RNC-NIC Neonatal Intensive Care Nurse Basic 4

Question 1

A 30-week premature neonate is started on caffeine citrate therapy. What is the primary indication for this medication in the NICU?

Accepted Answer

Prevention and treatment of apnea of prematurity

Answer

Caffeine citrate is the first-line treatment for apnea of prematurity, stimulating the central respiratory drive.

Question 2

Which complication is the NICU nurse most concerned about when a preterm infant receives a rapid IV fluid bolus?

Accepted Answer

Intraventricular hemorrhage

Answer

Rapid fluid boluses can cause sudden fluctuations in cerebral blood flow, increasing the risk of intraventricular hemorrhage in preterm neonates.

Question 3

A nurse is preparing to administer surfactant to a 26-week neonate. Which route is used for administration?

Accepted Answer

Directly into the endotracheal tube

Answer

Surfactant is instilled directly into the lungs via the endotracheal tube to coat alveolar surfaces and reduce surface tension.

Question 4

A neonate has a serum sodium of 125 mEq/L and is symptomatic with seizures. What is the most appropriate initial treatment?

Accepted Answer

Administer hypertonic 3% saline slowly

Answer

Symptomatic hyponatremia with seizures requires cautious correction with hypertonic saline to raise sodium rapidly enough to stop seizures.

Question 5

Which assessment tool is most commonly used to evaluate pain in nonverbal neonates in the NICU?

Accepted Answer

CRIES or N-PASS Scale

Answer

Validated neonatal pain tools like CRIES and N-PASS use behavioral and physiologic indicators since neonates cannot self-report pain.

Neonatal Intensive Care Nurse Exam Practice Test