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Top 10 Mistakes of IBCLC Exam-Takers & Strategies to Help You Succeed

Woman appearing stressed with hands on face.

Our practice exams do two important things: help give you an exam-taking experience similar to that of taking the IBCLC® exam and give me a chance to review exam-takers responses and gain a sense of the common IBCLC exam mistakes. I don’t have access to actual exam results, but here’s what I’ve learned from looking at the results of thousands of practice-exam test-takers.

What are the top mistakes? What are the pitfalls that cause many exam-takers to slip up?

Choosing a statement that is true, but does not answer the question

For example, if the question asks, “Which of these actions will correct the problem?” then the answer must resolve the problem.  

Although actions that alleviate the pain associated with the problem, correctly document the problem, or astutely anticipate consequences of the problem may all be true statements, they don’t answer the question — resolving the problem.

Focus on what the question is asking for.

Choosing look-alike, sound-alike options

I once caught a whole room full of people choosing the option doxycycline — a drug given for a variety of infections in non-lactating women — instead of dicloxycillin — a drug frequently used to treat lactational mastitis. It’s a natural mistake to make, but it’s one you won’t want to make on exam day! 

Watch those look-alike, sound-alike options.

Overlooking qualifiers — especially “least”

Qualifiers are words that alter a statement. In a multiple-choice test, qualifiers can make the difference between a correct answer (key) or an incorrect option (distractor).

Qualifiers include words like firstmost, or best suggest that more than one of the options provided might be helpful. But you need to focus on which would be first, or most, or best in the situation.  

Read carefully, every time.

Being unable to prioritize

This is closely related to the “qualifier” questions I just mentioned. The test item gives a little vignette, and the question asks which would be a priority for the client’s care.

Frequently, all the actions listed as answers are both appropriate and effective! But only one is a priority. 

Be discerning, and don’t rush in thinking it through.

Choosing something other than reflective listening as the FIRST response

When a mother is confused, bewildered, or upset, reflective listening should be your first response.

However, exam-takers often make the mistake of choosing a response that tells the mother what to do, (“You should…”), dismisses her concerns (“Don’t worry about…”), or probes for more information (“How many times a day are you pumping…”) 

Often, you need to settle the mother as the first step.

Picking an unfamiliar word/phrase

Knowing the terminology of breastfeeding care can make the difference between a higher and lower score.

Here’s an example from my Workbook. Unless you know the correct answer, it will be very tough to pick it from the other options.

A lesion on skin that is normally soft and pliable but later becomes thick and fibrous would be described accurately as:

Candidates may make the mistaking of picking the wrong answer because they don’t know their terminology. I have a FREE list of 1000 lactation terms you should know. I also have terminology matching exercises to help you quiz yourself.   

Make sure you’ve mastered your terminology before you sit the exam.

Choosing a “local” answer

The IBCLC exam is an international exam. The right response won’t necessarily be the way it’s done at your home hospital. Sure, to provide good clinical care at your facility, you’ll need to know recommendations from local or national authorities (e.g., the American Academy of Pediatrics).

However, when it comes to taking the IBCLC exam, the World Health Organization is your top authority. 

To avoid making mistakes, remember to think globally.

Missing what is age-appropriate

It seems to me this is one of IBLCE’s favorite ways to ensure that only one option is the correct answer Don’t make the mistake of missing the age-appropriate answer. The “right” answer for a 2-week-old is probably NOT the right answer for a 2-month-old or a 2-year-old. 

Keep the baby’s age in mind as a key detail.

Mis-assessing the severity of the problem

Some things are life-and-death issues. You may need to know that when sitting the exam. It’s true that there are few situations when breastfeeding is contraindicated. 

Know the contraindications for breastfeeding.

Missing that the mother is going to do “it” anyway

These are what I call “done deals.” The test item starts along the lines of, “Your client insists on doing [something]” and then asks, “Which would be MOST important to teach her?”

There’s a high likelihood that when you’re not around, the client will continue that behavior. Hence, teaching is the approach to take here, and that’s what the item specifies. 

Beware that the exam item is probably not asking you to name the risks, make a risk/benefit decision, or persuade the client of the risks. Rather, it may be asking you what she must know to reduce the risks as much as possible. 

Keep your eye on your role.

As you prepare for the IBCLC exam, I urge you to beware of the pitfalls, and don’t make these mistakes. You can also learn more about the “anatomy” of the exam to help you prepare, see my recommendations to avoid losing points, and try your hand at practice exams to give you a real sense of your preparedness.  

Which traps catch you off-guard? How will you avoid making these mistakes?

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  1. Andrea Denbow

    I have taken the exam twice and have passed. Marie is an excellent teacher and she knows what she is talking about. Her programs are excellent. The test is not easy you have to study hard.

  2. Kim Cook

    I took the test in Sept 2020 and the thing that seemed to be asked the most, dealt with asking the mom for how she felt and what were her thoughts. This was common sense for me in my role but when I was working as a clinical nurse, I would have probably answered the problem-solving answer. Marie’s course totally prepared me for the test. I highly recommend it.

    • Marie Biancuzzo

      Kim, I totally agree! In my courses, I often tell attendees that nurses are trained to “fix it.” Whatever “it” is, we jump in try to problem-solve! On the IBCLC exam, I’d say that “fixing” is often NOT the answer to the question. Interestingly, when people take my practice exams, I sometimes get messages from them that say, “But X is what we’re supposed to do for that condition!” And I have to come back and say yes, but the question is really asking you about how to support the mother, it’s not asking how to fix the problem. I also have written several blog posts on the qualifiers in the stem, which absolutely relates to this support issue. (And my practice exams are full of qualifiers!) That’s a way of getting the test-taker to give the answer that is supportive of the mother, but not necessarily a fix to the problem. Kim, thank you for always waving the flag for my Lactation Exam Review and my other courses. You’re a true disciple!

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