RNC-NIC Study test in depth Examination and 100% correctly verified Solutions Latest version 2024/2025
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Course
RNC
Institution
RNC
RNC-NIC Study test in depth Examination and 100% correctly verified Solutions Latest version 2024/2025
How many calories does an infant on TPN need? - correct answer Preemie needs at least 100-110 cal/kg/day
Main calorie component of TPN and amount needed? - correct answer Dextrose
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RNC-NIC Study test in depth Examination and 100%
correctly verified Solutions Latest version 2024/2025
How many calories does an infant on TPN need? - correct answer Preemie needs at
least 100-110 cal/kg/day
Main calorie component of TPN and amount needed? - correct answer Dextrose
Start at 6 mg/kg/min and increase to 10-12 mg/kg/min over a few days
Use of lipids and amount - correct answer For the absorption of fat soluble vitamins
A, D, & E
Start at 1 gm/kg/day and increase to 3 gm/kg/day
What are some diagnostic tests for NEC? - correct answer Platelet less than 100,000
Low or high WBC
acidosis
Abnormal abx and chest X-ray
What is lactase and what role does it play in diagnosing NEC? - correct answer The
enzyme required to metabolize lactose carbohydrates
A positive test for reducing substances in the stool of premature infant indicates
malabsorption of carbs and may be early sign of NEC
What is the purpose of trophic feedings? - correct answer Prevent atrophy of gut and
enhance GI maturation and small intestine motility
May protect preemies from NEC
What are the fluids of choice for trophic feedings and how much should be given? -
correct answer Colostrum, human breast milk, preterm infant formula
,1-2 mL/kg per feeding no more than 15 mL/kg/day
How do preterm formulas differ from term formulas and breast milk? - correct answer
24 cal/oz instead of 20
Increased protein, vitamins and minerals (esp vitamin D, calcium and phosphorous to
prevent osteopenia)
Less lactose (preemies short on lactase)
What are the main sources of calories in infant formulas and how much do they
provide? - correct answer Carbs-1 gram is 3.4 calories; makes up 1/3 of caloric
content
Lipids- 1 gram is 9 calories; makes up 2/3
Protein- 1 gram is 4 calories; less than 5% of caloric content in formulas
—provides amino acids used as building blocks for muscle and other tissue
What is osteopenia of prematurity? How is it diagnosed? - correct answer Decreased
bone mineralization
Craniotabes, impaired linear growth, thickening of wrists and ankles, elevated alkaline
phosphatase in blood serum
What are the risk factors for OOP? - correct answer Prematurity (<34 weeks) bc last
trimester large amounts of Ca and P are provided to fetus
Weight < 1500 g
Delayed onset of enteral feeds
Chronic use of steroids or diuretics by mother or infant
Feeding full term formulas to preterm infants
Role of vitamin A - correct answer Growth & development of tissues, functioning of
immune system
Reduces incidence of BPD
,Role of Vitamin D - correct answer Adequate Ca and P absorption to decrease risk of
rickets
Role of vitamin E - correct answer Limited in preterm infant making them susceptible
to developing hemolytic anemia
Role of Vitamin K - correct answer Clotting process
given shortly after birth to prevent hemorrhagic disease of the newborn
Carnitine and the preterm infant - correct answer Present in human breast milk and
formulas but premature infants have low tissue stores so may need supplementation so
they're better able to metabolize fats
Symptoms of carnitine deficiency - correct answer Increased episodes of apnea
Decreased muscle tone
Poor growth
When must a soy formula be used? - correct answer Galactosemia and hereditary
lactose deficiency
When can soy formula not be used? Why? - correct answer In preterm infants < 1800
g bc it results in less weight gain, increases risk of osteopenia, elevated ALP &
aluminum
What are three types of specialized formulas? - correct answer Pregestimil
Sim PM 60/40
Nutramigen LIPL
, What is pregestimil and when is it used? - correct answer A hypoallergenic formula
that provides predigested protein
For infants with malabsorption caused for GI or hepatobiliary disease
What is sim PM 60/40 and when is it used? Why is it called 60/40? - correct answer
Cows milk based formula with low P content and low renal solute load
For those with impaired renal function o hypocalcemia due to high P
Whey to casein ratio of 60:40
What is nutramigen LIPL and when is it used? - correct answer Hypoallergenic
formula with hydrolysis (digested) proteins that are easier to absorb
Used for infants sensitive to the intact protein found in cows milk based formula
Used when there is a cows milk protein allergy
What is the IV lipid protocol? Possible complications? - correct answer Start with 0.5
g/kg on third DOL & advance slowly to final admin rate of 3-3.5 g/kg/day by 7-10 days
Kernicterus in those with elevated unconjugated bili
Exacerbation of chronic lung dz & persistent pulm HTN
Protocol for iron supplementation in neonates - correct answer Preterm infants
susceptible to iron deficiency due to lack of maternal iron transfer during third trimester
Premature infants fed human milk should have supplemental iron once they reach full
feeds or iron fortified formulas
What is extrauterine growth restriction? What is it associated with? - correct answer
Poor growth after birth common in premature infants (especially VLBW)
Short stature
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