RNC-NIC Neonatal Evaluation & Monitoring 3

Question 1

A neonate born at 30 weeks has persistent metabolic acidosis with base deficit of -10. Which assessment finding is most consistent with this lab result?

Accepted Answer

Prolonged capillary refill and mottled skin

Answer

Poor perfusion signs such as prolonged capillary refill and mottled skin reflect inadequate tissue oxygen delivery, consistent with metabolic acidosis.

Question 2

Which electrolyte abnormality is most commonly associated with jitteriness, seizures, and hypotonia in the first 48 hours of life in a preterm neonate?

Accepted Answer

Hypocalcemia

Answer

Hypocalcemia is the most common cause of neonatal jitteriness and seizures in the first 48 hours, particularly in preterm infants.

Question 3

When evaluating a neonate's chest X-ray, which finding is characteristic of respiratory distress syndrome (RDS)?

Accepted Answer

Ground-glass appearance with air bronchograms

Answer

RDS presents with a diffuse ground-glass appearance and air bronchograms due to widespread alveolar collapse from surfactant deficiency.

Question 4

A 36-week infant has a total serum bilirubin of 12 mg/dL at 24 hours of life. According to the Bhutani nomogram, this falls in which zone?

Accepted Answer

High risk

Answer

A bilirubin of 12 mg/dL at 24 hours plots in the high-risk zone on the Bhutani hour-specific nomogram, requiring immediate evaluation and likely phototherapy.

Question 5

Which assessment tool is specifically validated to evaluate pain in preverbal neonates in the NICU setting?

Accepted Answer

NPASS (Neonatal Pain, Agitation, and Sedation Scale)

Answer

The NPASS is a validated, NICU-specific tool that assesses both pain/agitation and sedation levels in neonates.

(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 3