A woman gives birth to a small infant with a malformed skull.

The infant grows abnormally slowly and shows signs of substantial cognitive and intellectual deficits.

The child also has facial abnormalities including a short nose and thin lip that become more striking as it develops.

The correct answer is choice D. Chronic alcohol use.

Choice A rationale:

Active herpes simplex infection during pregnancy can lead to neonatal herpes, which is a serious condition, but it does not cause the symptoms described.

Choice B rationale:

Chronic cocaine use during pregnancy can lead to premature birth and low birth weight, but it does not typically result in the specific symptoms described.

Choice C rationale:

Folic acid deficiency during pregnancy can lead to neural tube defects, which can cause a range of symptoms, but not the specific ones described.

Choice D rationale:

Chronic alcohol use during pregnancy can lead to Fetal Alcohol Syndrome, which includes slow growth, cognitive and intellectual deficits, and the facial abnormalities described.

The correct answer is choice B.

Choice A rationale:

Focus on the family unit and its members is more characteristic of the “letting-go” phase.

Choice B rationale:

Expressions of excitement are common in the dependent, taking in phase as the mother is focused on her own needs and the experience of childbirth.

Choice C rationale:

Eagerness to learn newborn care skills is more characteristic of the “taking-hold” phase.

Choice D rationale:

Lack of appetite is not a typical characteristic of the dependent, taking in phase.