Page 1 of 83
LACTATION COUNSELOR EXAM REAL 230
QUESTIONS AND ANSWERS|NEW
UPDATE|ALREADY GRADED A+|
Q1. Which hormone is primarily responsible for the milk ejection
reflex (let-down)?
a) Prolactin
b) Oxytocin
c) Estrogen
d) Progesterone
Correct Answer: b) Oxytocin
Rationale: Oxytocin causes myoepithelial cells around the alveoli to
contract, ejecting milk into the ducts. Prolactin stimulates milk
synthesis. Estrogen and progesterone inhibit milk production during
pregnancy.
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Q2. A mother 3 days postpartum reports that her breasts feel
full, warm, and heavy, but milk is flowing well after nursing. This
is likely:
a) Mastitis
b) Engorgement
c) Plugged duct
d) Normal lactogenesis II (secretory activation)
Correct Answer: d) Normal lactogenesis II (secretory
activation)
*Rationale: Days 2-5 postpartum, increased blood flow and milk
production cause physiologic engorgement. As long as milk
transfer is effective, this is normal. Pathologic engorgement
prevents milk flow; mastitis includes systemic symptoms.*
Q3. Prolactin secretion is inhibited by which neurotransmitter?
a) Serotonin
b) Dopamine
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c) Norepinephrine
d) Acetylcholine
Correct Answer: b) Dopamine
Rationale: Dopamine from the hypothalamus inhibits prolactin
release from the anterior pituitary. Suckling suppresses dopamine,
allowing prolactin rise. Medications that block dopamine (e.g.,
metoclopramide) can increase prolactin.
Q4. The small openings on the nipple surface where milk exits
are called:
a) Montgomery glands
b) Lactiferous sinuses
c) Nipple pores (ductal orifices)
d) Areolar tubercles
Correct Answer: c) Nipple pores (ductal orifices)
*Rationale: Milk drains from lactiferous ducts to 5-10 openings
on the nipple tip. Montgomery glands are areolar sebaceous
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glands that secrete lubricant. Lactiferous sinuses are behind the
areola.*
Q5. Which maternal condition is associated with insufficient
glandular tissue (hypoplasia), leading to low milk supply?
a) Polycystic ovary syndrome (PCOS)
b) Gestational diabetes
c) Thyroiditis
d) Fibrocystic breast changes
Correct Answer: a) Polycystic ovary syndrome (PCOS)
Rationale: PCOS is associated with breast hypoplasia (tubular
breast shape, widely spaced breasts, asymmetry) due to hormonal
imbalances during development. Other conditions may affect
supply but not primarily glandular hypoplasia.
Q6. During pregnancy, which hormone inhibits lactogenesis I
(colostrum production) until delivery?
a) Oxytocin
LACTATION COUNSELOR EXAM REAL 230
QUESTIONS AND ANSWERS|NEW
UPDATE|ALREADY GRADED A+|
Q1. Which hormone is primarily responsible for the milk ejection
reflex (let-down)?
a) Prolactin
b) Oxytocin
c) Estrogen
d) Progesterone
Correct Answer: b) Oxytocin
Rationale: Oxytocin causes myoepithelial cells around the alveoli to
contract, ejecting milk into the ducts. Prolactin stimulates milk
synthesis. Estrogen and progesterone inhibit milk production during
pregnancy.
,Page 2 of 83
Q2. A mother 3 days postpartum reports that her breasts feel
full, warm, and heavy, but milk is flowing well after nursing. This
is likely:
a) Mastitis
b) Engorgement
c) Plugged duct
d) Normal lactogenesis II (secretory activation)
Correct Answer: d) Normal lactogenesis II (secretory
activation)
*Rationale: Days 2-5 postpartum, increased blood flow and milk
production cause physiologic engorgement. As long as milk
transfer is effective, this is normal. Pathologic engorgement
prevents milk flow; mastitis includes systemic symptoms.*
Q3. Prolactin secretion is inhibited by which neurotransmitter?
a) Serotonin
b) Dopamine
,Page 3 of 83
c) Norepinephrine
d) Acetylcholine
Correct Answer: b) Dopamine
Rationale: Dopamine from the hypothalamus inhibits prolactin
release from the anterior pituitary. Suckling suppresses dopamine,
allowing prolactin rise. Medications that block dopamine (e.g.,
metoclopramide) can increase prolactin.
Q4. The small openings on the nipple surface where milk exits
are called:
a) Montgomery glands
b) Lactiferous sinuses
c) Nipple pores (ductal orifices)
d) Areolar tubercles
Correct Answer: c) Nipple pores (ductal orifices)
*Rationale: Milk drains from lactiferous ducts to 5-10 openings
on the nipple tip. Montgomery glands are areolar sebaceous
, Page 4 of 83
glands that secrete lubricant. Lactiferous sinuses are behind the
areola.*
Q5. Which maternal condition is associated with insufficient
glandular tissue (hypoplasia), leading to low milk supply?
a) Polycystic ovary syndrome (PCOS)
b) Gestational diabetes
c) Thyroiditis
d) Fibrocystic breast changes
Correct Answer: a) Polycystic ovary syndrome (PCOS)
Rationale: PCOS is associated with breast hypoplasia (tubular
breast shape, widely spaced breasts, asymmetry) due to hormonal
imbalances during development. Other conditions may affect
supply but not primarily glandular hypoplasia.
Q6. During pregnancy, which hormone inhibits lactogenesis I
(colostrum production) until delivery?
a) Oxytocin
