The correct answer appears first and is boldface.

1. c. Anencephaly refers to a child born with an abnormally developed brain, which results when the cephalic (head) region of the neural tube fails to close.

a. Deformed arms and legs have been associated with the use of thalidomide during pregnancy, but such physical deformities are not called anencephaly.

b. A viral infection may cause abnormal development of the spinal cord, but anencephaly describes brain disorders, not spinal cord disorders.

d. Anencephaly describes a condition of abnormal brain growth, not abnormal growth of sexual organs.

2. a. In the second trimester, the woman is likely to feel fetal kicks called quickening.

b. Myelinization is the process of neural growth during which myelin forms around neurons to insulate and speed up the conduction of the neural impulse.

c. Viability refers to the ability of the developing fetus to survive outside the mother's womb.

d. Gestation refers to the period of carrying a developing embryo and fetus, that is, the period of pregnancy.

3. b. Gestational age is the common reference used to gauge prenatal development; it is based on the first day of the woman's last menstrual period.

a. The expectant woman is probably the person most likely to know approximately when fertilization took place; nevertheless, such estimates are not very accurate and therefore are not used to estimate gestational age.

c. A pregnancy test can determine whether or not a woman is pregnant, but it cannot provide an estimate of the baby's gestational age.

d. Although conception usually occurs approximately two weeks after the onset of the last menstrual period, it has become standard procedure to estimate gestational age using the onset of the last menstrual period.

4. d. It is the principle of critical or sensitive periods that maintains that the extent to which a teratogen will have negative consequences on the fetus depends on the developmental stage at which exposure to the teratogen occurred.

a. Developmental delay is one of the principles of teratology that describes effects of teratogens that do not appear until late in development.

b. Dose-response relationship is a principle of teratology that describes the importance of the dosage level of a teratogen in producing fetal damage.

c. The principle of access states that how a teratogen becomes available to a fetus or an embryo influences the degree of damage.

5. c. The more a woman smokes while pregnant, the lower the newborn baby's average weight.

a. Although harmful effects of maternal smoking on the developing infant do occur, studies have failed to uncover any consistent mental deficits or long-term consequences in infants born to smoking mothers.

b. Babies born to smoking women are usually smaller and lighter in weight, but not perfectly healthy and normal. Smoking is also associated with increased stillbirths and neonatal deaths.

d. Studies have consistently failed to find any evidence that smoking causes congenital defects such as hearing and visual problems.

6. b. Because women who use illegal drugs may not receive adequate nutrition, may have little prenatal care, and often have limited knowledge about the drugs they are taking, it is often difficult for researchers to draw conclusions about which of these many factors may be responsible for teratogenic effects observed in the newborns of these mothers.

a. Although the teratogenic effects of many illegal drugs may have consequences similar to those resulting from exposure to some diseases, determining whether such is the case is made difficult by the many other factors that are often confounded with use of illegal drugs.

c. Many different consequences for the fetus may be associated with illegal drug use. However, the primary difficulty for researchers is identifying whether the drug or some other confounding factor is responsible for a particular outcome.

d. Delayed or "sleeper effects" may result from exposure to illegal drugs, but researchers first need to separate the effects of drug exposure from other factors related to prenatal development before addressing this issue.

7. c. Rubella can cause a variety of physical and mental problems, including mental retardation.

a. Fetal alcohol syndrome, or FAS, occurs in babies born to alcoholic mothers. It is not caused by rubella.

b. Diethylstilbestrol, or DES, is a teratogenic drug that produces a "sleeper effect." It is not a cause of rubella.

d. Liver dysfunction is not a primary problem associated with rubella.

8. a. A pregnant woman with HIV is at risk of transmitting the disease to the fetus or her newborn infant. Zidovudine and other medical treatments have dramatically reduced this risk in recent years.

b. CMV (cytomegalovirus) continues to be the most frequent infection found in newborns. However, at present, medical treatments that might reduce the likelihood of its transmission to the fetus are not available.

c. FAS (fetal alcohol syndrome) is the consequence of exposure to alcohol.

d. DES (diethylstilbestrol), a hormone that was formerly administered to pregnant women to reduce the risk of miscarriage, is not a disease, but it does increase the risk of certain kinds of cancer later in development.

9. c. Teenagers and some women over age thirty-five are at greater risk for delivering less healthy babies than women between these two age groups.

a. A teenager is at considerable risk for delivering an unhealthy baby, primarily because the teenage population is least likely to seek adequate prenatal care.

b. Babies of women over thirty-five have an increased risk of Down syndrome, prematurity, and mortality, primarily because health-related problems generally accompany aging.

d. Babies of women over thirty-five have an increased risk of Down syndrome, prematurity, and mortality, primarily because health-related problems generally accompany aging.

10. d. The likelihood of giving birth to a child with Down syndrome increases with age; women over age thirty-five are particularly at risk.

a. Healthy women over thirty-five have no more complications during pregnancy than younger women. Since Annette doesn't smoke, there is no reason to expect that she is at risk of having a low-birth-weight baby.

b. Spina bifida is a disorder in which the spinal cord fails to develop properly. This disorder is not related to maternal age.

c. Toxoplasmosis results from infection by a parasite found in the feces of small animals such as cats and in raw or partially cooked meats. A forty-two-year-old woman is at no higher or lower risk of getting this disease than anyone else.

11. b. An increase in weight during pregnancy, typically twenty-five to thirty-five pounds, is now recommended for most women because of the benefits of adequate nutrition for the fetus.

a. Normally, expectant women need greater amounts of nutriments, including some increase in vitamins, than do nonpregnant women. However, the increase should not be excessive. For example, excessive amounts of vitamin A can cause birth defects.

c. Social support from friends and relatives helps lessen the consequences of stress and reduces complications during pregnancy. Expectant women normally are advised to continue their interactions with others. Of course, if others do display signs of illness, curtailing social interactions during possible periods of contagion might be wise, just as would be true for a woman who was not expecting.

d. Aspirin may increase susceptibility to bleeding. Other over-the-counter medications may also have possible teratogenic effects. During pregnancy, the use of any medication should be approved by a physician.

12. d. The presence of a trusted partner or supportive companion during childbirth has been shown to help reduce the length of labor and the need for drugs. It also seems to benefit the infant, who undergoes less fetal distress in such circumstances.

a. Research involving midwives as attendants suggests that positive outcomes for delivery of healthy infants are due in part to the greater involvement of expectant women who draw on their own inner resources to assist in childbirth.

b. Although a medical doctor may not be required, a midwife, nurse, or other health practitioner knowledgeable about the process of delivery is important to help ensure the birth of a healthy infant.

c. The recumbent position during both the first and second stages of labor is no longer required in many birthing facilities. Permitting greater flexibility in the activities allowed during labor seems to help expectant mothers to be more comfortable during childbirth.

13. a. A cesarean birth permits a quick delivery, which is critical if the baby is in severe distress. The baby is delivered through an incision in the woman's abdomen and uterus.

b. It is critical that birth occur as quickly as possible when a baby is in severe distress during labor. Since vaginal birth may take many minutes, the doctor is unlikely to recommend this method of birth.

c. A breech birth describes the situation where the baby is in a foot-first position in the uterus; it is not a method of birth.

d. Freestanding birthing centers provide a more natural and relaxed setting, but they are not equipped to handle complications that arise during labor.

14. d. Jerry would be less than thirty-five weeks' conceptual age, which is the criterion for a preterm classification.

a. Preterm babies are defined as those born less than thirty-five weeks' conceptual age.

b. Preterm babies are defined as those born less than thirty-five weeks' conceptual age.

c. Preterm babies are defined as those born less than thirty-five weeks' conceptual age.

15. b. Studies show that low-birth-weight infants in intervention programs that provide home visits and caregiver training show higher levels of cognitive performance than low-birth-weight infants not in such intervention programs.

a. Low-birth-weight infants in intervention programs had fewer eating problems later on.

c. Low-birth-weight infants in intervention programs gained weight more rapidly.

d. Low-birth-weight infants in intervention programs do show improvements in cognitive performance compared to low-birth-weight infants not in intervention programs.

16. a. Vernix caseosa is an oily, cheeselike substance that covers the newborn and helps protect against infection.

b. All normal newborns are born covered with this substance, but it does not play a role in regulating breathing.

c. All normal newborns are born covered with this substance, but it does not play a role in regulating body temperature.

d. There is no need to be concerned, because this substance covers all normal newborns and is not related to any form of distress.

17. d. An Apgar score of 7 or better usually indicates that the baby is healthy and not at risk.

a. An Apgar score of 7 or better usually indicates that the baby is healthy and not at risk; therefore, it is unlikely that Nicole would have difficulties with breathing.

b. An Apgar score of 7 or better usually indicates that the baby is healthy and not at risk; therefore, there is no need to provide Nicole with neonatal intensive care.

c. An Apgar score of 7 or better indicates that Nicole's muscle tone is normal.

18. b. During REM (rapid-eye-movement) sleep, muscle jerks are frequent, breathing and heart rate are irregular, and the eyes move rapidly under closed eyelids.

a. During quiet, or NREM, sleep, few movements are observed and breathing is regular.

c. During quiet, or NREM, sleep, few movements are observed and breathing is regular.

d. There is no stage of sleep called alert sleep.

19. a. Susceptibility refers to the idea that teratogens show different effects between different species. Thalidomide was tested in rats, unfortunately, humans were sensitive to a much smaller amount of the drug than were rats.

b Sensitive period refers to the idea that teratogens are time specific. The extent to which a teratogen will affect the fetus depends on the stage of development that the exposure occurs.

c Teratogenic response describes the principle that teratogens do not show effects uniformly on prenatal development.

d Sleeper effects refer to the fact that the effects of some teratogens do not show up until much later in development.

20. c. Although the effect is somewhat controversial, evidence suggests that children born to heavy coffee drinkers may show lower birth weight than children born to light coffee drinkers (less than 3 cups a day).

a There is no evidence that coffee drinking puts a child at risk for mental retardation.

b There is no evidence that coffee drinking puts a child at risk for limb defects.

d Children born to heavy coffee drinkers show the opposite effect; more agitation and movement.

21. c. Anoxia is when oxygen is cut-off during child birth. A typical cause of anoxia is when the umbilical cord wraps around the child's neck, and cerebral palsy is a common effect when the anoxia is prolonged.

a Low birth weight would not be affected by events at childbirth itself.

b FAS results from mother's drinking during pregnancy. Typical symptoms of FAS include mental retardation, but do not include cerebral palsy.

d DES is a hormone that was administered to women in the 1940-60s. Children who were born to mothers who took DES are at a higher risk of certain types of cancer.

22. d. Enriching experiences are used to help low birth weight and pre-term infants thrive. Enriching experiences are more akin to the environment that normal newborns are exposed to.

a Compensatory stimulation, such as using waterbeds or recordings of muffled human voices, tries to mimic the womb environment for the low birth weight or pre-term infant.

b Doula care is during labor for the mother. A doula stays with mother during labor and helps support her through the experience.

c Low birth weight babies need more than typical care for maximum development.