Low Risk Neonatal Nurse Exam

The RNC-LRN exam is a computer-based exam offered year-round by appointment, either at a PSI test center or through live remote proctoring from a quiet, private location. Every question is multiple choice with a single best answer and three answer choices. Lab values are shown in conventional units with international (SI) units in parentheses.

To sit for the RNC-LRN exam you need all of the following:

• A current, active, unencumbered RN license in the United States or Canada.
• At least 24 months of specialty experience as an RN, totaling at least 2,000 hours. You must meet both the time and the hours requirement.
• Employment in the specialty at some time within the last 24 months.

The specialty is the care of acutely and chronically ill neonates and their families in a Level II nursery, a continuing or chronic care unit or a step-down unit. Nurses who work mainly with critically ill neonates in Level III or IV units usually take NCC's separate RNC-NIC exam instead.

General Assessment covers maternal risk factors and birth history, physical and gestational age assessment, and laboratory and diagnostic data. Pathophysiologic Conditions covers cardiovascular, respiratory, gastrointestinal and genitourinary, musculoskeletal and integumentary, neurological, hematology and hyperbilirubinemia, and genetic, metabolic and endocrine conditions. General Management covers resuscitation and stabilization, nutrition and feeding, pharmacology and pain, fluids, electrolytes and glucose, oxygenation and acid-base balance, thermoregulation, neurodevelopmental care, infection and immunology, and psychosocial support and discharge planning. Professional Issues covers ethics, legal and professional practice, patient safety and quality improvement.

Only the 150 scored questions count. The passing standard is set by a panel of experts using item response theory, so you are measured against a fixed standard, not against other candidates. You cannot tell which 25 questions are unscored pretest questions, so give every question your best effort. There is no penalty for a wrong answer, so answer every question.

• Bedside scenarios in a special care nursery, mother-baby unit or delivery room that ask for the first or most appropriate nursing action
• Maternal histories that ask which newborn problem to anticipate
• Lab results, blood gases, bilirubin levels by hours of age, glucose logs and vital sign trends to interpret
• Feeding, weight and fluid situations, often with a calculation
• Medication questions about indications, adverse effects, monitoring and safe administration
• Parent teaching questions, often asking which statement shows a need for more teaching
• Ethical, legal, safety and quality improvement situations

• You do not receive a result at the test site.
• Your official pass or fail result is posted to your NCC account, usually within about 15 business days. A score report follows that shows your performance in each content area, from Very Weak to Very Strong.
• If you need to retest, you pay the full fee again, wait at least 45 days and may test no more than twice in a calendar year.