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These 10 free RNC-LRN questions are organized by exam domain, so you can see how each part of the Low Risk Neonatal Nursing blueprint is tested. Reveal the answer and explanation under each question.
After a vaginal birth complicated by shoulder dystocia, a term newborn moves one arm less than the other. Which additional finding most strongly favors a clavicular fracture over an isolated upper brachial plexus injury?
Correct answer: C - Focal tenderness and crepitus over the clavicle
An infant recovering from transient tachypnea is comfortable in room air. A promptly analyzed heel-stick sample from a well-perfused foot shows pH 7.37, PCO2 42 mm Hg, and PO2 38 mm Hg. Pulse oximetry is 96%, with a stable waveform and a displayed pulse matching the auscultated heart rate. How should the apparent mismatch between these oxygen measurements be interpreted?
Correct answer: D - Capillary PO2 cannot reliably substitute for arterial PO2.
A newborn delivered at 37 weeks is 48 hours old and has a total serum bilirubin of 14.7 mg/dL and a cephalohematoma. The infant has remained clinically stable since birth, without hemolysis or sepsis; serum albumin is 3.3 g/dL. At this age, the AAP phototherapy threshold for 37 weeks is 15.4 mg/dL without an additional neurotoxicity risk factor and 13.5 mg/dL with one. Which interpretation correctly selects the threshold?
Correct answer: A - Use 15.4 mg/dL; gestation is already incorporated and no additional risk factor applies.
Eight hours after a planned cesarean birth without labor, a 38-week infant remains tachypneic at 76/min and needs an inspired oxygen concentration of 0.24. A chest radiograph shows mildly increased lung volumes, perihilar streaking, and fluid in the interlobar fissures. The radiographic pattern is most consistent with:
Correct answer: B - Delayed absorption of fetal lung fluid
On day 13, a preterm infant develops abdominal distension, definite tenderness, absent bowel sounds, and visible blood in the stool. Imaging shows pneumatosis intestinalis and a small amount of ascites, without free intraperitoneal air. Laboratory findings include mild metabolic acidosis and a platelet count of 82,000/µL. Blood pressure and perfusion remain adequate, without severe apnea. Feeds have been stopped and treatment for necrotizing enterocolitis has begun. Assign the modified Bell stage that best fits this presentation.
Correct answer: A - Stage IIB: definite NEC with moderate illness
Echocardiography identifies critical coarctation in a 3-day-old infant with poor lower-body perfusion. An alprostadil infusion is started while transfer for cardiac care is arranged. Which flow route is the infusion intended to preserve?
Correct answer: D - Pulmonary artery to descending aorta through the ductus arteriosus
A convalescent infant born at 31 weeks is now 35 weeks 6 days postmenstrual age and stable in room air between feeds. During the last two bottle feeds, coughing and fatigue were followed by an SpO2 of 86% despite a slow-flow nipple and pacing. Each episode stopped when the bottle was removed. NG feeds remain well tolerated, and the abdomen is soft without distension. What feeding plan best addresses this pattern?
Correct answer: C - Pause oral feeds, request a feeding/swallowing assessment, and continue prescribed NG feeds.
During resuscitation, a 36-week newborn remains apneic after 45 seconds of mask ventilation. There is no visible chest movement, an air leak is audible, and the ECG heart rate is 56/min. The next resuscitation priority is to:
Correct answer: D - Correct the mask leak and airway position, then assess chest movement and heart rate.
A 2-kg preterm infant receives D10W at 7.5 mL/hour through a PICC, with stable blood glucose. A revised prescription calls for exactly a 20% reduction in this infusion's volume while preserving its glucose delivery. There are no other IV sources of glucose. Which replacement meets both parts of the prescription?
Correct answer: B - D12.5W at 6 mL/hour
A 39-week infant exposed to prescribed maternal methadone is 68 hours old and is being followed with Eat, Sleep, Console. The infant yawns frequently and has tremors when handled, but breastfeeds effectively, sleeps undisturbed for 85 minutes, and settles within 4 minutes when held by a parent. Vital signs are stable. Which plan fits the current functional assessment?
Correct answer: C - Continue rooming-in, supportive care, and scheduled functional assessments.
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