RNC-NIC Neonatal Evaluation & Monitoring 4

Question 1

A term neonate's cranial ultrasound shows a germinal matrix hemorrhage confined to the caudothalamic groove. This is classified as which grade?

Accepted Answer

Grade I IVH

Answer

Grade I (or subependymal) hemorrhage is confined to the germinal matrix at the caudothalamic groove without ventricular involvement.

Question 2

Which amplitude-integrated EEG (aEEG) pattern is most consistent with severe hypoxic-ischemic encephalopathy requiring therapeutic hypothermia?

Accepted Answer

Burst suppression pattern

Answer

Burst suppression on aEEG — alternating high-amplitude bursts with suppressed background — indicates severe cortical dysfunction consistent with HIE.

Question 3

A neonate receiving therapeutic hypothermia has a heart rate of 88 bpm. The RNC recognizes this as:

Accepted Answer

An expected physiologic response to cooling

Answer

Mild bradycardia (80-100 bpm) is an expected and acceptable physiologic response to therapeutic hypothermia in neonates with HIE.

Question 4

When performing a gestational age assessment using the New Ballard Score, a score of 25 corresponds to approximately which gestational age?

Accepted Answer

32 weeks

Answer

On the New Ballard Score, a total score of 25 corresponds to approximately 32 weeks gestation.

Question 5

A 25-week neonate on high-frequency oscillatory ventilation (HFOV) has a MAP of 12 cmH2O and amplitude of 30. The CO2 is 68 mmHg. Which adjustment addresses hypercarbia on HFOV?

Accepted Answer

Increase amplitude (delta P)

Answer

On HFOV, CO2 elimination is primarily controlled by amplitude (delta P); increasing amplitude improves CO2 clearance.

(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 4