RNC-NIC Developmental Care 2 — Questions and Answers
Question 1: A 28-week gestation neonate is positioned in a flexed, midline position with boundaries. Which physiologic benefit does this position primarily promote?
- Increased caloric expenditure
- Neuromuscular development and tone regulation (Correct answer)
- Enhanced gastric emptying
- Reduced need for supplemental oxygen
Correct answer: Neuromuscular development and tone regulation
Flexed midline positioning with boundaries mimics the intrauterine environment, promoting appropriate neuromuscular development and tone regulation in preterm neonates.
Question 2: The NICU team is implementing a clustered care protocol. What is the primary developmental rationale for grouping care activities?
- To reduce nursing workload
- To allow for longer uninterrupted sleep and rest cycles (Correct answer)
- To decrease the number of IV medications
- To improve parental visitation schedules
Correct answer: To allow for longer uninterrupted sleep and rest cycles
Clustering care minimizes repeated disturbances, allowing the preterm infant to experience longer uninterrupted sleep and rest cycles critical for brain development.
Question 3: A nurse observes a 30-week neonate displaying finger splaying, arching, and hiccupping during a feeding attempt. These cues are BEST interpreted as:
- Readiness cues indicating hunger
- Stress or disengagement cues (Correct answer)
- Approach behaviors signaling social interaction
- Signs of neurological maturity
Correct answer: Stress or disengagement cues
Finger splaying, arching, and hiccupping are stress/disengagement cues indicating the infant is overwhelmed and needs a pause or cessation of stimulation.
Question 4: Kangaroo care (skin-to-skin contact) has been shown to have which of the following effects on preterm neonates?
- Increased cortisol levels and stress response
- Improved thermoregulation and breastfeeding rates (Correct answer)
- Decreased oxygenation and increased apnea episodes
- Reduced parental bonding due to monitor alarms
Correct answer: Improved thermoregulation and breastfeeding rates
Kangaroo care stabilizes thermoregulation via maternal body heat and promotes breastfeeding by increasing milk production and infant readiness to feed.
Question 5: When assessing a preterm infant's sleep state for developmental care planning, which state is MOST conducive to learning and social interaction?
- Deep sleep (quiet sleep)
- Active sleep (REM sleep)
- Quiet alert state (Correct answer)
- Crying state
Correct answer: Quiet alert state
The quiet alert state is optimal for learning and social interaction as the infant is awake, calm, and receptive to environmental stimuli.
Question 6: A family asks why their 26-week infant's incubator is covered with a blanket. The BEST developmental care rationale the nurse should provide is:
- The blanket prevents heat loss from the incubator
- Reducing light exposure supports circadian rhythm development and decreases stress (Correct answer)
- It prevents staff from being distracted by the infant
- The blanket blocks noise from the NICU monitors
Correct answer: Reducing light exposure supports circadian rhythm development and decreases stress
Covering the incubator reduces ambient light exposure, supporting emerging circadian rhythm development and minimizing the stress response from continuous bright lighting.
Question 7: Which intervention BEST supports oral feeding development in a preterm infant not yet ready for nipple feeding?
- Increasing gavage feeding volume to accelerate readiness
- Non-nutritive sucking (NNS) during gavage feedings (Correct answer)
- Delaying all oral stimulation until 36 weeks corrected age
- Offering a bottle every feed to practice sucking
Correct answer: Non-nutritive sucking (NNS) during gavage feedings
Non-nutritive sucking during gavage feeds promotes sucking skill development, improves digestion, and supports the transition to oral feeding without the stress of full nutritive feeding.
RNC-NIC Developmental Care 2
A 28-week gestation neonate is positioned in a flexed, midline position with boundaries.
Which physiologic benefit does this position primarily promote?