RNC-NIC Exam Information and Guideline
NCC Neonatal Intensive Care Nursing 2025
Below are complete topics detail with latest syllabus and course outline, that will help you good knowledge about exam objectives and topics that you have to prepare. These contents are covered in questions and answers pool of exam.
Number of Questions: The examination consists of 175 multiple-choice questions.
Duration: Candidates are given 3 hours to complete the exam.
Passing Score: The passing score may vary; candidates are encouraged to check the NCC website for the most current passing standards.
- Antepartum Risk Factors and Birth History
- Effects of maternal medical complications
- hematologic
- thrombocytopenia
- hypertension
- chronic, gestational hypertension, HELLP Syndrome
- infections
- CMV, Toxoplasmosis, syphilis, herpes, hepatitis, HIV, gonorrhea, chlamydia
- renal disease
- Problems associated with amniotic fluid and membranes
- amniotic bands
- oligohydramnios
- polyhydramnios
- PROM and chorioamnionitis
- Significance of findings:
- alpha-fetoprotein/triple quad/screen
- biophysical profile
- diagnostic ultrasound
- Recognize neonatal significance of fetal heart rate patterns
- altered variability
- decelerations
- early, late, variable
- tachycardia, bradycardia
- Effects of maternal medications on the neonate
- tocolytics
- analgesia, anesthesia
- Problems in labor - impact on the neonate
- breech and other malpresentation
- maternal hemorrhage
- meconium
- Obstetric emergencies (impact on the neonate)
- abruptio placenta
- cord prolapse
- placenta previa
- Impact of methods of delivery on the neonate
- forceps, vacuum, cesarean
- Physical and Gestational Age Assessment
- Interpretation of growth curves
- weight, length and head circumference
- Physical and neuromuscular characteristics
- preterm
- term
- post-term
- AGA
- SGA
- LGA
- Associated risks with
- Preterm
- post-term
- SGA/IUGR
- LGA
- Normal/abnormal findings regarding:
- general appearance
- head, eyes, ears, nose & throat
- neck
- chest
- cardiovascular
- respiratory
- abdomen
- genitalia
- extremities
- spine/back
- skin
- maintaining skin integrity
- neuromuscular and reflexes
- Resuscitation and Stabilization
- Neonatal Cardiopulmonary Resuscitation (Per the American Heart Association & the American Academy of Pediatrics)
- initial evaluation (ABC)
- indications for ventilation
- indications for intubation
- indications for cardiac compressions
- medications
- Use of drugs
- epinephrine
- volume expanders
- Resuscitation and stabilization of the neonate with
- diaphragmatic hernia
- hydrops fetalis
- perinatal asphyxia
- upper airway obstruction
- Fluids, Electrolytes, and Glucose Homeostasis
- Normal fluid and electrolyte requirements
- Monitoring fluid and electrolyte status
- electrolytes
- urine output
- Effects of
- humidity
- maturity
- temperature
- Specific problems
- dehydration and overhydration
- gastrointestinal abnormalities
- insensible water loss
- patent ductus arteriosus
- post-asphyxia
- third spacing
- Parenteral fluid therapy
- Nutrition and Feeding
- Nutritional requirements and effects of excess & deficiency
- calories
- carbohydrates
- fat
- minerals
- protein
- vitamins
- Enteral feeding
- minimal enteral feedings (gut priming)
- gavage feeding
- bolus vs continuous feedings
- feeding cues
- feeding techniques
- bottle feeding
- formula composition
- breast feeding
- stimulating production
- composition of breast milk
- donor milk
- Parenteral nutrition
- indications
- composition
- complications
- Dietary supplements
- breast milk fortifiers
- glucose polymers
- iron
- MCT
- Vitamins
- probiotics
- Nutritional management for
- bronchopulmonary dysplasia
- prematurity
- short gut syndrome
- Oxygenation, Ventilation and Acid Base Homeostasis
- Oxygenation: interpretation and management
- hypoxia/hypoxemia
- oxygen saturation
- principles re: increasing/ decreasing FiO2 levels
- pulse oximeter
- Methods of oxygenation/ ventilation
- indications, complications
- noninvasive ventilation
- extracorporeal membrane oxygenation (ECMO)
- high flow nasal cannula
- Mechanical ventilation
- conventional
- high frequency
- other methods of oxygen delivery (hood, nasal cannula)
- Blood gases: interpretation and management
- metabolic acidosis (compensated & uncompensated)
- metabolic alkalosis (compensated & uncompensated)
- respiratory acidosis (compensated & uncompensated)
- respiratory alkalosis (compensated & uncompensated)
- mixed
- serum lactate
- Thermoregulation and Integumentary
- Mechanisms of heat loss and production
- assessment of thermal state
- responses to hypothermia and cold stress
- responses to hyperthermia
- Maintaining a neutral thermal environment
- Management of thermoregulation problems
- evaporation
- conduction
- convection
- radiation
- hypothermia and cold stress
- hyperthermia
- Equipment
- Incubators and radiant warmers
- Heat mattresses and wraps
- Skin Care
- Pharmacology, Pharmacokinetics and Pharmacodynamics
- Principles of neonatal pharmacology
- administration methods/issues
- absorption from GI tract, skin and muscle
- blood drug levels (toxic vs therapeutic)
- drug distribution in the body
- drug excretion
- drug incompatibilities
- drug withdrawal (therapeutic drugs)
- drug resistance
- Dosage calculations
- Common drugs
- anesthetics and analgesia (sedatives)
- antibiotics
- anticonvulsants
- antiviral drugs
- bronchodilators
- cardiovascular agents
- CNS stimulants (caffeine, etc)
- Diuretics
- muscle relaxants
- Management of the drug exposed neonate
- Fetal alcohol syndrome
- Neonatal abstinence syndrome and scoring
- Substance use and abuse
- Laboratory drug testing
- Neuroprotective and Neurodevelopmental Care
- Neurobehavioral development
- Habituation
- motor organization
- state organization
- sensory/interaction capabilities
- Self-regulatory (stability) and stress responses
- autonomic
- motoric
- state/sleep cycles
- attentional
- Impact of the NICU environment
- physical
- light
- sound
- social
- caregiver-infants interactions
- patterns of caregiving
- Intervention strategies
- reducing noise levels
- reducing light levels/diurnal patterns
- altering care patterns
- handling/positioning
- kangaroo care/skin-to-skin
- nonnutritive sucking
- Provision of sensory experiences
- auditory
- tactile
- visual
- vestibular and proprioceptive
- Pain
- assessment
- non-pharmacologic interventions
- Cardiovascular
- Transition to Extrauterine Life
- Cyanosis
- central vs peripheral
- cardiac vs pulmonary
- Specific Problems
- For all problems: presentation/assessment causes, management, complications, outcome
- arrhythmias
- cardiac tamponade
- congestive heart failure
- congenital heart defects
- AV canal
- coarctation of the aorta
- hypoplastic left heart
- pulmonary stenosis and atresia
- tetralogy of fallot
- transposition of the great vessels
- total anomalous pulmonary venous return
- ventricular septal defect
- cyanotic vs acyanotic disease
- hypertension
- patent ductus arteriosus
- shock
- Cardiovascular assessment
- blood pressure
- EKG
- cardiopulmonary monitoring
- indwelling lines
- Respiratory
- Normal pulmonary function, surfactant
- Specific respiratory problems
- For all problems: presentation/assessment causes, management, complications, outcome
- apnea of prematurity
- bronchopulmonary dysplasia
- diaphragmatic hernia/paralysis
- hypoplastic lungs
- meconium aspiration
- persistent pulmonary hypertension
- pneumothorax/air leaks
- pulmonary hemorrhage
- respiratory distress syndrome
- transient tachypnea of the newborn•
- newborn• Specific therapies
- For all problems: presentation/assessment causes, management, complications, outcome
- endotracheal intubation
- suctioning
- surfactant replacement therapy
- chest tubes and drainage systems
- Gastrointestinal/Genitourinary
- Normal gastrointestinal function
- Maturation of GI tract
- Specific GI problems
- For all problems: presentation/assessment, causes, management, complications, outcome
- GE reflux
- GI bleeds perforation/peritonitis
- Hirschsprung’s disease
- intestinal obstructions (duodenal, jejunal, ileal,
- imperforate anus)
- meconium ileus/plug
- malrotation/volvulus
- necrotizing enterocolitis
- omphalocele/gastroschisis
- short gut syndrome
- ostomy care
- colitis
- bloody stools
- protein allergies
- Renal function/urinary output
- Specific genitourinary problems
- For all problems: presentation/assessment, causes, management, complications, outcome
- Genital
- ambiguous genitalia
- inguinal hernia
- testicular torsion
- Urinary tract
- asphyxial renal damage
- renal abnormalities
- renal failure
- renal vein thrombosis
- Hematopoietic
- Interpret laboratory values
- CBC
- hematocrit, hemoglobin
- platelets
- total and direct serum bilirubin
- direct and indirect antibody test
- Kleihauer Betke test
- Developmental differences
- fetal vs adult hemoglobin
- RBC differences
- Administration of blood and blood products
- techniques
- risks
- Hyperbilirubinemia
- physiologic jaundice
- causes of direct hyperbilirubinemia
- causes of indirect hyperbilirubinemia
- phototherapy
- Specific hematologic problems
- anemia
- coagulopathies/DIC
- polycythemia and hyperviscosity
- Rh and ABO incompatibility/ hydrops fetalis
- Thrombocytopenia
- Neurological/ Neuromuscular/Musculoskeletal
- Birth injuries (neuromuscular)
- Hydrocephalus
- Hypoxic ischemic encephalopathy
- Neural tube defects
- Germinal matrix hemorrhage
- Intraventricular hemorrhage
- Periventricular leukomalacia
- Seizures
- Subdural hemorrhageVI
- hemorrhageVI. Genetic, Metabolic and Endocrine
- Interpret laboratory values
- calcium, phosphorus magnesium
- glucose
- Metabolic screening
- PKU
- Thyroid
- CAH
- Sickle cell
- Galactosemia
- Glucose homeostasis
- Specific metabolic/endocrine problems
- For all problems: presentation/ assessment, causes, management, complications, outcome
- hypocalcemia and hypercalcemia
- rickets
- hypoglycemia and hyperglycemia
- infant of diabetic mother
- thyroid disorders
- adrenal disorders
- Mendelian inheritance patterns
- autosomal recessive
- autosomal dominant
- sex-linked
- Chromosomal anomalies and diseases
- Trisomy 13
- Trisomy 18
- Trisomy 21
- Multifactorial diseases
- DiGeorge
- Turners
- Head, Eyes, Ears, Nose and Throat
- Eye prophylaxis
- Specific problems
- cephalhematoma
- choanal atresia
- cleft palate/lip
- retinopathy of prematurity
- tracheal stenosis/atresia
- tracheomalacia
- tracheostomy
- vocal cord paralysis
- subgaleal
- trachea-esophageal atresia (TEF)
- esophageal atresia
- micrognathia
- micrognathiaVIII. Infection and Immunology
- Interpret laboratory values
- WBC and differential
- cerebrospinal fluid
- Immature host defenses
- Neonatal sepsis/meningitis
- Viral and fungal infections
- candidiasis
- cytomegalovirus
- hepatitis B
- herpes
- HIV/AIDS
- toxoplasmosis
- varicella
- Specific bacterial infections such as E coli infection
- Group B Streptococcal infection
- Early/late onset
- staphylococcal infection
- syphilis
- enterovirus
- Infection control procedures
- nosocomial infection
- Discharge Management, Family-Centered Care, Grieving, Palliative Care, Mental Health
- General discharge planning and parent teaching
- car seats
- CPR
- CCHD screening
- feeding
- immunizations
- SIDS/safe sleep/plagiocephaly
- Visitors
- Shaken baby
- Discharge planning and parent teaching for infants with special needs
- nutrition
- medications
- special equipment needs
- special care needs
- developmental follow up
- visual screening
- hearing screening
- motor delay (including cerebral palsy)
- cognitive/language delay
- Anticipatory grief
- Stages of grieving and common behaviors and interventions
- Factors which impede\enhance grief process
- Pathologic responses
- Maternal/paternal differences (incongruent grieving)
- Specific circumstances
- chronic sorrow
- death of a twin (triplets, etc)
- repeated obstetric loss (recurrent abortion,
- stillbirth, preterm delivery)
- sibling responses
- Support systems and referrals
- bereavement groups
- parent support groups
- palliative care
- Parent-infant attachment behaviors
- Parental stress responses
- high risk birth
- changes in status
- transfer
- Barriers to parent infant interaction
- Specific circumstances
- adolescent parents
- grandparents and other extended family
- long distance nurturing of parent/ infant attachment
- sibling responses and interventions
- Specific interventions with parents and extended family
- counseling techniques
- parent teaching
- Shared decision making
- parent-staff disagreements
- regarding treatment
- Principles of culturally sensitive care
- Maternal psychiatric issues
- Post-traumatic stress disorder
- Post-partum depression