Deck 4: Birth and the Newborn Baby

Question 1

Most natural, or prepared, 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.

Answer 1

C

Question 2

An abnormal increase in maternal __________ in the third trimester of pregnancy is currently being evaluated as an early predictor of premature birth.

A) corticotropin-releasing hormone (CRH)
B) cortisol
C) insulin
D) thyroxine

Answer 2

A

Question 3

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

A) Lightening
B) The bloody show
C) Crowning
D) Transition

Answer 3

C

Question 4

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.

Question 5

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 is for appearance, pulse, and grimace, and the other 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 6

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.

Question 7

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 8

Lightening occurs when the

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

Question 9

Stage 2 of labor lasts __________ for a first baby and __________ in later births.

A) an average of 12 to 14 hours; 4 to 6 hours
B) an average of 4 to 6 hours; 20 to 50 minutes
C) about 50 minutes; 20 minutes
D) about 5 to 10 minutes; 90 minutes

Question 10

Compared with those who give birth lying on their backs, women who choose an upright position are likely to __________ to __________.

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

Question 11

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

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

Question 12

Lily is 21 inches long and weighs 8 pounds at birth. She is __________ than the average newborn.

A) shorter but heavier
B) longer and heavier
C) longer but lighter
D) shorter and lighter

Question 13

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 completely blue.
C) body, arms, and legs are completely pink.
D) body is blue with pink arms and legs.

Question 14

Andre received a combined Apgar score of 5. This means that Andre

A) is in good physical condition.
B) needs assistance in establishing breathing and other vital signs.
C) is in serious danger and should receive emergency medical attention.
D) was in danger at birth, but quickly recovered and is now in good physical condition.

Question 15

Stage 1 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 16

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 17

Mothers who are supported during labor-either by a lay birth attendant or a relative or friend with doula training-

A) more often need medication to control pain.
B) less often have instrument-assisted or surgical deliveries.
C) usually give birth at home or at the birth attendant's home.
D) usually give birth lying flat on their backs with their feet in stirrups.

Question 18

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 19

Before the late 1800s, childbirth usually took place

A) at home and was a family-centered event.
B) at home and far away from other family members.
C) in a hospital with trained midwives.
D) in the home of a medical professional or in a hospital.

Question 20

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

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

Question 21

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 22

Which of the following statements about fetal monitoring is true?

A) Fetal monitors are being phased out in U.S. hospitals because they are not necessary in most cases.
B) Fetal monitoring is not helpful in detecting hidden problems with the baby.
C) Critics worry that fetal monitors identify many babies as in danger who, in fact, are not.
D) Fetal monitoring increases the likelihood of infant brain damage and death.

Question 23

Which of the following mothers 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) Donna, a fifth-time mom whose baby is in a breech position
D) Prudence, a 30-year-old second-time mom, assisted by a certified nurse-midwife

Question 24

In her third trimester, Alicia's doctor informed her that the placenta was covering the cervical opening. Alicia's condition is known as

A) toxemia.
B) placenta previa.
C) placenta abruptio.
D) toxoplasmosis.

Question 25

Placenta abruptio

A) is a life-threatening event that involves premature separation of the placenta.
B) occurs when the blastocyst implants so low in the uterus that the placenta covers the cervix.
C) decreases the chance that the baby will experience anoxia during labor and delivery.
D) involves the squeezing of the umbilical cord due to its position during delivery.

Question 26

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 27

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

A) be irritable when awake.
B) be hyperactive and animated.
C) have trouble falling asleep.
D) suck more aggressively when feeding.

Question 28

Cerebral palsy

A) affects one out of every 100 American children.
B) is caused by brain damage before, during, or just after birth.
C) is usually the result of placenta abruptio or placenta previa.
D) is the result of oxygen deprivation in about 2 percent of cases.

Question 29

Brianna was born seven weeks premature. She has respiratory distress syndrome. Her parents can expect the hospital to use

A) a head-cooling device.
B) whole-body cooling.
C) a mechanical respirator.
D) "kangaroo care."

Question 30

Tonya is pregnant for a second time. She hopes to have a natural labor, though 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 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 31

Vacuum extractors

A) are used in nearly 30 percent of U.S. births.
B) are more likely than forceps to tear the mother's tissues.
C) have been rapidly replaced by forceps in most U.S. births.
D) doubles the risk of bleeding beneath the baby's skin.

Question 32

In induced labors, __________ than in naturally occurring labors.

A) medication is likely to be used in smaller amounts
B) the rate of cesarean delivery is less
C) contractions are harder and closer together
D) the chances of an instrument delivery are less

Question 33

Which of the following statements regarding home delivery is true?

A) Many home births are handled by certified nurse-midwifes.
B) Home delivery is more popular in the United States than in England.
C) Nearly 5 percent of American women now choose home delivery.
D) Home delivery is almost always dangerous for both mothers and babies.

Question 34

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 85 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 35

An induced labor

A) is justified when the baby is in a breech position.
B) often proceeds similarly to a naturally occurring one.
C) is performed in about 3 percent of U.S. deliveries.
D) is one that is started artificially.

Question 36

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

A) Cesarean delivery is never justified when the baby is in the breech position.
B) The breech position decreases the chance of squeezing of the umbilical cord.
C) Certain breech babies fare just as well with a normal delivery as with a cesarean.
D) The breech position decreases the chances of head injuries during delivery.

Question 37

__________ 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 38

Currently, the most common approach to controlling pain during labor is

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

Question 39

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 40

Which of the following statements about anoxia is true?

A) After initial brain injury from anoxia, another phase of cell death can occur several weeks later.
B) Whole-body cooling involves immersing an anoxic newborn in freezing water.
C) The effects of mild or even moderate anoxia rarely persist beyond infancy.
D) When development is severely impaired, the anoxia was probably extreme.

Question 41

Which of the following statements regarding the results of the landmark Kauai study is true?

A) Children born with serious birth complications will not grow into competent, well-adjusted adults unless they have supportive home environments.
B) Even when the overall balance of life events tips toward the favorable side, children with serious birth problems rarely develop successfully.
C) The impact of early biological risks often wanes as children's personal characteristics and social experiences contribute increasingly to their functioning.
D) Children born with birth complications often develop severe behavioral problems regardless of their home environment.

Question 42

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 43

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.
B) Dawn and Richard will need extensive coaching in infant care and everyday problem solving.
C) a few sessions of coaching in recognizing and responding to Amelia's needs could enhance their interaction with Amelia.
D) Dawn and Richard will need comprehensive long-term, intensive intervention to meet Amelia's needs.

Question 44

__________ is an especially important form of stimulation for preterm infants.

A) Music
B) Aromatherapy
C) Touch
D) Fresh air

Question 45

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 46

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 47

Which of the following statements about preterm infants is true?

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 48

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 49

Early contact with a baby in the period shortly after birth

A) guarantees immediate emotional closeness between the new parent and the newborn.
B) is vital for new 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 bonding because birth-related hormones facilitate parental responsiveness.

Question 50

Reflexes can help parents comfort a baby because they

A) are permanent, natural responses to stimulation.
B) remind the infant of its life in the womb.
C) reduce crying and promote sleep.
D) permit infants to control distress and amount of stimulation.

Question 51

Current evidence on bonding shows that

A) the human parent-infant relationship depends 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 relationships when the infant enters the family months after birth.

Question 52

Birth weight is the best available predictor of

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

Question 53

When Yolanda gives birth, her hospital offers her the option of having her newborn stay in her hospital room all or most of the time. This is known as

A) rooming in.
B) a birthing room.
C) bonding.
D) nursery care.

Question 54

Each country that outranks the United States in infant mortality 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 55

In infants who gain weight quickly, the stepping reflex

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

Question 56

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

A) evidence that her ability to bond with her baby will be compromised as a result of this decision.
B) evidence that her baby will suffer emotionally as a result of this decision.
C) no evidence that she will bond with her baby as strongly as her sisters bonded with their babies.
D) no evidence that her competence as a caregiver will be compromised or that the baby will suffer emotionally.

Question 57

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 58

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 59

The two factors that are largely responsible for neonatal mortality are __________ and __________.

A) birth defects; sudden infant death syndrome (SIDS)
B) child abuse; sudden infant death syndrome (SIDS)
C) serious physical defects; low birth weight
D) unintentional injuries; low birth weight

Question 60

Fathers show hormonal changes-specifically slight increases in __________ and __________-around the time of birth that are compatible with those of mothers.

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

Question 61

Young babies' sleep-wake cycles are affected more by __________ than by __________.

A) fullness-hunger; darkness-light
B) darkness-light; wetness-dryness
C) wetness-dryness; fullness-hunger
D) wetness-dryness; darkness-light

Question 62

Arthur wakes frequently to check to see if his sleeping infant, Sam, is breathing. Arthur can reduce the risk of sudden infant death syndrome (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 63

__________ is the most common reason young infants cry.

A) Fear
B) Pain
C) Overstimulation
D) Hunger

Question 64

The most fleeting state of arousal is

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

Question 65

Suzannah, an American teenager, is babysitting an infant for the first time. What advice is Suzannah most likely to get from the baby's parents regarding the most effective way to soothe the baby if she cries?

A) Expose the baby to continuous, monotonous, rhythmic sounds.
B) Lift the baby to the shoulder and rock or walk with her.
C) Dress the baby in several layers of clothing and blankets.
D) Let the baby cry because she needs to learn to self-soothe.

Question 66

Newborns relax their facial muscles in response to a __________ taste.

A) salty
B) sour
C) bitter
D) sweet

Question 67

Holding a newborn extensively

A) increases crying.
B) hinders early motor development.
C) promotes an insecure attachment relationship.
D) reduces crying.

Question 68

__________ doubles the risk of sudden infant death syndrome (SIDS).

A) Placing a sleeping baby on her back
B) Placing a baby on a firm sleep surface
C) Placing a sleeping infant on his side
D) Maternal cigarette smoking

Question 69

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 probably in which of the following states of arousal?

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

Question 70

Pediatricians 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 71

Early medical records of SIDS babies reveal

A) a family history of chromosomal abnormalities.
B) higher rates of prematurity and low birth weight, poor Apgar scores, and limp muscle tone.
C) they were born after their due date and had higher-than-average birth weights.
D) they often cried or whimpered in their sleep.

Question 72

In infants who have experienced birth trauma,

A) sleep behavior is organized and patterned.
B) disturbed REM-NREM sleep cycles are often present.
C) REM sleep is filled with vivid dreams.
D) sleep-wake cycles are affected more by darkness-light than by fullness-hunger.

Question 73

Crying usually peaks at about

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

Question 74

Wanda is concerned that her son, Max, will be in pain during his circumcision. You can tell Wanda that

A) newborn males do not experience much pain during circumcision.
B) offering a nipple that delivers a sugar solution reduces discomfort during circumcision.
C) local anesthetics cannot be used during newborn circumcisions because they elevate the heart rate.
D) local anesthetics can actually cause increased pain during minor procedures like circumcision.

Question 75

In industrialized nations, the leading cause of infant mortality between 1 week and 12 months is

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

Question 76

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

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 77

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 78

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 79

The cause of colic is

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

Question 80

Newborn babies

A) are not particularly sensitive to touch.
B) are not particularly sensitive to pain.
C) can distinguish the shapes and textures of small objects.
D) are especially sensitive to touch around the torso.