Preparing for the RNC-NIC (Neonatal Intensive Care Nursing) exam? Pathology is one of the areas our deck drills hardest: 480 of its 1030 flashcards focus on pathology, covering topics like ANC, IHM, Magnesium Sulfate. Try the sample questions below — every card is a real question-and-answer pair from the full deck.
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Infant born at 34 weeks to a mother with severe preeclampsia. CBC shows an absolute neutrophil count (ANC) of 850/mm3. What is the most likely mechanism for this finding?
Show answer →Maternal preeclampsia is a common cause of neonatal neutropenia. Mechanism: Maternal hypertension inhibits fetal bone marrow production of the myeloid lineage (neutrophils) rather than causing increased destruction. Clinical Pearl: This neutropenia usually resolves within 72-96 hours. Exam Tip: NCC often tests the difference between this and sepsis; PIH-induced neutropenia usually lacks a significant left shift (immature to total ratio is often normal), whereas sepsis typically shows an elevated I:T ratio.
A neonate is born at 37 weeks with a weight at the 3rd percentile, but head circumference at the 50th percentile. The mother had chronic hypertension. What is this growth pattern and its primary cause?
Show answer →This is Asymmetric Intrauterine Growth Restriction (IUGR). Primary cause: Uteroplacental insufficiency leading to brain sparing, where blood flow is prioritized to the brain, heart, and adrenals at the expense of the body and liver. Exam Tip: Contrast with Symmetric IUGR (early pregnancy insult like CMV or chromosomal issues where all measurements are low). Preeclampsia typically causes asymmetric IUGR in the late second or third trimester.
Why are infants of mothers with preeclampsia (IHM) at increased risk for hypoglycemia compared to the general population?
Show answer →Risk is due to: 1) Decreased placental transfer of glucose/nutrients leading to low hepatic glycogen stores. 2) Increased metabolic demand from the stress of chronic hypoxia. 3) Impaired gluconeogenesis. Unlike Infants of Diabetic Mothers (IDM), IHMs are NOT typically hyperinsulinemic. Exam Tip: Focus on depleted stores as the rationale for IHM hypoglycemia, whereas hyperinsulinism is the rationale for IDM hypoglycemia.
A neonate born to a mother treated with Magnesium Sulfate for eclampsia presents with hypotonia, weak suck, and a respiratory rate of 18. What is the priority intervention?
Show answer →Priority: Respiratory support (CPAP or PPV) and close monitoring. While Calcium Gluconate is the pharmacological antagonist, it is rarely used in neonates for this; supportive care is the mainstay. Magnesium stays in the neonatal system longer due to immature renal clearance. Clinical Pearl: Hypermagnesemia can also lead to delayed meconium passage and ileus. Exam Tip: Watch for lethargy and hyporeflexia as key descriptors of magnesium toxicity.
A 36-week neonate born to a mother with preeclampsia has a venous hematocrit of 69%. What is the physiological trigger for this condition in the context of maternal hypertension?
Show answer →Chronic placental insufficiency causes fetal hypoxia. The fetus compensates by increasing erythropoietin production, leading to polycythemia (venous Hct >65%). This increases blood viscosity, which can lead to organ ischemia, hypoglycemia, and hyperbilirubinemia. Exam Tip: NCC may ask about hyperviscosity syndrome. Treatment is usually increased hydration; partial exchange transfusion is reserved for symptomatic infants (e.g., respiratory distress, seizures).
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Try 30 free RNC-NIC cards firstThe full RNC-NIC deck contains 1030 flashcards, and 480 of them focus on pathology. This page shows 5 free samples.
Our RNC-NIC deck dedicates 480 of 1030 cards (47%) to pathology — always cross-check the official NCC exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the RNC-NIC preview page has 30 more free cards. Full access to all 1030 cards is a one-time $7.
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