APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 3 2026 question and
answers
Question 1
A 47-year-old woman presents after noticing a painless lump in her left breast while showering.
Diagnostic mammography and ultrasound reveal a 2.8-cm invasive ductal carcinoma.
Immunohistochemistry demonstrates that the tumor is HER2-positive, estrogen receptor (ER)-
negative, and progesterone receptor (PR)-negative. The oncology team recommends
trastuzumab as part of her treatment regimen.
Before initiating therapy, which assessment is most important?
A. Serum creatinine measurement
B. Baseline echocardiogram to determine left ventricular ejection fraction (LVEF)
C. Colonoscopy
D. Bone density scan
Correct Answer: B
Rationale
Trastuzumab (Herceptin) is associated with cardiotoxicity, including asymptomatic reductions
in LVEF and congestive heart failure. Cardiac function should be assessed before treatment and
monitored periodically throughout therapy.
Question 2
After receiving trastuzumab for six months, the same patient reports progressive fatigue, dyspnea
when climbing stairs, orthopnea, and bilateral ankle swelling.
What is the most appropriate next action?
A. Continue treatment and reassure the patient
B. Evaluate cardiac function immediately
C. Prescribe iron supplements
,APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 3 2026 question and
answers
D. Increase the trastuzumab dose
Correct Answer: B
Rationale
These symptoms are concerning for trastuzumab-induced cardiomyopathy. Cardiac evaluation
should be performed promptly.
Question 3
A 45-year-old premenopausal woman undergoes lumpectomy for ER-positive breast cancer.
She begins tamoxifen therapy.
Which serious adverse effect requires immediate patient education?
A. Dry mouth
B. Endometrial cancer
C. Cataracts
D. Kidney stones
Correct Answer: B
Rationale
Tamoxifen acts as an estrogen agonist in endometrial tissue, increasing the risk of endometrial
hyperplasia and carcinoma.
Question 4
A woman taking tamoxifen reports new vaginal bleeding six months after beginning therapy.
, APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 3 2026 question and
answers
What is the nurse practitioner's priority?
A. Increase calcium intake
B. Arrange immediate gynecologic evaluation
C. Stop exercising
D. Continue medication without evaluation
Correct Answer: B
Rationale
Postmenopausal or abnormal vaginal bleeding during tamoxifen therapy requires prompt
evaluation for endometrial pathology.
Question 5
A 34-year-old woman presents with lower abdominal pain, fever of 38.9°C (102°F),
mucopurulent cervical discharge, and marked cervical motion tenderness during pelvic
examination.
Which diagnosis is most likely?
A. Endometriosis
B. Pelvic inflammatory disease
C. Ruptured ovarian cyst
D. Uterine fibroids
Correct Answer: B
Rationale
& PRACTICE EXAM 3 2026 question and
answers
Question 1
A 47-year-old woman presents after noticing a painless lump in her left breast while showering.
Diagnostic mammography and ultrasound reveal a 2.8-cm invasive ductal carcinoma.
Immunohistochemistry demonstrates that the tumor is HER2-positive, estrogen receptor (ER)-
negative, and progesterone receptor (PR)-negative. The oncology team recommends
trastuzumab as part of her treatment regimen.
Before initiating therapy, which assessment is most important?
A. Serum creatinine measurement
B. Baseline echocardiogram to determine left ventricular ejection fraction (LVEF)
C. Colonoscopy
D. Bone density scan
Correct Answer: B
Rationale
Trastuzumab (Herceptin) is associated with cardiotoxicity, including asymptomatic reductions
in LVEF and congestive heart failure. Cardiac function should be assessed before treatment and
monitored periodically throughout therapy.
Question 2
After receiving trastuzumab for six months, the same patient reports progressive fatigue, dyspnea
when climbing stairs, orthopnea, and bilateral ankle swelling.
What is the most appropriate next action?
A. Continue treatment and reassure the patient
B. Evaluate cardiac function immediately
C. Prescribe iron supplements
,APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 3 2026 question and
answers
D. Increase the trastuzumab dose
Correct Answer: B
Rationale
These symptoms are concerning for trastuzumab-induced cardiomyopathy. Cardiac evaluation
should be performed promptly.
Question 3
A 45-year-old premenopausal woman undergoes lumpectomy for ER-positive breast cancer.
She begins tamoxifen therapy.
Which serious adverse effect requires immediate patient education?
A. Dry mouth
B. Endometrial cancer
C. Cataracts
D. Kidney stones
Correct Answer: B
Rationale
Tamoxifen acts as an estrogen agonist in endometrial tissue, increasing the risk of endometrial
hyperplasia and carcinoma.
Question 4
A woman taking tamoxifen reports new vaginal bleeding six months after beginning therapy.
, APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 3 2026 question and
answers
What is the nurse practitioner's priority?
A. Increase calcium intake
B. Arrange immediate gynecologic evaluation
C. Stop exercising
D. Continue medication without evaluation
Correct Answer: B
Rationale
Postmenopausal or abnormal vaginal bleeding during tamoxifen therapy requires prompt
evaluation for endometrial pathology.
Question 5
A 34-year-old woman presents with lower abdominal pain, fever of 38.9°C (102°F),
mucopurulent cervical discharge, and marked cervical motion tenderness during pelvic
examination.
Which diagnosis is most likely?
A. Endometriosis
B. Pelvic inflammatory disease
C. Ruptured ovarian cyst
D. Uterine fibroids
Correct Answer: B
Rationale
