IBCLC Exam Prep Questions and Answers 100% correct | Latest Update 2024, Exams of Advanced Education

Download IBCLC Exam Prep Questions and Answers 100% correct | Latest Update 2024 and more Exams Advanced Education in PDF only on Docsity! IBCLC Exam Prep Questions and Answers 100% correct | Latest Update 2024 What is the first question to consider when helping a breastfeeding mother with a medication question? A) What is the relative infant dose of the medication? B) What is the protein binding of the medication? C) What is the molecular weight of the medication? D) Is the medication really necessary to take now? - Correct Answer-D Which drug property results in more transfer of the drug into the mother's milk? A) Molecular weight >800 Daltons B) High protein binding C) High lipid solubility D) Low maternal plasma concentration - Correct Answer-C When it comes to medications and breastfeeding, drugs with a shorter half-life are preferred. How many half-lives until it is generally considered that the drug is eliminated from the system? A) 3 B) 5 C) 7 D) 9 - Correct Answer-B If a woman is given 80 mg of a drug to treat a urinary tract infection - and the drug has a half-life of 3 hours - how much will be left in her system after 3 half-lives? A) 40 mg B) 20 mg C) 10 mg D) 5 mg - Correct Answer-C What is considered a high enough molecular weight that the medication will be too big to easily get into the breast milk compartment? A) 200 Daltons B) 300 Daltons C) 400 Daltons B) L3 C) L4 D) L5 - Correct Answer-B In which lactation risk category in Medications and Mothers' Milk is this the recommendation: "The drug is contraindicated in women who are breastfeeding an infant." A) L2 B) L3 C) L4 D) L5 - Correct Answer-D) L5 Many antibiotics are safe for the breastfeeding mother to take. However, caution needs to be taken with this antibiotic, ________, about which Hale's Medications and Mothers' Milk says, "This antibiotic can be extremely toxic, particularly in neonates, and should not be used for trivial infections." A) Ampicillin B) Chloramphenicol C) Gentamicin D) Metronidazole - Correct Answer-B) Chloramphenicol Plasma levels of most topical and ophthalmic preparations are virtually nil and are not likely to produce milk levels at all. A) True B) False - Correct Answer-A) True Some drug pumping systems exist in the alveolar cell (the cells that line the milk sac). For example, iodine is readily pumped into the milk compartment. Therefore, any form of radioactive iodine should be avoided while breastfeeding. A) True B) False - Correct Answer-A) True Although there are many exceptions, in general, _______ of the maternal dose finds its way into the milk and, subsequently, to the baby. ***(Do not confuse this with Relative Infant Dose) A) <1% B) 5% C) 10% D) 12.5% - Correct Answer-A What is the AVERAGE volume of milk consumed per 24 hours by a breastfed baby around age 2-4 weeks? A) 550-600ml (18-20oz) B) 650-700ml (21.5-23oz) C) 750-800 ml (25-26.5oz) D) 850-900ml (28-30oz) - Correct Answer-C Which statement about the effect of human milk on the child's immune system would be MOST important to medical students? A)Human milk stimulates the baby to begin making his own SIgA and other antibodies. B)Exclusively breastfed babies have a poorer response to immunizations. C) The mother's own milk provides passive immunity between placentally acquired immunity and autonomous immune protection. D)The breastfed baby is at higher risk of infection because he relies on the mother's immune protection during breastfeeding - Correct Answer-C Which component of preterm milk is proportionally higher than in term milk? approximates that of an exclusively breastfed 3-month-old baby? A)4-6 feeds per day, total 60 minutes or more B)6-8 feeds per day, total 100 minutes or more C)8-10 feeds per day, total 120 minutes or more D)10-12 feeds per day, total 140 minutes or more - Correct Answer-D (8-12 feeds 140-160 minutes) When are fat levels in mother's milk highest? A)When the milk ejection reflex is strong B)During the night C)After the mother eats a high-fat diet D)When the breast is relatively empty - Correct Answer-D Which of the following is the MOST IMPORTANT function of lactoferrin? A)Bind and deactivate pathogens B)Nerve Myelinization C)Iron Transport D)Anti-inflammatory agent - Correct Answer-A (also transports iron and is anti-inflammatory) What is thought to be the PRIMARY function of Montgomery glands? A)Pigmented marker for visual targeting B)Lubricate the skin of the areola C)Secrete antibiotic substances D)Change elasticity of areola skin - Correct Answer-B Which hormone in the milk is MOST responsible for anti- inflammation activity? A)Prolactin B)Prostaglandins C)Oxytocin D)Relaxin - Correct Answer-B Which breast structure contains muscle fibers? A)Lactiferous sinuses B)Alvoli and ducts C)Montgomery tubercles D)Lactocytes - Correct Answer-B (contain smooth muscle fibers) Approximately how much milk does a baby age 1-3 days obtain at the breast? A)150ml/day (5oz/day) of colostrum B)The baby gets increasing amounts each day as milk volume increases C)The baby needs a supplement until day 5 when mother's supply is sufficient D)The baby gets 750ml/day (25oz/day) from day 2 onward - Correct Answer-B (baby may only get around 30mls or 1 oz per day in first couple of days but increases drastically) The tail of Spence is mammary glandular tissue that: A)is only present with supernumerary nipples B)does not produce milk C)extends into the axilla D)is not connected to the breast duct system - Correct Answer-C-extends into the axilla Which of the following BEST explains the ease with which human milk fat is digested by the infant? A)Unsaturated fats account for 57% of total lipids The only internationally certified healthcare provider with expertise in breastfeeding and lactation medicine is the: a. Certified Lactation Counselor (CLC) b. International Board-Certified Lactation Consultant (IBCLC) c. Certified Nurse Midwife (CNM) d. Physician Assistant (PA) - Correct Answer-B The International Board of Lactation Consultant Examiners (IBLCE): a. Only provides a test for IBCLCs b. Licenses IBCLCs to practice c. Provides the IBCLC exam and establishes standards in breastfeeding care - Correct Answer-C The International Board of Lactation Consultant Examiners (IBLCE) was founded to: a. Teach mothers about breastfeeding b. Protect the public by providing an internationally recognized level of knowledge of breastfeeding care c. Discourage the use of formula for newborns - Correct Answer-B The documents of the IBLCE apply in: a. The USA only b. The hospital setting only c. All countries and all settings - Correct Answer-C The Clinical Competencies of the IBCLC include: a. Providing evidence-based information on the impact of medications taken while breastfeeding b. Promoting the principles of the Baby-Friendly Hospital Initiative c. Both a and b - Correct Answer-C Taking the IBCLC exam requires: a. Lactation education only b. Lactation education and clinical experience c. Lactation clinical experience only - Correct Answer-B The IBLCE Code of Professional Conduct includes: a. Actions for the IBCLC who has engaged in substance abuse b. How the IBCLC should dress c. Where the IBCLC should practice - Correct Answer-A Briefly, what is due diligence? a. Declaring bankruptcy b. Taking reasonable care not to harm someone c. Making a mistake d. Doing something that is illegal - Correct Answer-B Briefly, what is misfeasance? a. Taking reasonable care not to harm someone. b. Making a mistake c. Doing something that is illegal d. Declaring bankruptcy - Correct Answer-B Andrea, an IBCLC, has been working with a mother and infant for several weeks. She saw the family 3 times, but billed the insurance company for 6 visits. This is an example of: a. Due diligence b. Misfeasance c. Malfeasance d. Tax evasion - Correct Answer-C b. Candida albicans c. Phospholipids d. Bifidus factor - Correct Answer-D Crying is MOST likely to be: a. distress at separation from mother b. an indication of pain c. infant's attempt to manipulate mother d. stressful to the baby's physiology - Correct Answer-D Manufacturers of formula milks (breast milk substitutes) have attempted to increase the protective properties in their products by adding which of the following nonprotein nitrogen compounds found in human milk? a. Polyamines b. Nucleic acids c. Nucleotides d. Creatinine - Correct Answer-C The MOST LIKELY result of a mother eating cantaloupe would be: a. her milk will contain more Vitamin A b. her milk supply will increase c. the baby's breath may smell like cantaloupe d. the baby will reject the cantaloupe-flavored milk - Correct Answer-C (mother's milk can have trace flavors present based on food choices) Which of the following statements BEST describes the difference in fat content of colostrum vs. mature milk? a. Colostrum has 4-5 g/100ml, while mature milk has 2-3g/100ml of fat b. Colostrum has 2-3g/100ml, while mature milk has 4-5g/100ml of fat c. Colostrum has roughly one-fourth the fat content of mature milk d. Colostrum has 10cc of fat, while mature milk has 20cc of fat - Correct Answer-B If a 4-year old girl had a chest tube placed in her ribs below and distal to her right nipple, what is the most significant effect this surgery might have on her ability to breastfeed? a. damage to the ductal structure b. damage to the blood vessels supplying the breast c. severed nerve pathways to the nipple d. cut blood vessels to the breast - Correct Answer-C (tube placement is close to location of 4th intercostal nerve) What is the MOST IMPORTANT function of viral fragments that appear in human milk? a. Often cause infant illness b. Act as a "vaccination" against disease c. Digested by the infant as food d. Can be killed by heat treatments - Correct Answer-B (triggers baby's immune response and does not appear to transmit disease) Some brands of artificial baby milk produced in the 1980s lacked which essential nutrient causing brain damage and learning disabilities in infants that were fed this milk exclusively? a. sodium b. chloride c. potassium d. calcium - Correct Answer-B B) Median C) Mode D) Range - Correct Answer-C Which term means 50% of the numbers fall below the number and 50% of the numbers fall above the number? A) Mean B) Median C) Mode D) Range - Correct Answer-B Which term refers to the average of a set of numbers? A) Mean B) Median C) Mode D) Range - Correct Answer-A What is the range of this set of numbers? 9, 5, 8, 2, 13, 29, 27 A) 9 B) 27 C) 29 D) 2 - Correct Answer-B (29-2) A qualitative study: A) Cannot be used if research subjects only speak English B) Allows for exploration of ideas and experiences in depth C) Deals with numbers and statistics D) Must have a statistically significant result - Correct Answer- B (qualitative has the letter "l" which is "lovely"--words and experiences are "Lovely") A Likert scale is an example of: A) Gender data B) Economic disparity data C) Nominal data D) Ordinal data - Correct Answer-D (ordinal=order) A meta-analysis: A) Is another word for protocol B) Is another word for policy C) Summarizes the literature on a topic D) Statistically combines the results from several studies as if they were all part of one big study - Correct Answer-D A Type 2 error is sometimes referred to as a false negative error. This is when a study concludes there is no difference even though there actually is a difference. What can lead to a Type 2 error? A) The sample size being too big B) The control group being too big C) The sample size being too small D) The control group being too small - Correct Answer-C Researchers in a hospital were trying to figure out how to improve their breastfeeding rates. They conducted a study in the Labor and Delivery suite where one group of birthing women held their babies skin-to-skin for 20 minutes immediately after birth and another group held their babies skin-to-skin for 60 minutes after birth. All mothers had vaginal births, all were taught skin-to-skin holding the same way, and all mothers and babies were stable. Length of time breastfeeding for the first two hours of birth prior to the mother leaving the L/D suite was studied. In this study the independent variable is: A) Length of time breastfeeding in the labor and delivery suite Bias is defined as any tendency which prevents unprejudiced consideration of a question. A) True B) False - Correct Answer-A Which type of study design tries the best to eliminate bias in research? A) Case report B) Cohort study C) Case - control study D) Randomized controlled trial (especially if double blinded) - Correct Answer-D Which milk component of human milk is active against at least 40 tumors? A)Alpha-lactalbumin B)Beta-lactoglobulin C)Lactoferrin D)Gangliocides - Correct Answer-A (also known as HAMLET) About how many calories are utilized in making milk per day? - Correct Answer-500 Which component of human milk affects stool composition and frequency in the baby? A. Whey:casein ratio B. Soluble proteins C. Lactose D. Lipids - Correct Answer-A (ratio changes from around 90:10 to around 60:40 from early postpartum to around 6 months of lactation-higher casein usually means more firm/less frequent stools) When are the growth factors most concentrated in human milk? A. 38 weeks gestation B. 2 days postpartum C. 2 months postpartum D. 7 months postpartum - Correct Answer-B (most concentrated in colostrum and early milk) When does object permanence emerge? - Correct Answer-4-8 month old period In the first 3-14 days, babies typically consume how much of the available milk from mother? A. all of it B. 3/4 C. 2/3 D. 1/2 - Correct Answer-C Which of the following foods would provide many of the nutrients contained in dairy products? A. Rice B. Pears C. Carrots D. Corn tortillas soaked in lime - Correct Answer-D (high levels of calcium) At what point during gestation does the mammary ridge develop? A. 4-5 weeks A. Sense of taste and smell of milk B. Pressure of the breast against the oral tissues C. Tactile sensation of breast filling the infant's mouth D. Ability of infant to control shape of breast - Correct Answer-C (critical part of imprinting and emotional and psychological development) Which is the MOST IMPORTANT factor in how breastfeeding protects the infant against allergy? A. Preventing the baby from exposure to nonhuman proteins B. Slowing or preventing the absorption of allergens through the baby's gut C. Protecting the baby's gut from inflammation, which weakens the mucosal barrier D. Providing white cells in milk, which attack the allergens directly - Correct Answer-A (they are key trigger in allergic disease) Which nodes collect most of the lymph drainage from the lactating breast? - Correct Answer-Axillary nodes At what developmental age is self-feeding MOST LIKELY to begin? - Correct Answer-6-7 months At what gestational age does the swallowing reflex first appear? - Correct Answer-16 weeks At what gestational age does an infant develop an immature suck pattern? - Correct Answer-26 weeks Fresh human milk can be instilled in the eye to treat infections. Which component of milk is MOST LIKELY to be therapeutic? - Correct Answer-Lysozyme What is Tanner's stage 3 in breast development for females - Correct Answer-female breast between the onset of puberty and before first pregnancy Which of the following is the MOST common breastfeeding behavior for a toddler? A. Playfulness at the breast B. Breastfeeding while mother is engaging in other activities C. Persistent biting D. Breastfeeding at night - Correct Answer-B When does the mammary secretory glandular tissue (Lactocytes) develop? - Correct Answer-During pregnancy and the early weeks postbirth A well-balanced diet with sufficient calories accompanied by early and regular prenatal care significantly reduces the incidence of: a. infants with diabetes b. low birth weight c. maternal gestational diabetes d. lactation failure - Correct Answer-b. low birth weight The standard temperature and time for Holder pasteurization used in donor human milk banks is: a. 87 degrees C for 10 minutes b. 70 degrees C for 25 minutes c. 62.5 degrees C for 30 minutes d. 60 degrees C for 60 minutes - Correct Answer-c. 62.5 degrees C for 30 minutes In the global context, the MOST IMPORTANT reason to use an open cup for feeding a preterm baby who cannot yet breastfeed is: a. it is inexpensive and readily available b. the low risk of fluid aspiration c. it fosters appropriate tongue motions d. the cup is easy to clean - Correct Answer-d. easier to clean spoons and cups Which falls outside the IBCLC scope of practice? a. providing newsletters from the local mother-support groups to mothers at your practice? b. working closely with a dietician in the case of a baby diagnosed with PKU c. obtaining a referral from a surgeon before providing breastfeeding help to the mother of a newborn with an unrepaired cleft palate d. discussing a feverish mother's inflamed breast with her physician to develop an appropriate care plan that preserves breastfeeding - Correct Answer-c (lactation consultant does not need a referral to do this work) You are about to assess a breastfeeding mother-baby dyad. What should you do FIRST? a. obtain written consent from the mother b. weigh the baby on a sensitive scale c. examine the mother's breasts d. wash your hands for 2 minutes - Correct Answer-a obtain written consent (written preferred over verbal) Which operational target is included in the Innocenti Declaration of 1990? a. developing a national infant and young child feeding policy b. adoption of the WHO growth standards in all health care settings c. implementation of the International Code of Marketing Breast-Milk Substitutes d. passage of legislation protecting a mother's right to breastfeed in public - Correct Answer-c (code also protects breastfeeding rights of working women not right to breastfeed in public) Which of the following features is MOST IMPORTANT in a pamphlet promoting breastfeeding? a. listing advantages of breastfeeding b. comparison of breastfeeding with artificial feeding c. information about making enough milk d. local sources of breastfeeding help - Correct Answer-c (not enough milk is a chief cause of breastfeeding failure) What is the most effective strategy in virtually all populations to support breastfeeding goals? - Correct Answer-peer support Which is the MOST IMPORTANT feature of an effective breast pump? - Correct Answer-effective milk transfer (operate at about 40-60 cycles per minute) A mother is collecting milk for her ill, premature baby. Which is the BEST container for her milk? a. open plastic cups or bottles b. nurser bags c. large containers holding several feeds d. glass containers with airtight lids - Correct Answer-d. glass What is the MOST LIKELY reason you would recommend finger feeding with a syringe? When doing a review of the literature for a research study, which sources are MOST IMPORTANT to include? a. review articles that analyze several studies b. textbooks that explain basic concepts c. peer-reviewed journal reports of research, written by researchers d. lectures given at large conferences by well-known speakers - Correct Answer-c (original research is best. review articles may be a good source of primary references to look into) Which product falls within the scope of the International Code of Marketing Breast-Milk substitutes? a. breast pumps b. milk storage bags c. pacifiers/dummies d. feeding bottles - Correct Answer-d feeding bottles and teats A mother is concerned that her baby has suddenly lost interest in breastfeeding. Your BEST response is to: a. do nothing. Breastfeeding mothers are usually overprotective b. reassure her that her baby's appetite may change abruptly c. carefully investigate the situation d. instruct her how to give milk via a bottle - Correct Answer-c (mothers are reliable reporters of their baby's condition) What is often the first level of research of a new phenomenon? a. an observational study c. a qualitative study c. a case report d. a clinical trial - Correct Answer-c. case report What is the most important difference between pasteurized donor milk and mother's own milk? a. species specificity b. allergy prevention c. bioavailability d. potential HIV exposure - Correct Answer-d (pasteurization kills the HIV virus) What is a clinically appropriate use of a nipple shield? a. feels like the breast in the baby's mouth b. therapeutic changes in the baby's oral-motor response c. enhance milk transfer in some babies with weak suck d. extends the duration of breastfeeding - Correct Answer-c (a thin shield found to be helpful in transfer of milk in premature babies) Why can't an LC refer a patient to the LC's own private breast pump rental business? - Correct Answer-Conflict of Interest Which component of human milk is destroyed by freezing? a. lactoferrin b. macrophages c. lysozyme d. SIgA - Correct Answer-Macrophages (living cells are killed by freezing) After you have corrected the latch-on technique for a mother with nipple pain and who has an 8-day-old infant that has been at the breast constantly since birth, has a short tight A woman had surgery to drain a breast abscess 3 days ago. What is the MOST appropriate action when visiting her in her home for the second time since the surgery: a. advise her to stop breastfeeding on this breast b. assist her to express milk from this breast every few hours c. encourage her to rest and continue breastfeeding on the other breast d. support her taking any prescribed antibiotics - Correct Answer-b (reduces risk of milk stasis and milk components can help her heal) Damage to this nerve may cause failure of the gag reflex. A) VII. Facial nerve B) XI. Accessory nerve C) V. Trigeminal nerve D) IX. Glossopharyngeal nerve - Correct Answer-D (Remember Gag-G-Glossopharyngeal) Which cranial nerve is most responsible for the movement of the tongue? A) XI. Accessory nerve B) X. Vagus nerve C) XII. Hypoglossal nerve D) V. Trigeminal nerve - Correct Answer-C (glossal means "of the tongue") A one-day old infant has a facial droop noticed on the left side. Which cranial nerve may be affected? A) I. Olfactory nerve B) II. Optic C) VII. Facial nerve D) XII. Hypoglossal nerve - Correct Answer-C A problem with this cranial nerve can cause Bell's Palsy. A) VII. Facial nerve B) VIII. Vestibulocholear nerve C) X. Vagus nerve D) XI. Accessory nerve - Correct Answer-A (Bell's Palsy affects facial expressions) A mother of a one-month old says she (the mother) can't taste anything on the front of her tongue. This could be due to a problem with this cranial nerve. A) IV. Trochlear nerve B) VI. Abducens nerve C) VII. Facial nerve D) IX. Glossopharyngeal nerve - Correct Answer-C (facial involves taste in front 2/3 of tongue) What cranial nerve is involved in chewing (mastication)? A) V. Trigeminal nerve B) VI. Abducens nerve C) XI. Accessory nerve D) IV. Trochlear - Correct Answer-A True or False: Determination of sufficient or insufficient glandular tissue for lactation can be made by visual examination alone. - Correct Answer-False True or False: Accurate documentation merely describes what is visually apparent. - Correct Answer-True A mother is planning for surgery to repair her 5-month-old baby's cleft palate. What would be your FIRST suggestion to support breastfeeding? c. cross-sectional surveys d. pre-test followed by post-test - Correct Answer-a (more likely to show that the explanation really did cause the outcome) If a speaker's lecture title is very similar to a lecture you have prepared and presented at a large conference already, and you have not given anyone else permission to use your lecture material, what action should you FIRST take? a, Report the speaker to the ethics committee of IBLCE b. contact the speaker and find out if proper attribution is being made in the presentation c. contact your attorney to investigate d. ignore the situation under the assumption that LCs may independently create similar material - Correct Answer-b (it may be a breach of the code of professional conduct) A mother requests your help with her faltering milk supply. After ruling out breastfeeding management, which of the following would be MOST appropriate? a. loan her a book about herbal preparations b. tell her to buy domperidone from an online pharmacy c. recommend that her physician conduct metabolic and endocrine tests d. suggest she discuss alternate therapies with her primary care provider - Correct Answer-c Which of the following actions by a health care worker is a VIOLATION of the ICofMBMS? a. accepting a carton of new specialized formula for research at the institutional level b. distributing generic volu0feed bottles to parents whose babies are in the NICU c. teaching formula-feeding parents how to safely prepare formula on a one-to-one basis d. Giving samples of two competing brands of formula to non- breastfeeding mothers so they can test them - Correct Answer-d (samples cannot be given except for professional evaluation or for research at the institutional level) You work in a clinic with a lactation consultant who advises mothers to "toughen up" their nipples by rubbing them with a rough wash cloth during pregnancy. The FIRST action you should take is to: a. immediately lodge a complaint with the IBLCE discipline committee b. bring in research evidence of the harmful nature of this practice, and discuss it with the LC c. form a committee to develop written protocols on all aspects of lactation practice for your clinic d. try to intercept all of her clients seen by this lactation consultant and correct the misinformation - Correct Answer-b (first step is to provide clinical evidence) A mother tells you that a lactation consultant in your city took a course in manipulative therapy and used her new skills on the mother's baby without informing the mother or the baby's PCP. What should you do FIRST? a. report the lactation consultant to the medical licensing board in your jurisdiction b. contact the LC and discuss what the mother reported to you c. express doubt to the mother that your colleague would do such a thing d. write a letter to the mother's doctor, explaining the nature of the training taken by your colleague - Correct Answer-b (discuss with LC first to verify accuracy before lodging a complaint with IBLCE) When a mother is trying to dry up her milk, should she stop pumping immediately? - Correct Answer-No. Suddenly stopping may cause other breast pathology. It should be a gradual process A mother who formula-fed her two previous babies wants to breastfeed her third. Which aspect of breastfeeding should you spend the MOST time discussing with her? a. increased infant alertness b. looser and more frequent stools c. more breast and nipple pain d. more frequent infant spitting up - Correct Answer-a (formula-fed babies tend to sleep longer and are at greater risk of SIDS. Stools may surprise mother and other choices not true) What is the most common concern when a mother is taking any psychoactive medications? - Correct Answer-brain growth in infants Are anticonvulsants compatible with breastfeeding? - Correct Answer-Yes To BEST prepare for a sudden influx of young families at a shelter for victims of a devastating hurricane, the MOST IMPORTANT action should be: a. use bottled water for preparing donations of powdered formula b. create private areas for pregnant and breastfeeding mothers c. stock plenty of ready-to-feed formula d. purchase hand-operated breast pumps to help relactation efforts - Correct Answer-b Exposure to _______________________ before gut closure can permanently sensitize a child's immune system to many other allergens. - Correct Answer-foreign proteins (formula) Is selling infant formula to mothers in your practice who are unable to produce enough milk prohibited under the IC of MBMS? - Correct Answer-No (mother does not produce enough milk and infant must supplement) Is distributing free samples of a new bottle that is marketed for breast milk feeding to all prenatal clients prohibited by ICofMBMS? - Correct Answer-Yes (feeding bottles undermine direct breastfeeding) If a mother complains of nipple soreness and you observe symptoms that look like an infection on her nipple, what would be your best course of action? a. tell her to stop breastfeeding on that breast immediately b. give her a tube of antibacterial ointment c. wash your hands, put on sterile gloves and wipe off nipple with gauze d. contact her PCP and request diagnosis and treatment of the condition - Correct Answer-d (you can't diagnose or treat and the infant has already been exposed or could even be the cause. stopping breastfeeding is not necessary) Is it necessary to boil a nipple shield daily? - Correct Answer- No What should you remind a mother to do who is using a nipple shield while breastfeeding? - Correct Answer-Remind mother to express milk or pump while the shield is being used What type of statement should you always begin with when entering a mother's room while she is breastfeeding or otherwise? - Correct Answer-A positive or empathetic response intended to build confidence At how many weeks gestation does the mammary ridge or milk line form? A) 4-5 weeks B) 9-10 weeks C) 13-14 weeks D) 16-18 weeks - Correct Answer-A During pregnancy, the areola: A) Enlarges B) Does not change C) Darkens D) A and C - Correct Answer-D Montgomery glands are found in the areola. What is their function? A) Provide lubrication B) Inhibit bacterial growth C) Produce a scent to help the infant find the breast D) Only A and C E) A, B and C - Correct Answer-E Montgomery glands are sebaceous glands and they can also produce a small amount of breast milk. A) True B) False - Correct Answer-A The nipple is made up of smooth muscle fibers. Another fact about the nipple is that during breastfeeding: A) The nipple length does not change compared to its resting length B) The nipple extends by 25% of its resting length C) The nipple extends by 50% of its resting length D) The nipple doubles in length or extends by 100% of its resting length - Correct Answer-D A mature breast is located between the second rib and the sixth intercostal space. A) True B) False - Correct Answer-A The Tail of Spence extends into the axilla. Another accurate statement about the Tail of Spence is that it: A) Never produces milk B) Is connected to the breast tissue ductal system C) Is not connected to the breast tissue ductal system D) Rarely enlarges during lactation - Correct Answer-B The supporting tissues of the breast (connective tissue, fat tissue, blood vessels, nerves, lymphatics) are found in the: A) Parenchyma B) Stroma C) Nipple D) Montgomery glands - Correct Answer-B (Stroma- Supporting Tissue, Parenchyma-Parts) Most (60%) of the blood supply to the breast comes from the: A) Lateral thoracic artery B) Superior thoracic artery C) 50 millimeters D) 60 millimeters - Correct Answer-A (30mm = 3cm = 1.18in) Myoepithelial cells surround the alveoli and contract when exposed to: A) Estrogen B) Oxytocin C) Prolactin D) Progesterone - Correct Answer-B Prolactin is a hormone produced in the ___________ that causes milk production in the mammary tissue. A) Adrenal cortex B) Thyroid gland C) Anterior pituitary gland D) Posterior pituitary gland - Correct Answer-C (PAP-Prolactin Anterior Pituitary) The basic unit of mature glandular tissue is the: A) Alveolus B) Lobe C) Milk duct D) Nipple-alveolar complex - Correct Answer-A The fat in breast milk is produced in: A) The maternal vascular system B) The lactocyte C) The maternal axillary lymph nodes D) The lactiferous sinus of the milk duct system - Correct Answer-B (lactocyte is the powerhouse cell that lines the alveolus and does all the work to make milk) Within the first minute or two of beginning a breastfeed, a 2-week-old infant gulps, coughs and chokes, then releases the breast. This incident most likely describes: a. an infant with decreased oral tone b. poor coordination of sucking, swallowing and breathing c. strong milk ejection reflex d. GER - Correct Answer-b (by 2 weeks, most term infants should be able to handle their mother's MER) A full-term baby at 36 hours old that is under bili lights is MOST likely experiencing what condition? a. exclusive, effective breastfeeding b. ABO incompatibility c. breast milk jaundice d. hypoglycemia - Correct Answer-b (this causes early onset jaundice, breast milk jaundice usually becomes apparent after the 3rd day) Which of the following respiratory conditions is MOST LIKELY to be related to infant feeding? a. otitis media b. bronchitis and bronchiolitis c. asthma d. wheezing/RAD - Correct Answer-c (most serious in babies who aren't breastfed and most prevalent) Which condition is most likely to be associated with bottle feeding? a. need for orthodontia b. weak masseter muscles persistent cranial molding (should resolve within first few weeks) What is a Galactocele? - Correct Answer-A milk filled lacteal cyst. Most frequent lump found in a lactating breast. What are some of the common symptoms of nipple thrush? - Correct Answer-1. shiny and/or flaky skin 2. reddened nipple and areola 3. possible crack at base of nipple 4. burning or stinging pain, stabbing pain What method of feeding for a 3 lb preterm infant that has cardiac and respiratory stable systems is supported by abundant research? a. breastfeeding without equipment or devices b. breastfeed with nasogastric tube in place c. cup-feed and allow the baby to suck at an empty breast for comfort d. bottle-feed with human milk before breastfeeding - Correct Answer-c A pregnant 38-year-old woman had breast reduction surgery using the inferior pedicle technique 10 years ago, after having breastfed two children for about a year each. She ha low milk production with each of the children. What is the likelihood of a full milk production for the new baby? a. high because of the surgical technique used b. high because of her two previous lactations c. unlikely because of the type of breast reduction surgery d. unlikely because of the length of time since reduction - Correct Answer-b What recanalizes milk ducts following surgery? - Correct Answer-hormonal stimulation during menstruation What is caput succedaneum? - Correct Answer-Edema between the skin and cranial bone and is usually associated with vacuum extraction What is a common sign of disorganized sucking in a 3 week old baby? - Correct Answer-A baby feeds for extended periods of time (30-45 minutes) with eyes closed What is mammary duct ectasia? - Correct Answer- inflammation of wall of subareolar ducts with dilation (ectasia) of subareolar ducts, can result in green discharge What does reddened skin found only on the infant's genitalia and anal opening usually suggest? - Correct Answer-Allergic response What are yeast infections on infant's bottom usually characterized by? - Correct Answer-bright red blisters or papules What can cause a sudden occurrence of eczema in an otherwise healthy infant? - Correct Answer-an allergic reaction to cow's milk-based formula A breastfeeding mother with Type 1 DM is at risk for which of the following conditions? a. insufficient milk supply b. mastitis c. oversupply A breastfeeding infant has been diagnosed with oral thrush. What is your FIRST recommendation? a. begin simultaneous treatment of the baby and the mother's breasts b. unless the mother has signs of infection, treat only the baby's mouth with an antifungal medicine c. check the mother's nipples for signs or symptoms of infection d. assume the mother's nipples, all infant sucking objects, and possibly other infant areas are infected until proven otherwise - Correct Answer-d a 22-year-old woman has had bilateral breast reduction surgery in which the surgeon reported success in not severing many, if any, lactiferous ducts. The surgical technique performed was the "Round Block" pedicle procedure, wherein the only incision is around the perimeter of the areola, with the areola and the nipple still attached to a pedicle of tissue that is moved to a higher position. What effect on her future milk production can she expect? a. it is impossible to estimate what her milk supply will be b. it is unlikely that there will be a diminished milk supply c. it is likely there will be a diminished milk supply d. other factors have a greater bearing on her milk supply - Correct Answer-c (an incision around the areolar perimeter that is deep enough to remove underlying tissue is likely to sever the 4th intercostal nerve, thereby diminishing oxytocin and prolactin response) If you observed a 14-day-old, thin, crying, and clearly not thriving infant in your office, what is the FIRST question you would ask the mother about her own health status? a. are you getting enough rest? b. are you eating a well-balanced diet? c. do you have a fever? d. what color and quantity is your vaginal discharge? - Correct Answer-d (possible retained placenta and suppressed onset of Lactogenesis II) Allergy triggers are usually food group? - Correct Answer- proteins Persistent spitting up in the otherwise normal exclusively breastfed baby is most likely an allergic or hypersensitivity response to ___________________ - Correct Answer- Something in the mother's diet 42% chance it's cow's milk What skin condition is locally contained and has a sudden onset? - Correct Answer-Atopic dermatitis True or False: Chickenpox is no longer contagious when all the lesions are completely crusted over and a mother with crusted chickenpox lesions can breastfeed normally. - Correct Answer- True What is galactosemia? - Correct Answer-a genetic disease where there is a deficiency in converting galactose to glucose. Infants with this cannot metabolize lactose and therefore cannot have breastmilk How long does the infant gut take to recover from damage caused by a reaction to a single bottle of artificial baby milk? - Correct Answer-2 weeks Can a baby transfer streptococcal infection to a mother's breast? - Correct Answer-Yes a. the infant is more at risk of hypoglycemia and hyperbilirubinemia b. onset of copious milk secretion may be delayed about 24 hours c. breastfeeding may help protect the infant against type 2 diabetes d. lactation will increase the mother's chance of developing adult-onset diabetes - Correct Answer-b Which maternal prenatal factor is MOST LIKELY to compromise lactation? a. three previous closely spaced pregnancies b. maternal underweight c. maternal obesity d. mother older than 35 years - Correct Answer-c (overweight/obese women are more likely to have a lower prolactin response to suckling) Which of the following conditions of labor is MOST LIKELY to delay the onset of Lactogenesis II (copious milk production)? a. very rapid labor b. birth before 37 weeks' gestation c. long, difficult labor d. vomiting during labor - Correct Answer-c For pregnant women with gestational diabetes, breastfeeding for at least _________________ reduces the risk of developing Type II diabetes - Correct Answer-3 months True or False: The immune components in breast milk have been shown to be protective against the spirochete that causes Lyme disease. - Correct Answer-True What do ovarian theca lutein cysts secrete that can delay Lactogenesis II? - Correct Answer-Testosterone The intensity of intra-oral negative pressure in an infant's suck, increases with _________________ - Correct Answer- gestational age Due to inherent thermal instability, late preterm infants may fall asleep if they are slightly _______________________ - Correct Answer-chilled (skin to skin contact can manage this and maintain alertness) What is the second most common allergen for infants? - Correct Answer-soy Approximately ____________________ of babies with a unilateral cleft lip will not grow adequately on direct breastfeeding alone. - Correct Answer-1/3 What is hyperkeratosis of the nipple? - Correct Answer- Thickening of the areola or nipple skin caused by a mass of keratinocytes that make the skin rough and patchy (looks a little like small warts) Which is most likely to cause blisters at a mother's nipple tip? a. rubbing expressed milk onto them for sore nipples b. a baby that can't stay latched very long c. a breast pump with really strong suction when first in use d. yeast infections during pregancy - Correct Answer-c A mother contacts you with a tender, hot, swollen breast with a wedge-shaped red area. She says she is running a fever and wonders if she has the flu. Her baby is nursing 6-7 times a day and uses a pacifier to stretch out the time between feeds, c. Oligosaccharide receptor analogues d. lactoferrin protein - Correct Answer-b Which of the following ALWAYS occurs in the processing of banked donor human milk WORLDWIDE? a. pasteurization of milk prior to dispensing b. bacteriological screening of milk c. screening milk for environmental contaminants d. serum screening of all donors - Correct Answer-d Which maternal factor is MOST responsible for the amount of milk consumed by a baby at a feed? - Correct Answer-number of milk ejections Which descriptions BEST describes the configuration of milk ducts in the lactating breast? a. deep in the breast, like the core of an apple b. branching begins posterior to the areolar margin c. bulbous pea-shaped swellings near the areolar margin d. superficial and easy to compress - Correct Answer-d Which factor is MOST LIKELY to put a premature infant at risk of evaporative water loss? a. lower brown fat reserves b. immature thyroid control of metabolic rate c. relatively large skin surface area d. poor insulin response leading to hyperglycemia - Correct Answer-c (preterm and low birthweight babies especially) Peeling skin on a newborn is one visual clue to a baby nearing _________________. - Correct Answer-Postterm gestational age Which is the bone that most often presents during a normal vaginal birth? - Correct Answer-Occipital bone (frontal bone second most common) Which muscle is a circular sphincter-like muscle that circles the mouth and closes the lips around an object in the mouth? - Correct Answer-orbicularis oris Which type of cell in human milk gives rise to antibodies targeted against specific microbes? a. neutrophils b. b-lymphocytes c. macrophages d. granulocytes - Correct Answer-b Which component of milk varies MOST with maternal diet? a. lactose b. immunoglobulins c. vitamins d. proteins - Correct Answer-c (especially water soluble) ___________________________________ in milk/colostrum is 10 times higher on the first postpartum day than at any other time during lactation. - Correct Answer-SIgA Which immunological component of breast milk continues to increase beyond 6 months of breastfeeding? a. epidermal growth factor b. SIgA c. lysozyme d. lactoferrin - Correct Answer-c Which milk component is the "last to go" during weaning? a. carbs b. white cells c. enzymes d. immunoglobulins - Correct Answer-d As weaning from breastfeeding progresses, which is the first milk component to diminish? - Correct Answer-lactose A pregnant woman had surgery to drain a breast abscess during a previous lactation and asks about the consequences to breastfeeding this time. Which aspect of the surgery is MOST LIKELY to negatively affect breastfeeding? a. the circumstances leading up to the abscess b. how long ago the surgery was performed c. location of the incision relative to milk ducts and nerves d. stage of lactation when the surgery was done - Correct Answer-c On the second postbirth day, an otherwise healthy term baby nurses for 45 minutes, sleeps briefly, then wakes with frantic crying. What is the MOST LIKELY explanation for this pattern? a. normal pattern for day 2 b. small for gestational age c. head injury during birth d. shallow latch at breast - Correct Answer-d (frantic crying suggests inadequate milk transfer) Breastfeeding mitigates the fall in __________________ levels in girls. - Correct Answer-leptin (leptin levels diminish rapidly in formula-fed babies which can cause increase in appetite) Babies are capable of grasping strips of foods at age __________________________. - Correct Answer-9 months Which facial muscle can be easily seen during breastfeeding? a. hyoglossus b. orbicularis oris c. temporalis d. frontalis - Correct Answer-c Which method of family planning is MOST LIKELY to interfere with breastfeeding? a. progestin-containing medications b. estrogen-containing medications c. cervical cap or diaphragm d. natural family planning (periodic abstinence) - Correct Answer-b (diminishes milk supply) Which is the MOST profound consequence of separating healthy mothers and babies short after birth? a. increased rates of infection b. improved rest for mother c. increase in infant stress hormones d. difficulty initiating breastfeeding - Correct Answer-c (increases infant and mother cortisol levels) Which condition is UNRELATED to women's lactation status? a. postpartum hemorrhage b. delayed return to pre-pregnancy weight c. menstrual irregularities and pain d. closely spaced pregnancies - Correct Answer-c