CBS Patient Assessment & Documentation 2 — Questions and Answers
Question 1: During a breastfeeding assessment, a mother reports her nipples are "blanching" after feeds. This is most likely indicative of:
- Raynaud's phenomenon of the nipple (Correct answer)
- Normal postpartum engorgement
- Candida infection
- Improper flange sizing during pumping
Correct answer: Raynaud's phenomenon of the nipple
Nipple blanching (turning white) followed by color changes is the hallmark sign of Raynaud's phenomenon, caused by vasospasm.
Question 2: When documenting a breastfeeding session, which BEST describes the 'transfer' component in a LATCH score?
- Whether milk is audibly swallowed by the infant (Correct answer)
- The position of the infant's lips on the breast
- The comfort level of the mother during the feed
- The duration of the feeding session
Correct answer: Whether milk is audibly swallowed by the infant
The 'T' in LATCH stands for 'Type of nipple/Transfer,' specifically assessing audible swallowing as evidence of milk transfer.
Question 3: A 4-day-old infant has had 3 wet diapers and 1 stool in 24 hours. The CBS should:
- Flag this as below expected output and assess for adequate milk transfer (Correct answer)
- Document this as normal for the age
- Recommend immediate formula supplementation
- Schedule a follow-up in one week
Correct answer: Flag this as below expected output and assess for adequate milk transfer
By day 4, infants should have at least 4–6 wet diapers and 3–4 stools per day; fewer indicates possible inadequate intake.
Question 4: Which maternal history finding is MOST relevant to document when assessing breastfeeding potential?
- Prior breast surgery involving the areola or nipple (Correct answer)
- History of seasonal allergies
- Preference for side-lying feeding position
- Type of prenatal vitamins taken
Correct answer: Prior breast surgery involving the areola or nipple
Breast surgery near the areola or nipple may have severed milk ducts or nerves critical for lactation and milk ejection.
Question 5: When assessing an infant's suck, a CBS notes the infant has a weak, disorganized pattern. The FIRST step is to:
- Document findings and refer to a pediatric feeding specialist or IBCLC (Correct answer)
- Instruct the mother to use a nipple shield immediately
- Recommend switching to bottle feeding
- Begin supplemental nursing system (SNS) without further evaluation
Correct answer: Document findings and refer to a pediatric feeding specialist or IBCLC
Disorganized sucking may indicate neurological or anatomical issues requiring specialist evaluation before implementing interventions.
Question 6: A mother's prenatal breast assessment reveals no change in breast size during pregnancy. This should be documented because it:
- May indicate insufficient glandular tissue and potential low milk supply risk (Correct answer)
- Is a normal variant requiring no further follow-up
- Confirms the mother will need to supplement from birth
- Suggests the mother has inverted nipples
Correct answer: May indicate insufficient glandular tissue and potential low milk supply risk
Lack of breast growth during pregnancy can be a marker for insufficient glandular tissue (IGT), which is a risk factor for low milk supply.
Question 7: When conducting a post-feed weight assessment using a precision infant scale, the weight difference before and after a feed estimates:
- Milk transfer volume in milliliters (1g ≈ 1mL) (Correct answer)
- The infant's hydration status
- The mother's milk fat content
- The infant's total daily caloric intake
Correct answer: Milk transfer volume in milliliters (1g ≈ 1mL)
Test weighing on a precision scale uses the principle that 1 gram of weight gain equals approximately 1 mL of milk consumed.
CBS Patient Assessment & Documentation 2
During a breastfeeding assessment, a mother reports her nipples are "blanching" after feeds.
This is most likely indicative of: