International Business Administration 70 –
Communication and Negotiation Ultimate
Exam
**Question 1.** Which hormone is primarily responsible for initiating copious milk secretion after birth?
A) Prolactin
B) Oxytocin
C) Progesterone
D) Estrogen
Answer: A
Explanation: Lactogenesis II, the onset of abundant milk production, is triggered by a sudden drop in
progesterone and estrogen combined with a rise in prolactin levels postpartum.
**Question 2.** A term infant at 2 weeks of age shows a persistent dry, cracked nipple after each feed.
The most likely cause is:
A) Bacterial infection
B) Inadequate latch
C) Hyperlactation
D) Vitamin D deficiency
Answer: B
Explanation: An improper latch creates excessive shear force on the nipple, leading to trauma and
cracking; infections usually present with erythema and discharge.
**Question 3.** Which of the following best describes the “autocrine control” of milk production?
A) Prolactin levels rise with each feeding.
B) Milk removal stimulates further synthesis locally.
C) Oxytocin release is triggered by infant suckling.
, International Business Administration 70 –
Communication and Negotiation Ultimate
Exam
D) Hormonal feedback from the placenta.
Answer: B
Explanation: Autocrine control refers to the local feedback loop where removal of milk from the breast
signals alveolar cells to produce more milk.
**Question 4.** According to WHO growth charts, a 37-week gestational age infant should have weight
plotted using:
A) Chronological age only
B) Adjusted age (post-menstrual age)
C) Length-for-age percentile only
D) No adjustment is needed after discharge
Answer: B
Explanation: Preterm infants require plotting by corrected (adjusted) age until two years to accurately
reflect growth expectations.
**Question 5.** Which cranial nerve is NOT directly involved in the suck-swallow-breathe sequence?
A) VII (Facial)
B) IX (Glossopharyngeal)
C) X (Vagus)
D) XII (Hypoglossal)
Answer: A
Explanation: The facial nerve controls facial expression and salivation, not the coordinated
suck-swallow-breathe reflex, which relies on IX, X, and XII.
, International Business Administration 70 –
Communication and Negotiation Ultimate
Exam
**Question 6.** The most common cause of early neonatal hyperbilirubinemia in exclusively breastfed
infants is:
A) Breast-milk jaundice
B) Hemolysis from ABO incompatibility
C) Breastfeeding jaundice due to inadequate intake
D) Crigler-Najjar syndrome
Answer: C
Explanation: Inadequate milk intake leads to dehydration and reduced bilirubin excretion, producing
“breastfeeding jaundice” within the first week.
**Question 7.** A mother with a history of breast reduction surgery is most likely to experience which
lactation challenge?
A) Hyperlactation
B) Inverted nipples
C) Low milk supply due to loss of glandular tissue
D) Mastitis due to duct obstruction
Answer: C
Explanation: Reduction surgery removes both fatty and glandular tissue, decreasing the number of
secretory units and potentially limiting milk production.
**Question 8.** Which of the following is considered a “red flag” feeding behavior in a newborn?
A) Rooting reflex present at 2 hours of life
B) Feeding every 2–3 hours with adequate weight gain
C) Persistent choking and coughing during feeds
, International Business Administration 70 –
Communication and Negotiation Ultimate
Exam
D) Sleeping > 14 hours per day
Answer: C
Explanation: Frequent choking suggests an oral-motor problem (e.g., tongue-tie) or dysphagia and
warrants further evaluation.
**Question 9.** The primary composition difference between foremilk and hindmilk is:
A) Higher protein in foremilk
B) Higher fat content in hindmilk
C) More lactose in hindmilk
D) Increased immune cells in foremilk
Answer: B
Explanation: Hindmilk is richer in fat, providing more calories; foremilk is more watery with higher
lactose and lower fat.
**Question 10.** Which maternal condition most commonly interferes with the milk ejection reflex?
A) Hypothyroidism
B) Diabetes mellitus type 2
C) Post-partum anxiety
D) Iron deficiency anemia
Answer: C
Explanation: Anxiety can suppress oxytocin release, reducing the milk ejection reflex and leading to poor
milk flow.
Communication and Negotiation Ultimate
Exam
**Question 1.** Which hormone is primarily responsible for initiating copious milk secretion after birth?
A) Prolactin
B) Oxytocin
C) Progesterone
D) Estrogen
Answer: A
Explanation: Lactogenesis II, the onset of abundant milk production, is triggered by a sudden drop in
progesterone and estrogen combined with a rise in prolactin levels postpartum.
**Question 2.** A term infant at 2 weeks of age shows a persistent dry, cracked nipple after each feed.
The most likely cause is:
A) Bacterial infection
B) Inadequate latch
C) Hyperlactation
D) Vitamin D deficiency
Answer: B
Explanation: An improper latch creates excessive shear force on the nipple, leading to trauma and
cracking; infections usually present with erythema and discharge.
**Question 3.** Which of the following best describes the “autocrine control” of milk production?
A) Prolactin levels rise with each feeding.
B) Milk removal stimulates further synthesis locally.
C) Oxytocin release is triggered by infant suckling.
, International Business Administration 70 –
Communication and Negotiation Ultimate
Exam
D) Hormonal feedback from the placenta.
Answer: B
Explanation: Autocrine control refers to the local feedback loop where removal of milk from the breast
signals alveolar cells to produce more milk.
**Question 4.** According to WHO growth charts, a 37-week gestational age infant should have weight
plotted using:
A) Chronological age only
B) Adjusted age (post-menstrual age)
C) Length-for-age percentile only
D) No adjustment is needed after discharge
Answer: B
Explanation: Preterm infants require plotting by corrected (adjusted) age until two years to accurately
reflect growth expectations.
**Question 5.** Which cranial nerve is NOT directly involved in the suck-swallow-breathe sequence?
A) VII (Facial)
B) IX (Glossopharyngeal)
C) X (Vagus)
D) XII (Hypoglossal)
Answer: A
Explanation: The facial nerve controls facial expression and salivation, not the coordinated
suck-swallow-breathe reflex, which relies on IX, X, and XII.
, International Business Administration 70 –
Communication and Negotiation Ultimate
Exam
**Question 6.** The most common cause of early neonatal hyperbilirubinemia in exclusively breastfed
infants is:
A) Breast-milk jaundice
B) Hemolysis from ABO incompatibility
C) Breastfeeding jaundice due to inadequate intake
D) Crigler-Najjar syndrome
Answer: C
Explanation: Inadequate milk intake leads to dehydration and reduced bilirubin excretion, producing
“breastfeeding jaundice” within the first week.
**Question 7.** A mother with a history of breast reduction surgery is most likely to experience which
lactation challenge?
A) Hyperlactation
B) Inverted nipples
C) Low milk supply due to loss of glandular tissue
D) Mastitis due to duct obstruction
Answer: C
Explanation: Reduction surgery removes both fatty and glandular tissue, decreasing the number of
secretory units and potentially limiting milk production.
**Question 8.** Which of the following is considered a “red flag” feeding behavior in a newborn?
A) Rooting reflex present at 2 hours of life
B) Feeding every 2–3 hours with adequate weight gain
C) Persistent choking and coughing during feeds
, International Business Administration 70 –
Communication and Negotiation Ultimate
Exam
D) Sleeping > 14 hours per day
Answer: C
Explanation: Frequent choking suggests an oral-motor problem (e.g., tongue-tie) or dysphagia and
warrants further evaluation.
**Question 9.** The primary composition difference between foremilk and hindmilk is:
A) Higher protein in foremilk
B) Higher fat content in hindmilk
C) More lactose in hindmilk
D) Increased immune cells in foremilk
Answer: B
Explanation: Hindmilk is richer in fat, providing more calories; foremilk is more watery with higher
lactose and lower fat.
**Question 10.** Which maternal condition most commonly interferes with the milk ejection reflex?
A) Hypothyroidism
B) Diabetes mellitus type 2
C) Post-partum anxiety
D) Iron deficiency anemia
Answer: C
Explanation: Anxiety can suppress oxytocin release, reducing the milk ejection reflex and leading to poor
milk flow.
