CLC Exam Questions and Answers (Latest Update 2025) Verified Answers, Exams of Nursing

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What are green/shiny stools a sign of? - Correct Answer ✅-sign of overproduction leading to less fat in milk, faster digestion causing not enough time for lactase to digest the lactose in milk. An improved latch could allow for more fat flow Signs of oversupply - Correct Answer ✅Rapid weight gain in infant, unsettled baby after feeding, recurrent plugged ducts and mastitis, painful feedings, voluminous (huge volumes of) stools- often green & shiny What causes nipple pain? - Correct Answer ✅Improper latch--> need lactation support to help with proper latch on, good seal True/false: baby should be pulled into breast. - Correct Answer ✅False! Do not pull baby into breast, let baby tilt head back for optimal latch. Hand on back of baby's head can interfere baby's interoral function by restricting the movement of the cranio-cervical spine--> causes nipple trauma. Make sure crook of arm in cradle position does not block baby from being able to fully tilt back.

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Should a latch be symmetric or asymmetric? - Correct Answer ✅Asymmetric! A baby should form a teat with breast tissue underneath the nipple as part of a latch What is a symmetric latch - Correct Answer ✅Not a good latch, causes nipple damage Asymmetric latch - Correct Answer ✅Optimal attachment to the breast, where the baby's lips are not centered in relationship to the areolar, but rather vertically off-centered with the baby's chin and lower lip closer to the edge of the areola than the baby's upper lip. A baby should form a teat with breast tissue underneath the nipple as part of a latch Do nipple creams work? - Correct Answer ✅Continued questions of effectiveness, fear of ingestion by baby

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What to do for oversupply? - Correct Answer ✅Decrease additional stimulation/milk removal if possible Consider block feeding (only nursing on one side only per feeding) Watch for mastitis Try australian posture (mother down under, baby on top) Consider donating to milk bank Consult with HCP for medical dx How many mL considered oversupply? - Correct Answer ✅normal milk production = 750-1000 mL/day Thrush during BF - Correct Answer ✅painful for mother & baby. may be visible or may not (whiteness that can't be wiped off) -mother will have itchy, flaky, shiny skin -candida not found inside the ducts or milk Treatment of candida on breast - Correct Answer ✅-nystatin first line

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-flucanizole second line -throw out all yeast vectors (pacifiers sterilize breast pumps) -flucanazole oral capsules may be used to clean yeast vectors due to the biofilm created on pacifiers by candida What to do if antifungal treatment for yeast doesn't work? - Correct Answer ✅Not candida infection! Reynaud's Phenomenon - Correct Answer ✅-vasospasm of nipple, recognized by triple color sign: from white--> blue--> raspberry or bicolor sign white --> raspberry. pain is extreme and spasmodic (not continuous) -this happens after feeding once baby's mouth comes off nipple has vasospasm, feels like frostbite treatment of reynauds - Correct Answer ✅-prevent/decrease cold exposure

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See PCP if clog hasnt moved in 24-48 hours or systemic symptoms of inflammation (flu like s/s) When to call PCP for clog/plug - Correct Answer ✅If plug hasn't moved in 24-48 hrs or systemic signs of inflammation (flu like s/s) Causes of clogs/plug - Correct Answer ✅too tight nursing bra what is a bleb - Correct Answer ✅small white spots on the face of the nipple that look like milk-filled blisters. one duct opening is usually covered what does a bleb feel like - Correct Answer ✅painful stabbing pinpoint pain how to get rid of blebs - Correct Answer ✅Same as clog treatment. Sometimes need t be lanced by HCP

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Common mastitis - Correct Answer ✅-can be non-infective or infective -blocked ducts from engorgment, hurried feedings, nipple shield (pressure will build until milk sneaks out of space, body reacts to this like invader) causes of common mastitis - Correct Answer ✅-tight bra (look for indentation of breast straps) -use of breast shell or nipple shell -attachment difficulties -anemia in the mother -tongue tie in baby (ineffective milk emptying) s/s common mastitis - Correct Answer ✅systemic- fever, ill, malaise, redness, pain, one inflamed breast What bacteria causes infective mastitis - Correct Answer ✅Staphylococcus

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Double mastitis - Correct Answer ✅EMERGENT AND UNCOMMON- tissue of both breasts inflamed. organism cause of double mastitis - Correct Answer ✅strep -potentially fatal, whole body inflammation, sepsis -not a problem with milk signs of inflammatory breast cancer - Correct Answer ✅- breast tissue is red, warm, has orange peel (peau d'orange), pitting appearance on skin surface

• breast mass may or may not be present True/false: MRSA can look like mastitis when on breast - Correct Answer ✅TRUE can masquerade as mastitis. might see peeling skin, pitting. can also cause lesions and abscess.

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Abscess on breast is full of ... - Correct Answer ✅PUS not MILK. as many as 60% positive for MRSA. can you nurse on same side as abscess - Correct Answer ✅No should nurse on other breast. must be aware of possible contamination on flanges, pump parts, can not track infection from one side to other. abscess surgical intervention - Correct Answer ✅can cut through nerves and ducts. try to avoid surgical intervention treatment of abscess - Correct Answer ✅drainage through ultrasound- guided technique is first choice (needle aspiration often has to be repeated) Report any suspicious area of the breast to a qualified provider because it could be... - Correct Answer ✅MRSA or herpes- fatal for babies

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• Tachycardia
• Dyspnea
• Grunting
• Cyanosis
• Apnea
• Low temperature
• High-pitched cry
• Irritability
• Lethargy & poor feeding
• Seizures, coma
• No signs (some infants may be asymptomatic) Do healthy term newborns need glucose checks - Correct Answer ✅No Jaundice is caused by - Correct Answer ✅Unconjugated bilirubin that accumulates in blood stream of newborn because fetal-type blood cells

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are broken down and live and intestines too immature to excrete at fast pace. Pathologic jaundice - Correct Answer ✅Result of an underlying disease appearing before 24 hours (or persistent after day 7) -due to sepsis, blood incompatibility Bhutani curve - Correct Answer ✅Chart that can be used to determine when bilirubin levels require treatment Early onset jaundice - Correct Answer ✅"Physiological" or "starvation" jaundice Peaks 72-96h after delivery Frequently related to underfeeding "lack of breastfeeding" jaundice Late onset jaundice - Correct Answer ✅develops second week of life infant thriving, gaining wt, stooling

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can skin to skin help a latch? - Correct Answer ✅yes- influences state organization and motor system modulation, can help with difficulty latching and sustaining a feed skin to skin with twins- each breast... - Correct Answer ✅warms up depending on the temperature of each baby closest to breast preemies/skin to skin - Correct Answer ✅decreased time of nicu stay, improved weight gain, more mature sleep patterns, improved cerebral blood flow, warmer/more stable, better breastfeeding Negative influences on milk production - Correct Answer ✅Long spaced between feedings Long, slow feedings-can effect prolactin production Excessive pressure in breast Breast surgery/injury Suboptimal breast anatomy

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Why does pressure occur in breast? - Correct Answer ✅Vascular, lymphatic, and third-spacing forces, especially early on Sensory activation- lactogenesis II Normal fullness vs engorgement - Correct Answer ✅Normal fullness= breast soft, body temp normal, mother feels well, breast may be hot, baby can grasp nipple Engorgment = hard breast, temp normal or higher, feels discomfort, breast hot & shiny, nipple difficult to grasp, baby can't latch When do engorgment symptoms most commonly occur? - Correct Answer ✅In days 3- Mothers who have had IV fluids in labor have higher levels of swelling up to day 9 C-section moms experience peak engorgement 24-48 hours later than those who deliver vaginally

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Why is breast surgery/injury a concern for BF? - Correct Answer ✅- damage to nerves/ducts may not be patent -peri-areolar incision extends all around areola, look for defined margin where color changes from areola to breast. Types of breast reduction - Correct Answer ✅-free nipple graft -pedicle (women who underwent breast reduction surgery had shorter time of exclusive/any BF) -chest masculinization "top" surgery Supporting chest feeding - Correct Answer ✅-restarting testosterone and binding were common concerns -care providers should communicate an understanding of gender dysphoria and transgender identities in order to build trust and provide transgender competent care Counseling implications after breast surgery - Correct Answer ✅- likelihood of full breastfeeding is unknown

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-hormonal exposure of pregnancy and lactation may mitigate some effects of surgery -assessment and close follow up are the keys -assure adequate nutrition for the infant -determine innervation/sensation Anatomical concerns for BF - Correct Answer ✅-absence of breast changes (in pregnancy or early days postpartum) -no postpartum breast fullness or signs of abundant milk production -hypoplastic breasts -discrepant breast size -one implant may indicate that were was a discrepant breast size When counseling moms with breast surgery- ask yourself - Correct Answer ✅Are ducts patent? Are nipple pores patent? Are there signs of hormonal connection?