Free Low Risk Neonatal Intensive Care Nursing examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Low Risk Neonatal Intensive Care Nursing examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1During a neonatal admission handoff, the nurse compares maternal histories of genital herpes. Which history places the infant in the highest perinatal transmission-risk group?

   1. A. Recurrent genital herpes documented before pregnancy
   2. B. First acquisition of genital herpes shortly before delivery
   3. C. First acquisition of genital herpes early in pregnancy
   4. D. Remote genital herpes with recurrences earlier in pregnancy

   Answer: B

   Explanation: CDC states, "The risk for transmission to the neonate from an infected mother is high (30%–50%) among women who acquire genital herpes near the time of delivery and low (<1%) among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy". Recent acquisition near delivery therefore carries the highest risk among these histories.

   Reference: Genital Herpes — STI Treatment Guidelines — Genital Herpes During Pregnancy

2. 2Echocardiography in a newborn shows a large ventricular septal defect with left-to-right flow. Which pulmonary consequence should the nurse anticipate from the increased workload described for a large defect?

   1. A. Fluid accumulation within the lungs
   2. B. Air accumulation within the lung interstitium
   3. C. Loss of alveolar aeration within the lungs
   4. D. Excessive expansion of a pulmonary lobe

   Answer: A

   Explanation: NHLBI explains that a large VSD "may cause fluid to build up in the lungs." Increased pulmonary blood flow can cause congestion; interstitial air, atelectasis, and lobar overinflation describe different pulmonary abnormalities rather than this shunt-related fluid accumulation.

   Reference: Congenital Heart Defects — Types — Ventricular septal defect

3. 3After initial steps, a newborn remains apneic with a heart rate of 80/min. Which intervention is indicated?

   1. A. Positive-pressure ventilation
   2. B. Continuous positive airway pressure
   3. C. Synchronized chest compressions
   4. D. Intravenous volume expansion

   Answer: A

   Explanation: The AHA/AAP indication includes apnea or a heart rate "less than 100/min" despite initial steps. This infant needs ventilation.

   Reference: Part 5: Neonatal Resuscitation — 2025 AHA/AAP Guidelines for CPR and ECC — 11.1 Recommendations for Ventilation in Newborn Infants

4. 4A neonatal research team examines whether the burdens of participation fall unfairly on disadvantaged families while benefits are available mainly to other families. Which ethical principle addresses this distribution?

   1. A. Autonomy
   2. B. Beneficence
   3. C. Nonmaleficence
   4. D. Justice

   Answer: D

   Explanation: The Belmont Report describes justice as "fairness in distribution". It specifically links justice to fair selection and distribution of research burdens and benefits; autonomy concerns choice, while beneficence and nonmaleficence concern benefit and harm.

   Reference: The Belmont Report — Part B.3, Justice; Part C.3, Selection of Subjects

5. 5A newborn has a normal examination and an RPR titer of 1:2; the mother's delivery RPR is also 1:2. She received stage-appropriate penicillin beginning 10 days before birth. Which CDC category applies when the nurse reviews this treatment history?

   1. A. Congenital syphilis unlikely
   2. B. Congenital syphilis less likely
   3. C. Possible congenital syphilis
   4. D. Proven or highly probable congenital syphilis

   Answer: C

   Explanation: Under possible congenital syphilis, CDC includes a normal examination with the specified low relative neonatal titer when "The mother received the recommended regimen but treatment was initiated <30 days before delivery." Ten days is below this interval, so appropriate drug selection alone does not move this infant into the less-likely category.

   Reference: Congenital Syphilis — STI Treatment Guidelines — Scenario 2: Possible Congenital Syphilis

6. 6The nurse explains a newborn's patent ductus arteriosus to the parents. Which two vessels remain connected by this structure?

   1. A. Pulmonary artery and superior vena cava
   2. B. Aorta and pulmonary artery
   3. C. Aorta and pulmonary vein
   4. D. Pulmonary vein and inferior vena cava

   Answer: B

   Explanation: NHLBI states, "The defect connects the aorta with the pulmonary artery, a connection that should have closed to form the ligamentum arteriosum (see Figure A) at birth." The persistent ductus joins these two arteries; the venae cavae and pulmonary veins are not its endpoints.

   Reference: Congenital Heart Defects — Types — Patent ductus arteriosus; normal-heart/PDA figure description

7. 7A neonate needs positive-pressure ventilation without chest compressions. Which inflation rate is recommended in the 2025 AHA/AAP guidance?

   1. A. 10–20/min
   2. B. 30–60/min
   3. C. 70–90/min
   4. D. 100–120/min

   Answer: B

   Explanation: The guideline recommends "30 to 60 inflations per minute". This is the neonatal ventilation rate.

   Reference: Part 5: Neonatal Resuscitation — 2025 AHA/AAP Guidelines for CPR and ECC — 11.2 Recommendations for Inflation Time and Rate

8. 8A newborn cannot independently decide about participation in a clinical study. Under the Belmont Report's protection of people with diminished autonomy, who should be able to observe the research and withdraw the newborn if participation is no longer in the newborn's best interest?

   1. A. The legally authorized representative
   2. B. The principal investigator
   3. C. The institutional review board chair
   4. D. The study sponsor

   Answer: A

   Explanation: Belmont states, "The person authorized to act on behalf of the subject should be given an opportunity to observe the research as it proceeds in order to be able to withdraw the subject from the research". That is the legally authorized representative. Investigator, IRB, and sponsor have other research responsibilities rather than this subject-specific proxy authority.

   Reference: The Belmont Report — Part C.1, Informed Consent, Comprehension

9. 9An asymptomatic neonate is born to a mother with untreated chlamydia. After communicating the exposure to the neonatal team, which plan should the nurse anticipate solely on the basis of this exposure?

   1. A. Presumptive systemic erythromycin with routine reassessment
   2. B. Presumptive topical erythromycin with routine reassessment
   3. C. Presumptive systemic azithromycin with routine reassessment
   4. D. Clinical monitoring with treatment if symptoms develop

   Answer: D

   Explanation: For these high-risk exposed neonates, CDC states, "However, presumptive treatment of the neonate is not indicated because the efficacy of such treatment is unknown. Infants should be monitored to ensure prompt and age-appropriate treatment if symptoms develop." Exposure calls for communication and monitoring rather than automatic antimicrobial treatment.

   Reference: Chlamydial Infections — STI Treatment Guidelines — Chlamydial Infection Among Neonates

10. 10Ibuprofen is prescribed to close a hemodynamically significant PDA in a premature neonate. What change is the medication intended to produce?

    1. A. Dilation of the ductal lumen
    2. B. Reversal of the ductal shunt direction
    3. C. Constriction of the ductal lumen
    4. D. Persistence of bidirectional ductal flow

    Answer: C

    Explanation: NHLBI states, "Indomethacin or ibuprofen triggers the patent ductus arteriosus to constrict or tighten, which closes the opening". The intended pharmacological response is narrowing and closure, rather than dilation, reversed shunting, or continued bidirectional flow.

    Reference: Congenital Heart Defects — Treatment — Medicines