RNC-NIC Neonatal Assessment 5

Question 1

A neonate at 28 weeks gestation has a PaO2 of 45 mmHg on room air. The nurse understands that fetal hemoglobin (HbF) affects oxygen transport by:

Accepted Answer

Shifting the oxyhemoglobin dissociation curve to the left, binding O2 more avidly

Answer

Fetal hemoglobin has a higher oxygen affinity (left-shifted curve) than adult hemoglobin, allowing it to extract oxygen from maternal blood at the placenta but also making O2 release to tissues less efficient.

Question 2

A nurse assesses a neonate and notes jaundice visible on the thighs and upper arms. Using Kramer's rule, this distribution of jaundice corresponds to an estimated serum bilirubin level of approximately:

Accepted Answer

12-14 mg/dL

Answer

Kramer's rule estimates that jaundice extending to the thighs (zone 4) correlates with serum bilirubin levels of approximately 12-14 mg/dL, progressing cephalocaudally with rising levels.

Question 3

During assessment of a neonate with suspected meconium aspiration syndrome (MAS), the nurse should prioritize monitoring for which complication?

Accepted Answer

Persistent pulmonary hypertension of the newborn (PPHN)

Answer

Meconium aspiration causes pulmonary vasoconstriction and airway obstruction, frequently leading to persistent pulmonary hypertension of the newborn (PPHN) as a serious complication.

Question 4

A nurse is assessing a neonate for pain using the NIPS (Neonatal Infant Pain Scale). Which parameter is included in this tool?

Accepted Answer

Facial expression

Answer

The NIPS assesses facial expression, cry, breathing pattern, arm position, leg position, and state of arousal — blood pressure, SpO2, and pupillary response are not included.

Question 5

A neonate born at 39 weeks gestation has a head circumference of 37 cm, length of 52 cm, and weight of 3,900 g. These measurements plot at the 90th, 75th, and 85th percentiles respectively. This infant is classified as:

Accepted Answer

Appropriate for gestational age (AGA)

Answer

All measurements between the 10th and 90th percentiles classify the neonate as appropriate for gestational age (AGA), indicating normal intrauterine growth.

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

RNC-NIC Neonatal Assessment 5