Page 1 of 35
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
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
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*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?
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.
,Page 3 of 35
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
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
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been nursing every 2-3 hours but the infant is lethargic. What is
the priority intervention?
a) Continue nursing and add fenugreek
b) Supplement with formula or expressed milk after each feed
and assess for transfer issues
c) Stop breastfeeding and switch to formula
d) Perform a heel poke for bilirubin
Correct Answer: b) Supplement with formula or expressed
milk after each feed and assess for transfer issues
Rationale: Severe weight loss and lethargy indicate inadequate
intake. Supplementation is urgent to prevent dehydration and
hypoglycemia. Investigate cause (latch, tongue-tie, low supply). Do
not stop breastfeeding unless medically necessary.
Q5 (Version A). A mother with a 2-week-old infant complains of
burning nipple pain that starts during feeding and continues
between feeds. Nipples are pink and shiny. The infant has white
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
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
,Page 2 of 35
*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?
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.
,Page 3 of 35
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
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
, Page 4 of 35
been nursing every 2-3 hours but the infant is lethargic. What is
the priority intervention?
a) Continue nursing and add fenugreek
b) Supplement with formula or expressed milk after each feed
and assess for transfer issues
c) Stop breastfeeding and switch to formula
d) Perform a heel poke for bilirubin
Correct Answer: b) Supplement with formula or expressed
milk after each feed and assess for transfer issues
Rationale: Severe weight loss and lethargy indicate inadequate
intake. Supplementation is urgent to prevent dehydration and
hypoglycemia. Investigate cause (latch, tongue-tie, low supply). Do
not stop breastfeeding unless medically necessary.
Q5 (Version A). A mother with a 2-week-old infant complains of
burning nipple pain that starts during feeding and continues
between feeds. Nipples are pink and shiny. The infant has white
