{
  "module": "103.9",
  "title": "103.9 Childbearing Years and Pregnancy",
  "pass_percent": 75,
  "pre_test": {
    "graded": false,
    "questions": [
      {
        "question": "How much folic acid should anyone who could become pregnant take each day?",
        "options": [
          "400 micrograms",
          "None until pregnancy is confirmed",
          "4 grams",
          "Only in the last month of pregnancy"
        ],
        "correct": 0,
        "explanation": "400 micrograms daily, starting before pregnancy, helps prevent birth defects of the brain and spine."
      },
      {
        "question": "In a healthy pregnancy, how often are prenatal visits between 28 and 36 weeks?",
        "options": [
          "Once a month",
          "About every 2 weeks",
          "Every day",
          "Only once"
        ],
        "correct": 1,
        "explanation": "Visits are about every 2 weeks from 28 to 36 weeks, then weekly."
      },
      {
        "question": "Which is an urgent maternal warning sign?",
        "options": [
          "Needing to pee more often",
          "Mild tiredness in early pregnancy",
          "A headache that will not go away or gets worse",
          "Craving certain foods"
        ],
        "correct": 2,
        "explanation": "A headache that will not go away or gets worse is on the CDC Hear Her urgent warning sign list."
      },
      {
        "question": "For how long after birth do urgent maternal warning signs matter?",
        "options": [
          "One day",
          "One week",
          "Six weeks only",
          "Up to one year"
        ],
        "correct": 3,
        "explanation": "Warning signs matter during pregnancy and for up to a year after birth."
      },
      {
        "question": "A pregnant client's blood pressure is 162/112. What should the CHW do?",
        "options": [
          "Tell her to rest and recheck next week",
          "Help her get urgent care now and tell the RN supervisor at once",
          "Tell her to cut back on salt",
          "Ignore it if she feels fine"
        ],
        "correct": 1,
        "explanation": "160/110 or higher is the severe range in pregnancy and needs urgent care."
      },
      {
        "question": "Two weeks after birth, a client has a bad headache and blurry vision. What should the CHW do?",
        "options": [
          "Tell her she is just tired",
          "Suggest pain medicine",
          "Wait until her next visit",
          "Help her get care right away and tell the RN supervisor"
        ],
        "correct": 3,
        "explanation": "These can be signs of postpartum preeclampsia, which needs care right away."
      },
      {
        "question": "What is the main difference between baby blues and postpartum depression?",
        "options": [
          "Baby blues fade in about two weeks; postpartum depression lasts longer",
          "Postpartum depression only happens in pregnancy",
          "Baby blues need hospital care",
          "There is no difference"
        ],
        "correct": 0,
        "explanation": "Baby blues usually fade within two weeks; lasting or worsening symptoms need care."
      },
      {
        "question": "A new mother says she has thoughts of harming herself. What should the CHW do first?",
        "options": [
          "Tell her to sleep it off",
          "Change the subject",
          "Stay with her and call 988 or 911",
          "Schedule a visit for next month"
        ],
        "correct": 2,
        "explanation": "Thoughts of harm are an emergency; stay with her and connect her to crisis help now."
      },
      {
        "question": "What is the main upstream cause of higher maternal death rates for Black women?",
        "options": [
          "Genetics",
          "Racism and unequal treatment in systems and care",
          "Not caring about their health",
          "Living in the city"
        ],
        "correct": 1,
        "explanation": "Racism, not race, drives the gap, which holds even among college-educated women."
      },
      {
        "question": "A pregnant client misses visits because the clinic is far. What is the best CHW step?",
        "options": [
          "Tell her missed visits are her own choice",
          "Report her to children services",
          "Tell her visits do not matter much",
          "Help arrange transportation and appointment times that fit her life"
        ],
        "correct": 3,
        "explanation": "CHWs remove barriers to care, such as transportation and scheduling."
      }
    ]
  },
  "post_test": {
    "graded": true,
    "questions": [
      {
        "question": "Two weeks after birth, a client has a bad headache and blurry vision. What should the CHW do?",
        "options": [
          "Tell her she is just tired",
          "Suggest pain medicine",
          "Wait until her next visit",
          "Help her get care right away and tell the RN supervisor"
        ],
        "correct": 3,
        "explanation": "These can be signs of postpartum preeclampsia, which needs care right away."
      },
      {
        "question": "For how long after birth do urgent maternal warning signs matter?",
        "options": [
          "One day",
          "One week",
          "Six weeks only",
          "Up to one year"
        ],
        "correct": 3,
        "explanation": "Warning signs matter during pregnancy and for up to a year after birth."
      },
      {
        "question": "Which is an urgent maternal warning sign?",
        "options": [
          "Needing to pee more often",
          "Mild tiredness in early pregnancy",
          "A headache that will not go away or gets worse",
          "Craving certain foods"
        ],
        "correct": 2,
        "explanation": "A headache that will not go away or gets worse is on the CDC Hear Her urgent warning sign list."
      },
      {
        "question": "A new mother says she has thoughts of harming herself. What should the CHW do first?",
        "options": [
          "Tell her to sleep it off",
          "Change the subject",
          "Stay with her and call 988 or 911",
          "Schedule a visit for next month"
        ],
        "correct": 2,
        "explanation": "Thoughts of harm are an emergency; stay with her and connect her to crisis help now."
      },
      {
        "question": "A pregnant client misses visits because the clinic is far. What is the best CHW step?",
        "options": [
          "Tell her missed visits are her own choice",
          "Report her to children services",
          "Tell her visits do not matter much",
          "Help arrange transportation and appointment times that fit her life"
        ],
        "correct": 3,
        "explanation": "CHWs remove barriers to care, such as transportation and scheduling."
      },
      {
        "question": "A pregnant client's blood pressure is 162/112. What should the CHW do?",
        "options": [
          "Tell her to rest and recheck next week",
          "Help her get urgent care now and tell the RN supervisor at once",
          "Tell her to cut back on salt",
          "Ignore it if she feels fine"
        ],
        "correct": 1,
        "explanation": "160/110 or higher is the severe range in pregnancy and needs urgent care."
      },
      {
        "question": "What is the main difference between baby blues and postpartum depression?",
        "options": [
          "Baby blues fade in about two weeks; postpartum depression lasts longer",
          "Postpartum depression only happens in pregnancy",
          "Baby blues need hospital care",
          "There is no difference"
        ],
        "correct": 0,
        "explanation": "Baby blues usually fade within two weeks; lasting or worsening symptoms need care."
      },
      {
        "question": "How much folic acid should anyone who could become pregnant take each day?",
        "options": [
          "400 micrograms",
          "None until pregnancy is confirmed",
          "4 grams",
          "Only in the last month of pregnancy"
        ],
        "correct": 0,
        "explanation": "400 micrograms daily, starting before pregnancy, helps prevent birth defects of the brain and spine."
      },
      {
        "question": "In a healthy pregnancy, how often are prenatal visits between 28 and 36 weeks?",
        "options": [
          "Once a month",
          "About every 2 weeks",
          "Every day",
          "Only once"
        ],
        "correct": 1,
        "explanation": "Visits are about every 2 weeks from 28 to 36 weeks, then weekly."
      },
      {
        "question": "What is the main upstream cause of higher maternal death rates for Black women?",
        "options": [
          "Genetics",
          "Racism and unequal treatment in systems and care",
          "Not caring about their health",
          "Living in the city"
        ],
        "correct": 1,
        "explanation": "Racism, not race, drives the gap, which holds even among college-educated women."
      }
    ]
  }
}