CLC EXAM 2025 NEWEST 250 ACTUAL EXAM QUESTIONS AND DETAILED CORRECT ANSWERS, Exams of Nursing

Download CLC EXAM 2025 NEWEST 250 ACTUAL EXAM QUESTIONS AND DETAILED CORRECT ANSWERS and more Exams Nursing in PDF only on Docsity! CLC EXAM 2024-2025 NEWEST 250 ACTUAL EXAM QUESTIONS AND DETAILED CORRECT ANSWERS | ALPP CLC STUDYGUIDE 100% CORRECT LATEST VERSION Allison tells you that 2-month-old baby Jeffrey has been fussy most of the time since he was about a week old. his birth weight was 8-4, his current weight is 9-1. Allison says she has been breastfeeding him a lot. The most likely cause of Jeffrey's fussiness is: a) he isn't getting enough to eat, b) he is sensitive to the dairy protein in Allison's diet, c) he is most likely experiencing symptoms of lactose intolerance d) he may have GER Correct Answer a) he isn't getting enough to eat Which of the following elements is increased in the milk of mothers who deliver preterm infants? a) LCPUFAs b) lactose c) calories d) calcium Correct Answer a) LCPUFAs Polly tells you that April has really been fussy at feeds, and though she is gaining well, Polly is just sure there is something wrong. Of the following, which is the most important for you to do during the assessment? a) oral digital exam, b) before and after feeding weights, c) infant hydration status d) observation of behavior during the feed Correct Answer d) observation of behavior during the feed Lindsey, 7 months pregnant, has just been diagnosed as an insulin-dependent diabetic. She is concerned that she will not be able to breastfeed. What information will be most helpful to her? a) after the delivery she may have to decrease her caloric intake, b) after delivery she may find her insulin needs are decreased, c) it's going to be in her best interest to not breastfeed d) when she weans her baby, her insulin levels will vary Correct Answer b) after delivery she may find her insulin needs are decreased The WHO Code is: a) part of a global initiative to promote breastfeeding, b) important to decreasing formula feeding in third world counties, c) a law in the U.S. d) concerned with the marketing of breast milk substitutes Correct Answer d) concerned with the marketing of breast milk substitutes Lactoferrin does all of the following EXCEPT: The Tail of Spence has which of the following characteristics? a) Will appear after primary engorgement is over b) Is unilateral in the majority of omwne c) Can be diagnosed after 20 weeks of gestation d) Is connected to the primary breast tissue Correct Answer d) Is connected to the primary breast tissue What is the most common reason for an infant to be diagnosed with FTT? a) Nipple or breast abnormalities of the mother b) Infant with oral motor dysfunction c) Infant with low body tone d) Mismanagement of breastfeeding Correct Answer d) Mismanagement of breastfeeding Under which condition would a mother with TB NOT be allowed to provide breast milk to her infant? a) Mother is diagnosed with TB mastitis b) Active TB with positive aerosolized sputum cultures c) Active pulmonary TB with suspected multi/drug resistance d) Abnormal chest x-ray indicating active disease Correct Answer a) Mother is diagnosed with TB mastitis A strong predictor for postpartum depression is: a) Formula-feeding b) Sleep disturbances c) Lack of social support d) Depression at any time in her life Correct Answer d) Depression at any time in her life Kayla and Grover are attending your prenatal breastfeeding class. Grover asks you how long Kayla should breastfeed. Your best response is: a) The WHO recommends breastfeeding for at least 2 years b) Weaning time is best if it's a joint decision between Kayla and the baby c) The AAP recommends breastfeeding for at least a year d) When the baby indicates that he or she is ready to wean Correct Answer b) Weaning time is best if it's a joint decision between Kayla and the baby Kayla wants to know what she needs to be doing to prepare for breastfeeding her baby who is due in 4 weeks. Your best response is: a) Enjoy the rest of the pregnancy and do some recommended reading b) Improve nipple grasp-ability by doing the Hoffman maneuver twice a day c) Have her physician check for nipple inversion to make sure she'll be able to breastfeed d) Gently rub a washcloth over the nipples several times a day too toughen them in preparation for the baby suckling Correct Answer a) Enjoy the rest of the pregnancy and do some recommended reading Mallory has been told to eliminate all dairy from her diet because the baby is lactose intolerant. Given what you know about lactose in human milk, what direction will your counseling take? a) She really only needs to eliminate cow's milk from her diet as that is the most significant form of lactose that she would be consuming b) Since babies cannot be lactose intolerant, it's another issue entirely c) It's unlikely for the baby to be lactose intolerant and going off dairy will not change the lactose in her milk d) Sympathize with her and tell her that the best solution for lactose intolerance in a baby is to stop breastfeeding and give a lactose-free formula Correct Answer c) It's unlikely for the baby to be lactose intolerant and going off dairy will not change the lactose in her milk Violet comes to you complaining of severe sore nipples, and tells you she is going to stop breastfeeding. What is your first response? a) Sore nipples are really common in the first couple of weeks. If you just stick with it a few more days, they'll get better. b) It isn't any fun to breastfeed when you are in pain. Let's see if we can figure out what is causing the soreness. c) I'm sure you must be uncomfortable. Lots of mothers wean when their nipples are sore, so don't feel guilty about it. d) Sore nipples are not really a normal part of breastfeeding. What do you think you might be doing incorrectly? Correct Answer b) It isn't any fun to breastfeed when you are in pain. Let's see if we can figure out what is causing the soreness. Joanna has comes complaining of low milk supply and a poor weight gain in Caleb, her 4-week-old infant. What do you need to know before creating a plan of care that will address Joanna's problems? a) How many times a day Caleb is nursing b) How long Joanna plans on breastfeeding Caleb c) Caleb's weight patterns since birth d) Joanna's willingness to supplement Correct Answer b) How long Joanna plans on breastfeeding Which is true about infants who are fed formula instead of being breastfed? a) More likely to develop diabetes b) More likely to develop mitral valve prolapse c) Greater chance of obesity after the age of 6 d) Greater chance of infantile depression Correct Answer a) More likely to develop diabetes DeCarvalho, in a classic 1982 study, found that bilirubin levels in infants decreased as: a) Stooling decreased b) Voiding increased c) Infant weight decreased d) Feedings increased Correct Answer d) Feedings increased- which increases voids and stools An effective way of increasing milk yield when pumping is to tell the mother to: a) Pump for a minimum of 20 minutes on each breast b) Massage the breast before and during pumping c) Pump immediately after a feed d) Drink sage tea to increase prolactin levels Correct Answer b) Massage the breast before and during pumping Studies of the demographics of breastfeeding initiation indicate which of the following groups are the most likely to initiate breastfeeding: a) College educated mothers b) Single mothers c) Middle income mothers d) Mothers aged 20-24 Correct Answer a) College educated mothers Which of the following enzymes, released through vagal stimulation enhances digestion, sedation and a feeling of satiation and well-being? a) Gastrin b) Cholecystekinin c) Casomorphin d) Lysozyme Correct Answer a) Gastrin The primary physiologic reason frequent breastfeeding is important in the first few days is that: a) The mother's milk will come in faster and in greater quantity b) The baby will lose less weight after birth, and gain it back more quickly c) Levels of oxytocin in the blood remain higher for longer periods of time d) It facilitates the laying down of a greater number of prolactin receptors Correct Answer d) It facilitates the laying down of a greater number of prolactin receptors One of the signs of food intolerance in a breastfed baby is: a) Diaper rash all over the buttocks not resolved by use of a diaper cream b) Inconsolable crying that begins about an hour after a feed c) Intestinal upset with gas, diarrhea and or vomiting d) Loose, yellow, seedy stools at least two times a da/ Correct Answer c) Intestinal upset with gas, diarrhea and/or vomiting Lucie, who gave birth 2 days ago to Willis, has been a diabetic since she was 15-years-old. She keeps her blood sugar under good control with several insulin injections each day. Which of the following instructions must be included in your teaching? a) It may be best to formula-feed as the lactose in her milk will vary b) Insulin requirements may change during breastfeeding c) Her chance of producing a full milk supply is about 50- 50 d) She should pump at least 4 times a day for the first two weeks since the milk supply of an insulin-dependent mother is slow to increase in volume Correct Answer b) Insulin requirements may change during breastfeeding June tells you she has a wicked cold, and wants to know what she should take to ease the symptoms. Lucien, her breastfeeding baby, is 3.5-months-old. What is your best recommendation? a) That is an excellent idea and is certainly better than supplementing your baby with formula b) HMBANA milk banks have quality control procedures in place assuring safety of the milk distributed c) You need to be careful as milk purchased from the internet has been shown to detect drugs of abuse and cow's milk d) Using milk from mothers that donate it to other mothers is better than purchasing it on the internet Correct Answer b) HMBANA milk banks have quality control procedures in place assuring safety of the milk distributed The average amount of milk a woman no breastfeeding problems produces by the end of the first month postpartum is: a) 450-550 mL/24 hours b) 600-700 mL/24 hours c) 750-850 mL/24 hours d) 900-1000 mL/24 hours Correct Answer c) 750-850 mL/24 hours Logan calls to ask you about a drug the physician has prescribed for her. Which of the following information tells you that a particular drug is most likely safe for her to take and continue to breastfeed? a) The drug is 50% protein bound b) The drug has a molecular weight of 950 c) The drug has a half-life of 24 hours d) The milk-plasma ratio of the drug is 2.3 Correct Answer b) The drug has a molecular weight of 950 A safe sleeping environment for an infant includes: a) Infant in the prone position b) Baby sleeping on a firm, flat surface c) Baby covered with infant-sized thermal blankets d) In the parents' bed, surrounded by pillows so he doesn't fall Correct Answer b) Baby sleeping on a firm, flat surface McKenzie visits you at 6-weeks postpartum. She wants to lose her "baby weight". Your best recommendation is: a) Limit her intake to no more than 1400 calories per day b) Lose the weight slowly or it will release toxins into her bloodstream c) She needs to drink more water so she will feel full and not eat as much d) Increase her level of exercise to help decrease her weight Correct Answer d) Increase her level of exercise to help decrease her weight Mary Beth can't get one-day-old Henri to latch to her breast. Which would be your best response to her plea for help? a) Many babies don't nurse will in the first 24 hours so what he is doing is within normal parameters b) Let's put him skin-to-skin in the laid back breastfeeding position to see if that helps him to be more interested in nursing c) Let's undress him and do the gentle doll's eye rocking maneuver to help wake him up d) Let's give him about an ounce of formula by bottle which will stimulate his sucking reflex, give him calories, and help wake him up so he will be interested in nursing Correct Answer b) Let's put him skin-to-skin in the laid back position to see if that helps him to be more interested in nursing You are doing an assessment on a baby and determine he has a type 3 tongue tie causing tongue restriction and sore nipples. What should you do? a) Refer the mom to the pediatrician for an evaluation b) Refer the mom to a pediatric dentist for a laser frenotomy c) Not say anything to the mother but call the pediatrician on your own d) Give the mother a nipple shield to use until the baby's frenulum stretches Correct Answer a) Refer the mom to the pediatrician for an evaluation A mom says she is about to wean because her two-year- old who is still nursing keeps trying to push the baby off the breast, yelling, "mine, mine!" How would you advise her? a) Tell her to gently explain the concepts of sharing to the 2-year-old b) Wean the 2-year-old and keep nursing the baby c) Put the two-year-old in time-out when she pushes the baby d) Offer the toddler the other breast when nursing the baby Correct Answer d) Offer the toddler the other breast when nursing the baby The amount of fat the normal, healthy infant consumes on a daily basis is regulated by: d) Inform the mothers that these photographs will be used for professional education in a presentation Correct Answer a) Obtain the mother's written consent before taking the photographs In order to culture yeast in human milk, it's necessary to add which of the following to the milk? a) Sugar b) Zinc c) Iron d) DHA Correct Answer c) Iron Mothers particularly, go through several stages in acquiring their new role as a parent. Which of the following is true of the "formal" acquisition stage? a) Parents want to do everything "right" and often feel guilty if they do something that "authorities" will consider incorrect b) Because of the high levels of anxiety during this stage, many women choose to give up breastfeeding c) This stage is characterized by fantasies of giving birth to the perfect child with extensive birth plans in hand d) During this phase, mothers become much more relaxed ans are not afraid of trying something new with their babies Correct Answer a) Parents want to do everything "right" and often feel guilty if they do something that "authorities" will consider incorrect You see Patrice, a new mom in the hospital who was given two doses of a drug for anxiety within the first 12 hours after birth. The pediatrician told her she had to pump and dump for 36 hours after the last dose. Mom wants to start breastfeeding now and asks your opinion. When you look up the drug, you find that it's considered compatible with breastfeeding when used short-term, but is not recommended for long-term use. What do you do? a) Tell the mom that she should follow the pediatrician's recommendations as she is the baby's primary HCP b) Tell the mom that based on your research and the information you can find that the pediatrician is incorrect and to go ahead and start breastfeeding c) Tell Patrice's nurse your findings and tell her to let the pediatrician that it is ok to start nursing d) Call the pediatrician yourself with your findings and discuss with him the possibility of the mother starting breastfeedin Correct Answer d) Call the pediatrician yourself with your findings and discuss with him the possibility of the mother starting breastfeeding now The Department of Health is conducting screening tests for tuberculosis among women of childbearing age. The results of the screening indicate that the screening test is sensitive. What does this mean? a) It means that the screening test is consistent over time b) It means that the screening test is consistent among those who perform it c) It means that the screening test is able to identify those with tuberculosis, or d) It means that the screening test is able to identify those without tuberculosis Correct Answer c) It means that the screening test is able to identify those with tuberculosis Which of the following is an independent variable? a) Levels of postnatal stress (relating multiple births) b) One-to-one teaching (and the effect of this teaching on maternal attachment) c) Perceived knowledge levels (after an educational class on latching techniques), or d) Compliance levels (after a class on the importance of completing the entire regimen) Correct Answer b) One-to- one teaching (an the effect of this teaching on maternal attachment) The practice of holding the baby so that his or her bare chest is against that of his or her mother or father to help to promote breastfeeding is: a) Parent-to-baby holding b) Skin-to-skin holding c) heart-to-heart holding, or d) baby-to-parent swaddle Correct Answer b) Skin-to-skin holding The best way for the mother to learn how to breastfeed is to: a) Follow the nurses' suggestions only b) Watch other mothers breastfeed c) Ask a friend who has just had a baby, or d) Follow the instructions of the nurses and a lactation consultant Correct Answer d) Follow the instructions of the nurses and a lactation consultant Anatomically, it is expected that an infant should grow how many cm in length by 6 months of age? benefits of breast milk for their preterm infants, many will decide to at least pump while the baby i in the NICU The whey protein component of milk that can decrease milk supply is known as: a) suppressor peptides, b) fractional proteins, c) putrescine, or d) Feedback Inhibitor of Lactation (FIL) Correct Answer d) Feedback Inhibitor of Lactation (FIL) Milk banks that are member of the Human Milk Banking Association of North America (HMBANA): a) provide milk only for preterm babies, b) don't accept milk from women with any body piercings, c) use the flash heating method to pasteurize the breast milk, or d) dispense milk for babies inside as well as outside hospital settings Correct Answer d) dispense milk for babies inside as well as outside hospital settings A congenital deficiency of zinc in an infant can cause: a) FTT and skin lesions, b) GI sensitivity to artificial feeds, c) congenital cataracts, or d) Forbes-Albright Syndrome Correct Answer a) FTT and skin lesions The MOST common food sensitivity in infancy is: a) egg, b) cow's milk, c) wheat, or d) soy Correct Answer b) cow's milk When examining the newborn's palate, you should see (or feel) a: a) U-shape, b) flat shape, c) V-shape, or d) C- shape Correct Answer a) U-shape The most important societal change necessary to increase breastfeeding is: a) reduce marketing of non-human milks, b) acceptance of the breast as other than an object of pleasure, c) reduce society's dependence on the use of pacifiers for infants, d) include breastfeeding education in the training of health care professionals Correct Answer b) acceptance of the breast as other than an object of pleasure Foods ingested by the mother can affect which of the following? a) the pH of the milk, b) the gaseous content of the milk, c) the protein content of the milk, or d) the flavor of the milk Correct Answer d) the flavor of the milk Three-week-old David is having stools twice a week. David weighed 7 lbs., 4 oz. at birth and today he weighs 8 lbs., 8 oz. David last nursed 2.5 hours ago. Doing ac/pc weights, in 30 minutes he takes 63 mL from the right breast and 40 mL from the left. Residual pumping gives 13 mL from the right and 10 mL from the left. You suspect: a) David may be receiving inadequate calories, b) Marlene may have a lower than normal amount of fat in her milk, c) David could have Hirschprung's disease, or d) David could have a metabolic disease which in interfering with the peristalsis of the intestines Correct Answer c) David could have Hirschsprung's disease Which of the following is true about weight gain from birth through the first two months in exclusively breastfed infants? a) most babies will lose around 10% of their birth weight within the first three days of life, b) infants should regain their birth weight by 10-14 days of age, c) between 2 and 6 weeks, the average daily weight gain is 24-26 grams, or d) an infant who is gaining 10 grams per day in considered FTT Correct Answer b) infants should regain their birth weight by 10-14 days of age What temperature should water that is to be mixed with powdered formula be to kill the Cronobacter sakazkii bacteria? a) boiled water cooled to body temperature, b) room temerature, c) at least 158 deg F, or d) boiling Correct Answer c) at least 158 deg F Which of the following would most likely be the best treatment for a yeast infection of the nipples? a) oral antifungal prescription medication, b) antifungal ointment, c) coconut oil, or d) eliminate yeast foods from her diet Correct Answer b) antifungal ointment The whey:casein ratio in late lactation is: a) 90:10, b) 60:40, c) 50:50, or d) 18:82 Correct Answer c) 50:50 Mavis contacts you concerned that 4-month-old Henry, who is 5 lbs. over his birth weight and who has been sleeping 8-9 hours at night, has suddenly started waking to nurse 2-3 times. Your first response to her is: a) you might want to have him checked by the pediatrician. Something may be physically wrong with him, b) it's not uncommon for this to happen. If you just go in and pat him, he'll be fine. He obviously doesn't need to be fed, c) you really enjoyed that nighttime sleep, didn't you? It's frustrating that Henry is waking up again just when you intake? a) preterm infants need to receive 109-140 kcal/kg body weight per day depending on gestational age, weight, and medical/physical problems, b) have the mother pump her milk and feed 35 mL mixed with human milk fortifier at each feed, c) do a before and after weight (ac/pc) and supplement to reach 35 mL at each feed after breastfeeding if needed, or d) since ac/pc weights are inaccurate at this point, follow each breastfeed with the required amount of supplement Correct Answer c) do a before and after weight (ac/pc) and supplement to reach 35 mL at each feed after breastfeeding if needed The IBCLC decides to use a nipple shield with baby Noah and his mom. At what point do you expect Noah will be able to be weaned off it? a) when the baby is approximately his full-term corrected age, b) as soon as the baby can latch comfortably and transfer milk using the shield, c) the chances of the infant being weaned from the shield is unlikely, or d) since milk supply will be decreased dramatically, shields should never be used with preterm infants Correct Answer a) when the baby is approximately his full-term corrected age Which one of the following substances in breast milk promotes the growth of beneficial bacteria in the infant? a) lactoferrin, b) interferon, c) transferas, or d) bifidus factor Correct Answer d) bifidus factor Symptomatic hypoglycemia in the newborn is manifested by which of the following: a) high pitched cry, b) exaggerated moro reflex, c) hypothermia, or d) tremors, jitters Correct Answer d) tremors, jitters Jake, Sarah's husband, says that he has heard that drinking beer will increase Sarah's milk supply. What do you tell him? a) Oh, that's an old wives' tale that has been around for years. There isn't any truth to it, b) Beer really won't do anything for milk supply unless mom has a low production. Then yes, it will help, c) Beer can increase prolactin levels and thus milk supply, but is offset by the decrease in the oxytocin levels so babies take less milk after alcohol consumption, or d) What they have found is that beer- or wine- helps the mother to relax so that she lets her milk down more quickly and effectively, thus it appears that it actually increases her supply Correct Answer c) Beer can increase prolactin levels and thus milk supply, but is offset by the decrease in the oxytocin levels so babies take less milk after alcohol consumption Which of the following do infants need for optimal development? a) their own room, b) a stay-at-home mom, c) interaction with adults, or d) a predictable schedule Correct Answer c) interaction with adults You are an IBCLC and have the opportunity to attend a lunch and learn given by the formula representative regarding their new organic formula. From an ethical perspective, which is your best course of action? a) not attend since this is presented by a formula company and by attending you will be in violation of the International Code of the Marketing of Breast-Milk Substitutes (The Code), b) attend the presentation, but announce when the lunch is served that you are not permitted to eat the food or you will be in violation of The Code, c) attend the presentation, bringing your own lunch with you, or d) not attend since this is a presentation about formula and as a lactation consultant there is no need for you to learn about formulas Correct Answer c) attend the presentation, bringing your own lunch with you Tiffany comes to your prenatal clinic and asks you how she can best prepare her nipples and breasts for breastfeeding. You advise her to: a) do a pinch test to determine grasp-ability, otherwise nothing, b) gently roll and pull the nipple 3 times a day, do the Hoffman technique 3 times a day, or d) express colostrum and rub into the areola daily Correct Answer a) do a pinch test to determine grasp-ability, otherwise nothing A neutral attitude towards breastfeeding may result in: a) not allowing a mother to make an informed and unbiased decision, b) providing a balanced choice environment without undue pressure, c) increasing the likelihood of early cessation of breastfeeding, or d) increasing the opportunity for a supportive environment for breastfeeding Correct Answer c) increasing the likelihood of early cessation of breastfeeding When would finger-feeding be most appropriate? a) finger- feeding is never appropriate in any case, b) in order to evaluate a baby's suck, swallow and breathe patterns, c) to supplement an infant who is unable to nurse at the The lactose in breast milk performs which of the following functions? a) Seal the gut lining of the infant's GI tract b) Supplies energy specific for baby's brain growth c) Mobilizes antibodies against viruses in the mom's environment d) Destabilizes outer cell membranes of bacteria Correct Answer b) Supplies energy specific for baby's brain growth Wanda who is 7 months pregnant and who has MS comes into your office to talk to you about breastfeeding. Which of the following would could impact her breastfeeding success. a) The severity of this condition prior to pregnancy was found to not impact breastfeeding duration b) None of the current medication commonly prescribed for a relapse is noted to be compatible with breastfeeding c) Her chance of relapsing is less if she nurses more than 2 months d) Wanda can expect profound exhaustion in the immediate postpartum period Correct Answer c) Her chance of relapsing is less if she nurses more than 2 months The Bellagio Consensus... a) Encourages that public health policies include teaching of LAM b) Encourages visiting Las Vegas to increase breastfeeding rates in Nevada c) Is part a global effort to promote breastfeeding d) Is a WHO/UNICEF initative Correct Answer a) Encourages that public health policies include teaching of LAM Maternal diet can affect which of the following nutrients in breast milk? a) Vitamin C b) Lactose c) Iron d) Calcium Correct Answer a) Vitamin C What is the average number of ductal openings at the end of nipple? a) 6 b) 9 c) 13 d) 19 Correct Answer b) 9 Janette tells you that a 4-week-old Agatha cries a lot and is only happy when she is being held or is breastfeeding. She wants to know what she should do. Your best advise is: a) Babies need to learn to self-comfort, so let Agatha cray a while b) She needs a breastfeeding evaluation to make sure it isn't hunger c) Crying won't hurt her. If you respond to her too quickly, you will spoil her d) The quicker you respond to Agatha, the quicker she will settle Correct Answer d) The quicker you respond to Agatha, the quicker she will settle Poor positioning can be associated with: a) Nipple trauma b) Yeast infection of the nipples c) Reflux in the infant d) Hyperlactation syndrome Correct Answer a) Nipple trauma Betty's baby is 4-weeks-old and she says that breastfeeding was going well until her nipples started to hurt. She is concerned that it's the baby's latch. When you see her, which question would support your first hunch? a) Have you taken any antibiotics in the last few months? b) Are you on birth control pills? c) Do you eat lots of sugar, yeast breads, cookies, and cakes? d) Are you fatigued and under stress? Correct Answer a) Have you taken any antibiotics in the last few months? Mature milk gets about 50% of its energy from: a) Fat b) Lactose c) Protein d) DHA Correct Answer a) Fat Taylor is 38 weeks pregnant. She wants to breastfeed, but her doctor said she will have problems because she has inverted nipples. What do you do first? a) Ask Taylor how she feels about having inverted nipples b) Assess Taylor's nipples to determine the severity of the problem d) The use of galactogogues is contraindicated when inducing lactation Correct Answer b) The success rate decreases if the baby has been bottle-fed for more than 4 weeks We know the following is true about the use of marijuana: a) Marijuana metabolites can be detected in the amniotic fluid b) Women are less likely to use marijuana during pregnancy c) Fetal growth is affected by use of more than 5 "joints" in a 24 hour period d) Marijuana levels are the same in the mother's milk as they are in her plasma Correct Answer a) Marijuana metabolites can be detected in the amniotic fluid You have assessed newborn Roland and think that he has torticollis. Which of the following supports your hunch? a) He has low set ears b) His eyes deviate toward the side to which his head is turned c) He has a flattened jaw line d) There is a callus on the clavicle on the affected side Correct Answer c) He has a flattened jaw line You know that all of the following is true about breast milk jaundice EXCEPT: a) Two-thirds of all breastfed infants have hyperbilirubinemia b) Hyperbilirubinemia in breastfed infants may persist for up to 3 months c) Treatment of breast milk jaundice should include stopping breastfeeding for 48-72 hours d) Breast milk jaundice is caused by a factor in human milk that promotes intestinal reabsorption of bilirubin Correct Answer c) Treatment of breast milk jaundice should include stopping breastfeeding for 48-72 hours The best treatment for a breastfeeding baby with vomiting and diarrhea is: a) Discontinue breastfeeding for 24 hours and give an oral rehydration solution b) Continue breastfeeding but supplement with an electrolyte solution c) Discontinue all milk products and offer only tea and rice water d) Continue breastfeeding and give no other food or fluids Correct Answer d) Continue breastfeeding and give no other food or fluids Oxytocin is considered the "mothering" hormone because: a) It causes the milk-ejection reflex (MER) b) Levels are maintained throughout lactation c) Release of oxytocin is controlled by suckling d) It promotes feelings of well-being Correct Answer d) It promotes feelings of well-being Infant self-regulation regarding feedings is dependent on: a) Enzymes in the breast milk b) Being fed from the breast c) Protein levels in the breast milk d) Fat mobilization in the gut stimulating peristalsis Correct Answer b) Being fed from the breast A mother who presents with a reddened painful breast and a temperature of 99.2 should be advised to do which of the following first? a) Empty breast thoroughly and frequently b) Call the primary health care provider immediately c) Apply cold packs to the breast every 2 hours for 15 minutes d) Apply moist heat to the breast every 4 hours after a breastfed Correct Answer a) Empty breast thoroughly and frequently We know that when a mother and infant bed share that: a) The infant is more likely to die of SIDS rather than suffocation b) Exclusive breastfeeding to 6 months is more likely to occur c) There is a longer duration of any breastfeeding d) Infants exhibit increased dependency on the mother Correct Answer c) There is a longer duration of any breastfeeding Shawna is ready to stop breastfeeding because she ex exhausted. What information you can provide to her which may help her continue is: a) Fatigue is symptomatic of new motherhood regardless of how the baby is fed b) The hormones of lactation are causing you to be tired An article published in a medical journal states that there is no difference in IQ in infants who are breastfed than in infants who are formula-fed. In reading this article, which of the following is MOST important for you to determine? a) The statistical significant between the IQ points in the formula-fed vs. breastfed infants b) The age at which the IQ was measured in these children c) The definition of the term "breastfed" d) The total number of infants in each group Correct Answer c) The definition of the term "breastfed" Besides giving breastfeeding mothers current information on drugs, you tell them that for a final determination they should check with: a) The pharmacist where she had the prescription filled b) Her OB or nurse midwife c) Her family HCP d) The baby's HCP Correct Answer d) The baby's HCP Which of the following is a description of postpartum blues? a) A mild to moderate form of depression b) May come on gradually over the first year after the brith c) Is more common in breastfeeding mothers d) Is more common in primiparas Correct Answer d) Is more common in primiparas (A and B = postpartum depression) What percentage of the maternal dose of a drug generally passes into the breast milk? a) 1-2% b) 3-4% c) 7-8 % d) 9-10% Correct Answer a) 1-2% Which of the following is LEAST likely to affect newborn infant suckling behaviors? a) Crying for 10 minutes prior to a feeding b) Maternal analgesia/anesthesia during labor c) Use of an artificial nipple prior to the first breastfeed d) Separation of mother and baby for 15 minutes before the first feed Correct Answer d) Separation of mother and baby for 15 minutes before the first feed Which of the following breastfed infants will most need vitamin D supplementation? a) An Asian baby living in Los Angeles, CA b) A black Muslim baby living in Minneapolis, MN c) An African American infant living in Topeka, KS d) A Caucasian infant living in Bangor, ME Correct Answer b) A black Muslim baby living in Minneapolis, MN Terrilynn's pediatrician has told her she must stop breastfeeding immediately because her son is allergic to her milk based on blood in his stools. What would be you best initial response to Terrilynn? a) I am sorry to hear about the blood in his stools, but with allergic colitis it's best to stop breastfeeding b) Did your pediatrician discuss any other possibilities for the blood in his stools? c) This must be very stressful for you, would you feel better if you had a second opinion? d) How frightening for you, but often blood in an infant's stool is caused by something in your diet. Would you like to talk about this possibility? Correct Answer d) How frightening for you, but often blood in an infant's stool is caused by something in your diet. Would you like to talk about this possibility? All of the following are acceptable medical reasons for giving infants food other than the mother's breast milk EXCEPT: a) The mother is HIV infected b) The baby has galactosemia c) The mother has documented leprosy d) The mother is on cytotoxic drugs Correct Answer c) The mother has documented leprosy Kasey calls you, crying. "I'm miserable. I can't sleep, the baby keeps me up all the time. I have no energy, and I don't like breastfeeding. I want to quit, but I am afraid if I do that the baby won't love me." What is your most appropriate response? a) Many mothers feel this way the first couple of weeks. If you stick with it you will feel better shortly. b) You sound really down. It's scary to think that the baby won't love you. Can you tell me more about what is going on? weighed 11 lbs. 3 oz. Approximately how much should he weigh now? a) 11 lbs. 3 oz. b) 12 lbs. 5 oz. c) 13 lbs. 1 oz. d) 14 lbs. 8 oz. Correct Answer c) 13 lbs. 1 oz. (gain 1 oz. per day through end of the 3rd mo. = 74 oz. = 4.5 lbs. ~13 lbs.) Which of the following would be MOST helpful in encouraging male support of a woman who wants to breastfeed? a) Provide the mother-to-be with written information regarding the benefits of breastfeeding to share with her partner b) Encourage him to attend prenatal and WIC visits where breastfeeding will be discussed c) Encourage the mother to tell her partner how much money will be saved by breastfeeding d) Change the breastfeeding dyad to triad in your printed material to recognize the importance of the male in the supporting breastfeeding Correct Answer b) Encourage him to attend prenatal and WIC visits where breastfeeding will be discussed The best way to know a 2-week-old baby is getting enough to eat is to: a) Count the number of swallows in the first 10 minutes of the feeding b) Make sure he nurses on both breasts for at least 15 minutes per side c) Count the number of wet diapers in a 24-hour period and supplement if there are less than 6 d) Get a weight check to see that he is gaining appropriately Correct Answer d) Get a weight check to see that he is gaining appropriately Marian is a missionary in Sierra Leone where she and her 4-month-old infant have tested positive for Ebola Virus Disease (EVD). The social worker should advise her to: a) Provide her son with her pumped milk, but no physical contact between them b) Continue to breastfeed as the benefits of breastfeeding outweigh the risk using replacement foods c) Stop breastfeeding as the risk of transmission outweighs the risk of replacement foods d) Flash pasteurize her milk and feed it to her infant Correct Answer b) Continue to breastfeed as the benefits of breastfeeding outweigh the risk using replacement foods The CDC has accepted the WHO growth charts for use on breastfed infants. The reason for this change is: a) The WHO growth chart was developed for all babies including formula-fed babies b) The WHO growth chart is based on the biological norm c) The WHO growth charts take into account that not all babies are weighed on accurate digital scale d) The WHO growth charts are based on babies born in sub-Saharan Africa Correct Answer b) The WHO growth chart is based on the biological norm Nadia calls you and tells you she is so engorged that the baby is unable to latch. Which of the following techniques to relieve engorgement would you recommend first? a) Reverse pressure softening for 60-120 seconds on each side b) Fresh cabbage leaves for 2 hours or until the breast is soft c) Hot, moist compression to the breast for 15-20 minutes prior to feeds d) Icy cold compresses to breast after feeds for 15-20 minutes Correct Answer a) Reverse pressure softening for 60-120 seconds on each side Jessie has come into the outpatient lactation clinic with 3- week-old baby Ryan, complaining of yet another episode of plugged ducts. You suspect that Jessie may have over supply. Which of the following symptoms would most support that diagnosis? a) Ryan has frequent yellow, seedy stools b) Ryan is 15 oz. above birth weight c) After nursing, Jessie's residual is a total of 80 mL d) Jessie had mastitis last week Correct Answer c) After nursing, Jessie's residual is a total of 80 mL Leslie doesn't think she has enough breast milk for 2- week-old Chelsea. You know which of the following is most likely to be cited in the literature as an indication of the baby not getting enough milk. a) Frequent sucking on hands b) Crying for prolonged periods of time c) Sleeping for short periods of time Mary, who is at 36 weeks gestation, is seeing you for a prenatal visit. When you ask is she has had any breast changes she says her breasts haven't gotten bigger yet and her areolas as still the same color as when she got pregnant. Which hormone are you concerned may be low? a) Estrogen b) Cortisone c) Insulin d) Progesterone Correct Answer d) Progesterone Of the following skills, which is the most important for Frankie, the new IBCLC, to have? a) Ability to set goals for herself and others b) Listening, counseling, and communication skills c) How to do referrals, when, and to whom should she refer d) Knowledge of current medical terminology Correct Answer b) Listening, counseling, and communication skills You are teaching a prenatal breastfeeding class, and Simone tells you that with her first baby she became terribly engorged. She wants to know the best way to prevent that this time. What is your first, best advice? a) Breastfeed in the birthing room and as often as possible thereafter b) Pump after every breastfeed to make sure the breasts are completely empty c) Wear a good fitting, supportive bra as soon as she moves to postpartum d) Avoid drinking excessive fluids to keep edema to a minimum Correct Answer a) Breastfeed in the birthing room and as often as possible thereafter Mary Grace just delivered as full-term baby. She has been in an insulin-dependent type 1 diabetic since she was 15- years-old. She has many questions and concerns about breastfeeding and her diabetes. Which of the following is true about diabetes and breastfeeding? a) Because of the increased sugar in her milk, t he baby will need to be supplemented with formula to prevent obesity b) Mary Grace will most likely find that her insulin needs are decreased so she will have to watch her glucose carefully c) In order to keep her blood glucose levels stabilized, Mary Grace should plan on formula-feeding the baby d) Breastfeeding will have no impact on her diabetes, so there is really nothing to be concerned about Correct Answer b) Mary Grace will most likely find that her insulin needs are decreased so she will have to watch her glucose carefully You work in a family practice clinic and are looking for ways to help the women who are breastfeeding to nurse longer. In your research which of the following do you find has the most positive relationship with a longer duration of breastfeeding? a) Positive support from health care professionals b) Membership in mother or mother support groups c) Providing information to mothers about the dangers of formula d) Mother was enrolled in WIC Correct Answer a) Positive support from health care professionals When interviewed most mothers who were breastfeeding said which of the following would help them most with breastfeeding? a) Private breastfeeding classes b) Hands-on help with breastfeeding c) Not having professional people all telling them different things d) To have been given a quality breast pump when discharged from the hospital Correct Answer b) Hands-on help with breastfeeding Chloe comes to you in tears. You have been working with her to get one-week-old baby Jonathan latched well, and finally things seem to be OK. The physician has just told her that Jonathan's bilirubin level is high enough that she wants her to stop breastfeeding and give formula for 48 hours to bring it down. What is your best advice? a) "It sounds as though it is breast milk jaundice. You really don't have to stop breastfeeding for that. The bilirubin will come down on its own." b) "Pump until your breasts are empty and then feed the baby with formula using a feeding tube at the breast." c) "I recommend that you pump and dump for the next 48 hours, feeding your baby with formula using a cup." d) "I know you are sad about having to stop breastfeeding, but if you use a bottle that has a bulbous base and a short c) Mother can stop pumping once the milk has stopped flowing d) Mothers should pump more often than she would be nursing at home Correct Answer a) If she double pumps, she will save herself time In recent years, additional federal funds have been provided to the WIC programs to: a) Be able to purchase special needs formulas b) Develop programs to teach the negative effects of formula discharge bags c) Provide more support for breastfeeding d) Develop information on the hazards of early cereal feeding Correct Answer c) Provide more support for breastfeeding Drugs generally enter the milk through a process known as: a) Osmosis b) Passive diffusion c) Convection d) Infusion Correct Answer b) Passive diffusion The primary reason mothers who are using a nipple shield should pump after feedings is: a) To insure a full milk supply b) To obtain milk for supplementation c) To elongate an inverted nipple d) To eliminate use of the shield sooner Correct Answer a) To insure a full milk supply Which of the following is true regarding sexual abuse? a) Women may fear exposure during breastfeeding in public b) Health care providers are reluctant to care for women who have been abused c) Abused women are less likely to initiate breastfeeding d) Childbirth will heal memories of sexual abuse Correct Answer a) Women may fear exposure during breastfeeding in public Infants with a congenital deficiency of zinc should be breastfed because: a) Breast milk contains higher quantities of zinc than do infant formulas b) Breast milk contains prostaglandin E, which enhances the absorption of zinc c) Without breast milk, the infant is likely to diet from pemphigus infantalis d) The linolenic acid in breast milk enhances the myelin sheath laid down Correct Answer b) Breast milk contains prostaglandin E, which enhances the absorption of zinc You are working with Elizabeth, who has given birth at 35 weeks to baby Sam. Which of the following would be good advice to give to her regarding nursing Sam? a) Gently wake him to nurse every 2 hours b) Make sure he takes both breasts at each feeding c) Limit him to nursing twice a day at the breast and feed him with his bottle the rest of the time d) Observe him for feeding cues, making sure he gets at least 6 feedings in every 24 hours Correct Answer d) Observe him for feeding cues, making sure he gets at least 6 feedings in every 24 hours One method of care that works across many different cultures is: a) Teaching manual expression b) Facilitated group discussions c) Peer counselor support d) Using olive oil for sore nipples Correct Answer a) Teaching manual expression Which of the following is covered by the International Code of the Marketing of Breast-Milk Substitutes? a) Breast pumps b) Tomato juice c) Tube feeding devices d) Bottles and nipples (teats) Correct Answer d) Bottles and nipples (teats) Henry was diagnosed with Hirschsprung's disease when he was 12-months-old. Which of the following would be a reason why there was a delay in establishing his diagnosis? a) Henry is still being breastfed b) The bacteria in Henry's gut is different than if he had been formula-fed c) Henry has frequent bouts of diarrhea d) Henry has not yet received any immunizations Correct Answer a) Henry is still being breastfed d) Keeping mothers and babies skin-to-skin until the first feed is accomplished Correct Answer d) Keeping mothers and babies skin-to-skin until the first feed is accomplished It has been 4 hours since baby Grace has nursed. You help her mother gently wake her up. Which of the following must Grace display in order for the feeding to be successful? a) Eyes wide open b) Quiet alert state c) Toes curled d) Mouthing movements Correct Answer d) Mouthing movements Confidence is higher for mothers when they view breastfeeding as manageable. One thing mothers have identified as helping them achieve this confidence is: a) Receiving a formula discharge bag before going home b) Assistance from the nurses while in the hospital c) Early discharge from the hospital d) Accessibility to lactation support after discharge Correct Answer d) Accessibility to lactation support after discharge Which of the following practices is protective against early termination of breastfeeding? a) Breastfeeding within the first hour b) Supplementing with formula no more than twice in 48 hours c) Giving no pain medication to mother in labor d) Using sucrose drops during painful procedures Correct Answer a) Breastfeeding within the first hour The hormonal trigger for breast milk production is due to: a) Release of prolactin from the anterior hypothalamus b) Release of oxytocin from the posterior pituitary c) Release of oxytocin from the posterior hypothalamus d) Release of prolactin from the anterior pituitary Correct Answer d) Release of prolactin from the anterior pituitary An effective strategy ti improve public health in the U.S. is: a)Increased funding for health care b) An increase in breastfeeding duration c) To provide nutritional guidelines for fast food d) To increase the requirements for PE in schools Correct Answer b) An increase in breastfeeding duration Wanda comes into the lactation clinic with a macerated left nipple that she has had for over a week. Which of the following is a recommended technique to help macerated nipples heal? a) Dry with hair dryer b) Vitamin E oil c) Coconut oil d) Vegetable oil Correct Answer c) Coconut oil In order to facilitate the best first feed: a) The baby should be placed on the mother's abdomen and crawl to the mother's breast b) The baby should be placed on his abdomen between mother's breasts c) The head of the mother's bed should be no more than a 20 degree angle d) The baby should be placed with his head on the left breast Correct Answer b) The baby should be placed on his abdomen between mother's breasts You are taking a history from Sheila concerning her possible mastitis. Which of the following is most likely to have occurred in the previous 48 hours? a) Nipple trauma b) Fever of unknown origin c) A severely stressful situation d) A report of extended fatigue Correct Answer a) Nipple trauma Causes of postpartum depression can include which of the following? a) Clinical depression in maternal 2nd degree relatives b) Having a difficult relationship with the mother-in-law c) Being diagnosed with hyperthyroidism d) Mom has a negative birth experience Correct Answer d) Mom has a negative birth experience One of the consequences of induction sing synthetic oxytocin for breastfeeding women is: a) Decreased likelihood of infant suckling effectively while skin-to-skin in first labor b) Increase in the rate of suckling for the newborn c) Decrease in rates of neonatal jaundice the third day after birth d) Decrease in the rates of neonatal weight loss post-birth Correct Answer a) Decreased likelihood of infant suckling effectively while skin-to-skin in first labor d) Overwhelming CNS stimulation in the baby Correct Answer d) Overwhelming CNS stimulation in the baby Alyssa reports that Ethan falls asleep whenever the nurses bring him to here to breastfeed. Which of the following would be the most helpful advice? a) Room-in with Ethan, watching him for feeding cues b) Wake him by washing his face with a cool, damp cloth c) Make sure the nurses bring him in as soon as he cries d) Coax him to the breast using drops of glucose water on the nipple Correct Answer a) Room-in with Ethan, watching him for feeding cues Babies who have early contact with their mothers and who were provided with postpartum support are more likely to: a) Have a faster weight gain than babies who are separated from mom b) Be able to sleep in their own room by one month c) Be breastfed long enough to meet the mother's goals d) Breastfeed more frequently at night Correct Answer d) Breastfeed more frequently at night On the physical exam of a 28-week preterm infant , which of the following is likely to be found? a) Lanugo all over the body b) Dry and peeling skin c) Palpable breast buds d) Ability to coordinate suck, swallow, and breathe Correct Answer a) Lanugo all over the body Cherie, a new mother, with a 4-week-old infant, visits you for a breastfeeding evaluation. In the process of taking her history, you find that Cherie eats mostly chips, cookies and soda "because she is just too busy to prepare anything". Your MOST IMPORTANT concern with Cherie's diet is: a) The quality of her breast milk b) The quantity of her breast milk c) The health of the baby d) The depletion of Cherie's nutrient stores Correct Answer d) The depletion of Cherie's nutrient stores Halli is now 2-hours-old and still has not shown any interest in nursing. You do a blood sugar test on Halli, and find that it's 38 mg/dL, which is lower than your hospital standard of 40 mg/dL. What should you do first? a) Put her under the warmer as she is most likely hypothermic b) Give her 1 oz. of formula by finger-feeding c) Have mom hand express colostrum and feed her with a spoon d) Wait about 30 seconds and use a second reagent strip to check the glucose Correct Answer d) Wait about 30 seconds and use a second reagent strip to check the glucose Mothers with breastfeeding problems may be hesitant to seek help from a professional for the following reason: a) Lack of insurance coverage for lactation services b) Having to leave her home to seek help c) Stress of having to repeat "her story" to multiple people d) Having problems is in conflict with the image of being a super-mom, which she wants to portray Correct Answer d) Having problems is in conflict with the image of being a super-mom, which she wants to portray A type of research that focuses on relationships among variables is called: a) Qualitative b) Quantitative c) Statistically significant d) Randomized controlled trials Correct Answer b) Quantitative Nipple erection is induced by which of the following? a) Myoepithelial cells contracting the lactiferous sinuses b) Somatic parasympathetic stimuli c) Autonomic sympathetic stimuli d) Adequate levels of aphrodisiacs Correct Answer b) Somatic parasympathetic stimuli Which of the following drug categories are contraindicated for use during breastfeeding? a) Pseudoephedrine b) Oral contraceptives c) Cancer chemotherapeutic agents d) Diuretics Correct Answer c) Cancer chemotherapeutic agents You are a nurse who works at St. Beneficial Hospital. You have just delivered preterm twins. A formula representative offers you samples of a new formula, which Florence birthed Josh at 32 weeks of gestation. Which of the following would be the first thing to include as a part of her pumping plan? a) Begin expressing within the first hour post-birth b) Determine her nipple size to provide her with the appropriate flange c) Use a hospital grade breast pump d) Pump using a double pumping system Correct Answer a) Begin expressing within the first hour post-birth Increased rates of autism spectrum disorders (ASD) are seen in children who: a) Received less than 1 hour of skin-to-skin after birth b) Received formula supplements in the first week of life c) Were formula-fed from the beginning of life d) Were exclusively breastfed for less than 3 months Correct Answer c) Were formula-fed from the beginning of life Which of the following statements about lactose in human milk is true? a) Lactose provides 60% of the calories in human milk b) Lactose is essential for CNS development c) Lactose is decreased in human milk when the mother eliminates dairy d) Lactose concentration decreases from 2-16 weeks Correct Answer b) Lactose is essential for CNS development Daisy, who is 21 days postpartum, is seen in the outpatient clinic with burning, painful, red nipples for the last 4 days. Which of the following is most likely to be a cause of her sore nipples? a) Baby has a shallow latch b) Allergic reaction to lanolin c) Her infant is tongue tied d) She has a yeast infection Correct Answer d) She has a yeast infection Hope is 3 weeks postpartum and doesn't have enough breast milk. Her history and exam haven't yielded any reason for the low supply. Which test would you want to have done first to possibly provide a reason for low milk supply? a) Thyroid levels b) Iron levels c) Testosterone levels d) Serum prolactin levels Correct Answer a) Thyroid levels Josey just delivered 29 week infant, Henry, by c-section because of high blood pressure and increasing amounts of protein in her urine. Which of the following is most likely to contribute to Josey have a low milk supply. a) Josey delivered by c-section b) Josey didn't start pumping until 6 hours after the birth c) Josey's average pumping frequency was 7-8 times per day d) Josey had pre-eclampsia at the time she delivered Correct Answer a) Josey delivered by c-section A potential milk donor may be excluded by the Human Milk Banking Association if the mother: a) Has a 6 oz. glass of wine on a daily basis b) Has been a practicing vegetarian for the last 3 years c) Received a blood transfusion in the past 4 months d) Has had influenza in the previous year Correct Answer c) Received a blood transfusion in the past 4 months Which of the following is an important component of the Baby Friendly Hospital Initiative? a) Adhering to the International (WHO) Code b) Following the Bellagio Consensus c) Minimize interventions in labor and delivery d) Providing follow-up for breastfeeding mothers and babies Correct Answer d) Providing follow-up for breastfeeding mothers and babies Cheryl calls the lactation hot-line complaining that her milk supply is decreasing. She also says that 4-week-old Ronnie spits up a lot and there appeared to be streaks of blood in his stool earlier in the day. What is your first suggestion? a) Take Ronnie to his pediatrician for an evaluation b) Visit the lactation clinic immediately for an evaluation and feeding assessment c) Have the mother record everything she has eaten in the last 48 hours to determine what food is causing the symptoms d) Tell the mother to eliminate dairy products for 14 days. Then keep a record of Ronnie's spitting and a description of his stools Correct Answer a) Take Ronnie to his pediatrician for an evaluation guidelines you need to consider when selecting your handouts should be: a) Information must be current and consistent b) Handouts should have a 4th grade reading level and lots of white space c) Include information on references for IBCLCs in your community d) Information should include common situations which may occur after the mom is discharged Correct Answer a) Information must be current and consistent Exclusive breastfeeding is more likely to occur if: a) The infant weighed 8 lbs. or more b) Did at least 30 minutes of skin-to-skin after birth c) Wasn't bathed for 4 hours post birth d) Mother who had a c-section did skin-to-skin in the recovery room Correct Answer a) The infant weighed 8 lbs. or more Susan has nipples that are raw and bleeding from nursing her infant who was tongue tied, but who had it revised yesterday. Which of the following would be a good first choice to use with her nipple trauma? a) Tea bags b) Coconut oil c) Saline soaks d) Antibiotic ointment Correct Answer c) Coconut oil Milk banks who are members of the Human Milk Banking Association of North America: a) Provide milk to both hospitals and individuals b) Allow selected donors to be paid c) Test donor milk for bacteria d) Sell the milk for a substantial profit Correct Answer a) Provide milk to both hospitals and individuals Infants may suddenly collapse while doing skin-to-skin. What can be done to decrease the risk of this happening? a) Mother lying flat with the baby between her breasts b) The baby's head is turned to one side, and is very slightly extended c) Head tilted back so trachea is straight and extremities extended d) Infant's chest is in contact with the mother's body and head is midline Correct Answer b) The baby's head is turned to one side, and is very slightly extended When a hospital who was working to become Baby Friendly eliminated pacifier use, what was the outcome? a) Supplemental formula increased from 18-28% b) Breastfeeding challenges decreased by a factor of 10 c) Exclusive breastfeeding rates increased from 68-79% d) 15% of mothers were sneaking pacifiers into the facility Correct Answer a) Supplemental formula increased from 18-28% The optimal time interval between pregnancies for a mother is: a) 6-9 months b) 12-15 months c) 24-30 months d) 36-59 months Correct Answer d) 36-59 months Rebecca tells you that Tanya, her 3-week-old breastfed infant, has colic. You know that the most common reason for "colic" is: a) Infant isn't being fed enough b) Mother is smoking more than 1/3 pack of cigarettes per day c) Mother has too much breast milk d) A diet that is very high in dairy products Correct Answer a) Infant isn't being fed enough Stacey visits you stating her "milk hasn't come in yet". Her baby is 10-days-old and hasn't regained her birth weight. After taking a history, you discover that Stacey continues to have heavy bleeding that contains blood clots. What do you suspect is the reason for the low milk supply? a) Retained placental fragments causing a decrease in prolactin levels b) Retained placental fragments causing estrogen levels to remain high c) Retained placental fragments causing progesterone levels to remain high d) Retained placental fragments causing a drop in the prolactin inhibitory factor (PIF) Correct Answer c) Retained placental fragments causing progesterone levels to remain high Krystal Starr is undecided about whether or not to breastfeed her baby because she smokes a pack of cigarettes per day. Which of the following is the most important to discuss with her? a) 7-9 months b) 9-12 months c) 12-14 months d) 14-18 months Correct Answer b) 9-12 months Cindy calls you saying her internist prescribed a new drug, "Diabloc" for her Crohn's disease. She wonders if it's compatible with breastfeeding. Which of the following properties of "Diabloc" might cause you to investigate further the safety of the use of the drug in breastfeeding mothers? a) Molecular weight = 825 b) Milk plasma ratio = 0.4% c) Protein binding = 33% d) Pediatric half-life = 2-3 hours Correct Answer c) Protein binding = 33% Lucy Maud wants to know if there are any foods she can eat to increase her supply. You tell her that while there aren't any that are research-based, it's commonly thought that which of the following is helpful. a) Oats and oatmeal b) Avocados c) Mangos d) Walnuts Correct Answer a) Oats and oatmeal Shawn was born at 33 weeks gestation. At 3 days of age, he is starting to be bottle-fed to wean him off his feeding tube. Which of the following should we expect of Shawn? a) Coordinate his suck, swallow and breathing while bottle-feeding b) Falling asleep after bottle-feeding for 2-3 minutes c) Will bottle-feed in a supported Semi-Fowlers position better than in a side-lying position d) Will have more problems with aspirations if he is fed preterm formula rather than breast milk Correct Answer d) Will have more problems with aspirations if he is fed preterm formula rather than breast milk Jordan says she thinks she isn't going to breastfeed because she has heard that there are contaminants in breast milk. She is afraid breast milk will hurt her baby. Based on the evidence, what do you tell her? a) Oh Jordan, I understand your concern, but you don't need to worry. There aren't any contaminants in human milk. b) Well, yes you are right. There are contaminants in breast milk. Depending on how bad the area is where you live, it may be better for you to feed your baby formula c) You are right to be concerned about that, but remember that cows have contaminants in their milk too d) Jordan, the biggest concern is during fetal life. While there are contaminants in human milk, it actually helps the baby to overcome the potential adverse neurological outcomes from exposure in utero Correct Answer d) Jordan, the biggest concern is during fetal life. While there are contaminants in human milk, it actually helps the baby to overcome the potential adverse neurological outcomes from exposure in utero