CH-3 Birth and the Newborn Child – Human Development: A Cultural Approach : Exam Guide

Chapter 3 Birth and the Newborn Child Section 1 Birth and Its Cultural Context Test Item File Multiple Choice Questions 1. According to the text, oxytocin is released from the _______________. A. fetus’s liver B. mother’s uterus C. fetus’s placenta D. mother’s pituitary gland Answer: D 2. _______________ is the hormone that is released by the mother’s pituitary gland that is responsible for initiating contractions in the uterus as a precursor to labor. A. Androgen B. Estrogen C. Testosterone D. Oxytocin Answer: D 3. What happens when the amount of oxytocin in a human female’s blood reaches a certain threshold? A. The likelihood of conception is at its highest. B. The process of birth begins. C. Labor pains are decreased considerably. D. Lactation begins. Answer: B. The process of birth begins. Correct: Uterine contractions signal the start of the birth process. D. Lactation begins. Incorrect: The process of birth begins. 4. How many stages are in the birth process? A. 2 B. 3 C. 4 D. 5 Answer: B 5. Which of the following represents the correct order of the birth process? A. delivery of the placenta and umbilical cord, labor, delivery of the baby B. delivery of the baby, delivery of the placenta and umbilical cord, labor C. labor, delivery of the baby, delivery of the placenta and umbilical cord D. delivery of the placenta and umbilical cord, delivery of the baby, labor Answer: C 6. What is the first stage of the birth process and is the longest and most taxing stage? A. labor B. Braxton Hicks C. crowning D. transition Answer: A 7. For first births, what is the average length of labor? A. 6 hours B. 12 hours C. 24 hours D. 36 hours Answer: B 8. Your brother and sister-in-law are discussing their plan to get to the hospital for the delivery of their first child. They are concerned about how quickly they could get to the hospital. You should tell them: A. That is a very good plan. You cannot get to the hospital quickly enough B. Labor for first pregnancies is 24 hours, so you could book a flight to a different city and still make it to the hospital. C. I would not really worry about it too much; the average labor for first pregnancies is 12 hours. You should be able to make it! D. Since they live in the city they should take a cab, many children are born in cabs and cab drivers know what they are doing. Answer: C. I would not really worry about it too much; the average labor for first pregnancies is 12 hours. You should be able to make it! Correct: The length of labor depends on many factors, especially the size of the woman and the size of the baby. A. That is a very good plan. You cannot get to the hospital quickly enough Incorrect: First births have labors that average 12 hours, so there should not be much concern about getting to the hospital rapidly. 9. What is the average length of labor for second or subsequent births? A. 6 hours B. 12 hours C. 24 hours D. 36 hours Answer: A 10. What needs to dilate to 10 centimeters (4.5 inches) during the process of labor? A. the cervix B. the uterus C. the fallopian tubes D. the ovaries Answer: A 11. You are at one of your last scheduled prenatal office visits and the doctor determined that your cervix has dilated to 10 centimeters. What should happen next? A. You should get to the hospital; you are ready to deliver the baby! B. You probably have at least a week of pregnancy left. C. Your doctor just made up that number. D. Something is not good. Cervixes do not dilate to 10 centimeters. Answer: A. You should get to the hospital; you are ready to deliver the baby! Correct: It is grounded in the understanding that cervical dilation to 10 centimeters typically indicates that the woman is in the active stage of labor and ready to deliver the baby. This is the point at which the cervix is fully dilated, allowing the baby to pass through the birth canal. B. You probably have at least a week of pregnancy left. Incorrect: Since the cervix has dilated to 10 cm, the fetus is ready to be born. 12. _______________ is/are responsible for the discomfort and pain associated with the labor birth process stage of labor. A. Increased blood pressure B. Low blood sugar C. Muscular contractions D. Increased adrenaline Answer: C. Muscular contractions Correct: During the labor process, muscular contractions of the uterus become more intense and frequent. D. Increased adrenaline Incorrect: During the labor process, muscular contractions of the uterus become more intense and frequent. This dilates the cervix, which can be extremely uncomfortable. 13. The second stage of the birthing process is called _______________. A. labor B. delivery C. transition D. crowning Answer: B 14. On average, how long does the second stage of the birth process, delivery, last? A. 15–30 minutes B. 30 minutes–1 hour C. 1–5 hours D. 12–24 hours Answer: B 15. What is it called when the fetus’s head appears at the outer opening of the vagina? A. birth B. transition C. delivery D. crowning Answer: D. crowning Correct: The woman often experiences a tingling or burning sensation at this point. A. birth Incorrect: When the fetus’s head appears at the outer opening of the vagina, crowning has occurred. 16. You are all waiting at home for the birth of your nephew. Your brother texts you and writes that he can see the top of the head. Your little sister asks what that means and you tell her that _______________. A. labor will take another two or three hours B. something must be wrong and the head is stuck C. your nephew is being born in the breech position D. your brother’s partner is in the crowning stage of labor and your nephew is about ready to be born Answer: D. your brother’s partner is in the crowning stage of labor and your nephew is about ready to be born Correct: Crowning is one of the final stages of delivery. B. something must be wrong and the head is stuck Incorrect: This is the stage of labor known as crowning. 17. _______________ describes when the fetus’s head appears at the outer opening of the vagina. A. Emerging B. Turtling C. Crowning D. Exiting Answer: C 18. What is the name of the procedure in which an incision is made to make the vaginal opening larger? A. crowning B. episiotomy C. vaginalectomy D. amniocentesis Answer: B. episiotomy Correct: Critics say this procedure is often unnecessary, and it is now used in only about 20% of births. C. vaginalectomy Incorrect: This procedure is known as an episiotomy. 19. Your best friend has recently had a 9.5-pound baby after a long and exhausting labor. She tells you that during labor her doctor performed an episiotomy to help ease the birth process. During this procedure __________ A. an incision is made to make the vaginal opening larger to prevent tearing B. the fetus is delivered surgically C. amniotic fluid is extracted so that genetic testing can be done D. the fetus is in “distress” Answer: A. an incision is made to make the vaginal opening larger to prevent tearing Correct: Option A is based on the purpose of an episiotomy, which is to make the vaginal opening larger to facilitate the birth process and potentially prevent tearing of the perineum (the area between the vagina and the anus). This procedure is typically performed by a doctor during labor if it's deemed necessary to assist with the delivery. B. the fetus is delivered surgically Incorrect: An episiotomy is an incision made to make the vaginal opening larger during labor. 20. The purpose of the episiotomy is to _______________. A. make the mother’s vagina less likely to tear as the fetus’s head comes out B. cut open the mother’s abdomen and retrieve the baby directly from the uterus C. help the family manage their anxiety D. assist the delivery process by placing a suction on the fetus’s head and apply slight force Answer: A 21. Because critics have argued that these procedures are unnecessary, they have decreased from 90% in 1970 to 20% in 2000. A. crownings B. episiotomies C. vaginalectomies D. amniocenteses Answer: B. episiotomies Correct: An episiotomy is an incision to make the vaginal opening larger during the birth process. D. amniocenteses Incorrect: Critics have argued that episiotomies are unnecessary. 22. What occurs during the third and final stage of labor? A. The amniotic sac ruptures. B. The fetus’s head crowns. C. The fetus is born. D. The placenta and umbilical cord are expelled. Answer: D 23. During what stage is the umbilical cord usually cut and tied? A. crowning B. active labor C. transitional labor D. The third stage of labor Answer: D 24. What are the common complications of the birth process? A. failure to progress and breech presentation B. inverted infant and hormonal stress C. cesarean delivery and epidural D. fetal heart rate and fetal monitoring Answer: A 25. _______________ means that the woman has begun the birth process but the process is taking longer than normal. A. Cesarean section B. Breech presentation C. Failure to progress D. Nonorganic failure to thrive Answer: C 26. When birth has begun but the process is taking longer than normal, what is happening? A. failure to progress B. problematic labor C. the increased likelihood that triplets are being born D. the third stage of labor Answer: A. failure to progress Correct: This is one of the most common birth complications. B. problematic labor Incorrect: “Failure to progress” means that the woman has begun the birth process but it is taking longer than normal. 27. You and your family are anxiously awaiting the birth of your niece. You see one of the nurses and ask how things are going. She tells you that this might be a while because your sister is experiencing “failure to progress.” Your grandmother overhears the conversation and become very uneasy. What do you tell her? A. Not to worry, that simply means that labor is taking longer than they expected. B. That the fetus is probably going to be born breech. C. That the fetus is in “distress” and an emergency cesarean section will likely be performed. D. The cervix has not dilated at all. Answer: A. Not to worry, that simply means that labor is taking longer than they expected. Correct: A pregnant woman can help stimulate progress by walking around, taking a nap, or having an enema. B. That the fetus is probably going to be born breech. Incorrect: Failure to progress indicates that the labor is taking longer than usual. 28. What is a strategy that can be used in latent labor if failure to progress occurs? A. sitting B. walking C. labor massage D. active stretching Answer: B 29. According to the text, if failure to progress continues for some time, what can be given to stimulate labor? A. oxygen B. gonadotropin C. synthetic oxytocin D. follical stimulating hormone Answer: C 30. What position is the fetus in when it is in a breech presentation? A. feet or buttocks down B. head down, face away from mother’s spine C. head down, face toward mother’s spine D. horizontal Answer: A. feet or buttocks down Correct: Breech presentation is one of the most common complications of the birthing process. D. horizontal Incorrect: Feet or buttocks down defines the breech presentation. 31. When the infant is turned around so the feet or the buttocks are positioned towards the birth canal, is known as _______________. A. upside-down baby B. inverted fetus C. F-B presentation D. breech position Answer: D 32. What percentage of fetuses present in the breech position? A. 4% B. 20% C. 36% D. 50% Answer: A 33. Breech births are potentially dangerous because the _____ A. umbilical cord can be constricted leading to brain damage B. fetus can get stuck in the birth canal C. fetus’s heart might stop beating D. mother can lose consciousness Answer: A 34. If the umbilical cord is constricted during delivery which of the following is a potential danger for the fetus? A. insufficient oxygen and brain damage B. a toxic buildup of iron in the blood stream C. elevated blood pressure and higher than normal heart rate D. slow capillary refill, and cold and clammy skin Answer: A. insufficient oxygen and brain damage Correct: If a fetus is in a breech presentation, there is a greater risk that the umbilical cord could be tangled around his or her neck or constricted, therefore suffocating the infant during the delivery process. C. elevated blood pressure and higher than normal heart rate Incorrect: If a fetus is in a breech presentation, there is a greater risk that the umbilical cord could be tangled around his or her neck or constricted, therefore suffocating the infant during the delivery process. 35. What procedure involves removing the fetus from the uterus surgically? A. fetalectomy B. vaginal birth C. cesarean birth D. Episiotomy Answer: C. cesarean birth Correct: In the United States, more than 30% of births are via cesarean delivery. A. fetalectomy Incorrect: A cesarean delivery is when the fetus is surgically removed from the uterus. 36. Which of the following best describes a cesarean delivery? A. a delivery process that takes longer than normal B. when the cervix is dilated to 10 cm wide C. surgically opening the mother’s abdomen and retrieving the baby directly from the uterus D. when the fetus is turned around so that the feet or the buttocks is presented in the birth canal first Answer: C 37. Until recently, cesarean-sections were risky surgical procedures because the field of medicine lacked _______________. A. sharp scalpels and rubber gloves B. sterile procedures and antibiotics C. anesthesia and epidurals D. a basic understanding of the anatomy and physiology Answer: B 38. Mehrak is HIV-positive and pregnant. Her physician wants to minimize the risk of the virus being transmitted to her child. Which of the following will help to minimize the risk of HIV transmission? A. having a vaginal birth B. having a cesarean-section C. having a breech presentation D. having a short prenatal period Answer: B. having a cesarean-section Correct: This lets the infant avoid traveling through the birth canal which may expose him or her to viral infection. A. having a vaginal birth Incorrect: Cesarean-sections are commonly performed if the mother is HIV-positive or has genital herpes. This lets the infant avoid traveling through the birth canal which may expose him or her to viral infection. 39. According to the text, what is the likely reason for the high rate of cesarean births in some parts of the world? A. so that physicians can become wealthy B. to give surgeons practice C. to avoid a potential disaster during birth D. because vaginal deliveries are dangerous Answer: C. to avoid a potential disaster during birth Correct: The diversity of cultures that have high rates of cesarean births suggests that extreme caution about possible complications from vaginal childbirth is a major factor. A. so that physicians can become wealthy Incorrect: Cesareans occur to avoid potential disaster during vaginal births. 40. Over the course of evolutionary history, the female body and pelvis did not grow in size, but the human brain’s size _______________. A. decreased by half B. did not change C. doubled D. quadrupled Answer: D 41. Why has birth for humans become increasingly difficult? A. Because humans have such extraordinarily large brains. B. Because humans are more likely to have genetic difficulties. C. Because humans are the only species to have single births. D. Because humans are so immature at the time of birth. Answer: A 42. Compared to other animals, the birth process for human beings is complicated by _______________. A. the size of the infant’s head B. the infant’s muscle to fat ratio C. the amount of amniotic fluid expelled D. the mother’s expectation of the birthing process Answer: A 43. Medical knowledge has led to methods that genuinely help mothers and babies only during the past _______________. A. 200 years B. 100 years C. 50 years D. 10 years Answer: C 44. If you were a member of the Ila people of Zimbabwe and just gave birth, how would others react and respond? A. They would congratulate and present you with gifts. B. They would shun you and fear the evil spirits that you brought into the village. C. They would pity you because the birth process lowered your social status. D. They would envy you because the status of motherhood is near godlike. Answer: A. They would congratulate and present you with gifts. Correct: Women attending the birth, the woman’s husband, and other male relations all congratulate the new mother. B. They would shun you and fear the evil spirits that you brought into the village. Incorrect: The Ila people view birth as a joy and an event that should be celebrated. 45. According to the text, why do traditional cultures have many beliefs that the birth puts women in a state of being spiritually unclean? A. They believe that pregnant women are possessed. B. They believe that the fetus is evil. C. Birth requires spiritual intervention. D. Birth is often dangerous. Answer: D. Birth is often dangerous. Correct: Different beliefs are used to attempt to gain control over this dangerous situation. B. They believe that the fetus is evil. Incorrect: In many traditional cultures, it is believed that birth is often dangerous and different beliefs are used to attempt to gain control over this dangerous situation. 46. In regards to the birth process, which of the following best describes the belief of many traditional cultures? A. It is unfair that the man does not have a similar process. B. Only women of status should have the right to bear children. C. It puts the woman in the state of being spiritually unclean. D. It is socially inappropriate and should not be rewarded in any way. Answer: C. It puts the woman in the state of being spiritually unclean. Correct: This may be a reaction to the potential dangers of birth. A. It is unfair that the man does not have a similar process. Incorrect: During the birthing process, there is an ample amount of blood and fluid that is discharged and this is viewed as unclean in many cultures. 47. If a culture believes that the birth process is spiritually unclean, which of the following is more likely to occur? A. The infant will have to be cleansed immediately following birth. B. Birth will most likely take place in a location where most people do not reside. C. The mother will have to travel to the city and give birth in a hospital. D. The family must pray to the Birthing Gods before the birthing process can occur. Answer: B. Birth will most likely take place in a location where most people do not reside. Correct: For example, among the Arapesh of New Guinea, birth is allowed to take place only at the outskirts of the village. C. The mother will have to travel to the city and give birth in a hospital. Incorrect: In many traditional cultures, the birthing process is viewed as being unclean; therefore, many have designated locations areas away from where most people reside. 48. Bronislaw Malinowski suggested that magical beliefs regarding the process of birth occur only in instances in which the _______________. A. culture is uneducated B. group is highly religious C. circumstances are not fully controlled D. birth process is very easy Answer: C. circumstances are not fully controlled Correct: Malinowski wrote, “the function of [magical beliefs] is to ritualize optimism, to enhance [our] victory in the faith of hope over fear.” A. culture is uneducated Incorrect: Bronislaw Malinowski suggested that magical beliefs regarding the process of birth occur only in instances in which the circumstances are not fully controlled. 49. According to the text, some Western advocates of natural childbirth _______________. A. eat the placenta B. bury the placenta C. burn the placenta D. make a skin lotion form the placenta Answer: A. eat the placenta Correct: This practice is uncommon, but is inspired by the fact that many other mammalian mothers do so. C. burn the placenta Incorrect: Some Western advocates of natural childbirth eat the placenta after birth. 50. From a traditional cultural perspective, which person will most likely assist the birth process? A. an older man B. a middle-age man C. a young woman D. an older women Answer: D. an older women Correct: Having the knowledge and experience of the birthing process, older women would most likely assist. A. an older man Incorrect: Having the knowledge and experience of the birthing process, older women would most likely assist. 51. In traditional cultures, who invariably assists the mother in the birth process? A. the father B. the oldest daughter C. older women D. nurses Answer: C. older women Correct: In traditional cultures, older women generally assist the mother during the birthing process. B. the oldest daughter Incorrect: In traditional cultures, older women generally assist the mother during the birthing process. 52. A classmate just returned from an educational trip to a traditional culture. During her visit she was surprised that fathers are not involved at all during the process of labor. Who is more likely to assist the mother through labor and delivery? A. The father B. The oldest daughter C. Older women D. Nurses Answer: C. Older women Correct: Having the knowledge and experience of the birthing process, older women would most likely assist. B. The oldest daughter Incorrect: In traditional cultures, older women generally assist the mother during the birthing process. 53. A _______________ is the person who helps with the birth process; she is generally older and has direct experience or has been trained at assisting births. A. nanny B. midwife C. wet nurse D. shaman Answer: B 54. Midwives tend to be _______________. A. young women B. sisters of the woman giving birth C. older women who have never had children D. older women who have had children Answer: D. older women who have had children Correct: Midwives are often older and have direct experience or have been trained at assisting births. A. young women Incorrect: Midwives tend to be older women who have had children. 55. A midwife is _______________. A. a female who serves as a surrogate breast for an infant’s mother who is unable to lactate B. generally a female who is trained or has direct experience with the birth process C. a trained physician who is skilled at monitoring the prenatal period and delivering babies D. a village elder who is knowledgeable about and connected to the spiritual world Answer: B 56. Within traditional Indian culture, the midwife is a member of which social caste? A. the lowest social caste B. the intellectual social caste C. the highest social caste D. the social bourgeoisie caste Answer: A 57. Neha was born in a traditional Indian culture. She is a midwife who assists women their village through labor and birth, which is believed to be an unclean process. What caste is Neha likely a part of? A. low B. the intellectual caste C. the highest caste D. the social elite Answer: A. low Correct: Since birth is deemed to be unclean and polluting, only women of the lowest caste are deemed fit to be part of it. B. the intellectual caste Incorrect: The midwife is in the lowest social class in India. 58. Which of the following is a common practice used by midwives in both developing and developed nations? A. magical rituals B. massages C. cesarean sections D. epidurals Answer: B. massages Correct: Massaging was a common practice used by midwives in both developing and developed nations before the advent of modern pain-relieving medicine. D. epidurals Incorrect: Massaging was a common practice used by midwives in both developing and developed nations before the advent of modern pain-relieving medicine. 59. What is one of the reasons that midwives perform abdominal massage? A. to determine the position of the fetus B. to determine the sex of the fetus C. to determine the size of the fetus D. to determine the length of the fetus Answer: A. to determine the position of the fetus Correct: If the fetus is in the breech position, the midwife can use massage to help turn it. C. to determine the size of the fetus Incorrect: During abdominal massage, the midwife can determine the position of the fetus. 60. On a recent trip abroad with her sociology course, your roommate mostly visited traditional cultures. She witnessed abdominal massage being performed with a pregnant woman, but was not sure what information was gathered during the process. You were able to tell her that through abdominal massage, the midwife was listening to what the pregnant woman was experiencing and also was determining the _______________. A. position of the fetus B. sex of the fetus C. size of the fetus D. length of the fetus Answer: A. position of the fetus Correct: If the fetus is in the breech position, the midwife can use massage to help turn it. C. size of the fetus Incorrect: During abdominal massage, the midwife can determine the position of the fetus. 61. Injecting an anesthetic drug into the spinal cord is referred to as a(n) _______________. A. ultrasound B. epidural C. subcutaneous injection D. episiotomy Answer: B 62. _______________ involves injecting an anesthetic drug into a mother’s spinal fluid to help her manage the pain while also remaining alert. A. A cesarean section B. An epidural C. An amniocentesis D. Braxton Hicks Answer: B 63. Nearly all cultures have some kind of _______________ position that is used during the birthing process. A. vertical B. inverted C. upright D. left lateral Answer: C 64. In the 20th century, which of the following was the most common position used during the birth process? A. supine B. upright C. lying flat D. squatting Answer: C 65. What makes delivery much more difficult for the woman? A. lying flat on her back B. squatting C. kneeling D. leaning back on a hammock Answer: A. lying flat on her back Correct: When a woman lies flat on her back during delivery, it can impede the natural alignment of the pelvis and hinder the descent of the baby through the birth canal. This position can also compress blood vessels, potentially reducing blood flow to the uterus and making contractions less effective. Conversely, positions such as squatting or leaning forward can utilize gravity to aid in the delivery process and may be more comfortable for the woman. B. squatting Incorrect: Squatting would actually be an easier position for delivery. Lying flat on one’s back during labor makes delivery more difficult. 66. Your spouse is pregnant and you both were discussing the process of labor. When your grandmothers gave birth they did so in a delivery room in a particular position, which was also the worst position to be in when in delivery. What position was that? A. Lying flat on her back B. Squatting C. Kneeling D. Leaning on a hammock Answer: A. Lying flat on her back Correct: This position fails to take advantage of gravity and makes more work for the woman. B. Squatting Incorrect: Squatting would actually be an easier position for delivery. Lying flat on one’s back during labor makes delivery more difficult. 67. When comparing positions used for the birth process, kneeling or squatting has an advantage over lying flat because it makes use of _____ A. centripetal force B. gravity C. pelvic muscles D. the uterine wall Answer: B 68. What is a liquid substance that in placed into the vagina to speed up the process of delivering the placenta in traditional cultures? A. a saline solution B. a medicated balm C. an effervescent brine D. a douche Answer: D. a douche Correct: In many cultures an herbal medicine is administered as a tea or douche. C. an effervescent brine Incorrect: A douche is a liquid substance that is placed into the vagina to speed up the process of delivering the placenta. 69. Most births throughout history were administered by? A. midwives B. nurses C. physicians D. shamen Answer: A. midwives Correct: This was true until the 15th century when midwives became widely suspected of being witches. C. physicians Incorrect: Throughout history, midwives were more likely to be involved with births. 70. If you were a midwife during the 15th century, you could be in danger of being viewed as a _______________. A. witch B. god C. demon D. ghost Answer: A 71. During the 15th century, who became suspected of witchcraft, resulting in many being put to death? A. nurses B. pregnant women C. fertility specialists D. midwives Answer: D. midwives Correct: A 1486 witch-hunting manual warned, “No one does more harm to the Catholic faith than midwives.” C. fertility specialists Incorrect: Actually, midwives were suspected of being witches and many were put to death. 72. What is the name of a tong-like apparatus that was used to extract the baby’s head from the womb? A. fetal monitor B. suction C. forceps D. transvaginal stirrup Answer: C 73. _______________ were commonly used before the 18th century to latch onto the baby’s head to help extract it from the womb. A. Claws B. Forceps C. Fires D. Hooks Answer: B 74. From the earlier half of the 20th century to 1973, the use of midwives _______________. A. increased to 40% B. decreased from 50 to 1% C. decreased by a third D. increased from 1 to 50% Answer: B 75. What percent of births are assisted by midwives in the United States? A. 10% B. 30% C. 50% D. 70% Answer: A 76. What percentage of births are assisted by midwives in Norway? A. 96% B. 70% C. 44% D. 20% Answer: A 77. Your father’s family lives in Norway, and his sister is expecting a baby. She mentioned speaking with her midwife, and you were surprised to hear this—when your mother’s sister had a baby in the United States the birth took place in a hospital. Your Norwegian aunt assures you that midwife-assisted births are very common. In fact, they account for _______________ percent of all births. A. 96% B. 70% C. 44% D. 20% Answer: A. 96% Correct: Midwife-assisted births are common throughout Europe, especially northern Europe. B. 70% Incorrect: Nearly all births—96%—are assisted by midwives in Norway. 78. Childbed fever was vanquished in the 1940s in the United States and Europe when obstetricians began to _______________. A. start making house calls B. use vaccinations C. wash their hands D. use aspirin and acetaminophen Answer: C. wash their hands Correct: Physicians learned to minimize the effects of bacterial growth by washing their hands, using rubber gloves, and antibiotics. B. use vaccinations Incorrect: Physicians minimize the effects of bacterial growth by washing their hands, using rubber gloves, and antibiotics. 79. What were two drugs commonly used during the 19th century to relieve pain during childbirth? A. aspirin and alcohol B. aspin bark and cedar extract C. digitalis and foxglove D. ether and chloroform Answer: D 80. What was the name of the method used to heavily medicate women in labor so that they became less inhibited, which helped her to relax and promoted cervical dilation? A. Twilight Sleep B. drug-induced coma C. hypnosis D. labor napping Answer: A 81. From the 1930s through the 1960s it was standard practice in hospitals in Western countries to _______________. A. have women in labor walk between contractions B. prevent women from entering hospitals until active labor C. heavily medicate women in labor D. encourage women in labor to deliver at home Answer: C. heavily medicate women in labor Correct: This didn’t make labor painless, but afterward they remembered none of it. D. encourage women in labor to deliver at home Incorrect: Standard practice during this time was to heavily medicate women in labor. 82. _______________ is a drug-and-technology-free approach to childbearing. A. Obstetrician-assisted childbirth B. Lamaze C. Bradley D. Natural childbirth Answer: D 83. What type of childbirth technique has been found to lower women’s anxiety about birth and help them feel more knowledgeable and more in control of the birth process? A. Twilight Sleep B. natural childbirth C. cesarean birth D. puffing childbirth Answer: B. natural childbirth Correct: The premise is that a substantial amount of the pain women experience in childbirth is based on the anxiety created by fear of the medical setting. C. cesarean birth Incorrect: Natural childbirth has reduced women’s anxieties about birth. 84. What technique of labor rejects medical technology and interventions and promotes breathing techniques to diminish pain? A. Twilight Sleep B. natural childbirth C. cesarean birth D. puffing childbirth Answer: B 85. In developed countries prior to the 1960s, who was excluded from childbirth? A. fathers B. nurses C. physicians D. midwives Answer: A. fathers Correct: By the late 1970s the majority of fathers were present when their partners gave birth. D. midwives Incorrect: Prior to the 1960s, fathers were excluded from childbirth. 86. Your father was born in 1957, and you’re curious about how your grandfather felt while he was in the delivery room. Unfortunately, he tells you he can’t be much help. Why not? A. Fathers were almost always excluded from childbirth. B. Nurses were excluded from childbirth. C. Physicians were excluded from childbirth. D. Midwives were excluded from childbirth. Answer: A. Fathers were almost always excluded from childbirth. Correct: Until the 1960s, fathers in developed countries were totally excluded from childbirth. D. Midwives were excluded from childbirth. Incorrect: Prior to the 1960s, fathers were excluded from childbirth. 87. What is the name of the technique that tracks the fetus’s heartbeat? A. fetal heart rate machine B. perinatal monitor C. electronic fetal monitor D. neonatal heart rate monitor Answer: C 88. Which of the following is a device that is used to track the fetus’s heartbeat via a monitor that attaches externally to the mother’s abdomen, or directly by running a wire through the cervix and placing a sensor on the fetus’s scalp? A. electronic fetal monitor B. amniocentesis C. epidural D. electroencephalograph Answer: A 89. In the United States what percentage of births include an electronic fetal monitor? A. 55% B. 70% C. 85% D. 100% Answer: C 90. What is one potential contributor to the increase in unnecessary cesarean deliveries? A. misreading an electronic fetal monitor B. drug usage during pregnancy C. panicky fathers in the delivery room D. obese mothers Answer: A. misreading an electronic fetal monitor Correct: Heart rate changes are not easy to interpret and don’t necessarily indicate distress. D. obese mothers Incorrect: One potential contributor to the increase in unnecessary cesarean deliveries is misreading an electronic fetal monitor. 91. You are the birthing coach for your best friend who is in labor at the hospital. As you enter the birthing room the fetal monitor alarm sounds. What is likely to happen? A. Nothing, no one pays attention to fetal monitors today. B. Your friend is have an intense abdominal massage C. There is a good chance that your friend will have a cesarean delivery. D. The fetus will be born with a genetic or chromosomal disorder. Answer: C. There is a good chance that your friend will have a cesarean delivery. Correct: The alarm typically alerts medical staff to changes in the fetal heart rate or other signs indicating fetal distress, which may necessitate urgent medical intervention such as a cesarean delivery to ensure the safety of the baby. Ignoring such alarms can pose risks to both the mother and the baby. D. The fetus will be born with a genetic or chromosomal disorder. Incorrect: Your friend’s baby is likely to be born via cesarean delivery. 92. Over the last century there have been dramatic improvements in the birth process for women living in developed countries; however, the world has a large proportion of individuals who lack basic access to trained physicians. What percent of the world lives outside of developed nations? A. 60% B. 70% C. 80% D. 90% Answer: C 93. Which of the following are two primary reasons why maternal mortality has decreased during the birthing process in developed countries? A. improvements in standardization for midwives B. improvements in healthcare reimbursements C. improvements in worldwide standards for physicians D. improvements in nutrition and health care access Answer: D Short Answer Questions 94. Give one reason that a woman would deliver by c-section (not including convenience of scheduling). Answer: Failure to progress or a breech birth are two reasons for a c-section. One reason for a cesarean delivery could be fetal distress, where there are signs indicating that the baby is not tolerating labor well, necessitating prompt intervention to ensure the baby's safety. 95. Name at least one part of the world where rates of c-sections are low? Explain why. Answer: In Northern Europe rates of c-section are low; this seems to be due, in part, to the belief that birth is a natural process and does not require extreme medical intervention. Poor countries, such as Africa, also have low rates because of lack of access to medical resources compared to the U.S. and other developed countries. 96. Describe the meaning of the placenta in a culture that is different from your own. Include rituals that occur involving the placenta. Answer: It include believing that the placenta has a soul of its own and therefore, is given a special burial similar to one a person in that culture would have. In some cultures like the Maori of New Zealand, the placenta is considered sacred and is often buried with special rituals to honor the connection between the baby, the placenta, and the land. These rituals symbolize the nurturing bond between the child and the earth. 97. What is twilight sleep and would you have wanted to experience it? Why or why not? Answer: Twilight sleep refers to a drug that was given to women in the early 1900s so that they would relax, making the birth easier. When the woman woke up from the sleep, they didn’t remember anything about the birth process. But many will likely say that they would not want it because it decreases a sense of control and does not allow the person to remember the joyous occasion of the birth. 98. Which ethnic group has the highest rate of neonatal and maternal mortality in the United States? Provide some reasons for these differences. Answer: African Americans have much higher rates of both neonatal deaths and maternal deaths. Due to higher rates of poverty and therefore, less access to prenatal care, they are more likely to have a variety of complications. Essay Questions 99. Describe what birth is like for women in at least one culture where the birth process is accompanied by fear rather than purely celebration. If possible, specify the country. Answer: In New Guinea, the Arapesh believe that birth can contaminate others. Therefore, women must be brought to the outskirts to give birth in a place reserved for other unclean activities, such as menstruation and excretion. 100. Describe a technological advance that has made birth safer for the mother and the baby in developed countries. Are there potential drawbacks to consider? Explain. Answer: Electronic fetal monitoring tracks the heart rate of the fetus, allowing medical attendants to know whether the fetus is in distress. If this is the case, a c-section may be performed to reduce the risk to the fetus. The problem with such intense monitoring is that it may prompt medical intervention when, in fact, it is not justified. For example, the heart rate might change for a number of reasons that do not include distress. If a c-section is done unnecessarily, it increases a number of risks, such as infection and a longer recovery time for the mother. MyDevelopmentLab Question Bank Pre-Test 1. What occurs when the level of oxytocin reaches threshold? A. Birth begins. B. Conception is likely. C. Labor pains decrease. D. Lactation begins. Answer: A 2. What is the second stage of labor? A. Labor B. Delivery C. Transition D. Crowning Answer: B 3. What is happening when labor has begun but is taking longer than normal? A. Failure to progress B. Problematic labor C. The presence of multiple fetuses D. A likely birth defect in the fetus Answer: A 4. What position is it when the fetus is in the breech position? A. Feet or buttocks down B. Head down, away from the mother's spine C. Head down, face toward the mother's spine D. Horizontal Answer: A 5. During the past _________________ years, medical knowledge has led to methods that genuinely help mothers and babies during birth. A. 50 B. 100 C. 200 D. 300 Answer: A 6. According to Bronislaw Malinowski, magical beliefs regarding the process of birth occur only in instances in which _______________. A. the culture is uneducated B. the culture is highly religious C. circumstances are not fully controlled D. the birth process is very easy Answer: C 7. You are a member of a traditional culture in India. Your mother is a midwife. Of what social class are you likely a member? A. High B. Medium C. Low D. Social elite Answer: C 8. You were discussing the process of labor with your grandmother. She indicated that she gave birth in what is now understood to be the worst position to give birth. What position was that? A. Squatting B. Kneeling C. Learning on a hammock D. Laying flat on her back Answer: D 9. You are a family practice physician who delivers quite a few babies. You recently returned from a vacation in Norway and are considering incorporating a method of assisting labor that is currently used in Norway. What method are you considering? Using: A. A warm pool B. Videography C. Forceps D. A midwife Answer: D 10. What percentage of births includes an electronic fetal monitor in the United States? A. 40% B. 55% C. 70% D. 85% Answer: D Post-Test 1. What hormone that is released by the mother's pituitary gland is responsible for initiating contractions in the uterus? A. Oxytocin B. Estrogen C. Testosterone D. Androgen Answer: A 2. During your prenatal visit the doctor informs you that your cervix has dilated to 10 centimeters. What should happen next? A. You probably have at least a week of pregnancy left. B. You should head to the hospital, you are having a baby. C. Your doctor just made up that number. D. Something is not good. Cervixes do not dilate to 10 centimeters. Answer: B 3. What does "crowning" mean? A. The fetus' head appears at the outer opening of the vagina. B. The fetus' head is too large for the pelvic opening. C. The delivery room is too full for additional patients. D. The mother won "mother of the year." Answer: A 4. What happens during the last stage of labor? A. The placenta is delivered. B. The amniotic sac ruptures. C. The fetus' head crowns. D. The fetus is turned. Answer: A 5. What percent of fetuses present in the Breech position? A. 4% B. 20% C. 36% D. 50% Answer: A 6. The birth process for human beings is more complicated than for other animals because of the _______________. A. the amount of amniotic fluid expelled during labor B. fetus' muscle-to-fat ratio C. size of the fetus' head D. the mother's expectation of the birthing process Answer: C 7. In traditional cultures, who is the individual who assists the mother during the birthing process? A. The oldest daughter B. A nurse C. An older woman D. The father Answer: C 8. What position makes delivery much more difficult for the woman? A. Leaning on a hammock B. Kneeling C. Squatting D. Lying flat on her back Answer: D 9. You have a family member who lives in Norway and she just went into labor. What percentage of births is assisted by midwives in Norway? A. 20% B. 44% C. 70% D. 96% Answer: D 10. You are an intern working at the maternity ward in a hospital. This is your first day on the job and a woman who is in labor had her fetal monitor alarm sound. What will you assume regarding this situation? A. Ignore the fetal monitor, there are many false alarms. B. You begin massaging the woman's abdomen. C. The fetus is probably going to be born with a genetic disorder. D. The fetus is in distress. Answer: D Chapter Exam 1. Oxytocin is released from _______________. A. the fetus' liver B. the mother's pituitary gland C. the mother's uterus D. the fetus' liver Answer: B 2. What stage of the birth process is the longest and most taxing to the mother? A. Braxton-Hicks B. Crowning C. Labor D. Transition Answer: C 3. What is the term that is used to indicate when the fetus' head appears at the outer opening of the vagina? A. Transition B. Crowning C. Birth D. Delivery Answer: B 4. Since critics have argued that they are unnecessary, these procedures have decreased from 90% in 1970 to 20% in 2000. A. Episiotomies B. Crowning C. Vaginalectomies D. Amniocenteses Answer: A 5. What is the birth position called when the fetus is feet or buttocks down? A. Breech B. Transverse C. Normal D. Triangular Answer: A 6. What is one of the reasons for the high rates of Cesarean births? A. To avoid a potential disaster during birth B. To help physicians become wealthy C. Vaginal deliveries are dangerous D. To give surgeons practice Answer: A 7. Why do traditional cultures have many beliefs that suggest that the woman giving birth is spiritually unclean? A. Birth is often dangerous B. Pregnant women are possessed C. The fetus is evil D. Birth requires spiritual intervention Answer: A 8. What is a midwife? A. A female who is trained or has direct experience with the birth process. B. A female who serves as a surrogate breast for an infant whose mother is unable to lactate. C. A village elder who is knowledgeable about and connected to the spiritual world. D. A trained physician who is skilled at monitoring the prenatal period and delivering babies. Answer: A 9. Midwives often perform abdominal massage. What is one of the reasons for doing this? To determine _______________. A. The position of the fetus B. The sex of the fetus C. The size of the fetus D. The length of the fetus Answer: A 10. Throughout history, most births were administered by _______________. A. Physicians B. Nurses C. Midwives D. Shaman Answer: C 11. Today, what percent of births are assisted by midwives in the United States? A. 10% B. 30% C. 50% D. 70% Answer: A 12. It was standard practice in hospitals in Western countries from the 1930s through the 1960s to _______________. A. encourage women in labor to deliver at home B. prevent women from entering hospitals until active labor C. heavily medicate women in labor D. have women in labor walk between contractions Answer: C 13. What childbirth technique rejects medical technology and interventions and promotes breathing techniques to diminish pain? A. Cesarean birth B. Huff and puff technique C. Natural childbirth D. Twilight sleep Answer: C 14. What medical technique is used to measure the fetus' heartbeat during the birthing process by attaching a device on the mother's abdomen or by placing a sensor on the fetus' scalp? A. Ultrasound B. Epidural C. Electronic fetal monitoring D. Amniocentesis Answer: C 15. What are two important reasons maternal mortality has decreased during labor in developed countries? Improvements in _______________. A. Nutrition and health care access B. Standardization for midwives C. Healthcare reimbursements D. Worldwide standards for physicians Answer: A Quick Review 1. How many stages are there in the birth process? A. 3 B. 4 C. 5 D. 6 Answer: A 2. What is/are responsible for the discomfort that is associated with birth process stage of labor? A. Increased blood pressure B. Muscular contractions C. Increased adrenaline D. Low blood sugar Answer: B 3. During what stage of labor is the umbilical cord generally cut? A. Third stage B. Active labor C. Crowning D. Transitional labor Answer: A 4. Why can breech births be dangerous? A. The umbilical cord can be constricted, leading to brain damage. B. The fetus can get stuck in the birth canal. C. The fetus' heart might stop beating. D. The mother can lose consciousness. Answer: A 5. How do members of the Ila people of Zimbabwe behave after a mother gives birth? A. The men congratulate the woman and present her with gifts. B. They pity her because the birth process lowered her social status. C. They shun her and fear the evil spirits that she brought into the village. D. They envy her because the status of motherhood is near godlike. Answer: A 6. If you lived in a traditional culture who would you expect to assist you during childbirth? A. An older woman B. An older man C. A middle-aged woman D. A young woman Answer: A 7. What is a common practice used by midwives in both developed and developing countries? A. Cesarean sections B. Magical rituals C. Massage D. Epidurals Answer: C 8. In the 20th century what was the most commonly used position in childbirth? A. Supine B. Squatting C. Sitting upright D. Laying flat on one's back Answer: D 9. Who was often suspected of being witches during the 15th century and were frequently put to death? A. Fertility specialists B. Pregnant women C. Nurses D. Midwives Answer: D 10. What is the technique that is used to assess the fetus' heartbeat during childbirth? A. Fetal pulse rate machine B. Perinatal monitor C. Neonatal heart rate monitor D. Electronic fetal monitor Answer: D Video Guide Questions Short Answer Questions 1. While thee video narrator tells us that the actual trigger for labor is still a mystery, he provides a few possibilities. Explain those possibilities. Answer: Perhaps a hormone signal is sent from the fetus that signals it is ready for birth. Possibly the placenta emits a sign that it is no longer able to sustain the growing baby. Another possibility is that the pituitary gland plays a central role. 2. List at least three of the signals a woman may experience to let her know she is about to begin labor. Answer: There are several signals that let a woman know that she is about to begin labor. The following are a few of the examples listed in this video: • Position of the cervix moves from back to the front of the body • cervix ripens or softens • cervix begins to thin or efface • she may have a vague or nagging backache or feel the need to change positions often • she may experience intermittent or continuous cramps • uterine contraction are the most common sign that labor has begun 3. Describe in detail the three stages of labor. Answer: The first stage of labor involves the thinning, effacing and opening or dilating of the cervix. It must dilate to 10 cm in order for the baby to pass through the birth canal. There are three phases within this stage. The first of these phases is the pre-labor phase when the woman typically dilates to 3 cm. This is typically the easiest but longest phase of labor. Active labor (the second phase of stage one), includes stronger, more frequent contractions and the cervix dilates from 4-7 cm. Transition is the final phase of stage one, and normally is the most physically challenging period of labor. The cervix dilates from 8-10 cm. Pushing can begin at 10 cm, and this is the second stage of labor. When the baby's head is visible (crowning), phase two of the pushing stage has begun. Stage two ends with the delivery of the baby. Stage three involves the birth of the placenta, and usually occurs within 15-30 minutes after the delivery of the baby. The placenta begins to detach from the uterine wall and typically a gentle push will expel it. Multiple Choice Questions 1. According to the video, which of the following is a signal that a woman is about to begin labor? A. The cervix hardens. B. The position of the cervix moves from the back to the front of her body. C. The cervix becomes very thick. D. The cervix moves from the front of her body to the back. Answer: B 2. The delivery of the baby is the last part of which stage of labor? A. stage 1 B. stage 2 C. stage 3 D. stage 4 Answer: B 3. The delivery of the placenta occurs in which stage of labor? A. stage 1 B. stage 2 C. stage 3 D. stage 4 Answer: C Section 2 The Neonate Test Item File Multiple Choice Questions 1. What is one evolutionary adaptation to assist in delivering the fetus? A. the fetus is smaller than expected B. the fetus’ skull is not yet fused C. the vaginal opening is very large D. the fetus still has a very small brain Answer: B 2. What are the “soft spots” on a neonate called? A. sutures B. cranium areas C. fontanels D. soft spots Answer: C 3. Your friend just brought her newborn home and was very concerned that her baby’s head was not right. There were two spots that seemed like the skull did not close. She thinks that there is a problem; what do you think? A. There is no problem. Those spots are fontanels and are supposed to be there B. You think that she should have her baby get corrective surgery before anyone else sees her C. You are not sure, but you think that she should take her baby to her doctor as soon as possible. D. It appears to you that the baby might have bone cancer. Answer: A. There is no problem. Those spots are fontanels and are supposed to be there Correct: It will take about 18 months before the pieces of the skull are firmly joined and the fontanels have disappeared. B. You think that she should have her baby get corrective surgery before anyone else sees her Incorrect: These spots are called fontanels and are present for about 18 months. 4. How long will it take before the pieces of the skull grow together and the fontanels disappear? A. 6 months B. 12 months C. 18 months D. 24 months Answer: C 5. What is the length of the average neonate? A. 18 inches B. 20 inches C. 22 inches D. 24 inches Answer: B 6. What is the weight of the average neonate? A. 6.0 pounds B. 7.5 pounds C. 9.0 pounds D. 10.5 pounds Answer: B 7. Neonates tend to lose about ____________% of their weight in their first few days, because they lose fluids. A. 5% B. 10% C. 15% D. 20% Answer: B 8. Neonates tend to lose about 10% of their birth weight. After how many days does the neonate begin to regain the lost weight? A. 2 B. 5 C. 8 D. 11 Answer: B 9. When your neighbors brought their baby home from the hospital he weighed less than at birth. They were very concerned; what would you tell them? A. They probably need to try to feed the newborn more frequently. B. That it is typical for babies to lose weight right after birth. He should regain the weight before a couple of weeks go by. C. The wife probably cannot breast-feed and they should start formula feeding immediately. D. He must have an eating disorder. Answer: B. That it is typical for babies to lose weight right after birth. He should regain the weight before a couple of weeks go by. Correct: Neonates lose about 10% of their birth weight in the first few days, but should be back to birth weight by the second week. C. The wife probably cannot breast-feed and they should start formula feeding immediately. Incorrect: It is typical for babies to lose weight right after birth. 10. How long does it take before the neonate has regained all of the weight that he or she lost right after birth? A. 2 weeks B. 3 weeks C. 4 weeks D. 5 weeks Answer: A 11. What condition occurs in which neonates have a yellowish look to their skin and eyeballs? A. kidney dysfunction B. renal failure C. jaundice D. epidermal fungus Answer: C 12. When Julius was born, his skin color and eyeballs looked yellowish and he was given phototherapy where he was exposed to blue light. Julius was born with neonatal _______________. A. anemia B. jaundice C. colic D. hypertension Answer: B. jaundice Correct: The yellowish appearance of neonates is jaundice and is due to an immature liver. C. colic Incorrect: The yellowish appearance of neonates is jaundice and is due to an immature liver. 13. Why does neonatal jaundice occur? A. The fetus does not eat enough. B. The mother is not capable of breast-feeding. C. The heart is accumulating fluid. D. The liver is immature and not functioning properly yet. Answer: D. The liver is immature and not functioning properly yet. Correct: In most cases, neonatal jaundice disappears after a few days. C. The heart is accumulating fluid. Incorrect: Jaundice occurs because the liver is immature and not functioning properly. 14. Your neighbors just had their baby today. They noticed that she had a yellow tint to her skin. They were really worried. What do you think? A. You think that it is the lighting in the hospital. B. The yellow tint means that she is very hungry and needs to be fed more often. C. The baby must have accidentally been given something to which she is allergic. D. The yellow tint is jaundice, which should correct itself fairly quickly. Answer: D. The yellow tint is jaundice, which should correct itself fairly quickly. Correct: Neonatal jaundice is due to the liver not yet functioning properly. C. The baby must have accidentally been given something to which she is allergic. Incorrect: The yellow tint is likely temporary and indicates jaundice. 15. When do most neonates begin breathing? A. after the physician slaps their bottom B. just before they are born C. as soon as they are exposed to air D. two minutes after birth Answer: C 16. Deprivation of oxygen is referred to as _______________. A. brain damage B. anoxia C. neonatal lung immaturity D. jaundice Answer: B 17. _______________ is a condition where an infant is deprived of oxygen, which results in swift and massive death of brain cells. A. Hypertension B. Jaundice C. Anoxia D. Tachycardia Answer: C 18. Who devised the Apgar scale? A. Dr. Thomas Apgar B. Dr. Virginia Apgar C. Dr. Jeff Arnett D. Dr. Yuthica Kim Answer: B 19. The Apgar scale assesses color, heart rate, breathing, muscle tone and _______________. A. weight B. speed of responding C. reflexes D. strength Answer: C 20. Which of the following areas are measured by the Apgar scale? A. sleepiness, blood pressure, heart rate, and pulse B. appearance, pulse, grimace, activity, and respiration C. iron levels, blood glucose, heart rate, and blood pressure D. blood pressure, heart rate, blood glucose, and respiration Answer: B 21. Your sister and brother-in-law just had a baby. There were a bit confused because they were told that their baby had a score of 7 and then a 10. At first they were joking that that meant that their baby girl was very beautiful. What would you tell them? A. Those were scores that all doctors and nurses use to indicate attractiveness of the newborn. B. Those scores were estimates of later intelligence and range from 1 to 10. C. Those were scores for the Apgar scale that ranges from 1 to 10. D. Those particular score indicate how pink a neonate is. Answer: C. Those were scores for the Apgar scale that ranges from 1 to 10. Correct: The Apgar scale assesses color, heart rate, breathing, muscle tone, and reflexes. B. Those scores were estimates of later intelligence and range from 1 to 10. Incorrect: The scores were from the Apgar Scoring System. 22. Why is a neonate rated on the Apgar scoring system at 1 minute and again at 5 minutes after birth? A. The mother insists on it . B. Physicians are likely to make a mistake. C. The neonate is crying too much at the first assessment. D. A neonate’s condition can change quickly. Answer: D. A neonate’s condition can change quickly. Correct: A score of 7 to 10 means the neonate is in good to excellent condition, but complications can occur within seconds in the first moments of a baby’s life. A. The mother insists on it . Incorrect: A neonate is rated on the Apgar scoring system at 1 minute and again at 5 minutes after birth because the neonate’s condition can change quickly. 23. What range of Apgar scores indicates that the neonate is in good to excellent condition? A. 1–3 B. 4–6 C. 7–10 D. 10 or greater Answer: C 24. Your friend just gave birth and tells you that the baby’s Apgar score was a 10. What can you assume about the baby’s condition? A. The baby is in critical condition because an Apgar score of 10 is extremely low. B. The baby is doing extremely well because an Apgar score of 10 is the highest. C. The baby is doing OK because an Apgar score of 10 is in the middle of the range. D. The baby is doing well because an Apgar score of 10 is just beneath the highest of 15. Answer: B. The baby is doing extremely well because an Apgar score of 10 is the highest. Correct: More than 98% of American babies receive an Apgar score of 7 or higher. D. The baby is doing well because an Apgar score of 10 is just beneath the highest of 15. Incorrect: A 10 is a perfect score on the Apgar scoring system. 25. For American infants, what percent are born with an Apgar score of 7 to 10? A. 52% B. 64% C. 76% D. 98% Answer: D 26. An Apgar score in which range indicates that the neonate is in life-threatening danger? A. 1–3 B. 4–6 C. 7–10 D. 10 or greater Answer: A 27. The Apgar score not only is useful in determining the neonate’s status at birth, but also predicts _______________. A. the likelihood of death in the first month of life B. adult height C. risk of cancer in childhood D. scores on the Brazelton Neonatal Behavioral Assessment Scale at two months Answer: A. the likelihood of death in the first month of life Correct: The Apgar score can alert physicians that careful monitoring of a neonate’s health will be necessary. B. adult height Incorrect: The Apgar score predicts the likelihood of death in the first month of life. 28. The Brazelton Neonatal Behavioral Assessment Scale is comprised of 27 items that the infant is assessed on. Which of the following are a few of those items? A. temperament, personality, and reactivity B. reflexes, physical states, and responsiveness to social stimulation C. appearance, temperament, and grimace D. capillary refill, blood pressure, and heart rate Answer: B 29. On which neonatal assessment scale is the infant assessed on 27 items and receives an overall rating of worrisome, normal or superior? A. Apgar scale B. Brazelton Neonatal Behavioral Assessment Scale C. Wechsler Infant Intelligent Scale D. Stanford-Binet Scale Answer: B 30. Based upon the assessment of 27 items, the Brazelton Neonatal Behavioral Assessment Scale categorizes infants into one of three categories _______________. A. sub-average, average, or above average B. below normal, normal, above normal C. worrisome, normal, or superior D. scary, good, or extremely well Answer: C 31. As compared to the Apgar scale, the Brazelton Neonatal Behavioral Assessment Scale differs in that __________ A. it has been greatly criticized for being too subjective and lacks scientific support B. it is only used by midwives, and gynecologists and obstetricians are not allowed to perform it C. it has been criticized for being biased towards women from developed countries D. it is performed about a day after birth and can be given any time within the first two months Answer: D. it is performed about a day after birth and can be given any time within the first two months Correct: The Apgar scale, on the other hand, is performed within minutes after birth. A. it has been greatly criticized for being too subjective and lacks scientific support Incorrect: The Brazilian Neonatal Behavioral Assessment Scale has better predictive value when it is given one day after birth and about one week later. 32. When is the Brazelton NBAS generally administered? A. a day prior to birth B. immediately after birth and then at one year C. about a day after birth and then a week later D. When the infant is one year old Answer: C. about a day after birth and then a week later Correct: The Brazelton NBAS effectively predicts future development when administered at these times. D. When the infant is one year old Incorrect: The Brazelton NBAS is generally administered one day after birth and then a week later. 33. What neonates are at risk for early developmental problems? Those who are assessed as _______________. A. worrisome at time one and time two B. superior at time one and time two C. normal at time one and superior at time two D. worrisome at time one and superior at time two Answer: A. worrisome at time one and time two Correct: Neonates who show no improvement between the first and second assessment are at risk for developmental problems. D. worrisome at time one and superior at time two Incorrect: Neonates who are assessed at worrisome at time one and two are at risk for early developmental problems. 34. What is one of the most important indicators of a neonate’s survival and healthy development? A. gestational age B. Brazelton score C. Apgar score D. birth weight Answer: D 35. Your newborn cousin was born at the optimal 40 weeks after gestation, but she was only 4.5 pounds. Should your aunt and uncle be worried? A. No, this just means that your cousin will always be thin. B. A little; your cousin is always going to be very short. C. Yes, birth weight is highly predictive of intelligence. D. Yes, birth weight is associated with survival and healthy development. Answer: D. Yes, birth weight is associated with survival and healthy development. Correct: Low-birth-weight babies are at high risk of death in their first year of life. B. A little; your cousin is always going to be very short. Incorrect: Birth weight is associated with survival and healthy development, but not with adult height. 36. An infant born weighing less than _______________ pounds is considered low birth weight. A. 5.5 (2,500 grams) B. 6.5 (3,000 grams) C. 7.5 (3,500 grams) D. 8.5 (4,000 grams) Answer: A 37. In order to be considered preterm an infant must be born before the _______________ week of prenatal development. A. 37th B. 38th C. 39th D. 40th Answer: A 38. An infant that is born weighing less than 5.5 pounds and before 37 weeks is considered: A. at risk B. very small C. post-mature D. preterm Answer: D 39. According to the text, what are neonates who weigh less than 90% of what they should for their gestational age referred to as? A. very light B. light for gestational age C. small for date D. preterm Answer: C 40. Your sister did everything that she could to have a healthy pregnancy, but her baby was born at 33 weeks and was “small for date.” She is not sure what that means. What would you tell her? This means that her baby was _______________. A. born weighing less than was expected for her gestational age B. born prematurely C. very short D. lucky not to be resuscitated at birth Answer: A. born weighing less than was expected for her gestational age Correct: Small-for-date neonates are especially at risk, with an infant death rate 4 times higher than that of preterm infants. C. very short Incorrect: “Small for date” means that the baby weighs less than was expected for his or her gestational age. 41. Which of the following describes a neonate who was born small-for-date? A. the circumference of their head is 85% of other infants born the same gestational age B. they weigh less than 90% of other infants born at the same gestational age C. they are 10% shorter than other infants born the same gestational age D. their height is 15% longer than other infants born at the same gestational age Answer: B 42. _______________ is defined as the number of weeks since conception. A. Birth weight B. Gestational age C. Pregnancy timeline D. Small-for-date Answer: B 43. _______________ neonates have a four time higher death rate than _______________ infants. A. Small-for-date; preterm B. Preterm; small-for-date C. Gestational age; colicky D. Colicky; gestational age Answer: A 44. Which continents have the highest rates of low-birth-weight neonates? A. North and South America B. Europe and Australia C. Asia and Africa D. Australia and North America Answer: C 45. What is the current percentage of low-birth-weight neonates in the United States? A. 8% B. 18% C. 28% D. 38% Answer: A 46. What is the main cause of low birth weight in developed countries? A. maternal malnourishment B. maternal drug abuse C. maternal anemia D. maternal cigarette smoking Answer: D. maternal cigarette smoking Correct: In developing countries, malnutrition and lack of access to prenatal health care are more common causes of low birth weight. B. maternal drug abuse Incorrect: Smoking is the main cause of low birth weight babies in developed countries. 47. Your roommate is a smoker. You and he are having an argument because he not only thinks that smoking is OK, but also thinks it is fine when a pregnant woman smokes—his mother did. You argue that, among other things, women who smoke when pregnant have newborns who are _______________. A. more likely to be low birth weight, which is not a good start for the baby B. more sickly, but also more intelligent C. very energetic and can be hyperactive D. very likely to have an eating disorder Answer: A. more likely to be low birth weight, which is not a good start for the baby Correct: Low-birth-weight babies are at high risk of death in their first year of life. B. more sickly, but also more intelligent Incorrect: Women who smoke while pregnant are more likely to have low-birth-weight babies. 48. For developing countries, the main cause for low birth weight neonates is __________; whereas, in developed countries it is _______________. A. iron deficiency; HIV B. HIV; iron deficiency C. cigarette smoking; malnourishment D. malnourishment; cigarette smoking Answer: D 49. Low birth weight is the _______________ in developed countries. A. leading cause of death in infancy B. second most common cause of death in infancy C. leading cause of intellectual disability D. second most common cause of mental disabilities Answer: B. second most common cause of death in infancy Correct: It is second only to genetic birth defects. A. leading cause of death in infancy Incorrect: Low birth weight is the second most common cause of death in infancy. 50. For infants who are born before the 25th week after gestation, their chance of survival is _______________. A. 25% B. 50% C. 75% D. 100% Answer: B 51. Low birth weight usually occurs because _______________. A. there was a disruption during prenatal development B. of factors that researchers have not yet been able to determine C. of trauma to the placenta D. of irresponsible parents Answer: A. there was a disruption during prenatal development Correct: These could be due to poor maternal nutrition, illness, or disease; or because of exposure to teratogens like nicotine and alcohol. B. of factors that researchers have not yet been able to determine Incorrect: Low birth weight usually occurs because of a disruption during prenatal development. 52. What is the substance called that coats the lungs and keeps the air sacs in the lungs from collapsing? A. pulmonary oil B. mucus C. surfactant D. liquivent Answer: C 53. Which of the following is a substance that lubricates the lungs and helps the neonate breathe independently? A. surfactant B. leptin C. acetylcholine D. white blood cells Answer: A 54. What type of intervention advises mothers and fathers to place their low-birth-weight neonates on their chests for 2 to 3 hours a day? A. papoose care B. kangaroo care C. marsupial care D. frequent contact care Answer: B 55. Your roommate’s brother and sister-in-law just had a baby girl. Their daughter was born with very low birth-weight. They did not get much help in terms of advice and are now leaving the hospital after only being there 7 days. What type of close-contact intervention would you advise for them? A. papoose care B. kangaroo care C. marsupial care D. frequent contact care Answer: B. kangaroo care Correct: Kangaroo care involves parents having skin-to-skin contact with their baby for 2 to 3 hours a day. A. papoose care Incorrect: It is referred to as kangaroo care. 56. Research has shown that what type of intervention for low-birth-weight neonates helps them to survive their first year? A. papoose care B. kangaroo care C. marsupial care D. frequent contact care Answer: B 57. Tatem is a low-birth-weight neonate who now has longer periods of sleep, cries less, and has gained weight much faster than other preterm babies. Which of the following treatments would you suspect that Tatem’s parents are using? A. calcium supplements B. Harlow treatments C. kangaroo care D. Montessori care Answer: C. kangaroo care Correct: Kangaroo care involves parents having skin-to-skin contact with their baby for 2 to 3 hours a day. B. Harlow treatments Incorrect: Preterm infants treated with kangaroo care are more likely to have longer periods of sleep, cry less, and gain weight faster than other preterm infants. 58. What type of intervention for low-birth-weight neonates is so successful that it is used in over 75% of neonatal intensive care units in the United States? A. papoose care B. kangaroo care C. marsupial care D. frequent contact care Answer: B 59. What is another very useful technique for assisting low-birth-weight babies? A. educating their mothers B. smoking cessation program for the parents C. infant isolation D. infant massage Answer: D. infant massage Correct: Low-birth-weight babies are often placed in covered, sterile environments called isolettes, and infant massage provides important sensory and social stimulation. C. infant isolation Incorrect: Infant massage is a very useful technique for assisting low-birth-weight babies. 60. Your roommate’s brother and sister-in-law just had a baby girl. Their daughter was born with very low birth-weight. What advice can you give them in terms of providing additional care for her? A. Try infant massage. B. Leave her in her crib with a bottle to insure that she gets plenty to eat. C. Just be calm; there is not much a parent can do at this point. D. Get an infant monitor so that you can listen to her breathing constantly. Answer: A. Try infant massage. Correct: Low-birth-weight babies are often placed in covered, sterile environments called isolettes, and infant massage provides important sensory and social stimulation. C. Just be calm; there is not much a parent can do at this point. Incorrect: Infant massage can be helpful. 61. Adolescents who were born with low birth weight were more likely to _______________. A. be obese and have poor muscle tone B. be depressed and reclusive C. have low intelligence test scores and more likely to repeat a grade D. have poor secondary sexual characteristic development Answer: C. have low intelligence test scores and more likely to repeat a grade Correct: This can be a result of language delays and poor school performance that low-birth-weight babies experience as younger children. B. be depressed and reclusive Incorrect: They are more likely to have low intelligence test scores and more likely to repeat a grade. 62. An adult who was low birth weight is more likely to _______________. A. have brain abnormalities B. be obese C. have very short stature D. have severe psychological problems Answer: A. have brain abnormalities Correct: Attention deficits and low educational attainment are also common outcomes. C. have very short stature Incorrect: An adult who was low birth weight is more likely to have brain abnormalities. 63. Low birth weight babies in either developed or developing countries are most likely to be born to parents who have the _______________. A. highest socio-economic status B. fewest resources C. least educational status D. most children Answer: B. fewest resources Correct: Low birth weight babies are most likely to be born to parents who have the fewest resources available to them to assist them in parenthood. D. most children Incorrect: Low birth weight babies are most likely to be born to parents who have the fewest resources available to them to assist them in parenthood. 64. How many hours a day does the average neonate sleep? A. 8–10 B. 11–13 C. 16–17 D. 20–22 Answer: C 65. Your friends are worried because their newborn sleeps 16 or 17 hours a day. What would you tell them? A. That their newborn probably has a sleeping disorder. B. They should try to wake up their neonate every 8 hours. C. The average neonates sleep about this amount of time. D. Sleeping this long is highly associated with laziness during adolescence. Answer: C. The average neonates sleep about this amount of time. Correct: There is great variation among newborns, but 16 to 17 hours per day is normal. B. They should try to wake up their neonate every 8 hours. Incorrect: The average newborn generally sleeps 16 to 17 hours a day. 66. Unlike later in life, a neonate’s sleep-wake patterns are governed by _______________. A. light or dark cues B. hunger C. activity level D. hormonal level Answer: B. hunger Correct: Often, neonates will wake up every two hours to feed. A. light or dark cues Incorrect: Often, neonates will wake up every two hours to feed. 67. In terms of sleep, most parents of neonates from developed countries _______________. A. sleep considerably longer than other parents B. are sleep deprived C. sleep with their neonates D. have their neonates sleep with nannies Answer: B 68. One way that neonates’ sleep is distinctive is that they spend a high proportion of their sleep in _______________. A. alpha stage sleep B. a coma-like sleep C. a position that is face down D. rapid eye movement (REM) sleep Answer: D 69. You are watching your infant sleep and suddenly notice that her eyes sway back and forth from side to side beneath her eyelids. At first you are frightened, but then remember that this phenomenon was described in your textbook and is a normal stage of sleep. Which of the following stage of sleep is your infant in? A. hypersleep B. ESP C. REM D. fMRI Answer: C. REM Correct: Neonates spend up to half of their sleep in the REM sleep, as opposed to 20% for most adults. A. hypersleep Incorrect: When one’s eyes flutter from side to side beneath the eyelids while sleeping, he or she is in the REM stage of sleep. 70. Compared to adults, infants spend _______________ in REM sleep. A. less time B. more time C. the same amount of time D. only the first half of the night Answer: B 71. Whereas adults typically spend about 20% of their time in REM sleep, what percentage of time do neonates spend in REM sleep? A. 30% B. 50% C. 70% D. 90% Answer: B 72. Adults spend about _______________ of their time sleeping in REM; whereas, infants spent about _______________ of their time sleeping in REM. A. 5%; 20% B. 10%; 30% C. 15%; 40% D. 20%; 50% Answer: D 73. When neonates fall asleep, they almost always enter _______________ instantly. A. Stage I B. EKG sleep C. non-EFP D. REM sleep Answer: D 74. While writing a research paper, you propose that infants need a greater amount of sleep than adults because sleep stimulates brain development. Which of the following supports your stance? A. Neonate’s brain wave patterns during REM sleep are different from the patterns of adults. B. The neonate’s brain is 40% smaller than that of an adult and REM sleep increases its size. C. During REM sleep neonates appear to be lucid. D. Neonates spend at least 80% of their sleep in REM sleep. Answer: A. Neonate’s brain wave patterns during REM sleep are different from the patterns of adults. Correct: For adults, REM brain waves look similar to waking brain waves, but for infants the REM brain waves are different. B. The neonate’s brain is 40% smaller than that of an adult and REM sleep increases its size. Incorrect: For adults, REM brain waves look similar to waking brain waves, but for infants the REM brain waves are different than during either waking or non-REM sleep. 75. What purpose do researchers believe is served by neonates’ extended periods of REM sleep? A. It assists the neonate in reducing stress. B. It helps neonates gain weight faster. C. It stimulates brain development. D. It promotes calm behavior. Answer: C. It stimulates brain development. Correct: Option C is that researchers believe extended periods of REM (Rapid Eye Movement) sleep in neonates play a crucial role in stimulating brain development. During REM sleep, the brain is highly active, and this activity is believed to be essential for processes such as memory consolidation, neural connectivity, and overall brain maturation in newborns. A. It assists the neonate in reducing stress. Incorrect: It is proposed that REM sleep stimulates brain development. 76. What is defined as automatic responses to certain kinds of stimulation? A. classical conditioning B. voluntary behavior C. reflexes D. Apgar scores Answer: C 77. Infants are born with 27 automatic responses that occur from being stimulated certain ways. These automatic responses are known as _______________. A. innate learning B. conscious behaviors C. reflexes D. superficial reactions Answer: C 78. _______________ is the reflex that helps the neonate find the nipple before they have learned how to feed from their mother’s breast. A. Babkin reflex B. Suckling reflex C. Moro reflex D. Rooting reflex Answer: D 79. What helps the neonate find the breast because it causes them to turn their heads and open their mouths when touched on the cheek or side of the mouth? A. Moro reflex B. Nursing reflex C. Grasping reflex D. Rooting reflex Answer: D 80. When caught off guard by the crash of thunder, 2-month-old Daiane arches her back, flails her arms outward, and then quickly brings them together in an embrace. Which of the following reflexes did the loud crash of thunder trigger? A. Babkin reflex B. rooting reflex C. Babinski reflex D. Moro reflex Answer: D. Moro reflex Correct: This reflex generally disappears by the third month. C. Babinski reflex Incorrect: With the Moro reflex, the neonate flings out his or her arms and then brings them quickly together in an embrace in response to a sensation of falling backwards or a loud sound. 81. Which of the following appear to have no apparent purpose for the infant? A. Dive and gag reflexes B. Morrow and rooting reflexes C. Deep tendon and suckling reflexes D. Babkin and Babinski reflexes Answer: D 82. The Babinski reflex is when _______________. A. the infant’s leg jerks forward as pressure is exerted on its knee B. the infant twists its foot inward as the sole of its foot is stroked C. the infant blinks as a puff of air is blown towards an eye D. the infant’s eyes track light as it is moved across its plain of view Answer: B 83. What is the earliest sense to develop in neonates? A. sight B. touch C. hearing D. smell Answer: B 84. In terms of pain, what did physicians believe about neonates until recent decades? A. They felt pain very sensitively. B. They did not feel pain. C. They could be soothed very quickly. D. They felt pain in the same manner as adults. Answer: B. They did not feel pain. Correct: They believed that even if neonates felt pain, it was less important than the danger of giving anesthetic medication to such a young child. A. They felt pain very sensitively. Incorrect: Physicians previously believed that neonates did not feel pain. 85. Which taste do neonates prefer? A. sweet B. sour C. bitter D. salty Answer: A 86. Some propose infants have a preference for sweet tasting items as an adaptive principle because _______________. A. adults have a preference for sweets B. sweet things have more calories C. breast milk is slightly sweet D. they have an aversion to bitter foods Answer: C. breast milk is slightly sweet Correct: Tasting something sweet can also have a calming effect on infants who are in pain. D. they have an aversion to bitter foods Incorrect: Sweets would be preferred, possibly because breast milk is slightly sweet. 87. _______________ is the ability to distinguish where a sound originates. A. Hemispheric separation B. Sound localization C. The Doppler Effect D. Auditory monitoring Answer: B 88. Which of the following are structures of the eye? A. lens, retina, cones, and optic nerve B. malleus, incus, stapes, and cochlea C. metatarsal, diaphragm, and cranial plate D. pharyngeal, nasopharynx, and oropharynx Answer: A 89. Which of the following best describes the visual abilities of a neonatal infant? A. their visual acuity is the same as the average adult B. their visual acuity is worse than the average adult C. their visual acuity is better than the average adult D. their visual acuity has never been measured Answer: B. their visual acuity is worse than the average adult Correct: Sight is the least developed of the average neonate’s senses. C. their visual acuity is better than the average adult Incorrect: The average infant has a visual acuity of 20/200 to 20/600, which means the clarity and accuracy of their perception of an object 20 feet away is comparable to a person with normal 20/20 vision looking at the same object from 200 to 600 feet away. 90. At what distance can neonates focus most accurately? A. 1 to 7 inches B. 8 to 14 inches C. 15 to 21 inches D. 22 to 28 inches Answer: B. 8 to 14 inches Correct: Vision improves steadily as their eyes mature, and reaches 20/20 some time in the second half of the first year. A. 1 to 7 inches Incorrect: Neonates focus most directly on items 8 to 14 inches away. 91. Infant’s visual acuity is at best a distance of _______________. A. 8–14 inches B. 24–44 inches C. 8–14 feet D. 24–44 feet Answer: A 92. _______________ occurs when we combine information from both eyes for perceiving depth and motion. A. Stereo vision B. Myopic vision C. Binocular vision D. Monocular vision Answer: C 93. At what age are infants able to use binocular vision, the ability to combine information from both eyes so that depth perception is possible? A. 3 to 4 months B. 9 to 10 months C. 15 to 16 months D. 21 to 22 months Answer: A 94. As an infant begins to crawl, their ability to perceive depth and motion improves dramatically. At what age do most infants have binocular and color vision? A. 1 to 2 months B. 3 to 4 months C. 1 to 2 years D. 3 to 4 years Answer: B 95. Neonates can distinguish between red and _______________, but not between white and other colors, probably because the _______________ is/are immature. A. white; cones B. green; retinas C. white; binocular vision D. pink; lens Answer: A 96. Neonates can distinguish between red and white but not between white and other colors. Why? A. Neonates are color blind. B. Their cone receptors are immature. C. Their retina is not developed. D. Neonates are not awake long enough to tell. Answer: B. Their cone receptors are immature. Correct: Cones are the part of the eye that identifies color. C. Their retina is not developed. Incorrect: Neonates’ cone receptors, those that detect color, are immature. Short Answer Questions 97. What are three possible causes of low birth weight? Indicate which is more likely in developed versus developing countries. Answer: • Malnutrition (more likely in developing countries) • cigarette smoking (more likely in developed countries) • multiple births (more likely in developed countries) 98. What is kangaroo care? Answer: This refers to the practice of putting preterm babies on their caregiver’s chest in skin-to-skin contact. This is soothing for both the parent and baby and has a number of beneficial health effects: regulates body functions, increases weight gain, reduces crying, increases sleep, and is correlated with lower mortality. 99. Discuss the research findings on the effects of infant massage. Answer: Developed as a way to soothe low-birth-weight babies and foster the human connection that was missing when they were in the isolettes, infant massage was found to have a number of benefits. Babies gain more weight and are more active and alert compared to controls who did not receive massage. 100. Name and describe two reflexes that you would see within the first eight months of a baby’s life. Answer: - rooting reflex- baby turns head and begins sucking in the direction of the cheek that was stimulated. Moro reflex- a response to fear (when experiencing the sensation of being dropped or when hearing a loud noise). Baby will arch her back and extend arms and legs, then bring her arms together as if trying to hold on to her caregiver. 101. Describe one sense that is well-developed before birth. Cite research in your response. Answer: Hearing or taste. Preference for sweet taste is present before birth as shown by studies that involved injecting artificial sweetener into the amniotic fluid. Babies showed an increase in sucking response. Essay Questions 102. You visit your relative who is working as a photojournalist in Africa. She takes you to a village where you see a newborn baby whose eyeballs have a yellowish tint. Is this normal? Explain. Answer: The baby has jaundice, a normal condition in the first days of life due to an immature liver. If the eyes are not white after a few days, that could indicate a problem. If left untreated it could cause brain damage. Exposure to sunlight (which contains vitamin D) is an effective treatment. 103. You visit your friend in the hospital after giving birth to her first child, and her husband mentions that he is so relieved that the APGAR score was a 9, so now he doesn’t have to worry about any problems. He states that, “My best friend had a baby with Down Syndrome, and their baby’s APGAR was really low; we are so lucky that our baby is above average in intelligence.” Explain what the APGAR stands for and comment on the above quote. Answer: The APGAR is a relatively quick way of assessing the overall health of the neonate. It is done 5 minutes after birth and then again at 30 minutes after birth. Babies are assessed on Appearance, Pulse, Grimace (reflex irritability), Activity (muscle tone), and Respiration, with a perfect score being 10 (2 on each dimension). The above quote is a misinterpretation of the meaning of the score on this scale. A child with an APGAR above 7 is in good health, but that in no way ensures that s/he is above average or even free of cognitive disabilities. MyDevelopmentLab Question Bank Pre-Test 1. Your sister and her husband just brought their baby son home from the hospital. They noticed two spots on his head that seemed to throb with each heart beat and were very concerned about this. It seemed very strange and they think there is a problem. What do you think? A. There is no problem. Those spots are fontanels and are supposed to be there. B. You think that your nephew should have corrective surgery. C. You are not sure, but think that they should have your nephew checked out by their doctor very soon. D. You think that your nephew has bone cancer. Answer: A 2. Neonates frequently have jaundice. Why? A. Neonates do not eat enough. B. Their livers are not mature yet and do not function properly. C. The heart is accumulating fluid. D. The mother may not be accustomed to breastfeeding yet. Answer: B 3. Your sister told you that your niece's Apgar score was 10. What does this mean? Your niece is _______________. A. doing extremely well because an Apgar score of 10 is the highest B. in critical condition because an Apgar score of 10 is extremely low C. doing OK because an Apgar score of 10 is in the mid-range D. doing well since an Apgar score of 10 is at the high range, with the ultimate score being 15 Answer: A 4. Which of the following is the most important indicator of a neonate's survival and health? A. Birth weight B. Gestational age C. Apgar score D. Brazelton score Answer: A 5. What type of neonate is four times more likely to die than preterm infants? A. Small-for-date neonates B. Colicky neonates C. Post-mature neonates D. Neonates with Apgar scores of 7 Answer: A 6. What is the name of the substance that coats the lungs and keeps the air sacs in the lungs from collapsing? A. Pulmonary gel B. Liquivent C. Surfactant D. Pulmonary mucus Answer: C 7. When individuals who were born with low birth weight become adolescents, they are more likely to ______ A. be obese and have poor muscle tone B. be depressed and reclusive C. have low intelligence test scores and be more likely to repeat a grade D. have poor secondary sexual characteristic development Answer: C 8. When neonates fall asleep, they nearly always instantly enter _______________. A. State I sleep B. EKG sleep C. EFP sleep D. REM sleep Answer: D 9. You are fascinated watching your neonate. Even when he is not doing much. He looks around and seems content. However, the other day you dropped a glass near him and he arched his back, flailed his arms, and started crying. What was going on? He was displaying _______________. A. the Babinski reflex B. the fear reflex C. the anger reflex D. the Moro reflex Answer: D 10. Infants have a preference for sweet-tasting items. It has been proposed that infants have this preference as an adaptive response because _______________. A. bitter items are generally poisonous B. sweet foods have more calories C. all humans have a preference for sweets D. breast milk is sweet Answer: D Post-Test 1. The "soft spots" on a neonate's head are called: A. Fontanels B. Sutures C. Cranium areas D. defects Answer: A 2. When your brother and his wife brought their neonate home from the hospital she weighed less than at birth. Why? A. They probably need to try to feed the newborn more frequently. B. It is typical for babies to lose weight right after birth. She should regain the weight before a couple of weeks go by. C. The wife probably cannot breastfeed and they should start formula feeding immediately. D. She must have an eating disorder Answer: B 3. Virginia Apgar developed a neonatal screening system. The Apgar scoring system assesses color, heart rate, breathing, muscle tone, and: A. Reflexes B. Speed of responding C. Strength D. weight Answer: A 4. A neonate is assessed on the Apgar scoring system at 1 and 5 minutes after birth. Why? A. The neonate's condition can change quickly. B. Physicians can make mistakes. C. The mother insists on it. D. Neonates cry too much at 1 minute to be assessed. Answer: A 5. According to the Brazelton NBAS, when are neonates considered at risk for early developmental problems? When the outcome of the NBAS is _______________. A. worrisome at time 1 and time 2 B. superior at time 1 and time 2 C. normal at time 1 and superior at time 2 D. worrisome at time 1 and superior at time 2 Answer: A 6. Your neighbor did all in her power to have a healthy pregnancy. However, she gave birth at 33 weeks and her neonate was "small for date." This means that her baby was _______________. A. born exactly as one would expect B. very short C. born weighing less than was expected for her gestational age D. lucky to have survived the birthing process Answer: C 7. Why are low birth-weight neonates at high risk for death? A. Because there was trauma to the placenta. B. No one knows, there was no factor that has been determined to be responsible. C. There was a disruption during prenatal development. D. Irresponsible parents Answer: C 8. Research has shown that there are effective interventions for low-birth-weight neonates to help them survive the first year of life. What is one of the most effective interventions? A. Constant-contact care B. Marsupial care C. Papoose care D. Kangaroo care Answer: D 9. You are fascinated watching your neonate sleep. She looks very peaceful and is very quiet. Even though she has not really been moving at all, you suddenly notice that her eyes are moving quite rapidly underneath her eye lids. What is happening? A. She is experiencing nervousness in that she must feel your presence. B. She is in hypersleep. C. She is convulsing. D. She is in REM sleep. Answer: D 10. Infants are born with automatic responses that help them to survive. These automatic responses are known as _______________. A. Innate learning B. Conscious behaviors C. Superficial reactions D. Reflexes Answer: D Chapter Exam 1. Fetuses have very large heads. What is an evolutionary adaptation to assist in delivering the fetus? A. The fetus is generally very small. B. The fetus' skull is not yet fused. C. The fetus has a very small head. D. The vaginal opening is very large. Answer: B 2. Neonates generally lose approximately 10% of their birth weight. How long does it take to gain it back? A. About a week B. 8 days C. About 2 weeks D. 2 days Answer: C 3. Lack of oxygen to the brain is referred to as _______________. A. Brain damage B. Anoxia C. Jaundice D. Synaptic pruning Answer: B 4. What Apgar score indicates that the newborn is in good to excellent condition? A. 1 to 3 B. 4 to 6 C. 7 to 10 D. 10 or greater Answer: C 5. Approximately when is the Brazelton NBAS administered? A. A day after birth or any time in the first 2 months B. A day prior to birth C. At one year D. Immediately after birth and then six months later Answer: A 6. What is the term for a neonate that weighs less than 5.5 pounds and is less than 37 weeks gestationally? A. Preterm B. Post-mature C. Very weak D. At risk Answer: A 7. What is the main cause for low birth weight in developed countries? A. Cigarette smoking B. HIV C. Malnourishment D. Iron deficiency Answer: A 8. What is the chance of survival for an infant who is born in the U.S. before the gestation age of 25 weeks? A. 40% B. 50% C. 60% D. 70% Answer: B 9. What technique is very useful for assisting low-birth-weight babies? A. Infant massage B. Smoking cessation programs for the parents C. Infant stimulation D. Parental education Answer: A 10. The average neonate sleeps how many hours a day? A. 8 to 10 B. 11 to 13 C. 16 to 17 D. 20 to 22 Answer: C 11. Adults spend about 20% of their sleep time in REM sleep. What percentage do neonates spend in REM sleep? A. 30% B. 50% C. 70% D. 90% Answer: B 12. What reflex helps the neonate find its mother's breast to feed? A. Babkin B. Sucklng C. Rooting D. Moro Answer: C 13. What sense is the first to develop in neonates? A. Smell B. Sight C. Touch D. Taste Answer: C 14. At what distance are infants' visual acuities the best? A. 8 to 14 inches B. 18 to 24 inches C. 30 to 36 inches D. 40 to 48 inches Answer: A 15. In terms of color vision, neonates can detect the differences between red and white, but not between white and other colors. Why? A. Their cones are immature. B. Neonates are color blind. C. Their retinas are not developed. D. Their rod receptors have not yet formed. Answer: A Quick Review 1. At what age will the pieces of the skull generally grow together so that the fontanels disappear? A. 6 months B. 12 months C. 18 months D. 24 months Answer: C 2. At what point does a neonate begin breathing on his or her own? A. After the physician slaps their buttocks B. As soon as it is exposed to air C. Two minutes after birth D. Just before they are born Answer: B 3. What percent of American neonates are born with an Apgar score from 7 to 10? A. 98% B. 76% C. 64% D. 52% Answer: A 4. A low-birth-weight neonate weighs less than _______________. A. 5.5 pounds B. 6.5 pounds C. 7.5 pounds D. 8.5 pounds Answer: A 5. Low birth weight in developed countries has been linked to mothers who _______________. A. smoke cigarettes B. abuse drugs C. are anemic D. are malnourished Answer: A 6. What intervention for low-birth-weight neonates is currently used in 75% of neonatal intensive care units in the United States? A. Ultrasound care B. Ultraviolet light care C. Kangaroo care D. Swaddling care Answer: C 7. In what ways are neonate's sleep-wake patterns governed? A. By activity level B. By light or dark cues C. By hunger and whether it is dark or light out D. By hormonal level Answer: C 8. Why do neonates have such extended periods of REM sleep? It _______________. A. promotes calm behavior B. assists the neonate in reducing stress C. helps with weight gain D. stimulates brain development Answer: D 9. What did physicians previously believe about neonates and pain? A. Pain could be smoothed very quickly in neonates. B. Neonates felt pain very intensely. C. Neonates enjoyed pain. D. Neonates did not feel pain. Answer: D 10. Neonates do not have the best vision. At what distance can neonates best focus? A. 1 to 7 inches B. 8 to 14 inches C. 15 to 21 inches D. 22 to 28 inches Answer: B Video Guide Questions Short Answer Questions 1. What are some of the advances in care that technology has provided to the NICU? Answer: High frequency ventilator & oscillator (both are oxygenation systems), monitors to continually watch the vital signs, and developmental care (workers are more educated) are a few of the advances in technology. 2. In this video, the speaker discussed several reasons why babies might end up in the NICU. List some of the causes that were mentioned and highlight those that can be controlled by the mother as well as those that cannot be controlled by the mother. Answer: Some of the reasons include premature labor, an incompetent cervix, pregnancy-induced hypertension, and drug or alcohol use. 3. What are some of the complications (both long and short term) that premature babies might encounter? Answer: Some of the complications include blindness, deafness, risk of infection, RDS, apnea, jaundice, delayed growth and development, mental and physical disabilities or delays, and cerebral palsy. Multiple Choice Questions 1. As noted by the nurse interviewed in this segment, the age of viability is about _______________. A. 23 weeks B. 28 weeks C. 30 weeks D. 34 weeks Answer: A 2. Which of the following drugs poses the greatest risk for early delivery of a premature baby? A. penicillin B. marijuana C. cocaine D. high blood pressure medication Answer: C 3. Compared to an adult, a premature baby’s breathing rate is _________________. A. much slower B. a little slower C. about the same D. much faster Answer: D Section 3 Caring for the Neonate Test Item File Multiple Choice Questions 1. The _______________ glands are responsible for milk production. A. thyroid B. pituitary C. mammary D. adrenal Answer: C 2. What expands greatly in size as milk-producing cells multiply and mature? A. areolas B. Montgomery glands C. milk cells D. mammary glands Answer: D 3. At what month gestation in humans are the breasts ready to produce milk? A. 2 B. 4 C. 8 D. 10 Answer: B 4. When a mother who is breast feeding hears her infant cry, what typically happens? A. breast-swelling reflex B. milking reflex C. let-down reflex D. lactation reflex Answer: C 5. Your friend is breast-feeding although no one in her family ever has. She is very concerned because it seems like whenever her infant cries, breast milk begins to flow even when she has not picked her baby up yet. What would you tell her is happening? A. She is having a breast-swelling reflex. B. She is experiencing a milking reflex. C. She is experiencing the let-down reflex. D. She is having a lactation reflex. Answer: C. She is experiencing the let-down reflex. Correct: It is that it accurately describes the phenomenon experienced by the breastfeeding mother. The let-down reflex, also known as the milk ejection reflex, is triggered by various stimuli such as the sound of the baby crying, the sight or smell of the baby, or even just the thought of breastfeeding. A. She is having a breast-swelling reflex. Incorrect: A let-down reflex in the mother’s breasts causes milk to be released to the tip of her nipples whenever she hears the sound of her infant’s cry, sees its open mouth, or even thinks about breast-feeding. 6. _______________ is a reflex that causes milk to be released if a mother hears the cry of her infant, sees an open mouth, or even thinks about breast-feeding. A. Babinski reflex B. Let-down reflex C. Sneeze reflex D. Feeding time reflex Answer: B 7. At 30 minutes after birth, what are the neonate’s strongest reflexes? A. sucking and rooting reflexes B. Moro and Babinski reflexes C. Palmer and plantar reflexes D. swimming and walking reflexes Answer: A. sucking and rooting reflexes Correct: Within a few days neonates also recognize their mother’s smell and the sound of her voice, which helps orient them for feeding. C. Palmer and plantar reflexes Incorrect: At 30 minutes after birth, the sucking and rooting reflexes are the strongest reflexes. 8. Soon after birth an infant will root for a nipple and begin to suckle. How long after birth is this likely to occur? A. 30 minutes B. 60 minutes C. 90 minutes D. 120 minutes Answer: A 9. Within a few days, neonates _______________. A. are able to crawl and have depth perception B. recognize their mother’s smell and the sound of her voice C. have 20/20 vision and see in color D. have a strong receptive language but lack expressive skills Answer: B 10. Chimpanzees breast-feed their infants for about _______________ years. A. 2 B. 3 C. 4 D. 5 Answer: C 11. According to archaeological and historical evidence, most cultures breast fed their infants as a primary or sole source of food for _______________ years, followed by _______________ years of occasional nursing. A. 0–1; 0–1 B. 1–2; 1–2 C. 2–3; 2–3 D. 3–4; 3–4 Answer: C 12. To support hypotheses on breast-feeding that have been generated from archaeological and historical evidence, researchers have also examined _______________. A. modern cultural practices in Southeast Asia B. modern hunter-gatherer cultures in Central Africa C. historic zoological records in Central America D. historic volcanic records in mainland China Answer: B. modern hunter-gatherer cultures in Central Africa Correct: The !Kung San provide evidence that traditional cultures throughout human history had similar breast-feeding habits. C. historic zoological records in Central America Incorrect: Modern-day hunter-gatherer cultures in Central Africa provide evidence that traditional cultures through human history had similar breast-feeding habits. 13. What have anthropologists concluded regarding the proximity of mothers and infants during infancy? For 99% of human history, infants were _______________. A. cared for by their older sisters B. only picked up during feeding C. bound or close to their mothers almost constantly D. separated from their mothers for sleeping Answer: C. bound or close to their mothers almost constantly Correct: In traditional, nonindustrial cultures, it is typical for infants to be bound to or close to their mothers almost constantly, day and night, allowing for frequent feeding. B. only picked up during feeding Incorrect: In traditional, nonindustrial cultures, it is typical for infants to be bound to or close to their mothers almost constantly, day and night, allowing for frequent feeding. 14. Over the course of history, which of the following have been common substitutes for breast milk? A. sheep’s and dog’s milk B. goat’s and elephant’s milk C. cow’s and goat’s milk D. cat’s and cow’s milk Answer: C 15. Assume you’re living in a tribal group in Africa and one of the village mothers cannot produce enough breast milk for her infant. Which the following would most likely serve as a substitute for a mother’s breast milk? A. sheep’s milk B. goat’s milk C. elephant’s milk D. dog’s milk Answer: B. goat’s milk Correct: These are two species that are domesticated in many cultures and so readily available. D. dog’s milk Incorrect: Goat’s and cow’s milk are commonly used as a substitute for a mother’s breast milk. 16. What name is given to a lactating woman who breast-feeds an infant but is not its mother? A. wet nurse B. breast-feeding nurse C. surrogate mother D. lactating non-mother Answer: A 17. Historically, if a mother could not or did not want to breast-feed she might have used a(n) _______________. A. lactation consultant B. wet nurse C. midwife D. obstetrician/gynecologist Answer: B 18. Your grandmother is convinced that formula is the best way to feed infants because that is the way that she was fed as an infant. Although you do not want to argue, why did her mother’s generation formula feed rather than breast-feed? A. Companies that produced formula convinced the public that formula feeding was the healthiest way to feed infants. B. Your great-grandmother was correct, we should be formula feeding. C. In the 1930s and 1940s it was much more difficult to breast-feed. D. Evidence is now beginning to emerge indicating that breast-feeding can be dangerous to infants. Answer: A. Companies that produced formula convinced the public that formula feeding was the healthiest way to feed infants. Correct: Doctors were persuaded—thanks in part to generous payments from the corporations—and they in turn persuaded new mothers to use the milk substitutes. B. Your great-grandmother was correct, we should be formula feeding. Incorrect: Breast-feeding is the best approach. Companies that produced formula marketed their product well and convinced people to formula feed. 19. Imagine that it is the late 1800s, and you and your wife are speaking with the doctor discussing how to best care for your newborn baby. Your doctor would recommend that the baby be given _______________. A. calcium supplements B. high fructose corn syrup C. a multivitamin D. condensed or evaporated milk Answer: D. condensed or evaporated milk Correct: During the Industrial Revolution, many women were misinformed and led to believe that breast milk substitutes were best for their infant. A. calcium supplements Incorrect: During the Industrial Revolution, many women were misinformed and led to believe that breast milk substitutes were best for their infant. 20. With the advent of condensed and evaporated milk in the late 1800s and its continuous growth in popularity in the United States, by 1940 what percent of mothers breast fed their babies? A. 10–20% B. 20–30% C. 30–40% D. 40–50% Answer: B 21. Toward the 1970s, scientific evidence had accumulated and which of the following statements is true? A. breast milk is far better than any substitute B. the majority of births in the United States take place at home with the use of a midwife C. cesarean sections are far riskier now then they have ever been before D. modern milk-formula is far better than breast milk Answer: A. breast milk is far better than any substitute Correct: It is grounded in the scientific evidence accumulated towards the 1970s, which supported the notion that breast milk is superior to any substitute. This evidence led to a shift in medical advice, advocating for breastfeeding due to its numerous benefits for infant health and development. D. modern milk-formula is far better than breast milk Incorrect: In just recent times, medical practitioners have encouraged breast-feeding due to its beneficial effects over prepared formula. 22. Supported by research, UNICEF and the World Health Organization have begun a campaign to _______________. A. promote breast-feeding B. improve the nutritional value of milk-based formula C. seek political asylum for those who are of childbearing age D. encourage the use of rice as a substitute for breast milk Answer: A 23. What percentage of infants are currently breast fed in the United States and Canada? A. 10% B. 40% C. 70% D. 99% Answer: C 24. Which of the following are correlating factors as to whether a mother will breast-feed? A. social economic status, age, and personality traits B. family income, temperament, and level of education C. geographical location, level of education, and temperament D. age, level of education, and social economic status Answer: D. age, level of education, and social economic status Correct: These are all positive correlating factors when it comes to the likelihood that a mother will breast feed. C. geographical location, level of education, and temperament Incorrect: Age, level of education, and social economic status exist in a positive correlation for breast-feeding. 25. In general, the higher the mother’s age, educational level, and socioeconomic status, the more likely she is to _______________. A. breast-feed B. formula feed C. be unable to breast-feed D. use supplements along with formula feeding Answer: A 26. Compared to breast milk, formula lacks which of the following? A. protein B. antibodies C. calcium D. vitamin D Answer: B 27. What contains antibodies and other substances that strengthen the baby’s immune system? A. Formula that contains supplements B. Solutions that are injected into the baby C. Vitamin supplements for infants D. Breast milk Answer: D 28. Breast-fed babies have been shown to have a lower rate of illnesses and disease such as diphtheria, pneumonia, ear infections, and diarrhea. Which of the following is an explanation for this lower rate? A. breast milk contains a high level of white blood cells B. breast milk contains antibodies C. breast milk contains penicillin D. breast milk contains a high level of platelets Answer: B. breast milk contains antibodies Correct: Breast milk contains viral antibodies that are produced by the mother and are passed to the infant. C. breast milk contains penicillin Incorrect: Breast milk contains viral antibodies that are produced by the mother and are passed to the infant. 29. What is a hypothesis regarding why breast-fed infants tend to score higher than bottle-fed infants on measures of cognitive functioning? A. They actually do not; this has been an artifact of research. B. Mothers who breast-feed are considerably more intelligent than those who do not breast-feed. C. Breast milk contains nutrients that promote early brain development D. Mothers play with their infants during breast-feeding. Answer: C. Breast milk contains nutrients that promote early brain development Correct: Even after controlling for many other factors such as parents’ intelligence and education, breast-fed babies tend to score higher in measures of cognitive functioning. D. Mothers play with their infants during breast-feeding. Incorrect: Breast-fed infants tend to score higher than bottle-fed infants on measures of cognitive functioning, perhaps because the nutrients in breast milk promote early brain development. 30. Which the following are three major benefits of breast-feeding? A. increased bonding, weight reduction, and lower prevalence of diabetes B. convenience, overwhelming popularity, and economically viability C. the passing of antibodies, increased cognitive development, and reduced childhood obesity D. a lower prevalence of personality disorders, increased cognitive development, and an increased frequency of mild temperament Answer: C. the passing of antibodies, increased cognitive development, and reduced childhood obesity Correct: Scientific research has demonstrated these and other benefits of breast-feeding over formula. A. increased bonding, weight reduction, and lower prevalence of diabetes Incorrect: The passing of antibodies, cognitive development, and reduced childhood obesity are all documented positive effects of breast-feeding. 31. What reduces the likelihood of obesity in childhood? A. breast-feeding for six months B. introducing solid foods as early as possible C. formula feeding for at least a year D. encouraging the infant to walk as soon as possible Answer: A. breast-feeding for six months Correct: This is especially important in developed countries, where rates of obesity have risen dramatically in recent decades. B. introducing solid foods as early as possible Incorrect: Breast-feeding for six months reduces the likelihood of childhood obesity. 32. Of the benefits listed below, which one has not been associated with breast-feeding and health in adolescence and adulthood? A. superior bone density B. taller stature C. enhanced vision D. improved cardiovascular functioning Answer: B 33. Breast-feeding triggers the release of the hormone oxytocin. What effect does oxytocin have for mothers during the days following the birth of their neonates? A. decreases blood pressure B. starts the process of ovulation C. reduces bleeding in the uterus D. delays abdominal cramping Answer: C. reduces bleeding in the uterus Correct: Oxytocin reduces the likelihood of ovulation and reduces bleeding in the uterus. B. starts the process of ovulation Incorrect: Oxytocin reduces the likelihood of ovulation and reduces bleeding in the uterus. 34. Nursing helps the mother return to her pre-pregnancy weight. Nursing requires the mother to burn how many additional calories per day? A. 10-400 B. 500–1,000 C. 2,000–2,500 D. 4,000–4,500 Answer: B 35. Your neighbor who just gave birth has always been a health nut, is very careful what she eats, and is interested in getting back to her pre-pregnancy weight. What advice could you give her? She should: A. Go on a restrictive diet and reduce her caloric intake by 500 calories. B. Eat regularly and breast-feed, which burns approximately 500 to 1,000 calories. C. Consider taking diet pills D. Run at least 5 miles a day to burn an extra 500 calories. Answer: B. Eat regularly and breast-feed, which burns approximately 500 to 1,000 calories. Correct: Nursing the neonate helps mothers return to their pre-pregnancy weight. C. Consider taking diet pills Incorrect: Since breast-feeding burns additional calories, eating regularly and breast-feeding will take the weight off quicker and more healthily. 36. Which of the following are known benefits for the mother who breast-feeds? A. stress reduction, increased development of a mild personality, and weight reduction B. the slowing of metabolism, increased patience, and increased bonding C. reduction in bleeding of the uterus, increased weight loss, and increased release of oxytocin D. reduction of white blood cells, increased lactation, and weight reduction Answer: C. reduction in bleeding of the uterus, increased weight loss, and increased release of oxytocin Correct: Nursing has long-term effects as well on mothers’ health, strengthening their bones, and reducing their risk of ovarian and breast cancer even many years later. D. reduction of white blood cells, increased lactation, and weight reduction Incorrect: Reduction in bleeding of the uterus, increased weight loss, and increased loss of oxytocin are all known benefits for the mother who breast-feeds. 37. According to the World Health Organization, it is recommended that women breast-feed for a period of _______________. A. 6 months, with solid foods being introduced immediately B. 1 year, with solid foods being introduced at 3 months C. 2 years, with solid foods being introduced at 6 months D. 3 years, with solid foods being introduced at 1 year Answer: C 38. What is the name of the thick, yellowish milk that is extremely rich in protein and antibodies that the mother first produces? A. milk precursor B. breast milk C. colostrum D. yellow milk Answer: C 39. _______________ is a thick, yellowish liquid that is extremely rich in protein and antibodies that strengthen the neonate’s immune system. A. Epidural B. Colostrum C. Lanugo D. Rh factor Answer: B 40. Your friend wants to breast-feed and has been very excited about it since she became pregnant. She was horrified to think that she would not be able to breastfeed her neonate since the first day a thick yellowish substance was coming from her breasts whenever she wanted to breast-feed. What would you tell her? A. That was colostrum, which is rich in proteins and antibodies and is completely normal and expected. B. She is correct, something is definitely wrong with her breast milk. C. That substance is “yellow milk” and is very sweet, which entices the baby to want to breast-feed. D. She should not breast-feed until her “regular” breast milk comes in. Answer: A. That was colostrum, which is rich in proteins and antibodies and is completely normal and expected. Correct: Colostrum is especially important for neonates to receive, but it lasts only a few days. B. She is correct, something is definitely wrong with her breast milk. Incorrect: This is completely normal and is referred to as colostrum, which is rich in proteins and antibodies. 41. As compared to developing nations, in developed nations the benefits of breast-feeding are _______________. A. greater B. the same C. relatively small D. nonexistent Answer: C 42. Breast-feeding in developing countries is extremely important. UNICEF estimates that _______________ babies die each year because they are bottle-fed rather than breast-fed. A. 100,000 B. 150,000 C. 1 million D. 1.5 million Answer: D 43. You are having a heated debate regarding breast-feeding in developing countries with your father. He claims that because of the shortage of food in some developing countries, we should provide formula to these mothers. You argue that breast milk is a better way to go and that a great number of children die because they are formula fed. What do you tell your father why formula-feeding is not really such a great idea? A. You finally concede since you discover that women in developing countries cannot breast-feed. B. You finally concede because you learn that malaria can be spread through breast milk. C. The formula is often mixed with contaminated water, which leads to 1.5 million infant deaths per year. D. The formula is tainted in shipment, which causes severe illness and death Answer: C. The formula is often mixed with contaminated water, which leads to 1.5 million infant deaths per year. Correct: Infant formula is typically mixed with water, and in many developing countries the available water is not purified and may contain disease. D. The formula is tainted in shipment, which causes severe illness and death Incorrect: The formula is generally mixed with contaminated water which leads to illness and death. 44. What is one of the most damaging aspects of formula feeding in developing countries? A. Mothers have no means to sterilize the nipples on the bottles. B. The formula is mixed with contaminated water. C. Fathers refuse to assist in the bottle-feeding of their infants. D. Mothers are likely to die prematurely and leave the infant malnourished. Answer: B. The formula is mixed with contaminated water. Correct: In many developing countries the available water is not purified and may contain disease. A. Mothers have no means to sterilize the nipples on the bottles. Incorrect: One of the most damaging aspects of formula feeding in developing countries is that the formula is mixed with contaminated water. 45. What mothers in developing countries would be advised not to breast-feed? A. very poor mothers B. mothers who could afford to formula feed C. mothers with small breasts D. mothers with infectious diseases such as HIV/AIDS Answer: D. mothers with infectious diseases such as HIV/AIDS Correct: Infectious diseases such as HIV/ AIDS, tuberculosis, or West Nile virus could be transmitted through breast milk. B. mothers who could afford to formula feed Incorrect: Mothers who have infectious diseases such as HIV/AIDS are not advised to breast-feed. 46. Which of the following is a reason why a mother should not breast-feed? A. The World Health Organization recommends breast-feeding should only occur as a last resort. B. Modern formula is far better than breast milk. C. The mother has an infectious disease such as HIV/AIDS, tuberculosis, or West Nile virus. D. The American Pediatric Association supports the use of high-protein milk-based formula. Answer: C. The mother has an infectious disease such as HIV/AIDS, tuberculosis, or West Nile virus. Correct: Infectious diseases could be transmitted through breast milk. B. Modern formula is far better than breast milk. Incorrect: Viruses can travel through the breast milk to infect an infant. 47. Even though a high percentage of mothers in developing countries could safely breast-feed, why is there such a low rate of breast-feeding in these areas? A. They have no training on how to breast-feed. B. Corporations have unethically convinced mothers that formula is better. C. Religious practices discourage women from breast-feeding. D. Poor women in these areas are malnourished and are not capable of breast-feeding. Answer: B. Corporations have unethically convinced mothers that formula is better. Correct: The marketing campaigns of corporations selling infant formula have deceived many women into believing formula is actually better for infants than breast milk is. A. They have no training on how to breast-feed. Incorrect: Companies have unethically convinced mothers that formula is better than breast milk. 48. What type of cry is a “warm-up” cry that occurs when babies are mildly distressed? A. happy B. pain C. anger D. fussing Answer: D 49. When a baby is fussing, their cry is closer to a ____ A. complete panic where all control is lost B. warming up and a mild distress C. moderate-grade distress which may transition into panic suddenly D. panic attack Answer: B. warming up and a mild distress Correct: It is fairly soft in volume, an unsteady whimper punctuated by pauses and long intakes of breath. C. moderate-grade distress which may transition into panic suddenly Incorrect: Fussing is a kind of warm-up cry. 50. According to the text, what type of cry expels a large volume of air through the vocal cords? A. happy B. anger C. pain D. fussing Answer: B 51. Which of the following are three types of crying that an infant may demonstrate? A. tantrum, angry, and hungry B. fussing, anger, and pain C. gassy, sleepy and fussing D. sleepy, hungry, and upset Answer: B 52. What type of cry has a sudden onset with no initial fussing? The baby takes a large intake of breath and holds it then lets loose. A. happy B. anger C. pain D. fussing Answer: C 53. Baby Jane was just bottle-fed by a babysitter. Having very little experience, her babysitter forgot to burp her. As a result of a buildup of gas, baby Jane is in extreme pain and begins to cry. Which of the following best captures Jane’s cry? A. a cry that expels a small volume of air through the vocal cords B. a large intake of breath, briefly held, then let loose C. soft in volume, an unsteady whimper punctuated by pauses and long intakes of breath D. a warm-up cry with mild whimpers Answer: B. a large intake of breath, briefly held, then let loose Correct: It is that it accurately describes the pain cry typically exhibited by infants in response to discomfort, such as gas buildup. A pain cry often involves a sudden and intense intake of breath, followed by a brief pause, and then a vigorous expulsion of air through the vocal cords. This pattern reflects the infant's attempt to release tension and communicate distress caused by physical discomfort. A. a cry that expels a small volume of air through the vocal cords Incorrect: A pain cry has a sudden onset, with no fussing to herald it. The baby takes a large intake of breath and holds it, then lets loose. 54. Most parents can generally distinguish between the different types of cries their infants at _______________ month(s). A. 1 B. 2 C. 3 D. 4 Answer: A 55. According to the text, what type of cry does not have a distinctive cry and can occur when the baby is hungry, lonely, has wet or soiled diapers, is tired, or uncomfortable? A. basic B. pain C. anger D. fussing Answer: A 56. Why is it important for parents to remember that a lot of the crying that infants do in their early life occurs for no particular reason? A. It triggers distress in those around the infants B. It is thought to communicate important information C. It is just a way for infants to increase lung volume D. It has no communicative purpose Answer: A. It triggers distress in those around the infants Correct: Crying can be very frustrating for parents and caretakers. D. It has no communicative purpose Incorrect: Crying triggers distress in those around the infants and can be very frustrating. 57. Early in their lives, four out of five American infants have frequent episodes of crying that last for 15 or more minutes _______________. A. because of separation anxiety B. for no apparent cause. C. as a function of frustration for lack of parental attention. D. because their environment is not warm enough. Answer: B. for no apparent cause. Correct: It behind choosing option B is that it accurately reflects the phenomenon described in the statement. The majority of American infants experience frequent episodes of crying lasting 15 minutes or more during their early months of life, often without any apparent cause. A. because of separation anxiety Incorrect: Four out of five American infants have daily crying episodes in the early months of life that last least 15 minutes and do not have any apparent cause. 58. Your next-door neighbors are going crazy. They brought their newborn home from the hospital only to find that he cries for long periods of time and do not know what to do about it. What would you tell them? A. The baby might have diaper rash. B. Many American infants cry frequently for no apparent cause. C. The incessant crying indicates that there is a neurological problem. D. It is because they have a lot to learn as parents, but they will figure it out. Answer: B. Many American infants cry frequently for no apparent cause. Correct: This is important for parents to remember, because distress in neonates often triggers distress in those around them. C. The incessant crying indicates that there is a neurological problem. Incorrect: Many American infants cry frequently for no apparent reason. 59. In cultures where babies are held or carried around much of the day _______________. A. prolonged episodes of crying are common. B. prolonged episodes of crying are rare. C. they cry because infants need time alone. D. they cry because they sense that their mothers are frustrated with them. Answer: B 60. Compared to American mothers, Korean mothers _____ A. rarely carry their infants and allow them to cry longer B. were no different in the way they responded to their infants C. carried their infants twice as long per day and responded to their infants immediately D. never carried their infants, but responded to them immediately Answer: C. carried their infants twice as long per day and responded to their infants immediately Correct: It is grounded in the comparison between American and Korean mothers' caregiving practices. Research indicates that Korean mothers tend to carry their infants for longer periods each day and respond to their infants' needs more promptly compared to American mothers. This cultural difference highlights varying approaches to infant care and responsiveness to infant cues. A. rarely carry their infants and allow them to cry longer Incorrect: Compared to American mothers, Korean mothers carry their infants twice as long per day and respond to their infants immediately. 61. When comparing the crying behaviors of South Korean infants to the crying behaviors of American infants it is clear that: A. the behaviors of the mother influenced the average length of time an infant cries. B. temperament varies between cultures and affects the length of time an infant cries. C. there are no differences between cultures in length of time that an infant cries. D. the attitudes of the father influence their infants length of crying. Answer: A. the behaviors of the mother influenced the average length of time an infant cries. Correct: Option A is that it reflects the difference observed between South Korean and American infants in terms of maternal responsiveness to infant crying. Research suggests that South Korean mothers tend to respond more quickly to their infants' cries compared to American mothers, which can influence the average length of time an infant cries. C. there are no differences between cultures in length of time that an infant cries. Incorrect: Mothers in South Korea are quicker to respond to their infant’s cry than American mothers. 62. In the experiment by Hunziker and Barr (1986), mothers in Group A were instructed to carry their infants for at least three hours a day while the mothers in Group B were not given any special instructions. What were the results? A. There were no differences between Group A and B infants. B. Both groups of infants cried the same number of times, but Group A infants cried half as long Group B infants. C. Group B infants learned to sooth themselves and cried less than Group A infants. D. Group B infants cried many more times during the day than Group A infants. Answer: B. Both groups of infants cried the same number of times, but Group A infants cried half as long Group B infants. Correct: This suggests a positive correlation between carrying infants, and reduced duration of crying. A. There were no differences between Group A and B infants. Incorrect: Group A infants cried half as long as Group B infants even though they cried as frequently. 63. When neonates in traditional cultures cry, what are the two common responses that occur? A. breast-feeding and swaddling B. picking them up and rocking them C. singing to them and letting them continue to cry D. ignoring them and walking away Answer: A 64. _______________ and _______________ are two common techniques used in traditional cultures to comfort a crying infant. A. Walking; caressing B. Rocking; singing C. Breast-feeding; swaddling D. Lightly bouncing; patting Answer: C 65. As a means to comfort a neonate infant, _______________ is when babies are wrapped tightly in cloths or a blanket so that their arms and legs cannot move. A. swaddling B. snuggling C. securing D. sneaking Answer: A 66. What condition occurs when crying is of extreme duration? A. colic B. dysphoric crying C. intestinal inflammation D. infant abuse Answer: A 67. What is it called when babies cry for more than three hours a day over more than three days at a time for more than three weeks? A. dysphoric crying B. colic C. autism spectrum disorder D. incessant crying Answer: B 68. The rules of threes: If the crying goes on for more than three hours a day, over more than three days at a time and for more than three weeks is the infant is _______________. A. easy tempered B. colicky C. overly gassy D. melancholy Answer: B 69. You are having a conversation with a friend who has a colicky baby and is worried about the long-term effects. Which the following is an appropriate response? A. Most professional athletes were colicky babies so long-term effects are desired. B. Colicky babies are more likely to be difficult tempered so she should speak to her pediatrician. C. Evidence shows that there appears to be no long-term effects of colic during infancy. D. The research shows that babies with colic have higher IQs overall. Answer: C. Evidence shows that there appears to be no long-term effects of colic during infancy. Correct: How- ever, this may be of little comfort to parents who must endure the persistent crying of an inconsolable infant for many weeks. B. Colicky babies are more likely to be difficult tempered so she should speak to her pediatrician. Incorrect: Research has shown that there are no long-term physical, emotional, or social effects of colic. 70. According to Zeskind and Lester (2001), what is a risk factor for parental mistreatment of infants? A. infants post mature at birth B. lower income levels C. colic D. lower intelligence levels Answer: C 71. What is the instant and enduring bond to the first moving object that geese see after hatching? A. attachment B. imprinting C. mother-offspring relationship D. mother-offspring reunion Answer: B 72. Unlike other animals, human infants do not _______________. A. seek B. imprint C. attach D. connect Answer: B 73. Who first identified the imprinting process in which geese would bond to any moving object they saw soon after hatching, including him? A. Lev Vygotsky B. Konrad Lorenz C. B. F. Skinner D. Jean Piaget Answer: B 74. In humans, what was the name of the concept suggesting that shortly after birth was a critically important time for mothers and infants, quite similar to what occurs in animals? A. bonding B. imprinting C. attachment D. evaluating Answer: A 81. What did the research examining the concept of bonding in humans discover? A. that bonding is critically important to infant’s development B. that only good mothers can bond with their infants C. that fathers can not bond with their infants D. that bonding immediately with a caregiver does not cause developmental problems later in life for infants Answer: D. that bonding immediately with a caregiver does not cause developmental problems later in life for infants Correct: The concept of human bonding did have the unintended positive effect of inspiring hospitals to reexamine their policies of separating mother and child immediately after birth. C. that fathers can not bond with their infants Incorrect: Humans are not at risk for later emotional and social problems if they do not bond with a caregiver in the first minutes, hours, or days after birth. 75. _______________ of mothers and _______________ of fathers feel overwhelmed by the burden of caring for a newborn in the United States and the United Kingdom. A. 20%; 60% B. 15%; 30% C. 10%; 4% D. 0 %; 5% Answer: C 76. In the United States and the United Kingdom what percent of fathers experience postpartum depression? A. 4% B. 8% C. 12% D. 16% Answer: B 77. What can happen when rapid post-birth hormonal changes occur and the high concentrations of estrogen and progesterone return to normal levels? A. increased probability of ovulation B. rapid weight loss C. postpartum euphoria D. postpartum depression Answer: D. postpartum depression Correct: About 10% of new mothers report experiencing postpartum depression. C. postpartum euphoria Incorrect: This condition is referred to as postpartum depression. 78. For some parents the burdens of caring for a newborn are overwhelming. According to your text, what condition can occur if parents feel completely overwhelmed, which can lead to intense sadness and anxiety? A. postpartum depression B. childcare depression C. parental neurosis D. infant abuse Answer: A 79. Your friend is very concerned because his wife seems to be overwhelmed by the responsibilities of caring for an infant. They were both extremely excited when they became pregnant, but now his wife is intensely sad and anxious. What do you tell him she probably has? A. postpartum depression B. childcare depression C. parental neurosis D. infant abuse Answer: A. postpartum depression Correct: About 10% of new mothers report experiencing postpartum depression. C. parental neurosis Incorrect: She is exhibiting symptoms of postpartum depression. 80. What is a risk factor for postpartum depression? A. The mother has lower intelligence and less education. B. The mother had symptoms of major depression before pregnancy. C. The mother had no support from her partner. D. The mother smoked. Answer: B 81. Which of the following is related to the likelihood that a mother develops postpartum depression? A. being diagnosed with a sleeping disorder B. a history of having a difficult temperament C. a history of major depression D. having extreme changes in appetite and difficulty sleeping Answer: C 82. Infants who are irritable, have problems eating and sleeping, and have difficulty forming attachments are more likely to have mothers who have _______________. A. schizophrenia B. postpartum depression C. no health insurance D. no support from their partners Answer: B 83. Infants born to mothers with postpartum depression have been found to be more likely to have higher rates of _______________. A. malnutrition and calcium deficiency B. conduct disorder with a greater tendency to become oppositionally defiant C. irritability, problems eating and sleeping, and difficulty forming attachments D. schizophrenia and eating disorders Answer: C 84. An association has been found between postpartum depression and infant characteristics. What is a major difficulty involved in interpreting this relationship? A. There has been no genotype discovered that is directly linked with postpartum depression. B. It cannot be determined if the postpartum depression caused poor infant characteristics or if the poor infant characteristics caused postpartum depression. C. There has been no genotype discovered that is directly linked with poor infant characteristics. D. The mother’s and infant’s genotype are too closely related to interpret the relationship. Answer: B. It cannot be determined if the postpartum depression caused poor infant characteristics or if the poor infant characteristics caused postpartum depression. Correct: There has been no way to determine causality. A. There has been no genotype discovered that is directly linked with postpartum depression. Incorrect: There has been no way to determine causality. 85. Research examining postpartum depression has found that mothers with postpartum depression talk to, look at, touch, and smile _______________. A. more at their infants than mothers who do not have postpartum depression B. the exact same amount as mothers without postpartum depression C. less at their infants than mothers who do not have postpartum depression D. the same amount as mothers without postpartum depression, but hold and rock them more Answer: C Short Answer Questions 87. What are two variables that correlate with breastfeeding in developed countries? Answer: More highly educated mothers are more likely to breast feed. Older mothers are more likely to breastfeed. In developed countries, higher levels of education and socioeconomic status are positively correlated with breastfeeding rates. 88. Are there ethnic differences in breastfeeding in the U.S.? Explain your response. Answer: Yes, there are ethnic differences. African American women breast feed less than their Latino and White counterparts, but the rates are rising across all ethnic groups. 89. What is colostrum? Do all cultures view it similarly? Explain. Answer: It is the thick, rich liquid that is produced right after the baby is born and ceases to be produced after a few days. It has a high concentration of protein and antibodies, making it very important for the neonate’s health. In some cultures it is considered bad for babies, perhaps because it looks so different from breast milk. In India, babies are given a mixture of honey and butter that looks similar to it, but is believed to be safer. 90. Why is breastfeeding even more crucial in developing countries than in developed countries? Answer: In developing countries the risks of many diseases are much higher than in developed countries, so it is even more important that babies receive the benefits to the immune system from breastfeeding. In addition, in poor, developing countries, those who do not breastfeed mix their formula with water that is often contaminated. They may even dilute the formula, leading to malnutrition. Breastfeeding in developed countries is often a matter of life and death. 90. As you arrive to babysit your cousin’s six-week-old baby so she and her husband can go out, you find her swaddling the baby on the couch. You ask her why she is doing that. In fact, you wonder if it will negatively affect the baby’s motor skills as well as make her cry more because her movement is so restricted. Drawing upon research, what does your cousin tell you? Answer: Swaddling is soothing for babies and reduced their crying. It is practiced in many cultures and does not inhibit motor development. Essay Questions 91. Consider two American women of similar ethnic and socioeconomic backgrounds: one who gave birth in the 1950’s and the other who gave birth in the 1970’s. Which one would be more likely to have breastfed? Explain why. Briefly explain breastfeeding trends in the U. S. from the 1980’s until today. Answer: The mother from the 70’s would be more likely to breastfeed because research was coming out on the many benefits. There were also campaigns to promote it. In the 40’s and 50’s new formulas were coming on the market convincing mothers that it was better than breast milk, and some people considered it more modern (even less barbaric) to use formula. Since the 80’s the percentage of women breastfeeding has increased. 92. Your good friend tells you that she is going to breastfeed for as long as she can, no matter how hard it is when she returns to work because “she knows that breastfed babies are smarter.” She says that she would feel guilty if she stopped before her baby turned one because she would be “disadvantaging her child.” How could you explain the research in such a way that she would feel better about her decision if she chose to stop breastfeeding after a couple of months? Answer: Research has shown that breastfeeding is correlated with a number of positive outcomes, such as higher intelligence in offspring. However, correlation does not imply causation. It could be that differences in outcomes could be due to differences in the mothers’ education and the quality of the environment that comes along with a higher SES. Studies have tried to take these differences into account statistically, but they are still confounded. Furthermore, even if some studies have found the IQ to be even a few points higher among those children who were breastfed, IQ is not the only determinant of success. MyDevelopmentLab Question Bank Pre-Test 1. Which glands increase in size as milk-producing cells multiply and mature in preparation for the neonate? A. Mammary glands B. Adrenal C. Thyroid D. Pituitary Answer: A 2. Anthropologists have suggested that for 99% of human history, infants were _______________. A. cared for by their older sisters B. only picked up during feeding C. bound or close to their mothers almost constantly D. separated from their mothers for sleeping Answer: C 3. In the United States and Canada what percentage of infants are breast-fed? A. More than 70% B. 60% C. Under 50% D. 40% Answer: A 4. Breast-fed infants tend to score higher than bottle-fed infants on measures of cognitive functioning. Why? A. Breast milk contains nutrients that promote early brain development. B. They actually do not; this is an artifact of research. C. Mothers play with their infants during breast feeding. D. Mothers who breast feed are considerably more intelligent than those who do not breast feed. Answer: A 5. Your sister wanted to breast feed, but on the first day a very thick yellowish substance was coming from her breasts whenever she wanted to breast feed. She thinks that she will not be able to breast feed because this is abnormal. What would you tell her? A. The substance is colostrum, which is rich in proteins and antibodies and is completely normal and expected. B. She is correct, something is definitely wrong with her breast milk. C. The substance is "yellow milk" and is very sweet, which entices the baby to breast feed. D. She should not breast feed until her "regular" breast milk comes in. Answer: A 6. The cry of a baby who is fussing is characterized as _______________. A. a complete panic where all control is lost B. a panic attack C. a warming up cry with mild distress D. moderate distress that may transition into panic Answer: C 7. Your brother and his wife brought their newborn home and your niece cries for long periods of time when she is awake. What is going on? A. There might be a neurological problem. B. They have a lot to learn as parents. C. Many American infants cry frequently for no apparent cause. D. The baby might have diaper rash. Answer: C 8. What is it called when babies are wrapped tightly in clothes or a blanket so that their arms and legs cannot move, which is very soothing to babies. A. Sneaking B. Securing C. Snuggling D. Swaddling Answer: D Post-Test 1. When milk-producing cells multiply and mature, what gets considerably larger? A. Mammary glands B. Areolas C. Montgomery glands D. Milk cells Answer: A 2. Archaeological and historical evidence suggests that most cultures breast-fed their infants as a primary or sole source of food for how many years? A. 0 to 1 B. 1 to 2 C. 2 to 3 D. 3 to 4 Answer: C 3. Your great, great grandmother who had her babies in the late 1800s, probably was told by her physician to give her infants _______________. A. Condensed or evaporated milk B. A multivitamin C. High-fructose corn syrup D. A calcium supplement Answer: A 4. What variables are related to whether a mother will breast feed? A. Age, level of education, and social economic status B. Social economic status, age, and personality traits C. Geographic location, level of education, and temperament D. Family income, temperament, and level of education Answer: A 5. What is linked to a reduced likelihood of obesity in childhood? A. Breast feeding for six months B. Introducing solid foods as early as possible C. Formula feeding for at least a year D. Encouraging the infant to walk as soon as possible Answer: A 6. What is the thick, yellowish milk that is extremely rich in protein and antibodies that the mother first produces? A. Milk precursor B. Breast milk C. Colostrum D. Yellow milk Answer: C 7. When would mothers in developing countries be advised not to breast feed? A. If they are very poor. B. If they could not afford formula. C. If they have an infectious disease, such as HIV/AIDS. D. If they have small breasts. Answer: C 8. You had to answer the front door while you were finishing bottle feeding. Your baby needed to be burped and now is in quite a bit of distress. As a result, what type of cry is your baby producing? A. Anger cry B. Tired cry C. Fussing D. Pain cry Answer: D 9. Zeskind and Lester (2001) found that one of the following was a risk factor for parental mistreatment of infants _______________. A. Low parental intelligence levels B. Infants who were post-mature at birth C. Lower income levels D. Colic Answer: D 10. Your sister has a new infant. She has been having a difficult time adapting to the new home life with an infant and is anxious. Her concentration of estrogen and progesterone have yet return to normal levels. What might be wrong with your sister? A. She is experiencing a return to ovulation. B. She probably has experienced rapid weight loss. C. She has postpartum euphoria. D. She has postpartum depression. Answer: D Chapter Exam 1. What are the glands responsible for milk production? A. Thyroid B. Mammary C. Pituitary D. Adrenal Answer: B 2. What is the reflex that causes milk to be released if a mother hears the cry of her infant? A. Babinski reflex B. Babcock reflex C. Let-down reflex D. Feeding-time reflex Answer: C 3. To confirm theories regarding breast-feeding that have been generated from archaeological and historical evidence, researchers have also examined _______________. A. historic volcanic records in mainland China B. modern hunter-gatherer cultures in Central Africa C. modern cultural practices in Southeast Asia D. historic zoological records in Central America Answer: B 4. Several generations ago people believed that formula was superior to breast milk. Why? A. In the 1930s and 1940s it was much more difficult to breast feed. B. Evidence is now beginning to emerge that indicates that breast feeding can be dangerous to infants. C. Companies that produced formula convinced the public that formula feeding was the healthiest way to feed infants. D. The government provided free formula to everyone who wanted it. Answer: C 5. What percentage of mothers in the United States and Canada currently breast feed? A. 50% B. 60% C. 70% D. 80% Answer: C 6. Which of the following benefits is NOT associated with breast feeding and health in adolescence and adulthood? A. Taller stature B. Superior bone density C. Enhanced vision D. Improved cardiovascular functioning Answer: A 7. How long does the World Health Organization (WHO) recommend that women breast feed? A. 6 months B. 1 year C. 2 years D. 3 years Answer: C 8. UNICEF estimates that _______________ babies die each year in developing countries because they are bottle-fed rather than breast-fed? A. 100,000 B. 150,000 C. 1 million D. 1.5 million Answer: D 9. When babies are mildly distressed they produce a "warm-up" cry known as _______________. A. Fussing B. Happy cry C. Pain cry D. Anger cry Answer: A 10. After how many months can parents generally distinguish between the different types of cries? A. 1 B. 2 C. 3 D. 4 Answer: A 11. What is likely to happen when neonates in traditional cultures cry? They will be _______________. A. picked up and rocked B. breast-fed and swaddled C. sung to D. ignored Answer: B 12. An infant who cries for more than three hours a day, over more than three days at a time, and for more than three weeks is ______ A. Easy tempered B. Overly gassy C. Colicky D. Melancholy Answer: C 13. Human infants do not do this but other animals do. A. Seek B. Attach C. Imprint D. Connect Answer: C 14. According to the text, what percentage of fathers in the United States and the United Kingdom experience postpartum depression? A. 20% B. 15% C. 4% D. 1% Answer: C 15. According to the text, what condition can occur if parents feel completely overwhelmed by caring for a newborn and can lead to intense sadness and anxiety? A. Postpartum depression B. Childcare depression C. Parental neurosis D. Infant abuse Answer: A Quick Review 1. When are the breasts ready to produce milk? A. 2 months after conception B. 4 months after conception C. 8 months after conception D. 10 months after conception Answer: B 2. Which of the following have been common substitutes for breast milk over the course of human history? A. Cat and cow's milk B. Sheep and dog's milk C. Cow and goat's milk D. Sheep and dog's milk Answer: C 3. When the mother's age, educational level, and socioeconomic status are higher, the more likely she will _______________. A. Breast feed B. Formula feed C. Be unable to breast feed D. Use supplements along with formula feeding Answer: A 4. What are three major benefits of breast feeding? A. the passing of antibodies, increased cognitive development, and reduced childhood obesity B. a lower prevalence of personality disorders, increased cognitive development, and an increased frequency of mild temperament C. convenience, overwhelming popularity, and economic viability D. increased bonding, weight reduction, and lower prevalence of diabetes Answer: A 5. The most damaging aspect of formula feeding in developing countries is _______________. A. The formula is mixed with contaminated water. B. Mothers have no means to sterilize the nipples on the bottles. C. Fathers refuse to assist in the bottle feeding of their infants. D. Mothers are likely to die prematurely and leave the infant malnourished. Answer: A 6. When a baby takes a large intake of breath, holds it, and then lets loose after a sudden onset with no fussing, what type of cry is it? A. Happy cry B. Anger cry C. Pain cry D. Fussing Answer: C 7. There are differences in the way that mothers of various cultures respond to their infants. Compared to American mothers, Korean mothers _______________. A. were no different in the way they responded to their infants B. rarely carried their infants and allowed them to cry longer C. carried their infants twice as long per day and responded to them immediately D. never carried their infants, but responded to them immediately Answer: C 8. What is happening when a baby cries for more than three hours a day for more than three days at a time for more than three weeks? A. Incessant crying B. Autism spectrum disorder C. Dysphoric crying D. Colic Answer: D 9. The likelihood that a mother will have postpartum depression increases if she _______________. A. smoked B. had lower intelligence and less education C. had no support from the father D. had symptoms of major depression before pregnancy Answer: D 10. A significant correlation exists between postpartum depression and infant characteristics. What is a major difficulty involved in interpreting this relationship? A. There has been no genotype discovered that is directly linked with postpartum depression. B. There has been no genotype discovered that is directly linked with poor infant characteristics. C. The mother's and infant's genotypes are too closely related to interpret the relationship. D. It cannot be determined if the postpartum depression caused poor infant characteristics or if the poor infant characteristics caused postpartum depression. Answer: D Video Guide Questions Short Answer Questions 1. Were you surprised to see that many of the women interviewed have similar reasons for breastfeeding (regardless of their culture)? What are some of the benefits of breastfeeding that they mentioned? Answer: Breast milk is always with you, it is less expensive than formula, it is more natural, and it helps with bonding. 2. Although she was not asked the question about how she would comfort her child, how do you think the expectant mother from the U.S. would answer? Do you think that she would answer in a way similar to the mothers from the other countries? Would the American mother have additional options that the other mothers may not? Answer: The expectant mother from the U.S. might likely answer that she would comfort her child through physical touch, soothing sounds, and rocking. While similarities may exist in comforting strategies among mothers from different countries, the American mother may have additional options such as using pacifiers or employing specific baby products widely available in the U.S. 3. What are your thoughts on the lengths of time that the mothers planned to breastfeed and the reasons that they had for the lengths? Answer: The varying lengths of time planned for breastfeeding among mothers reflect cultural norms, access to resources, and individual preferences. Their reasons for these lengths may stem from beliefs about health benefits, societal norms, practical considerations, and personal experiences with breastfeeding. Multiple Choice Questions 1. There were many benefits of breastfeeding discussed in this video. Which of the following was not mentioned? A. It is always with you. B. It is less sanitary. C. It is less expensive. D. It helps with bonding. Answer: B 2. The narrator lists three reasons why the expectant mother from the Mayan village plans to breastfeed. Which of the following includes the three reasons that were listed by the narrator? A. health reasons, tradition, practicality B. tradition, bonding, necessity C. health reasons, necessity, medical reasons D. tradition, psychological reasons, medical reasons Answer: A 3. The American expectant mother discusses a process by which the baby is allowed to breastfeed for as long as they want to. This process is called: A. self-wearing B. self-control C. self-weaning D. natural-termination Answer: C Practice Test Questions from the Textbook 1. Juanita’s cervix is 10 centimeters dilated so she A. is just beginning the labor stage. B. requires an episiotomy. C. has completed labor and is ready to deliver the baby. D. requires a c-section. Answer: C 2. C-sections A. are performed when the baby is in the breech position and attempts to turn the baby into a head first position have not been successful. B. require the same recovery time as a vaginal birth if they are performed correctly. C. have only been proven safe in the case where there is a failure to progress. D. are performed at equally small rates around the world because they are seen as a last resort. Answer: A 3. In traditional cultures, birth is only allowed to take place in certain settings. The LEAST LIKELY explanation is A. so others will not be contaminated. B. to feel a sense of control over an often perilous situation. C. to find a place where medical help is available if complications arise. D. so that the mother or her infant will not be endangered. Answer: C 4. Surita is a midwife in a traditional culture. She is MOST LIKELY to A. have spent time as an apprentice to a more experienced midwife. B. be childless so she is able to devote more time to this work. C. be a young woman because she will be able to practice midwifery for longer than her older counterparts. D. exclude other relatives from being present to reduce possible contamination. Answer: A 5. Which of the following is true about birthing practices? A. Recently, midwifery has seen a revival, and about 50% of births in the United States are assisted by midwives. B. In the early 1900s, the intervention of doctors often made the birth process less dangerous because they now had better expertise and medical equipment. C. In the 1960s, doctors began administering drugs such as ether and chloroform, which offered pain relief without any side effects. D. Twilight Sleep was a drug used in the early 20th century that promoted dilation of the cervix and resulted in mothers forgetting the events of birth. Answer: D 6. In developing countries A. most pregnant women now have access to modern medical technologies. B. giving birth is relatively free of risks because of modernization and globalization. C. maternal mortality has decreased over the past 30 years. D. rates of infant mortality are lower than in developed countries because of more holistic and natural approaches to childbirth. Answer: C 7. The five characteristics that are evaluated in the Apgar scale are A. the Babinski, Moro, stepping, swimming, and grasping reflexes. B. color, heart rate, reflex irritability, muscle tone, and breathing. C. reaction to cuddling, startling, intelligence, vocal response, and visual response. D. sucking reflex, responses to social stimulation, and disease symptoms. Answer: B 8. Preterm babies are considered at risk because A. their immune systems are immature. B. they have too much surfactant in their lungs. C. their bodies generate too much heat. D. their gestational age is 40 weeks and that is still too early to perform basic functions such as sucking. Answer: A 9. Compared to adults, neonates A. spend a lower proportion of their sleep in REM. B. enter REM sooner after falling asleep. C. spend less time sleeping. D. do not experience eye movements under the eyelids or brain-wave changes during REM sleep. Answer: B 10. Which of the following reflexes is LEAST LIKELY to have survival value? A. the rooting reflex B. the Moro reflex C. the Babinski reflex D. the grasping reflex Answer: C 11. The earliest sense to develop is A. taste. B. touch. C. vision. D. hearing. Answer: B 12. Breast feeding A. is more common among women from low socioeconomic status groups. B. increased in popularity as formulas came on to the market because the formulas were very expensive and women worried about product safety. C. is something both mother and baby are biologically prepared to do. D. rates have stayed about the same in the United States since the 1940s. Answer: C 13. Which of the following statements about breastfeeding is most accurate? A. Babies in developing countries are more at risk for health problems if their mothers do not breast-feed them than are babies in developed countries. B. Breast feeding promotes better health in childhood, but does not have any influence on long-term health. C. Breast-fed babies are more likely than bottle-fed babies to become obese in childhood because they are used to eating on demand. D. The colostrum that mothers produce in the first weeks after birth can be dangerous to babies so doctors advise using formula until the mother begins producing milk. Answer: A 14. American infants A. are less likely to experience colic than are babies in non-Western cultures. B. typically experience colic until they are about a year of age. C. show the same frequency, intensity, and duration of crying as babies from all over the world. D. have been found to cry more than babies from cultures where they are held or carried for much of the day. Answer: D 15. Which of the following statements about bonding is most accurate? A. There is a critical period for mother–child relations in all species. B. Imprinting is another name for the stepping reflex. C. In humans, if there is no contact with the mother shortly after birth, the baby’s future development is at risk. D. Konrad Lorenz showed that following the first moving object after birth has survival value. Answer: D 16. Postpartum depression A. is less common among women who have had previous episodes of major depression because they tend to seek preventive treatment. B. is experienced by men as well as by women. C. has a genetic component and, therefore, has not been correlated with levels of social support. D. has been linked with developmental outcomes for babies, but only among male babies. Answer: B Test Bank for Human Development: A Cultural Approach Jeffrey J. Arnett 9780205987887, 9780134641348