Neonatal Nurse Practitioner NCC Practice Exam

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• In compensation for a primary metabolic disorder, which value is primarily assessed?
• In Pressure Support Ventilation (PSV), which factors primarily determine the delivered tidal volume?
• What are typical signs of neonatal sepsis in a preterm infant?
• In compensation for a primary respiratory disorder, which value is primarily assessed?
• Which intervention is commonly used to treat surfactant deficiency in preterm infants?
• In suspected necrotizing enterocolitis, which of the following actions constitutes initial management?
• What follow-up is recommended after starting levothyroxine for congenital hypothyroidism?
• For neonates weighing 1-2 kilograms, what HFOV frequency is used?
• The empiric regimen for early-onset neonatal sepsis is typically chosen based on what consideration?
• When should continuous positive airway pressure (CPAP) be initiated in infants at risk for RDS?
• Which condition is listed as a normal anion gap metabolic acidosis cause?
• During metabolic alkalosis, what changes occur in bicarbonate and carbon dioxide?
• Rule of 6 Nasal ET: The estimated depth is equal to which formula?
• Compliance is defined as the change in volume divided by the change in pressure.
• What is the initial management for a neonate with confirmed hypoglycemia who is able to feed?
• When does caput succedaneum resolve?
• Which finding on physical examination is a common sign of NEC?
• Which mode provides breaths synchronized with spontaneous efforts and allows spontaneous breaths between mandatory breaths?
• Which of the following is a metabolic alkalosis cause?
• Rule of 6 Oral ET: The estimated depth is equal to which formula?
• If PDA does not respond to medical closure, what is the next step in management?
• Which HFOV setting directly modulates tidal volume?
• HFOV Rate is expressed as which parameter?
• If a neonate weighs 4 kg, what is the nasal ET depth according to the Rule of 6?
• Which are types of non-invasive respiratory support used in neonates?
• Which statement best describes fetal circulation under the described conditions?
• Which category of disorders is commonly included in the standard newborn metabolic/genetic screening panel alongside metabolic disorders and a hearing screen?
• A left shift in Hb affinity results in which effect?
• What is the typical loading and maintenance dosing range for caffeine citrate in preterm infants?
• Non-invasive respiratory support requires close monitoring for which complication?
• PEEP promotes and improves which lung parameter?
• To improve oxygenation on a ventilator, which parameter is adjusted?
• Which imaging modality is used to screen for brain injuries in preterm infants?
• Essential fatty acids (EFAs) help to improve which aspects?
• In metabolic acidosis with high anion gap, which mechanism contributes to bicarbonate loss?
• Which domains are used in PIPP/NPASS pain scales?
• In the notes, inhaled nitric oxide usage is associated with gestational age greater than which threshold?
• Which practices help keep umbilical catheters clean and safe in the NICU?
• Left shift causes which of the following?
• Which anticonvulsant is commonly used for neonatal seizures?
• In HFOV, which parameter is typically held constant while amplitude changes affect tidal volume?
• Tidal volume is defined as the difference between PIP and PEEP.
• What is the standard empiric antibiotic regimen for early-onset neonatal sepsis in many centers?
• In conventional ventilation, CO2 removal is most affected by which factors?
• High-Frequency Jet Ventilation (HFJV) works by which mechanism?
• Which statement describes oxygenation in neonatal ventilation?
• APGAR score less than 3 indicates which level of resuscitation?
• If you increase frequency while decreasing amplitude, what is the expected effect on CO2?
• Which factor is referenced as a consideration for iNO use in neonates?
• Which statement correctly describes the 'Rule of 6' for oral endotracheal tube depth?
• Which of the following is a fetal response to hypoxia?
• Pressure Support Ventilation (PSV) involves inspiration controlled by preset pressure. What determines the tidal volume?
• To increase CO2 with HFJV and CV, which adjustment is suggested?
• Volume Control Ventilation delivers which characteristic?
• Which of the following describes the nasal Rule of 6 for ETT depth?
• Which statement best describes High-Flow Nasal Cannula (HFNC) oxygen delivery?
• What effect does breast milk have on NEC risk?
• Ventilation primarily involves which process?
• Parenteral nutrition in the NICU is indicated when enteral feeding is contraindicated or insufficient.
• To decrease FiO2 and MAP while using HFJV with CV, which option is recommended?
• For neonates weighing greater than 2 kilograms, what HFOV frequency is used?
• To decrease CO2 on HFOV, which adjustment combination is recommended?
• Which sign can be associated with NEC in neonates?
• If a neonate weighs 3 kg, what is the oral ET depth according to the Rule of 6?
• If a hypoglycemic neonate does not respond to feeding, what is the next step in management?
• What is the initial management for suspected neonatal meningitis?
• Which signs indicate neonatal dehydration?
• Biophysical Profile assesses five variables in the fetus; which is NOT one of them?
• How does caput succedaneum feel?
• Caput succedaneum crosses suture lines?
• Which combination of actions constitutes initial management for suspected NEC?
• In suspected NEC, which imaging is typically obtained to evaluate disease?
• Which equation represents the time constant in neonatal respiratory mechanics?
• What is the typical respiratory rate range for a healthy term neonate at rest?
• Right shift causes which of the following?
• Before initiating anticonvulsant therapy for suspected neonatal seizures, what step is typically performed?
• During HFOV, which parameters are typically decreased to minimize lung injury?
• Right shift in Hb affinity is associated with which combination?
• Exhalation during HFJV is a result of
• In suspected neonatal meningitis, what is the rationale for obtaining CSF via lumbar puncture before starting antibiotics?
• Which two components determine the time constant in respiratory mechanics?
• Intermittent Mandatory Ventilation (IMV) is best described as what?
• Which statement correctly describes a right shift?
• Fetal circulation in blood vessels is described as which of the following?
• Caloric needs in the NICU are typically adjusted based on which factors?
• What does a positive direct Coombs test indicate in a neonate with jaundice?
• HFOV is commonly used in which newborn conditions?
• For neonates weighing less than 1 kilogram, what HFOV frequency is used?
• In HFOV, which parameter determines the tidal volume delivered around a constant MAP?
• Assist Control ventilation is characterized by which of the following?
• Which pathogens are most commonly associated with early-onset neonatal sepsis?
• How would you recognize a patent ductus arteriosus clinically in a newborn?
• Which statement correctly describes the 'Rule of 6' for nasal endotracheal tube depth?
• Which two conditions are most common causes of respiratory distress in term neonates within the first hours of life?
• Which statement about universal newborn hearing screening is NOT true?
• What is the primary purpose of obtaining abdominal radiographs in NICU patients with gastrointestinal concerns?
• What is a common medical strategy to close a hemodynamically significant PDA in neonates?
• Alkalosis is described as which combination?
• What is a major sign of neonatal abstinence syndrome?
• Which of the following is NOT a characteristic feature of a patent ductus arteriosus?
• Which statement best describes safety measures for phototherapy to prevent dehydration?
• Caput succedaneum is best described as edema under the scalp due to presenting part of head against the cervix.
• What is the role of parenteral nutrition in the NICU?
• What is the recommended initial approach when a neonate has fever with no obvious source?
• Which HFOV parameter adjustments are described as decreasing during optimization?
• Why is intrapartum prophylaxis against GBS recommended?
• In HFOV, which parameter primarily governs oxygenation?
• Resistance is defined as the change in pressure divided by the change in flow.
• In a term newborn during the first 24 hours, what is the normal resting heart rate range?
• To decrease CO2 when using HFJV with CV, which adjustment is recommended?
• How does maternal diabetes affect neonatal glucose homeostasis?
• Not a non-invasive respiratory support modality is which option?
• In HFOV, the golden rule calls for titrating AMP in increments until chest wiggle is observed. By what increment should AMP be increased?
• Mean Airway Pressure (Paw) is defined as what?
• Which statement is accurate about starting MAP for HFOV in RDS vs PIE?
• What is the primary goal of phototherapy in neonatal jaundice?
• After discharge from the NICU, how should growth be tracked in a neonate?
• Which radiographic finding is most characteristic of transient tachypnea of the newborn (TTN)?
• Which ventilation mode may interfere with an infant's spontaneous breathing due to scheduled breaths?
• In preterm infants, what is the primary role of neonatal cranial ultrasound?
• What screening tests are part of the standard newborn metabolic/genetic screen?
• Metabolic acidosis compensation is described as which change?
• Not a cause of metabolic alkalosis?
• A left shift in the oxyhemoglobin dissociation curve results in which of the following?
• Arterial PO2 reflects the exchange of oxygen.
• What is the recommended strategy to increase oxygenation when FiO2 is already high?
• On chest radiographs, which finding best differentiates TTN from RDS?
• Which condition is a cause of metabolic acidosis with normal anion gap?
• What are the steps in resuscitating a non-breathing newborn at birth?
• Which of the following is true about arterial oxygen tension as an indicator of gas exchange?
• Which option correctly describes the recommended vitamin K administration at birth?
• Which timeframe is associated with fetal fibronectin testing predicting birth?
• When is exchange transfusion indicated in neonatal hyperbilirubinemia?
• What is the key difference highlighted between PIP and PEEP?
• In HFJV, exhalation depends primarily on what mechanism?
• Therapeutic hypothermia for a term infant with suspected HIE is considered under which conditions?
• What is the primary purpose of non-invasive respiratory support in neonates?
• What is used to fortify breast milk for a very low birth weight infant?
• Which APGAR interpretation corresponds to a need for intensive resuscitation?
• What is the standard initial therapy for suspected RDS in a preterm infant?
• CPAP can be delivered how?
• In respiratory alkalosis compensation, which changes occur?
• Which of the following best describes a factor that affects mean airway pressure (Paw)?
• Which radiographic feature is more typical of respiratory distress syndrome (RDS) in a preterm infant?
• In respiratory acidosis compensation, which changes occur?
• HFOV rate is quantified by which term?
• What is the HFOV Oxygenation Golden Rule for RDS: where should the initial MAP be positioned relative to the CV MAP?
• What is the primary purpose of thermoregulation in the immediate neonatal period?
• Which approach best supports bonding between the newborn and family in the NICU?
• To increase FiO2, MAP, and iTime to improve oxygenation on HFJV with CV, which choice matches?
• How is neonatal hypoglycemia defined in term infants?
• Which statement about iNO usage is supported by the notes?
• Why is caffeine citrate used in neonatal care?
• Which statement best describes HFOV oxygenation in relation to MAP?
• Which weight category uses a HFOV frequency of 15 Hz?
• Why is maternal GBS screening and intrapartum prophylaxis important?
• Which HFOV parameter adjustments are described as decreasing during optimization?
• What is the initial management approach for a febrile neonate with no identified source?
• During neonatal phototherapy, which safety measures are essential to prevent injury?
• To increase CO2 on HFOV, which adjustment combination should be made?
• For PIE/Air Leak HFOV, what MAP relative to CV should be used?
• Factors that impact oxygenation include which combination?
• Which radiographic finding is highly suggestive of NEC?
• Which of the following best describes bicarbonate-related disturbances?
• Which chronic lung disease is commonly seen in preterm infants?
• Nasal CPAP interfaces include which delivery methods?
• If congenital hypothyroidism is diagnosed after birth, what is the recommended initial management?
• What impacts infant CO2 removal?
• Which parameter is primarily used on HFOV to adjust oxygen delivery?
• Acidosis is described as which pattern?
• Normal neonatal tidal volume is 4-6 mL/kg.
• Which of the following statements describes a left shift?
• APGAR score of 4-6 indicates which level of resuscitation efforts?
• Which two HFOV parameters are used together to increase oxygenation?
• Neonatal GBS infection typically occurs at what age after birth?
• HFNC stands for which term?
• HFJV are used for which conditions?
• What is the safe target range for blood glucose in a hypoglycemic neonate to avoid brain injury?
• What are the core elements of family-centered care in the NICU?
• When should removal of an umbilical catheter be considered?
• Which of the following represents a cause of metabolic acidosis with high anion gap?
• Which of the following is NOT a Biophysical Profile parameter?
• How should neonatal pain be assessed?
• In an uncompensated respiratory disorder, which of the following is usually normal?
• In HFJV with CV, what is the reported effect on CO2?
• To increase oxygenation on HFOV, which adjustment combination should be used?
• HFJV is commonly used to treat which disorders?
• For oxygenation during HFJV or CV, which two factors are involved?
• Nasal CPAP is delivered as what?
• A left shift in Hb affinity is associated with which condition?
• Which two adjustments are typically made to reduce oxygen exposure during HFOV?
• HFOV Oxygenation Golden Rule for PIE/Air Leak: what MAP reference should be used relative to CV, and what else should be adjusted?
• An uncompensated respiratory disorder would show which of the following?
• Fetal fibronectin (fFN) testing indicates a high probability of birth within which timeframe?
• In HFOV, which parameter primarily governs oxygenation?
• CPAP stands for which of the following?
• What is the recommended HFOV amplitude (AMP) range?
• Name two common electrolyte disturbances seen in preterm infants due to immature renal function.
• Which adjustment would increase CO2 according to the source?
• Which concept describes the storage volume in the lungs at the end of passive expiration?
• Synchronized Intermittent Mandatory Ventilation (SIMV) delivers breaths that are:
• What is the typical first-line management of neonatal pain during procedures?
• Paw is affected by which of the following?
• In NICU care, what is the approximate target caloric intake for most term neonates?
• In metabolic alkalosis, which combination of changes characterizes the compensatory response?
• What does a universal newborn hearing screen assess?
• High Frequency Oscillatory Ventilation (HFOV) has which feature regarding inspiration and expiration?