RNC-NIC Neonatal Intensive Care Nursing

A preterm infant born at 28 weeks gestation is being assessed. Which of the following physical findings is most consistent with this gestational age?

• AAbundant lanugo over the entire body
• BWell-developed, firm ear cartilage
• CDeep sole creases covering the entire foot
• DProminent clitoris and labia majora covering the labia minora

What is the primary purpose of administering surfactant to a preterm infant with respiratory distress syndrome (RDS)?

• ATo increase pulmonary blood flow
• BTo prevent alveolar collapse
• CTo relax bronchial smooth muscle
• DTo decrease the work of breathing

A neonatal nurse is caring for an infant receiving phototherapy for hyperbilirubinemia. Which intervention is essential to prevent complications?

• AApplying lotion to the infant's skin to prevent drying
• BCovering the infant's eyes with opaque patches
• CRestricting oral fluid intake to prevent dehydration
• DDiscontinuing breastfeeding during treatment

A term infant is diagnosed with necrotizing enterocolitis (NEC). Which of the following is a classic sign of this condition?

• AHyperactive bowel sounds
• BScaphoid abdomen
• CBloody stools
• DNormal temperature

What is the most common cause of respiratory distress in a term infant?

• ATransient tachypnea of the newborn (TTN)
• BMeconium aspiration syndrome (MAS)
• CRespiratory distress syndrome (RDS)
• DPneumonia

A nurse is preparing to administer a gavage feeding to a preterm infant. What is the most reliable method to verify the placement of the nasogastric tube?

• AAuscultating for a rushing sound over the epigastrium after injecting air
• BAspirating gastric contents and testing the pH
• CPlacing the end of the tube in water and observing for bubbles
• DMeasuring the length of the tube from the nose to the earlobe to the xiphoid process

A newborn is diagnosed with a patent ductus arteriosus (PDA). The nurse would expect to hear which type of heart murmur?

• AA harsh, pansystolic murmur at the lower left sternal border
• BA continuous, machine-like murmur at the upper left sternal border
• CA soft, blowing, diastolic murmur at the upper right sternal border
• DA crescendo-decrescendo systolic ejection murmur at the upper left sternal border

Which of the following is a sign of cold stress in a newborn?

• AShivering
• BIncreased activity
• CHypoglycemia
• DFlushed skin

A preterm infant is at risk for intraventricular hemorrhage (IVH). The nurse should implement which of the following interventions to minimize this risk?

• AAdministering a rapid bolus of intravenous fluids
• BMaintaining the infant in a flat, supine position
• CPerforming frequent, vigorous suctioning of the airway
• DMinimizing handling and providing a quiet, dark environment

A mother of a critically ill infant expresses feelings of guilt and helplessness. What is the most appropriate response by the nurse?

• A"Don't worry, your baby is in good hands."
• B"It's normal to feel this way. Let's talk about what's on your mind."
• C"You should focus on the positive aspects of your baby's condition."
• D"I'll call the hospital chaplain to come and talk with you."

A nurse is administering gentamicin to a neonate. Which of the following is a potential side effect of this medication?

• AHypoglycemia
• BOtotoxicity
• CBradycardia
• DHypertension

A newborn is suspected of having congenital diaphragmatic hernia (CDH). Which of the following is a characteristic finding in this condition?

• ABowel sounds heard in the chest
• BSymmetrical chest movement
• CAbsence of respiratory distress
• DPink, well-perfused extremities

What is the primary goal of developmental care for preterm infants?

• ATo accelerate weight gain and growth
• BTo minimize stress and promote optimal neurodevelopment
• CTo encourage early discharge from the hospital
• DTo reduce the risk of hospital-acquired infections

A nurse is caring for an infant with gastroschisis. What is the priority nursing intervention in the immediate pre-operative period?

• ACovering the exposed bowel with a sterile, saline-soaked dressing
• BAdministering a bolus of intravenous fluids
• CPlacing the infant in a prone position
• DInitiating oral feedings to promote gut motility

A newborn is at risk for early-onset sepsis. Which of the following is a maternal risk factor?

• AMaternal age over 35
• BGestational diabetes
• CProlonged rupture of membranes (>18 hours)
• DHistory of a previous C-section

A nurse is preparing to administer an intramuscular injection to a newborn. What is the preferred injection site?

• ADorsogluteal muscle
• BVastus lateralis muscle
• CDeltoid muscle
• DRectus femoris muscle

A newborn is diagnosed with anencephaly. The parents are devastated and ask the nurse what this means for their baby. What is the most appropriate response?

• A"This is a serious condition, but with surgery, your baby can have a normal life."
• B"Anencephaly is a fatal condition. We will provide comfort care for your baby."
• C"You should talk to the doctor about the prognosis."
• D"I can't give you that information. It's best to wait for the doctor."

A nurse is caring for an infant with a myelomeningocele. What is the priority nursing intervention to prevent infection?

• APlacing the infant in a prone position and covering the sac with a sterile, moist dressing
• BAdministering prophylactic antibiotics
• CKeeping the infant in a reverse isolation room
• DCleaning the sac with povidone-iodine solution every 4 hours