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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- Registered Nurse Certified in Neonatal Intensive Care Nursing NCC RNC-NIC Final Exam Review Questions and Answers | 100% Pass Guaranteed | Graded A+ | Read All Instructions Carefully and Answer All the Questions Correctly Good Luck: - What risks are present in infants born to mothers who receive no or little prenatal care? - Answer>> LBW premature birth Maternal iron-deficiency anemia Increased neonatal mortality Describe the fetal response to mothers with diabetes - Answer>> Because glucose crosses the placenta, the baby's BG increases as the mom's does. Insulin does not cross the placenta and the fetal pancreas does not produce it until 20 weeks. So, before insulin production, the increased BG leads to restricted growth. Once the insulin is produced, it produces rapidly to respond to the high BG, and these high levels trigger rapid fetal growth—> hepatosplenomegaly, cardiomegaly, increased head size What is commonly seen in IDM immediately after birth? Why? - Answer>> Hypoglycemia The sudden withdrawal from maternal glucose + continued production of insulin What conditions does an IDM present with? - Answer>> Birth trauma r/t cephalopelvic disproportion Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com What is oligohydramnios? What conditions are associated with it? - Answer>> Decreased AF UT anomalies like obstructive uropathy, renal agenesis, polycystic kidneys Pulmonary hypoplasia Pressure deformities Compression of umbilical cord & hypoxia Mecon staining (remember hypoxia causes release of mecon in utero) Post-term gestation Leaking AF, prolonged or premature ROM What is polyhydramnios & what is it associated with? - Answer>> Increased AF TEF, EA, duodenal atresia Anencephaly CNS abnormalities that impair swallow Twin-twin transfusion Macrosomia Fetal/neonatal hydrops & assoc CV rhythms Trisomy 21, 18, 13 Skeletal malformations Inc risk for prolapsed cord/placental abruption What is the biochemical marker useful in predicting preterm birth? - Answer>> Fibronectins Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com What is the best indicator of fetal oxygenation status during labor as seen on electric fetal monitoring? - Answer>> Variability What are the five parts of the biophysical profile? - Answer>> Fetal tone, breathing, movement; no stress test, amniotic fluid volume When should one have a glucose screening during pregnancy if they're at low risk for developing GD? - Answer>> 24-28 weeks When women give birth sitting upright, what shows lower values in cord blood? - Answer>> PCO An intrauterine pressure catheter, placed for monitoring of uterine pressure, amino infusion, and fluid sampling, is useful in the treatment of what? - Answer>> Variable decelerations by correcting cord compression What is the normal blood volume for a neonate? - Answer>> 85-100 mL/kg What are some risks for fetal maternal hemorrhage? - Answer>> Maternal trauma Placental abruption Placental tumors Third semester amnios Fetal hydrops Twins Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com C section Prematurity SGA Congenital heart disease Maternal alcohol use can lead to... - Answer>> Spontaneous abortion Placental abruption Amnionitis Premature birth FAS What characteristics are common with FAS? - Answer>> Craniofacial abnormalities CNS abnormalities (microcephalic, ID, delays, ADD) Skeletal abnormalities (contracture, scoliosis) Congenital abnormalities (cleft palates, heart defect) SGA and growth deficiency What risks are present with maternal age over 35? - Answer>> Chromosomal abnormalities Pre-eclampsia Placenta previa Increased incidence of gestational diabetes Premature birth Still birth Twins Adolescent pregnancies have what associated risks? - Answer>> Cephalopelvic disproportion & c section Maternal death Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com Pre eclampsia Placenta previa LBW IUGR because moms growth competes with fetal nutrition Premature birth What is placenta previa? - Answer>> Implantation of placenta over or near cervical os What risks accompany placenta previa? - Answer>> Hemorrhage in third trimester Poor growth Congenital anomalies Premature birth What is placental abruption? Risks? - Answer>> Detachment of placenta from uterine wall prematurely; partial or total Partial leads to IUGR Severe bleeding with total detachment—premature or death What factors contribute to insensible water loss? - Answer>> Prematurity Radiant warmers Phototherapy Fever Low humidity Tachypnea Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com What does an EKG look like with hyperkalemia? - Answer>> Peaked T waves and widened QRS What is hypocalcemia and how does it present? Late onset? Treatment? - Answer>> <4. Presents with jitters, irritability, stridor, tetany, high pitched cry, seizures, decreased myocardial contractility Late onset is after first WOL and is typically caused by digeorge syndrome, hyperphosphatemia, low vitamin D, hypoparathyroidism, mg deficiency, diuretic therapy Treat with slow Ca infusion What is hypermagnesemia? S/S and cause? - Answer>> Mg
Hypotonia, hyporeflexia, apnea, low BP, constipstion Commonly caused by maternal administration prior to delivery (aka for pre eclampsia) What is the normal glucose requirement in neonates? - Answer>> 4-8 mg/kg/min Use 4 for preterm, 8 for term as preteens have lower tolerance Normal fluid requirement - Answer>> 100-150 mL/kg/day Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com What happens to the K level shortly after birth? - Answer>> Rises within 24-72 hrs, especially in preterm; falls to normal Hypokalemia causes, symptoms, and tx - Answer>> Chronic diuretic use and excessive nasogastric drainage Cardiac arrhythmias, ileus, lethargy Slow k administration oral or IV What are the caloric needs for a newborn? Preterm? When will that change? - Answer>> Full term 100-120 cal/kg/day Preterm 110-160 cal/kg/day Those recovering from surgery or with chronic illness may need up to 160- How many calories do most formulas & breast milk contain?
- Answer>> 20 cal per oz How many ounces does an infant need to ingest the right amount of calories? - Answer>> 6 oz/kg/day to reach 120 cal/kg/day What are the protein requirements for a preterm infant? Full term infant? How to reach them? - Answer>> Preterm 3-3.5 g/kg/day Term 1.8-2.2 g/kg/day Parenteral nutrition with protein, special formulas, breast milk fortifiers Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com What are the fluids of choice for trophic feedings and how much should be given? - Answer>> Colostrum, human breast milk, preterm infant formula 1-2 mL/kg per feeding no more than 15 mL/kg/day How do preterm formulas differ from term formulas and breast milk? - Answer>> 24 cal/oz instead of 20 Increased protein, vitamins and minerals (esp vitamin D, calcium and phosphorous to prevent osteopenia) Less lactose (preemies short on lactase) What are the main sources of calories in infant formulas and how much do they provide? - Answer>> Carbs-1 gram is 3.4 calories; makes up 1/3 of caloric content Lipids- 1 gram is 9 calories; makes up 2/ Protein- 1 gram is 4 calories; less than 5% of caloric content in formulas —provides amino acids used as building blocks for muscle and other tissue What is osteopenia of prematurity? How is it diagnosed? - Answer>> Decreased bone mineralization Craniotabes, impaired linear growth, thickening of wrists and ankles, elevated alkaline phosphatase in blood serum What are the risk factors for OOP? - Answer>> Prematurity (<34 weeks) bc last trimester large amounts of Ca and P are provided to fetus Weight < 1500 g Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com Delayed onset of enteral feeds Chronic use of steroids or diuretics by mother or infant Feeding full term formulas to preterm infants Role of vitamin A - Answer>> Growth & development of tissues, functioning of immune system Reduces incidence of BPD Role of Vitamin D - Answer>> Adequate Ca and P absorption to decrease risk of rickets Role of vitamin E - Answer>> Limited in preterm infant making them susceptible to developing hemolytic anemia Role of Vitamin K - Answer>> Clotting process given shortly after birth to prevent hemorrhagic disease of the newborn Carnitine and the preterm infant - Answer>> Present in human breast milk and formulas but premature infants have low tissue stores so may need supplementation so they're better able to metabolize fats Symptoms of carnitine deficiency - Answer>> Increased episodes of apnea Decreased muscle tone Poor growth Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com What is the IV lipid protocol? Possible complications? - Answer>> Start with 0.5 g/kg on third DOL & advance slowly to final admin rate of 3-3. g/kg/day by 7-10 days Kernicterus in those with elevated unconjugated bili Exacerbation of chronic lung dz & persistent pulm HTN Protocol for iron supplementation in neonates - Answer>> Preterm infants susceptible to iron deficiency due to lack of maternal iron transfer during third trimester Premature infants fed human milk should have supplemental iron once they reach full feeds or iron fortified formulas What is extrauterine growth restriction? What is it associated with? - Answer>> Poor growth after birth common in premature infants (especially VLBW) Short stature Adverse neurological outcomes like neurosensory impairments, delayed development & poor school performances What are some causes of respiratory acidosis? - Answer>> Processes that disturb the transfer of CO2 across the respiratory membrane eg inflammation or excessive fluid Decreased respiratory rate Severe pulmonary disease Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com Muscle fatigue Central depression of breathing What vent changes should be made to treat respiratory acidosis? - Answer>> Increase tidal volume by increasing PIP, PEEP or rate What are some causes of metabolic acidosis? - Answer>> Lactic acidosis production from inadequate tissue perfusion and oxygenation Hypothermia —> increased lactic acid production Renal failure Excessive chloride in IVF diarrhea When does late metabolic acidosis of prematurity occur? - Answer>> In premature infants who receive high protein or amino acid feedings bc the immature kidneys cannot excrete the acids How do you screen for late metabolic acidosis of prematurity? - Answer>> Check urine pH, if it's less than 5. then it indicates kidneys are maximizing their ability to excrete acid Low blood pH, low pCO2 ( compensating), low bicarb What complications arise from late metabolic acidosis of prematurity? How is it treated? - Answer>> Less weight gain and increased excretion of Na Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com What can cause a low anion gap? - Answer>> Lactic acidosis from sepsis Multiple myeloma Low Na Low albumin High Mg What is the oxygen hemoglobin dissociation curve? - Answer>> A graph that plots the % of hbg that is saturated with O2 on the y and different partial pressures of O2 on the x It represents how strongly the hgb is binding to the O What does a shift to the R on the O2 hgb curve mean? Shift to L? - Answer>> Hgb has less affinity for oxygen (greater amounts of O2 are released) Increased affinity of hgb to oxygen Fetal hgb vs adult - Answer>> Greater affinity for oxygen than adult so aids in transfer of oxygen from maternal blood to fetal blood in placenta What is permissive hypercapnia and why do we do it? - Answer>> Those receiving assisted ventilators support are allowed to have slightly higher CO2 levels To increase resp drive, shorter duration of vent, decreased lung trauma from less aggressive settings Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
📧 Hybridgrades101@gmail.com What is a potential harm associated with permissive hypercapnia? - Answer>> Increased cerebral blood flow —> increased risk of IVH Why does lactic acidosis occur? Effects? - Answer>> Secondary to tissue hypoperfusion from hypoxia, sepsis... decreases cardiac contractility and worsens tissue perfusion Treatments of lactic acidosis - Answer>> Sodium bicarb and tromethamine (THAM) Risks associated with bicarb tx for acidosis - Answer>> Decreased K & Ca Increased Na Increased PCO Risks associated with THAM tx for acidosis? Positive? - Answer>> High K Low BG Hepatic necrosis Should raise pH without producing excess CO What is a neutral thermal environment? - Answer>> Environmental temp at which the baby must expend the least energy to maintain its proper temperature ie where oxygen consumption and caloric utilization are lowest What are the types of heat transfer in neonates? - Answer>> Radiation-not in contact, eg by a window Need Writing 📧Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed📧
