CLC Practice Exam #3 (Questions and Answers A+ Graded 100% Verified)

CLC Practice Exam #3 (Questions and Answers A+ Graded 100% Verified) Which of the following breast surgeries will likely cause the most breastfeeding problems? a) Biopsy of a benign lump in the supper outer quadrant of the breast b) Removal of a benign lump, 2 cm by 3 cm just above the areola c) Breast augmentation using a periareolar incision d) Breast reduction surgery using the pedicle technique CORECT ANSWER: d) Breast reduction surgery using the pedicle technique A pediatric practice sends out a questionnaire to 245 mothers in its practice that are using a certain parenting program which advocates scheduled feedings. The results of their survey indicate that 68% of the mothers using this program breastfeed their infants at least 6 months which is higher than the national average. Assuming all the following are true, which indicates a bias that may impact the results of the study? a) The author of the program develops and administers the questionnaire b) Mothers in this practice are given a pump as a baby gift c) Mothers are all signed up for the infant formula "Sunshine" Club d) All the mothers were given the questionnaire at 6 months postpartum CORECT ANSWER: a) The author of the program develops and administers the questionnaire 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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? CORECT 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. A baby who is latched on well at the breast will demonstrate which of the following? a) Minimal puckering on the cheeks b) Wide mouth with flanged lips c) Chin and nose pressed close to the breast d) Rapid sucking, lasting for at least 3 minutes CORECT ANSWER: b) Wide mouth with flanged lips Maternal lactation risk factors include which of the following? a) Small breast milk storage capacity b) Family history of insufficient milk supply c) Unrelieved postpartum breast engorgement d) Maternal age younger than 21 years CORECT ANSWER: c) Unrelieved postpartum breast engorgement Maria speaks only Spanish. You speak only English and a little bit of French. As you speak to Maria through an interpreter, you know that it's most important to: a) Always look directly at the mother b) Look back forth between the mother and interpreter so both are included c) Speak slowly and clearly d) Watch the body language of the interpreter CORECT ANSWER: a) Always look directly at the mother During the analysis of an article, you read that the p-value is <0.001. This means the findings of the investigation are: a) Statistically insignificant b) Odds less than 1 in 10 that they are due to chance c) Statistically significant d) Clinically significant CORECT ANSWER: c) Statistically significant One of the ways that oligosaccharides prevent infection is through: a) Destroying cell walls of bacteria using sialic acid b) Inhibiting bacteria from adhering to epithelial surfaces c) Preventing pathogens from ingesting the iron d) Targeting the nucleus of bacterial cells and preventing reproduction CORECT ANSWER: b) Inhibiting bacteria from adhering to epithelial surfaces The most effective method of promoting breastfeeding is to: a) Inform the mother about the benefits of breastfeeding b) Teach the mother correct breastfeeding techniques c) Explore and address the mother's concerns d) Assist the mother in making an informed choice CORECT ANSWER: c) Explore and address the mother's concerns Newborns have buccal fat pads. The primary reason for the pads is to: a) Create a higher negative pressure during sucking b) Prevent the baby from "Dimpling" during suckling c) Provides a mechanism to keep the nipple from slipping out during feeds d) Provide extra fat stores for mobilization of calories if inadequate milk intake CORECT ANSWER: a) Create a higher negative pressure during sucking 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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/ CORECT 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 CORECT 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) Ask her what she usually takes and then give her current information about the drug b) Tell her that non of the OTC medications are approved for breastfeeding and that she needs to contact her physician c) Explain that it's not within the scope of practice of the IBCLC to recommend any medications and that you are unable to help her d) Tell her she shouldn't be taking drugs while breastfeeding, and ask her if she has tried any home remedies such as chicken soup or hot tea with honey and lemon CORECT ANSWER: a) Ask her what she usually takes and then give her current information about the drug The Baby Friendly Hospital Initiative: a) Requires all babies in Baby Friendly Hospitals to be breastfed b) Allows hospitals to provide formula to babies but only if it's without charge c) Was developed by the WHO and UNICEF d) Requires that all supplementation be given by cup CORECT ANSWER: c) Was developed by the WHO and UNICEF When the "milk comes in" (lactogenesis 2) there is an increase in: a) Lactose b) Sodium c) Protein d) Chloride CORECT ANSWER: a) Lactose A reason breastfed infants may be less likely to die of SIDS is that breastfed infants: a) Sleep more soundly than formula-fed infants b) Have the same sleep patterns as adults c) Are more arousable at 2-3 months than formula-fed infants d) Are awakened by their mothers more often CORECT ANSWER: c) Are more arousable at 2-3 months than formula-fed infants Silicone nipple shields should: a) Never be used because there is no current research to support their use b) Only be used for sore nipples c) Be used when a mother has mastitis and it's too painful to nurse d) Be used to assist with latch if the baby is unable to accomplish it CORECT ANSWER: d) Be used to assist with latch if the baby is unable to accomplish it Milk stasis can be caused by which of the following? a) Restriction of duration or frequency of feeds b) Low milk supply c) Fatigue and a low vitamin D level d) Breast implants through the areola CORECT ANSWER: a) Restriction of duration or frequency of feeds Heidi asks you about purchasing donor milk from the internet and wonders what your thoughts are. Your best advice is: 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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: a) The size and volume capacity of the breast b) The mother determining the length of a feed c) The infant himself d) The mother's diet CORECT ANSWER: c) The infant himself The most common cause of jaundice in breastfeeding babies during the first few days is: a) Rapid breakdown of excess RBCs the first 3 days after birth b) Presence of a substance in the mother's milk that inhibits conjugation of bilirubin c) A hemolytic disease process such as ABO incompatibility or the Rh factor d) Decrease in breast milk intake causing a decrease in stool output CORECT ANSWER: a) Rapid breakdown of excess RBCs the first 3 days after birth. b- breast milk jaundice c- not common d- lack of protein intake The "half-life" of a drug refers to the length of time it takes: a) For the drug concentration in the serum to reduce by one-half b) For a drug to be worn off and half gone from the milk c) Half the drug to be half strength was to begin with d) The drug to be completely gone from the milk CORECT ANSWER: a) For the drug concentration in the serum to reduce by one-half When used correctly, the Lactational Amenorrhea Method (LAM) of birth control is: a) 63% effective b) 75% effective c) 87% effective d) 98% effective CORECT ANSWER: d) 98% effective Infant crying can threaten brain development due to: a) Hyper-oxygenation of the blood flow to the brain b) Increased cortisol levels in the blood c) Constriction of capillaries within the brain d) Decrease in spinal fluid pressure CORECT ANSWER: b) Increased cortisol levels in the blood Formula-feeding increases the risk of infants developing a variety of ailments. Which is currently NOT considered to be an increased risk of being fed formula? a_ Myasethenia gravis b) Donor organ rejection c) Ulcerative colitis d) Cognitive deficiencies CORECT ANSWER: a) Myasthenia gravis You have arranged with the hospital photographer to take pictures of infants with tongue-tie and mandibular asymmetry. Which of the following statements is included in IBCLE's Code of Professional Conduct? a) Obtain the mother's written consent before taking the photographs b) Refrain from including mother's face and her breasts in the photograph c) Use a black bar to obscure the infant's eyes on the photograph d) Inform the mothers that these photographs will be used for professional education in a presentation CORECT 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 CORECT 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 CORECT 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 CORECT 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 CORECT 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) CORECT 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 CORECT 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 CORECT 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? a) 5-8 cm b) 6-8 cm c) 14-18 cm, or d) 18-22 cm CORECT ANSWER: b) 18-22 cm