RNC-NIC Neonatal Evaluation & Monitoring 2

Question 1

A neonate at 28 weeks gestation has a transcutaneous CO2 reading of 58 mmHg. Which action is most appropriate?

Accepted Answer

Obtain an arterial blood gas to confirm

Answer

Transcutaneous monitors require correlation with ABG before ventilator changes, especially when values are borderline or unexpected.

Question 2

When assessing a neonate using the Ballard Maturational Assessment, which neuromuscular sign indicates greater gestational maturity?

Accepted Answer

Decreased popliteal angle

Answer

A decreased (more restricted) popliteal angle indicates greater muscle tone and neuromuscular maturity.

Question 3

A term neonate has a capillary blood glucose of 38 mg/dL at 2 hours of life. The infant is asymptomatic and breastfeeding. What is the priority nursing action?

Accepted Answer

Recheck glucose after next feeding

Answer

Asymptomatic late preterm and term neonates with borderline glucose levels are managed with feeding and recheck per institutional protocol.

Question 4

Which near-infrared spectroscopy (NIRS) value for cerebral regional oxygen saturation (rSO2) should prompt clinical concern in a NICU neonate?

Accepted Answer

55%

Answer

Cerebral rSO2 below 55-60% is generally considered a threshold for intervention, as it may signal inadequate cerebral oxygen delivery.

Question 5

A 34-week preterm infant on CPAP has nasal flaring, grunting, and subcostal retractions. Using the Silverman-Anderson score, how would this presentation most likely score?

Accepted Answer

Score of 5-7 — moderate distress

Answer

The presence of three signs (flaring, grunting, retractions) but without see-saw respirations or xiphoid retractions typically places the score in the moderate range.

(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 Evaluation & Monitoring 2