WHNP-BC CERTIFICATION Exam| YEAR
2026–2027 | Comprehensive 150-Question
Practice Test with Answers & Rationales|
Pdf Access ALREADY GRADED A+.
SECTION 1: GYNECOLOGY & REPRODUCTIVE HEALTH (Questions 1–25)
Q1. A 24-year-old G0 presents with irregular menstrual cycles occurring every 21–45 days, acne
on her face and chest, and increased facial hair. Her BMI is 31. Physical exam reveals acanthosis
nigricans on the back of her neck. What is the MOST likely diagnosis?
A. Hypothalamic amenorrhea
B. Polycystic ovary syndrome (PCOS)
C. Hyperprolactinemia
D. Thyroid dysfunction
Answer: B
Rationale: PCOS is the most common endocrine disorder in reproductive-aged women. The
Rotterdam criteria require two of three: oligo-ovulation or anovulation, clinical or biochemical
hyperandrogenism, and polycystic ovaries on ultrasound. Acanthosis nigricans is a marker of
insulin resistance, commonly seen in PCOS .
Q2. A 22-year-old G0 presents with a 2-week history of thin, gray-white, fishy-smelling vaginal
discharge. She denies itching or dysuria. Wet mount shows clue cells and a positive whiff test.
What is the most likely diagnosis?
A. Bacterial vaginosis (BV)
B. Trichomoniasis
C. Candidiasis
D. Atrophic vaginitis
Answer: A
Rationale: BV is diagnosed using Amsel criteria, requiring three of four: thin homogenous gray-
,white discharge, pH >4.5, positive whiff test (fishy odor with KOH), and clue cells on wet mount.
BV is not an STI but is associated with sexual activity .
Q3. A 35-year-old G2P2 presents with a 1-year history of cyclic pelvic pain beginning 3 days
before menses and resolving 2 days after menses. She also reports deep dyspareunia and pain
with bowel movements during her period. Pelvic exam reveals tender nodularity in the
uterosacral ligaments. What is the most likely diagnosis?
A. Pelvic inflammatory disease
B. Endometriosis
C. Ovarian cyst
D. Uterine fibroids
Answer: B
Rationale: Endometriosis classically presents with chronic pelvic pain, dysmenorrhea, and
dyspareunia. Findings may include a retroverted uterus and uterosacral ligament nodularity. The
cyclic nature of pain tied to menses is characteristic .
Q4. A 55-year-old postmenopausal woman presents with vaginal bleeding. She has not had a
period in 3 years. What is the most appropriate initial diagnostic test?
A. Transvaginal ultrasound
B. Endometrial biopsy
C. Hysteroscopy
D. Pap smear
Answer: B
Rationale: Postmenopausal bleeding requires evaluation for endometrial cancer. Endometrial
biopsy is the gold standard initial diagnostic test. Transvaginal ultrasound may be used initially
to assess endometrial thickness, but biopsy is required for definitive diagnosis .
Q5. A 32-year-old G2P2 presents with a 6-month history of heavy menstrual bleeding (soaking
through a super-plus tampon every 1–2 hours for the first 2 days of her cycle). Her hemoglobin
is 9.2 g/dL. Pelvic ultrasound reveals a 4 cm submucosal fibroid. What is the MOST appropriate
next step?
A. Endometrial biopsy
B. Saline infusion sonography (SIS)
,C. Hysteroscopy with biopsy
D. CA-125 blood test
Answer: C
Rationale: Submucosal fibroids are a common cause of heavy menstrual bleeding and anemia.
Hysteroscopy is the gold standard for visualizing the endometrial cavity, confirming the location
and size of the fibroid, and obtaining an endometrial biopsy if needed .
Q6. A 28-year-old female presents with heavy, prolonged menstrual bleeding. She has no known
medical conditions. Which of the following is the most appropriate initial laboratory evaluation?
A. CBC, thyroid function tests, serum ferritin
B. CBC, coagulation studies, pregnancy test
C. CBC, TSH, serum ferritin, pregnancy test, coagulation studies
D. Pelvic ultrasound only
Answer: C
Rationale: Initial evaluation of abnormal uterine bleeding should include CBC (to assess for
anemia), serum ferritin (iron stores), TSH (thyroid dysfunction), pregnancy test (pregnancy-
related bleeding), and coagulation studies (if indicated by history of bleeding disorders) .
Q7. During a pelvic examination, the practitioner notes a bulge in the anterior vaginal wall when
the patient is asked to bear down. The cervix is visualized through the introitus with straining.
What is the most appropriate description of this finding?
A. Uterine prolapse, stage 1
B. Uterine prolapse, stage 2
C. Cystocele, stage 2
D. Rectocele, stage 2
Answer: B
Rationale: This describes uterine prolapse. Stage 1: cervix above the hymen. Stage 2: cervix
descends to the introitus. Stage 3: cervix extends beyond the introitus. Stage 4: complete
procidentia. A cystocele involves bladder herniation into the anterior vaginal wall .
Q8. A 45-year-old female presents with a family history of breast cancer (mother diagnosed at
age 48). She has no breast symptoms. According to current guidelines, what is the most
appropriate breast cancer screening recommendation?
, A. Begin annual mammography at age 50
B. Begin annual mammography at age 40 with shared decision-making
C. Begin MRI screening immediately
D. Begin mammography at age 45
Answer: B
Rationale: For women with a first-degree relative diagnosed with breast cancer before age 50,
the American Cancer Society recommends shared decision-making about mammography
starting at age 40. MRI screening is reserved for women at very high risk (e.g., BRCA mutations) .
Q9. A 27-year-old female presents with LSIL on cervical cytology and positive HPV. What is the
next step?
A. Repeat cytology in 12 months
B. Immediate colposcopy
C. Perform LEEP procedure
D. Repeat co-testing in 3 years
Answer: B
Rationale: For women age 25 and older with LSIL and positive HPV, immediate colposcopy is
required to check for underlying high-grade dysplasia .
Q10. What is the first-line treatment for uncomplicated vulvovaginal candidiasis?
A. Oral Fluconazole 150 mg single dose
B. Oral Metronidazole 500 mg single dose
C. Azithromycin 1 g orally single dose
D. Clindamycin vaginal cream
Answer: A
Rationale: Oral fluconazole 150 mg single dose is first-line for uncomplicated vulvovaginal
candidiasis. Metronidazole is for BV and trichomoniasis. Azithromycin is for chlamydia .
Q11. A patient with recurrent bacterial vaginosis has failed metronidazole. What is an
alternative regimen?
A. Oral Fluconazole 150 mg single dose
B. Clindamycin 2% vaginal cream once daily for 7 days
2026–2027 | Comprehensive 150-Question
Practice Test with Answers & Rationales|
Pdf Access ALREADY GRADED A+.
SECTION 1: GYNECOLOGY & REPRODUCTIVE HEALTH (Questions 1–25)
Q1. A 24-year-old G0 presents with irregular menstrual cycles occurring every 21–45 days, acne
on her face and chest, and increased facial hair. Her BMI is 31. Physical exam reveals acanthosis
nigricans on the back of her neck. What is the MOST likely diagnosis?
A. Hypothalamic amenorrhea
B. Polycystic ovary syndrome (PCOS)
C. Hyperprolactinemia
D. Thyroid dysfunction
Answer: B
Rationale: PCOS is the most common endocrine disorder in reproductive-aged women. The
Rotterdam criteria require two of three: oligo-ovulation or anovulation, clinical or biochemical
hyperandrogenism, and polycystic ovaries on ultrasound. Acanthosis nigricans is a marker of
insulin resistance, commonly seen in PCOS .
Q2. A 22-year-old G0 presents with a 2-week history of thin, gray-white, fishy-smelling vaginal
discharge. She denies itching or dysuria. Wet mount shows clue cells and a positive whiff test.
What is the most likely diagnosis?
A. Bacterial vaginosis (BV)
B. Trichomoniasis
C. Candidiasis
D. Atrophic vaginitis
Answer: A
Rationale: BV is diagnosed using Amsel criteria, requiring three of four: thin homogenous gray-
,white discharge, pH >4.5, positive whiff test (fishy odor with KOH), and clue cells on wet mount.
BV is not an STI but is associated with sexual activity .
Q3. A 35-year-old G2P2 presents with a 1-year history of cyclic pelvic pain beginning 3 days
before menses and resolving 2 days after menses. She also reports deep dyspareunia and pain
with bowel movements during her period. Pelvic exam reveals tender nodularity in the
uterosacral ligaments. What is the most likely diagnosis?
A. Pelvic inflammatory disease
B. Endometriosis
C. Ovarian cyst
D. Uterine fibroids
Answer: B
Rationale: Endometriosis classically presents with chronic pelvic pain, dysmenorrhea, and
dyspareunia. Findings may include a retroverted uterus and uterosacral ligament nodularity. The
cyclic nature of pain tied to menses is characteristic .
Q4. A 55-year-old postmenopausal woman presents with vaginal bleeding. She has not had a
period in 3 years. What is the most appropriate initial diagnostic test?
A. Transvaginal ultrasound
B. Endometrial biopsy
C. Hysteroscopy
D. Pap smear
Answer: B
Rationale: Postmenopausal bleeding requires evaluation for endometrial cancer. Endometrial
biopsy is the gold standard initial diagnostic test. Transvaginal ultrasound may be used initially
to assess endometrial thickness, but biopsy is required for definitive diagnosis .
Q5. A 32-year-old G2P2 presents with a 6-month history of heavy menstrual bleeding (soaking
through a super-plus tampon every 1–2 hours for the first 2 days of her cycle). Her hemoglobin
is 9.2 g/dL. Pelvic ultrasound reveals a 4 cm submucosal fibroid. What is the MOST appropriate
next step?
A. Endometrial biopsy
B. Saline infusion sonography (SIS)
,C. Hysteroscopy with biopsy
D. CA-125 blood test
Answer: C
Rationale: Submucosal fibroids are a common cause of heavy menstrual bleeding and anemia.
Hysteroscopy is the gold standard for visualizing the endometrial cavity, confirming the location
and size of the fibroid, and obtaining an endometrial biopsy if needed .
Q6. A 28-year-old female presents with heavy, prolonged menstrual bleeding. She has no known
medical conditions. Which of the following is the most appropriate initial laboratory evaluation?
A. CBC, thyroid function tests, serum ferritin
B. CBC, coagulation studies, pregnancy test
C. CBC, TSH, serum ferritin, pregnancy test, coagulation studies
D. Pelvic ultrasound only
Answer: C
Rationale: Initial evaluation of abnormal uterine bleeding should include CBC (to assess for
anemia), serum ferritin (iron stores), TSH (thyroid dysfunction), pregnancy test (pregnancy-
related bleeding), and coagulation studies (if indicated by history of bleeding disorders) .
Q7. During a pelvic examination, the practitioner notes a bulge in the anterior vaginal wall when
the patient is asked to bear down. The cervix is visualized through the introitus with straining.
What is the most appropriate description of this finding?
A. Uterine prolapse, stage 1
B. Uterine prolapse, stage 2
C. Cystocele, stage 2
D. Rectocele, stage 2
Answer: B
Rationale: This describes uterine prolapse. Stage 1: cervix above the hymen. Stage 2: cervix
descends to the introitus. Stage 3: cervix extends beyond the introitus. Stage 4: complete
procidentia. A cystocele involves bladder herniation into the anterior vaginal wall .
Q8. A 45-year-old female presents with a family history of breast cancer (mother diagnosed at
age 48). She has no breast symptoms. According to current guidelines, what is the most
appropriate breast cancer screening recommendation?
, A. Begin annual mammography at age 50
B. Begin annual mammography at age 40 with shared decision-making
C. Begin MRI screening immediately
D. Begin mammography at age 45
Answer: B
Rationale: For women with a first-degree relative diagnosed with breast cancer before age 50,
the American Cancer Society recommends shared decision-making about mammography
starting at age 40. MRI screening is reserved for women at very high risk (e.g., BRCA mutations) .
Q9. A 27-year-old female presents with LSIL on cervical cytology and positive HPV. What is the
next step?
A. Repeat cytology in 12 months
B. Immediate colposcopy
C. Perform LEEP procedure
D. Repeat co-testing in 3 years
Answer: B
Rationale: For women age 25 and older with LSIL and positive HPV, immediate colposcopy is
required to check for underlying high-grade dysplasia .
Q10. What is the first-line treatment for uncomplicated vulvovaginal candidiasis?
A. Oral Fluconazole 150 mg single dose
B. Oral Metronidazole 500 mg single dose
C. Azithromycin 1 g orally single dose
D. Clindamycin vaginal cream
Answer: A
Rationale: Oral fluconazole 150 mg single dose is first-line for uncomplicated vulvovaginal
candidiasis. Metronidazole is for BV and trichomoniasis. Azithromycin is for chlamydia .
Q11. A patient with recurrent bacterial vaginosis has failed metronidazole. What is an
alternative regimen?
A. Oral Fluconazole 150 mg single dose
B. Clindamycin 2% vaginal cream once daily for 7 days
