RNC-NIC Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

Symmetric growth restriction from an early insult such as infection: Symmetric IUGR involves proportionally reduced weight, length and head circumference from an early-pregnancy insult.

Appropriate for gestational age with normal variation in weight: A weight below the 10th percentile is small for gestational age, not appropriate.

Asymmetric growth restriction from uteroplacental insufficiency: Correct. Head sparing with low weight reflects late-pregnancy placental insufficiency, as with maternal hypertension and preeclampsia.

Large for gestational age with a disproportionately large head: LGA means weight above the 90th percentile; here weight is low, and head circumference is normal.

Asymmetric IUGR (head spared, weight down) = late placental insufficiency; symmetric IUGR (all parameters down) = early insult (chromosomal, TORCH). SGA infants are at risk for hypoglycemia, polycythemia and hypothermia.

Answer: B

Dry the infant thoroughly, then swaddle in warm blankets: For infants under 32 weeks, drying and swaddling is less effective than immediate plastic wrapping without drying.

Place in a polyethylene wrap without drying, under a warmer: Correct. Infants born before 32 weeks should be placed in a plastic bag or wrap without drying, with a hat, thermal mattress and warm room.

Bathe in warm water to remove vernix and fluid right away: Bathing increases evaporative heat loss and is contraindicated in an unstable preterm infant.

Keep the delivery room cool to help reduce the infection risk: NRP recommends a warm delivery room (about 23-25 degrees C) for preterm births.

Under 32 weeks: warm room, radiant warmer, polyethylene wrap without drying, hat and thermal mattress; aim for 36.5-37.5 degrees C axillary.

Answer: D

0.05 mL: This is a tenfold underdose (0.005 mg), from a decimal error.

1.25 mL: 1.25 mL = 0.125 mg = 0.05 mg/kg, which is in the endotracheal dose range, not the ordered IV dose.

5 mL: 5 mL = 0.5 mg = 0.2 mg/kg, a tenfold overdose.

0.5 mL: Correct. 0.02 mg/kg x 2.5 kg = 0.05 mg; 0.05 mg / 0.1 mg/mL = 0.5 mL, followed by a normal saline flush.

Neonatal epinephrine (0.1 mg/mL): IV 0.01-0.03 mg/kg (0.1-0.3 mL/kg), ET 0.05-0.1 mg/kg. Dose (mg) = mg/kg x kg; volume = dose / concentration.

Answer: B

Left-to-right shunting through a patent foramen ovale: Left-to-right shunting does not cause postductal desaturation.

Right-to-left shunting across the ductus arteriosus: Correct. A preductal (right hand) saturation higher than postductal (foot) by more than about 5-10% indicates right-to-left ductal shunting from high pulmonary vascular resistance, typical of PPHN.

A faulty probe because readings should always match: Differences between pre- and postductal readings are clinically meaningful; dismissing them delays diagnosis.

Peripheral vasoconstriction from cold stress only: Cold may affect perfusion, but a consistent large pre-postductal gap points to ductal shunting.

PPHN: labile hypoxemia, pre-postductal gradient, minimal handling, optimize oxygenation and ventilation, support blood pressure and consider inhaled nitric oxide.

Answer: C

Continue prone sleep at home because the baby is used to it: Prone sleep at home increases SIDS risk; preterm infants are at higher risk and should sleep supine.

Use side-lying with foam wedges for safer breathing at home: Side-lying and positioning devices are not recommended because infants can roll prone and devices pose suffocation risk.

Prone was monitored therapy; at home, always use supine sleep: Correct. Prone positioning under continuous monitoring is used therapeutically; infants transition to supine well before discharge, and parents should always use supine sleep in a bare crib.

Choose the sleep position based on the infant's preference: Safe sleep guidance is supine for every sleep, regardless of the infant's preference.

NICU infants should be transitioned to supine sleep as soon as clinically stable (by about 32 weeks PMA) so parents see safe sleep modeled before discharge.

Answer: A

Bar-code scanning that matches each milk bottle to the infant: Correct. Bar-code or two-person verification at preparation and feeding matches milk to the correct infant, preventing misadministration.

Storing all mothers' milk together in one large refrigerator: Shared storage without patient-specific identification increases the risk of mix-ups.

Allowing parents to label bottles in their own handwriting: Handwritten, nonstandard labels are a known contributor to milk misadministration.

Requiring staff to memorize which mother's milk is in each bottle: Relying on memory is an unsafe human factor and not a reliable safeguard.

Treat human milk like a medication: standardized labels with two patient identifiers and bar-code or two-person verification at each step.