This Document Contains Chapters 3 to 4 Chapter 03 Pregnancy and Prenatal Development True / False Questions 1. Women are born with an infinite number of eggs. FALSE 2. During the gestation period, the zygote grows into an embryo and then a fetus. TRUE 3. The normal range of gestation is limited to 25-30 weeks. FALSE 4. The proximodistal principle dictates that development proceeds from the head to the lower part of the trunk. FALSE 5. Within 36 hours after fertilization, the zygote enters a period of rapid cell division and duplication, known as mitosis. TRUE 6. Defects that occur at the embryonic stage in the pregnancy are likely to be more serious than those that occur later. TRUE 7. The most severely defective embryos usually do not survive beyond the first trimester. TRUE 8. Spontaneous abortion is commonly called stillbirth. FALSE 9. Males are more likely than females to be spontaneously aborted or to be stillborn. TRUE 10. Most early miscarriages occur in cases where chromosomal abnormalities strongly undermine the viability of the pregnancies. TRUE 11. Mature taste cells appear at about 14 weeks of gestation. TRUE 12. Pregnant women typically need between 300 to 500 additional calories a day, including extra protein. TRUE 13. Research indicates that not eating enough calories during pregnancy might put children at risk for later obesity. TRUE 14. Malnourished women who take dietary supplements while pregnant tend to have bigger, healthier, more active, and more visually alert infants. TRUE 15. The risk of HIV transmission from mother to child can be reduced by choosing a natural childbirth over a cesarean delivery. FALSE 16. Rubella is an infection transmitted through contact with cat feces. FALSE 17. Diabetes can deprive the embryo of oxygen and cause cell damage in the first 8 weeks of pregnancy. TRUE 18. Adolescents tend to have premature or underweight babies. TRUE 19. Prenatal alcohol exposure is the most common cause of mental retardation and birth defects in the United States. TRUE 20. In the United States, prenatal care has uniform national standards and involves a guaranteed coverage. FALSE Multiple Choice Questions 21. The normal human gestation period ranges between _____ weeks in length. A. 28-32 B. 21-25 C. 37-41 D. 10-15 22. The prenatal period of development, between conception and birth, is called _____. A. gametogenesis B. ovulation C. fertilization D. gestation 23. A fertilized ovum grows into a(n) _____. A. embryo B. oocyte C. follicle D. corpus luteum 24. The correct order for the three prenatal stages is A. fetal, embryonic, and germinal. B. embryonic, fetal, and germinal. C. germinal, fetal, and embryonic. D. germinal, embryonic, and fetal. 25. Which of the following terms describes the principle of prenatal development in which the sequence of growth is from the head to the feet? A. Proximodistal B. Cephalocaudal C. Dorsoventral D. Rostro dorsal 26. According to _____ principle, development proceeds from parts near the center of the body to outer ones. A. proximodistal B. cephalocaudal C. dorsoventral D. rostro dorsal 27. The _____ stage includes the first two weeks of development after fertilization. A. fetal B. embryonic C. germinal D. neonatal 28. In which stage of prenatal development does the fertilized ovum become implanted in the wall of the uterus? A. Germinal stage B. Neonatal stage C. Fetal stage D. Embryonic stage 29. The zygote begins rapid cell division and forms a blastocyst during the _____ stage. A. germinal B. embryonic C. fetal D. neonatal 30. The fluid-filled sphere that floats freely in the uterus until the 6th day after fertilization, and then implants itself into the wall of the uterus is called the _____. A. ovum B. blastocyst C. follicle D. corpus luteum 31. The portion of the blastocyst from which the baby develops is called the _____. A. embryonic disk B. follicle C. ampulla D. corpus luteum 32. Which of the following cell groups develops into the outer layer of skin, hair, nails, sensory organs, and nervous system? A. Ectoderm B. Endoderm C. Mesoderm D. Neuroderm 33. Dr. McGuire is studying the cells in the blastocyst that eventually become the brain and the spinal cord. These cells are constituents of the cell group called _____. A. mesoderm B. ectoderm C. endoderm D. epiderm 34. The portion of the embryonic disk that eventually becomes the digestive system and the respiratory system is the _____. A. ectoderm B. endoderm C. epiderm D. neuroderm 35. Which of the following is NOT involved in nurturing and protecting the unborn child throughout the pregnancy? A. Amniotic sac B. Embryonic disk C. Umbilical cord D. Placenta 36. The _____ is a fluid-filled membrane that encases the developing embryo, giving it room to move. A. umbilical system B. placenta C. follicle D. amniotic sac 37. The _____, which contains both maternal and embryonic tissue, develops in the uterus to allow oxygen, nourishment, and wastes to pass between mother and embryo. A. placenta B. amniotic sac C. ectoderm D. follicle 38. Which of the following carries nutrients from the mother's blood to the embryo? A. Umbilical cord B. Corpus luteum C. Follicle D. Amniotic sac 39. Which of the following is true of the organs developed to protect and nurture the embryo? A. The placenta is a fluid-filled membrane that encases the developing embryo, giving it room to move. B. The mesoderm produces the hormones that support pregnancy. C. The placenta plays a role in elimination of wastes from the embryo through the maternal blood vessels. D. The placenta and the umbilical cord function independently. 40. Which of the following is true of the placenta? A. It encases the baby within a fluid-filled membrane. B. It contains maternal tissue, and no embryonic tissue. C. It fights internal infections and provides immunity to the baby. D. It nourishes the offspring only in the first two stages of gestation. 41. During the _____, from about 2 to 8 weeks, the organs and major body systems respiratory, digestive, and nervous—develop rapidly. A. germinal stage B. embryonic stage C. fetal stage D. fertilization stage 42. Which of the following statements characterizes the embryonic stage in gestation? A. It lasts from conception till the second week of gestation. B. It involves the development of the major organ systems and body structure. C. It primarily involves the formation and implantation of the blastocyst. D. It progresses from the development of the outer parts of the body to the inner parts. 43. In a normal pregnancy, which of the following developments is associated with the embryonic stage? A. Development of the blastocyst B. Development of the fingernails and toenails C. Development of the respiratory system D. Development of sight and eyelids 44. _____ is the term used to denote the expulsion from the uterus of an embryo or fetus unable to survive outside the womb. A. Ectopic pregnancy B. Stillbirth C. Post maturity D. Spontaneous abortion 45. Which of the following is true with regard to spontaneous abortions in the first trimester? A. When a fetus is born dead at or after the 20th week following conception, it is termed as spontaneous abortion. B. Widespread cultural variations exist in the rates of spontaneous abortions. C. The rates of spontaneous abortion are the lowest in the first trimester. D. Most spontaneous abortions occur before the mother realizes that she is pregnant. 46. _____ is the term used to describes fetuses that are dead at or after the 20th week following conception. A. Ectopic pregnancy B. Stillborn C. Post maturity D. Spontaneous abortion 47. Research has shown that A. more males are conceived than females. B. males develop greater immunity than females and this advantage lasts throughout the lifespan. C. females are more active than males while in the womb. D. female fetuses are more likely to be spontaneously aborted than male fetuses. 48. Which of the following statements highlights the adaptive value of early miscarriages? A. A vast majority of early miscarriages are highly preventable. B. A vast majority of early miscarriages occur in pregnancies that are not viable because of chromosomal defects in the baby. C. Once the first trimester has passed, the risk of spontaneous abortions and stillbirths is negligible. D. The choices made by a pregnant woman during gestation can reverse the effects of existing severe chromosomal abnormalities in the fetus. 49. The appearance of _____ results in the transition from the embryonic to the fetal stage of prenatal development. A. toenails B. bone cells C. eyelids D. fingernails 50. The _____ stage is the final stage of gestation. A. embryonic B. neonatal C. fetal D. germinal 51. Which prenatal stage of development lasts the longest? A. Germinal stage B. Fetal stage C. Embryonic stage D. Neonatal stage 52. Tehra's obstetrician is using a medical procedure that employs high-frequency sound waves to detect the outline of the fetus and to observe its movements. This is called A. amniocentesis. B. bioacoustics. C. ultrasound. D. karyotyping. 53. In the fetal stage, the fetus A. produces immature neurons rapidly and these form the basis of its genetic programming. B. produces movements but they cannot be perceived by expectant mothers till birth. C. obtains nutrients and eliminates wastes without the help of the placenta. D. lacks the ability to perceive taste and smell as these sensory systems develop after birth. 54. Which of the following statements is true with regard to male fetuses? A. Male fetuses tend to be more active than female fetuses. B. Male fetuses tend to be conceived less often when compared to female fetuses. C. Male fetuses tend to have higher levels of immunity when compared to female fetuses from conception. D. Male fetuses tend to be less likely to experience spontaneous abortions than female fetuses. 55. Which of the following conclusions is true of fetuses' reaction to sound? A. Newborns prefer male voices to female voices. B. Newborns prefer female voices to male voices. C. Newborns fail to recognize their mother's native language. D. Newborns are unable to perceive sound and recognize speech sounds heard before birth. 56. Environmental factors that may cause developmental abnormalities are called A. estrogens. B. androgens. C. teratogens. D. progestins. 57. How many additional calories should a woman consume each day during a normal pregnancy? A. 300 to 500 B. 600 to 700 C. 700 to 900 D. Over 1,000 58. _____, a B vitamin found in leafy vegetables and in fortified cereals and breads, is a critical part of a pregnant woman's diet. A. Phytic acid B. Lactic acid C. Folic acid D. Amino acid 59. _____ is a condition caused by the deficit of Folic acid in which the brain of the fetus is formed incompletely or improperly. A. Encephalitis B. Myelitis C. Multiple sclerosis D. Anencephaly 60. A condition in which the baby's spinal cord is not properly enclosed is termed as _____. A. meningitis B. spina bifida C. spinal puncture D. multiple sclerosis 61. Insufficient intake of folic acid during pregnancy directly increases the risk of having a baby with A. phenylketonuria. B. leukemia. C. spina bifida. D. diabetes. 62. Doctors have found that increasing a woman's folic acid consumption by just 5 milligrams each day reduces the incidence of _____ by 85 percent. A. cleft palate B. cerebral palsy C. Down syndrome D. neurological defects 63. Which of the following statements best describes the appropriate level of physical activity for pregnant women? A. Pregnant women should exercise strenuously to promote circulation. B. Pregnant women should reduce all physical activities to the bare minimum in the last month of their pregnancy. C. Pregnant women should engage in exercises only in the first trimester as the risk of miscarriage is low. D. Pregnant women should exercise moderately throughout their pregnancy. 64. Della Ray is seven months into her first pregnancy, which has been progressing normally. Della's increased food intake and rest has resulted in a lot of weight gain and she is worried about putting on any more weight. Which of the following exercise regimens would be appropriate for Della at this stage of her pregnancy? A. Weightlifting and power B. Skating and skiing C. Prenatal yoga D. Biking 65. _____ is a disease caused by the human immunodeficiency virus, which undermines functioning of the immune system. A. AIDS B. Toxoplasmosis C. Rubella D. Diabetes 66. _____, if contracted by a woman before her 11th week of pregnancy, is almost certain to cause deafness and heart defects in her baby. A. Spina bifida B. Toxoplasmosis C. Rubella D. Diabetes 67. Rubella has the potential of damaging an unborn child during which period of pregnancy? A. First 11 weeks B. 13 to 16 weeks C. 18 to 22 weeks D. After 24 weeks 68. Jane is 8 weeks pregnant and has just contracted rubella. If you were Jane's physician, what information would you give her regarding the health of her unborn baby? A. The child will almost certainly be deaf. B. The child will be normal if Jane takes additional folate supplements. C. The child will have minor defects like a squint. D. The child will have normal cardiac functioning. 69. _____ is caused by a parasite harbored in the bodies of cattle, sheep, and pigs, and in the intestinal tracts of cats, typically produces either no symptoms or symptoms like those of the common cold. A. Hepatitis C B. Toxoplasmosis C. Rubella D. Diabetes 70. Which of the following is true of Toxoplasmosis? A. It is harmful to the child only if it is contracted within the first trimester of pregnancy. B. It is manifested through severe symptoms like brain fever and seizures in the mother. C. It is manifested through fetal brain damage, stillbirth, or death of the baby. D. It is caused by the human immunodeficiency virus. 71. The negative effects of toxoplasmosis are A. the most potent if the mother contracts it in the second or third trimester. B. the least potent if the mother contracts it but shows no major symptoms. C. negligible if the child survives the first year. D. uncontrollable through any preventive measures or vaccines taken by the mother. 72. Moderate maternal stress or anxiety during pregnancy A. represents a normal adaptive response to pregnancy. B. elevates the risk of intellectual disability of the fetus. C. increases activity of the fetus, raising the fetal heartbeat to dangerous levels. D. elevates the risk of facial malformation in the fetus. 73. An example of a history-graded influence is the current increase in the age at which women become pregnant. This in turn increases the likelihood that these women will have A. inadequate prenatal care. B. more miscarriages. C. low blood pressure during pregnancy. D. single births rather than multiple births. 74. Babies born to women over 30-35 years of age are A. more likely to show chromosomal abnormalities. B. most unlikely to be twins or quadruplets. C. less likely to have Down syndrome than babies born to younger mothers. D. more likely to exhibit withdrawal symptoms. 75. Marcella is pregnant with her first child. She works at a manufacturing plant where she is exposed to radioactive chemicals. As a consequence of this exposure A. her baby is more likely to have an Rh-factor incompatibility. B. her baby is more likely to have hemophilia. C. she is more likely to have twins. D. she is more likely to have a low-birth weight baby. 76. Vera has been experiencing minor episodes of depression and mania for the last two years and has been treated extensively with Lithol, a lithium carbonate drug. Vera conceived while she was on this medication but took great care to avoid any other teratogens that may harm her child. As a result of this exposure to lithium, her child has an elevated risk of _____. A. fetal alcohol syndrome B. sudden infant death syndrome C. withdrawal symptoms D. nicotine dependence 77. Which of the following is true of drug usage during pregnancy? A. Over the counter drugs are safe for use by pregnant women. B. Medications for psychiatric treatment typically carry no risks for pregnant women. C. All medications that have been tested safely on animals are proven safe for use by pregnant women. D. Central nervous system depressants may be harmful when taken during pregnancy. 78. The combination of mental, motor, and developmental abnormalities affecting the offspring of women who drink heavily during pregnancy is known as A. Korsakoff's syndrome. B. fetal alcohol syndrome. C. cirrhosis. D. Delirium tremens. 79. _____ is the most common cause of mental retardation and the leading preventable cause of birth defects in the United States. A. Toxoplasmosis B. Phenylketonuria C. Lead poisoning D. Prenatal exposure to alcohol 80. Which of the following statements regarding breast-feeding and alcohol use is true? A. Once the child is born, the adverse effects of alcohol consumption by the mother are negligible. B. Alcohol consumption by the mother accelerates the lactation process in the mother. C. Breast-feeding should be avoided for two hours after a drink. D. Unlike other toxins, alcohol is not eliminated from the mother's breast milk by the liver. 81. The adverse effects of nicotine exposure are A. limited to exposure in the first trimester after conception. B. restricted to those cases where the mother smokes actively. C. linked to second-hand smoke or passive smoking by the mother. D. limited to minor symptoms like common cold and bear no impact on long-term development. 82. Which of the following is a desirable paternal factor in prenatal development? A. Low levels of exposure to ozone B. Low levels of exposure to lead C. Advanced paternal age D. Toxoplasmosis 83. Which of the following statements characterizes the impact of paternal age on prenatal development? A. Paternal age is a negligible factor in prenatal development because males continue to produce sperm throughout their lifespan. B. Paternal age is a significant factor in prenatal development only when the father has some established genetic abnormalities. C. Advanced paternal age is linked to risk factors like dwarfism, autism, schizophrenia, and bipolar disorder. D. The adverse effects of advanced paternal age are limited to physical disabilities in the child. 84. Men who smoke are more likely to A. lack any mutational changes in their sperm. B. exert a greater effect on prenatal development than mothers who smoke during pregnancy. C. transmit genetic abnormalities to their offspring. D. experience exposure to large amounts of radiation. 85. Which of the following is a non-invasive technique of assessing prenatal development? A. Amniocentesis B. Chorionic villus sampling C. Umbilical cord sampling D. Ultrasound 86. If a mother wanted to have a clear image of the fetus in her womb, which procedure would she most likely undergo? A. Amniocentesis B. Ultrasound C. Fetal biopsy D. Chorionic villus sampling 87. Because of the rapid weight gain experienced by Marilyn early in her pregnancy, the doctor ordered a(n) _____ to see if she was having twins. A. umbilical cord sampling B. maternal blood test C. ultrasound D. amniocentesis 88. In which of the following procedures is a sample of fluid taken from around the fetus and analyzed for possible defects? A. Amniocentesis B. Chorionic villus sampling C. Ultrasound D. Embryoscopy 89. In which prenatal assessment procedure is tissue taken from the membrane around the embryo? A. Chorionic villus sampling B. Amniocentesis C. Maternal blood test D. Ultrasound 90. Chorionic villus sampling A. is a procedure in which tissue from the membrane surrounding the fetus is removed and analyzed. B. is the insertion of a tiny viewing scope into the mother's uterus through the abdominal wall for a direct look at the embryo. C. is a procedure in which a sample of amniotic fluid is withdrawn for analysis. D. is a procedure which allows direct access to fetal DNA in the blood vessels of the umbilical cord for diagnosis. 91. _____ is the insertion of a tiny viewing device into the mother's uterus through the abdominal wall for a direct look at the embryo. A. Chorionic villus sampling B. Embryoscopy C. Amniocentesis D. Umbilical cord sampling 92. Which of the following techniques can help diagnose no chromosomal disorders? A. Chorionic villus sampling B. Amniocentesis C. Umbilical cord sampling D. Embryoscopy 93. Which of the following is true about umbilical cord sampling? A. It is a non-invasive procedure to detect chromosomal abnormalities. B. It allows direct access to fetal DNA. C. It involves analyzing amniotic fluid. D. It analyzes the tissue from the membrane surrounding the fetus. 94. In the United States, which of the following pregnant women is likely to get the least amount of prenatal care? A. Angela, an unmarried teenager B. Bea, a married woman C. Delia, who has a college education D. Sandra, who just turned 45 years of age 95. Which of the following statements is correct with regard to prenatal care? A. It can help prevent maternal or infant death and other birth complications. B. The United States has uniform national standards for prenatal care. C. Prenatal care is intended exclusively to screen for treatable defects and diseases. D. It is not possible to address the causes of low birth weight through prenatal care. Essay Questions 96. Outline the first stage of prenatal development and explain the characteristics of this stage. Answer: The germinal stage includes the first two weeks of development after fertilization. During this time, the zygote divides, becomes more complex, and is implanted in the wall of the uterus. Within 36 hours after fertilization, the zygote enters a period of rapid cell division and duplication, or mitosis. About 72 hours after fertilization, it has divided into 16 to 32 cells; 24 hours later it has increased in number to 64 cells. While the fertilized ovum is dividing, it is also making its way down the Fallopian tube to the uterus. Its form changes into a blastocyst, a fluid-filled sphere that floats freely in the uterus. Before implantation, as cell differentiation begins, some cells around the edge of the blastocyst cluster on one side to form the embryonic disk, a thickened cell mass from which the embryo begins to develop. Other parts of the blastocyst begin to develop into organs that will nurture and protect the embryo. The amniotic sac is a fluid-filled membrane that encases the developing embryo, giving it room to move. The placenta, which contains both maternal and embryonic tissue, develops in the uterus to allow oxygen, nourishment, and wastes to pass between mother and embryo. It is connected to the embryo by the umbilical cord. Nutrients from the mother pass from her blood to the embryonic blood vessels and are then carried, via the umbilical cord, to the embryo. 97. What is spontaneous abortion? When do most spontaneous abortions take place? What is the primary reason for early spontaneous abortion? Answer: The most severely defective embryos usually do not survive beyond the first trimester of pregnancy. As many as 1 in 4 recognized pregnancies end in a spontaneous abortion, commonly called a miscarriage, which is the expulsion from the uterus of an embryo or fetus unable to survive outside the womb. Most miscarriages occur early in the pregnancy. Women often agonize over their choices and the things they did or did not do when they miscarry. However, most early miscarriages—by some estimates as much as 70 percent—are due to chromosomal abnormalities; these pregnancies were never viable. Miscarriages later in pregnancy, however, can be the result of smoking, drinking alcohol, or drug use. 98. Karen and Mark just discovered that they are going to have a baby. They want to give their baby the best possible environment to develop in. Explain how environmental influences such as maternal nutrition and physical activity can have both positive and negative effects on prenatal development. Answer: Prenatal malnutrition may have long-range effects. It is important to identify malnutrition early in pregnancy so it can be treated. Malnourished women who take dietary supplements while pregnant tend to have bigger, healthier, more active, and more visually alert infants, and women with low zinc levels who take daily zinc supplements are less likely to have babies with low birth weight and small head circumference. In a large-scale randomized study of low-income households in 347 Mexican communities, infants whose mothers took nutrient-fortified dietary supplements while pregnant or lactating tended to grow more rapidly and were less likely to be anemic. Moderate exercise any time during pregnancy does not seem to endanger the fetuses of healthy women. Regular exercise prevents constipation and improves respiration, circulation, muscle tone, and skin elasticity, all of which contribute to a more comfortable pregnancy and an easier, safer delivery. However, strenuous working conditions, occupational fatigue, and long working hours may be associated with a greater risk of premature birth. 99. Define fetal alcohol syndrome. Describe the devastating effects that high concentrations of alcohol can have on the physical, intellectual, and psychosocial development of the fetus. Answer: Fetal alcohol syndrome (FAS) is a combination of retarded growth, facial and bodily malformations, and disorders of the central nervous system. Prenatal alcohol exposure is the most common cause of mental retardation and the leading preventable cause of birth defects in the United States. FAS problems can include, in infancy, reduced responsiveness to stimuli, slow reaction time, and reduced visual acuity (sharpness of vision). FAS problems throughout childhood include short attention span, distractibility, restlessness, hyperactivity, learning disabilities, memory deficits, and mood disorders, as well as aggressiveness and problem behavior. Some FAS problems recede after birth; but others, such as retardation, behavioral and learning problems, and hyperactivity, tend to persist. Enriching these children's education or general environment does not always seem to enhance their cognitive development, but recent interventions targeted at cognitive skills in children with FAS are showing promise. Children with FAS may be less likely to develop behavioral and mental health problems if they are diagnosed early and are reared in stable, nurturing environments. 100. Doctors have several assessment techniques to help prospective parents monitor their pregnancy. Describe each of the following — amniocentesis, chorionic villus sampling, embryoscopy, and umbilical cord sampling. Answer: Amniocentesis is a procedure in which a sample of amniotic fluid is withdrawn for analysis. Chorionic villus sampling is a procedure in which tissue from the membrane surrounding the fetus is removed and analyzed. Embryoscopy is the insertion of a tiny viewing scope into the mother's uterus through the abdominal wall for a direct look at the embryo, can help diagnose no chromosomal disorders. Umbilical cord sampling allows direct access to fetal DNA in the blood vessels of the umbilical cord for diagnosis. Chapter 04 Birth and the Newborn True / False Questions 1. After the turn of the twentieth century in Europe and the United States, childbirth began to be professionalized, at least in urban settings. TRUE 2. Mortality rates for both mothers and children increased dramatically in the twenty-first century. FALSE 3. Local anesthesia allows the mother to remain alert and participate in the birth process. TRUE 4. Labor is brought on by a series of uterine, cervical, and other changes that begin about 8 weeks before delivery. FALSE 5. The third stage of childbirth starts when the baby's head starts to move through the cervix into the vaginal canal. FALSE 6. A cesarean is often needed when the fetus is in the breech position or in the transverse position. TRUE 7. Once a woman has had one cesarean delivery, many physicians warn that she should only attempt a vaginal birth after cesarean (VBAC) with caution. TRUE 8. Colostrum contains more fat and calories than breast milk. FALSE 9. Lanugo is absorbed into the skin after birth. FALSE 10. The continued persistence of certain reflexes after they should have disappeared can be evidence of neurological problems. TRUE 11. The fetus obtains oxygen and eliminates carbon dioxide through the fallopian tubes. FALSE 12. Blood is collected via a heel stick from newborn babies at the hospital and used to screen for PKU and other conditions. TRUE 13. Congenital malformations are the most common cause of death in infancy. TRUE 14. Birth weight and length of gestation are poor predictors of an infant's survival and health. FALSE 15. Respiratory distress syndrome is common in preterm babies who lack an adequate amount of surfactant. TRUE 16. Postmature babies tend to be fatter than baby's born at full-term. FALSE 17. Because postmature fetuses are at risk of brain damage or even death, doctors sometimes induce labor or perform cesarean deliveries. TRUE 18. Many stillborn fetuses are small for date, indicating malnourishment in the womb. TRUE 19. Infant care practices are universal. FALSE 20. Charles Darwin highlighted the adaptive significance of the process of parental bonding. TRUE Multiple Choice Questions 21. Which of the following statements about the modern childbirth practices in the United States is true? A. The prospective father is not allowed to be present while the partner is in labor. B. The rates of cesarean births are negligible in the United States. C. Nearly all births occur in the hospital with a physician attending them. D. A majority of babies are born at home under the supervision of midwives today. 22. Women who have given birth during the past fifty years have benefited from a dramatic reduction in risks surrounding pregnancy and childbirth. This is due to A. increased assistance of midwives. B. increase in the number of home births. C. decrease in the number of cesarean births. D. medicalization of childbirth. 23. Which of the following is a trend to humanize the experience of childbirth? A. Discouraging the partner from being present during labor B. Administering a general anesthesia to eliminate pain during labor C. Allowing rooming-in facilities to help the mother and baby bond D. Expanding the medicalization process in childbirth 24. _____ is brought on by a series of uterine, cervical, and other changes that begin about 2 weeks before delivery. A. Implantation B. Conception C. Labor D. Fertilization 25. Julie and Adam learned in their prenatal classes that the first stage of the birth process is the longest, and for Julie, who is having her first child, it will generally last about _____ hours. A. 3 to 5 B. 6 to 8 C. 2 to 4 D. 12 to 14 26. Yvonne has begun to experience uterine contractions that are causing her cervix to dilate. She is in the _____ stage of childbirth. A. first B. second C. third D. fourth 27. Which of the following occurs during the first stage of childbirth? A. Crowning of the head B. Dilation of the cervix C. Expulsion of the placenta D. Clamping of the umbilical cord 28. Mary is in the delivery room giving birth to her first child. Her cervix is sufficiently dilated and the baby's head has started to move through the cervix into the vaginal canal. Which of the following stages of childbirth is Mary in? A. First stage B. Third stage C. Second stage D. Fourth stage 29. When Harriet's labor had gone on for quite a while, her physician decided to grasp the baby's head with forceps to deliver the baby safely. Which of the following stages of childbirth is Harriet in? A. First stage B. Fourth stage C. Third stage D. Second stage 30. The end of the second stage of childbirth is indicated by A. the urge to push the baby. B. the emergence of the baby from the mother's body. C. the expulsion of the placenta. D. the contractions that occur every 2 to 5 minutes. 31. The placenta is expelled from the mother's body during the _____ stage of childbirth. A. first B. second C. third D. fourth 32. A surgical cut between the vagina and anus, intended to enlarge the vaginal opening, speed delivery, and prevent the vagina from tearing is known as a(n) _____. A. episiotomy B. nephrectomy C. hysterectomy D. lobectomy 33. An electronic fetal monitor is used for A. tracking the time of child birth. B. measuring the weight of the fetus. C. measuring maternal oxygen usage rate. D. tracking the fetus's heartbeat. 34. Which of the following is true of electronic fetal monitoring? A. Its use is restricted to high-risk deliveries. B. It is relatively cheap facility and is provided for all deliveries. C. It is associated with an extremely high false-positive rate. D. It is associated with doctors opting for vaginal deliveries, when a cesarean section may be required. 35. Kathleen was told by her physician that the baby's feet are moving down the birth canal first. Which of the following types of delivery is likely to be performed considering Kathleen's baby's position? A. Lamaze delivery B. Vaginal delivery C. Natural delivery D. Cesarean delivery 36. A fetus whose feet or buttock appears first instead of the head in the uterus, is in a _____ position. A. normal B. transverse C. breech D. crosswise 37. Krystal's obstetrician has told her that the baby she is about to deliver is lying crosswire in the uterus. Which of the following describes the baby's position? A. Normal B. Transverse C. Breech D. Lateral 38. A surgical incision was made in Lana's abdomen in order to remove the baby from the uterus. This procedure is called a A. forceps birth. B. natural birth. C. cesarean section. D. Lamaze birth. 39. Cesarean deliveries A. are most common among low-income women. B. are increasing due to rising proportion of older first-time mothers. C. are associated with healthier babies and natural births. D. are typically linked to shorter hospital stays. 40. A medicated delivery is one in which A. the Lamaze method of childbirth is used. B. the woman is trained to pant or breathe rapidly in sync with the increasing intensity of her contractions and to concentrate on other sensations to ease the perception of pain. C. the mother receives anesthesia. D. the childbearing women are attended by a doula at home throughout the birth process. 41. Patrick and Lacey attend prepared childbirth classes where they are taught breathing and muscular responses designed to A. promote self-birth without the assistance of a doula or a midwife. B. ease pain associated with labor. C. create a hypnotic state during delivery. D. slow down contractions during labor. 42. A method of childbirth whereby mothers are trained to make breathing and muscular responses to sensations of uterine contractions is called A. prepared childbirth. B. medicated childbirth. C. sensitivity training. D. cesarean response training. 43. Which of the following statements about the use of prepared childbirth is true? A. It involves the use of anesthesia and delivering babies in dimly lit, isolated rooms. B. It allows the mother to relax during the birth process by giving her general anesthesia. C. It allows the father to be involved in labor and delivery. D. It uses medical help in hospital settings to deliver the baby safely. 44. _____ renders the woman completely unconscious and greatly increases the risks to the mother and the baby. A. Local anesthesia B. Epidural block C. General anesthesia D. Spinal tap 45. Jim and Heather are delivering their first child. Jim is coaching Heather in her breathing and encouraging her to practise her relaxation techniques. This is an example of A. a cesarean delivery. B. catecholamine method that reduces stress on the baby. C. medicated delivery. D. the Lamaze method. 46. A criticism of the use of anesthesia during childbirth is that it A. fails to relieve the mother's discomfort. B. proves to be too expensive and can be availed by well-to-do women only. C. greatly increases the risks to mother and baby. D. contributes to the withdrawal symptoms many new mothers experience. 47. Linda will have a medicated delivery. Which of the following if given early is most likely to lessen her pain, shorten her labor, and allow her to participate in the birth process? A. Over-the-counter pain killers B. Acetaminophen C. Epidural block D. General anesthetia 48. Which of the following is true of doulas? A. They have professional medical training. B. They are an active part of the childbirth process. C. They provide emotional support to the mother throughout childbirth. D. They work as assistants to anesthesiologists during the birth process. 49. An experienced helper who provides emotional support to a woman during labor but does not actively participate in the delivery is referred to as a A. gynaecologist. B. doula. C. obstetrician. D. health care professional. 50. A doula is a(n) A. gynaecologist who specializes in delivering babies at home. B. anesthesiologist who monitors fetal reactivity during birth. C. person who gives emotional support during childbirth. D. person offering the option of surrogacy to mothers. 51. Though Elaine has no formal medical training, she has helped deliver many babies, and has exceptionally good interpersonal skills. She would like to receive training that would enable her to support other women emotionally during the birthing process and give information about what is happening. Which of the following roles should she look into? A. Obstetrician B. Doula C. Gynaecologist D. Pediatrician 52. Research evidence has associated the presence of a doula at childbirth to a A. longer labor during childbirth. B. use of general anesthesia. C. no complications in childbirth. D. more cesarean deliveries. 53. The first four weeks after a baby is born is known as the _____ period. A. prepartum B. neonatal C. prenatal D. fetal 54. Which of the following is true of the neonatal period? A. It is limited to the first two weeks after birth. B. Boys tend to be slightly longer and heavier than girls at birth. C. A firstborn child is likely to weigh more at birth than laterborns. D. Neonates experience rapid gain in weight from the first day of life. 55. An average newborn weighs _____ pounds in the United States. A. 5 B. 7½ C. 4½ D. 11 56. When the baby is born, the mother produces a special high-protein type of milk in the first couple of days called _____. A. lanugo B. fetoprotein C. meconium D. colostrum 57. In the first couple of days of life, newborns typically A. have small heads in proportion to their bodies. B. acquire lanugo. C. lose weight. D. have evenly toned skin. 58. Places in the neonate's skull where the bones are not completely fused are called the A. fontanels. B. lanugos. C. medullas. D. hyalines. 59. When Billy's mother brought his new baby sister home from the hospital, the first thing that he asked her was if he could touch her. His mother said yes, but asked him not to touch the soft spots on her head. Billy's mother is referring to the A. medulla. B. lanugos. C. fontanels. D. hyalines. 60. Which of the following statements about the first few days of life is true? A. Neonates have an elongated chin and evenly-toned skin. B. Babies gain as much as 40% of their body weight in the first few days. C. The head seems disproportionately smaller when compared to the body in case of all neonates. D. Neonates born through vaginal delivery are more likely to have misshapen heads for about a week after birth. 61. Fontanels are present in the neonate's skull A. to allow for draining of cerebrospinal fluid. B. to prevent calcium deposits from damaging cartilage. C. to allow the head to pass through the mother's birth canal. D. to prevent any damage due to toxoplasmosis. 62. During the first few days, some neonates are very hairy because some of the _____, a fuzzy prenatal hair on the shoulders, back, forehead, and cheeks, has not yet fallen off. A. vernix B. follicle caseosa C. meconium D. lanugo 63. _____ refers to a white, oily, cheese like substance that is formed in the womb by secretions from the fetal oil glands and protects against infection. A. Vernix caseosa B. Lanugo C. Meconium D. Fontanel 64. When a baby turns its head toward a soft touch on the cheek and begins to search for a nipple, he/she is demonstrating the _____ reflex. A. Moro B. Palmer Grasp C. rooting D. Babinsky 65. When a baby's head is turned to one side, one arm extends and one bends back, as if the baby were getting ready to fire an arrow. This is known as the _____ reflex. A. Moro B. tonic neck C. rooting D. Palmer Grasp 66. The Costello's baby daughter did not begin to breathe till 5 minutes after birth and doctors were concerned that she may have suffered brain damage owing to A. hypothermia. B. anoxia. C. hyperphagia. D. phenylketonuria. 67. If breathing has not begun within 5 minutes after birth, the baby is at risk of developing A. PKU (phenylketonuria). B. neonatal jaundice. C. sickle-cell anemia. D. brain damage. 68. _____ is a stringy, greenish-black waste matter formed in the fetal intestinal tract. A. Colostrum B. Meconium C. Lanugo D. Vernix caseosa 69. A few days after birth, many babies develop a yellowish tinge in their skin and eyeballs. These symptoms indicate _____, which is due to immaturity of the _____. A. anoxia; lungs B. anoxia; brain C. neonatal jaundice; liver D. neonatal jaundice; kidneys 70. Neonatal jaundice is caused by the A. incomplete development of the pulmonary system. B. failure of the liver to filter out bilirubin in the first days of life. C. incomplete development of the respiratory system. D. inability of the diaphragm to pump air into and out of lungs. 71. Anthony was born with neonatal jaundice, which A. requires treatment with strong antibiotics. B. damages the child's immature respiratory system permanently. C. occurs in about half of all neonates. D. occurs after the neonatal period elapses. 72. The Apgar scale does NOT measure A. pulse. B. temperature. C. respiration. D. activity. 73. Which of the following is true of the Apgar scale? A. It represents a medical and behavioral assessment of the baby that is performed at least a day after birth. B. It assesses the baby on the dimensions of appearance, pulse, grimace, activity, and respiration. C. It indicates a 5-minute score of 3-5 for a vast majority of babies born in the United States, reflecting their excellent condition. D. It lacks the ability to assess the severity of a neonate's respiratory immaturity. 74. An Apgar score of 3 indicates that the baby A. is in excellent condition. B. is functioning within normal range. C. is functioning at a level that is slightly below normal. D. is at high risk for neurological damage. 75. The _____ can be used to test five aspects of behavior in order to measure a newborn's response to the environment up to the age of 2 months. A. Apgar scale B. Brazelton Neonatal Behavioral Assessment Scale C. Denver scale D. PKU screen 76. Gannon and his twin brother, Garrett, have just been evaluated for their responses to stress, ability to calm down, reflexes, hand-mouth coordination, alertness, and response to cuddling in a test that took half an hour for each of them. Which of the following tests have they been given? A. Apgar scale B. Brazelton Neonatal Behavioral Assessment Scale C. Denver Scale D. PKU screen 77. PKU (phenylketonuria) is A. a form of neonatal jaundice. B. a disorder caused by the deficit of vitamin B in the mother's diet. C. an enzyme disorder characterized by the need for a special diet. D. a disorder that is irreversible even after dietary changes. 78. If an infant inherits the gene for PKU and is left untreated, the infant will be at a heightened risk for A. neonatal jaundice. B. toxoplasmosis. C. hemophilia. D. mental retardation. 79. Infant's physiological and behavioral status at a given moment in the periodic daily cycle of wakefulness, sleep, and activity is called _____. A. temperament B. state of arousal C. periodic change D. mood swing 80. Dan and Diane are exhausted because 4-week-old Jake, their son, wakes up three to four times each night. What is the most probable explanation for Jake's behavior? A. He is suffering from separation anxiety. B. He is not getting enough attention from his parents. C. He is experiencing a lack of security. D. He is exhibiting a sleep pattern that is typical of newborn babies. 81. Cody is one week old. He often spends a lot of time looking around his room quietly. The state of arousal described here is one of A. alert inactivity. B. active sleep. C. waking activity. D. drowsiness. 82. Jada was born five days before her due date. She weighed 4 pounds at birth. Jada is most accurately classified as a _____ baby. A. normal B. premature C. preterm D. low-birth-weight 83. Betty gave birth to her daughter in the thirtieth week of pregnancy. Her baby would have been classified as a _____ infant at birth. A. postmature B. preterm C. normal D. full-term 84. Troy was born after the completion of 38 weeks of gestation. He weighs 5 pounds and has slow fetal growth. He is a _____ infant. A. full-term B. preterm C. postmature D. small-for-date 85. Who is most likely to have a low-birth-weight baby? A. Adele, who is 25 and had one cesarean delivery B. Bianca, who is 30, in generally good health but has high blood pressure, and has had no previous pregnancies C. Carol, who is 20, pregnant for the first time and is in good health D. Dana, who is 33, smokes and has had three previous pregnancies 86. _____, a method of skin-to-skin contact in which a newborn is laid face down between the mother's breasts for an hour or so at a time after birth, seems to reduce stress on the central nervous system and help with self-regulation of sleep and activity. A. Kangaroo care B. Assisted care C. Swaddling D. Doula care 87. Helena who is 38 years old delivered a preterm baby boy a week ago. Though the baby was in a delicate condition, the medical expertise of the NICU team was able to save him and is keeping him under close observation. For the last three days, Helena is being allowed to hold ber baby against her bare chest for limited periods of time. The doctors believe that this will help stabilize the baby's heartbeat and forge strong bonds between Helena and her son. This scenario depicts the method of _____. A. doula care B. assisted care C. swaddling D. kangaroo care 88. Dr. Smith informed a mother that her newborn suffers from hyaline membrane disease. The baby is having problems with A. the membranes that cover the fontanels. B. the control of eye muscles. C. urination and expulsion of wastes. D. respiration, owing to the lack of surfactant. 89. A newborn's air sacs keep collapsing, making it very difficult for her to breathe. A likely diagnosis for this infant's problem is A. hyaline membrane disease. B. hemophilia. C. toxoplasmosis D. phenylketonuria. 90. Christa is now in her 42nd week of pregnancy. Her unborn baby is considered to be A. postmature. B. preterm. C. neonatal. D. high-birth weight. 91. _____ is the death of a fetus at or after the 20th week of gestation. A. Post maturity B. Implantation C. Full-term birth D. Stillbirth 92. Which of the following statements about the father's presence during childbirth is correct? A. Fathers are not allowed to be present while their partners give birth in most hospitals. B. The father's attachment to his child depends solely on his presence during childbirth. C. Evidence suggests that a father's presence during childbirth makes him a better father. D. Fathers who are present at the birth of a child often see the event as a peak emotional experience. 93. Which of the following statements is true regarding a mother-infant bond? A. Mother-infant bond can develop only during the first few hours after birth. B. A process similar to imprinting is required for mother-infant bond. C. Mother-infant bond can take longer to develop in mothers using kangaroo care. D. The mother-infant bond involves the need for closeness in addition to feeding. 94. Experiments by Harlow and his colleagues demonstrated _____ in the process of parental bonding. A. the importance of the father being present at birth B. the role of close bodily contact C. the importance of feeding D. the role of natural selection 95. In Harlow's experiments, the rhesus monkeys A. withdrew socially as they were separated from their mothers. B. developed strong attachments with the wire mother as it provided them with food. C. spent a majority of their time with the cloth surrogates. D. spent an equal amount of time with both surrogates reflecting the equally strong needs of food and contact comfort. Essay Questions 96. Describe the changes that have occurred in childbirth practices during the twentieth century. How do these practices differ from those of previous centuries? Answer: Customs surrounding childbirth reflect a culture's beliefs, values, and resources. While cultural differences regarding childbirth abound, differences can also be seen across time within many countries as childbirth and labor became increasingly medicalized and moved from the home to hospital settings. Childbirth in earlier times was "a struggle with death" for both mother and baby. Childbirth in Europe and in the United States followed similar patterns. The woman, surrounded by female relatives and neighbors, sat up in her bed or perhaps in the stable, modestly draped in a sheet; she might stand, walk around, or squat over a birth stool. Chinks in the walls, doors, and windows were stuffed with cloth to keep out chills and evil spirits. Neither the prospective father nor doctors were present, although midwives without formal training often were. After the turn of the twentieth century in Europe and the United States, childbirth began to be professionalized, at least in urban settings. The growing use of maternity hospitals led to safer, more antiseptic conditions for childbirth. Hospital deliveries reduced mortality for women, and the new field of obstetrics grew. The dramatic reductions in risks surrounding pregnancy and childbirth in the industrialized world are largely due to the availability of antibiotics, blood transfusions, safe anesthesia, improved hygiene, and drugs for inducing labor when necessary. In addition, improvements in prenatal assessment and care make it far more likely a baby will be born healthy. Mortality rates for both mothers and children have decreased dramatically in today's world. 97. Women today can select one of several alternative childbirth methods and settings. List and describe some of the options that women may consider. Discuss the terms midwife and doula. Answer: With the development of varied methods to manage difficult labor and deliveries have come a wealth of medical and nonmedical options for women to take advantage of during the birthing process. The usual method of childbirth is vaginal delivery. Alternatively, cesarean delivery can surgically remove the baby from the uterus through an incision in the mother's abdomen. A cesarean is often needed when the fetus is in the breech position (feet or buttocks first) or in the transverse position (lying crosswise in the uterus), or when the head is too big to pass through the mother's pelvis. In addition, a cesarean delivery is more likely to occur when labor is induced, as is common in women whose pregnancy progresses past 40 weeks. For centuries, pain was considered an unavoidable part of giving birth. Then, in the mid-nineteenth century, sedation with ether or chloroform became common practice as more births took place in hospitals. Because of growing concerns that the use of drugs might pose risks for babies, and a desire for both parents to participate fully in a natural, empowering experience, several alternative methods of natural, or prepared, childbirth were developed during the twentieth century. The most common model of natural childbirth is the Lamaze method, introduced by the French obstetrician Fernand Lamaze in the late 1950s. The woman is trained to pant or breathe rapidly in sync with the increasing intensity of her contractions and to concentrate on other sensations to ease the perception of pain. She learns to relax her muscles as a conditioned response to the voice of her coach (usually the prospective father, a friend, or a midwife), who attends classes with her, takes part in the delivery, and helps with the exercises. In many traditional cultures, and increasingly in developed countries, childbearing women are attended by a doula, an experienced mentor, coach, and helper who can give emotional support and information about what is happening and can stay at a woman's bedside throughout labor. A doula does not actively participate in the delivery but supports the mother throughout the process. Some expectant mothers also work with midwives. Although certification processes vary, midwives are generally trained to provide care during pregnancy, labor, and the postpartum period; many also offer assistance in breastfeeding and other primary care services to women. 98. Hospital personnel and new parents should know certain terms so that childbirth events are understandable to everyone. Explain each of the following terms: neonate, fontanels, Lanugo, anoxia, and neonatal jaundice. (Learning Objective: 3) Answer: Hospital personnel and new parents should know certain terms so that childbirth events are understandable to everyone. The following terms: neonate, fontanels, Lanugo, anoxia, and neonatal jaundice are explained below. Newborn baby, up to 4 weeks old is known as neonate. Newborn babies have fontanels—soft spots on the head covered with a tough membrane—where an infant's skull bones are not yet fused. During the first few days, some neonates are very hairy because some of the lanugo, a fuzzy prenatal hair on the shoulders, back, forehead, and cheeks, has not yet fallen off. Most babies start to breathe as soon as they are exposed to air. A baby who has not begun breathing within 5 minutes may suffer permanent brain injury from anoxia, lack of oxygen, or hypoxia, a reduced oxygen supply. Three to four days after birth, about half of all babies, and a larger proportion of babies born prematurely, develop neonatal jaundice: their skin and eyeballs look yellow. The immaturity of the liver and failure to filter out bilirubin, a by-product resulting from the breakdown of red blood cells, cause this kind of jaundice. 99. Ken and Kristie have a low-birth-weight baby. What kind of babies are included in this category? What are the factors that contribute to low birth weight? Answer: Low-birth-weight babies weigh less than 5½ pounds (2,500 grams) at birth; they may be either preterm (born early) or small-for-date (born small by comparison to other babies of the same age), or both. More than 43 percent of preterm (premature) infants, born before completing the 37th week of pregnancy, are of low birth weight (Martin et al., 2009). Small-for-date (small-for-gestational-age) infants, who may or may not be preterm, weigh less than 90 percent of babies born at the same age. Their small size is generally a result of inadequate prenatal nutrition, which slows fetal growth. Factors that increase the likelihood that a woman will have an underweight baby include: demographic and socioeconomic factors, such as being African American, under age 17 or over 40, poor, unmarried, or undereducated, and being born in certain regions, such as the southern and plains states. medical factors predating the pregnancy, such as having no children or more than four, being short or thin, having had previous low-birth-weight infants or multiple miscarriages, having been low birth weight oneself, or having genital or urinary abnormalities or chronic hypertension. prenatal behavioral and environmental factors, such as poor nutrition; inadequate prenatal care; smoking; use of alcohol or other drugs; or exposure to stress, high altitude, or toxic substances. medical conditions, such as vaginal bleeding, infections, high or low blood pressure, anemia, too little weight gain, and having last given birth less than 12 months or more than 5 years ago. 100. Describe Harry Harlow's experiment with rhesus monkeys. What do you think these researchers might have hypothesized about mother-infant bonding prior to conducting their research? What were the methods and results of this research? Answer: For many years, psychology theorists thought babies bonded to their parents because parents provided food, which babies naturally enjoyed. Over time, babies would start to associate their parents with the provision of food and would then become attached to them. A series of pioneering experiments with monkeys by Harry Harlow and his colleagues established that more than feeding is involved in the mother-infant bond. In these experiments, rhesus monkeys were separated from their mothers and raised in a laboratory. The infant monkeys were put into cages with two kinds of surrogate "mothers": a plain cylindrical wire-mesh form with an attached bottle for nursing or a form covered with terry cloth that provided no food. The essential question was "to which mother would the baby monkeys become attached?" If earlier theorists were right, the babies should have become attached to the wire "mother" because she provided food. However, the monkeys actually became attached to the soft terry cloth "mother." When the monkeys were allowed to spend time with either kind of "mother," they all spent more time—indeed the majority of their time—clinging to and cuddling with the cloth surrogates. It is hardly surprising that a dummy mother would not provide the same kinds of stimulation and opportunities for positive development as a live mother. These studies show that feeding is not the most important thing babies get from their mothers. Mothering includes the comfort of close bodily contact and, at least in monkeys, the satisfaction of an innate need to cling. Test Bank for Child M-Series: From Birth to Adolescence Gabriela Martorell 9780078035517
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