RNC-NIC Cheat Sheet 2026

The 30 highest-yield RNC-NIC facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Necrotizing enterocolitis (NEC) is most commonly seen in: → Preterm infants under 32 weeks gestation
2. Which vitamin deficiency is a NICU nurse most concerned about in infants receiving exclusive breast milk without supplementation? → Vitamin D deficiency
3. Persistent pulmonary hypertension of the newborn (PPHN) is characterized by: → Elevated pulmonary vascular resistance causing right-to-left shunting
4. Neonatal pain assessment in a non-verbal preterm infant is best performed using: → A validated neonatal pain scale such as NIPS or PIPP
5. Short bowel syndrome following NEC surgery is caused by: → Insufficient intestinal absorptive surface area after resection of necrotic bowel
6. Hyperkalemia in the first 72 hours of life in an extremely preterm infant is most likely caused by: → Non-oliguric hyperkalemia from immature Na/K-ATPase pump activity
7. Which developmental care intervention has the strongest evidence for reducing pain during minor procedures in preterm neonates? → Oral sucrose with non-nutritive sucking
8. The BEST indication of fetal oxygenation status during labor when electronic fetal monitoring is used is: → Moderate fetal heart rate variability
9. Which congenital heart defect is considered ductal-dependent for systemic circulation, requiring prostaglandin E1 to maintain cardiac output? → Hypoplastic left heart syndrome (HLHS)
10. Which sign indicates hypothermia in a neonate? → Peripheral vasoconstriction, lethargy, poor feeding, and acrocyanosis
11. During therapeutic hypothermia for HIE, the target core temperature is: → 33–34°C for 72 hours
12. Which medication is used as an antidote for neonatal opioid toxicity? → Naloxone
13. A NICU nurse is assessing a neonate for patent ductus arteriosus. Which clinical finding is most characteristic? → Continuous machine-like murmur at the upper left sternal border
14. A neonate with persistent pulmonary hypertension (PPHN) does not improve with 100% oxygen. Which inhaled medication is the first-line treatment? → Inhaled nitric oxide (iNO)
15. Neonatal abstinence syndrome (NAS) is most commonly assessed using the: → Finnegan Neonatal Abstinence Scoring Tool
16. Daily weights in the NICU are most important for monitoring: → Fluid balance, nutritional adequacy, and edema
17. Which sign is an early indicator of feeding intolerance in a tube-fed neonate? → Increasing gastric residuals, abdominal distension, or emesis
18. Bell's staging criteria classifies NEC into stages I, IIA/B, and IIIA/B. Stage III requires: → Surgical intervention due to intestinal perforation or severe deterioration
19. Prostaglandin E1 (PGE1) is initiated in a neonate with suspected ductal-dependent congenital heart disease. What is its primary mechanism of action? → Maintains or reopens the ductus arteriosus
20. The Dubowitz/Ballard examination is used to assess: → Gestational age based on neuromuscular and physical maturity
21. Which complication is the NICU nurse most concerned about when a preterm infant receives a rapid IV fluid bolus? → Intraventricular hemorrhage
22. A premature infant is transitioning from gavage to oral feeding. The nurse should assess feeding readiness by evaluating: → Cue-based signs: rooting, sucking, alertness, and tolerance of handling
23. When administering gentamicin to a neonate, the nurse should monitor which laboratory value most closely? → Serum creatinine and BUN
24. A preterm infant at 28 weeks gestation is placed on mechanical ventilation. Which ventilator parameter directly controls oxygenation? → FiO2 and PEEP
25. Four-extremity blood pressure measurement in a neonate is performed primarily to screen for which condition? → Coarctation of the aorta
26. A bulging anterior fontanelle in a febrile neonate is a sign of: → Increased intracranial pressure (e.g., meningitis)
27. A neonate receives phenobarbital for seizures. Which side effect requires close monitoring? → Respiratory depression and sedation
28. What is the most common ECMO (extracorporeal membrane oxygenation) complication? → Bleeding
29. A neonate born at 34 weeks has decreased tone, minimal response to stimulation, and poor suck. These findings are MOST consistent with: → Hypotonia from prematurity, birth asphyxia, or CNS depression
30. Hypoxic-ischemic encephalopathy (HIE) is graded using the Sarnat classification. Grade II (moderate) HIE is characterized by: → Lethargy, hypotonia, absent Moro reflex, and possible seizures