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RNC NIC Exam Questions and answers | With complete solution 2024/25

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RNC NIC Exam Questions and answers | With complete solution 2024/25

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  • August 11, 2024
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RNC NIC Exam Questions and answers |
With complete solution 2024/25
GIR - 6-8mcg/kg/min caloric intake
ii ii ii ii ii ii




ii D10 Bolus - 2mL/kg ii ii ii ii ii




ii Fluid Volume Bolus - 10mL/kg ii ii ii ii ii ii




Term Parenteral Fluid Requirement - 80mL/kg/day
ii ii ii ii ii ii ii ii



Enteral 100-150 mlk/kg/day ii ii




Preterm Parenteral Fluid Requirement - 120
ii ii ii ii ii ii ii ii



Enteral 150-200ml/kig/day ii




ii GIR Calculation - (%dextrose x IV rate) / (6 x wt in kg)
ii ii ii ii ii ii ii ii ii ii ii ii ii ii




ii I/T ratio - %Metas + Bands / %Metas + Bands + Segs
ii ii ii ii ii ii ii ii ii ii ii ii ii ii




I/T ratio greater than >0.2 to >.25 suggestive of infection
ii ii ii ii ii ii ii ii ii



>0.8 associated with shock ii ii ii




Absolute Neutrophil COUNT - WBC x (%) Segmented neutrophils + band neutrophils +
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii



metamyelocytes
ii




Example. 15,000 x 35 segs + 15 bands + 3 metas (turns into percent) ii ii ii ii ii ii ii ii ii ii ii ii ii



15,000 x .53 = 7950 ii ii ii ii




ANC <1800 suggestive of infection
ii ii ii ii



Normal Range ii




ii Mature WBCs - Poly, Segs, Neutrophils ii ii ii ii ii ii ii




ii Immature WBCs - Meta, Bands, Stabs ii ii ii ii ii ii ii




Platelet Range - 150-400k
ii ii ii ii ii ii



Thrombocytopenia (< 100,000/mm 3 ): possible association with bacterial sepsis or viral ii ii ii ii ii ii ii ii ii ii ii



infection, but usual onset does not occur until 1 to 3 days after infection onset (late
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indicator). May also occur with maternal HELLP syndrome ( h emolysis, e levated l iver
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function test results, and l ow p latelet count), pregnancy-induced hypertension, and
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intrauterine growth restriction, as well as some syndromes such as trisomies 13, 18, and
ii ii ii ii ii ii ii ii ii ii ii ii ii ii



21, Turner's syndrome, and hemolytic disease.
ii ii ii ii ii ii




ii CRP level - CRP level usually <1.6 for the first two days of life
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii

,Elevated cord blood CRP levels are associated with chorioamnionitis with prolonged
ii ii ii ii ii ii ii ii ii ii



rupture of membranes.
ii ii ii




Most common pathogens - Currently, GBS
ii ii ii ii ii ii ii ii



E. coliii




Candidas - -Diaper dermatitis presents with intense erythema and satellite lesions.
ii
ii
ii ii ii ii ii ii ii ii ii ii ii ii ii




-Congenital candidiasis presents with widespread erythematous maculopapular rash, and ii ii ii ii ii ii ii ii



preterm infants may present with pneumonia.
ii ii ii ii ii ii




Congenital CMV infection - congenital infection include: intrauterine growth restriction,
ii ii ii ii ii ii ii ii ii ii ii ii



hepatosplenomegaly, jaundice, purpura, pneumonitis, microcephaly, hydrocephalus,
ii ii ii ii ii ii



intracerebral calcifications, hearing loss, chorioretinitis, and optic atrophy.
ii ii ii ii ii ii ii ii




ii Endotracheal Measurement - 6 + wt in kg ii ii ii ii ii ii ii ii ii ii




Proper placement on an endotracheal tube is midway between the thoracic inlet and the
ii ii ii ii ii ii ii ii ii ii ii ii ii



carina.
ii




Polyethelane Wrap for Infant < 29 weeks - Dry infants head only
ii ii ii ii ii ii ii ii ii ii ii ii ii ii



Place infant in bag, from neck down
ii ii ii ii ii ii



Remove bag once infant is in an NTE and humidified environment
ii ii ii ii ii ii ii ii ii ii




UAC Placement - High Placement T6-T9
ii ii ii ii ii ii ii ii



Low Placement L3-L4
ii ii




UVC Placement - 1 to 2cm above the diaghragm
ii ii ii ii ii ii ii ii ii ii ii ii



Low Lying 2-4cm in the cord
ii ii ii ii ii




Chest Tube Placement - Mid Clavicular line with distal chest tube hole inside the thoracic
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii



space
ii




lecithin/sphingomyelin (L/S) ratio - An L/S ratio greater than 2:1 is considered to indicate
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii



fetal lung maturity.
ii ii ii




Anatomic events Five stages of lung development - 1. Embryonic development (weeks 1
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii



to 5). The endoderm-derived embryonic foregut provides a single lung bud that begins to
ii ii ii ii ii ii ii ii ii ii ii ii ii ii



divide ventrocaudally through the mesenchyme surrounding the foregut. The pulmonary
ii ii ii ii ii ii ii ii ii ii



vein develops and extends to join the lung bud. The trachea develops at the end of the
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii



embryonic period. There are three divisions on the right side and two on the left side that
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii



will eventually become the lobes of the lungs.
ii
ii
ii ii ii ii ii ii ii ii




2. Pseudoglandular period (weeks 6 to 16). All conducting airways are formed. Cartilage
ii ii ii ii ii ii ii ii ii ii ii ii



appears; main bronchi are formed; demarcation of major lobes occurs; formation of new
ii ii ii ii ii ii ii ii ii ii ii ii ii



bronchi is complete; capillary bed is formed with connecting bronchial blood supply; no
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connection made with terminal air sacs. The lung at this time undergoes 14 more
ii ii ii ii ii ii ii ii ii ii ii ii ii ii

,generations of branching and the formation of the terminal bronchioles. The lung
ii ii ii ii ii ii ii ii ii ii ii ii



resembles an exocrine organ because of surrounding loose mesenchymal tissues, hence
ii ii ii ii ii ii ii ii ii ii ii



the name pseudoglandular .
ii
ii
ii ii ii ii




3. Canalicular period (weeks 16 to 26). Formation of gas-exchanging acinar units (i.e.,
ii ii ii ii ii ii ii ii ii ii ii ii



respiratory units). The appearance of glycogen-rich cuboidal cells and inclusions for
ii ii ii ii ii ii ii ii ii ii ii



surface-active material storage are seen; capillaries invade terminal airway walls; type II
ii ii ii ii ii ii ii ii ii ii ii ii



alveolar epithelial cells appear. Airway changes from glandular to tubular and increases in
ii ii ii ii ii ii ii ii ii ii ii ii ii



length and diameter. Vascular system proliferates and the capillaries are now closer to the
ii ii ii ii ii ii ii ii ii ii ii ii ii ii



epithelium-conducting airways. Respiratory bronchioles that will participate in gas
ii ii ii ii ii ii ii ii ii



exchange can be differentiated.
ii
ii
ii ii ii ii




4. Terminal sac period (weeks 26 to birth). Around week 26 alveolar sacs are formed; air-
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii



blood surface area is limited for gas exchange; and type II cells are unable to release
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii



surfactant in sufficient quantity to maintain air breathing. Capillary loops increase; type II
ii ii ii ii ii ii ii ii ii ii ii ii ii



cells cluster at alveolar ducts, beco
ii ii ii ii ii ii




IUGR asymmetrical - Weight low for Gestation Age
ii ii ii ii ii ii ii ii ii ii



Head Sparing (less restriction on brain growth)
ii ii ii ii ii ii



Old man appearance
ii ii



Appear wasted, thin ii ii




Results from: Poor Placental function ii ii ii ii



Maternal Hypertension* ii



Smoking

IUGR Symmetric - Lower weight, height, length, and head circumference for gestational
ii ii ii ii ii ii ii ii ii ii ii ii ii ii



age
ii




Results from intrauterine viral infection, chromosomal genetic abnormalities, long standing
ii ii ii ii ii ii ii ii ii



disease
ii




ii Prostaglandin E1 (alprostadil) - Prevent premature closure of the PDA ii ii ii ii ii ii ii ii ii ii ii




Side Effects: Apnea, hypotension, hyperthermia, bradycardia
ii ii ii ii ii




Indomethicin (NSAID - 1. Hypoglycemia
ii ii ii ii ii ii ii



2. Platelet dysfunction
ii ii



3. Gastrointestinal perforation w/ steroids
ii ii ii ii



4. Renal effects, decreases urine output!
ii ii ii ii ii ii




Used if PDA fails to close to prevent pulmonary over circulation and PPHN
ii ii ii ii ii ii ii ii ii ii ii ii




Diuretics effects - 1. Metabolic Alkalosis
ii ii ii ii ii ii ii ii



2. Ototoxicity
ii



3. Decreased calcium absorption in bones
ii ii ii ii ii




ii Theophylline - Bronchodilator. Opens airways. ii ii ii ii ii ii ii

, Short half life, caffeine preferred treatment due to longer half life and more tolerable side
ii ii ii ii ii ii ii ii ii ii ii ii ii ii



effect profile.
ii ii




Digoxin - Enhances contractility
ii ii ii ii ii ii



Inhibits Na + K+ ATP ii ii ii ii



Reduces HR, CI'd if HR <60 ii ii ii ii ii



Hypokalemia increases drug concentration ii ii ii




Most frequent disorder associated with downsyndrome - Deudonal Atresia
ii ii ii ii ii ii ii ii ii ii ii



Double Bubble ii



May see VSD, AV Canal, Tetralogy of Fallot
ii ii ii ii ii ii ii




ii Upper GI Gold Standard for - Malrotation
ii ii ii ii ii ii ii ii




Position for gastroschesis - Lateral (side lying) to prevent occlusion of the mesenteric
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii



arteries that supply blood to the bowel. Tie bag to the axilla.
ii ii ii ii ii ii ii ii ii ii ii ii




ii VACTERAL, associated with what two disorders? - TEF/EA ii ii ii ii ii ii ii ii ii




vertebral defects ii



anal atresia
ii



cardiac anomalies ii



trachoesophageal fistula ii



radial defects ii ii



renal and limb anomalies
ii ii ii




Hirschbrung Disease - Starts in distal rectum
ii ii ii ii ii ii ii ii ii



Clinical sign : failure to pass meconium within first 24-48 hours
ii ii ii ii ii ii ii ii ii ii



May be associated with bilious emesis and a distended abdomen
ii ii ii ii ii ii ii ii ii



Associated with CF ii ii




Types of test to determine diagnosis: Barium enema, biopsy of rectum
ii ii ii ii ii ii ii ii ii ii




Congenital Diaphragmatic Hernia - Space occupying lesion, intestinal contents fill the
ii ii ii ii ii ii ii ii ii ii ii ii ii



lung cavity
ii ii ii



Presents with a scaphoid abdomen, barrel chest ii ii ii ii ii ii ii



Can result in pulmonary hypoplasia, pulmonary hypertension
ii ii ii ii ii ii



Requires intubation, HFOV, ECMO ii ii ii



Insert OG or NG tube ii ii ii ii ii



CPAP is Contraindicated! ii ii




Clinical Signs of Pyloric Stenosis - Dehydration
ii ii ii ii ii ii ii ii ii



Non bilious projectile vomiting
ii ii ii



Peristaltic waves in the epigastrium ii ii ii ii ii



Electrolyte disturbances ii

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