NSGl 554/l NSG554l Examl 3l –l (NEWl
2026/l 2027l Update)l Nursel Practitionersl
inl Primaryl Carel Il Guidel |l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
Amenorrhea,l primary
Answer:
Nol mensesl byl agel 13l yearsl withl absencel ofl secondaryl sexl characteristicsl
OR
Nol mensesl byl agel 15l yearsl withl normall secondaryl characteristics
QUESTION
Amenorrhea,l secondary
Answer:
Cessationl ofl mensesl forl 3l monthsl ifl previouslyl normall menstruall cyclesl orl 6l monthsl ifl
al historyl ofl irregularl cycles
QUESTION
Causesl ofl primaryl amenorrhea
Answer:
Gonadall dysgenesisl orl failurel (Turnerl sx,l autoimmune,l idiopathic)
Anatomicl abnormalities
Hypothalamic-pituitaryl abnormalities
PCOS
Androgenl insensitivityl syndrome
,Congenitall adrenall hyperplasia
QUESTION
Causesl ofl secondaryl amenorrhea
Answer:
Pregnancy
Hypothalamicl dysfunction
Pituitaryl dz
Thyroidl dz
PCOS
Ovarianl disorders
Anatomicl abnormalities
QUESTION
Amenorrhea,l historyl (questionsl tol ask)
Answer:
Weightl change
Symptomsl ofl pregnancyl orl menopause
Virilizingl changes
Cyclicl pelvicl pain
Galactorrhea
HA
Visionl changes
Fatiguel
Palpitations
Polyuria/polydipsia
Growthl andl pubertyl hx
Hxl ofl chronicl illness,l trauma,l surgery,l medsl (contraceptives),l chemo,l radiation
Obstetricall hx
Psychiatricl hx
Sociall hx,l includingl dietl andl exercise,l drugl abuse,l sexuall hx,l stress
Familyl hxl ofl delayedl orl absentl puberty
,QUESTION
Amenorrheal physicall (whatl tol lookl for)
Answer:
Ht/wt/growth/BMI
S/sl ofl anorexia:l hypotension,l bradycardia/hypotension,l finel downyl hair,l dentall erosionl
(bulimia),l
S/sl ofl PCOS:l acanthosisl nigricans,l acne,l hirsutism,l ovarianl enlargement
Galactorrheal (prolactinoma)
S/sl ofl Turnerl sx:l webbedl neck,l shieldl chest
S/sl ofl hormonel deficiency/excess:l sparsel hair,l clitoromegaly,l thin,l palel vaginall mucosal
withoutl rugae,l presencel ofl cervicall mucus,l blindl vaginall pouch
QUESTION
Diagnosticsl forl primaryl amenorrhea
Answer:
Seruml hCG
Prolactin
TSH
FSH
QUESTION
Diagnosticsl forl secondaryl amenorrhea
Answer:
Seruml hCG
PRL
TSH
FSH
Ifl hyperandrogenisml suspected,l measurel totall testosterone,l DHEA-S,l 17-OHl progesteronel
levels
USl forl ovarianl cysts,l evaluatel uterus,l endometriall thickness
QUESTION
, Treatmentl ofl amenorrhea
Answer:
Identifyl andl correctl underlyingl pathology
HRTl mayl bel safel forl symptoml managementl inl youngl womenl tol maintainl secondaryl
sexl characteristicsl andl tol preventl osteoporosisl butl isl notl recommendedl forl long-terml
managementl ofl amenorrheal inl olderl women
COCsl mayl improvel BMDl andl decreasel hirsutisml inl PCOS
QUESTION
Amenorrheal referral
Answer:
Manyl causesl ofl amenorrheal requirel referrall tol specialistsl inl OB/GYN,l endocrine,l
surgery,l and/orl psychiatry
QUESTION
Symptomsl ofl perimenopause
Answer:
Irregularl cyclesl withl heavyl bleedingl followedl byl diminishedl bleeding
Hotl flashesl (face,l neck,l chest,l lastsl 1-5l mins)
Clamminess,l anxiety,l heartl palpitations
Generallyl 2l yearsl beforel finall menstruall period,l peaksl duringl 1l yearl afterl finall
menstruall period,l thenl diminishes
Vulvovaginall atrophyl (dryness,l itching,l dyspareunia,l possiblel sexuall dysfunction)
Alkalinel pHl andl atrophyl increasel riskl ofl vagl infxl andl UTI
Anxiety/depressionl 2.5xl morel likely
Sleepl disturbance
Changel inl intensityl andl severityl ofl migraines
Skinl thinning,l mildl hirsutism,l brittlel nails
QUESTION
Menopausel treatments
2026/l 2027l Update)l Nursel Practitionersl
inl Primaryl Carel Il Guidel |l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
Amenorrhea,l primary
Answer:
Nol mensesl byl agel 13l yearsl withl absencel ofl secondaryl sexl characteristicsl
OR
Nol mensesl byl agel 15l yearsl withl normall secondaryl characteristics
QUESTION
Amenorrhea,l secondary
Answer:
Cessationl ofl mensesl forl 3l monthsl ifl previouslyl normall menstruall cyclesl orl 6l monthsl ifl
al historyl ofl irregularl cycles
QUESTION
Causesl ofl primaryl amenorrhea
Answer:
Gonadall dysgenesisl orl failurel (Turnerl sx,l autoimmune,l idiopathic)
Anatomicl abnormalities
Hypothalamic-pituitaryl abnormalities
PCOS
Androgenl insensitivityl syndrome
,Congenitall adrenall hyperplasia
QUESTION
Causesl ofl secondaryl amenorrhea
Answer:
Pregnancy
Hypothalamicl dysfunction
Pituitaryl dz
Thyroidl dz
PCOS
Ovarianl disorders
Anatomicl abnormalities
QUESTION
Amenorrhea,l historyl (questionsl tol ask)
Answer:
Weightl change
Symptomsl ofl pregnancyl orl menopause
Virilizingl changes
Cyclicl pelvicl pain
Galactorrhea
HA
Visionl changes
Fatiguel
Palpitations
Polyuria/polydipsia
Growthl andl pubertyl hx
Hxl ofl chronicl illness,l trauma,l surgery,l medsl (contraceptives),l chemo,l radiation
Obstetricall hx
Psychiatricl hx
Sociall hx,l includingl dietl andl exercise,l drugl abuse,l sexuall hx,l stress
Familyl hxl ofl delayedl orl absentl puberty
,QUESTION
Amenorrheal physicall (whatl tol lookl for)
Answer:
Ht/wt/growth/BMI
S/sl ofl anorexia:l hypotension,l bradycardia/hypotension,l finel downyl hair,l dentall erosionl
(bulimia),l
S/sl ofl PCOS:l acanthosisl nigricans,l acne,l hirsutism,l ovarianl enlargement
Galactorrheal (prolactinoma)
S/sl ofl Turnerl sx:l webbedl neck,l shieldl chest
S/sl ofl hormonel deficiency/excess:l sparsel hair,l clitoromegaly,l thin,l palel vaginall mucosal
withoutl rugae,l presencel ofl cervicall mucus,l blindl vaginall pouch
QUESTION
Diagnosticsl forl primaryl amenorrhea
Answer:
Seruml hCG
Prolactin
TSH
FSH
QUESTION
Diagnosticsl forl secondaryl amenorrhea
Answer:
Seruml hCG
PRL
TSH
FSH
Ifl hyperandrogenisml suspected,l measurel totall testosterone,l DHEA-S,l 17-OHl progesteronel
levels
USl forl ovarianl cysts,l evaluatel uterus,l endometriall thickness
QUESTION
, Treatmentl ofl amenorrhea
Answer:
Identifyl andl correctl underlyingl pathology
HRTl mayl bel safel forl symptoml managementl inl youngl womenl tol maintainl secondaryl
sexl characteristicsl andl tol preventl osteoporosisl butl isl notl recommendedl forl long-terml
managementl ofl amenorrheal inl olderl women
COCsl mayl improvel BMDl andl decreasel hirsutisml inl PCOS
QUESTION
Amenorrheal referral
Answer:
Manyl causesl ofl amenorrheal requirel referrall tol specialistsl inl OB/GYN,l endocrine,l
surgery,l and/orl psychiatry
QUESTION
Symptomsl ofl perimenopause
Answer:
Irregularl cyclesl withl heavyl bleedingl followedl byl diminishedl bleeding
Hotl flashesl (face,l neck,l chest,l lastsl 1-5l mins)
Clamminess,l anxiety,l heartl palpitations
Generallyl 2l yearsl beforel finall menstruall period,l peaksl duringl 1l yearl afterl finall
menstruall period,l thenl diminishes
Vulvovaginall atrophyl (dryness,l itching,l dyspareunia,l possiblel sexuall dysfunction)
Alkalinel pHl andl atrophyl increasel riskl ofl vagl infxl andl UTI
Anxiety/depressionl 2.5xl morel likely
Sleepl disturbance
Changel inl intensityl andl severityl ofl migraines
Skinl thinning,l mildl hirsutism,l brittlel nails
QUESTION
Menopausel treatments
