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

Abundant lanugo over the entire body

Well-developed, firm ear cartilage

Deep sole creases covering the entire foot

Prominent clitoris and labia majora covering the labia minora

to track

2026 Statistics

Key Facts: RNC-NIC Exam

175

Total Questions

NCC

3 hours

Exam Time

NCC

$325

Exam Fee

NCC

The RNC-NIC exam is a competency-based examination for neonatal intensive care nurses. It consists of 175 multiple-choice questions, and you are given 3 hours to complete it. The exam fee is $325. While the NCC does not publish pass rates, thorough preparation is key to success.

Sample RNC-NIC Practice Questions

Try these sample questions to test your RNC-NIC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A preterm infant born at 28 weeks gestation is being assessed. Which of the following physical findings is most consistent with this gestational age?

A.Abundant lanugo over the entire body

B.Well-developed, firm ear cartilage

C.Deep sole creases covering the entire foot

D.Prominent clitoris and labia majora covering the labia minora

Explanation: Preterm infants born at approximately 28 weeks gestation typically have abundant lanugo, which is fine, downy hair covering their body. Ear cartilage is soft and pliable, sole creases are faint or absent, and in female infants, the clitoris is prominent with small, separated labia majora.

2What is the primary purpose of administering surfactant to a preterm infant with respiratory distress syndrome (RDS)?

A.To increase pulmonary blood flow

B.To prevent alveolar collapse

C.To relax bronchial smooth muscle

D.To decrease the work of breathing

Explanation: Surfactant is a substance that reduces surface tension in the alveoli, preventing them from collapsing at the end of expiration. In preterm infants with RDS, surfactant deficiency is the primary cause of respiratory failure.

3A neonatal nurse is caring for an infant receiving phototherapy for hyperbilirubinemia. Which intervention is essential to prevent complications?

A.Applying lotion to the infant's skin to prevent drying

B.Covering the infant's eyes with opaque patches

C.Restricting oral fluid intake to prevent dehydration

D.Discontinuing breastfeeding during treatment

Explanation: Phototherapy can cause retinal damage, so it is crucial to protect the infant's eyes with opaque patches. The patches should be removed periodically to assess for any signs of infection or irritation and to provide visual stimulation.

4A term infant is diagnosed with necrotizing enterocolitis (NEC). Which of the following is a classic sign of this condition?

A.Hyperactive bowel sounds

B.Scaphoid abdomen

C.Bloody stools

D.Normal temperature

Explanation: Necrotizing enterocolitis (NEC) is a serious inflammatory condition of the intestines. Bloody stools are a classic sign of NEC due to mucosal injury and hemorrhage.

5What is the most common cause of respiratory distress in a term infant?

A.Transient tachypnea of the newborn (TTN)

B.Meconium aspiration syndrome (MAS)

C.Respiratory distress syndrome (RDS)

D.Pneumonia

Explanation: Transient tachypnea of the newborn (TTN) is the most common cause of respiratory distress in term infants. It is a self-limiting condition caused by delayed clearance of fetal lung fluid.

6A 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?

A.Auscultating for a rushing sound over the epigastrium after injecting air

B.Aspirating gastric contents and testing the pH

C.Placing the end of the tube in water and observing for bubbles

D.Measuring the length of the tube from the nose to the earlobe to the xiphoid process

Explanation: Aspirating gastric contents and testing the pH is the most reliable method for verifying nasogastric tube placement. A pH of 5 or less indicates proper placement in the stomach.

7A newborn is diagnosed with a patent ductus arteriosus (PDA). The nurse would expect to hear which type of heart murmur?

A.A harsh, pansystolic murmur at the lower left sternal border

B.A continuous, machine-like murmur at the upper left sternal border

C.A soft, blowing, diastolic murmur at the upper right sternal border

D.A crescendo-decrescendo systolic ejection murmur at the upper left sternal border

Explanation: A patent ductus arteriosus (PDA) is a persistent connection between the aorta and the pulmonary artery. The classic murmur of a PDA is a continuous, machine-like murmur heard at the upper left sternal border.

8Which of the following is a sign of cold stress in a newborn?

A.Shivering

B.Increased activity

C.Hypoglycemia

D.Flushed skin

Explanation: Cold stress in a newborn can lead to hypoglycemia. When a newborn is cold, their metabolic rate increases to generate heat, which consumes glucose stores and can result in low blood sugar.

9A preterm infant is at risk for intraventricular hemorrhage (IVH). The nurse should implement which of the following interventions to minimize this risk?

A.Administering a rapid bolus of intravenous fluids

B.Maintaining the infant in a flat, supine position

C.Performing frequent, vigorous suctioning of the airway

D.Minimizing handling and providing a quiet, dark environment

Explanation: Minimizing handling and providing a quiet, dark environment can help reduce the risk of intraventricular hemorrhage (IVH) in preterm infants. These interventions help to decrease fluctuations in cerebral blood flow and blood pressure.

10A 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."

Explanation: The most appropriate response is to acknowledge the mother's feelings and provide an opportunity for her to express her concerns. This validates her emotions and establishes a therapeutic relationship.

About the RNC-NIC Exam

The RNC-NIC certification is for registered nurses who have at least two years of experience in neonatal intensive care. The exam tests the knowledge and skills required to provide care to acutely and critically ill neonatal patients and their families.

Questions

175 scored questions

Time Limit

3 hours

Passing Score

Pass/Fail

Exam Fee

$325 (National Certification Corporation (NCC))

RNC-NIC Exam Content Outline

General Assessment

Gestational age, physical, and neurological assessment.

39%

General Management

Fluids, electrolytes, nutrition, feeding, oxygenation, ventilation, and pharmacology.

44%

Assess & Manage Pathophysiologic States

Respiratory, cardiovascular, neurological, gastrointestinal, and hematologic disorders.

Psychosocial Support

Family-centered care, grief, and bereavement.

Professional Issues

Ethics, legal aspects, and quality improvement.

How to Pass the RNC-NIC Exam

What You Need to Know

Passing score: Pass/Fail
Exam length: 175 questions
Time limit: 3 hours
Exam fee: $325

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

RNC-NIC Study Tips from Top Performers

1Focus on the major content areas: General Management (39%) and Assess & Manage Pathophysiologic States (44%).

2Review the normal and abnormal findings in the physical and neurological assessment of a newborn.

3Understand the principles of fluid and electrolyte balance, nutrition, and pharmacology in the neonatal population.

4Familiarize yourself with common neonatal respiratory, cardiovascular, and neurological disorders.

5Practice with as many sample questions as possible to become familiar with the format and style of the exam questions.

Frequently Asked Questions

How many questions are on the RNC-NIC exam?

The RNC-NIC exam contains 175 multiple-choice questions. 150 are scored, and 25 are pretest questions that do not count towards your score.

How long do I have to complete the exam?

You will have 3 hours to complete the 175 questions on the RNC-NIC exam.

What is the passing score for the RNC-NIC exam?

The RNC-NIC exam is a pass/fail exam. The passing score is determined by a criterion-referenced standard, not a curve.

How much does it cost to take the RNC-NIC exam?

The fee for the RNC-NIC exam is $325.