Page 1 of 46
BCIT NSPN 7150 THE
BREASTFEEDING EXPERIENCE
FINAL 2026|2 VERSIONS|ALL
580Qs&As|GRADED A+
Q1 (Version A). A primiparous mother 48 hours
postpartum reports that her breasts feel "full and
heavy" but milk is not yet flowing. The baby is
nursing every 3 hours for 10 minutes per side and
has had 2 wet diapers and 1 meconium stool in the
last 24 hours. What is the most appropriate nursing
action?
a) Advise formula supplementation due to
insufficient milk
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b) Reassure that this is physiologic engorgement
and assist with latch and feeding frequency
c) Order a prolactin level
d) Recommend pumping after every feed
Correct Answer: b) Reassure that this is
physiologic engorgement and assist with
latch and feeding frequency
*Rationale: Physiologic engorgement (lactogenesis
II) occurs day 2-5. Increased feeding frequency and
effective latch prevent pathologic engorgement.
The infant’s output is borderline (should have more
than 2 wet diapers on day 2), but first intervention
is to improve feeding, not supplement.*
Q2 (Version A). Which hormone is responsible for
the synthesis of milk in the alveolar cells?
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a) Oxytocin
b) Prolactin
c) Estrogen
d) Progesterone
Correct Answer: b) Prolactin
Rationale: Prolactin stimulates milk production
(lactogenesis). Oxytocin causes milk ejection.
Estrogen and progesterone inhibit milk production
during pregnancy.
Q3 (Version A). A mother with a history of breast
reduction surgery (free nipple graft technique) is
likely to have which breastfeeding challenge?
a) Overactive letdown
b) Insufficient glandular tissue and disrupted ducts,
leading to low milk supply
, Page 4 of 46
c) Severe nipple pain only
d) No effect on lactation
Correct Answer: b) Insufficient glandular
tissue and disrupted ducts, leading to low
milk supply
Rationale: Free nipple graft breast reduction
transects many ducts and removes glandular
tissue, often resulting in insufficient milk
production. Some women produce minimal milk;
they may still breastfeed with supplementation.
Q4 (Version A). The infant of a mother with a low
milk supply is 10 days old and has lost 12% of birth
weight. The mother has been nursing every 2-3
hours but the infant is lethargic. What is the
priority intervention?
BCIT NSPN 7150 THE
BREASTFEEDING EXPERIENCE
FINAL 2026|2 VERSIONS|ALL
580Qs&As|GRADED A+
Q1 (Version A). A primiparous mother 48 hours
postpartum reports that her breasts feel "full and
heavy" but milk is not yet flowing. The baby is
nursing every 3 hours for 10 minutes per side and
has had 2 wet diapers and 1 meconium stool in the
last 24 hours. What is the most appropriate nursing
action?
a) Advise formula supplementation due to
insufficient milk
,Page 2 of 46
b) Reassure that this is physiologic engorgement
and assist with latch and feeding frequency
c) Order a prolactin level
d) Recommend pumping after every feed
Correct Answer: b) Reassure that this is
physiologic engorgement and assist with
latch and feeding frequency
*Rationale: Physiologic engorgement (lactogenesis
II) occurs day 2-5. Increased feeding frequency and
effective latch prevent pathologic engorgement.
The infant’s output is borderline (should have more
than 2 wet diapers on day 2), but first intervention
is to improve feeding, not supplement.*
Q2 (Version A). Which hormone is responsible for
the synthesis of milk in the alveolar cells?
,Page 3 of 46
a) Oxytocin
b) Prolactin
c) Estrogen
d) Progesterone
Correct Answer: b) Prolactin
Rationale: Prolactin stimulates milk production
(lactogenesis). Oxytocin causes milk ejection.
Estrogen and progesterone inhibit milk production
during pregnancy.
Q3 (Version A). A mother with a history of breast
reduction surgery (free nipple graft technique) is
likely to have which breastfeeding challenge?
a) Overactive letdown
b) Insufficient glandular tissue and disrupted ducts,
leading to low milk supply
, Page 4 of 46
c) Severe nipple pain only
d) No effect on lactation
Correct Answer: b) Insufficient glandular
tissue and disrupted ducts, leading to low
milk supply
Rationale: Free nipple graft breast reduction
transects many ducts and removes glandular
tissue, often resulting in insufficient milk
production. Some women produce minimal milk;
they may still breastfeed with supplementation.
Q4 (Version A). The infant of a mother with a low
milk supply is 10 days old and has lost 12% of birth
weight. The mother has been nursing every 2-3
hours but the infant is lethargic. What is the
priority intervention?
