Want to test your pharmacology knowledge before the RNC-NIC exam? Below are free sample flashcards from the 100-card pharmacology section of our 1030-card RNC-NIC (Neonatal Intensive Care Nursing) deck.
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A 26-week GA neonate has RDS. What is the optimal timing for early rescue surfactant administration according to current 2026 NCC standards?
Show answer →Early rescue surfactant is ideally administered within the first 30–60 minutes of life for infants with RDS. Evidence demonstrates that early administration significantly reduces the risk of air leaks, bronchopulmonary dysplasia (BPD), and neonatal mortality compared to delayed therapy. NCC Exam Strategy: Differentiate between prophylactic (given in the delivery room regardless of symptoms, which is less common now) and early rescue (given based on clinical signs or FiO2 needs). Current standards favor early rescue for infants failing CPAP to minimize unnecessary intubation while ensuring rapid treatment for those who need it.
A 2.5 kg neonate is ordered Dopamine at 5 mcg/kg/min. The pharmacy provides a concentration of 1600 mcg/mL. What is the correct infusion rate in mL/hr?
Show answer →Rate = 0.47 mL/hr. Rationale: 1. Calculate mcg/min: 5 mcg * 2.5 kg = 12.5 mcg/min. 2. Calculate mcg/hr: 12.5 mcg/min * 60 min = 750 mcg/hr. 3. Calculate mL/hr: 750 mcg / 1600 mcg/mL = 0.46875 mL/hr. Exam Strategy: Round to the nearest hundredth for neonatal infusions via syringe pumps. NCC often tests the ability to convert mcg/kg/min to mL/hr as it is a critical safety skill. Common distractor: Forgetting to multiply by 60 minutes or using the wrong weight.
A 3-day-old, 26-week GA neonate has a MAP of 24 mmHg. Dopamine is started at 5 mcg/kg/min. What is the primary physiological effect expected at this dosage, and what is the current 2026 evidence regarding renal dosing in neonates?
Show answer →At 5-10 mcg/kg/min, Dopamine primarily stimulates Beta-1 receptors, increasing myocardial contractility and heart rate. Clinical Pearl: The renal dose (0.5-2 mcg/kg/min) once thought to improve renal perfusion via dopaminergic receptors is NO LONGER supported by evidence in neonates and is not recommended for this purpose. Exam Strategy: NCC focuses on dose-dependent receptor activation. Remember: Low dose (Beta-1) = Inotropy; High dose (>10 mcg/kg/min, Alpha-1) = Vasoconstriction. Monitoring for tachycardia and arrhythmias is essential as Dopamine is highly arrhythmogenic compared to other agents.
A 28-week GA neonate (PMA 30 weeks) is receiving Gentamicin. When should the first trough level be drawn, and what is the target range to minimize nephrotoxicity?
Show answer →For extended-interval dosing (common in 2026), the first trough is typically drawn before the 2nd or 3rd dose (approx 24-48h). Target trough: <1-2 mcg/mL. Rationale: Gentamicin is concentration-dependent; high troughs correlate with ototoxicity and nephrotoxicity. Exam Tip: NCC emphasizes that dosing intervals are determined by Post-Menstrual Age (PMA) and weight, not just Gestational Age (GA), due to maturing renal clearance.
A 26-week GA infant receives a rapid bolus of Fentanyl (5 mcg/kg) for intubation. The nurse notes sudden difficulty with manual ventilation and a rock-hard chest. What is the immediate treatment and the name of this phenomenon?
Show answer →Chest wall rigidity (Wooden Chest Syndrome) is a side effect of rapid opioid administration, particularly Fentanyl. It results from muscle contraction of the thoracic and abdominal walls. Treatment: Immediate administration of a neuromuscular blocking agent (e.g., Succinylcholine or Vecuronium) and/or Naloxone (though Naloxone reverses analgesia). Exam Strategy: NCC focuses on safety. To prevent this, administer Fentanyl over 3-5 minutes. Distractor: Increasing PIP is often ineffective against the mechanical resistance.
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Try 30 free RNC-NIC cards firstThe full RNC-NIC deck contains 1030 flashcards, and 100 of them focus on pharmacology. This page shows 5 free samples.
Our RNC-NIC deck dedicates 100 of 1030 cards (10%) to pharmacology — always cross-check the official NCC exam outline for the current blueprint weighting.
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