NRNP 6552 EXAM / ACTUAL NRNP 6552 FINAL EXAM 2026/2027
PRACTICE QUESTIONS ACCURATE EXAMA
1. 28-year-old woman presents for preconception counseling and reports that
her first child was born with spina bifida. She is not currently taking a
prenatal vitamin and asks what intervention would most effectively reduce
the recurrence risk of neural tube defects in a future pregnancy. Which
recommendation is most appropriate?
A. Begin folic acid supplementation before conception and continue it
during early pregnancy at a dose appropriate for a woman with a previous
neural tube defect pregnancy.
B. Begin iron supplementation only after a positive pregnancy test because
folate is not needed before conception.
C. Wait until the second trimester to begin folic acid because neural tube
development occurs after the first trimester.
D. Take vitamin B12 alone because folate supplementation has no
established role in neural tube defect prevention.
Answer: A
2. A 34-year-old woman requests counseling before attempting pregnancy.
She has chronic hypertension treated with an ACE inhibitor and takes
several over-the-counter supplements. She asks whether she can continue
her current regimen after conception. Which approach by the nurse
practitioner is most appropriate?
A. Tell her to discontinue every medication immediately without further
evaluation.
B. Review every prescription, nonprescription medication, and supplement
for pregnancy safety and coordinate substitution of potentially fetotoxic
therapy before conception when possible.
C. Continue all medications unchanged because untreated chronic disease is
always more dangerous than medication exposure.
D. Wait until the first prenatal visit after conception before reviewing
medications because preconception counseling does not affect fetal
1
, outcomes.
Answer: B
3. A 31-year-old patient presents for an annual reproductive-health visit and
states that she has not had a menstrual period for three months. She
reports fatigue and nausea but has not used contraception consistently.
Which diagnostic step should be prioritized before pursuing other causes of
secondary amenorrhea?
A. Order a pelvic MRI immediately.
B. Measure serum testosterone before asking about sexual activity.
C. Obtain a pregnancy test as an initial evaluation.
D. Schedule an endometrial biopsy regardless of pregnancy status.
Answer: C
4. A 25-year-old woman reports irregular menstrual cycles occurring every 45
to 70 days, increased facial hair, acne, and difficulty conceiving. Her BMI is
elevated, and examination reveals signs of androgen excess. Which
additional finding would most strongly support a diagnosis of polycystic
ovary syndrome after appropriate exclusion of alternative causes?
A. Consistently low serum androgen concentrations.
B. Regular ovulatory cycles occurring every 28 days.
C. Isolated dysmenorrhea without ovulatory dysfunction.
D. Evidence of chronic ovulatory dysfunction accompanied by clinical or
biochemical hyperandrogenism.
Answer: D
5. A patient with suspected polycystic ovary syndrome asks why the nurse
practitioner is concerned about her long-term health even though her
primary complaint is irregular menstruation. Which explanation best
reflects an important long-term concern associated with PCOS?
A. PCOS can be associated with insulin resistance, dyslipidemia,
hypertension, and increased cardiometabolic risk.
B. PCOS inevitably progresses to ovarian cancer within several years.
C. PCOS permanently prevents pregnancy in nearly all affected patients.
2
, D. PCOS is associated exclusively with reproductive symptoms and has no
metabolic implications.
Answer: A
6. A 29-year-old woman with PCOS has irregular menses and does not
currently desire pregnancy. She wants treatment that provides reliable
contraception while also helping regulate bleeding and reducing androgen-
related symptoms. Which option is most appropriate when no
contraindication exists?
A. Combined hormonal contraception.
B. Immediate referral for hysterectomy.
C. Long-term high-dose systemic estrogen without progestin.
D. Ovulation induction with letrozole despite not desiring pregnancy.
Answer: A
7. A 32-year-old woman with PCOS is attempting pregnancy and has
confirmed anovulatory infertility without another identified cause. Which
pharmacologic treatment is generally preferred for ovulation induction in
this setting?
A. Continuous combined hormonal contraception.
B. Letrozole.
C. Depot medroxyprogesterone acetate.
D. Long-term danazol therapy.
Answer: B
8. A 26-year-old patient reports severe cramping beginning shortly before
menstruation and continuing through the first two days of menstrual flow.
She denies abnormal bleeding, pelvic masses, fever, or dyspareunia, and the
pelvic examination is normal. Which condition is most consistent with this
presentation?
A. Endometriosis.
B. Uterine leiomyoma.
C. Primary dysmenorrhea.
3
, D. Pelvic inflammatory disease.
Answer: C
9. A 37-year-old patient reports progressively worsening dysmenorrhea, deep
dyspareunia, chronic pelvic pain, and difficulty conceiving. The symptoms
have persisted despite appropriate first-line treatment for uncomplicated
menstrual cramps. Which diagnosis should be strongly considered?
A. Primary dysmenorrhea.
B. Vulvovaginal candidiasis.
C. Functional hypothalamic amenorrhea.
D. Endometriosis.
Answer: D
10. A patient with suspected endometriosis asks why the condition may cause
infertility even when routine pelvic examination findings are minimal.
Which explanation is most appropriate?
A. Endometriosis can produce inflammatory changes, adhesions, distorted
pelvic anatomy, and impaired reproductive function.
B. Endometriosis causes infertility only by permanently destroying both
ovaries.
C. Endometriosis prevents ovulation in every affected patient.
D. Endometriosis affects only the cervix and therefore does not influence
fertility.
Answer: A
11. A 42-year-old woman reports heavy menstrual bleeding, pelvic pressure,
urinary frequency, and an enlarged irregular uterus on examination.
Pregnancy testing is negative. Which diagnosis is most likely?
A. Uterine leiomyomas.
B. Vulvar lichen sclerosus.
C. Pelvic inflammatory disease.
D. Genitourinary syndrome of menopause.
Answer: A
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PRACTICE QUESTIONS ACCURATE EXAMA
1. 28-year-old woman presents for preconception counseling and reports that
her first child was born with spina bifida. She is not currently taking a
prenatal vitamin and asks what intervention would most effectively reduce
the recurrence risk of neural tube defects in a future pregnancy. Which
recommendation is most appropriate?
A. Begin folic acid supplementation before conception and continue it
during early pregnancy at a dose appropriate for a woman with a previous
neural tube defect pregnancy.
B. Begin iron supplementation only after a positive pregnancy test because
folate is not needed before conception.
C. Wait until the second trimester to begin folic acid because neural tube
development occurs after the first trimester.
D. Take vitamin B12 alone because folate supplementation has no
established role in neural tube defect prevention.
Answer: A
2. A 34-year-old woman requests counseling before attempting pregnancy.
She has chronic hypertension treated with an ACE inhibitor and takes
several over-the-counter supplements. She asks whether she can continue
her current regimen after conception. Which approach by the nurse
practitioner is most appropriate?
A. Tell her to discontinue every medication immediately without further
evaluation.
B. Review every prescription, nonprescription medication, and supplement
for pregnancy safety and coordinate substitution of potentially fetotoxic
therapy before conception when possible.
C. Continue all medications unchanged because untreated chronic disease is
always more dangerous than medication exposure.
D. Wait until the first prenatal visit after conception before reviewing
medications because preconception counseling does not affect fetal
1
, outcomes.
Answer: B
3. A 31-year-old patient presents for an annual reproductive-health visit and
states that she has not had a menstrual period for three months. She
reports fatigue and nausea but has not used contraception consistently.
Which diagnostic step should be prioritized before pursuing other causes of
secondary amenorrhea?
A. Order a pelvic MRI immediately.
B. Measure serum testosterone before asking about sexual activity.
C. Obtain a pregnancy test as an initial evaluation.
D. Schedule an endometrial biopsy regardless of pregnancy status.
Answer: C
4. A 25-year-old woman reports irregular menstrual cycles occurring every 45
to 70 days, increased facial hair, acne, and difficulty conceiving. Her BMI is
elevated, and examination reveals signs of androgen excess. Which
additional finding would most strongly support a diagnosis of polycystic
ovary syndrome after appropriate exclusion of alternative causes?
A. Consistently low serum androgen concentrations.
B. Regular ovulatory cycles occurring every 28 days.
C. Isolated dysmenorrhea without ovulatory dysfunction.
D. Evidence of chronic ovulatory dysfunction accompanied by clinical or
biochemical hyperandrogenism.
Answer: D
5. A patient with suspected polycystic ovary syndrome asks why the nurse
practitioner is concerned about her long-term health even though her
primary complaint is irregular menstruation. Which explanation best
reflects an important long-term concern associated with PCOS?
A. PCOS can be associated with insulin resistance, dyslipidemia,
hypertension, and increased cardiometabolic risk.
B. PCOS inevitably progresses to ovarian cancer within several years.
C. PCOS permanently prevents pregnancy in nearly all affected patients.
2
, D. PCOS is associated exclusively with reproductive symptoms and has no
metabolic implications.
Answer: A
6. A 29-year-old woman with PCOS has irregular menses and does not
currently desire pregnancy. She wants treatment that provides reliable
contraception while also helping regulate bleeding and reducing androgen-
related symptoms. Which option is most appropriate when no
contraindication exists?
A. Combined hormonal contraception.
B. Immediate referral for hysterectomy.
C. Long-term high-dose systemic estrogen without progestin.
D. Ovulation induction with letrozole despite not desiring pregnancy.
Answer: A
7. A 32-year-old woman with PCOS is attempting pregnancy and has
confirmed anovulatory infertility without another identified cause. Which
pharmacologic treatment is generally preferred for ovulation induction in
this setting?
A. Continuous combined hormonal contraception.
B. Letrozole.
C. Depot medroxyprogesterone acetate.
D. Long-term danazol therapy.
Answer: B
8. A 26-year-old patient reports severe cramping beginning shortly before
menstruation and continuing through the first two days of menstrual flow.
She denies abnormal bleeding, pelvic masses, fever, or dyspareunia, and the
pelvic examination is normal. Which condition is most consistent with this
presentation?
A. Endometriosis.
B. Uterine leiomyoma.
C. Primary dysmenorrhea.
3
, D. Pelvic inflammatory disease.
Answer: C
9. A 37-year-old patient reports progressively worsening dysmenorrhea, deep
dyspareunia, chronic pelvic pain, and difficulty conceiving. The symptoms
have persisted despite appropriate first-line treatment for uncomplicated
menstrual cramps. Which diagnosis should be strongly considered?
A. Primary dysmenorrhea.
B. Vulvovaginal candidiasis.
C. Functional hypothalamic amenorrhea.
D. Endometriosis.
Answer: D
10. A patient with suspected endometriosis asks why the condition may cause
infertility even when routine pelvic examination findings are minimal.
Which explanation is most appropriate?
A. Endometriosis can produce inflammatory changes, adhesions, distorted
pelvic anatomy, and impaired reproductive function.
B. Endometriosis causes infertility only by permanently destroying both
ovaries.
C. Endometriosis prevents ovulation in every affected patient.
D. Endometriosis affects only the cervix and therefore does not influence
fertility.
Answer: A
11. A 42-year-old woman reports heavy menstrual bleeding, pelvic pressure,
urinary frequency, and an enlarged irregular uterus on examination.
Pregnancy testing is negative. Which diagnosis is most likely?
A. Uterine leiomyomas.
B. Vulvar lichen sclerosus.
C. Pelvic inflammatory disease.
D. Genitourinary syndrome of menopause.
Answer: A
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