Chapter 3 - Prenatal Development and Childbirth 1. According to the text, about what percent of fertilized eggs are lost within the first two weeks following conception? a. 2-3% b. 5-9% c. 25% d. 60-70% Answer: d Rationale: This high percentage is due to the fact that many fertilized eggs fail to implant successfully in the uterus or are not viable for various reasons, leading to spontaneous miscarriages often before a woman even realizes she is pregnant. 2. When infants reach the age of viability at 24 weeks, they have about a ______ % chance of surviving outside of the uterus if given high-quality medical treatment. a. 90 b. 70 c. 50 d. 10 Answer: c Rationale: Viability refers to the point at which a fetus has the potential to survive outside the womb. At 24 weeks, although still premature, with advanced medical care, about 50% of infants can survive. 3. The sequence of growth in which development proceeds from the head toward the feet is known as: a. gross-to-specific trend b. proximodistal trend c. cephalocaudal trend d. differentiated-to-integrated trend Answer: c Rationale: The cephalocaudal trend is evident in prenatal development as well as in infancy, where growth and development initially occur in the head region before progressing down the body towards the feet. 4. If a baby were born with no bowel and with complications involving the small intestines as the result of a problem very early in development, the most likely cause would be with the development of the: a. ectoderm b. mesoderm c. endoderm d. placenta Answer: b Rationale: The mesoderm is the embryonic germ layer that gives rise to the development of the digestive tract and other internal organs. Issues with the development of the mesoderm could result in such complications. 5. If a teratogen interferes with prenatal development only during a particular period of time, the period of development in which the teratogen can exert its effect is called: a. a teratogenic period b. a teratogenic stage c. a critical period d. a high-risk – low-reward stage Answer: c Rationale: A critical period is a specific window of time during development when a fetus is particularly susceptible to the effects of teratogens, which can lead to structural abnormalities or other developmental issues. 6. In prepared childbirth, the primary function of the relaxation and breathing techniques used is to: a. increase the supply of oxygen to the baby during delivery b. increase the Apgar score of the baby at the time of delivery c. help the mother cope more effectively with the pain of delivery d. reduce the carbon dioxide content of the mother’s blood Answer: c Rationale: The relaxation and breathing techniques in prepared childbirth aim to help the mother manage the pain and stress of labor more effectively, promoting a smoother delivery experience. 7. When a neonate’s hand is stimulated by an object such as a finger or a pencil, the infant’s fingers will close tightly in a grasp. This behavior is best considered to be an example of: a. the plantar reflex b. the palmar grasp reflex c. the Moro reflex d. the Babinski reflex Answer: b Rationale: The palmar grasp reflex is a natural response in newborns where they instinctively close their fingers around any object that comes into contact with their palms. 8. Suppose that Judy’s menstrual cycle begins on the first day of July. On which day should she expect that ovulation will occur? a. July 1 b. July 10 c. July 14 d. July 28 Answer: c Rationale: Ovulation typically occurs around the middle of a woman's menstrual cycle, which is approximately 14 days before the start of her next period. Given Judy's cycle, ovulation would likely occur around July 14th. 9. Which of the following mothers is at the greatest risk of having a miscarriage? a. Anne, who is 20 b. Judy, who is 28 c. Lucretia, who is 35 d. Mary, who is 42 Answer: d Rationale: Advanced maternal age, typically defined as 35 and older, is associated with a higher risk of miscarriage due to various factors such as decreased egg quality and increased risk of chromosomal abnormalities. 10. An excited father who is watching his daughter be born exclaims with excitement, “I can see her head!” Technically, this would be referred to as: a. “showing” b. “crowning” c. an Apgar of 1 d. traditional childbirth Answer: b Rationale: "Crowning" refers to the stage of childbirth when the baby's head becomes visible at the vaginal opening during the pushing stage of labor. It's a significant milestone indicating that the baby is about to be born. 1. When does ovulation typically occur? a. during menstruation b. the day before the onset of menstruation c. the 14th day after the onset of menstruation d. the day after menstruation has ceased Answer: c Rationale: Ovulation typically occurs around the middle of a menstrual cycle, approximately 14 days after the onset of menstruation, when an egg is released from the ovary. This timing can vary slightly from woman to woman but is generally around day 14 in a 28-day menstrual cycle. 2. The digestive system, lungs, and some other internal organs develop from which of the following layers of cells present in the embryo? a. ectoderm b. mesoderm c. endoderm d. zygoderm Answer: c Rationale: The digestive system, lungs, and other internal organs develop from the endoderm layer of cells in the embryo. The endoderm is one of the three primary germ layers formed during gastrulation and gives rise to the epithelial lining of the digestive tract, respiratory tract, and associated organs. 3. According to the text, traditional childbirth is typically done: a. in a birthing center b. in a hospital c. at home d. anywhere, including in a birthing center, in a hospital, or at home Answer: b Rationale: According to traditional practices, childbirth is typically done in a hospital setting where medical professionals can provide necessary care and interventions if complications arise during labor and delivery. 4. If a pregnancy test can detect pregnancy within two weeks after fertilization, it most likely works by: a. detecting the hormone human chorionic gonadotropin in the woman’s urine b. detecting a rise in the woman’s body temperature from 98.6 to about 99.3 c. detecting the presence of a much higher percentage of alpha brain waves during the woman’s sleep cycles d. detecting a dramatic increase in the acidity of the woman’s urine Answer: a Rationale: Pregnancy tests typically work by detecting the hormone human chorionic gonadotropin (hCG) in a woman's urine. This hormone is produced by the placenta shortly after implantation, which occurs about a week after fertilization. 5. Doug is told that his wife should not visit his office during the second and third month of her pregnancy because chemicals there could negatively affect the development of their baby. However, he is also told that it would be safe for her to visit after the fourth month, since the chemicals would not affect fetal development. This example highlights the concept of: a. critical period b. gross-to-specific trend c. fetal development d. ectopic pregnancy risk Answer: a Rationale: This example highlights the concept of a critical period during fetal development when exposure to certain substances or factors can have significant and lasting effects on the developing embryo or fetus. In this case, the critical period is during the second and third months of pregnancy when the baby is most vulnerable to potential harm from chemicals. 6. Heart defects are especially common when pregnant mothers are exposed to a teratogen during which prenatal period? a. the germinal period b. the embryonic period c. the fetal period d. the last two weeks before birth Answer: b Rationale: Heart defects are especially common when pregnant mothers are exposed to teratogens during the embryonic period, which is the period of rapid organogenesis and differentiation. Exposure during this time can disrupt normal development of the heart and other organs. 7. Suppose a baby is born whose Apgar score is 3. What would such a score most likely indicate? a. All vital signs are perfect. b. All vital signs are normal. c. Some of the baby’s bodily processes are not functioning fully. d. Immediate emergency measures are required. Answer: d Rationale: A low Apgar score of 3 indicates that immediate emergency measures are required. The Apgar score assesses the newborn's overall health and well-being based on five criteria: heart rate, respiratory effort, muscle tone, reflex irritability, and color. A score of 3 suggests severe distress and requires immediate medical attention. 8. Suppose Dr. Barnes is a fertility specialist who studies the sex of recently fertilized ova. If her research population included all fertilized ova conceived in a population, and if she found that 1,000 of these zygotes were female, she should expect that the population would also include _____ male zygotes. a. 960 b. 1,000 c. 1,040 d. 1,250 Answer: d Rationale: Assuming a typical 50/50 distribution of male and female zygotes, if 1,000 zygotes are female, then there should be an equal number of male zygotes. Therefore, the population would also include 1,000 male zygotes. The total number of zygotes would be 2,000, with 1,000 of each sex. 9. Maria is in her ninth month of pregnancy. She begins to feel contractions, but when she gets up and walks around, the contractions go away. Most likely, she has experienced which of the following? a. showing b. the first stage of labor c. the second stage of labor d. Braxton-Hicks contractions Answer: d Rationale: Maria's experience is characteristic of Braxton-Hicks contractions, which are irregular and often painless contractions that occur during pregnancy, particularly in the third trimester. These contractions are typically harmless and do not signify the onset of labor. 10. Jackie is a new mother who says, “I just can’t stand to be away from my baby. I feel so close to him emotionally that I just love him.” Jackie’s comments reflect the core principle involved in: a. crowning b. attachment c. the Moro reflex d. the Babinski reflex Answer: b Rationale: Jackie's comments reflect the core principle of attachment, which is the emotional bond that forms between a caregiver and an infant. Attachment is characterized by feelings of closeness, affection, and a desire to be near the infant, as described in Jackie's statement. Multiple Choice questions: Prenatal Growth and Development 1. Nancy is 15 years old and has just found out she is pregnant. Although the pregnancy is unintended, Nancy may take some comfort in knowing that unintended pregnancies comprise about what percent of all teen pregnancies in the United States today? a. two-thirds b. half c. one-third d. 10% Answer: a Rationale: As noted in the textbook, 50% of all U.S. pregnancies are unintended. For teens, however, the percentage of unintended pregnancies is even higher—about 66%. 2. Lacy is 38 years old and has just found out she is pregnant. Although the pregnancy is unintended, Lacy may take some comfort in knowing that unintended pregnancies comprise about what percent of all pregnancies in the United States today? a. two-thirds b. half c. one-third d. 10% Answer: b Rationale: As noted in the textbook, 50% of all U.S. pregnancies are unintended. 3. Which type of genetic information is NOT included in a one-celled fertilized egg? a. genetic instructions for whether the sex of the child will be male or female b. genetic instructions for how tall the child will likely be at adulthood c. genetic instructions for eye color d. All genetic instructions are present from the point of fertilization on. Answer: d Rationale: At the time of fertilization, the genetic material of two individuals “fuses” and is translated into a new living entity called a zygote. All of the genetic instructions are present from this point on. 4. In a typical normal pregnancy, which of the following statements about the length of trimesters is correct? a. The first trimester is the longest. b. The second trimester is the longest. c. The third trimester is the longest. d. All trimesters are about the same length. Answer: d Rationale: The correct answer is d. In a typical normal pregnancy, all trimesters are approximately the same length, lasting around 13 weeks each. This distribution ensures that the pregnancy spans roughly nine months, or 40 weeks, from conception to birth. 5. What is the correct developmental sequence of the periods of prenatal development? a. germinal, embryonic, fetal b. embryonic, fetal, germinal c. fetal, germinal, embryonic d. germinal, fetal, embryonic Answer: a Rationale: The germinal period lasts from conception through 2 weeks, the embryonic period spans weeks 2 through 8, and the fetal period spans weeks 9 through 38. 6. The germinal period of prenatal development begins with conception and ends about ___ later. a. one trimester b. two weeks c. one month d. 12 weeks Answer: b Rationale: The germinal period ends when implantation is complete, about two weeks after conception. 7. What is the release of the ovum from the ovary called? a. ovulation b. fertilization c. implantation d. menstruation Answer: a Rationale: Ovulation refers to the release of a mature egg from the ovary, which typically occurs midway through the menstrual cycle. This egg is then available for fertilization by sperm. 8. When does ovulation typically occur? a. during menstruation b. the day before the onset of menstruation c. the 14th day after the onset of menstruation d. the day after menstruation has ceased Answer: c Rationale: Ovulation typically occurs around the middle of a woman's menstrual cycle, approximately 14 days before the onset of the next menstrual period. This timing can vary among women but generally occurs around day 14 in a 28-day menstrual cycle. 9. After studying human prenatal development, Rita should know that one (or more) of her ova will begin to undergo the final stage of meiosis at about what point in each of her menstrual cycles? a. on the first or second day of a regular menstrual period b. on about the 10th day after the start of a regular menstrual period c. about two weeks after the start of a regular menstrual period d. on about the 28th day after the start of a regular menstrual period Answer: b Rationale: As noted in the text, at about the 10th day after the start of a regular menstrual period, stimulated by hormones, an ovum enters the final stage of meiosis. 10. Suppose that Judy’s menstrual cycle begins on the first day of July. On which day should she expect that ovulation will occur? a. July 1 b. July 10 c. July 14 d. July 28 Answer: c Rationale: As noted in the text, at about the 10th day after the start of a regular menstrual period, stimulated by hormones, an ovum enters the final stage of meiosis. By the end of the 13th or 14th day of this growth, the follicle (sac) surrounding the ovum breaks, releasing the mature ovum: This process is called ovulation. 11. Suppose that Latisha’s menstrual cycle begins on the first day of January. If she is planning on having sexual intercourse but does not want to become pregnant, she should be most concerned about using contraception (or abstaining from intercourse) during which of the following dates? a. January 2-7 b. January 10-15 c. January 20-26 d. January 27-31 Answer: b Rationale: By the end of the 13th or 14th day of this growth, the follicle (sac) surrounding the ovum breaks, releasing the mature ovum: This process is called ovulation. The ovum can survive for 12 to 24 hours. Sperm can survive for about 5 days once deposited in the vagina. Thus, Latisha should be most concerned about becoming pregnant from January 10 to January 15. 12. Fertilization normally takes place: a. in the uterus b. in the vagina c. in the ovary from which the egg is released d. in the fallopian tube Answer: d Rationale: Fertilization typically occurs in the fallopian tube, where sperm meets and penetrates the egg. This usually happens within hours of ovulation. 13. The attachment of the zygote to the uterine wall is called: a. ovulation b. menstruation c. fertilization d. implantation Answer: d Rationale: Implantation is the process by which the fertilized egg, now called a zygote, attaches to the lining of the uterus, where it will develop into an embryo and eventually a fetus. 14. The germinal period of prenatal development occurs during which trimester(s)? a. the first trimester b. the second trimester c. the third trimester d. the second and third trimesters Answer: a Rationale: The germinal period lasts from conception through the second week; the first trimester spans weeks 1 through 13. 15. The embryonic period of prenatal development occurs during which trimester(s)? a. the first trimester b. the second trimester c. the third trimester d. the second and third trimesters Answer: a Rationale: The embryonic period lasts from the second through the eighth week; the second trimester spans weeks 13 through 25. 16. The fetal period of prenatal development occurs during which trimester(s)? a. the first trimester b. the second trimester c. the third trimester d. the second and third trimesters Answer: d Rationale: The fetal period lasts from the ninth through the 38th week; the third trimester spans weeks 26 through 38. 17. Normally, sperm can survive and be viable for about how long following ejaculation? a. 2-3 hours b. 24-36 hours c. 1-2 days d. about 5 days Answer: d Rationale: Sperm can typically survive and remain viable within the female reproductive tract for up to about 5 days after ejaculation. This allows for the possibility of fertilization occurring even if intercourse happens a few days before ovulation. 18. The number of sperm contained in each ejaculation is approximately: a. 200 b. 2,000 c. 200,000 d. 200,000,000 Answer: d Rationale: Each ejaculation contains millions of sperm, typically ranging from around 20 to 200 million sperm cells, with 200 million being a commonly cited average. 19. If George and his wife wish to increase the chances of becoming pregnant, they should know that George’s sperm can survive about how long following ejaculation? a. 2-3 hours b. 6-12 hours c. 24-36 hours d. 5 days Answer: d Rationale: After sperm are deposited in the vagina during sexual intercourse, they can survive there for about 5 days. 20. The union of an ovum and sperm creates a(n): a. gamete b. embryo c. amnion d. zygote Answer: d Rationale: A zygote, by definition, is a fertilized ovum It is the first cell of a human being that occurs as a result of fertilization. 21. Implantation of a fertilized egg in the uterine wall typically occurs: a. within 1 to 2 hours following fertilization b. within 12 to 24 hours following fertilization c. within 2 to 3 days following fertilization d. about one week following fertilization Answer: d Rationale: Implantation of the fertilized egg into the uterine lining typically occurs about one week following fertilization. This process allows the developing embryo to establish a connection with the mother's blood supply for nourishment and development. 22. If Susanna was worried that she has just become pregnant as the result of intercourse last night, and she wants to take a drug to make sure that implantation of the fertilized ovum does not occur, she should be sure to take this drug: a. immediately, because implantation occurs in the first day after fertilization b. within 24 hours, because implantation occurs in the first 24 to 36 hours after fertilization c. within 2 days, because implantation occurs about 3 days following fertilization d. within 5-6 days, because implantation occurs about 1 week following fertilization Answer: d Rationale: As noted in the textbook, toward the end of the first week the dividing cells have developed into a blastula—a ball of cells around a fluid-filled center—that has made its way to the uterus. Once formed, the blastula starts to burrow into the lining of the uterus, breaking tiny blood vessels to obtain nutrients. The cells begin the process of differentiation, and within a few days, if all goes well, the blastula is implanted in the uterine wall. 23. If Jacob was going to draw a picture of a blastula, the shape he would produce would be most like which of the following? a. a straight line b. a square c. a circle d. a “glob” that looks like the shape of Lake Michigan Answer: c Rationale: The book describes the blastula as a hollow, fluid-filled sphere of cells that forms soon after conception. 24. If a pregnancy test can detect pregnancy within two weeks after fertilization, it most likely works by: a. detecting the hormone human chorionic gonadotropin in the woman’s urine b. detecting a rise in the woman’s body temperature from 98.6 to about 99.3 c. detecting the presence of a much higher percentage of alpha brain waves during the woman’s sleep cycles d. detecting a dramatic increase in the acidity of the woman’s urine Answer: a Rationale: As noted in the textbook, cell differentiation is the point at which home urine tests can assess pregnancy: The cells of the supportive structures begin secreting a detectable hormone called human chorionic gonadotropin (hcg), which shuts down further ovulation and prevents the next menstrual period. 25. According to the text, about what percent of fertilized eggs are lost within the first two weeks following conception: a. 2-3% b. 5-9% c. 25% d. 60-70% Answer: d Rationale: It's estimated that a significant percentage of fertilized eggs are lost within the first two weeks following conception, with some studies suggesting that as many as 60-70% of fertilized eggs fail to implant or are lost shortly after implantation, often without the woman even being aware of it. 26. Janae wants to become pregnant and believes that fertilization has taken place. However, she does not want to get her hopes up too quickly because she knows that about _______ of fertilized ova are lost during the first two weeks of pregnancy. a. 5% b. 10-15% c. a third d. two-thirds Answer: d Rationale: As noted in the textbook, an estimated two-thirds of all fertilized eggs may be lost within the first 2 weeks, some because they are incompletely formed and others because the uterine environment is inhospitable. 27. Combining the percentage of fertilized eggs that are lost within the first two weeks with the percent that are aborted or lost due to miscarriage in the remaining months of pregnancy, you should conclude that about ________ of all fertilized eggs eventually result in the birth of a baby. a. 20% b. half c. two-thirds d. almost 90% Answer: a Rationale: An estimated two-thirds of all fertilized eggs may be lost within the first two weeks. Another 19% are aborted and 17 % are lost through miscarriage. Thus, of the choices provided, 20% is the best estimate of the number of fertilized eggs that eventually result in the birth of a baby. 28. Dr. Shepard is an advocate for laws that would prohibit abortion under all circumstances. To make her case, she argues that, of pregnancies that survive the first few weeks, over half are terminated by an abortion. You know that Dr. Shepard’s argument is false because the percentage of pregnancies that are terminated by abortion after the first few weeks is actually: a. 2% b. 6% c. 19% d. 36% Answer: c Rationale: According to the National Center for Health Statistics (2008), in the United States, of those pregnancies that survive the first few weeks, 19% are aborted. 29. Suppose that prior to implantation, Janetha’s fertilized egg divides into two cells, and these cells then split entirely. If Janetha’s pregnancy results in a healthy birth, you would know that she would have: a. a girl b. a boy c. a girl and a boy d. twins with identical genetic characteristics Answer: d Rationale: Sometimes in the first few divisions of the zygote, the two identical cells or small groups of cells separate and develop into two (or more) embryos. The result is monozygotic (identical) twins. 30. The similarity of genetic traits carried by two individuals who are dizygotic twins would be most comparable to which of the following pairs of individuals? a. their mother and father b. any two siblings, regardless of gender c. two clones of the same person d. two unrelated individuals Answer: b Rationale: When two ova are released simultaneously and each unites with a different sperm, dizygotic (fraternal) twins are produced. The genetic traits inherited by fraternal twins can be as similar or as different as those of any two siblings: Fraternal twins may be of the same sex or different sexes. 31. John (a boy) and Jill (a girl) claim that they are twins. You would know for certain that: a. if they are twins, they are monozygotic twins b. if they are twins, they are dizygotic twins c. if they are twins, John was born first and Jill was born second d. they could not possibly be twins Answer: b Rationale: When two ova are released simultaneously and each unites with a different sperm, dizygotic (fraternal) twins are produced. The genetic traits inherited by fraternal twins can be as similar or as different as those of any two siblings: Fraternal twins may be of the same sex or different sexes. 32. Jane and Jill are monozygotic twins. Therefore, they: a. share the same physical traits b. are no more alike than any other two siblings c. developed from two separate ova fertilized by two separate sperm d. have been raised in different environments Answer: a Rationale: Because monozygotic twins develop from the same fertilized zygote, they have the same genes: Identical twins are always the same sex and share the same physical traits. 33. Tom and Forrest are dizygotic twins. Therefore, they: a. share the same physical traits b. resulted from the division of a single fertilized ovum c. are no more alike genetically than any other two siblings d. have been raised in different environments Answer: c Rationale: When two ova are released simultaneously and each unites with a different sperm, dizygotic (fraternal) twins are produced. The genetic traits inherited by fraternal twins can be as similar or as different as those of any two siblings. 34. When a woman becomes pregnant from the fertilization of two separate ova by two separate sperm, these twins are called _________ twins: a. dizygotic b. monozygotic c. identical d. nonfraternal Answer: a Rationale: As noted in the textbook, when two ova are released simultaneously and each unites with a different sperm, dizygotic (fraternal) twins are produced. 35. Which of the following statements regarding fraternal twins is FALSE? a. They are produced when two ova are released and each unites with a sperm. b. They may be of the same or opposite sex. c. The twins develop from the same zygote. d. The genetic traits of the two twins can be as different or as similar as those of any other two siblings. Answer: c Rationale: When two ova are released simultaneously and each unites with a different sperm, dizygotic (fraternal) twins are produced. The genetic traits inherited by fraternal twins can be as similar or as different as those of any two siblings: Fraternal twins may be of the same sex or different sexes. 36. Suppose that Maddie has difficulty becoming pregnant and decides to use reproductive technologies to increase her chances of having a baby. According to the text, one side effect of this technology that she should be aware of is that it: a. increases the risk of miscarriage b. increases her chances of getting a divorce c. increases her chances of having twins d. increases her likelihood of experiencing postpartum depression Answer: c Rationale: About two-thirds of the dramatic increase in multiple births (76% from 1980 to 2009) is accounted for by the use of reproductive technologies. 37. Which of the following develops from the embryonic disk? a. the placenta b. the baby c. the amniotic sac d. the amniotic fluid Answer: b Rationale: The embryonic disk, also known as the embryonic disc, is a structure formed during embryonic development. It gives rise to the embryo itself, which ultimately develops into the baby. 38. Which of the following structures is most similar in function to a filtering system in the engine of a car that moves gas from the gas tank, filters impurities out of it, and delivers it to the carburetor? a. the amniotic fluid b. the amniotic sac c. the placenta d. the embryonic disk Answer: c Rationale: The placenta permits the exchange of nutritive and waste materials by diffusion across cell membranes, normally without any exchange of blood cells. Thus, the placenta serves as a filter. The placenta’s role can be considered analogous to the role of a filtering system in the engine of a car. 39. A fluid-filled membrane that encloses the developing embryo or fetus is called the: a. amniotic sac b. embryonic disk c. fallopian tube d. placenta Answer: a Rationale: The amniotic sac is a membrane filled with amniotic fluid that surrounds and protects the developing embryo or fetus during pregnancy. It provides a cushion against external pressure and helps maintain a stable environment for fetal development. 40. The disk-shaped structure that nourishes the embryo and fetus is called the: a. amniotic sac b. umbilical disk c. embryonic disk d. placenta Answer: d Rationale: The placenta is a temporary organ that develops during pregnancy and serves as the primary connection between the mother and the developing fetus. It provides oxygen and nutrients to the fetus and removes waste products from the fetal bloodstream. 41. During which period of prenatal development do most major structures, such as the heart, develop in rudimentary form? a. embryonic period b. fetal period c. germinal period d. zygotic period Answer: a Rationale: The embryonic period is the second prenatal period, which lasts from implantation to the end of the second month after conception; all the major structures and organs of the individual are formed at this time. 42. The digestive system, lungs, and some other internal organs develop from which of the following layers of cells present in the embryo? a. ectoderm b. mesoderm c. endoderm d. zygoderm Answer: c Rationale: The endoderm is one of the three primary germ layers in the developing embryo. It gives rise to the epithelial lining of the digestive tract, respiratory tract, and several other internal organs such as the liver and pancreas. 43. The skin, sense organs, and the brain develop from which of the following layers of cells present in the embryo? a. ectoderm b. mesoderm c. endoderm d. zygoderm Answer: a Rationale: The ectoderm is another primary germ layer in the developing embryo. It gives rise to structures such as the epidermis of the skin, nervous system (including the brain), sensory organs, and various glands. 44. The muscles, blood, and the excretory system develop from which of the following layers of cells present in the embryo? a. ectoderm b. mesoderm c. endoderm d. zygoderm Answer: b Rationale: The mesoderm is the third primary germ layer in the developing embryo. It gives rise to muscles, connective tissues, blood and blood vessels, kidneys, gonads, and parts of the excretory system. 45. If a baby were born with malformed eyes and ears as the result of a problem very early in development, the most likely cause would be with the development of the: a. ectoderm b. mesoderm c. endoderm d. placenta Answer: a Rationale: Immediately after implantation, the embryonic disk develops into three distinct layers. The outer layer, known as the ectoderm, will become the skin, the sense organs, and the brain and nervous system. 46. If a baby were born with no bowel and with complications involving the small intestines as the result of a problem very early in development, the most likely cause would be with the development of the: a. ectoderm b. mesoderm c. endoderm d. placenta Answer: b Rationale: Immediately after implantation, the embryonic disk develops into three distinct layers. The middle layer, known as the mesoderm, will become muscles, blood, and the excretory system. 47. If a baby were born with an incompletely formed digestive system and lung problems as the result of a problem very early in development, the most likely cause would be with the development of the: a. ectoderm b. mesoderm c. endoderm d. placenta Answer: c Rationale: Immediately after implantation, the embryonic disk develops into three distinct layers, The inner layer, known as the endoderm, will become the digestive system, lungs, thyroid, thymus, and other organs. 48. Which of the following developmental events occurs earliest in the prenatal period? a. the baby is able to hear b. the baby is able to see c. the heart starts beating d. the neural tube develops into a three-part brain Answer: c Rationale: By the end of the fourth week after conception, the heart is beating. 49. An advertising campaign urges pregnant women to get good prenatal care by saying that all of the structures that we recognize as human (including arms, legs, eyes, internal organs, and a beating heart) have already developed early in pregnancy. Having studied prenatal development, you know that the most accurate statement is that these structures are present, at least in rudimentary form, by: a. the end of the second week of pregnancy b. the end of the second month of pregnancy c. the end of the fourth week of pregnancy d. the end of the fourth month of pregnancy Answer: b Rationale: As noted in the textbook, by the end of the embryonic period, the embryo has developed arms, legs, fingers, toes, a face, a heart that beats, a brain, lungs, and all of the major organ systems. The embryonic period lasts through the eighth week (i.e., end of the second month). 50. Suppose a friend calls you and tells you that she has had a miscarriage during the fourth month of her pregnancy. Technically, her miscarriage would be termed: a. spontaneous abortion b. term abortion c. mid-term abortion d. developmental abortion Answer: a Rationale: Miscarriages are, in technical terms, known as spontaneous abortions and defined as a naturally triggered expulsion of the developing child before it is viable. 51. Suppose Naomi is in her third trimester of pregnancy. If Naomi is worried that her pregnancy might end with a spontaneous abortion, you might be able to provide some comfort to her by stating that _____ of spontaneous abortions occur in the first trimester. a. about half b. about two-thirds c. about 90% d. about 99.9% Answer: c Rationale: Miscarriages occur primarily during the first trimester; almost 90% occur by 12 or 13 weeks, and miscarriages beyond 20 weeks are rare. 52. Which of the following groups would be expected to have the highest rate of miscarriage? a. babies whose fathers are younger than 20 b. babies whose fathers are between 20 and 30 years of age c. babies whose fathers are between 30 and 40 years of age d. babies whose fathers are older than 40 Answer: d Rationale: The miscarriage rate for pregnancies conceived by fathers over 40 years of age is nearly three times higher than those of fathers under age 25. 53. Suppose Paul is working in a hospital. For every 100 female babies born, he should expect that about ____ male babies will be born. a. 94 b. 100 c. 105 d. 125 Answer: c Rationale: Although there are about 125 male conceptions for every 100 females conceived, at birth this ratio falls to about 105 to 100. These data reflect both the greater likelihood of the sperm containing the smaller Y chromosome to fertilize the egg and the greater vulnerability of the male during the prenatal period. 54. Suppose Dr. Barnes is a fertility specialist who studies the sex of recently fertilized ova. If her research population included all fertilized ova conceived in a population, and if she found that 1,000 of these zygotes were female, she should expect that the population would also include _____ male zygotes. a. 960 b. 1,000 c. 1,040 d. 1,250 Answer: d Rationale: There are about 125 male conceptions for every 100 females conceived. It should be noted, however, that at birth this ratio falls to about 105 to 100. These data reflect both the greater likelihood of the sperm containing the smaller Y chromosome to fertilize the egg and the greater vulnerability of the male during the prenatal period 55. Generalizing from data presented in the text, you should conclude that ______ embryos are more vulnerable during the prenatal period and _______ are more vulnerable during the first two years of life. a. male; male b. female; female c. male; female d. female; male Answer: a Rationale: Despite the fact that there are about 125 male conceptions for every 100 females conceived, at birth this ratio falls to about 105 to 100. These data reflect both the greater likelihood of the sperm containing the smaller Y chromosome to fertilize the egg and the greater vulnerability of the male during the prenatal period. The book also notes that males continue to be more vulnerable throughout childhood. 56. Rex describes a period of the lifespan as “the time when primitive organ systems mature and become functional.” The period he is describing would correctly be identified as: a. the germinal period b. the fetal period c. the embryonic period d. the viability period Answer: b Rationale: During the fetal period the organs and systems mature and become functional, although different systems develop at different points throughout this period. 57. Dr. Peters tells a pregnant woman that she is now at the point in her pregnancy where her baby would have a 50% chance of surviving if it were born today. At what point in pregnancy is this woman? a. 24 weeks b. 29 weeks c. 32 weeks d. 35 weeks Answer: a Rationale: At 24 weeks, a healthy fetus reaches the age of viability, meaning it now has about a 50% chance of surviving outside the uterus if given high-quality intensive care, although currently over half of the surviving fetuses born at 24 weeks have serious anomalies. 58. When infants reach the age of viability at 24 weeks, they have about a ______ % chance of surviving outside of the uterus if given high-quality medical treatment. a. 90 b. 70 c. 50 d. 10 Answer: c Rationale: Viability refers to the ability of a fetus to survive outside the uterus. At 24 weeks, with advanced medical care, infants have approximately a 50% chance of surviving if born prematurely. 59. In developed economies like the U.S., a healthy fetus reaches the age of viability at: a. 30 weeks b. 24 weeks c. 20 weeks d. 16 weeks Answer: b Rationale: The correct answer is b. In developed economies such as the U.S., a healthy fetus typically reaches the age of viability at around 24 weeks of gestation. Viability refers to the point at which the fetus has developed sufficiently to have a chance of surviving outside the womb with medical intervention. 60. Dr. Buresh tells a pregnant woman that she is now at the point in her pregnancy where her baby would have a 50% chance of surviving if it were born. This point is termed: a. the age of viability b. the beginning of the fetal period c. the beginning of the embryonic period d. the end of the embryonic period Answer: a Rationale: At 24 weeks, a healthy fetus reaches the age of viability, meaning it now has about a 50% chance of surviving outside the uterus if given high-quality intensive care, although currently over half of the surviving fetuses born at 24 weeks have serious anomalies. 61. Suppose that Winnie is ill and should deliver her baby as soon as it develops to the point at which it will have a 90% chance of surviving. Willie should expect to deliver her baby at what point? a. at 24 weeks b. at 25 weeks c. at 28 weeks d. at 33 weeks Answer: c Rationale: At 28 weeks, over 90% of babies survive with a good outcome, provided that they receive quality intensive care. 62. If prenatal care was very poor in a particular country, you would expect that the age of viability in that location would be ______ the age of viability in the United States today. a. lower than b. higher than c. about the same as d. unrelated to Answer: b Rationale: The age of viability refers to the age at which the fetus has a 50% chance of surviving outside the womb, provided quality intensive care is available. If such care was not available, we would expect the age of viability to be higher. 63. According to the text, which of the following most correctly describes the relationship between the father’s age at conception and the probability that his conceived child will be miscarried? a. There is no relationship between paternal age and risk of miscarriage. b. Fathers over age 40 have 3 times the risk for miscarriage. c. Fathers under age 25 have 3 times the risk for miscarriage. d. Fathers over age 40 and fathers under age 25 have half the risk of having their child miscarried as do fathers age 25-40. Answer: b Rationale: Research suggests that advanced paternal age, typically considered over 40, is associated with an increased risk of miscarriage, although the exact mechanisms are not fully understood. 64. The fetal period of prenatal development begins at ________ and ends at _______: a. conception; birth b. conception; the end of the 2nd month c. the end of the 1st month; birth d. the end of the 2nd month; birth Answer: d Rationale: The fetal period begins at the end of the embryonic period, which is around the end of the second month of gestation, and continues until birth. 65. If the director of a prenatal care clinic had a goal that the percentage of women in the geographic area served by the clinic reached the U.S. national average for prenatal care, the clinic’s goal would be to provide prenatal care to ____ % of the local population. a. 50 b. 67 c. 85 d. 97 Answer: d Rationale: Today, the percentage of U.S. women who begin prenatal care in the first trimester is about 82%, and only 3% received no prenatal care at all. 66. There is a tendency for an infant to react to a stimulus with generalized, whole-body movements at first, with responses becoming more specific and refined later. This trend is referred to as which of the following? a. body-in-total trend b. cephalocaudal trend c. proximodistal trend d. gross-to-specific trend Answer: d Rationale: The gross-to-specific trend refers to the developmental pattern where infants initially respond to stimuli with generalized, whole-body movements, which then become more specific and refined over time. This trend reflects the progression from general to more precise motor control and coordination. 67. The sequence of growth in which development proceeds from the head toward the feet is known as: a. gross-to-specific trend b. proximodistal trend c. cephalocaudal trend d. differentiated-to-integrated trend Answer: c Rationale: The cephalocaudal trend refers to the pattern of development where growth and development proceed from the head (cephalic region) down to the feet (caudal region). This means that during early development, the head develops before other parts of the body, such as the arms and legs. This is evident in infants who typically gain control over their head and neck muscles before they gain control over their limbs. 68. When 2-year-old Nicholas was first learning to draw, he often moved his whole body, even his tongue. Only later did he confine the action to his fingers, hand, and slight arm motion. This tendency is called the: a. gross-to-specific trend b. proximodistal trend c. cephalocaudal trend d. differentiated-to-integrated trend Answer: a Rationale: The gross-to-specific trend refers to the tendency to react to body stimuli with generalized, whole-body movements at first, with these responses becoming more local and specific later. 69. Developing the ability to grab with the full hand before the ability to pick up something with a finger and thumb is best considered to be an example of the: a. gross-to-specific trend b. proximodistal trend c. cephalocaudal trend d. differentiated-to-integrated trend Answer: b Rationale: The proximodistal trend refers to the pattern of development where growth and development proceed from the center of the body (proximal) outward to the extremities (distal). In the given example, the ability to grab with the full hand (proximal) develops before the ability to pick up something with a finger and thumb (more distal). This trend is commonly observed in motor development during infancy. 70. Marty notices that her baby develops arm coordination well in advance of leg coordination. This finding is best considered an example of which of the following growth trends? a. the gross-to-specific trend b. the proximodistal trend c. the cephalocaudal trend d. the specific-to-gross trend Answer: c Rationale: The cephalocaudal trend refers to the sequence of growth that occurs first in the head and progresses downward. 71. Dan notices that his son develops the ability to manipulate his hands and arms long before he can coordinate the movements of his fingers. This finding is best considered an example of which of the following growth trends? a. the patterned-response trend b. the proximodistal trend c. the differentiated-to-integrated trend d. the specific-to-gross trend Answer: b Rationale: The proximodistal trend refers to the sequence of growth that occurs first at the body’s center (in this case the arms, then the hands) and progresses downward outward (in this case to the fingers). This finding could also be considered an example of the gross-to-specific trend, but this is not one of the options provided. 72. At 6 months of age, Alexandra could reach out and grab a toy with her hand, but was unable to pick up a small toy with her finger and thumb until she was 9 months of age. This illustrates what developmental trend? a. patterned-response trend b. gross-to-specific trend c. cephalocaudal trend d. differentiated-to-integrated trend Answer: b Rationale: The gross-to-specific trend refers to the tendency to react to body stimuli with generalized, whole-body movements at first, with these responses becoming more local and specific later. Prenatal Environmental Influences 73. According to statistics presented in the text, about what percent of babies born in the United States today are born before 34 weeks’ gestation? a. 1-2% b. 3-4% c. 8% d. 14% Answer: c Rationale: Approximately 8% of babies born in the United States today are born before 34 weeks' gestation, according to the statistics provided in the text. This indicates the prevalence of preterm birth, which can pose various health risks and challenges for both the infant and the mother. 74. If your friend were interested in having a baby at the age where risks to the baby were the lowest, you should advise her that she should consider having her baby at which of the following ages? a. age 16 b. age 22 c. age 33 d. age 40 Answer: b Rationale: As noted in the textbook, mothers in their 20s experience the lowest risk of miscarriages, stillbirths, or births of children with congenital anomalies. 75. Which of the following individuals has the lowest risk for a miscarriage? a. a woman over the age of 40 b. a woman between 20 and 24 c. a teenager d. None of the other choices is correct because age is not a risk factor for miscarriage. Answer: b Rationale: As noted in the textbook, mothers in their 20s experience the lowest risk of miscarriages, stillbirths, or births of children with congenital anomalies. 76. Which of the following mothers is at the greatest risk of having a miscarriage? a. Anne, who is 20 b. Judy, who is 28 c. Lucretia, who is 35 d. Mary, who is 42 Answer: d Rationale: Older mothers are also at greater risk for miscarriage and for some congenital anomalies. One study of over 1.2 million pregnancies in Denmark indicated that the miscarriage rate was over 50% for women over age 40 and 75% for women over 45. The miscarriage rate for mothers age 20 to 24 was 9% by comparison. 77. Suppose Ann and her sister are both going to have a baby. Ann is age 28; her sister is age 45. Generalizing from statistics noted in the text, you would know that Ann’s probability of having a child with Down syndrome are: a. about the same as her sister’s b. slightly greater than her sister’s c. slightly less than her sister’s d. more than 10 times less than her sister’s Answer: d Rationale: Down syndrome increases from about 1 in 800 births for mothers under age 35 to about 1 in 25 for mothers age 45 or older. 78. If a woman is age 25, her risk of having a child with Down syndrome is about 1 in ____; if she is age 45, her risk is about 1 in ____. a. 1000; 500 b. 500; 1000 c. 800; 25 d. 500; 10 Answer: c Rationale: As noted in the textbook, Down syndrome increases from about 1 in 800 births for mothers under age 35 to about 1 in 25 for mothers age 45 or older. 79. If Lorraine, who is going to have a baby, gets good prenatal care, you would expect her physician would recommend that she gain about how many pounds during her pregnancy: a. 18 pounds b. 24 pounds c. 30 pounds d. 40 pounds Answer: c Rationale: Regardless of age, mothers who begin pregnancy fit and in good health, eat a balanced diet rich in protein and calcium, and gain about 25 to 35 pounds (11 to 16 kilograms) are more likely to give birth to healthy babies. 80. Malnutrition during pregnancy is especially problematic for the baby if it is: a. of long duration b. the result of eating too little sodium c. the result of eating too little sugar d. the result of eating too little meat Answer: a Rationale: Malnutrition is especially problematic when it occurs over a long period of time. Research with animals has shown that the mother protects the fetus from the effects of short-term malnutrition by drawing on her own stored reserves. Therefore, if previously well-nourished mothers go through a temporary period of malnutrition during pregnancy, but the baby has a good diet and responsive caregivers after birth, there likely will be few long-lasting effects. 81. The text discusses a study in which malnourished children in Guatemala were given food supplements to counteract the effects of poor diets. In particular, the effects were positive when the diets were rich in: a. minerals b. complex sugars such as fructose and sucrose c. complex starches from vegetables such as corn and beans d. protein Answer: d Rationale: The effects of food supplements were positive when the diets were rich in protein. Protein is essential for various aspects of growth and development, including muscle development, tissue repair, and overall health. Malnourished children benefit significantly from protein-rich diets to support their nutritional needs. 82. Doug is told that his wife should not visit his office during the second and third month of her pregnancy because chemicals there could negatively affect the development of their baby. However, he is also told that it would be safe for her to visit after the fourth month, since the chemicals would not affect fetal development. This example highlights the concept of: a. critical period b. gross-to-specific trend c. fetal development d. ectopic pregnancy risk Answer: a Rationale: Critical period refers to the period of development during which the effect of a teratogen occurs. A teratogen is a toxic agent of any kind (including chemicals) that potentially causes abnormalities in the developing child. 83. Exposure to toxins during weeks 3 to 5 during a pregnancy would be most likely to result in defects in which of the body’s organs? a. the brain b. the ears c. the heart d. the genitalia (sexual organs) Answer: c Rationale: As shown on the chart on page 75, the heart is susceptible to teratogens during weeks 3 to 5. The brain, ears, and genitalia are not generally susceptible until later in the prenatal period. 84. If a teratogen interferes with prenatal development only during a particular period of time, the period of development in which the teratogen can exert its effect is called: a. a teratogenic period b. a teratogenic stage c. a critical period d. a high-risk – low-reward stage Answer: c Rationale: Critical period refers to the period of development during which the effect of a teratogen occurs. A teratogen is a toxic agent of any kind (including chemicals) that potentially causes abnormalities in the developing child. 85. To state that a particular teratogen has an effect during a “critical period” means that it: a. can affect organ systems that are critical for sustaining life b. can cause the mother to become critically ill and perhaps die c. exerts its effect on development only during a particular stage of development d. will require the mother to be hospitalized, most likely in a critical care unit Answer: c Rationale: Critical period refers to the period of development during which the effect of a teratogen occurs. A teratogen is a toxic agent of any kind (including chemicals) that potentially causes abnormalities in the developing child. 86. Exposure to toxins during weeks 20 to 36 during a pregnancy would be most likely to result in defects in which of the body’s organs? a. the brain b. the ears c. the heart d. the genitalia (sex organs) Answer: a Rationale: As shown on the chart on page 75 of the text, the brain is susceptible to teratogens during the weeks 20 to 36. The ears, heart, and genitalia are susceptible at earlier periods in the prenatal stage of development. 87. Exposure to toxins during the 12th week of a pregnancy would be most likely to result in defects in which of the body’s organs? a. the brain b. the ears c. the heart d. the genitalia (sex organs) Answer: d Rationale: As shown on the chart on page 75 of the text, external genitalia are susceptible to teratogens during the 12th week of pregnancy. The heart and ears are susceptible earlier, and the brain is susceptible later. 88. Thalidomide was prescribed in the late 1950s and early 1960s for the treatment of which of the following? a. migraine b. anxiety c. morning sickness d. cancer Answer: c Rationale: The correct answer is c. Thalidomide was prescribed in the late 1950s and early 1960s as a treatment for morning sickness in pregnant women. However, its use led to severe birth defects in thousands of babies, highlighting the importance of rigorous testing for drugs, especially during pregnancy. 89. A toxic agent of any kind that potentially causes abnormalities in a developing child is called a: a. teratogen b. karyotype c. protein d. critical agent Answer: a Rationale: The correct answer is a. A toxic agent of any kind that potentially causes abnormalities in a developing child is called a teratogen. Teratogens can include substances such as drugs, chemicals, infections, or radiation that interfere with prenatal development and may lead to birth defects or developmental disorders. 90. A developing fetus is at greater risk for which of the follow abnormalities if the mother becomes ill with rubella during pregnancy? a. heart abnormality b. deafness c. limb deformities d. All of these abnormalities can be associated with rubella. Answer: d Rationale: The correct answer is d. If a mother becomes ill with rubella (German measles) during pregnancy, the developing fetus is at greater risk for a range of abnormalities, including heart abnormalities, deafness, and limb deformities. All of these abnormalities can be associated with rubella infection during pregnancy, making it a significant concern for maternal and fetal health. 91. Newborns are routinely treated with silver nitrate eye drops as a preventative treatment for which of the following? a. syphilis b. gonorrhea c. rubella d. HIV Answer: b Rationale: The correct answer is b. Newborns are routinely treated with silver nitrate eye drops as a preventative treatment for gonorrhea. This helps prevent gonococcal eye infections (ophthalmia neonatorum) that can lead to serious eye damage or blindness if left untreated. 92. Andrew has AIDS and is receiving HAART therapy. This means that he is: a. having frequent blood transfusion b. is taking a “cocktail” of several medications c. should not conceive a child because he is at high risk for passing the AIDS virus on to the child he would have d. should drastically reduce his intake of dairy products Answer: b Rationale: At present, there is no vaccine to halt completely the transmission of the AIDS virus, but new therapies that involve combinations of drugs, called HAART (highly active antiretroviral therapies) or “drug cocktails,” have dramatically reduced AIDS-related deaths and mother-to-infant transmission of the virus. 93. According to the text, at present about _______ % of the children and adults with AIDS live in Africa: a. one-fourth b. one-half c. two-thirds d. 90% Answer: c Rationale: The correct answer is c. According to the text, at present, about two-thirds of the children and adults with AIDS live in Africa. This underscores the disproportionate burden of HIV/AIDS in sub-Saharan Africa, where access to treatment and prevention programs may be limited compared to other regions. 94. If a woman with AIDS found out she was pregnant, her treatment would most likely consist of: a. bed rest while she stops taking her AIDS drugs during the last 3 months of pregnancy b. bed rest while she stops taking her AIDS drugs during the second trimester of pregnancy c. treatment with retroviral drugs and having a caesarian section delivery method d. abstaining from sexual intercourse during her entire pregnancy Answer: c Rationale: By using a combination of HAART therapy to keep mothers’ viral counts low and cesarean section delivery methods when possible, it now appears that mother-to-infant HIV transmission can be reduced to about 2%. 95. Suppose 3 mothers were accidentally exposed to a teratogen during their pregnancies. Who would have the lowest risk for having a child with some sort of birth defect? a. Abbey, who is exposed during the germinal period of prenatal development b. Brittany, who is exposed during the embryonic period of prenatal development c. Whitney, who is exposed during the fetal period of prenatal development d. All 3 women would have approximately equal chances of having a child affected by the teratogen. Answer: a Rationale: During the germinal period, teratogens rarely have an effect, because implantation has not yet occurred; therefore, chemicals and diseases are not easily transmitted to the zygote. 96. Heart defects are especially common when pregnant mothers are exposed to a teratogen during which prenatal period? a. the germinal period b. the embryonic period c. the fetal period d. the last two weeks before birth Answer: b Rationale: The heart is typically susceptible to teratogens during weeks 3 to 5, which fall in the embryonic period (weeks 3-8). 97. The drug tetracycline, which is a frequently prescribed antibiotic, has been shown to have a teratogenic effect on: a. the development of the eyes and ears b. the development of limbs c. the development of the heart d. the development of teeth and bones Answer: d Rationale: The correct answer is d. Tetracycline, a frequently prescribed antibiotic, has been shown to have a teratogenic effect on the development of teeth and bones in the fetus if taken during pregnancy. This underscores the importance of caution when prescribing medications to pregnant individuals, as certain drugs can adversely affect fetal development. 98. According to statistics cited in the text, about what percent of U. S. women who know they are pregnant report “risk drinking” of alcohol? a. 25% b. 15% c. 10% d. 3% Answer: d Rationale: One of every thirty women (about 3%) that knows she is pregnant reports risk drinking, which is defined as seven or more drinks per week or five or more drinks on any one occasion. 99. Research suggests that fetal alcohol syndrome is most closely associated with which of the following conditions? a. newborns being born overweight b. facial abnormalities c. heart defects d. hyperactivity Answer: b Rationale: Fetal alcohol syndrome (FAS) is characterized by a range of physical and developmental abnormalities, including facial abnormalities such as a smooth philtrum, thin upper lip, and small eye openings. These facial features are key diagnostic markers for FAS. 100. The position of the Surgeon General of the United States is that women who are pregnant should drink no more than what amount of alcohol per week during pregnancy? a. no more than 3 drinks per week, and never more than one drink per day b. no more than 2 drinks per week c. no more than 1 drink per week d. No alcohol whatsoever should be consumed during pregnancy. Answer: d Rationale: The Surgeon General of the United States advises that pregnant women should abstain from alcohol consumption entirely during pregnancy to prevent any risk of fetal alcohol spectrum disorders. 101. Research cited in the text suggests that cigarette smoking during pregnancy interferes with prenatal development primarily because: a. oxygen flow is reduced to the fetus b. cigarette smoke includes teratogens that can cross the placental barrier c. women who smoke cigarettes are more likely to also use alcohol d. women who smoke are more likely to have poor nutrition Answer: a Rationale: Research suggests the smoking damages fetuses through damage to the placenta and constriction of blood vessels in the uterus, leading to a reduced flow of nutrients and oxygen. 102. According to the text, marijuana exposure during the prenatal period leads to: a. a greater likelihood that the child will be born with an addiction b. a greater likelihood that the child will develop an addiction later in life c. low birth weight and a higher risk of stillbirth d. disruptions in the brain and other organ systems Answer: d Rationale: Prenatal exposure to marijuana can lead to disruptions in the development of the fetal brain and other organ systems, potentially leading to cognitive and behavioral issues later in life. 103. The negative effects of prenatal exposure are especially significant for: a. boys b. girls c. first-born children d. last-born children Answer: a Rationale: Research suggests that male fetuses may be more vulnerable to the negative effects of prenatal exposure to substances such as drugs and alcohol compared to female fetuses. 104. The addictive drug that is most closely tied to an increased risk of spontaneous abortion, a higher risk of premature birth, greater complications during labor, and increased risk of developing attention deficit disorder and learning disabilities during childhood is: a. alcohol b. marijuana c. cocaine d. nicotine Answer: c Rationale: Cocaine use during pregnancy is associated with a range of adverse outcomes for both the mother and the fetus, including spontaneous abortion, premature birth, labor complications, and increased risks of developmental issues in the child. 105. Prenatal exposure to mercury is most likely to result from eating a diet high in: a. cereals b. raw vegetables c. beef and pork d. fish Answer: d Rationale: Prenatal exposure to mercury primarily occurs through the consumption of certain types of fish that are contaminated with high levels of mercury, such as swordfish, shark, tilefish, and king mackerel. 106. If a woman’s doctor urged her to be especially careful about eating food served on hand-made pottery, you would assume that the doctor is trying to limit this woman’s exposure to: a. PCBs b. lead c. radiation d. harmful bacteria Answer: b Rationale: Lead is sometimes used in the glazes and paints used in making pottery. 107. Because radiation can have damaging effects during the prenatal period, pregnant women are usually cautioned to avoid: a. fish from the oceans off Japan b. x-rays that are not essential c. eating from glazed pottery dishes d. swimming in polluted lakes and rivers Answer: b Rationale: X-ray procedures exposed people to small doses of radiation. Although the radiation level of x-rays is very small and unlikely to cause damage, it is generally recommended that pregnant women delay them if possible until after childbirth. Childbirth 108. Which of the following stages is NOT one of the stages of childbirth? a. afterbirth b. initial labor c. delivery d. Braxton-Hicks contractions Answer: d Rationale: Braxton-Hicks contractions, also known as false labor, are not considered one of the formal stages of childbirth. They are irregular, sporadic contractions that can occur throughout pregnancy, typically becoming more noticeable as the due date approaches. 109. When initial labor begins, mild uterine contractions usually are about ______ minutes apart: a. 60 b. 10 c. 15 to 20 d. 1 to 2 Answer: c Rationale: During the initial stage of labor, contractions typically start off mild and occur approximately every 15 to 20 minutes as the cervix begins to dilate and efface. 110. The typical length of initial labor ranges from between a few minutes to as many as ____ hours. a. 100 b. 60 c. 30 d. 2 Answer: c Rationale: The initial stage of labor can last varying lengths of time, ranging from a few minutes to around 30 hours, depending on factors such as the mother's health, the baby's position, and whether it's a first or subsequent pregnancy. 111. When Braxton-Hicks contractions occur, they are considered to be part of: a. false labor b. initial labor c. delivery d. afterbirth Answer: a Rationale: Braxton-Hicks contractions are often referred to as false labor because they are irregular contractions that do not lead to cervical dilation or true labor. They are considered a normal part of pregnancy. 112. Suppose that your pregnant friend calls to tell you that she has just experienced “showing.” You should know that showing: a. occurs as the amniotic sac ruptures and fluid is released b. involves the release of the mucous plug that covers the cervix c. involves the baby’s descent into the birth canal, where its body features can now be distinguished more clearly d. she is having Braxton-Hicks contractions Answer: b Rationale: One event that may occur during initial labor is called showing, in which a mucus plug that covers the cervix is released; some bleeding may also occur during showing. 113. Maria is in her ninth month of pregnancy. She begins to feel contractions, but when she gets up and walks around, the contractions go away. Most likely, she has experienced which of the following? a. showing b. the first stage of labor c. the second stage of labor d. Braxton-Hicks contractions Answer: d Rationale: False labor, also called Braxton–Hicks contractions, refer to contractions that generally diminish if the mother walks. 114. One method of determining whether contractions are part of false labor is to see if they go away or diminish: a. when the mother breathes deeply b. after 10 minutes c. when the mother walks d. after several minutes of abdominal massage Answer: c Rationale: Braxton-Hicks contractions typically subside or diminish in intensity when the mother changes positions, such as walking or moving around. This is a key characteristic that helps differentiate them from true labor contractions, which persist and become stronger over time. 115. When a mother’s water breaks, this is the result of which of the following? a. the mucus plug that covers the cervix is released b. the mother urinates uncontrollably c. the amniotic sac ruptures and amniotic fluid is expelled d. the placenta is expelled Answer: c Rationale: During initial labor, the amniotic sac may break and amniotic fluid may rush forth. When this happens we say that the mother’s “water breaks.” 116. In comparison to having her first child, a mother having her third child should expect that: a. this child will be more likely to be a boy b. this child will be more likely to be a girl c. her labor and delivery will take longer d. her labor and delivery will take a shorter amount of time Answer: d Rationale: As noted in the text, labor and delivery usually takes from 10 to 40 minutes and tends to be shorter with succeeding births. 117. An excited father who is watching his daughter be born exclaims with excitement, “I can see her head!” Technically, this would be referred to as: a. “showing” b. “crowning” c. an Apgar of 1 d. traditional childbirth Answer: b Rationale: Normally, the first part of the baby to emerge from the birth canal is the head. First it “crowns,” or becomes visible, then it emerges farther with each contraction. 118. Sometimes physicians make an incision during childbirth to enlarge the vaginal opening. Such a procedure is called: a. caesarean section b. amniocentesis c. episiotomy d. chorionic villus sampling Answer: c Rationale: During birth, the tissue of the mother’s perineum (the region between the vagina and the rectum) must stretch considerably to allow the baby’s head to emerge. In U.S. hospitals, the attending physician often makes an incision called an episiotomy to enlarge the vaginal opening. 119. In most cases, why would an episiotomy be performed? a. because the baby needs to be born faster, due to complications b. because the baby’s Apgar score is very low c. because the mother is unable to deliver the baby without pain killing medication d. because the baby’s head is so large that the vaginal opening might tear Answer: d Rationale: During birth, the tissue of the mother’s perineum (the region between the vagina and the rectum) must stretch considerably to allow the baby’s head to emerge. In U.S. hospitals, the attending physician often makes an incision called an episiotomy to enlarge the vaginal opening. It is believed that an incision will heal more neatly than the jagged tear that might otherwise occur. 120. Which of the following positions of the child during birth is considered most typical? a. head first, face down b. head first, face up c. buttocks first, face down d. buttocks first, face up Answer: a Rationale: As noted in the textbook, the first part of the baby to emerge from the birth canal is normally the head. In most normal births, the baby is born in a face-down position. 121. Which of the following stages of labor is typically least painful for the mother? a. initial labor b. the second stage of labor c. the birth itself d. the afterbirth Answer: d Rationale: The expulsion of the placenta, the umbilical cord, and related tissues marks the third stage of childbirth, called afterbirth. This stage is virtually painless and typically occurs within 20 minutes after the delivery. 122. During the process of labor and delivery, when is the afterbirth typically delivered? a. just before the infant is born b. at the same time that the infant is born c. about 1 to 2 hours after the infant is born d. about 20 minutes after the infant is born Answer: d Rationale: The afterbirth, also known as the placenta, is typically delivered about 20 minutes after the infant is born. This is a normal part of the third stage of labor. 123. According to the text, traditional childbirth is typically done: a. in a birthing center b. in a hospital c. at home d. anywhere, including in a birthing center, in a hospital, or at home Answer: b Rationale: Traditional childbirth is typically done in a hospital setting. While options such as birthing centers and home births are available, the majority of traditional births occur in hospitals where medical facilities and expertise are readily accessible. 124. If a mother wanted a midwife to deliver her baby, the type of childbirth method most likely involved would be: a. traditional childbirth b. Caesarean section c. natural childbirth d. premature childbirth Answer: c Rationale: A midwife is a woman who is experienced in childbirth, with or without training, who assists with home delivery. 125. In prepared childbirth, the primary function of the relaxation and breathing techniques used is to: a. increase the supply of oxygen to the baby during delivery b. increase the Apgar score of the baby at the time of delivery c. help the mother cope more effectively with the pain of delivery d. reduce the carbon dioxide content of the mother’s blood Answer: c Rationale: As noted in the text, the relaxation exercises help reduce the pain of labor and delivery; the breathing and other techniques help distract the mother from any discomfort she may be feeling. 126. Which of the following is generally true, regarding the use and philosophy of birthing centers? a. Usually mothers stay for a least a week in a birthing center following delivery. b. Fathers are usually excluded from the birthing center except during delivery, so the baby has a better chance of becoming attached to the mother. c. Usually babies are removed from the birthing center and cared for by experienced nurses, so that the exhausted mother can get some much-needed rest. d. The entire labor and delivery occurs in the same room. Answer: d Rationale: Birthing centers (or suites) are designed to accommodate the entire childbirth process from labor through delivery and recovery; thus, they attempt to combine the privacy and intimacy of a home birth with the safety and backup of medical technology. Mothers are encouraged to spend lots of time with baby to encourage early attachment. 127. Suppose Janet is 12 weeks pregnant and is concerned that she may be carrying twins or triplets. She goes in for diagnostic testing, which most likely would consist of: a. amniocentesis b. chorionic villus sampling c. an ultrasound d. fetal monitoring Answer: c Rationale: Ultrasound is typically done around the 15th week, but with high-resolution scanning, can now be done earlier. It is the least invasive and most widely used method to provide information about the growth and health of the fetus. 128. Which of the following methods of providing information about the growth and health of the fetus is the least invasive and most widely used? a. amniocentesis b. fetoscopy c. CVS d. ultrasound Answer: d Rationale: Ultrasound is the least invasive and most widely used method for providing information about the growth and health of the fetus. It uses sound waves to create images of the fetus and is routinely used during pregnancy for various purposes such as confirming pregnancy, monitoring fetal development, and assessing fetal health. 129. Suppose that Aletha is in her first trimester of pregnancy and she begins to experience some vaginal bleeding. Her doctor suspects an ectopic pregnancy, so most likely the doctor will do which of the following procedures? a. amniocentesis b. chorionic villus sampling c. an ultrasound d. fetal monitoring Answer: c Rationale: Ultrasound is typically done around the 15th week, but with high-resolution scanning, can now be done earlier. It is the least invasive and most widely used method to provide information about the growth and health of the fetus. 130. Amniocentesis is typically performed at about which week of pregnancy? a. 16th week b. 21th week c. 25th week d. 32nd week Answer: a Rationale: Amniocentesis is typically performed around the 16th week of pregnancy. It involves taking a sample of the amniotic fluid surrounding the fetus for genetic testing and other diagnostic purposes. 131. Chorionic villus sampling is: a. done much later in a pregnancy than amniocentesis b. done earlier in a pregnancy than amniocentesis c. is another name for amniocentesis d. is only done when amniocentesis cannot be done Answer: b Rationale: Chorionic villus sampling (CVS) is done earlier in a pregnancy than amniocentesis. It is typically performed between the 10th and 13th weeks of pregnancy and involves taking a sample of the chorionic villi, which are tiny finger-like projections on the placenta, for genetic testing. 132. Which of the following techniques results in a karyotype picture of the baby’s chromosomes? a. ultrasound b. fetal monitoring c. chorionic villus sampling d. an Apgar test Answer: c Rationale: Chorionic villus sampling (CVS) refers to the withdrawal and analysis of cells from the membranes that surround the fetus, either with a syringe or with a catheter. Both amniocentesis and CVS involve the collection of cells for karyotyping, but because more cells are collected in this procedure than in amniocentesis, the test can be completed more quickly. 133. Why is fetal monitoring generally used only with high-risk deliveries? a. because it is dangerous, and can cause a miscarriage b. because it reduces the supply of oxygen available to the baby during the birth process c. because it is quite painful for the mother d. because its use is associated with a significantly higher use of unnecessary caesarean sections Answer: d Rationale: Fetal monitoring is generally used only with high-risk deliveries because its use is associated with a significantly higher rate of unnecessary caesarean sections. It is not inherently dangerous or painful, but its overuse can lead to interventions that may not be necessary in low-risk deliveries. 134. If a baby is positioned so that it will be born face up, this is called a _________ presentation; if the baby is positioned so that it will be born buttocks first, this is called a _____________ presentation. a. normal; breech b. breech; normal c. breech; posterior d. posterior; breech Answer: d Rationale: If a baby is positioned so that it will be born face up, it is called a posterior presentation; if the baby is positioned so that it will be born buttocks first, it is called a breech presentation. 135. Sondra finds out that her baby will be born head first, face up. This birthing situation would be correctly described as which of the following? a. posterior presentation b. breech presentation c. posterior breech presentation d. normal Answer: a Rationale: Posterior presentation refers to a situation in which the baby is facing the mother’s abdomen rather than her back; In this situation, a more difficult birth process often results. 136. While observing the birth of his daughter, Mr. Johnson sees that she will be born buttocks first. He would correctly describe this type of birth as: a. posterior presentation b. breech presentation c. normal presentation d. Apgar presentation Answer: b Rationale: Breech presentation refers to a position of the baby in the uterus in which the head will emerge last. In this situation, assistance is sometimes needed in such cases to prevent injury to the infant. 137. About what percent of births in the U.S. today are performed by cesarean section? a. 5-10% b. 15-20% c. 25% d. 33% Answer: d Rationale: Approximately 33% of births in the U.S. today are performed by cesarean section. This rate has been a subject of discussion and concern due to its potential overuse and associated risks compared to vaginal delivery. 138. Why did the American Academy of Pediatrics take the position that electronic fetal monitoring be abandoned in low-risk pregnancies: a. it is very expensive b. it takes too much of the doctor’s time during labor and delivery c. it leads to an increase in cesarean deliveries d. it is too risky for the fetus Answer: c Rationale: Electronic fetal monitoring has been associated with an increased rate of cesarean deliveries, particularly in low-risk pregnancies where it may not provide significant benefits in terms of outcomes. Therefore, the American Academy of Pediatrics recommended abandoning it in such cases to avoid unnecessary surgical interventions. 139. What is a perfect Apgar score? a. 0 b. 1 c. 7 d. 10 Answer: d Rationale: A perfect Apgar score is 10, indicating that the newborn is in the best possible condition immediately after birth, with optimal heart rate, respiratory effort, muscle tone, reflex irritability, and color. 140. Suppose a baby is born whose Apgar score is 3. What would such a score most likely indicate? a. All vital signs are perfect. b. All vital signs are normal. c. Some of the baby’s bodily processes are not functioning fully. d. Immediate emergency measures are required. Answer: d Rationale: A perfect Apgar score is 10 points, with a score of 7 or more considered normal. Scores below 7 indicate that some bodily processes are not functioning fully and may require special procedures. Babies with a score of 4 or less require immediate emergency measures. 141. Mary's newborn son was given the Apgar test at 1 minute and again at 5 minutes after birth. If he received a perfect score both times, what would the first and second Apgar scores be, respectively: a. 0 and 10 b. 5 and 10 c. 10 and 10 d. 10 and 20 Answer: c Rationale: A perfect Apgar score is 10 points, with a score of 7 or more considered normal. The scale does not change between first and second administrations of the test. 142. Baby Doe is born at 38 weeks and weighs just 4 pounds. He would be considered: a. premature b. preterm c. small-for-date d. malnourished Answer: c Rationale: A small-for-date newborn is a full-term newborn who weighs less than 5 pounds 8 ounces. Since Baby Doe was born at 38 weeks (full-term) he is neither premature nor preterm. The Evolving Family 143. The technique of kangaroo-care emphasizes the importance of: a. physical contact and a quiet environment b. having the father do some of the feedings, if possible c. making sure that no excess drugs are given to the mother during labor and delivery d. preparing older siblings for the birth of a new brother or sister Answer: a Rationale: Kangaroo care involves skin-to-skin contact between a newborn and the parent, usually the mother, promoting bonding, warmth, and stability in the newborn's environment. It emphasizes physical contact and a quiet environment to support the newborn's development. 144. About what percent of couples in the U.S. today have difficulty conceiving a child? a. 2-3% b. 5-7% c. 12% d. 23% Answer: c Rationale: Approximately 12% of couples in the U.S. experience difficulty conceiving a child, highlighting the prevalence of infertility issues in the population. 145. About what percent of U.S. women today use some type of reproductive technology to become pregnant? a. 0.1% b. 1% c. 4% d. 15% Answer: c Rationale: Around 4% of U.S. women today use some form of reproductive technology to become pregnant, including procedures such as in vitro fertilization (IVF) or artificial insemination. 146. If a 42-year old woman elected to use assisted reproductive technology to help her become pregnant, she should expect to spend about for one cycle of treatment and know that her odds of success are about . a. $500; 60% b. $2,000; 40% c. $12,000; 15% d. $35,000; 5% Answer: c Rationale: Today, one cycle of ART costs about $12,000 to $15,000. For healthy women under age 35, chances of success are about 42%, but by age 41 this percentage has fallen to about 15%. 147. A baby who is between 0 and 1 month of age is referred to as a(n): a. embryo b. neonate c. fetus d. zygote Answer: b Rationale: A baby who is between 0 and 1 month of age is referred to as a neonate, which is the term used to describe a newborn infant. 148. In the last few moments before birth, infants experience a major surge of: a. adrenaline and noradrenalin b. oxygen c. carbon dioxide d. protein Answer: a Rationale: In the last few moments before birth, infants experience a surge of adrenaline and noradrenaline, which helps prepare them for the transition to the outside world by increasing heart rate, breathing rate, and alertness. 149. A new mother is surprised to see that her newborn looks like he is covered with cottage cheese. The substance she is noticing is called: a. vernix caseosa b. noradrenalin c. lanugo d. molding Answer: a Rationale: As noted in the text, the body of a newborn may be covered with remnants of the vernix caseosa, a cheesy-looking protective coating. 150. A new mother is surprised to see that her newborn looks “furry” like he is covered with a coat of hair. The “fur” she notices is called: a. vernix caseosa b. lanugo c. molding d. crowning Answer: b Rationale: As noted in the textbook, the body of a newborn may be covered with lanugo hair, which should disappear during the first month. 151. When baby Rex is bounced gently on his father’s knee, his father can see the skin on the top of Rex’s head move up and down, sort of like the skin is covering a bowl of jello. This is because: a. Rex’s brain has not yet solidified and is a soft mass of tissue b. the fontanels in Rex’s head have not yet fused into bone c. Rex must have some sort of bone disease that has prevented his skull from forming correctly d. Rex probably has Down syndrome Answer: b Rationale: At the time of birth, the soft, bony plates of the skull—called fontanels—are connected only by cartilage areas, which are squeezed together in the birth canal to allow the baby’s head to pass through, giving the newborn a “cone-head” appearance. Fontanels do not fully harden and fuse until late in infancy, which is why an infant’s or young toddler’s head must be protected from bumps; otherwise, there is a risk of concussion. 152. Which of the following is NOT an example of a survival response? a. palmar grasp b. sucking c. rooting d. breathing Answer: a Rationale: Survival reflexes are just that: reflexes necessary for adaptation and survival, especially during the first days or weeks before the higher brain centers begin to take control. Primitive reflexes are not necessary for survival now, but may have been important at some stage in our evolutionary history. The palmar grasp is a primitive reflex: When an infant’s palm is stimulated, the infant will grasp tightly and increase the strength of the grasp if the stimulus is pulled away. 153. When a neonate’s hand is stimulated by an object such as a finger or a pencil, the infant’s fingers will close tightly in a grasp. This behavior is best considered to be an example of: a. the plantar reflex b. the palmar grasp reflex c. the Moro reflex d. the Babinski reflex Answer: b Rationale: The palmar grasp is a primitive reflex. As noted in the textbook this reflex refers to the finding that when an infant’s palm is stimulated, the infant will grasp tightly and increase the strength of the grasp if the stimulus is pulled away. 154. When infants are held upright with their feet against a surface and are moved forward, they appear to walk in a coordinated way. This reflex is referred to as: a. palmar reflex b. stepping reflex c. Babinski reflex d. walking reflex Answer: b Rationale: As noted in the textbook, when infants are held upright with their feet against a flat surface and are moved forward, they appear to walk in a coordinated way – a reflex known as the stepping reflex. This reflex disappears after 2 or 3 months. 155. Which of the following is NOT considered to be a survival reflex present in newborns? a. breathing b. rooting c. sucking d. kicking Answer: d Rationale: Kicking is not considered a survival reflex in newborns. Breathing, rooting (searching for the nipple), and sucking are all reflexes essential for newborn survival. 156. Jackie is a new mother who says, “I just can’t stand to be away from my baby. I feel so close to him emotionally that I just love him.” Jackie’s comments reflect the core principle involved in: a. crowning b. attachment c. the Moro reflex d. the Babinski reflex Answer: b Rationale: Attachment refers to the reciprocal emotional bond that develops between a child and caregivers. 157. When her baby is born, Cynthia refuses to look at him or hold him. She feels no emotional connection with him at all and won’t give him a name. Cynthia’s reaction demonstrates a problem with the concept referred to as: a. attachment b. primitive reflexes c. advanced reflexes d. the Moro reflex Answer: a Rationale: Attachment refers to the reciprocal emotional bond that develops between a child and caregivers. Changing Perspectives: Nurse-Family Partnerships: An Early Intervention Program That Works 158. Which of the following is NOT one of the outcomes associated with the Nurse-Family Partnership program described in the text? a. much lower rates of child abuse and neglect b. much lower rates of arrest of teenagers raised in the program c. considerably higher rates of participation in welfare programs d. much lower rates of behavioral and intellectual problems for children raised in the program Answer: c Rationale: Participation in welfare programs is not an outcome associated with the Nurse-Family Partnership program. The program aims to reduce child abuse, improve developmental outcomes, and decrease involvement in criminal activities among participants. 159. According to the text, the cost of the Nurse-Family Partnership program described is about __________ per family served and the benefit to society is about _________ per family served. a. $13,000; $70,000 b. $34,000; $10,000 c. $50,000; $60,000 d. $80,000; $250,000 Answer: a Rationale: This program costs about $4,000 per year for 3 years ($13,500), but the benefit to society is about 5 times the cost ($67,500). 160. The major cost savings that result from providing Nurse-Family Partnership programs to at-risk families is achieved primarily through: a. private donations that are given to fund the program b. fewer doctor visits required for babies and children since these are covered by the nurse c. fewer emergency room calls d. less use of welfare programs Answer: d Rationale: The major cost savings from Nurse-Family Partnership programs primarily result from reduced reliance on welfare programs due to improved outcomes for children and families participating in the program. This includes decreased need for social services and public assistance. 161. The text describes a Nurse-Family Partnership program that aims to improve outcomes for newborns. Which of the following statements is the best description for what this program involves? a. Food supplements are delivered by nurses to low-income mothers beginning at the 3rd month and continuing on for 3 years after birth. b. Nurses provide counseling to at-risk mothers beginning in the prenatal period and continuing on for 2 years after birth. c. Nurses in the labor and delivery room with low-income mothers continue to visit them in their homes for 6 to 12 months to give advice on childrearing. d. Students in nursing school are paired with pregnant women so that they learn more about the psychological and social aspects of pregnancy and parenting. Answer: b Rationale: As noted in the textbook, the Nurse–Family Partnership begins when the mother is 20 to 28 weeks into her first pregnancy and focuses on addressing substance abuse issues and other behaviors that contribute to family poverty, subsequent pregnancies, poor maternal and infant outcomes, and poor child-care opportunities. Each mother enrolled in the program is matched with a highly trained public health nurse, who visits her every 1 to 2 weeks for the next 30 months, until the infant is about age 2. 162. Which of the following was NOT stated as an outcome for the Nurse-Family Partnership program described in the text? a. substantially lower rates of child abuse and neglect b. substantially fewer criminal convictions of children served when they grew to age 15 c. less time for the family spent on welfare d. substantially fewer divorces among parents in the families served by the program Answer: d Rationale: The textbook notes that research has yielded each of the findings above except the finding regarding divorce. Current Issues: Kangaroo Care for Low-Birth-Weight Infants: An Experimental Approach Being Tried in Countries Around the World 163. Kangaroo care is generally recommended when: a. the infant has no biological mother to care for it b. the mother is addicted to drugs c. the baby is born with HIV d. the baby is low birth weight Answer: d Rationale: Kangaroo care is aimed at calming and stabilizing fragile, low-birth-weight babies. 164. The primary feature of a “kangaroo care” environment is that it: a. involves a quiet and calming environment b. utilizes the skills of many different types of caregivers c. always is done within a hospital environment so appropriate medical intervention is available if needed d. is supported by Title 19 so that mothers do not have to pay for these services Answer: a Rationale: Kangaroo care emphasizes skin-to-skin contact between a newborn and the parent, typically the mother, in a quiet and calming environment. This close physical contact promotes bonding, warmth, and stability for the newborn, facilitating better developmental outcomes. True-False questions: Prenatal Growth and Development 165. In the United States, fewer than 30% of all pregnancies are unplanned. Answer: False Rationale: In the U. S. about 50% of all pregnancies are unintended; for teens the percentage is about 66%. 166. A trimester is a period of time during pregnancy equal to about 3 months. Answer: True Rationale: A trimester is indeed approximately three months long, and pregnancy is often divided into three trimesters: the first trimester lasts from week 1 to week 12, the second trimester from week 13 to week 26, and the third trimester from week 27 until birth. 167. Ovulation in the female typically occurs approximately 14 days after menstruation. Answer: True Rationale: Ovulation usually occurs around the middle of the menstrual cycle, which is typically around day 14 in a 28-day cycle. However, this can vary among individuals and cycles may vary in length. 168. Sperm can only survive in the vagina for 24 hours. Answer: False Rationale: Sperm can survive about 5 days in the vagina. 169. Fertilization takes place in the uterus. Answer: False Rationale: Fertilization usually takes place in the fallopian tubes. 170. Implantation of the zygote in the uterus occurs after it has formed into a blastula, but before the cells begin to differentiate. Answer: True Rationale: Implantation typically occurs around 6-10 days after fertilization, at which point the zygote has developed into a blastocyst. At this stage, the cells have begun to differentiate into the inner cell mass and the trophoblast, but full differentiation into specific tissues has not yet occurred. 171. Dizygotic twins have identical DNA. Answer: False Rationale: Dizygotic twins are formed when two different ova are fertilized by two different sperm. Therefore, genetically dizygotic twins are as similar as any sibling pair. Monozygotic twins are formed when a single fertilized ovum divides into two identical zygotes. Monozygotic twins are genetically identical. 172. The layer of cells in the ectoderm will eventually differentiate to become the skin, the sense organs, and the brain and nervous system. Answer: True Rationale: During embryonic development, the ectoderm is one of the primary germ layers that gives rise to various tissues and structures, including the epidermis (skin), nervous system (including the brain), and sensory organs. 173. All of the structures that we recognize as human, such as arms, legs, and eyes, develop during the first 2 weeks of pregnancy. Answer: False Rationale: The structures we recognize as human develop during the second month of pregnancy. 174. For every 100 males conceived, there are about 110 females conceived. Answer: False Rationale: For every 100 females conceived, about 125 males are conceived. 175. Currently in the U. S., the age of viability is 24 weeks, but just 4 weeks later the survival rate increased to about 90%. Answer: True Rationale: The age of viability refers to the gestational age at which a fetus has a chance of surviving outside the womb with medical intervention. In the U.S., this is typically considered to be around 24 weeks of gestation, although survival rates increase significantly with each passing week. By 28 weeks, the survival rate is indeed around 90% or higher with appropriate medical care. 176. In most parts of the world, the infant mortality rate has been declining. Answer: True Rationale: Infant mortality rates have generally been decreasing globally due to advancements in healthcare, improved sanitation, better access to nutrition, and other factors promoting infant health. 177. The cephalocaudal trend describes growth that occurs from the “head to the tail”. Answer: True Rationale: The cephalocaudal trend is a principle of development stating that growth and development proceed from the head (cephalic region) down to the tail (caudal region), meaning that the head develops before the lower parts of the body. Prenatal Environmental Influences 178. The lowest risk for miscarriage and congenital anomalies is observed for mothers under 20 years of age. Answer: False Rationale: The lowest risk for miscarriage and congenital anomalies is observed for mothers in their 20s. 179. Today, most doctors recommend that a healthy pregnant woman who is carrying one child should gain about 18 pounds during pregnancy. Answer: False Rationale: The text states that a woman should gain between 25 and 35 pounds during pregnancy. 180. The effects of prenatal malnutrition are usually least when the malnutrition is of short duration. Answer: True Rationale: Prenatal malnutrition can have detrimental effects on fetal development, but the severity of these effects often depends on factors such as the timing, duration, and extent of malnutrition. Short-term malnutrition may have milder effects compared to long-term or severe malnutrition. 181. Research has demonstrated that providing prenatal education to expectant mothers who otherwise would not receive it can reduce infant mortality rates and premature-birth rates. Answer: True Rationale: Prenatal education can empower expectant mothers with knowledge about proper nutrition, prenatal care, and healthy behaviors during pregnancy, which can contribute to reducing infant mortality rates and the incidence of premature births through improved maternal and fetal health. 182. A critical period is a time span in development during which teratogens will have no effect. Answer: False Rationale: Teratogens influence development during critical periods. 183. The specific effect that a teratogen such as thalidomide has depends on when the exposure to the teratogen takes place. This concept is referred to as a “critical period” in development. Answer: True Rationale: A critical period in development refers to a specific window of time during embryonic or fetal development when an organism is particularly vulnerable to the effects of teratogens. Exposure to teratogens during these critical periods can result in specific developmental abnormalities or defects. Thalidomide, for example, is known to cause limb malformations when exposure occurs during the critical period for limb development. 184. Bacterial infections experienced by the mother during pregnancy typically have little or no impact on the developing fetus because bacteria cannot cross the placental barrier. Answer: True Rationale: True. The placental barrier is highly effective in preventing most bacteria from crossing into the fetal bloodstream. Therefore, bacterial infections in the mother generally do not directly affect the fetus unless there are complications such as fever or other systemic effects. 185. In Africa, about 5% of the population is infected with HIV. Answer: True Rationale: True. HIV/AIDS is a significant health concern in Africa, with several countries in the region experiencing high prevalence rates. While the exact percentage may vary by country and region, a figure of around 5% is not uncommon in many African nations. 186. Accutane, a drug given to treat acne, is a known teratogen. Answer: True Rationale: True. Accutane (isotretinoin) is indeed classified as a teratogen, meaning it can cause birth defects if taken during pregnancy. It is highly teratogenic and is associated with a range of serious birth defects, particularly if taken during the first trimester of pregnancy. 187. According to research cited in the text, even small amounts of alcohol consumption during pregnancy can lead to abnormalities in the fetus. Answer: True Rationale: True. Research has shown that even small amounts of alcohol consumption during pregnancy can pose risks to the developing fetus. Fetal alcohol spectrum disorders (FASDs) can result from prenatal alcohol exposure, leading to a range of physical, behavioral, and cognitive abnormalities in the child. 188. To date, there have been no known birth defects associated with the mother’s use of marijuana during pregnancy. Answer: False Rationale: Smoking cannabis (marijuana) is linked to birth defects in the cardiovascular and gastrointestinal systems, and to certain structural defects. It also is linked to general cognitive deficiencies, including increased impulsiveness and problems paying attention and to deficits in learning and memory. 189. To reduce exposure risk to mercury, pregnant women are sometimes recommended to limit their consumption of fish. Answer: True Rationale: True. Fish consumption can be a significant source of mercury exposure, which is known to be harmful, especially during pregnancy. Therefore, pregnant women are often advised to limit their intake of certain types of fish, particularly those high in mercury, to reduce the risk of adverse effects on the developing fetus. Childbirth 190. During childbirth, when the mother’s “water breaks,” urine is involuntarily released. Answer: False Rationale: When the mother’s water breaks, this results from a rupture in the amniotic sac, which allows the amniotic fluid to be released. 191. An episiotomy is a surgical procedure in which the mother’s skin is cut in order to increase the size of the vaginal opening and prevent tearing during the birth process. Answer: True Rationale: True. An episiotomy is indeed a surgical procedure performed during childbirth to widen the vaginal opening, reducing the risk of severe tearing during delivery. However, the routine use of episiotomy has declined in recent years due to evidence suggesting it may not offer significant benefits and could lead to complications. 192. Birthing centers are places where all stages of childbirth can occur. Answer: True Rationale: True. Birthing centers are facilities specifically designed to provide a more homelike environment for childbirth, offering a range of maternity care services. These centers support natural childbirth and typically provide care throughout all stages of labor, delivery, and the immediate postpartum period. 193. The most widely used diagnostic procedure used to provide information about the developing fetus is amniocentesis. Answer: False Rationale: Ultrasound is the most widely used procedure. 194. Physicians routinely recommend that expectant mothers over the age of 35 consider amniocentesis in order to test for genetic abnormalities in the fetus. Answer: True Rationale: True. Advanced maternal age, typically defined as 35 years or older at the time of delivery, is associated with an increased risk of chromosomal abnormalities such as Down syndrome in the fetus. Therefore, physicians often recommend amniocentesis, a prenatal diagnostic test, to assess for genetic abnormalities in pregnancies involving older mothers. 195. Physicians generally use fetal monitors only in high-risk pregnancies because they pose an increased risk for infection for the mother. Answer: False Rationale: Fetal monitors are usually used only for high-risk pregnancies because their use is linked to a higher than necessary rate of caesarean deliveries. 196. The most desirable score on the Apgar scale is a 5. Answer: False Rationale: The Apgar scale runs from 1 to 10, with high scores indicating better health at the time of birth. Thus, the most desirable score would be a 10. 197. If a child is born early, it is referred to as having preterm status. If it is born early and it weighs less than 5 pounds 8 ounces, it is termed small-for-date. Answer: False Rationale: If a child is born before 35 weeks of gestation, it is referred to as having preterm status. However, to be termed small-for-date, the baby must weigh less than 5 pounds 8 ounces and also be full term. 198. Infants who are born prematurely are at higher risk for having learning disabilities and hyperactivity. Answer: True Rationale: True. Premature birth, especially very preterm birth (before 32 weeks of gestation), is associated with a higher risk of neurodevelopmental complications, including learning disabilities and attention-deficit/hyperactivity disorder (ADHD). Factors such as immature brain development and potential complications related to prematurity contribute to these risks. The Evolving Family 199. Today in the U.S., about 10% of women use one or more reproductive technologies to become pregnant. Answer: False Rationale: The current usage rate is about 4%. 200. Although Freud viewed birth as a traumatic experience for the newborn, modern psychologists do not believe that the process of birth places stress on the infant. Answer: False Rationale: The birth process requires enormous changes for the newborn and is a very stressful time. 201. At birth, newborns do not possess any survival reflexes; rather, these reflexes emerge gradually during the two weeks following birth. Answer: False Rationale: The survival reflexes are present at birth and they help the newborn adjust to life outside its mother’s body. 202. Attachment is a term psychologists use to refer to the reciprocal bonds of affection and emotional closeness that form between an infant and its parents or caregivers. Answer: True Rationale: True. Attachment theory, pioneered by John Bowlby, describes the emotional bond that forms between infants and their primary caregivers, typically parents. This bond is crucial for the infant's emotional development and influences their future relationships and social interactions. Short Answer questions: Prenatal Growth and Development 203. Describe how the three periods of prenatal development (germinal, embryonic, and fetal) overlap with the three trimesters of pregnancy. Answer: The three periods of prenatal development overlap with the three trimesters of pregnancy as follows: 1. Germinal Period: This period begins at conception and lasts for about two weeks until implantation into the uterine wall. It corresponds roughly to the first trimester, particularly the first month. 2. Embryonic Period: This stage begins after implantation and lasts until the end of the eighth week of pregnancy. It coincides with the first and second trimesters, primarily encompassing the first three months. 3. Fetal Period: It starts at the beginning of the ninth week and continues until birth. This period corresponds to the third trimester, covering the last six months of pregnancy. 204. Explain the process by which monozygotic and dizygotic twins occur, explaining why monozygotic twins are more similar to each other than are dizygotic twins. Answer: • Monozygotic Twins: Monozygotic twins occur when a single fertilized egg, or zygote, splits into two embryos during early development, usually within the first two weeks after conception. These twins share identical genetic material and are thus called identical twins. They are more similar to each other because they originate from the same zygote, inheriting the same set of genes. • Dizygotic Twins: Dizygotic twins result from the fertilization of two separate eggs by two separate sperm cells, leading to the development of two genetically distinct embryos. These twins are no more genetically similar than any other siblings, as they share approximately 50% of their genetic material on average. They are commonly referred to as fraternal twins. 205. What are the most important developmental events that occur in the germinal period? Answer: The germinal period is characterized by several critical developmental events, including: 1. Fertilization: The fusion of sperm and egg to form a zygote. 2. Formation of the Zygote: Following fertilization, the zygote undergoes rapid cell division through mitosis. 3. Migration and Implantation: The zygote travels down the fallopian tube to the uterus, where it implants into the uterine wall around 6-10 days after fertilization. 4. Formation of the Blastocyst: The zygote transforms into a blastocyst, consisting of an inner cell mass that will develop into the embryo and an outer layer that will form the placenta. 5. Initiation of Amniotic Sac and Placenta Development: The amniotic sac, which surrounds and protects the developing embryo, begins to form, and the placenta starts to develop, facilitating nutrient and waste exchange between the mother and the embryo. 206. Identify two body structures that develop from each of the following parts of the embryonic disk: ectoderm, mesoderm, and endoderm. Answer: • Ectoderm: 1. Central Nervous System: This includes the brain and spinal cord. 2. Epidermis: The outer layer of the skin and its appendages, such as hair and nails. • Mesoderm: 1. Musculoskeletal System: This includes muscles, bones, and connective tissues. 2. Cardiovascular System: Structures like the heart, blood vessels, and blood cells originate from the mesoderm. • Endoderm: 1. Gastrointestinal Tract: The lining of the digestive system, including the stomach, intestines, and associated organs. 2. Respiratory System: Structures such as the lungs and bronchi develop from the endoderm. 207. How does the development of the body’s structures differ in the embryonic period from that which occurs in the fetal period? Answer: During the embryonic period, the basic structures of the body form through processes like gastrulation and neurulation, leading to the development of major organ systems. In contrast, the fetal period is characterized by the growth and refinement of these structures, as organs mature and develop further. 208. Suggest two reasons why males are more vulnerable in early life than are females. Answer: 1. Developmental vulnerability: Male fetuses tend to develop more slowly and have a higher incidence of complications such as prematurity and low birth weight compared to females, making them more vulnerable in early life. 2. Genetic factors: Some genetic disorders are more common in males, which can increase their vulnerability in early life compared to females. 209. Give a clear example of each of the following developmental trends: cephalocaudal trend, proximodistal trend, and gross-to-specific trend. Answer: 1. Cephalocaudal trend: This refers to the pattern of development where growth and development occur from head to toe. An example is the development of motor skills, where infants first gain control over their head movements before mastering control over their limbs. 2. Proximodistal trend: This trend involves development from the center of the body outward. An example is the development of the arms, where control over shoulder movements precedes control over hand movements. 3. Gross-to-specific trend: This trend involves the development of general skills before more specific ones. An example is in language development, where infants first produce simple sounds like cooing before progressing to specific phonemes and words. Prenatal Environmental Influences 210. Suggest two reasons that might explain why older mothers have higher risks for miscarriage and for some congenital anomalies. Answer: 1. Increased chromosomal abnormalities: As women age, the quality of their eggs decreases, leading to a higher risk of chromosomal abnormalities such as Down syndrome, which increases the risk of miscarriage and congenital anomalies. 2. Decreased ovarian reserve: Older mothers have a reduced number of viable eggs and a decline in ovarian function, which can lead to difficulties in conception and an increased risk of miscarriage and congenital anomalies. 211. Describe the results of the malnutrition research described in the text, noting the outcomes of programs that attempt to remediate malnutrition by providing food supplements in infancy. Answer: The results of malnutrition research often highlight the critical importance of early intervention. Programs that aim to remediate malnutrition by providing food supplements in infancy have shown promising outcomes. These interventions not only address immediate nutritional deficiencies but also contribute to long-term health and cognitive development. Studies have demonstrated that infants who receive adequate nutrition during critical developmental periods tend to exhibit improved physical growth, cognitive function, and overall well-being compared to those who experience prolonged malnutrition. 212. Define the term “critical period” as it is used in studies of how teratogens exert their effects. Answer: In studies of teratogens, the term "critical period" refers to a specific developmental stage during which the embryo or fetus is particularly vulnerable to the effects of external factors. These periods are characterized by rapid and crucial physiological and morphological changes. Exposure to teratogens during these critical periods can significantly disrupt normal development, leading to structural abnormalities, functional impairments, or other adverse outcomes. 213. Describe three different ways a teratogen can be passed along to the developing embryo or fetus, and provide an example of a teratogen that is passed along in each of these three methods. Answer: 1. Maternal circulation: Teratogens can be transmitted to the developing embryo or fetus through the mother's bloodstream. For example, alcohol consumed by the mother crosses the placental barrier, exposing the fetus to its teratogenic effects. 2. Placental barrier breach: Some teratogens can directly breach the placental barrier and enter the fetal bloodstream. A notable example is the rubella virus, which can cross the placenta and cause congenital rubella syndrome. 3. Amniotic fluid exposure: Teratogens may also enter the developing embryo or fetus through exposure to contaminated amniotic fluid. An example of this is exposure to certain medications or illicit drugs that the mother consumes during pregnancy, such as thalidomide, which can lead to limb deformities. 214. What are two things that can be done to prevent the HIV virus from being passed from mother to fetus? Answer: 1. Antiretroviral therapy (ART): Administering antiretroviral drugs to the HIV-positive mother during pregnancy, labor, and delivery significantly reduces the risk of vertical transmission to the fetus. ART effectively suppresses viral replication, thereby lowering the viral load in maternal blood and bodily fluids, minimizing the chances of transmission to the fetus. 2. Elective Cesarean section: In cases where maternal viral load remains detectable close to delivery despite ART, opting for a scheduled cesarean delivery (elective cesarean section) can further decrease the risk of HIV transmission to the fetus. Delivery via cesarean section reduces exposure of the infant to maternal blood and vaginal secretions, which may contain the virus. 215. Describe the symptoms associated with fetal alcohol syndrome (FAS). Answer: Fetal Alcohol Syndrome (FAS) is characterized by a range of physical, cognitive, and behavioral abnormalities resulting from prenatal alcohol exposure. Symptoms include facial abnormalities (such as smooth philtrum, thin upper lip, and small eye openings), growth deficiencies, central nervous system impairments (such as intellectual disabilities, learning disabilities, and poor coordination), and behavioral problems. 216. Identify three different risk factors for a baby that are associated with the mother’s use of cocaine or other amphetamines during pregnancy. Answer: Three risk factors associated with maternal use of cocaine or other amphetamines during pregnancy include premature birth, low birth weight, and an increased risk of birth defects (such as congenital heart defects or abnormalities of the brain, spine, or urinary tract). Childbirth 217. What is an episiotomy and why is it sometimes performed? Answer: An episiotomy is a surgical incision made in the perineum (the area between the vagina and the anus) during childbirth. It is sometimes performed to widen the vaginal opening and facilitate delivery of the baby, particularly in cases where there is concern about tearing or if the baby needs to be delivered quickly to prevent complications. 218. Why might a woman choose to have her baby in a birthing center rather than a traditional hospital room? Answer: A woman might choose to have her baby in a birthing center rather than a traditional hospital room for various reasons, including a desire for a more home-like environment, access to midwives and natural birthing techniques, fewer medical interventions, a focus on family-centered care, and the opportunity for a more personalized birth experience with increased autonomy and control over the birthing process. 219. What does ultrasound do and why is it often used during pregnancy? Answer: Ultrasound utilizes sound waves to create images of the fetus in the womb. It's often used during pregnancy to monitor fetal development, check for any abnormalities, determine the baby's position, estimate the due date, and assess the health of the placenta and amniotic fluid. 220. Why did the American Academy of Pediatrics recommend that fetal monitors be used only in high-risk pregnancies? Answer: The American Academy of Pediatrics recommended limiting the use of fetal monitors to high-risk pregnancies because extensive monitoring in low-risk pregnancies doesn't necessarily improve outcomes and may lead to unnecessary interventions, increasing the risk of cesarean sections and other complications. 221. Distinguish between a premature baby that is preterm and one that is small-for-date. Answer: A preterm baby is one born before completing 37 weeks of gestation, regardless of their size. On the other hand, a baby who is small-for-date, also known as small for gestational age (SGA), is born at or near term but has a lower birth weight compared to other babies of the same gestational age due to growth restriction in the womb. 222. Give an example of how culture can influence the experience of childbirth. Answer: In some cultures, childbirth is viewed as a communal event involving extended family and close friends providing support to the mother. For instance, in certain African cultures, there are rituals and ceremonies surrounding childbirth where women are attended to by elder women in the community, emphasizing the collective involvement and support during labor and delivery. The Evolving Family 223. Describe why a neonate’s head can be cone-shaped for a few days immediately following birth. Answer: During birth, the neonate's head may undergo molding, a process where the bones of the skull overlap and shift to accommodate passage through the birth canal. This can result in a temporary cone shape to the head. The softness and flexibility of the skull bones in newborns allow for this molding to occur without causing permanent damage. 224. Name and describe three survival reflexes that are observed in neonates. Answer: 1. Rooting Reflex: When the corner of a neonate's mouth or cheek is stroked, they turn their head and open their mouth in the direction of the touch, seeking nourishment. This reflex helps in finding and latching onto the mother's breast for feeding. 2. Sucking Reflex: When something is placed in a neonate's mouth, they automatically begin to suck on it. This reflex supports feeding, allowing the neonate to ingest milk or formula for nourishment. 3. Moro Reflex: Also known as the startle reflex, when a neonate experiences a sudden change in their environment, such as a loud noise or sudden movement, they reflexively throw out their arms and legs, arch their back, and then bring their limbs back toward their body. This reflex is thought to have evolved to help infants grasp onto their caregiver when they feel they are falling, aiding in survival. 225. Define attachment and provide an example that demonstrates why psychologists describe it as a reciprocal process between caregiver and infant. Answer: Attachment refers to the strong emotional bond that develops between an infant and their primary caregiver, typically the mother or father. This bond provides the infant with a sense of security and comfort, especially in times of distress. Psychologists describe attachment as a reciprocal process because it involves interactions between the caregiver and infant, where both parties contribute to the development and maintenance of the bond. For example, when an infant cries, the caregiver responds by comforting and soothing them. Through this interaction, the infant learns that their caregiver is reliable and available to meet their needs, which strengthens the attachment bond. Similarly, the caregiver's responsiveness to the infant's cues fosters trust and security in the relationship, creating a reciprocal cycle of care and attachment. Essay questions: Prenatal Growth and Development 226. Explain how fertilization occurs, noting when and where each step in the process takes place. Answer: Fertilization is the process by which a sperm cell and an egg cell fuse to form a zygote. It typically occurs in the fallopian tubes, specifically in the ampulla, which is the wider part of the tube closer to the ovary. Here's a breakdown of the steps: 1. Ovulation: This is the release of a mature egg from the ovary. It usually occurs around the middle of a woman's menstrual cycle. 2. Sperm Transport: Sperm cells are deposited into the female reproductive tract through sexual intercourse. They travel through the cervix and into the uterus, then into the fallopian tubes where fertilization takes place. 3. Fertilization: If sperm are present in the fallopian tubes during ovulation, they can penetrate the protective layers surrounding the egg and one sperm cell will fuse with the egg cell, forming a zygote. 4. Formation of Zygote: The fusion of the sperm and egg nuclei creates a single diploid cell called a zygote. This marks the beginning of embryonic development. 5. Implantation: After fertilization, the zygote undergoes several rounds of cell division as it travels down the fallopian tube towards the uterus. Around 6-7 days after fertilization, the blastocyst, a hollow ball of cells, implants itself into the lining of the uterus, where it will continue to develop into an embryo. 227. Suppose a couple wants to become pregnant. During which days in the woman’s monthly menstrual cycle is conception likely to occur? As part of your answer, be sure to describe the timing of ovulation and the life expectancy of sperm. Answer: Conception is most likely to occur during the fertile window of a woman's menstrual cycle, which typically spans a few days around ovulation. Ovulation, the release of a mature egg from the ovary, usually occurs approximately midway through the menstrual cycle, around day 14 in a 28-day cycle. However, this timing can vary from woman to woman and cycle to cycle. Sperm cells can survive in the female reproductive tract for up to 5 days after ejaculation, although their lifespan is typically shorter. Therefore, the fertile window extends a few days before ovulation and includes the day of ovulation itself. This means conception is most likely to occur if intercourse takes place in the days leading up to and including ovulation. 228. Describe in detail how the zygote becomes a blastula and how the blastula differentiates into the embryonic disk and supportive structures. Answer: After fertilization, the zygote undergoes several rounds of cell division through a process called cleavage. Initially, these divisions result in the formation of a solid ball of cells called a morula. As cell division continues, a fluid-filled cavity called the blastocoel begins to form within the morula, transforming it into a blastocyst. The blastocyst consists of two main components: the inner cell mass (embryoblast), which will develop into the embryo, and the outer layer of cells called the trophoblast. The trophoblast plays a crucial role in implantation by facilitating attachment to the uterine lining and eventually giving rise to extraembryonic membranes, such as the placenta. As the blastocyst implants into the uterine lining, the inner cell mass undergoes further differentiation. A small group of cells within the inner cell mass forms a flattened structure known as the embryonic disk, which consists of two layers: the epiblast and the hypoblast. These layers will give rise to the various tissues and organs of the developing embryo. Meanwhile, cells of the trophoblast proliferate and differentiate into structures that support embryonic development, such as the chorion and amnion. The chorion contributes to the formation of the placenta, which provides oxygen and nutrients to the developing embryo and removes waste products. The amnion forms the amniotic sac, which surrounds and protects the embryo, providing a fluid-filled environment for growth and development. 229. Suggest three different reasons why infant mortality rates generally have declined in the United States over the past five decades. Answer: 1. Advancements in Healthcare: Over the past five decades, improvements in healthcare infrastructure, including access to prenatal care, neonatal intensive care units (NICUs), and medical technology, have significantly contributed to the decline in infant mortality rates. This includes better management of premature births, advancements in surgical techniques for congenital anomalies, and widespread availability of vaccines to prevent infant diseases. 2. Public Health Initiatives: Public health campaigns focusing on maternal education, safe sleeping practices, breastfeeding promotion, and reducing risk factors such as smoking during pregnancy have played a crucial role in lowering infant mortality rates. These initiatives have increased awareness among parents and caregivers about practices that can help ensure infant health and safety. 3. Social and Economic Factors: Socioeconomic factors such as improvements in living standards, increased access to education, and better nutrition have indirectly contributed to the decline in infant mortality rates. Reductions in poverty levels, better housing conditions, and improved social support systems have all positively impacted infant health outcomes. Prenatal Environmental Influences 230. What prenatal risks are associated with malnutrition? What kinds of intervention programs can most effectively reduce these risks? Answer: Prenatal Risks Associated with Malnutrition: Malnutrition during pregnancy can lead to various risks for both the mother and the developing fetus. These risks include low birth weight, preterm birth, intrauterine growth restriction (IUGR), neural tube defects, and cognitive impairments in the offspring. Maternal malnutrition can also increase the likelihood of maternal complications such as gestational diabetes and preeclampsia. Intervention Programs to Reduce Risks: Effective intervention programs to reduce the risks associated with prenatal malnutrition typically involve a combination of nutritional supplementation, education, and support. Prenatal vitamins containing folic acid, iron, and other essential nutrients are often recommended to ensure adequate maternal nutrition. Additionally, nutritional counseling and education about healthy eating habits during pregnancy can help women make informed dietary choices. Community-based programs that provide access to nutritious food, prenatal care, and social support are also essential in addressing maternal malnutrition and improving birth outcomes. 231. Give an example of how a teratogen can have different effects on the developing embryo or fetus, depending on what stage of development is involved. Use this example to explain what is meant by the term, "critical period" of development. Answer: Example of Teratogen Effects and Critical Period: A classic example of how a teratogen can have different effects depending on the stage of development is thalidomide. Thalidomide was prescribed to pregnant women in the late 1950s and early 1960s as a sedative and anti-nausea medication. However, it was later discovered that prenatal exposure to thalidomide during specific critical periods of limb development resulted in severe limb deformities, such as phocomelia (shortened or absent limbs). The critical period for limb development in humans occurs between approximately the 24th and 36th days after fertilization. If exposure to thalidomide happens during this critical period, when limb buds are forming, it can disrupt the normal development of limbs, leading to malformations. However, if exposure occurs outside of this critical period, the effects on limb development may be minimal or non-existent. This example illustrates the concept of a critical period in development, which refers to a specific window of time during embryonic or fetal development when a particular structure or organ system is most susceptible to the effects of teratogens. Teratogens can cause permanent damage or abnormalities if exposure occurs during these critical periods, highlighting the importance of timing in prenatal development and the potential impact of environmental factors on fetal health. 232. Describe three different ways by which a disease present in the mother may be passed to the fetus or newborn infant. Answer: 1. Vertical Transmission during Pregnancy: Diseases like rubella, cytomegalovirus (CMV), and toxoplasmosis can be transmitted from the mother to the fetus through the placenta during pregnancy. These pathogens can cross the placental barrier and infect the developing fetus, leading to congenital infections. 2. During Labor and Delivery: Some infections can be transmitted to the infant during labor and delivery. For example, if the mother has active genital herpes lesions, there's a risk of transmitting the virus to the baby during passage through the birth canal. 3. Postnatal Transmission: After birth, diseases like HIV can be transmitted from mother to child through breast milk if the mother is HIV positive. This highlights the importance of appropriate medical interventions and precautions to prevent transmission during breastfeeding. 233. Summarize the evidence that supports the Surgeon General’s statement on women’s consumption of alcohol during pregnancy. Is drinking alcohol safe? Answer: The Surgeon General's statement is supported by extensive evidence showing that consuming alcohol during pregnancy can harm the developing fetus. Research indicates that alcohol can cross the placenta and reach the fetus, potentially causing a range of birth defects and developmental issues known as Fetal Alcohol Spectrum Disorders (FASDs). These disorders can lead to physical, behavioral, and intellectual disabilities that may last a lifetime. Therefore, drinking alcohol during pregnancy is considered unsafe, and abstinence is recommended to ensure the health and well-being of both the mother and the unborn child. 234. Identify two environmental pollutants that are known teratogens and describe how pregnant women can limit their risks for each. Answer: 1. Mercury: Mercury exposure during pregnancy, primarily through contaminated fish consumption, is linked to developmental abnormalities in the fetus. Pregnant women can limit their exposure by avoiding certain types of fish known to have high mercury levels, such as shark, swordfish, king mackerel, and tilefish. Instead, they can opt for low-mercury fish like salmon, shrimp, and catfish. Additionally, they should follow fish consumption advisories provided by health authorities. 2. Lead: Exposure to lead during pregnancy is associated with adverse effects on fetal development, including neurodevelopmental deficits. Pregnant women can reduce their risk of lead exposure by avoiding areas with known lead contamination, such as old buildings with lead-based paint. Regular handwashing and maintaining a clean environment also help minimize exposure to lead dust. Moreover, consuming a diet rich in calcium and iron may help reduce the absorption of lead in the body. Childbirth 235. Describe how a typical labor and delivery would proceed, noting the major events associated with each of the three stages of childbirth. Answer: During a typical labor and delivery, there are three main stages: 1. First Stage• Initial Labor: This stage begins with the onset of contractions and includes the dilation and effacement of the cervix. Contractions become progressively stronger and closer together, indicating the start of active labor. This stage can last for several hours, especially for first-time mothers. 2. Second Stage• Labor and Delivery: This stage involves the actual birth of the baby. As the cervix reaches full dilation (around 10 centimeters), the mother begins to push with contractions to help the baby move through the birth canal. This stage typically lasts from a few minutes to a few hours, depending on various factors such as the position of the baby and the mother's pushing efforts. 3. Third Stage• Afterbirth: After the baby is born, the third stage involves the delivery of the placenta. The uterus continues to contract, causing the placenta to separate from the uterine wall. The healthcare provider may assist by gently pulling the umbilical cord to deliver the placenta. This stage usually lasts from a few minutes to half an hour after childbirth. 236. Describe the major events that occur in each of the three stages of childbirth: initial labor, labor and delivery, and afterbirth Answer: Major events in each stage of childbirth include: 1. First Stage• Initial Labor: • Onset of contractions • Dilation and effacement of the cervix • Transition from early to active labor • Contractions becoming stronger and closer together 2. Second Stage• Labor and Delivery: • Full dilation of the cervix (around 10 centimeters) • Mother begins pushing with contractions • Birth of the baby • Cutting of the umbilical cord 3. Third Stage• Afterbirth: • Continued uterine contractions • Separation of the placenta from the uterine wall • Delivery of the placenta • Examination of the placenta for completeness and health 237. How does natural (or prepared) childbirth differ from traditional childbirth? Answer: Natural (or prepared) childbirth and traditional childbirth differ primarily in their approach to pain management and medical interventions: • Natural Childbirth: This approach emphasizes minimal medical intervention and often involves techniques such as breathing exercises, relaxation techniques, movement, and positioning to manage pain. Women opting for natural childbirth may also use techniques like hypnosis or water immersion for pain relief. The focus is on letting labor progress as naturally as possible without routine medical interventions like epidurals or continuous fetal monitoring. • Traditional Childbirth: Traditional childbirth typically involves more medical interventions, including the use of pain medications such as epidurals or narcotics to manage labor pain. Continuous fetal monitoring, routine induction or augmentation of labor with medications, and episiotomies (surgical cuts to widen the vaginal opening) may also be part of traditional childbirth practices. This approach tends to prioritize pain relief and may involve more interventions aimed at controlling the progress of labor. 238. Discuss the advantages and disadvantages associated with both traditional childbirth procedures and natural childbirth procedures. If your best friend were having a baby, which would you recommend to her, and why would you make this choice? Answer: Advantages and Disadvantages of Traditional Childbirth Procedures: Traditional childbirth procedures, such as medicated births involving epidurals or other pain-relief medications, offer significant pain management during labor, which can help ease discomfort and stress for the mother. Additionally, they allow for medical interventions if complications arise, ensuring the safety of both the mother and the baby. However, these procedures may lead to longer labor durations, increased risk of medical interventions like cesarean sections, and potential side effects from medications, such as dizziness or nausea. Advantages and Disadvantages of Natural Childbirth Procedures: Natural childbirth procedures, which involve minimal to no medical interventions or pain relief medications, offer a more holistic approach to childbirth. They empower women to rely on their bodies' natural abilities to give birth and may lead to shorter labor durations, quicker recovery times, and reduced risks of medical interventions. However, natural childbirth can be more physically demanding and intense, requiring significant mental and emotional preparation. There's also a risk of increased pain during labor without the assistance of pain relief medications. Recommendation for My Best Friend: If my best friend were having a baby, I would recommend natural childbirth procedures if she is open to the idea and has no medical complications that would make it risky. Natural childbirth promotes a deeper connection with the birthing process and often results in a more empowering experience for the mother. However, I would emphasize the importance of being well-prepared through childbirth education classes, practicing relaxation techniques, and having a supportive birth team in place. Ultimately, the choice between traditional and natural childbirth should align with her preferences, values, and overall health. 239. Describe three diagnostic procedures that can be used to monitor the health of the unborn child during pregnancy: ultrasound, amniocentesis, and chorionic villus sampling. What kinds of health problems does each method help diagnose? Answer: Ultrasound: Ultrasound is a common prenatal diagnostic procedure that uses sound waves to create images of the fetus in the womb. It helps monitor the growth and development of the fetus, assess the placenta, detect multiple pregnancies, evaluate the fetal heartbeat, and identify any structural abnormalities or birth defects, such as neural tube defects or heart abnormalities. Amniocentesis: Amniocentesis involves the extraction of a small amount of amniotic fluid from the amniotic sac surrounding the fetus. This fluid contains fetal cells that can be analyzed for genetic disorders, chromosomal abnormalities (such as Down syndrome or trisomy 18), neural tube defects, and certain metabolic disorders. It is typically performed between 15 and 20 weeks of pregnancy. Chorionic Villus Sampling (CVS): CVS involves the sampling of chorionic villi, which are tiny finger-like projections on the placenta, to obtain fetal genetic material for testing. This procedure is used to diagnose chromosomal abnormalities, such as Down syndrome, genetic disorders, and certain inherited conditions. CVS is usually performed between 10 and 13 weeks of pregnancy. 240. Describe the differences between amniocentesis and chorionic villus sampling and discuss when and why each might be preferred over the other. Answer: Differences between Amniocentesis and Chorionic Villus Sampling (CVS): 1. Timing: Amniocentesis is typically performed between 15 and 20 weeks of pregnancy, while CVS is usually done earlier, between 10 and 13 weeks. 2. Sample Source: Amniocentesis involves extracting a small amount of amniotic fluid from the amniotic sac, whereas CVS involves sampling chorionic villi from the placenta. 3. Risk of Miscarriage: The risk of miscarriage associated with amniocentesis is slightly lower than that of CVS. 4. Type of Information: Amniocentesis provides information on chromosomal abnormalities, neural tube defects, and certain metabolic disorders, while CVS focuses primarily on chromosomal abnormalities and genetic disorders. When to Prefer Each Procedure: • Amniocentesis: It might be preferred when a more comprehensive analysis of chromosomal abnormalities, neural tube defects, or certain metabolic disorders is required, especially if the pregnancy has progressed beyond the timeframe suitable for CVS. • Chorionic Villus Sampling (CVS): CVS might be preferred when an early diagnosis of chromosomal abnormalities or genetic disorders is desired, as it can be performed earlier in pregnancy than amniocentesis, allowing for earlier decision-making and possible interventions if needed. However, it's important to consider the slightly higher risk of miscarriage associated with CVS compared to amniocentesis. 241. What are the advantages and disadvantages associated with the use of caesarean section procedures for childbirth? Answer: Caesarean section procedures offer advantages such as a reduced risk of birth injuries, particularly in cases of difficult deliveries, and the ability to plan the timing of birth, which can be critical for certain medical conditions. However, they come with disadvantages like increased risk of surgical complications for both the mother and the baby, longer recovery times for the mother, and potential respiratory issues for the baby due to lack of exposure to vaginal bacteria during birth. 242. What is the Apgar Scoring System? How are scores computed? What factors are related to an infant receiving a “good” score versus a “bad” score? Answer: The Apgar Scoring System is a quick assessment of a newborn's physical condition following birth. Scores are computed based on five criteria: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration (breathing rate and effort). A score of 7-10 is considered "good," while a score below 7 may indicate the need for medical intervention. Factors related to a good score include vigorous crying, strong muscle tone, and normal breathing, while a bad score may result from factors like low heart rate, poor muscle tone, or weak breathing effort. 243. What special risks are associated with premature childbirth? How might a preterm infant pose different problems than a small-for-date infant? Answer: Premature childbirth carries risks such as respiratory distress syndrome, underdeveloped organs, and increased susceptibility to infections due to the immature immune system. Preterm infants may face complications like intraventricular hemorrhage and necrotizing enterocolitis. Conversely, a small-for-date infant, while also at risk for developmental issues, may not necessarily face the same respiratory challenges as preterm infants but may experience intrauterine growth restriction-related problems such as hypoglycemia and hypothermia. The Evolving Family 244. Describe two major concerns about becoming a parent that typically are identified among mothers and two concerns that are identified among fathers. How might these concerns reflect cultural and family forces? Answer: Concerns Identified Among Mothers: 1. Work-Life Balance: Many mothers worry about how to balance their career aspirations with the demands of parenting. They often grapple with the pressure to excel in their professions while also wanting to be present for their children's milestones. 2. Guilt and Self-Doubt: Mothers commonly experience feelings of guilt and self-doubt regarding their parenting abilities. They may question whether they are doing enough for their children or making the right decisions for their well-being. Concerns Identified Among Fathers: 1. Provider Role: Fathers often feel pressure to be the primary providers for their families. Concerns about financial stability and fulfilling the role of the breadwinner can weigh heavily on expectant or new fathers. 2. Work-Life Balance and Involvement: Similar to mothers, fathers may struggle with balancing work commitments with family responsibilities. They may also worry about being actively involved in their children's lives while managing other obligations. Reflection on Cultural and Family Forces: These concerns often reflect deeply ingrained cultural and familial expectations surrounding gender roles and responsibilities. In many cultures, mothers are expected to prioritize caregiving and nurturing roles, while fathers are often expected to prioritize providing financially and maintaining stability. These societal norms can influence individuals' perceptions of parenthood and contribute to the specific concerns they may face. 245. What roles do the survival reflexes play in helping the neonate adjust to life outside the womb? Answer: Survival reflexes play crucial roles in helping the neonate adjust to life outside the womb by facilitating essential functions necessary for survival and adaptation. These reflexes are instinctual responses that are present from birth and aid in basic physiological needs such as feeding, breathing, and protection from harm. For example, the rooting reflex helps the newborn locate the mother's breast for feeding, while the sucking reflex enables them to extract milk. The Moro reflex, triggered by sudden movements or loud noises, assists in alerting the baby to potential danger by prompting them to reach out or cling to ensure their safety. By instinctively responding to stimuli through these reflexes, neonates can initiate vital processes crucial for their survival and adjustment to the external environment. 246. How do the primitive reflexes differ from the survival reflexes? Give an example of each reflex type to support your answer. Answer: Primitive reflexes and survival reflexes are both involuntary responses exhibited by newborns, but they serve distinct purposes and manifest differently. Primitive Reflexes: These reflexes are automatic movements typically observed in newborns and gradually disappear as the central nervous system matures. One example is the Palmar Grasp Reflex, where the infant instinctively grasps objects placed in their palms. This reflex aids in the development of hand-eye coordination. Survival Reflexes: Unlike primitive reflexes, survival reflexes are crucial for the immediate survival and adjustment of the newborn to the external environment. An example is the Sucking Reflex, where the infant instinctively sucks on objects placed in their mouth, facilitating feeding and nutrient intake essential for survival. In summary, primitive reflexes primarily contribute to motor development and coordination, while survival reflexes are focused on meeting immediate physiological needs for survival outside the womb. 247. Define in your own words what is meant by the term “attachment.” Give an example that demonstrates how attachment develops in a reciprocal fashion between infant and caregiver. Answer: Attachment refers to the emotional bond and connection formed between an infant and their primary caregiver, typically the mother or father, which influences the child's sense of security, trust, and exploration of the world around them. It involves the infant seeking proximity, comfort, and protection from the caregiver, especially in times of distress or uncertainty. An example illustrating reciprocal attachment development is when a baby cries, signaling distress. In response, the caregiver approaches, soothes the baby, and attends to their needs, such as feeding or cuddling. Through this responsive caregiving, the infant's distress diminishes, and they begin to associate the caregiver with comfort and security. Over time, as the caregiver consistently responds to the infant's cues with love and care, the infant develops trust in the caregiver's availability and responsiveness. In turn, the caregiver also experiences a deepening bond with the infant, feeling rewarded by the ability to provide comfort and support. This reciprocal interaction forms the foundation of attachment, as both parties contribute to and benefit from the emotional connection and sense of security it provides. Test Bank for Understanding Human Development Wendy L. Dunn, Grace J. Craig 9780205989522, 9780135164204, 9780205233878, 9780205753079
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