NNP-BC study guide, planned by item count

1. Week 1, a baseline: the practice test untimed. Sort misses by area.
2. Weeks 2–3, lungs and the delivery room: respiratory care (14 questions) with the resuscitation half of general management.
3. Week 4, infection and the heart: infectious diseases (11) and cardiac care (10).
4. Week 5, nutrition, fluids and acid–base: the other half of general management, drilled with the calculations below.
5. Week 6, assessment and blood: general assessment and hematology and bilirubin.
6. Week 7, drugs and the smaller systems: pharmacology, then neurology, GI, metabolic and genetic disorders and the rest from the notes below.
7. Week 8, timing: the practice test again at test-day pace, then only your two weakest areas.

The 2023 job analysis lists calculation as an NNP task in its own right. The testing screen has a calculator and a comment box instead of scratch paper (remote testing page), so the formulas are what you bring:

• Glucose infusion rate: dextrose % × mL/kg/day ÷ 144 = mg/kg/min (worked on general management).
• Calories: kcal/oz ÷ 30 = kcal/mL, times mL/kg/day.
• Urine output: mL ÷ kg ÷ hours.
• Weight-based doses: mg/kg × kg, then mg ÷ mg/mL for the volume (worked on pharmacology).

It is on NCC's list: the sixth edition (2021) of Verklan and colleagues' Core Curriculum for Neonatal Intensive Care Nursing. It is also written for NICU nursing, so on its own it leaves gaps where the NP exam asks you to diagnose, order and dose. The guide's list (candidate guide, study resources) pairs it with physician-level references; these map most directly onto the outline:

• The AHA and AAP Textbook of Neonatal Resuscitation, edited by Weiner and colleagues, now in its 2025 ninth edition.
• Stark and colleagues, Cloherty and Stark’s Manual of Neonatal Care, 9th ed., 2023, or Gomella, Gomella’s Neonatology, 8th ed., 2020, for management.
• Martin and Fanaroff, Fanaroff and Martin’s Neonatal-Perinatal Medicine, 12th ed., 2024, for depth.
• Kimberlin and colleagues, Red Book 2024–2027, AAP, for infections and immunization.
• Witt and Wallman, Tappero and Honeyfield’s Physical Assessment of the Newborn, 7th ed., 2024.
• Taketomo, Pediatric and Neonatal Dosage Handbook, 28th ed., 2021.

Review courses and question books for neonatal NPs exist from several publishers; this site ranks none of them and has no tie to NCC.

Old review material is not just thin; on these topics it gives a wrong answer:

• Resuscitation: NCC now lists the 9th edition of the NRP textbook (2025). Cord clamping, oxygen and airway steps from the 8th edition are out of date (general management).
• Jaundice: the AAP 2022 guideline replaced risk zones with curves by gestational age (hematology and bilirubin).
• CCHD screening: the 2025 AAP algorithm passes or fails on one repeat, not two (cardiac care).
• RSV: infant monoclonal antibody or a maternal vaccine replaced routine palivizumab (infectious diseases).
• Drug monitoring and withdrawal: vancomycin by AUC, and function-based care for opioid withdrawal (pharmacology).

These areas have no page of their own yet; you will meet them in the practice test.

Neurology

7 questions. Phenobarbital remains the first drug for neonatal seizures in the ILAE 2023 guideline. Therapeutic hypothermia is for moderate or severe encephalopathy; according to the AAP clinical report published in January 2026, it is not recommended for mild HIE, and a sentinel event is not required. AAP's 2020 report on routine neuroimaging calls for screening head ultrasound in infants born before 31 weeks. Kernicterus belongs with jaundice: see hematology and bilirubin.

Gastrointestinal

7 questions. Bilious vomiting in a newborn is malrotation with volvulus until an upper GI study says otherwise. AAP (2021) does not support routine probiotics for preterm infants, and FDA warned in 2023 after a fatal infection in a preterm infant given a probiotic.

Metabolic, endocrine and genetic disorders

11 questions. In congenital hypothyroidism, an abnormal screen calls for confirmatory serum tests and prompt levothyroxine; AAP's 2023 guideline stresses treatment early in the first weeks of life. Salt-wasting CAH tends to declare itself in the first weeks, often the second or third, with low sodium and high potassium. Hyperammonemia from an inborn error calls for stopping protein, giving dextrose and involving metabolic specialists at once. Syndromes often carry a heart lesion: 22q11.2 deletion with conotruncal defects and low calcium, trisomy 21 with atrioventricular canal, Turner syndrome with coarctation.

Renal and genitourinary

6 questions. A boy with bilateral hydronephrosis and a thick bladder suggests posterior urethral valves, studied by voiding cystourethrogram. Neonatal acute kidney injury is staged by a rise in creatinine from its lowest value or by low urine output (neonatal modified KDIGO).

Musculoskeletal

3 questions. AAP's 2016 guideline on hip dysplasia advises imaging at about 6 weeks for infants with risk factors such as breech presentation in the third trimester.

Integumentary

3 questions. Erythema toxicum and transient neonatal pustular melanosis are benign; extremely preterm skin loses water fast, which is why many units nurse these infants in humidified incubators early on.

Eyes, ears, nose and throat

3 questions. AAP's 2018 statement screens for retinopathy of prematurity at a birth weight of 1,500 g or less or 30 weeks or less, plus selected larger infants with an unstable course.

Professional issues

3% of the score: ethics, consent, documentation, safety and quality improvement in the NICU. Questions on general APRN law and ethics are treated once on this site, on PMHNP-BC ethics and legal care.