RNC--Low Risk Neonatal vs. Neonatal Intensive Care

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Specializes in NICU.

Hi all! I'm wondering if anyone can give me perspective on the two RNC exams--Low Risk Neonatal and Neonatal Intensive Care. I currently work in the Level II part of a large children's facility. We are a referral center with full surgical services, ECMO, etc. I generally work in the Level II, but I also work some of my shifts in the Level III. I am comfortable with conventional vents, lines, stable drips, etc. However, they generally don't give me extremely ill infants, and I am not trained on HFOV, jets, ECMO, head cooling, etc. So I feel like my experience overall might be that of a nurse working in a smaller Level III. I am looking at taking an RNC exam and trying to decide which be the most fitting exam. Many other nurses in our Level II (who do NOT also work Level III) have taken the low-risk exam and have done just fine. However, I want to consider whether it might be a good fit to take the neonatal intensive care exam. For those who have taken one or the other, do you have any perspective on the content of each? I have looked at the NCC website, content, and sample questions--both of look to be within my comfort level...with some studying of course. I would be especially interested to hear perspective from nurses who have worked in smaller Level IIIs who do not have significant experiencce with HFOV, jets, ECMO, etc. All thoughts are welcome!

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Specializes in Neonatal ICU (Cardiothoracic).

I found the NIC RNC exam quite challenging, and this was after working for 2 years in a unit that handled HFOV, drips, lines, frequent vent changes, delivery room management, HFJV, postops, etc.....

There were a lot of delivery room questions, vent questions, etc...\

I believe that you can't take the RNC NIC exam *unless you have 2 years of level III experience. But don't quote me on that.

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Specializes in NICU.

Thanks that is helpful. On the NCC website, they don't use the terms Level II and Level III (although I think it's a rough approximation). I would guess this is because there is such a wide variation in what Level II and Level III mean. Some Level IIs do vents, lines, etc. Some smaller level IIIs do these things but not as frequently because of their small size and patient acuity. What if you worked in this type of Level III so that maybe 75% of your patient care experience is more generally Level II? There seems to be a somewhat blurry line there. Thanks for your thoughts Steve!

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Specializes in NBN, NICU.

I am in the same boat. I have many years exp. level II and a few levelIII but limited . Do you think a study class is worth the money or should I study from the core curriculum??

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Specializes in Neonatal ICU (Cardiothoracic).

I used the Core Curriculum and answered all the questions in the study guide. You WILL end up drawing heavily on your experience.

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Specializes in NBN, NICU.

Is there a difference between CCRN and RN-C ??

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Specializes in NICU III/Transport.

2 years and 2000 hours in the specialty is required. I don't know if they differentiate between LII/LIII.

My background is very large/very busy/very sick LIIIs. In addition to what Steve posted, there are a lot of questions on E/VLBW and FEN management in these patients... and don't forget your dopamine drip calculation! There are also quite a few cardio-pulmonary questions. Know PPHN, pulmonary atresia, TAPVR, TGA, right-to-left/left-to-right shunting, coarc, PGE1 and all the other cardiac meds. You also need to be pretty familiar with iNO, HFOV and somewhat with ECMO. There were a few questions "Your ABG looks like this... what vent changes would you make?" Know your lab values and how to calculate ANC and I/T ratio. Know s/sx of hypo/hyper kalemia, natremia, calcemia, glycemia, magnesemia and their treatments. Know autosomal recessive/dominant, know transient neonatal pustular melanosis, harlequin sign, Strawberry hemangioma and "Blueberry Muffin rash"... ;)

I bought the Core Curriculum book and borrowed the review questions (with rationale) book. I think I opened the Core book 3 times but completed the review questions book. I think it helped me focus my study and identify my strengths and weaknesses, but as Steve said, I really had to draw from experience. The test is not a "regurgitate information" test... you really have to know the entire patient picture. Almost all of the questions have 1 wrong answer and 2 correct answers with 1 of them being "more" correct.

I think if you read, understand and can apply most of the Core Curriculum book, you'd do just fine... but that's a lot of in-depth info. Honestly, I can't recommend any study alternative to experience. With the blurred definitions of LII/LIII and even LIV, it's hard to say that an experienced LII would not pass the test. However, I can't imagine that someone prepared for the Low Risk Neonatal test would come close to passing the Neonatal Intensive Care test. (my opinion solely based on the names of the tests)

Hope that helps!

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I am a level 1, 2 nurse with NICU experience in the past. I have been reading about a low risk Neonatal test. Is there one and what books would be good to use to study for it.

I just took a great 3 day NICU review and was planning to study just as if I was taking a NICU RNC test.

Any suggestions?

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I took the regular exam, this was the hardest test I ever took in my life, I passed but lots of thinking involved. I had worked level II almost III for 4 years for experience transferring from Adult ICU with 20+ years of experience and this was do able but hard. I did also do a seminar first and use the core curriculum for study.

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