HLTH 644 Quiz 4: A Multitude of
Complications | Module 4 Week 4 |
Questions and Answers | 2026/2027 Updated
| 100% Correct - Liberty University
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
50 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This quiz assesses advanced understanding of maternal and early childhood complications, including
hypertensive disorders of pregnancy, gestational diabetes, preterm birth, postpartum hemorrhage, and
congenital anomalies. It also covers breastfeeding contraindications, developmental screening, immunization
safety, and the public health policies that shape maternal-child outcomes in the United States.
STUDY GUIDE
Recommended duration: 75 minutes. Passing target: 80%.
HIGHP - Page 1 of 17
,1. A pregnant client at 34 weeks gestation presents with a blood pressure of 168/112 mm
Hg and 3+ proteinuria. She reports a severe frontal headache and visual changes. Which
of the following is the most appropriate immediate management?
[ ] A. Administer intravenous magnesium sulfate and initiate antihypertensive therapy with labetalol.
[ ] B. Schedule an elective cesarean delivery within 48 hours without acute stabilization.
[ ] C. Prescribe oral methyldopa and discharge home with strict bed rest instructions.
[ ] D. Obtain a 24-hour urine collection before starting any antihypertensive medication.
CORRECT: A. Administer intravenous magnesium sulfate and initiate antihypertensive therapy with
labetalol.
This presentation is consistent with preeclampsia with severe features; immediate magnesium sulfate
prevents seizures and labetalol controls severe hypertension. Delaying treatment for a 24-hour urine
collection or home management is unsafe, and delivery timing requires stabilization first.
2. A newborn is noted to have a sacral dimple with a tuft of hair and a small skin tag.
Which of the following is the most appropriate next step in evaluation?
[ ] A. Reassure the parents that isolated sacral dimples are always benign.
[ ] B. Order a spinal ultrasound or MRI to evaluate for occult spinal dysraphism.
[ ] C. Obtain a plain radiograph of the lumbosacral spine to rule out spina bifida.
[ ] D. Refer for immediate surgical excision of the skin tag to prevent infection.
CORRECT: B. Order a spinal ultrasound or MRI to evaluate for occult spinal dysraphism.
A sacral dimple with a tuft of hair or skin tag is a red flag for occult spinal dysraphism, requiring imaging of
the spinal cord. Plain radiographs do not visualize the cord, and surgical excision without imaging is
inappropriate.
3. A lactating mother is prescribed a medication that is considered contraindicated during
breastfeeding. Which of the following factors most strongly determines the amount of
drug transferred into breast milk?
[ ] A. The mother's body mass index and hydration status.
[ ] B. The drug's molecular weight, lipid solubility, and protein binding.
[ ] C. The infant's gestational age at birth and current weight.
[ ] D. The time of day the medication is administered.
CORRECT: B. The drug's molecular weight, lipid solubility, and protein binding.
Drug transfer into breast milk is primarily governed by the drug's physicochemical properties-molecular
weight, lipid solubility, protein binding, and oral bioavailability. Maternal BMI and timing are less predictive,
and infant factors affect risk but not transfer.
HIGHP - Page 2 of 17
, 4. Which of the following congenital heart defects is most commonly associated with
maternal diabetes mellitus?
[ ] A. Atrial septal defect
[ ] B. Ventricular septal defect
[ ] C. Transposition of the great arteries
[ ] D. Tetralogy of Fallot
CORRECT: C. Transposition of the great arteries
Transposition of the great arteries is strongly associated with maternal diabetes, likely due to altered glucose
metabolism during cardiac looping. While VSDs are common in the general population, they are not as
specifically linked to diabetic embryopathy.
5. A public health program aims to reduce preterm birth rates in a high-risk urban
community. Which of the following interventions has the strongest evidence for reducing
recurrent preterm birth?
[ ] A. Routine cervical length screening for all pregnant women.
[ ] B. Weekly progesterone supplementation for women with a prior spontaneous preterm birth.
[ ] C. Universal bed rest for women with a history of preterm labor.
[ ] D. Elective induction at 37 weeks for all women with prior preterm birth.
CORRECT: B. Weekly progesterone supplementation for women with a prior spontaneous preterm
birth.
Weekly progesterone supplementation (17-OHPC or vaginal progesterone) is proven to reduce recurrent
preterm birth in women with a prior spontaneous preterm birth. Bed rest lacks evidence, and elective
induction at 37 weeks does not prevent preterm birth.
6. A 2-month-old infant is brought to the clinic for a well-child visit. The parent reports that
the infant has not received any vaccines due to concerns about autism. Which of the
following is the most appropriate response?
[ ] A. Respect the parent's decision and document refusal without further discussion.
[ ] B. Explain that the MMR vaccine is the only vaccine linked to autism and offer to delay it.
[ ] C. Provide evidence-based education that vaccines do not cause autism and recommend catch-up
vaccination.
[ ] D. Refer the family to a developmental pediatrician before administering any vaccines.
CORRECT: C. Provide evidence-based education that vaccines do not cause autism and recommend
catch-up vaccination.
Extensive research has disproven any link between vaccines and autism; the appropriate response is to
educate and offer catch-up vaccination. Delaying or avoiding vaccines increases risk of preventable
diseases, and referral is unnecessary unless developmental concerns exist.
HIGHP - Page 3 of 17
Complications | Module 4 Week 4 |
Questions and Answers | 2026/2027 Updated
| 100% Correct - Liberty University
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
50 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This quiz assesses advanced understanding of maternal and early childhood complications, including
hypertensive disorders of pregnancy, gestational diabetes, preterm birth, postpartum hemorrhage, and
congenital anomalies. It also covers breastfeeding contraindications, developmental screening, immunization
safety, and the public health policies that shape maternal-child outcomes in the United States.
STUDY GUIDE
Recommended duration: 75 minutes. Passing target: 80%.
HIGHP - Page 1 of 17
,1. A pregnant client at 34 weeks gestation presents with a blood pressure of 168/112 mm
Hg and 3+ proteinuria. She reports a severe frontal headache and visual changes. Which
of the following is the most appropriate immediate management?
[ ] A. Administer intravenous magnesium sulfate and initiate antihypertensive therapy with labetalol.
[ ] B. Schedule an elective cesarean delivery within 48 hours without acute stabilization.
[ ] C. Prescribe oral methyldopa and discharge home with strict bed rest instructions.
[ ] D. Obtain a 24-hour urine collection before starting any antihypertensive medication.
CORRECT: A. Administer intravenous magnesium sulfate and initiate antihypertensive therapy with
labetalol.
This presentation is consistent with preeclampsia with severe features; immediate magnesium sulfate
prevents seizures and labetalol controls severe hypertension. Delaying treatment for a 24-hour urine
collection or home management is unsafe, and delivery timing requires stabilization first.
2. A newborn is noted to have a sacral dimple with a tuft of hair and a small skin tag.
Which of the following is the most appropriate next step in evaluation?
[ ] A. Reassure the parents that isolated sacral dimples are always benign.
[ ] B. Order a spinal ultrasound or MRI to evaluate for occult spinal dysraphism.
[ ] C. Obtain a plain radiograph of the lumbosacral spine to rule out spina bifida.
[ ] D. Refer for immediate surgical excision of the skin tag to prevent infection.
CORRECT: B. Order a spinal ultrasound or MRI to evaluate for occult spinal dysraphism.
A sacral dimple with a tuft of hair or skin tag is a red flag for occult spinal dysraphism, requiring imaging of
the spinal cord. Plain radiographs do not visualize the cord, and surgical excision without imaging is
inappropriate.
3. A lactating mother is prescribed a medication that is considered contraindicated during
breastfeeding. Which of the following factors most strongly determines the amount of
drug transferred into breast milk?
[ ] A. The mother's body mass index and hydration status.
[ ] B. The drug's molecular weight, lipid solubility, and protein binding.
[ ] C. The infant's gestational age at birth and current weight.
[ ] D. The time of day the medication is administered.
CORRECT: B. The drug's molecular weight, lipid solubility, and protein binding.
Drug transfer into breast milk is primarily governed by the drug's physicochemical properties-molecular
weight, lipid solubility, protein binding, and oral bioavailability. Maternal BMI and timing are less predictive,
and infant factors affect risk but not transfer.
HIGHP - Page 2 of 17
, 4. Which of the following congenital heart defects is most commonly associated with
maternal diabetes mellitus?
[ ] A. Atrial septal defect
[ ] B. Ventricular septal defect
[ ] C. Transposition of the great arteries
[ ] D. Tetralogy of Fallot
CORRECT: C. Transposition of the great arteries
Transposition of the great arteries is strongly associated with maternal diabetes, likely due to altered glucose
metabolism during cardiac looping. While VSDs are common in the general population, they are not as
specifically linked to diabetic embryopathy.
5. A public health program aims to reduce preterm birth rates in a high-risk urban
community. Which of the following interventions has the strongest evidence for reducing
recurrent preterm birth?
[ ] A. Routine cervical length screening for all pregnant women.
[ ] B. Weekly progesterone supplementation for women with a prior spontaneous preterm birth.
[ ] C. Universal bed rest for women with a history of preterm labor.
[ ] D. Elective induction at 37 weeks for all women with prior preterm birth.
CORRECT: B. Weekly progesterone supplementation for women with a prior spontaneous preterm
birth.
Weekly progesterone supplementation (17-OHPC or vaginal progesterone) is proven to reduce recurrent
preterm birth in women with a prior spontaneous preterm birth. Bed rest lacks evidence, and elective
induction at 37 weeks does not prevent preterm birth.
6. A 2-month-old infant is brought to the clinic for a well-child visit. The parent reports that
the infant has not received any vaccines due to concerns about autism. Which of the
following is the most appropriate response?
[ ] A. Respect the parent's decision and document refusal without further discussion.
[ ] B. Explain that the MMR vaccine is the only vaccine linked to autism and offer to delay it.
[ ] C. Provide evidence-based education that vaccines do not cause autism and recommend catch-up
vaccination.
[ ] D. Refer the family to a developmental pediatrician before administering any vaccines.
CORRECT: C. Provide evidence-based education that vaccines do not cause autism and recommend
catch-up vaccination.
Extensive research has disproven any link between vaccines and autism; the appropriate response is to
educate and offer catch-up vaccination. Delaying or avoiding vaccines increases risk of preventable
diseases, and referral is unnecessary unless developmental concerns exist.
HIGHP - Page 3 of 17
