CBS Patient Assessment & Documentation 3 — Questions and Answers
Question 1: Which finding on an oral assessment is MOST associated with difficulty achieving a deep latch?
- High, narrow palate arch (Correct answer)
- Short frenulum alone
- Macroglossia
- Cleft lip repaired before birth
Correct answer: High, narrow palate arch
A high, narrow palatal arch prevents the infant's tongue from cupping the breast properly, making a deep latch difficult.
Question 2: A CBS is completing intake documentation for a mother with a history of polycystic ovary syndrome (PCOS). This is clinically significant because:
- PCOS is associated with hormonal imbalances that may affect milk supply (Correct answer)
- PCOS mothers typically produce excess milk
- PCOS has no known effect on lactation
- PCOS primarily affects infant latch ability
Correct answer: PCOS is associated with hormonal imbalances that may affect milk supply
PCOS is linked to insulin resistance and androgen excess, which can impair prolactin sensitivity and delay or reduce milk production.
Question 3: During a home visit on day 5 postpartum, the CBS notes the infant's skin has a yellow tinge extending below the knees. The appropriate documentation and action is:
- Document jaundice extending to the lower extremities and urgently refer to the pediatric provider (Correct answer)
- Document as normal physiologic jaundice and reassure the mother
- Recommend more frequent breastfeeding and recheck in 48 hours without referral
- Document and schedule a routine follow-up in one week
Correct answer: Document jaundice extending to the lower extremities and urgently refer to the pediatric provider
Jaundice extending below the knees suggests a bilirubin level that warrants prompt medical evaluation beyond the newborn norm.
Question 4: When documenting maternal nipple anatomy, which term correctly describes a nipple that inverts when stimulated?
- Truly inverted (grade 3) (Correct answer)
- Pseudoinverted
- Flat nipple
- Retracted nipple
Correct answer: Truly inverted (grade 3)
A grade 3 (truly inverted) nipple inverts with any stimulation or pressure and cannot be manually everted, requiring specific management.
Question 5: A mother at 3 weeks postpartum reports her breasts 'never feel full.' The MOST important assessment finding to document first is:
- Current infant weight and weight gain trajectory since birth (Correct answer)
- Mother's fluid intake per day
- Number of breast pumping sessions per day
- Mother's return to work date
Correct answer: Current infant weight and weight gain trajectory since birth
Infant weight gain is the primary objective measure of adequate milk supply; subjective breast fullness is not a reliable indicator.
Question 6: Which component is ESSENTIAL to include in breastfeeding session documentation for continuity of care?
- Duration of feed, breast(s) used, infant behavioral cues, and maternal comfort level (Correct answer)
- Only the total time of the feeding session
- Infant's diaper color from the previous day
- Name of the breastfeeding support group the mother attends
Correct answer: Duration of feed, breast(s) used, infant behavioral cues, and maternal comfort level
Complete session documentation must include feed duration, sides used, cues, and comfort to allow other providers to assess progress accurately.
Question 7: An infant consistently falls asleep at the breast after 3–4 minutes before completing a feed. Assessment should focus FIRST on:
- Evaluating milk transfer and ruling out hyperbilirubinemia-induced sleepiness (Correct answer)
- Instructing the mother to restrict feeding time to 10 minutes per side
- Documenting this as a normal newborn sleep pattern
- Recommending a pacifier to extend awake time
Correct answer: Evaluating milk transfer and ruling out hyperbilirubinemia-induced sleepiness
Early sleepiness at the breast may signal inadequate transfer or jaundice-related lethargy, both requiring prompt clinical assessment.
CBS Patient Assessment & Documentation 3
Which finding on an oral assessment is MOST associated with difficulty achieving a deep latch?