HERZING UNIVERSITY
Course Code: NU 646
Instructor:
Date: 2026
FINAL EXAM – PRIMARY CARE OF WOMEN
Which physiological change commonly occurs during menopause due to
decreased estrogen production?
A) Increased bone density
B) Vaginal mucosa thinning
C) Increased cervical mucus production
D) Menstrual cycle regularity
Answer: B) Vaginal mucosa thinning
Rationale: Declining estrogen levels during menopause lead to thinning and
dryness of vaginal mucosa, increasing risk for irritation and infections.
Which hormone is predominantly responsible for maintaining the
endometrium during the luteal phase of the menstrual cycle?
A) Follicle-stimulating hormone (FSH)
B) Luteinizing hormone (LH)
C) Progesterone
D) Estrogen
Answer: C) Progesterone
Rationale: Progesterone stabilizes the endometrium following ovulation to
prepare for potential implantation.
During a pelvic health assessment, the nurse detects a cystocele. This
condition involves:
A) Prolapse of the uterus into the vagina
B) Herniation of the bladder into the vaginal canal
C) Rectal wall protrusion into the vagina
1
,D) Enlargement of Bartholin’s glands
Answer: B) Herniation of the bladder into the vaginal canal
Rationale: Cystocele refers to anterior vaginal wall weakness with bladder
bulging into the vagina.
An effective long-acting reversible contraception (LARC) option for women
seeking minimal maintenance is:
A) Oral contraceptive pills
B) Intrauterine device (IUD)
C) Diaphragm
D) Condoms
Answer: B) Intrauterine device (IUD)
Rationale: IUDs provide long-term contraception (3-10 years) without daily
compliance.
True or False
Menstruation typically begins between ages 8 and 16 in adolescent females.
Answer: True
Rationale: The usual menarche age range is 8 to 16 years due to individual
and ethnic variability.
Pregnancy increases a woman’s blood volume by approximately 30 to 50%.
Answer: True
Rationale: Physiological adaptations during pregnancy include increased
plasma volume to support fetal needs.
Pelvic inflammatory disease (PID) is primarily caused by viral infections.
Answer: False
Rationale: PID is most often caused by bacterial infections such as
Chlamydia trachomatis or Neisseria gonorrhoeae.
Use of combined estrogen-progestin contraceptives effectively protects
against both pregnancy and sexually transmitted infections (STIs).
Answer: False
Rationale: Hormonal contraceptives prevent pregnancy but do not protect
against STIs.
Fill in the blank
The _____________ phase of the menstrual cycle is characterized by
shedding of the endometrial lining.
Answer: menstrual
2
, Rationale: The menstrual phase involves endometrial sloughing when
implantation does not occur.
A common symptom of polycystic ovary syndrome (PCOS) includes
____________, which is an excess of androgens leading to hirsutism.
Answer: hyperandrogenism
Rationale: PCOS involves elevated androgen levels causing symptoms such
as hirsutism, acne, and alopecia.
The ____________ reflex is checked during the postpartum assessment to
evaluate uterine involution.
Answer: fundal
Rationale: Palpation of the uterine fundus assesses contraction and
involution after delivery.
During family planning counseling, the effectiveness of barrier methods
largely depends on correct and consistent ____________.
Answer: use
Rationale: Barrier contraceptive efficacy is highly dependent on proper and
consistent application.
Multiple Choice
Which lab test is most specific for confirming menopause?
A) Serum estradiol
B) Follicle-stimulating hormone (FSH) levels
C) Thyroid stimulating hormone (TSH)
D) Prolactin
Answer: B) Follicle-stimulating hormone (FSH) levels
Rationale: Elevated FSH (>30-40 mIU/mL) indicates ovarian failure,
correlating with menopause.
Which of the following is a contraindication for combined estrogen-progestin
contraception?
A) Controlled hypertension
B) History of deep vein thrombosis
C) Mild migraine without aura
D) Postpartum after 6 months
Answer: B) History of deep vein thrombosis
Rationale: Combined hormonal contraceptives increase thromboembolism
risk, contraindicated in prior DVT.
In conducting a comprehensive reproductive health assessment, the most
3
Course Code: NU 646
Instructor:
Date: 2026
FINAL EXAM – PRIMARY CARE OF WOMEN
Which physiological change commonly occurs during menopause due to
decreased estrogen production?
A) Increased bone density
B) Vaginal mucosa thinning
C) Increased cervical mucus production
D) Menstrual cycle regularity
Answer: B) Vaginal mucosa thinning
Rationale: Declining estrogen levels during menopause lead to thinning and
dryness of vaginal mucosa, increasing risk for irritation and infections.
Which hormone is predominantly responsible for maintaining the
endometrium during the luteal phase of the menstrual cycle?
A) Follicle-stimulating hormone (FSH)
B) Luteinizing hormone (LH)
C) Progesterone
D) Estrogen
Answer: C) Progesterone
Rationale: Progesterone stabilizes the endometrium following ovulation to
prepare for potential implantation.
During a pelvic health assessment, the nurse detects a cystocele. This
condition involves:
A) Prolapse of the uterus into the vagina
B) Herniation of the bladder into the vaginal canal
C) Rectal wall protrusion into the vagina
1
,D) Enlargement of Bartholin’s glands
Answer: B) Herniation of the bladder into the vaginal canal
Rationale: Cystocele refers to anterior vaginal wall weakness with bladder
bulging into the vagina.
An effective long-acting reversible contraception (LARC) option for women
seeking minimal maintenance is:
A) Oral contraceptive pills
B) Intrauterine device (IUD)
C) Diaphragm
D) Condoms
Answer: B) Intrauterine device (IUD)
Rationale: IUDs provide long-term contraception (3-10 years) without daily
compliance.
True or False
Menstruation typically begins between ages 8 and 16 in adolescent females.
Answer: True
Rationale: The usual menarche age range is 8 to 16 years due to individual
and ethnic variability.
Pregnancy increases a woman’s blood volume by approximately 30 to 50%.
Answer: True
Rationale: Physiological adaptations during pregnancy include increased
plasma volume to support fetal needs.
Pelvic inflammatory disease (PID) is primarily caused by viral infections.
Answer: False
Rationale: PID is most often caused by bacterial infections such as
Chlamydia trachomatis or Neisseria gonorrhoeae.
Use of combined estrogen-progestin contraceptives effectively protects
against both pregnancy and sexually transmitted infections (STIs).
Answer: False
Rationale: Hormonal contraceptives prevent pregnancy but do not protect
against STIs.
Fill in the blank
The _____________ phase of the menstrual cycle is characterized by
shedding of the endometrial lining.
Answer: menstrual
2
, Rationale: The menstrual phase involves endometrial sloughing when
implantation does not occur.
A common symptom of polycystic ovary syndrome (PCOS) includes
____________, which is an excess of androgens leading to hirsutism.
Answer: hyperandrogenism
Rationale: PCOS involves elevated androgen levels causing symptoms such
as hirsutism, acne, and alopecia.
The ____________ reflex is checked during the postpartum assessment to
evaluate uterine involution.
Answer: fundal
Rationale: Palpation of the uterine fundus assesses contraction and
involution after delivery.
During family planning counseling, the effectiveness of barrier methods
largely depends on correct and consistent ____________.
Answer: use
Rationale: Barrier contraceptive efficacy is highly dependent on proper and
consistent application.
Multiple Choice
Which lab test is most specific for confirming menopause?
A) Serum estradiol
B) Follicle-stimulating hormone (FSH) levels
C) Thyroid stimulating hormone (TSH)
D) Prolactin
Answer: B) Follicle-stimulating hormone (FSH) levels
Rationale: Elevated FSH (>30-40 mIU/mL) indicates ovarian failure,
correlating with menopause.
Which of the following is a contraindication for combined estrogen-progestin
contraception?
A) Controlled hypertension
B) History of deep vein thrombosis
C) Mild migraine without aura
D) Postpartum after 6 months
Answer: B) History of deep vein thrombosis
Rationale: Combined hormonal contraceptives increase thromboembolism
risk, contraindicated in prior DVT.
In conducting a comprehensive reproductive health assessment, the most
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