CLC Practice Exam -1 Questions & Answers

CLC Practice Exam -1 Questions & Answers As you walk into the hospital room to see Erin, you find her breastfeeding her baby, chatting with a couple of friends, with her gown down around her waist and her breasts exposed. Your response is to: a) tell her to cover herself up, as there is no need to just "whip it out", b) do and say nothing about the exposed breasts, c) cover her and the infant with a baby blanket, or d) ask the visitors to please leave until Erin is finished nursing b) do and say nothing about the exposed breasts The most important information to include in your breastfeeding class is: a) advantages of breastmilk, b) a video showing how to latch a baby on the breast, c) how dads can help with breastfeeding, or d) strategies for making breastfeeding eaier d) strategies for making breastfeeding easier Susie is considering pregnancy for the first time. One supplement she should be certain to include is: a) vitamin A, b) vitamin C, c) vitamin D, or d) vitamin E c) vitamin D Bertha, who is pregnant, asks you when her breasts will stop getting bigger so she can get some new bras. You tell her that usually most pregnancy breast growth is completed by week: a) 18, b) 24, c) 29, or d) 34 c) 29 Which of the following is most likely to be a symptom of postpartum depression? a) bodily aches and pains, b) overeating, c) feeling tired and grumpy, or d) sadness lasting longer than 2 weeks d) sadness lasting longer than 2 weeks Which infant is at risk for iron-deficiency anemia? a) infant weighing more than 3000 g at birth, b) breastfed infant whose mother lost 2 units of blood at delivery, c) infant who is exclusively breastfed for longer than 6 months, or d) infant who is fed cow's milk before a year of age d) infant who is fed cow's milk before a year of age Sixteen-year-old Trudy delivered her son at 29 weeks gestation. The NICU staff reports that she plans on formula-feeding. You decide to talk to her about breastfeeding. The most important reason you decide to do this is because: a) When women hear about the benefits of breast milk for their preterm infants, many will decide to at least pump while the baby is in the NICU, b) Trudy probably chose to formula-feed because it was unlikely she had any role models that had breastfed, c) the staff probably assumed she was going to formula-feed because Trudy is an adolescent, or d) the infant is still NPO and you have time to convince Trudy to changer her mind a) when women hear about the 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) 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 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 a) FTT and skin lesions The MOST common food sensitivity in infancy is: a) egg, b) cow's milk, c) wheat, or d) soy 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 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 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 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 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 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 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 b) antifungal ointment 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, or d) he may have GER 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, or d) calcium 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, or d) observation of behavior during the feed 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, or d) when she weans her baby, her insulin levels will vary 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., or d) concerned with the marketing of breast milk substitutes d) concerned with the marketing of breast milk substitutes Lactoferrin does all of the following EXCEPT: a) promotes growth of the intestinal epithelium, b) withholds iron from iron-requiring pathogens, c) alters the properties of the bacterial cell wall, or d) destroys overgrowth of mutated cells a) promotes growth of the intestinal epithelium The onset of copious milk supply in Lactogenesis 2 seems to be triggered primarily by: a) an increase in lactose, b) a drop in estrogen, c) withdrawal or progesterone, or d) an increase in plasma prolactin c) withdrawal of pregesterone Which of the following is true about the transmission of HIV? a) formula-feeding prevents the transmission of HIV, b) exclusive breastfeeding limits the transmission of HIV, c) engorgement can be a risk factor for the transmission of HIV, or d) mixed feeds (breastfeeding and formula) slow the transmission of HIV b) exclusive breastfeeding limits the transmission of HIV Physiologic jaundice of the newborn is caused by which of the following? a) rapid breakdown of immature fetal RBCs, b) ineffective breastfeeding, not getting enough protein, c) a substance in colostrum that inhibits conjugation of bilirubin, or d) not enough albumin in the plasma for the bilirubin to bind to a) rapid breakdown of immature RBCs The whey:casein ratio in late lactation is: a) 90:10, b) 60:40, c) 50:50, or d) 18:82 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 thought things were getting better, or d) I'm so sorry. You should probaby just let him cry it out for a couple of night and he'll start going back to sleep on his own. c) you really enjoyed that nighttime sleep, didn't you? It's frustrating that Henry is waking up again just when you thought things were getting better A galactogogue is given to a mother in order to: a) increase milk supply, b) decrease milk supply, c) increase calories in milk, or d) improve the flavor of the milk a) increase milk supply The following are all signs of dehydration in a newborn EXCEPT: a) a sunken anterior fontanel when the baby is lying supine, b) poor skin turgor, c) dry, mucous membranes, or d) dry, flaky or peeling skin d) dry, flaky or peeling skin The clinical practice of the IBCLC focuses primarily on which of the following: a) assessment, planning, interventions and evaluations of care, b) prescribing medications which will have minimal effect on infant and/or milk supply, c) complete, accurate, and timely documentation of care, d) communication and collaboration with other health care professionals a) assessment, planning, interventions, and evaluation of care One of the most effective treatments for a plugged duct is: a) a course of antibiotic therapy, b) icy cold compresses over the site of the plug for 20 minutes, c) breastfeeding regularly every 3 hours, or d) apply heat and gentle massage over affected area d) apply heat and gentle massage over affected area Leukocytes in human milk are: a) are more concentrated in the first 6 months, b) pathogen killing cells, c) organic oligosaccharides, or d) anti-inflammatory factor b) pathogen killing cells Which of the following is most likely to be an early factor in causing insufficient milk supply at 10 days? a) not breastfeeding within the first hour after birth, b) injectable progestin contraceptive given shortly after delivery, c) infant not suckling effectively within the first 24 hours, or d) inadequate oxytocin levels b) injectable progestin contraceptive given shortly after delivery One of the main reasons the Lactation Amenorrhea Method (LAM) prevents conception is that: a) frequent suckling results in higher prolactin levels which prevents ovulation, b) levels gonadotropin are decreased in all postpartum women, c) levels of the follicle stimulating hormone (FSH) are increased, or d) levels of the luteinizing hormone (LH) are increased a) frequent suckling results in higher prolactin levels which prevents ovulation The neonatologist has determined that week old, 3 lbs. 15 oz. baby Noah in the NICU needs to take in 35 mL/feeding- feeding q3h. What is the best way to ensure that this breastfed baby is getting an adequate caloric 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 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 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 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 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 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 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 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 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 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 breast, or d) to transition a breastfeeding infant to the bottle b) in order to evaluate a baby's suck, swallow and breathe patterns In teaching mothers about safe sleep, it is important to emphasize: a) the baby must be in her own crib in her own room, b) the room should be kept warm enough so no covers are needed, c) the baby must be on her back on a flat, firm surface, or d) the baby's pillow must be no more than 1" deep c) the baby must be on her back on a flat, firm surface In a meta-analysis on postpartum engorgement what conclusion was drawn? a) not enough evidence on any intervention to justify widespread implementation, b) use of cabbage on the breasts between feeds, c) use of ice packs to the breasts between feeds, or d) use of hot packs to the breasts for 2 minutes prior to a feed a) not enough evidence on any interventions to justify widespread implementation When may cup-feeding may be used with a preterm infant? a) Never. Cup-feeding for preterm infants is not evidence based, b) only in babies at least 32 weeks gestation or more, c) infant is sleepy but needs to be fed, or d) following nursing at the breast when a supplement is needed d) following nursing at the breast when a supplement is needed Shelby, who is a healthy full-term infant, is breastfeeding exclusively. By the time of discharge from the hospital on day two she has lost 6% of her birth weight. This is most likely related to: a) lactogenesis 2 has not yet occurred, b) physiological diuresis of extracellular fluid, c) Shelby is not transferring milk effectively, or d) overload of maternal fluids during labor b) physiological diuresis of extracellular fluid