Deck 4: Birth and the Newborn Baby

Question 1

The infant is born during

A) the first stage of labor.
B) the second stage of labor.
C) transition.
D) the third stage of labor.

Answer 1

B

Question 2

In South America, the Jarara mother

A) leans against the body of the "head helper" to give birth.
B) gives birth in full view of the entire community.
C) gives birth in a hammock with a crowd of women close by.
D) gives birth in a freestanding birth center.

Answer 2

B

Question 3

A combined Apgar score of ____ or better indicates that an infant is in good physical condition.

A) 4
B) 5
C) 6
D) 7

Answer 3

D

Question 4

Dorita is given an Apgar appearance rating of 1. This means her

A) body is pink with blue arms and legs.
B) body, arms, and legs are all blue.
C) body, arms, and legs are all pink.
D) body is blue with pink arms and legs.

Question 5

The first stage of labor

A) is the shortest.
B) involves delivery of the baby.
C) climaxes with a brief phase called transition.
D) involves birth of the placenta.

Question 6

The third stage of labor typically lasts

A) 5 to 10 minutes.
B) 15 to 30 minutes.
C) 45 minutes to one hour.
D) one to two hours.

Question 7

The placenta is delivered during

A) the first stage of labor.
B) the second stage of labor.
C) crowning.
D) the third stage of labor.

Question 8

Lightening occurs when the

A) amniotic sac is ruptured.
B) mucus plug is released from the cervix.
C) fetus's head drops low into the uterus.
D) first uterine contractions take place.

Question 9

Which of the following statements is true about the average newborn infant?

A) Girls are slightly heavier than boys.
B) The average newborn is 23 inches long.
C) Boys are slightly longer than girls.
D) The average newborn weighs 6½ pounds.

Question 10

When mothers are upright during labor, they are

A) more likely to have a longer labor.
B) likely to need an episiotomy.
C) less likely to use pain-relieving medication.
D) more likely to deliver a breech baby.

Question 11

Two Apgar ratings are given because

A) one is given by the pediatrician, and one is given by the labor and delivery nurse.
B) one score is for appearance, pulse, and grimace, and the other score is for activity and respiration.
C) some babies have trouble adjusting at first but do quite well after a few minutes.
D) one is taken immediately after birth, and the other is taken just before the newborn is released from the hospital.

Question 12

During transition, the

A) baby is forced down and out of the birth canal.
B) placenta is delivered.
C) cervix opens completely.
D) cervix begins to dilate and efface.

Question 13

________ occurs when the vaginal opening is stretched around the baby's entire head.

A) Lightening
B) Bloody show
C) Crowning
D) Transition

Question 14

Most natural childbirth programs draw on methods developed by Grantly Dick-Read and Fernand Lamaze, who recognized that

A) new labor medications could be used to reduce the pain of childbirth.
B) hospital costs could be saved if women used prepared childbirth methods.
C) cultural attitudes had taught women to fear the birth experience.
D) the mother's home was the safest and least painful place to give birth.

Question 15

Devin is given a combined Apgar score of 7. The medical professionals should

A) immediately provide medical attention because he is in serious danger.
B) tell Devin's parents that he is in good physical condition.
C) provide assistance in establishing breathing and other vital signs.
D) immediately put him on a ventilator and monitor his situation closely.

Question 16

A sure sign that labor is only hours or days away is

A) contractions in the upper part of the uterus.
B) the bloody show.
C) lightening.
D) frequent urination.

Question 17

Prepared childbirth

A) includes routine use of strong pain-relieving drugs.
B) does not allow family members and friends to participate in the birth.
C) always takes place outside of a hospital setting.
D) involves techniques aimed at reducing pain and medical intervention.

Question 18

Which of the following statements is true about the newborn baby's appearance?

A) Proportionally, if an adult head were as large as that of a newborn infant, it would be the size of an orange.
B) Their round faces, chubby cheeks, large foreheads, and big eyes make adults feel like picking them up and cuddling them.
C) They may not match their parents' idealized image because they have a combination of a small head and a long torso.
D) Their legs are long and bowed, and their heads are small compared to the rest of the body.

Question 19

As pregnancy advances, the placenta releases increasing amounts of

A) CRH.
B) cortisol.
C) insulin.
D) thyroxine.

Question 20

Mothers who are supported during labor by a doula

A) often do not have access to other forms of support.
B) usually give birth at home or at the home of the doula.
C) have fewer birth complications than women who do not have supportive companionship.
D) give birth lying flat on their backs with their feet in stirrups.

Question 21

Epidural analgesia

A) numbs the entire lower half of the body.
B) limits pain reduction to the pelvic region.
C) strengthens uterine contractions.
D) reduces the chances of cesarean delivery.

Question 22

Fetal monitoring is linked to a(n)

A) reduction in the rates of infant brain damage.
B) reduction in the rates of infant death.
C) reduction in the use of instrumental deliveries.
D) increase in the number of cesarean deliveries.

Question 23

Which mother is a good candidate for a home delivery?

A) Heather, a healthy 43-year-old who previously had a cesarean delivery
B) Helena, a first-time mom who wants to deliver her own baby unassisted
C) Prudence, a 30-year-old second-time mom, assisted by a certified nurse-midwife
D) Donna, a fifth-time mom whose baby is in a breech position

Question 24

Cerebral palsy

A) affects one out of every 300 American children.
B) can range from very mild tremors to mental retardation.
C) is especially common in water births.
D) is caused by either placenta abruptio or placenta previa.

Question 25

The most common approach to controlling pain during labor is

A) epidural analgesia.
B) pitocin.
C) a spinal block.
D) meditation.

Question 26

___________ results when the blastocyst implants so low in the uterus that the placenta covers the cervical opening.

A) Toxemia
B) Placenta previa
C) Placenta abruptio
D) Toxoplasmosis

Question 27

About ___ percent of American labors are induced.

A) 8
B) 14
C) 22
D) 28

Question 28

Which of the following statements is true about anoxia?

A) After initial brain injury from anoxia, another phase of cell death can occur several weeks later.
B) Whole-body cooling involves immersing a newborn with an initial brain injury in freezing water from the neck down.
C) The effects of mild or even moderate anoxia rarely persist beyond infancy.
D) Healthy newborns can survive periods of little or no oxygen longer than adults can.

Question 29

Continuous fetal monitoring

A) measures the baby's blood oxygen levels during labor.
B) is required in most U.S. hospitals and used in over 80 percent of U.S. births.
C) is linked to a decreased rate of cesarean deliveries.
D) reduces the rate of infant brain damage and death in all pregnancies.

Question 30

Henrietta is concerned about using epidural analgesia during labor. You can tell her that newborns exposed to epidural analgesia tend to

A) have trouble falling asleep.
B) be hyperactive and animated.
C) have lower Apgar scores.
D) suck more aggressively when feeding.

Question 31

Tonya is pregnant for a second time. She hopes to have a vaginal delivery, although her first delivery was cesarean. You should advise Tonya that

A) she will be required to have a second cesarean delivery.
B) a natural labor after a cesarean is associated with slightly increased rates of maternal death.
C) a natural labor after a cesarean is just as safe as a repeated cesarean delivery.
D) a natural labor after a cesarean is associated with slightly increased rates of rupture of the uterus.

Question 32

Which of the following statements is true regarding home delivery?

A) It is often attended by a certified nurse-midwife.
B) It is more popular in the United States than in England and Sweden.
C) It poses no additional risks to the mother and the baby.
D) It is almost always dangerous for mothers and babies.

Question 33

Abbie was born seven weeks premature. Her tiny lungs were so poorly developed that the air sacs collapse. A mechanical respirator is being used to keep Abbie breathing. Abbie suffers from

A) cerebral palsy.
B) toxemia.
C) hyaline membrane disease.
D) acidosis.

Question 34

In induced labors,

A) contractions are shorter and more widely spaced apart than in spontaneous labors.
B) the rate of cesarean delivery is less than in spontaneous labors.
C) the mother is given a synthetic hormone that simulates contractions.
D) the chances of an instrument delivery are less than in spontaneous labors.

Question 35

Which of the following statements is true about the breech position?

A) Cesarean delivery is never justified when the baby is in the breech position.
B) The breech position decreases the chance of oxygen deprivation.
C) Certain breech babies fare just as well with vaginal delivery as with a cesarean.
D) Babies in the breech position are turned facing toward the mother's back rather than facing outward.

Question 36

___________ is appropriate if the mother's pushing during the second stage of labor does not move the baby through the birth canal in a reasonable period of time.

A) Instrument delivery
B) Epidural analgesia
C) Use of an anesthetic
D) Induced labor

Question 37

The rate of cesarean delivery is

A) substantially higher in induced than spontaneous labors.
B) lower today than it was forty years ago.
C) currently about 10 percent in the United States.
D) lower in the United States than in other industrialized countries.

Question 38

___________ during pregnancy is associated with premature separation of the placenta.

A) Tobacco and cocaine use
B) Exposure to PCBs
C) High maternal stress
D) HIV infection

Question 39

Vacuum extractors

A) are not as safe as forceps.
B) are more likely than forceps to tear the mother's tissues.
C) have been used since the sixteenth century to speed up delivery.
D) can cause bleeding beneath the baby's skin and on the outside of the skull.

Question 40

Induced labors are justified when

A) continuing the pregnancy threatens the well-being of the mother or baby.
B) the baby has not arrived by its due date.
C) the doctor determines that it is a convenient time to deliver the baby.
D) the mother and father want the baby to arrive on a particular date.

Question 41

Unlike her two sisters, when Teresa gives birth, she does not choose rooming in. Teresa should know that

A) her ability to bond with the baby will be compromised as a result of this decision.
B) her baby will suffer emotionally as a result of this decision.
C) her competence as a caregiver will be compromised as a result of this decision.
D) there is no evidence that her parenting ability or her baby's emotional well-being will be affected.

Question 42

Contact with the baby after birth

A) guarantees immediate emotional closeness between the new mother and the newborn.
B) is vital for fathers so they can bond with the baby.
C) may be one of several factors that help build a good parent-infant relationship.
D) is essential for maternal bonding because birth-related hormones facilitate responsiveness to the infant.

Question 43

Baby Sunni quickly closes her eyelids when her father claps his hands near her head. The function of this reflex is to

A) stimulate the eye muscle.
B) protect the infant from a blow to the head.
C) protect the infant from strong stimulation.
D) communicate irritation toward a caregiver.

Question 44

Kangaroo skin-to-skin contact

A) is not commonly used in developing nations where hospitalization is not always possible.
B) fosters improved oxygenation of the baby's body, temperature regulation, and infant survival.
C) is rarely used in Western nations where preterm infants are placed in hospital intensive care units.
D) provides babies with touch stimulation but neglects the other sensory modalities.

Question 45

Carol lives in Wyoming and works for a small company with 12 employees. Carol hopes to take 12 weeks of maternity leave. What advice can you give Carol?

A) The United States mandates 12 weeks of paid maternity leave for all new mothers.
B) Federal law mandating unpaid maternity leave does not apply to her employer.
C) The United States mandates six weeks of paid maternity leave for all new mothers.
D) The United States mandates 12 weeks of unpaid maternity leave for all new mothers.

Question 46

Dawn and Richard have the economic and personal resources to care for Amelia, their preterm infant. Research shows that

A) interventions are not usually needed for economically advantaged parents like Dawn and Richard to promote healthy development.
B) Dawn and Richard will need extensive coaching in recognizing and responding to Amelia's needs.
C) just a few sessions of coaching in recognizing and responding to Amelia's needs could reduce Amelia's crying and improve her sleep.
D) Dawn and Richard will need comprehensive long-term, intensive intervention to meet Amelia's needs.

Question 47

Travis is born three days after his due date and weighs five pounds. Travis is a(n) ________ infant.

A) preterm
B) small-for-date
C) average-weight
D) anoxic

Question 48

Which of the following statements is true about preterm infants?

A) They are born below their expected weight considering the length of the pregnancy.
B) They usually have more serious problems than small-for-date infants.
C) Although they are small, their weight may still be appropriate, based on time spent in the uterus.
D) They are more likely than small-for-date infants to show evidence of brain damage.

Question 49

Research shows that mothers learn to discriminate their newborn baby from other infants on the basis of touch, smell, and sight after as little as __________ of contact.

A) 15 minutes
B) 30 minutes
C) one hour
D) two hours

Question 50

Which of the following statements is true about interventions for preterm infants?

A) Air is filtered before it enters an isolette, but temperature cannot be controlled.
B) Simulating preterm infants is harmful because the tiny babies are fragile.
C) Touch is the least important form of infant stimulation.
D) When preterm infants are gently massaged several times each day, they gain weight faster.

Question 51

In international rankings, the infant death rate in the United States has slipped from seventh in the 1950s to ____ in 2009.

A) tenth
B) fourteenth
C) twentieth
D) twenty-eighth

Question 52

The two factors that are largely responsible for neonatal mortality are

A) birth defects and sudden infant death syndrome.
B) child abuse and sudden infant death syndrome.
C) serious physical defects and low birth weight.
D) unintentional injuries and low birth weight.

Question 53

The Kauai study tells us that

A) even children who experience mild birth trauma and grow up in stable families do not do as well on measures of intelligence as children with no birth problems.
B) as long as birth injuries are not overwhelming, a supportive home can restore children's growth.
C) a supportive home environment does little to alleviate the effects of birth trauma, as brain injuries are often permanent.
D) children who experience moderate birth trauma and are exposed to poverty will have serious learning difficulties even if they are otherwise resilient.

Question 54

Birth weight is the best available predictor of

A) childhood obesity.
B) adolescent anorexia.
C) myopia.
D) infant survival.

Question 55

Compared to full-term infants, preterm babies are

A) at a greater risk for child abuse.
B) more often held close.
C) talked to more gently.
D) more often touched.

Question 56

Each country that outranks the United States in infant survival provides its citizens with

A) government-sponsored health-care benefits.
B) stronger crime prevention and family planning programs.
C) more up-to-date health-care technology.
D) higher numbers of well-trained medical professionals.

Question 57

African-American and Native-American babies are more than ____ as likely as white infants to be born early and underweight and are _____ as likely as white infants to die in the first year.

A) twice; half
B) twice; twice
C) three times; twice
D) three times; half

Question 58

Current evidence on bonding shows that

A) the human mother-infant relationship depends largely on what happens during a sensitive period immediately after birth.
B) the human parent-infant relationship does not depend on a precise, early period of togetherness.
C) skin-to-skin contact between parent and baby is vital for the parent to feel affection and concern for the infant.
D) adoptive parents have difficulty developing warm, affective relationships when the infant enters the family months after birth.

Question 59

In several studies, fathers showed slight increases in ________ and ________ when holding their newborn babies that were comparable with those of mothers.

A) oxytocin; prolactin
B) prolactin; estrogens
C) androgens; oxytocin
D) estrogens; androgens

Question 60

_________ has the most up-to-date health-care technology in the world.

A) The United States
B) China
C) Sweden
D) Canada

Question 61

Pediatricians usually test newborn reflexes carefully because reflexes can reveal

A) ineffective parenting.
B) the baby's temperament.
C) a compromised circulatory system.
D) the health of the baby's nervous system.

Question 62

SIDS victims usually

A) have normal sleep-wake patterns.
B) have normal Apgar scores.
C) show physical problems from the beginning.
D) were full-term, normal-weight newborns.

Question 63

Researchers believe that the stimulation of REM sleep is

A) necessary to refine fine muscle development of the eye.
B) more important in adolescence than in infancy.
C) more important for adults than for babies.
D) vital for growth of the central nervous system.

Question 64

Although Baby Irina's eyelids are closed, occasional rapid eye movements can been seen beneath them. Her breathing is irregular. She stirs occasionally and grimaces while she sleeps. Irina is MOST likely in which of the following states of arousal?

A) regular sleep
B) drowsiness
C) quiet alertness
D) REM sleep

Question 65

In infants who have experienced serious birth trauma,

A) sleep behavior is organized and patterned.
B) disturbed REM-NREM sleep cycles are often present.
C) NREM sleep occurs, but REM sleep does not.
D) sleep-wake cycles are affected more by darkness-light than by fullness-hunger.

Question 66

Which of the following individuals is the most likely to spend the greatest amount of time in REM sleep?

A) Trevor, a preterm baby
B) Alice, a five-year-old
C) Henry, a full-term infant
D) Erica, a 13-year-old

Question 67

The stepping reflex

A) is permanent.
B) appears at around 3 months.
C) reveals the health of the leg muscles.
D) disappears at around 2 months.

Question 68

Crying usually peaks at about

A) 6 weeks.
B) 12 weeks.
C) 6 months.
D) 18 months.

Question 69

REM sleep accounts for ____ percent of a newborn baby's sleep time.

A) 20
B) 30
C) 50
D) 70

Question 70

The cause of colic is

A) central nervous system damage.
B) unknown.
C) unpleasant stimuli.
D) gas.

Question 71

Which of the following statements is true about reflexes and the development of motor skills?

A) The stepping reflex appears only when the newborn's body is in upright position.
B) Certain reflexes drop out early, but the motor functions involved are renewed later.
C) Parents should deliberately exercise newborn stepping reflexes to encourage early walking.
D) The tonic neck reflex may prepare the baby for voluntary walking.

Question 72

Arthur wakes frequently to check to see if his sleeping infant, Sam, is breathing. Arthur can reduce the risk of SIDS by

A) wrapping Sam in very warm clothing and blankets.
B) placing Sam to sleep on his stomach.
C) placing Sam to sleep on his back.
D) providing Sam with soft bedding and taking away his pacifier.

Question 73

A baby will display the Moro reflex when his caregiver

A) shines a bright light at his eyes.
B) produces a sudden loud sound against the surface supporting him.
C) places him face down in a pool of water.
D) strokes his cheek near the corner of his mouth.

Question 74

The leading cause of infant mortality between 1 week and 12 months in industrialized nations is

A) birth trauma.
B) congenital defects.
C) child abuse.
D) sudden infant death syndrome.

Question 75

___________ doubles the risk of SIDS.

A) Placing a sleeping baby on her back
B) Prenatal abuse of drugs
C) Placing a sleeping infant on his side
D) Maternal cigarette smoking

Question 76

Maddy is babysitting an infant for the first time. What can you tell her is the most effective way to soothe the baby if she cries?

A) Sing to her softly.
B) Lift her to the shoulder and rock or walk with her.
C) Swaddle her.
D) Take her for a ride in her stroller.

Question 77

When parents hold their babies extensively, the amount of crying in the early months is reduced by about

A) one-fourth.
B) one-third.
C) one-half.
D) two-thirds.

Question 78

Young infants most often cry because they are

A) cold.
B) scared.
C) in pain.
D) hungry.

Question 79

The function of the Babinski reflex is

A) unknown.
B) to prepare the infant for voluntary walking.
C) to prepare the infant for voluntary reaching.
D) to help the infant cling to its mother.

Question 80

The most fleeting state of arousal is

A) NREM sleep.
B) REM sleep.
C) drowsiness.
D) quiet alertness.