NRNP 6552 FINAL EXAM CHAMBERLAIN UNIVERSITY
ACTUAL EXAM QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
Question 1
A 38-year-old woman presents requesting contraception. She smokes
approximately 1 pack of cigarettes daily and has smoked for 18 years. Her blood
pressure is 128/78 mm Hg, and she has no history of thromboembolism, migraine
with aura, or cardiovascular disease. Which contraceptive option should the nurse
practitioner avoid because of the patient's age and smoking status?
A. Copper intrauterine device
B. Etonogestrel subdermal implant
C. Combined oral contraceptive
D. Levonorgestrel intrauterine device
Answer: C
Rationale: Combined hormonal contraceptives are contraindicated in women aged
35 years or older who smoke 15 or more cigarettes per day because of the
substantially increased risk of myocardial infarction and stroke. The copper IUD,
levonorgestrel IUD, and etonogestrel implant are highly effective alternatives
without the estrogen-related cardiovascular risk.
Question 2
A 27-year-old woman with no significant medical history wants the most effective
reversible contraceptive method available. She does not want to become pregnant
for at least 5 years but may desire pregnancy afterward. Which method provides
the best match?
A. Combined oral contraceptive
B. Male condom
C. Etonogestrel subdermal implant
D. Fertility-awareness method
,Answer: C
Rationale: The etonogestrel implant is a highly effective long-acting reversible
contraceptive, with typical-use effectiveness exceeding 99%. IUDs are also highly
effective LARC options. Oral contraceptives and fertility-awareness methods have
substantially higher typical-use failure rates.
Question 3
A 24-year-old patient presents for an annual examination. Her Pap test
demonstrates ASC-US. She has no history of cervical dysplasia,
immunocompromise, or cervical cancer. What is the most appropriate next step?
A. Immediate colposcopy
B. Immediate excisional treatment
C. Repeat cervical cytology in 12 months
D. Repeat cytology and HPV cotesting immediately
Answer: C
Rationale: In patients aged 21–24 years with ASC-US, conservative follow-up is
preferred because HPV infections and low-grade abnormalities frequently regress
spontaneously. Repeat cytology in approximately 12 months is appropriate rather
than immediate colposcopy or invasive treatment.
Question 4
A healthy 34-year-old woman asks how frequently she should undergo cervical
cancer screening. She has no history of CIN 2+, cervical cancer,
immunocompromise, or DES exposure. Which screening strategy is acceptable?
A. Pap cytology every year
B. Cytology alone every 3 years
C. HPV testing every year
D. Colposcopy every 3 years
Answer: B
,Rationale: For women aged 30–65 years at average risk, USPSTF-supported
strategies include cytology alone every 3 years, primary high-risk HPV testing
every 5 years, or cotesting every 5 years. Annual Pap testing is not recommended
for average-risk women.
Question 5
A 31-year-old woman has a Pap test showing ASC-US. Reflex testing is positive
for high-risk HPV. Which factor is most important in determining the next
management step?
A. Her HPV vaccination history alone
B. Her previous cervical screening history and current risk
C. Her number of lifetime sexual partners
D. Whether she has received a pelvic ultrasound
Answer: B
Rationale: Management of abnormal cervical screening results is risk-based.
Current findings are interpreted together with relevant prior screening and
treatment history to estimate the patient's immediate and future risk of clinically
significant cervical precancer.
Question 6
A 29-year-old woman is planning pregnancy. Her first child was born with an open
neural tube defect. She asks what she should do before attempting another
pregnancy. Which recommendation is most appropriate?
A. Begin folic acid 400 mcg daily after conception
B. Begin folic acid 800 mcg daily after the first missed period
C. Begin folic acid 4 mg daily before conception
D. Avoid folic acid because it can mask vitamin B12 deficiency
Answer: C
, Rationale: A prior pregnancy affected by a neural tube defect places the patient in
a higher-risk category. ACOG recommends 4 mg of folic acid daily beginning
before conception and continuing through early pregnancy, rather than the standard
400 mcg dose used for average-risk patients.
Question 7
A pregnant patient taking carbamazepine for seizure control asks why her prenatal
care may require additional attention. Which fetal complication is particularly
associated with maternal exposure to certain antiseizure medications such as
carbamazepine?
A. Neural tube defects
B. Polyhydramnios caused by fetal hyperthyroidism
C. Congenital cataracts
D. Maternal cervical insufficiency
Answer: A
Rationale: Several antiseizure medications are associated with congenital
malformations, including neural tube defects. Preconception medication review
and appropriate folic acid supplementation are important components of care for
patients with epilepsy who may become pregnant.
Question 8
A 26-year-old woman at 10 weeks' gestation reports mild breast tenderness,
urinary frequency, and occasional nausea. She denies bleeding, severe abdominal
pain, fever, or syncope. Which finding would require the most urgent evaluation if
it developed?
A. Increased urinary frequency
B. Breast tenderness
C. Persistent severe vomiting with inability to retain fluids
D. Mild morning nausea
Answer: C
ACTUAL EXAM QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
Question 1
A 38-year-old woman presents requesting contraception. She smokes
approximately 1 pack of cigarettes daily and has smoked for 18 years. Her blood
pressure is 128/78 mm Hg, and she has no history of thromboembolism, migraine
with aura, or cardiovascular disease. Which contraceptive option should the nurse
practitioner avoid because of the patient's age and smoking status?
A. Copper intrauterine device
B. Etonogestrel subdermal implant
C. Combined oral contraceptive
D. Levonorgestrel intrauterine device
Answer: C
Rationale: Combined hormonal contraceptives are contraindicated in women aged
35 years or older who smoke 15 or more cigarettes per day because of the
substantially increased risk of myocardial infarction and stroke. The copper IUD,
levonorgestrel IUD, and etonogestrel implant are highly effective alternatives
without the estrogen-related cardiovascular risk.
Question 2
A 27-year-old woman with no significant medical history wants the most effective
reversible contraceptive method available. She does not want to become pregnant
for at least 5 years but may desire pregnancy afterward. Which method provides
the best match?
A. Combined oral contraceptive
B. Male condom
C. Etonogestrel subdermal implant
D. Fertility-awareness method
,Answer: C
Rationale: The etonogestrel implant is a highly effective long-acting reversible
contraceptive, with typical-use effectiveness exceeding 99%. IUDs are also highly
effective LARC options. Oral contraceptives and fertility-awareness methods have
substantially higher typical-use failure rates.
Question 3
A 24-year-old patient presents for an annual examination. Her Pap test
demonstrates ASC-US. She has no history of cervical dysplasia,
immunocompromise, or cervical cancer. What is the most appropriate next step?
A. Immediate colposcopy
B. Immediate excisional treatment
C. Repeat cervical cytology in 12 months
D. Repeat cytology and HPV cotesting immediately
Answer: C
Rationale: In patients aged 21–24 years with ASC-US, conservative follow-up is
preferred because HPV infections and low-grade abnormalities frequently regress
spontaneously. Repeat cytology in approximately 12 months is appropriate rather
than immediate colposcopy or invasive treatment.
Question 4
A healthy 34-year-old woman asks how frequently she should undergo cervical
cancer screening. She has no history of CIN 2+, cervical cancer,
immunocompromise, or DES exposure. Which screening strategy is acceptable?
A. Pap cytology every year
B. Cytology alone every 3 years
C. HPV testing every year
D. Colposcopy every 3 years
Answer: B
,Rationale: For women aged 30–65 years at average risk, USPSTF-supported
strategies include cytology alone every 3 years, primary high-risk HPV testing
every 5 years, or cotesting every 5 years. Annual Pap testing is not recommended
for average-risk women.
Question 5
A 31-year-old woman has a Pap test showing ASC-US. Reflex testing is positive
for high-risk HPV. Which factor is most important in determining the next
management step?
A. Her HPV vaccination history alone
B. Her previous cervical screening history and current risk
C. Her number of lifetime sexual partners
D. Whether she has received a pelvic ultrasound
Answer: B
Rationale: Management of abnormal cervical screening results is risk-based.
Current findings are interpreted together with relevant prior screening and
treatment history to estimate the patient's immediate and future risk of clinically
significant cervical precancer.
Question 6
A 29-year-old woman is planning pregnancy. Her first child was born with an open
neural tube defect. She asks what she should do before attempting another
pregnancy. Which recommendation is most appropriate?
A. Begin folic acid 400 mcg daily after conception
B. Begin folic acid 800 mcg daily after the first missed period
C. Begin folic acid 4 mg daily before conception
D. Avoid folic acid because it can mask vitamin B12 deficiency
Answer: C
, Rationale: A prior pregnancy affected by a neural tube defect places the patient in
a higher-risk category. ACOG recommends 4 mg of folic acid daily beginning
before conception and continuing through early pregnancy, rather than the standard
400 mcg dose used for average-risk patients.
Question 7
A pregnant patient taking carbamazepine for seizure control asks why her prenatal
care may require additional attention. Which fetal complication is particularly
associated with maternal exposure to certain antiseizure medications such as
carbamazepine?
A. Neural tube defects
B. Polyhydramnios caused by fetal hyperthyroidism
C. Congenital cataracts
D. Maternal cervical insufficiency
Answer: A
Rationale: Several antiseizure medications are associated with congenital
malformations, including neural tube defects. Preconception medication review
and appropriate folic acid supplementation are important components of care for
patients with epilepsy who may become pregnant.
Question 8
A 26-year-old woman at 10 weeks' gestation reports mild breast tenderness,
urinary frequency, and occasional nausea. She denies bleeding, severe abdominal
pain, fever, or syncope. Which finding would require the most urgent evaluation if
it developed?
A. Increased urinary frequency
B. Breast tenderness
C. Persistent severe vomiting with inability to retain fluids
D. Mild morning nausea
Answer: C
