provide additional fluid to cushion the umbilical cord and prevent variable decelerations from occurring. Careful monitoring and documentation of fluid infused is important to avoid iatrogenic polyhydramnios. Amnion Fusion has been shown to significantly improve fetal heart rate patterns characterized by variable decelerations but does not affect the late decelerations or patterns with minimal to absent variability. Amnioinfusion does not affect decreased fetal heart rate variability. The patient is experiencing preterm labor at 33 weeks' gestation. She has a history of preterm Labor and is currently showing regular contractions. To ensure that she receives her two doses of steroids promote funeral lung maturity, a tocolytic medication is prescribed. This Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com medication, a calcium channel blocker, has been marketed to treat hypertension, angina, and arrhythmia and does not commonly have adverse effects on the fetus or near Nate. The medication is: a. Magnesium sulfate b. Ketorolac (Toradol) c. terbutaline (Breathine) d. nifedipine (Procardia) - Answer>> d. nifedipine (Procardia) Nifedipine (Procardia) work by inhibiting voltage-dependent channels of calcium entry into the smooth muscle cells, acting to decrease intracellular calcium and decrease the release of stored calcium. It is rapidly absorbed after oral Administration, which makes it convenient to use. It should not be used in combination with other magnesium sulfate or beta sympathomimetics (terbutaline). Magnesium sulfate is an anticonvulsant an act to relax the smooth muscle of the uterus by substituting itself in place of calcium. Ketorolac (Toradol) is an anti-inflammatory and an antiprostaglandin generally used for pain management.Its use can cause oligohydramnios and premature closure of the ductus arteriosus.Terbutaline is a beta- sympathomimetic that supplements or mimics the effects of norepinephrine and epinephrine. Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com c. Decrease in pulmonary vascular resistance, increase in systemic vascular resistance d. Decrease in pulmonary vascular resistance, decrease in systemic vascular resistance - Answer>> c. Decrease in pulmonary vascular resistance, increase in systemic vascular resistance Systemic vascular resistance in the aorta order normally uses postnatally with the removal of the placenta.Pulmonary vascular resistance normally decreases postnatally with the onset of ventilation and the dilatation of the pulmonary vasculature, which increases pulmonary blood flow to the lungs. An increase in pulmonary vascular resistance after birth would further. Increased pulmonary vascular resistance can develop from cardiac defects (e.G., ventricular septal defect, single ventricle) or in infants with persistent pulmonary hypertension. What is the name of the fetal shunt that is responsible for shunting blood between the aorta and the pulmonary artery? a. Foramen ovale b. Ductus venosus c. Ductus arteriosus d. Blalock-Taussig shunt - Answer>> c. Ductus arteriosus Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com During fetal life, the ductus arteriosus is responsible for shunting blood away from the lungs to the aorta.This shunt functionally closes during the transition. Following delivery.The foramen ovale is an opening between the left and right atria. Following delivery, as pressures increase on the left side of the heart and decrease on the right side of the heart, disconnection functionally closes.Changes in an infant's condition can open this connection and allow blood to shut in either direction. The ductus venosus is responsible for shunting blood from the umbilical vein to the inferior vena cava so that blood bypasses the liver. A Blalock Taussig shunt is a surgical procedure performed to connect the subclavian artery to the pulmonary artery The nurse in the labor, delivery, and recovery (LDR) department calls the nursery to request an immediate assessment of a term infant displaying signs and symptoms of respiratory distress following an uneventful vaginal delivery. Upon arrival to the LDR, the nursery nurse observes that the LDR nurse is providing bag-and-mask ventilation. The infant is dusky and has a scaphoid abdomen with an asymmetric appearing chest with breath sounds greater on the right side. Based on this information, the infant most likely has what condition? a. Pneumothorax b. Diaphragmatic hernia Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com 40 2/7 week gestation infant is delivered with vacuum assistance after a prolonged second stage of labor. The infant weighs 3.75 kg. This is the mother's first baby. The Apgar scores were 3, 5, and 8 at 1, 5, and 10 minutes, respectively. After stabilizing the infant following the delivery, the nurse conducts the head to toe assessment. Scalp edema is noted. When the head and neck areas are palpating, it is observed that swelling crosses the suture lines and feels boggy.Based on these, what would be a probable diagnosis? a. Cephalohematoma; add mint to the NICU for close observation b. Subgaleal Hemorrhage; admit to the NICU for close observation c. Cephalohematoma; keep Mother and baby together in the labor and delivery department d. Caput succedaneum; keep mother and baby together in the labor and delivery department - Answer>> b. Subgaleal Hemorrhage; admit to the NICU for close observation Vacuum-assisted delivery places for developing and subgaleal hemorrhage. A subgaleal hemorrhage can result in massive blood loss, leading to shock and death. Any changes in Vital Signs, Consciousness, or swelling that is extending to the eye and neck requires the caregiver to transfer the infant into an intensive care environment so Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com that the delivery of products and hemodynamic stabilization are not delayed. Preparation may also be needed to transfer this infant higher level of care.Cephalohematoma can be unilateral or bilateral but does not cross the suture line; it will usually resolve within weeks after birth. A cephalohematoma generally does not require the event to be cared for in a NICU unless or significant what laws or fractured skull is suspected and the baby needs further evaluation. Otherwise, these infants can stay with their mothers in the labor and delivery department. However, they must be assessed for hyperbilirubinemia, for which they are at a higher risk. Caput succedaneum is caused by contact with the presenting part (scalp) with the cervix. The swelling is fluid in the subcutaneous tissues of the scalp.The swelling usually within 1 to 2 days after birth.These infants can stay with their mothers in the labor and delivery department. A 38-week-gestation infant is delivered by cesarean section due to a breech presentation. The Apgar score is 8 at 1 minute and 9 at 5 minutes. The mother received late prenatal care. The Hepatitis B status of the mother is unknown. The plan of care of this infant should include which one of the following options? a. Administer monovalent hepatitis B vaccine before discharge from b. Draw maternal blood for determination of surface antigen status before performing any interventions Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com 37-week-gestation infant was delivered precipitously to 33-year-old G4 P3 mother.The mother's pregnancy was uneventful. The Apgar score was 7 at 1 minute and 9 at 5 Minute. The infant will stay skin to skin on the mother's chest immediately after birth. The infant is now 1 hour old, in the nurse has just completed the first assessment. The infant has mild peripheral cyanosis of the hands and feet.The axillary temperature is 36.4 degrees Celsius (97.6 degrees Fahrenheit). The head is rounded. Petechiae are noted on the face.Breath sounds are slightly coarse and equal with occasional expiratory grunting noted. Respiratory rate is 50 to 60 breaths/minute with an occasional increase to 70. Heart rate is 144 beats/minute. Tone is normal with flexion of arms and legs. Abdomen soft and non-tender with bowel sounds present. Based on these assessment findings, follow-up care should include which of the following interventions - Answer>> c. Keep the infant with a mother. Have the mother attempt to breastfeed and continue to monitor vital signs as per protocol Assessment findings are normal during the transition (first 4-6 hours) following birth. The petechiae are the result of the precipitous delivery. Because the lungs are attempting to clear the fluid, infants can often have more sounding breath sounds, intermittently elevated respiratory rates, and occasional grunting. Transfer to the Special Care Nursery/Neonatal Intensive Care Unit should be considered if the infant has a sudden deterioration in respiratory status, difficulty maintaining temperature, or changes in Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com neurological status. The Pediatric provider should be contacted if the respiratory grunting, increased work of breathing, and/or Central color change. The peripheral cyanosis is normal during the transition. After birth. The risk of aspiration occurring is very rare in this circumstance. Feeding should be delayed if the elevated respiratory rate is sustained. A term infant is not 24 hours old. The infant underwent a normal spontaneous vaginal delivery. Rupture of membranes occurred 12 hours prior to delivery. Results of the prenatal Group B streptococcus green were negative. Internal temperature prior to delivery was normal. Damn the attic fluid headlight meconium staining. The infant was vigorous at Birth and did not require resuscitation other than drying and clearing the airway. The Apgar score was 8 at 1 minute and 9 x 5 minutes. The infant has been roaming in with the mother. The nurse on the mother/baby unit completed her shift assessment of the infant with the following findings: color slightly pale with decreased perfusion and pulses in the lower extremities compared with upper extremities; slightly lethargic; respiratory rate 70 to 80 breaths/minute; no grunting, flaring, or retraction; last effective breastfeed was 6 hours ago.Based on the assessment findings, t - Answer>> b. Notify the physician; transfer the infant to the nursery for observation and placed under a radiant warmer with a possible diagnosis of coarctation of the aorta Coarctation of the aorta has the classic finding of decreased perfusion and pulses in the lower extremities. These infants Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
