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BARKLEY-STYLE WHNP PRACTICE EXAM 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
WHNP
Prepare for the Barkley WHNP Practice Exam with a focused study resource covering
essential concepts in women's health and advanced practice nursing. It supports
review of reproductive health, gynecologic conditions, prenatal and postpartum care,
screening, contraception, patient assessment, and evidence-based management. Use
the material to reinforce clinical knowledge, strengthen clinical judgment, and
identify areas that may require additional review. This resource is best suited for
WHNP students and nurse practitioner certification candidates preparing for women's
health board examinations.
MULTIPLE CHOICE.
SECTION 1: REPRODUCTIVE HEALTH & CONTRACEPTION (Questions 1-25)
1. A 22-year-old woman presents requesting contraception. She has a
history of migraine with aura. Which contraceptive method is
CONTRAINDICATED for this patient?
a) Progestin-only pill
b) Etonogestrel implant
c) Combined oral contraceptive pill
d) Copper IUD
Answer: c) Combined oral contraceptive pill
Rationale: Combined oral contraceptives (COCs) are contraindicated in
women with migraine with aura due to an increased risk of ischemic stroke.
The aura suggests a neurological phenomenon that increases stroke risk
when combined with estrogen. Progestin-only methods (pill, implant, IUD) are
safe alternatives.
2. A patient is interested in starting the etonogestrel implant (Nexplanon).
The WHNP should counsel the patient that the most common side effect
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is:
a) Weight gain
b) Acne
c) Irregular bleeding
d) Depression
Answer: c) Irregular bleeding
Rationale: Irregular bleeding is the most common side effect of the
etonogestrel implant and is the primary reason for discontinuation. Bleeding
patterns are unpredictable and may include amenorrhea, frequent bleeding,
or prolonged bleeding. Patients should be counseled on this side effect before
insertion.
3. A 25-year-old woman is interested in using the vaginal ring (NuvaRing)
for contraception. The WHNP should instruct the patient to:
a) Remove the ring for 7 days after 3 weeks of use
b) Remove the ring for 7 days after 4 weeks of use
c) Replace the ring every 3 weeks with no ring-free interval
d) Remove the ring during intercourse
Answer: a) Remove the ring for 7 days after 3 weeks of use
Rationale: The vaginal ring (NuvaRing) is inserted for 3 weeks (21 days) and
then removed for 7 days, during which withdrawal bleeding occurs. A new ring
is inserted after the 7-day ring-free interval. If the ring is removed for >3 hours
during the active use period, backup contraception is required.
4. A patient is prescribed a progestin-only pill (POP). The WHNP should
counsel the patient that:
a) The pill must be taken at the same time every day
b) The pill is effective even if taken up to 6 hours late
c) The pill does not cause any bleeding irregularities
d) The pill is safe for use during breastfeeding
Answer: a) The pill must be taken at the same time every day
Rationale: Progestin-only pills (POPs) require strict adherence and should be
taken at the same time every day. If a POP is taken >3 hours late, backup
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contraception is required for 48 hours. POPs are safe during breastfeeding
and do not affect milk supply. Irregular bleeding is a common side effect.
5. A 32-year-old woman is requesting an IUD. She has a history of pelvic
inflammatory disease (PID) 2 years ago, currently has a normal Pap smear,
and is in a monogamous relationship. Which IUD is most appropriate?
a) Copper IUD (Paragard)
b) Levonorgestrel IUD (Mirena)
c) Neither, due to history of PID
d) Both are appropriate
Answer: d) Both are appropriate
Rationale: Both copper and levonorgestrel IUDs are safe for women with a
past history of PID, provided they currently have no active infection and are at
low risk for STIs. Current PID is a contraindication, but a history of PID is not.
The decision should be based on patient preference regarding side effects
(bleeding patterns).
6. A patient is being started on a combined oral contraceptive (COC). The
WHNP should counsel the patient about which serious potential adverse
effect?
a) Weight gain
b) Venous thromboembolism (VTE)
c) Acne
d) Nausea
Answer: b) Venous thromboembolism (VTE)
Rationale: VTE is a serious potential adverse effect of COCs, with an
increased risk compared to non-users. Risk factors include obesity, smoking
(especially >35 years), and a history of VTE. Patients should be counseled on
signs and symptoms of VTE (leg pain, swelling, chest pain, shortness of
breath).
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7. A patient is using the copper IUD (Paragard). The WHNP should counsel
the patient that this method:
a) Can be used for up to 10 years
b) Frequently causes amenorrhea
c) Is less effective than hormonal methods
d) Requires removal during menses
Answer: a) Can be used for up to 10 years
Rationale: The copper IUD (Paragard) is approved for up to 10 years of use. It
is >99% effective, causes heavier menstrual bleeding (not amenorrhea), and
does not require removal during menses. It is a non-hormonal, highly effective
long-acting reversible contraceptive.
8. A patient is considering the levonorgestrel-releasing intrauterine
system (LNG-IUS, Mirena). The WHNP should explain that this method:
a) Is effective for up to 3 years
b) Is associated with increased menstrual bleeding
c) Is effective for up to 5-7 years
d) Is a barrier method
Answer: c) Is effective for up to 5-7 years
Rationale: The LNG-IUS (Mirena) is effective for up to 5-7 years (depending on
the device: Mirena 5-7 years, Kyleena 5 years, Liletta 6 years, Skyla 3 years). It
is associated with decreased menstrual bleeding and is a long-acting
reversible contraceptive (LARC), not a barrier method.
9. A patient has an IUD in place and presents with pelvic pain, fever, and
abnormal vaginal discharge. The WHNP should suspect:
a) Normal IUD side effects
b) Pelvic inflammatory disease (PID)
c) Ectopic pregnancy
d) IUD expulsion
Answer: b) Pelvic inflammatory disease (PID)
Rationale: PID is a possible complication of IUD insertion, particularly in the
first 20 days. The presence of pelvic pain, fever, and abnormal discharge
BARKLEY-STYLE WHNP PRACTICE EXAM 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
WHNP
Prepare for the Barkley WHNP Practice Exam with a focused study resource covering
essential concepts in women's health and advanced practice nursing. It supports
review of reproductive health, gynecologic conditions, prenatal and postpartum care,
screening, contraception, patient assessment, and evidence-based management. Use
the material to reinforce clinical knowledge, strengthen clinical judgment, and
identify areas that may require additional review. This resource is best suited for
WHNP students and nurse practitioner certification candidates preparing for women's
health board examinations.
MULTIPLE CHOICE.
SECTION 1: REPRODUCTIVE HEALTH & CONTRACEPTION (Questions 1-25)
1. A 22-year-old woman presents requesting contraception. She has a
history of migraine with aura. Which contraceptive method is
CONTRAINDICATED for this patient?
a) Progestin-only pill
b) Etonogestrel implant
c) Combined oral contraceptive pill
d) Copper IUD
Answer: c) Combined oral contraceptive pill
Rationale: Combined oral contraceptives (COCs) are contraindicated in
women with migraine with aura due to an increased risk of ischemic stroke.
The aura suggests a neurological phenomenon that increases stroke risk
when combined with estrogen. Progestin-only methods (pill, implant, IUD) are
safe alternatives.
2. A patient is interested in starting the etonogestrel implant (Nexplanon).
The WHNP should counsel the patient that the most common side effect
, Page 2 of 39
is:
a) Weight gain
b) Acne
c) Irregular bleeding
d) Depression
Answer: c) Irregular bleeding
Rationale: Irregular bleeding is the most common side effect of the
etonogestrel implant and is the primary reason for discontinuation. Bleeding
patterns are unpredictable and may include amenorrhea, frequent bleeding,
or prolonged bleeding. Patients should be counseled on this side effect before
insertion.
3. A 25-year-old woman is interested in using the vaginal ring (NuvaRing)
for contraception. The WHNP should instruct the patient to:
a) Remove the ring for 7 days after 3 weeks of use
b) Remove the ring for 7 days after 4 weeks of use
c) Replace the ring every 3 weeks with no ring-free interval
d) Remove the ring during intercourse
Answer: a) Remove the ring for 7 days after 3 weeks of use
Rationale: The vaginal ring (NuvaRing) is inserted for 3 weeks (21 days) and
then removed for 7 days, during which withdrawal bleeding occurs. A new ring
is inserted after the 7-day ring-free interval. If the ring is removed for >3 hours
during the active use period, backup contraception is required.
4. A patient is prescribed a progestin-only pill (POP). The WHNP should
counsel the patient that:
a) The pill must be taken at the same time every day
b) The pill is effective even if taken up to 6 hours late
c) The pill does not cause any bleeding irregularities
d) The pill is safe for use during breastfeeding
Answer: a) The pill must be taken at the same time every day
Rationale: Progestin-only pills (POPs) require strict adherence and should be
taken at the same time every day. If a POP is taken >3 hours late, backup
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contraception is required for 48 hours. POPs are safe during breastfeeding
and do not affect milk supply. Irregular bleeding is a common side effect.
5. A 32-year-old woman is requesting an IUD. She has a history of pelvic
inflammatory disease (PID) 2 years ago, currently has a normal Pap smear,
and is in a monogamous relationship. Which IUD is most appropriate?
a) Copper IUD (Paragard)
b) Levonorgestrel IUD (Mirena)
c) Neither, due to history of PID
d) Both are appropriate
Answer: d) Both are appropriate
Rationale: Both copper and levonorgestrel IUDs are safe for women with a
past history of PID, provided they currently have no active infection and are at
low risk for STIs. Current PID is a contraindication, but a history of PID is not.
The decision should be based on patient preference regarding side effects
(bleeding patterns).
6. A patient is being started on a combined oral contraceptive (COC). The
WHNP should counsel the patient about which serious potential adverse
effect?
a) Weight gain
b) Venous thromboembolism (VTE)
c) Acne
d) Nausea
Answer: b) Venous thromboembolism (VTE)
Rationale: VTE is a serious potential adverse effect of COCs, with an
increased risk compared to non-users. Risk factors include obesity, smoking
(especially >35 years), and a history of VTE. Patients should be counseled on
signs and symptoms of VTE (leg pain, swelling, chest pain, shortness of
breath).
, Page 4 of 39
7. A patient is using the copper IUD (Paragard). The WHNP should counsel
the patient that this method:
a) Can be used for up to 10 years
b) Frequently causes amenorrhea
c) Is less effective than hormonal methods
d) Requires removal during menses
Answer: a) Can be used for up to 10 years
Rationale: The copper IUD (Paragard) is approved for up to 10 years of use. It
is >99% effective, causes heavier menstrual bleeding (not amenorrhea), and
does not require removal during menses. It is a non-hormonal, highly effective
long-acting reversible contraceptive.
8. A patient is considering the levonorgestrel-releasing intrauterine
system (LNG-IUS, Mirena). The WHNP should explain that this method:
a) Is effective for up to 3 years
b) Is associated with increased menstrual bleeding
c) Is effective for up to 5-7 years
d) Is a barrier method
Answer: c) Is effective for up to 5-7 years
Rationale: The LNG-IUS (Mirena) is effective for up to 5-7 years (depending on
the device: Mirena 5-7 years, Kyleena 5 years, Liletta 6 years, Skyla 3 years). It
is associated with decreased menstrual bleeding and is a long-acting
reversible contraceptive (LARC), not a barrier method.
9. A patient has an IUD in place and presents with pelvic pain, fever, and
abnormal vaginal discharge. The WHNP should suspect:
a) Normal IUD side effects
b) Pelvic inflammatory disease (PID)
c) Ectopic pregnancy
d) IUD expulsion
Answer: b) Pelvic inflammatory disease (PID)
Rationale: PID is a possible complication of IUD insertion, particularly in the
first 20 days. The presence of pelvic pain, fever, and abnormal discharge
