NCC NNP-BC study guide
NCC NNP-BC · Work through your exam, one topic at a time.
The NNP-BC is a board certification for neonatal nurse practitioners, administered by the National Certification Corporation (NCC). It is designed for advanced practice registered nurses who have completed a graduate-level neonatal nurse practitioner program and who assess, diagnose, and manage care for preterm and critically ill newborns, typically in level II through IV NICUs. The NCC NNP-BC study guide has 14 sections and about 3,822 words.
01Antepartum and Intrapartum Assessment and Care
Antepartum and intrapartum questions ask you to interpret fetal surveillance and connect maternal and obstetric events to neonatal risk. You need NICHD terminology, not vague phrases such as nonreassuring.
357 words, about 2 min02Transition to Extrauterine Life and Resuscitation
At birth, warm, dry, stimulate, and clear the airway if needed; assess tone, breathing, and heart rate by about 30 seconds. Apnea, gasping, or HR below 100 bpm means PPV.
305 words, about 2 min03Respiratory System
Respiratory distress syndrome reflects surfactant deficiency, most often in preterm infants. Signs include tachypnea, grunting, retractions, and increasing oxygen need; chest radiograph shows low volumes and ground-glass opacities.
281 words, about 1 min04Cardiovascular System
Functional ductal closure occurs in 24-72 hours; anatomic closure takes weeks. A hemodynamically significant PDA causes a systolic murmur, bounding pulses, wide pulse pressure, pulmonary edema, and worsening respiratory status.
278 words, about 1 min05Neurologic System
Hypoxic-ischemic encephalopathy is staged by Sarnat criteria (alertness, tone, reflexes, seizures). Cooling criteria generally include gestation of 36 weeks or more, birth weight at least 1800-2000 g, evidence of acidosis (cord pH 7.0 or less or base deficit 16 or more), 10-minute Apgar 5 or less, or resuscitation at 10 minutes, plus moderate-to-severe encephalopathy.
294 words, about 1 min06Gastrointestinal and Nutrition
Human milk is first choice; donor milk is used for VLBW infants when maternal milk is unavailable. Fortify human milk to 22-24 kcal/oz for preterm infants.
269 words, about 1 min07Renal and Fluid-Electrolyte Management
Start day 1 with 60-80 mL/kg/day of 10% dextrose; increase by 10-20 mL/kg/day toward 150 mL/kg/day, higher in extremely preterm infants because of insensible losses. Add sodium (3-5 mEq/kg/day) and potassium (1-3 mEq/kg/day) after diuresis, usually day 2-3.
276 words, about 1 min08Hematology and Immunology
Term infants reach a physiologic hemoglobin nadir of 9-11 g/dL at 8-12 weeks; preterm infants nadir at 7-9 g/dL at 4-6 weeks (anemia of prematurity). Transfuse based on symptoms, FiO2, and gestational age rather than a single threshold.
270 words, about 1 min09Infectious Disease and Sepsis
Risk factors include GBS colonization, rupture of membranes 18 hours or more, maternal temperature 38 degrees C or higher, chorioamnionitis, and prematurity. Obtain a blood culture and CBC; perform a lumbar puncture when sepsis is suspected or the infant is unstable.
266 words, about 1 min10Endocrine and Metabolic Disorders
Screen infants at risk, including infants of diabetic mothers, LGA, SGA, preterm, and those with perinatal stress, at 1-2 hours of age. A glucose below 40 mg/dL in the first 4 hours or below 45 mg/dL thereafter needs action.
278 words, about 1 min11Genetics, Dysmorphology, and Congenital Anomalies
Trisomy 21: hypotonia, upslanting palpebral fissures, single palmar crease, sandal gap, atrioventricular canal, duodenal atresia, and Hirschsprung disease. Trisomy 18 and 13: growth restriction, clenched hands, rocker-bottom feet, congenital heart disease, and poor survival.
211 words, about 1 min12Professional Practice
NNP practice is governed by state licensure, institutional privileging, and a collaborative agreement. Know your scope: assessment, diagnosis, ordering, procedures, and referral.
252 words, about 1 min13Family-Centered Care
Families are partners, not visitors. Promote unrestricted parental presence, skin-to-skin care, cue-based feeding, and participation in rounds.
237 words, about 1 min14Systems
Level I: well newborn nursery. Level II: special care for infants at 32 weeks or more or with moderate illness.
248 words, about 1 min