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Sample Family Nurse Practitioner Questions

 

353)  You are testing the reflexes of a neonate.  One of the reflexes you test is the Babinkski Reflex.  What is the physical response for the Babinkski Reflex?

            a) When stimulating outer sole of foot from heel upward and across ball of foot toward large toe, large toe dorsiflexes and toes flare

            b) When startled (noise, jarring), arms extend and abduct with fingers forming a C while knees and hips flex slightly, arms return to chest in an embracing motion

            c) When touching cheek or lips, head turns toward touch and mouth opens in attempt to suck

            d) When supine with head turned to one side, extremities on same side straighten and extremities on opposite side flex

 

Answer: a) Babinski Reflex: When stimulating outer sole of foot from heel upward and across ball of foot toward large toe, large toe dorsiflexes and toes flare

 

354)  You are testing the reflexes of a neonate.  One of the reflexes you test is the Tonic Neck Reflex.  What is the physical response for the Tonic Neck Reflex?

            a) When stimulating outer sole of foot from heel upward and across ball of foot toward large toe, large toe dorsiflexes and toes flare

            b) When startled (noise, jarring), arms extend and abduct with fingers forming a C while knees and hips flex slightly, arms return to chest in an embracing motion

            c) When touching cheek or lips, head turns toward touch and mouth opens in attempt to suck

            d) When supine with head turned to one side, extremities on same side straighten and extremities on opposite side flex

 

Answer: d) Tonic Neck Reflex: When supine with head turned to one side, extremities on same side straighten and extremities on opposite side flex

 

355)  You are testing the reflexes of a neonate.  One of the reflexes you test is the Rooting Reflex.  What is the physical response for the Rooting Reflex?

            a) When stimulating outer sole of foot from heel upward and across ball of foot toward large toe, large toe dorsiflexes and toes flare

            b) When startled (noise, jarring), arms extend and abduct with fingers forming a C while knees and hips flex slightly, arms return to chest in an embracing motion

            c) When touching cheek or lips, head turns toward touch and mouth opens in attempt to suck

            d) When supine with head turned to one side, extremities on same side straighten and extremities on opposite side flex

 

Answer: c) Rooting Reflex: When touching cheek or lips, head turns toward touch and mouth opens in attempt to suck

 

356)  A mother has just given birth to a new baby.  Before separating them, you give them ID bracelets.  What should be on the ID bracelets?

            a) name, sex, time of birth, blood type, ID number

            b) name, sex, date, time of birth, ID number

            c) ID number, sex, date, time of birth, blood type

            d) ID number, attending doctor, sex, date, time of birth, blood type

 

Answer: b) name, sex, date, time of birth, ID number should be on the matching bracelets

 

357)  Right after the mother has given birth, you have to complete the identification form for the baby.  What is on the form?

            a) newborn handprint, mother's fingerprints, name, date, time of birth

            b) newborn fingerprints, mother's fingerprints, name, date, time of birth

            c) newborn footprint, mother's fingerprints, name, date, time of birth

            d) newborn handprint, mother's handprints, name, date, time of birth

 

Answer: c) newborn footprint, mother's fingerprints, name, date, time of birth should be on form

 

358)  A baby has just been delivered and you immediately clamp the umbilical cord.  How long do you clamp the cord for?

            a) Clamp for 24 hours until cord is dry

            b) Clamp for 48 hours; remove before cord is dry

            c) Clamp for 48 hours until cord is dry

            d) Clamp for 2 weeks (when cord should fall off)

 

Answer a) Clamp umbilical cord for 24 hours until cord is dry

 

359)  You are administering vitamin K to a newborn.  The mother asks you why newborns need vitamin K to be administered externally.  What is your answer?

            a) The baby has not produced vitamin K yet because vitamin K is produced in the GI tract when

bacterial formation occurs after ingesting breast milk or formula, usually by 8th day.

            b) Vitamin K is not produced in the human body and only ingested (eg. bananas).  As the baby is not eating solid food yet, vitamin K must be administered externally.

            c) The baby is producing its own vitamin K, but is not producing enough, therefore you are giving the infant supplements.

            d) The amount of vitamin K the infant receives depends on the breast milk and how much vitamin K the mother has ingested.  Vitamin K is administered externally as a precaution in case the mother does not receive enough vitamins in her daily diet.

 

Answer: a) Vitamin K is administered externally because the baby has not produced vitamin K yet because vitamin K is produced in the GI tract when bacterial formation occurs after ingesting breast milk or formula, usually by 8th day.

 

360)  You are administering vitamin K to an infant and the father asks you what the vitamin K is used for.  Your response is that vitamin K is used to:

            a) promote nerve growth

            b) promote formation of antibodies

            c) promote bone growth

            d) promote normal clotting

 

Answer:d) Vitamin K promotes normal clotting

 

361)  A baby still has her umbilical cord attached.  What special care would the cord need?

            a) No special care is needed – the cord will fall off in 10 – 14 days

            b) Assess cord for bleeding or infection.  Clean cord with soap and water after each diaper change and apply topical antibiotic if ordered.  Place diaper below umbilical cord stump.

            c) Assess cord for bleeding or infection.  Clean cord with soap and water daily apply topical antibiotic if ordered.  Place diaper below umbilical cord stump.

            d) Assess cord for bleeding or infection.  Clean cord with soap and water daily and apply topical antibiotic if ordered.  Place diaper on top of umbilical cord stump.

 

Answer: b) Care for umbilical cord: assess cord for bleeding or infection.  Clean cord with soap and water after each diaper change and apply topical antibiotic if ordered.  Place diaper below umbilical cord stump.

 

362)  You are about to insert an ophthalmic antibiotic in the newborn's eye.  The parent asks you what the antibiotic is for.  What is your response?

            a) It prevents gonorrheal or chalamydial infection of eyes contracted during vaginal birth

            b) It prevents ophthalmia neonatorum contracted during caesarean birth

            c) It prevents eye infection caused by insufficient eye development due to preterm birth

            d) It is a precaution to prevent eye infection caused by contact with improperly sterilized surgical instruments

 

Answer: a) Ophthalmic antibiotic given to newborn to prevent gonorrheal or chalamydial infection of eyes contracted during vaginal birth

 

363)  A newborn has just been circumcised.  The doctor reminds you to monitor the circumcision for swelling, redness and bleeding.  How long should you monitor the baby for?

            a) Every 2 hours for 12 hours, then with each diaper change

            b) Every 2 hours for 24 hours, then with each diaper change

            c) Every 30 minutes for 24 hours, then with each diaper change

            d) Every 30 minutes for 2 hours, then every 2 hours for 24 hours, then with each diaper change

 

Answer: d) Should assess for swelling, redness, bleeding after circumcision every 30 minutes for 2 hours, then every 2 hours for 24 hours, then with each diaper change

 

364)   While changing the diaper of a baby who was circumcised the day before, you noticed some yellowish exudate.  What should you do?

            a)  Immediately inform the doctor

            b) Wipe the exudate away and apply antibiotic cream

            c) Avoid disrupting it as it is part of the healing process

            d) Check for signs of infection, before wiping away the exudate and administering oral antibiotics.

 

Answer: c) Avoid disrupting the yellowish exudate as it is part of the healing process after circumcision

 

365)  A baby is placed in the charge of a junior nurse after circumcision. She asks you if she should apply a diaper to the baby.  Your response is:

            a) avoid applying diapers to the baby for the next three days until the baby has healed

            b) apply diaper as normal

            c) apply diaper tightly to increase pressure

            d) apply diaper loosely to decrease pressure and friction

 

Answer: d) after circumcision, apply diaper loosely to decrease pressure and friction

 

366)  A baby has just been delivered and the doctor hands you the baby.  How should you clean the baby?

            a) Bathe with warm water and mild soap to remove amniotic fluid, blood, vaginal secretions, and skin residue.

            b) Sponge bathe to remove amniotic fluid, blood, vaginal secretions, and skin residue.

            c) Bathe with water (no soap) to remove amniotic fluid, blood, vaginal secretions and skin residue

            d) Sponge bathe to remove blood, vaginal secretions and skin residue, but leave the amniotic fluid until the doctor has examined it.

 

Answer: a) Bathe neonate with warm water and mild soap to remove amniotic fluid, blood, vaginal secretions, and skin residue.

 

367)  You are teaching a new mother how to take care of her new baby.  She asks you how to bathe it.  What is your response?

            a) Tub bathe with mild soap after returning from the hospital

            b) Sponge bathe daily until the cord falls off and circumcision is healed.  Tub bathe afterward.

            c) Sponge bathe daily until baby can sit up by him/herself.

            d) Do not bathe until the cord falls off and circumcision is healed.  Tub bathe afterward.

 

Answer: b) Sponge bathe newborn daily until the cord falls off and circumcision is healed.  Tub bathe afterward.

 

368)  An expectant mother wants to breastfeed and asks you about some of the benefits.  What are the maternal benefits of breastfeeding?

            a) Increases attachment.  Releases oxytocin promoting uterine contraction and involution.  Energy and calories increase weight reduction.  Extends anovultion beyond 4 – 6 weeks.  Convenient and economical.  Decreases risk of breast and ovarian cancer.

            b)Increases attachment.  Releases estrogen promoting uterine contraction and involution.  Energy and calories decrease, causing weight gain.  Reduces anovultion to 4 – 6 weeks.  Convenient and economical.  Decreases risk of breast, gastro-intestinal and ovarian cancer.

            c)Increases attachment.  Releases estrogen promoting uterine contraction and involution.  Energy and calories increase, causing weight loss.  Reduces anovultion to 4 – 6 weeks.  Convenient and economical.  Decreases risk of breast and  gastro-intestinal.

            d)Increases attachment.  Releases estrogen and progesterone promoting uterine contraction and involution.  Energy and calories decrease, causing weight gain.  Reduces anovultion to 4 – 6 weeks.  Decreases risk of breast, gastro-intestinal and ovarian cancer.

 

Answer: a) Maternal benefits of beastfeeding are: increases attachment.  Releases oxytocin promoting uterine contraction and involution.  Energy and calories increase weight reduction.  Extends anovultion beyond 4 – 6 weeks.  Convenient and economical.  Decreases risk of breast and ovarian cancer.

 

369)  An expectant mother is considering breastfeeding.  She wants to know how long her child can be on only breast milk for.  You tell her that:

            a) breast milk, while nutritious should never be given by itself; calcium and vitamin D supplements should be added from the start

            b) breast milk gives optimum nutritional value for first year, but potassium, calcium,  vitamin D and fluoride supplements should be given after first year

            c) breast milk gives optimum nutritional value for first 6 months, but vitamin D and fluoride supplements should be given after 6 months

            d) breast milk gives optimum nutritional value for first 3 months, but potassium, calcium,  vitamin D and fluoride supplements should be given after 3 months

 

Answer: c) breast milk gives optimum nutritional value for first 6 months, but vitamin D and fluoride supplements should be given after 6 months

 

370)  An expectant father is very interested in the benefits of breast milk and asks you how it can benefit his child's immune system.  You tell him:

            a) breast milk provides passive immunity  through carrier A, B, G immunoglobulins, , microphages, leukocytes, lymphocytes

            b) breast milk provides passive immunity via lgE, lgM, and lgA immunoglobulins, macrophages, leukocytes, lymphocytes, neurtrophils

            c) breast milk provides passive immunity via mmunoglobulins, macrophages, microphages, leukocytes, lymphocytes, tetrocytes, miterocytes

            d) breast milk provides passive immunity via carrier A, B, G immunoglobulins, macrophages, microphages, leukocytes, lymphocytes, blastocysts

 

Answer: b) breast milk provides passive immunity via lgE, lgM, and lgA immunoglobulins, macrophages, leukocytes, lymphocytes, neurtrophils

 

371)  An expectant mother who is HIV positive has been warned by her doctor not to breastfeed her baby.  The mother shouldn't breastfeed when she is/has:

            a) HIV positive, active TB, hepatitis, narcotic addiction, breast abnormalities. Chronic disease that interferes with lactation or maternal status. Taking drugs excreted in breast milk that are harmful to infant. Inadequate maternal fluid/nutrition intake

            b) HIV positive, active TB, alcoholic, hepatitis, Huntingdon's disease, narcotic addiction, breast abnormalities from trauma, burns, radiation. Chronic disease that interferes with lactation or maternal status.  Inadequate maternal fluid/nutrition intake

            c) HIV positive, active and passive TB, active and passive hepatitis, infected with encephalitis, narcotic addiction, breast abnormalities from trauma, burns, radiation. Chronic disease that interferes with lactation or maternal status. Taking drugs excreted in breast milk that are harmful to infant.

            d) HIV positive, active TB, narcotic addiction, breast abnormalities from trauma, burns, radiation. Chronic disease that interferes with lactation or maternal status. Taking drugs excreted in breast milk that are harmful to infant. Inadequate maternal fluid/nutrition intake

 

Answer: d) Mothers should not breastfeed when they are/have HIV positive, active TB, narcotic addiction, breast abnormalities from trauma, burns, radiation. Chronic disease that interferes with lactation or maternal status. Taking drugs excreted in breast milk that are harmful to infant. Inadequate maternal fluid/nutrition intake

 

372)  An new mother plans on breastfeeding her child.  You teach her how to care for her breasts.  Other than cleansing her breasts with water daily, what else should she do?

            a)  Wear a supportive brassiere during the day, but take it off at night; wear nursing pads to absorb leaking milk; dry nipples with a dryer several times a day.

            b) Wear a supportive brassiere day and night; wear nursing pads to absorb leaking milk; allow nipples to air-dry several times a day.

            c) Wear a supportive brassiere during the day, but take it off at night; wear nursing pads to absorb leaking milk; allow nipples to air-dry several times a day.

            d)  Wear a supportive brassiere during the day, but take it off at night; wear nursing pads to absorb leaking milk; dry nipples with a cloth or napkins several times a day.

 

Answer: b) Self-breast care includes: Wear a supportive brassiere day and night; wear nursing pads to absorb leaking milk; allow nipples to air-dry several times a day.

 

373)  An expectant mother plans on breastfeeding and asks you when she should start to breastfeed.  When should the mother start breastfeeding?

            a) As soon as possible (preferably in birthing room)

            b) One day after birth

            c) One week after birth (formula milk with vitamin K until baby has started producing vitamin K him/herself)

            d) Two weeks after birth (formula milk with vitamin K until baby has started producing vitamin K him/herself)

 

Answer: a) Breastfeeding should start as soon as possible (preferably in birthing room)

 

374)  A new mother has just started breastfeeding her baby and wants to know how often she should feed the baby.  You tell her that she should:

            a) offer breast every 2-3 hours or on demand

            b) offer breast every 2-3 hours, then alternate with formula milk

            c) offer breast every 4 hours, or on demand; baby will need less milk at night, so every 6 hours is fine

            d) baby needs to be trained to drink at set times, so mother should find a schedule that suits her; as long as baby is fed at least 3 times a day, baby will be healthy

 

Answer: a) The mother should offer breast every 2-3 hours or on demand

 

375)  An infant is about to be discharged (after birth).  What should he be immunized with?

            a) Hepatitis B

            b) Diphthera, Tetanus, Pertussis

            c) Hepatitis A

            d) Inactivated Polio

 

Answer: a) Infant should be immunized against Hepatitis B (1st dose) after birth before discharge

 

376)  A baby is 2 months old.  What should she be immunized against?

            a)  Diphthera, Tetanus, Pertussis; Haemophilus influenzae b conjugate vaccine; Inactivated polio, Pneumococcal; Rotavirus vaccine

            b)Diphthera, Tetanus, Pertussis; Pneumococcal; Rotavirus vaccine; Measles, mumps, rubella; Pneumococcal; Rotavirus vaccine

            c)  Diphthera, Tetanus, Pertussis; Pneumococcal; Rotavirus vaccine

            d) Measles, mumps, rubella; Pneumococcal; Rotavirus vaccine

 

Answer: At 2 months, baby is given vaccines for: a)  Diphthera, Tetanus, Pertussis; Haemophilus influenzae b conjugate vaccine; Inactivated polio, Pneumococcal; Rotavirus vaccine

 

377)  You are going through the US immunization schedule with new parents.  When should a child be immunized against varicella?

            a) dose at 2 and 4mo. IM

            b)1st dose after birth before discharge, 2nd at 4wk after 1st dose, 3rd at ≥24wk. IM

            c)1st dose 12–15 mo, 2nd at 4–6yr. Sub-Q

            d)1st dose at 6mo; yearly ≥59mo. IM

 

Answer: c)Varicella immunization schedule: 1st dose 12–15 mo, 2nd at 4–6yr. Sub-Q

 

378) You are going through the US immunization schedule with new parents.  They are especially concerned about the flu, which has been going around. When should a child be immunized against influenza?

            a) dose at 2 and 4mo. IM

            b)1st dose after birth before discharge, 2nd at 4wk after 1st dose, 3rd at ≥24wk. IM

            c)1st dose 12–15 mo, 2nd at 4–6yr. Sub-Q

            d)1st dose at 6mo; yearly ≥59mo. IM

 

Answer: d)influenza immunization: 1st dose at 6mo; yearly ≥59mo. IM

 

379)  You are going through the US immunization schedule with new parents.  When should a child be immunized against Haemophilus influenzae b?

            a) dose at 2 and 4mo. IM

            b)1st dose after birth before discharge, 2nd at 4wk after 1st dose, 3rd at ≥24wk. IM

            c)1st dose 12–15 mo, 2nd at 4–6yr. Sub-Q

            d)1st dose at 6mo; yearly ≥59mo. IM

 

Answer: a) Haemophilus influenzae b conjugate vaccine should be dosed at 2 and 4mo. IM

 

380)  Parents who have been overseas come back with a four-month old baby.  They are missing some immunizations, specifically the child has not been given the Rotavirus vaccine.  What do you tell the parents:

            a) first dose is given at 4 months, so parents are just in time

            b) first dose should have been given at 2 months old, but an extra dose can be given later on to make up for missed dose

            c) since vaccination does not start until the baby is 12 months old, nothing more needs to be done until then

            d) the vaccine cannot be initiated after the baby is 12 weeks old

 

Answer: d) the Rotavirus vaccine cannot be initiated after the baby is 12 weeks old

 

381)  A child has just finished their childhood Diphtheria, tetanus, pertussis (DtaP) immunizations.  You tell the parents that boosters are still required periodically.  When should boosters be administered after that?

            a) Every year

            b) Every 5 years

            c) Every 10 years

            d) Every 20 years

 

Answer: c) Diphtheria, tetanus, pertussis immunizations should be boosted every 10 years

 

382)  You are administering an immunization to two-year-old toddler.  Which muscle should you apply the needle to?

            a) vastus lateralis or ventrogluteal

            b) vastus lateralis or deltoid

            c) vastus lateralis only

            d) deltoid

 

Answer: d) deltoid may be used for immunizations on those 18 months or over

 

383)  You are measuring the vital signs of a toddler.  The father mentions that his blood pressure is slightly high at 170/120. What is expected blood pressure for a toddler?

            a) 60-80/30-60

            b) 90-100/50-65

            c)  110-140/60-8

            d )110-140/60-90

 

Answer:Blood pressure for toddler should be 90-100/50-65

 

384)  You are measuring the vital signs of an adolescent.  He has been feeling dizzy lately and is worried that it's due to low blood pressure. What is expected for an adolescent?

            a) 60-80/30-60

            b) 90-100/50-65

            c) 110-140/60-80

            d )110-140/60-90

 

Answer: c)Blood pressure for adolescent should be  110-140/60-8

 

385)  You are measuring the vital signs of a newborn. She had low blood pressure in the first few days, and the parents are anxious. What is expected for a newbornt?

            a) 60-80/30-60

            b) 90-100/50-65

            c) 110-140/60-80

            d )110-140/60-90

 

Answer: a)Blood pressure for a newborn should be 60-80/30-60

 

386)  You are measuring the vital signs of a newborn.  He had an irregular heart rate when he was first born, and his parents are worried.  What is the expected heart rate of a newborn?

            a) 50 - 90

            b) 60 - 100

            c) 60 - 110

            d) 80 - 180

 

Answer:d) Newborn's expected heart rate is: 80 - 180

 

387)  You are measuring the vital signs of a school age child.  He had an irregular heart rate when he was first born, and his parents are worried.  What is the expected heart rate of a school age child?

            a) 50 - 90

            b) 60 - 100

            c) 60 - 110

            d) 80 - 180

 

Answer: c) School age child's expected heart rate is: 60 - 110

 

388))  You are measuring the vital signs of an adult.  She has been under a lot of stress lately and is worried that she is not exercising enough..  What is the expected heart rate of an adult?

            a) 50 - 90

            b) 60 - 100

            c) 60 - 110

            d) 80 - 180

 

Answer: b) Adult's expected heart rate is:  60 - 100

 

389) An adult comes into the clinic and you measure her respirations.  She wants to know what the normal range for adults is as she is going to start a marathon soon and wants to keep track of her respirations.  What is the expected number of respirations for adults?

            a) 12-20

            b) 16-20

            c) 18-26

            d) 24-32

 

Answer: a) Adults are expected to respirate 12-20 times

 

390)  An toddler comes into the clinic and you measure her respirations.  The father wants to know what the normal range for toddlers is as she is going to start a father-daughter marathon soon and he wants to keep track of her respirations.  What is the expected number of respirations for toddlers?

            a) 12-20

            b) 16-20

            c) 18-26

            d) 24-32

 

Answer: d) Toddlers are expected to respirate 24-32 times

 

391) An adolescent comes into the clinic and you measure her respirations.  She wants to know what the normal range for adolescents is as she is going to start swimming wants to keep track of her respirations.  What is the expected number of respirations for adolescents?

            a) 12-20

            b) 16-20

            c) 18-26

            d) 24-32

 

Answer: b) Adolescents are expected to respirate 16-20 times

 

392)  A mother has started breastfeeding her baby and wants to know if she should breastfeed using only one breast, or both.  You tell her that she should:

            a)  alternate starting breast; use one breast for one feeding, and the alternate breast for the next one in order to not dry out the breasts

            b) use the same starting breast so child is familiarized with procedure; use one breast for one feeding, and the alternate breast for the next one in order to not dry out the breasts

            c) use the same starting breast so child is familiarized with procedure; both breasts should be used at each feeding to increase milk production.

            d) alternate starting breast and use both breasts at each feeding to increase milk production

 

Answer: d) When breastfeeding, mothers should alternate starting breast and use both breasts at each feeding to increase milk production

 

393) A father is arguing with his wife over how lay their child down after breastfeeding.  He believes infant should be down on his back, whereas the mother believes the child should be placed on his stomach.  How should infant be placed down after feeding.

            a) Infant should be placed on back with back roll and pillow

            b) Infant should be placed on stomach with back roll and pillow

            c) Infant should be placed on side with back roll or supine

            d) Infant should be placed on stomach on surface cleared of obstacles

 

Answer: c) Infant should be placed on side with back roll or supine after feeding

 

394) A mother is feeding her infant and would like to know if the infant's burping is normal.  She asks you for advice about burping the child.  The infant should be burped:

            a) before feeding

            b) during feeding

            c) during and after feeding

            d) after feeding

 

Answer: c) Infant should be burped during and after feeding

 

395)  A new mother tells you that she is going to be away from her baby for a few days.  The father will be taking care of the baby, but she wants to know if the breast milk can be stored.  You inform her that:

            a) breast milk cannot be stored

            b) breast milk can be refrigerated for 72 hours, then must be discarded

            c) breast milk can be refrigerated for 24 hours or frozen for six months or less

            d) breast milk can be refrigerated for 72 hours or frozen for six months or less

 

Answer: d) breast milk can be refrigerated for 72 hours or frozen for six months or less

 

396)  A breastfeeding mother has swollen, hard, hot, tender and dry breasts four days postpartum.  What is this called?

            a) breast engorgement

            b) lactosis engorgio

            c) inverted nipples

            d) materna irratatio

 

Answer: a) breast engorgement is when breasts are  swollen, hard, hot, tender and dry

 

397) A new mother has engorged breasts that are swollen, hard, hot and tender.  What can she do to ameliorate the symptoms?

            a) stop breastfeeding

            b) breastfeed every two hours and empty breasts entirely by pumping; apply ice between feedings 15 min on and 45 off

            c) breastfeed every two hours, by stop when breasts are halfway empty; apply warm packs between feedings 15 min on and 45 off

            d) stop breastfeeding; apply warm packs between feedings 15 min on and 45 off

 

Answer: b) Care for breast engorgement: breastfeed every two hours and empty breasts entirely by pumping; apply ice between feedings 15 min on and 45 off

 

398)  A new mother's breasts are engorged.  She wants to know the cause of the breast engorgement and asks if it is due to the fact that she is breastfeeding.  Breast engorgement is due to:

            a) an infection

            b) vascular congestion before secreting milk

            c) the baby is sucking too hard

            d) a side effect of the antibiotics administered after labor

 

Answer: b) breast engorgement is due to vascular congestion before secreting milk