RNC-NIC Practice Test (15 Questions)

9%

General Assessment

Connect antepartum and intrapartum risk with gestational-age assessment, growth, physical findings, neurobehavior, and the first signs that a neonate is not transitioning normally.

• Identify the neonatal significance of maternal disease, infection, medication exposure, membrane or fluid disorders, fetal testing, fetal heart patterns, labor complications, obstetric emergencies, and delivery method
• Interpret weight, length, head circumference, gestational age, maturity, and AGA, SGA, LGA, preterm, term, or post-term classification
• Perform systematic physical, neuromuscular, reflex, neurobehavioral, respiratory, cardiovascular, abdominal, genitourinary, musculoskeletal, skin, and HEENT assessment
• Differentiate expected transitional findings from abnormalities requiring immediate intervention or escalation

39%

General Management

Provide stabilization and ongoing neonatal intensive care across resuscitation, homeostasis, nutrition, respiratory support, thermoregulation, pharmacology, pain, and developmental care.

• Apply neonatal resuscitation principles, including initial evaluation, ventilation, intubation, compressions, epinephrine, volume expansion, and stabilization of diaphragmatic hernia, hydrops, asphyxia, or airway obstruction
• Monitor and manage fluids, electrolytes, glucose, urine output, insensible losses, humidity, maturity-related needs, dehydration, overhydration, and parenteral therapy
• Provide individualized enteral, gavage, oral, breast-milk, donor-milk, fortified, supplemental, and parenteral nutrition while recognizing feeding intolerance and complications
• Interpret oxygenation, saturation, blood gases, lactate, and acid-base status and safely support noninvasive, conventional, high-frequency, or extracorporeal respiratory therapies
• Maintain neutral thermal and skin environments; apply neonatal dosing, administration, therapeutic monitoring, interaction, resistance, withdrawal, and medication-safety principles
• Provide neuroprotective, neurodevelopmental, pain, positioning, handling, kangaroo-care, sensory, light, noise, sleep, and stress-reduction interventions

44%

Assess and Manage Pathophysiologic States

The largest domain requires recognition and management of neonatal disease across organ systems, integrating presentation, causes, diagnostics, therapies, complications, and expected outcomes.

• Differentiate transitional, congenital, rhythm, structural, perfusion, PDA, heart-failure, tamponade, hypertension, and shock states using cardiovascular assessment and monitoring
• Recognize and manage apnea, BPD, diaphragmatic or pulmonary hypoplasia, meconium aspiration, PPHN, air leak, hemorrhage, RDS, TTN, airway intervention, surfactant, and chest drainage
• Assess GI and GU maturation and disorders including NEC, obstruction, perforation, reflux, malrotation, abdominal-wall defects, short gut, renal failure, thrombosis, genital anomalies, and ostomy care
• Interpret blood counts, bilirubin, antibody studies, and coagulation data and manage anemia, jaundice, DIC, polycythemia, incompatibility, thrombocytopenia, phototherapy, and blood products
• Manage HIE, IVH, PVL, hydrocephalus, seizures, hemorrhage, neural-tube or neuromuscular injury, and related neurodevelopmental risk
• Recognize genetic, chromosomal, metabolic, endocrine, glucose, calcium, screening, HEENT, airway, infection, sepsis, meningitis, immune, and nosocomial conditions

5%

Psychosocial Support

Support families through hospitalization, changing prognosis, attachment, discharge, special needs, grief, palliative care, mental health, and culturally responsive shared decision-making.

• Plan discharge education for routine and special-needs care, medications, equipment, feeding, safe sleep, car seats, CPR, screening, immunization, follow-up, and developmental surveillance
• Assess attachment, parent and sibling responses, stress, distance, adolescent or extended-family needs, barriers to interaction, and opportunities for participation
• Recognize anticipatory, acute, complicated, and incongruent grief and connect families with bereavement, peer, mental-health, and palliative-care resources
• Use counseling, teaching, cultural humility, shared decision-making, and conflict-resolution strategies while recognizing postpartum depression and post-traumatic stress

3%

Professional Issues

Apply ethical, legal, evidence-based, quality, staffing, communication, and patient-safety principles to neonatal intensive care nursing.

• Apply autonomy, beneficence, nonmaleficence, justice, consent, documentation, regulation, scope, liability, negligence, and malpractice principles
• Address staffing and assignment concerns through policy, chain-of-command, objective communication, and professional accountability
• Use reliability, validity, significance, levels of evidence, research utilization, quality improvement, and safety reporting appropriately
• Communicate effectively within the interprofessional team and escalate emerging safety or clinical concerns