Deck 8: Fertility, Pregnancy, and Childbirth

Question 1

How has modern medicine changed death rates for mothers and newborn babies in the United States?

A) Death rates have greatly decreased at equal rates for all socioeconomic groups.
B) Death rates have slightly decreased at equal rates for all socioeconomic groups.
C) Death rates have decreased only for the wealthy; they remain high for the poor.
D) Death rates have decreased most for babies, but up to 5 percent of mothers still die during childbirth.
E) Death rates have greatly decreased, but minority groups still have higher death rates than the general population.

Answer 1

E

Question 2

The odds of a woman dying during childbirth in the United States are closest to

A) 1 in 100.
B) 5 in 100.
C) 2 in 1,000.
D) 5 in 100,000.
E) 17 in 100,000

Answer 2

E

Question 3

A woman becomes pregnant five days after her last sexual encounter. What is the most likely explanation for this?

A) Her partner's sperm are unusually strong and long-lived.
B) Her partner's sperm swam slowly and reached the oviduct very late.
C) Sperm held in quiescence and released gradually fertilized a just-released egg.
D) Surviving sperm waited at the distant end of the oviduct, waiting for an egg to be released.
E) The egg and sperm encountered each other immediately, but fertilization was delayed five days.

Answer 3

C

Question 4

The correct order of the process that occurs when a sperm encounters an egg is the

A) sperm reaches ovum, zona pellucida dissolves, zygote is formed, implantation occurs, and the embryo begins secreting hCG.
B) sperm reaches ovum, zona pellucida dissolves, zygote is formed, embryo begins secreting hCG, and implantation occurs.
C) sperm reaches ovum, zygote is formed, implantation occurs, zona pellucida dissolves, and the embryo begins secreting hCG.
D) zona pellucida dissolves, sperm reaches ovum, zygote is formed, implantation occurs, and the embryo begins secreting hCG.
E) zona pellucida dissolves, sperm reaches ovum, zygote is formed, embryo begins secreting hCG, and implantation occurs.

Question 5

Doctors consider a pregnancy to be confirmed, or "established," at which point?

A) Implantation
B) Fertilization
C) Production of hCG
D) First missed menstrual cycle
E) Presence of morning sickness

Question 6

Given what you know of the role of human chorionic gonadotropin (hCG), what would you predict would happen if a woman was injected with hCG?

A) She would ovulate within 24 hours.
B) She would be less likely to menstruate on schedule.
C) She would begin menstruating earlier than expected.
D) It would make fertilization more likely.
E) It would make implantation more likely.

Question 7

A woman very eager to become pregnant takes a home pregnancy test about a week before her period is due because there is a chance an egg has already been fertilized. She is devastated when the test comes back negative, but then she fails to get her period a week later. What would a doctor most likely tell her?

A) She should not be too disappointed because about 50 percent of fertilized eggs do not lead to pregnancy.
B) She should not be too disappointed because it takes most couples over two years to become pregnant.
C) A significant number of pregnancies end in early miscarriages, which would explain the negative pregnancy test and her late period.
D) She took the pregnancy test too early and should retest because she may be pregnant.
E) Home pregnancy tests are highly unreliable; women should only use laboratory tests.

Question 8

Which would provide the most reliable and accurate evidence of pregnancy very soon after implantation?

A) An ultrasound
B) A home pregnancy test
C) A laboratory blood test for hCG
D) A laboratory blood test for progesterone
E) A missed period

Question 9

An avid marathon runner in his early thirties and his wife have been trying unsuccessfully for the last year to get pregnant. What advice would a doctor be most likely to give them?

A) Don't worry, only about 70% of couples become pregnant in the first year of trying.
B) Consider a sperm donor, as male fertility declines rapidly after age 30.
C) Try to boost sperm count by exercising less.
D) Try to boost sperm count by exercising more.
E) Try to increase sperm motility by wearing snug-fitting clothing to keep the testes warm.

Question 10

How does artificial insemination increase the likelihood of conception?

A) Sperm is combined with and fertilizes a donor egg in a petri dish.
B) Sperm samples are screened to identify sperm with rapid motility.
C) Sperm samples are screened to eliminate sperm with abnormal structures.
D) Sperm samples are screened to eliminate sperm with abnormal DNA.
E) Sperm count is increased by collecting and combining sperm.

Question 11

The standard method of in vitro fertilization (IVF) involves

A) injecting a sperm cell directly into a harvested ovum in a petri dish.
B) placing a dozen or more harvested ova into a petri dish with many sperm.
C) placing a single harvested ovum into a petri dish with many sperm.
D) injecting a sperm cell directly into an ovum within the ovary.
E) injecting many sperm directly into an ovum within the ovary.

Question 12

A couple planning to undergo IVF is also considering preimplantation genetic screening

Question 13

After having a son with a severe genetic disease, a couple working with doctors in the United States undergoes preimplantation genetic screening

Question 14

A couple wants a second child that is biologically related to them. They have been trying for five years. The wife is 45 years old and healthy, with no history of sexually transmitted diseases. Three rounds of artificial insemination with her husband's sperm have failed. There is no evidence of any problem with her husband's sperm count or motility. What would be the most likely next step?

A) Another round of artificial insemination with the husband's sperm
B) Artificial insemination using donor sperm
C) In vitro fertilization using the wife's egg and donor sperm
D) In vitro fertilization using a donor egg and her husband's sperm
E) In vitro fertilization using a donor egg and donor sperm

Question 15

A woman is infertile due to extensive scarring in her oviducts. Her doctor would most likely suggest

A) hysterectomy.
B) in vitro fertilization.
C) hormonal treatments.
D) induction of ovulation.
E) artificial insemination by donor (AID).

Question 16

Refer to the figure.
The graph shows the percentage of women, grouped by age at marriage, who remain childless after a first marriage in spite of continued efforts to produce a child. What is the most accurate conclusion that can be drawn from the graph?

A) Childbirth after age 40 is dangerous.
B) Fertility declines rapidly after age 35.
C) Fertility increases steadily as women age.
D) Virtually all women have children, regardless of marital age.
E) Pregnancy rates have declined over the last decade.

Question 17

What is the likelihood of pregnancy for a postmenopausal woman?

A) It can never occur.
B) It sometimes occurs spontaneously.
C) It can occur naturally if the father is under 40.
D) It can occur via artificial insemination if the father is under 40.
E) It can occur using donated ova and hormone treatments.

Question 18

The likelihood that a woman will give birth to a child with Down syndrome increases with maternal age. However, four out of five babies with Down syndrome are born to women younger than age 35. This is because women under 35

A) give birth to more babies.
B) have fewer miscarriages.
C) are less likely to receive good prenatal care.
D) engage in more behaviors that put the fetus at risk.
E) are unlikely to be offered genetic screening.

Question 19

Which couple is statistically most likely to have a child with Down syndrome?

A) A 50-year-old man having a baby with a 25-year-old woman.
B) A 45-year-old woman having a baby with a 35-year-old man.
C) A 45-year-old woman using a donor egg from a 22-year-old woman.
D) A 45-year-old woman using her own egg, which she froze when she was 25.
E) A 30-year-old woman having a baby with a 30-year-old man.

Question 20

The number of children available for adoption in the United States is

A) increasing, due to more out-of-wedlock births.
B) increasing, due to poor economic conditions.
C) stable, because major factors affecting abortion have not changed.
D) decreasing, because more unmarried mothers are keeping their babies.
E) decreasing, because adoptions from foreign countries are now banned in the United States.

Question 21

An Rh incompatibility problem in a fetus occurs if the mother

A) and father are both Rh negative.
B) is Rh positive, and the father is Rh negative.
C) has a blood defect that prevents her from having an Rh factor.
D) develops anti-Rh antibodies during her first pregnancy that attack her first child.
E) develops anti-Rh antibodies during her first pregnancy that attack subsequent children.

Question 22

A woman's period is about three weeks past due. She is experiencing abdominal pain and pain when she urinates. What is happening to her?

A) She is showing typical first trimester symptoms of pregnancy.
B) She is having a miscarriage.
C) She is experiencing an ectopic pregnancy.
D) She is experiencing placenta previa.
E) She is pregnant and suffering from an incompetent cervix.

Question 23

An ectopic pregnancy occurs when

A) an embryo implants outside the uterus.
B) an embryo implants in the uterus too late.
C) an embryo implants in the uterus too early.
D) the mother is Rh negative and the father is Rh positive.
E) the mother develops anti-Rh antibodies that attack the fetus.

Question 24

Only about 1 in 200 babies is born with a chromosomal abnormality. What is the main factor preventing this number from being much larger?

A) Spontaneous abortion early in pregnancy
B) Spontaneous abortion late in pregnancy
C) Damaged ova that are not fertilized
D) Rarity of sperm with chromosomal abnormalities
E) Ensuring the embryo's Rh compatibility early in pregnancy

Question 25

A woman has a positive pregnancy test the first day after a missed period, but she begins to menstruate two weeks later. The most likely explanation is that

A) the pregnancy test was inaccurate.
B) she took the test too early in the pregnancy.
C) she had endometriosis rather than a pregnancy.
D) taking the pregnancy test caused her to miscarry.
E) an embryo implanted briefly but did not survive.

Question 26

According to the American Academy of Pediatrics, a fetus's "gestational age" is counted from the date of

A) fertilization.
B) implantation.
C) onset of last menstrual period.
D) the first positive pregnancy test.
E) one week after the end of last menstrual period.

Question 27

A pregnant woman knows that she last ovulated 6 weeks ago because she used an ovulation tracker to help her get pregnant. How many weeks pregnant is she?

A) 2 weeks
B) 4 weeks
C) 6 weeks
D) 8 weeks
E) It is not possible to estimate based on this information.

Question 28

A woman who is 37 weeks pregnant made plans to take a seven-day hiking trip in the backcountry the following week. She expects to deliver her baby in the hospital after she returns from the trip. What is her doctor likely to tell her?

A) Thirty-seven weeks is considered a term pregnancy, meaning there is a significant risk that she will deliver her baby before or during her trip.
B) She should attempt to induce labor now. If she does not go into labor, she will be cleared for the trip.
C) She should consider an elective C-section at 37 weeks, because that represents an optimal, full-term pregnancy.
D) There should be no problem with the trip, as she is unlikely to deliver until 40 weeks
E) There should be no problem with the trip, as women typically deliver their babies at 42 weeks.

Question 29

A woman is experiencing nausea, an aversion to strong-tasting foods, a need to urinate frequently, and breast tenderness. It is likely she is

A) ovulating.
B) in her first trimester.
C) in her second trimester.
D) in her third trimester.
E) in labor.

Question 30

According to medical professionals, the best time to begin prenatal care is

A) at least 6 months before pregnancy.
B) at least 3 months before pregnancy.
C) during the first trimester.
D) during the second trimester.
E) at least a month prior to giving birth.

Question 31

A woman whose prepregnancy weight is in the normal range should gain approximately how many pounds during pregnancy?

A) 5-10
B) 10-20
C) 25-35
D) 35-45
E) 45-50

Question 32

Which action poses the most risk to a developing fetus?

A) Smoking
B) Getting a flu shot
C) Taking folic acid supplements
D) Eating a healthy vegan diet
E) Having a pelvic exam

Question 33

If at all possible, a pregnant woman should avoid exposure to X-rays, which increase the baby's risk of

A) low birth weight.
B) childhood cancer.
C) spontaneous abortion.
D) heart, brain, or limb defects.
E) sudden infant death syndrome.

Question 34

A premature infant with a low birth weight is showing signs of addiction and withdrawal. During pregnancy, the mother was likely exposing her fetus to

A) heroin.
B) thalidomide.
C) diethylstilbestrol (DES).
D) marijuana.
E) isotretinoin.

Question 35

An embryo is considered a fetus

A) when its sex can be distinguished by genetic testing.
B) after 8 weeks of gestation, when all of its organs are present.
C) when it reaches 4 weeks of gestational age.
D) at the end of the first trimester.
E) once all of its organs are functional.

Question 36

Refer to the figure.
The figure illustrates _______, which is used to test for fetal abnormalities.

A) quickening
B) amniocentesis
C) the Bradley method
D) chorionic villus sampling
E) cell-free fetal DNA analysis

Question 37

A 37-year-old woman is concerned about giving birth to a baby with Down syndrome, but she does not want to risk a miscarriage caused by genetic screening. She is not concerned about other genetic disorders. Which type of genetic screening would her doctor recommend?

A) Chorionic villus sampling
B) Amniocentesis
C) Cell-free fetal DNA analysis
D) None because older women have very low risk of giving birth to babies with Down syndrome
E) None because no genetic screening method outweighs the risk for miscarriage in women over age 30

Question 38

A doctor testing for fetal abnormalities would choose chorionic villus sampling instead of amniocentesis in order to

A) identify spina bifida.
B) identify problems earlier in pregnancy.
C) decrease the risk of miscarriage.
D) identify sex-linked abnormalities.
E) obtain DNA for cell-free DNA analysis.

Question 39

As a woman progresses through the second trimester of pregnancy, all of the following activities are usually acceptable except

A) having coitus.
B) using a vibrator during sex.
C) low-impact exercises.
D) anal sex.
E) having coitus in the man-on-top position.

Question 40

A woman's breasts have begun to release small amounts of colostrum and she feels the need to urinate frequently. Her energy level is high and she is not experiencing any nausea, but she has difficulty sleeping now that she can feel her baby's movements. She is likely

A) in the first trimester of pregnancy.
B) in the second trimester of pregnancy.
C) in the third trimester of pregnancy.
D) about a week away from giving birth.
E) about a day away from giving birth.

Question 41

A woman wants to give birth in a personalized, homelike environment. However, her doctor is concerned that she might develop complications and would like her to deliver where a C-section would be possible if needed. Which location would best meet both of these needs?

A) Her home
B) A hospital
C) A standalone birthing center
D) A birthing center attached to a hospital
E) A home birth with transfer to a hospital if needed

Question 42

A woman wants her birth to be as natural as possible, without any use of anesthesia, and with her partner present to coach her throughout labor. Which childbirth strategy would she be most likely to choose?

A) Water birth
B) Bradley method
C) Lamaze method
D) Perineal massage
E) Braxton Hicks method

Question 43

A woman is at high risk for giving birth prematurely. To reduce risk to the infant, her doctor is likely to

A) use the Bradley method to trigger effacement.
B) use chorionic villus sampling to test for incompetent cervix.
C) have her practice perineal massage daily.
D) administer corticosteroids to speed lung development.
E) administer antibodies to reduce risk of Rh factor incompatibility.

Question 44

The third trimester of pregnancy is defined as beginning

A) at 27 weeks of gestational age.
B) when the fetus weighs at least 3 pounds.
C) when Braxton Hicks contractions begin.
D) when quickening occurs.
E) when the fetus possesses rudimentary versions of all organs.

Question 45

A woman who is 35 weeks pregnant has been having contractions about every 15 minutes for the last few hours and her cervix has effaced. She is probably

A) also having Braxton Hicks contractions.
B) a few hours away from engagement.
C) in the first stage of labor.
D) in the second stage of labor.
E) in the third stage of labor.

Question 46

Uterine contractions during the first stage of labor are necessary to

A) speed up the process of delivery.
B) move the baby down toward the birth canal.
C) pull the cervix upward to form a continuous birth canal.
D) fatigue the uterine muscles so they will relax and release the baby.
E) harden and tighten the cervix so it can withstand the birth process.

Question 47

A woman is experiencing intense pain during childbirth that is unable to be controlled with breathing techniques. Which common intervention is most likely to significantly reduce her pain?

A) The Bradley method
B) Episiotomy
C) Epidural anesthesia
D) Cervical effacement
E) Perineal massage

Question 48

A pregnant woman has begun to feel a strong urge to push. She is likely

A) having Braxton Hicks contractions.
B) experiencing engagement.
C) in the first stage of labor.
D) in the second stage of labor.
E) in the third stage of labor.

Question 49

An incision is sometimes made during labor to extend the length of the vaginal opening and prevent tearing of the vaginal wall. This is called a(an)

A) epidural.
B) episiotomy.
C) effacement.
D) engagement.
E) dilation.

Question 50

Premature babies born before 28 weeks are most likely to

A) die at birth.
B) survive with minimal medical intervention.
C) have complications involving the eyes, lungs, brain, or intestines.
D) be small at birth, but catch up quickly and develop normally.
E) be healthier than full-term babies because delivery is easier.

Question 51

A pregnant woman is almost three weeks overdue and shows no signs of delivering her baby. Her doctor is most likely to suggest

A) letting nature take its course.
B) doing a Caesarean section.
C) inducing labor with oxytocin and prostaglandins.
D) jogging or other heavy exercise to stimulate labor.
E) giving an epidural to stimulate labor.

Question 52

A woman who is 40 weeks pregnant has an active sexually transmitted infection. What is her doctor likely to recommend?

A) Vaginal birth to reduce the risk of complications
B) Cesarean section to avoid exposing the baby to infection
C) Inducing labor with Pitocin
D) Delaying delivery to 43 weeks while the infection is treated
E) Use of episiotomy to speed labor

Question 53

One study showed that postpartum depression in China (where boys are preferred) was more common in women who gave birth to girls. A study in the United States showed that estrogen treatment can reduce symptoms of postpartum depression. These studies, together, suggest that postpartum depression is caused primarily by

A) hormonal imbalances.
B) genetic factors.
C) psychosocial factors.
D) cultural factors.
E) a combination of biological, psychological, and cultural factors.

Question 54

Allie gave birth two weeks ago. Although she had been looking forward to becoming a mother, she now wants to give her daughter up for adoption because she believes the child is not actually human. What is the most likely explanation?

A) Allie is suffering from sleep deprivation.
B) Allie has postpartum psychosis.
C) Allie has postpartum depression.
D) Allie has overly high levels of estrogen.
E) Allie has overly high levels of prolactin.

Question 55

A woman recently gave birth vaginally and suffered some tearing of the vagina. Three weeks after giving birth, her husband would like to have sex. . What is her obstetrician likely to recommend?

A) Resuming sex after three weeks is perfectly normal and should cause no problems.
B) Resuming sex after three weeks may be painful, but is fine if the husband wishes it.
C) Typically, a new mother can safely resume sex after about six months of healing.
D) Typically, a new mother can safely resume sex after about six weeks of healing.
E) A new mother can resume sex whenever she feels ready and will not need contraception for six months.

Question 56

A breastfed baby may lose up to 10 percent of its birth weight during the first few days after birth. This occurs because

A) the baby is inexperienced at breastfeeding.
B) the baby is stressed due to the birth process.
C) colostrum is low in calories.
D) the mother is inexperienced in breastfeeding.
E) breast milk lacks nutrients available in infant formula.

Question 57

A woman is most likely to be advised not to breastfeed her baby

A) if she has hepatitis or HIV.
B) because it is time-consuming and expensive.
C) if she wants to recover quickly from childbirth.
D) if she wants to avoid becoming pregnant again.
E) if she has a cold or fever.

Question 58

Breastfeeding is recommended because

A) only breastfed infants bond fully with their mothers.
B) women are likely to develop breast infections if they do not breastfeed.
C) breastfeeding improves fertility.
D) breastfeeding reduces risk for infant infections.
E) breastfeeding provides life-long immune benefits.

Question 59

The American Academy of Pediatrics recommends that

A) women rely exclusively on formula, as modern versions are more nutritious than breast milk.
B) women supplement breast-feeding with formula for balanced nutrition.
C) infants be exclusively breastfed for six months.
D) infants be exclusively breastfed for a year.
E) infants have access to breast milk through the first two years of life.

Question 60

A woman hoping to have a child took a home pregnancy test the day her period was due. Explain how should she interpret a negative test result and why.

Question 61

Discuss reasons for male infertility.

Question 62

A couple has been trying for over a year to get pregnant without success. Tests show no problems with the man's sperm motility or sperm count. They wish to have a child biologically related to both of them. What might be causing their infertility and what options do they have?

Question 63

What are the risks and benefits of allowing parents to learn the sex of a child before birth?

Question 64

Explain the statement "Nature has not completely mastered the intricate task of creating a normal embryo." What factors can bring about an embryo's early demise?

Question 65

Describe each trimester of pregnancy from an expectant mother's point of view.

Question 66

Design a bulleted brochure for women hoping to get pregnant that outlines the choices they can make now and in the first trimester that will increase their chances of delivering a healthy infant.

Question 67

A pregnant 40-year-old woman is not sure whether she wants to do a Down syndrome screening. What should she know about the likelihood of having a child with Down syndrome, her screening options, and the risks of those options?

Question 68

A woman with placenta previa wants to deliver her baby with the fewest medical interventions possible in a home-like setting. Describe the types of childbirth preparation and birth settings that would best balance her preferences and safety during a higher-risk delivery.

Question 69

Describe the three stages of labor involved in a typical vaginal delivery.

Question 70

A working mother of a three-month-old hoped to breastfeed for at least six months, but has found it extremely difficult to pump breastmilk at work. What information might be useful as she decides what to do?