NRNP 6552 2026/2027 | Walden University NRNP 6552
Reproductive Health Exam Study Guide, Advanced Reproductive
Health Care, Women’s Health, Primary Care, Contraception,
Menstrual Disorders, STIs, Breast Health, Pregnancy, Menopause,
Practice Questions, Answers & Rationales
Question 1: A 28-year-old woman presents with a 3-day history of vaginal
discharge and vulvar irritation. On speculum examination, a frothy, greenish-
yellow discharge is noted. Which organism is the most likely causative agent?
A. Candida albicans
B. Gardnerella vaginalis
C. Trichomonas vaginalis
D. Neisseria gonorrhoeae
CORRECT ANSWER: C. Trichomonas vaginalis
Rationale: The classic presentation of trichomoniasis includes a frothy, greenish-
yellow, malodorous vaginal discharge with vulvar irritation. Candida typically
presents with thick, white, cottage cheese-like discharge. Gardnerella is
associated with thin, gray discharge and a fishy odor. Gonorrhea may present
with purulent discharge but is less commonly frothy.
Question 2: A 52-year-old woman reports experiencing hot flashes, night
sweats, and irregular menstrual periods over the past 8 months. Which term
best describes her current reproductive stage?
A. Premenopause
B. Perimenopause
C. Menopause
D. Postmenopause
CORRECT ANSWER: B. Perimenopause
Rationale: Perimenopause is the transitional phase before menopause
characterized by fluctuating hormone levels, vasomotor symptoms, and irregular
menstrual cycles. Menopause is defined retrospectively after 12 consecutive
months of amenorrhea. Postmenopause follows menopause.
Question 3: Which hormone is responsible for the surge that triggers ovulation
in the menstrual cycle?
,A. Follicle-stimulating hormone
B. Estrogen
C. Luteinizing hormone
D. Progesterone
CORRECT ANSWER: C. Luteinizing hormone
Rationale: A sharp surge in luteinizing hormone (LH) approximately 24-36 hours
before ovulation triggers the release of the mature oocyte from the ovarian
follicle. While FSH stimulates follicular growth, it is the LH surge that directly
causes ovulation.
Question 4: A 34-year-old woman asks about emergency contraception. She had
unprotected intercourse 48 hours ago. Which method is most effective for her
at this time?
A. Combined oral contraceptive pills
B. Copper intrauterine device
C. Levonorgestrel emergency contraceptive pill
D. Ulipristal acetate
CORRECT ANSWER: B. Copper intrauterine device
Rationale: The copper IUD is the most effective form of emergency contraception,
with a failure rate of less than 0.1%. It can be inserted up to 5 days after
unprotected intercourse. While levonorgestrel and ulipristal are effective, the
copper IUD has superior efficacy.
Question 5: A 45-year-old woman presents with heavy menstrual bleeding
lasting 10 days each cycle for the past 6 months. Which term best describes her
condition?
A. Menorrhagia
B. Metrorrhagia
C. Menometrorrhagia
D. Polymenorrhea
CORRECT ANSWER: A. Menorrhagia
,Rationale: Menorrhagia refers to abnormally heavy or prolonged menstrual
bleeding occurring at regular intervals. Metrorrhagia is bleeding between periods.
Menometrorrhagia is heavy bleeding at irregular intervals. Polymenorrhea refers
to cycles shorter than 21 days.
Question 6: According to the USPSTF, at what age should routine breast cancer
screening with mammography begin for average-risk women?
A. 30 years
B. 35 years
C. 40 years
D. 50 years
CORRECT ANSWER: C. 40 years
Rationale: The USPSTF recommends that average-risk women begin biennial
screening mammography at age 40 and continue through age 74. This represents
a shift from previous recommendations that offered flexibility for starting
between ages 40 and 50 .
Question 7: A 26-year-old woman presents with a painful, vesicular lesion on
her vulva. She reports similar episodes in the past. Which medication is most
appropriate for acute treatment?
A. Metronidazole
B. Acyclovir
C. Fluconazole
D. Doxycycline
CORRECT ANSWER: B. Acyclovir
Rationale: Acyclovir is an antiviral medication used to treat herpes simplex virus
infections, including genital herpes. Metronidazole treats bacterial vaginosis and
trichomoniasis. Fluconazole treats candidiasis. Doxycycline treats chlamydia and
other bacterial infections.
Question 8: Which screening test is recommended for cervical cancer in women
aged 21-29 years?
, A. HPV testing alone
B. Cytology alone every 3 years
C. Co-testing every 5 years
D. Visual inspection with acetic acid
CORRECT ANSWER: B. Cytology alone every 3 years
Rationale: For women aged 21-29, cervical cancer screening should be performed
with cytology alone every 3 years. HPV testing is not recommended as primary
screening in this age group due to the high prevalence of transient HPV infections
in young women.
Question 9: A 38-year-old woman reports a 6-month history of irregular cycles,
acne, and excessive hair growth on her face and chest. Which diagnosis is most
likely?
A. Hypothyroidism
B. Polycystic ovary syndrome
C. Cushing syndrome
D. Premature ovarian failure
CORRECT ANSWER: B. Polycystic ovary syndrome
Rationale: PCOS is characterized by ovulatory dysfunction (irregular cycles),
hyperandrogenism (acne, hirsutism), and often polycystic ovaries on ultrasound.
Hypothyroidism can cause menstrual irregularities but not typically hirsutism.
Cushing syndrome would present with additional features such as central obesity
and striae .
Question 10: Which contraceptive method has the highest typical-use failure
rate?
A. Etonogestrel implant
B. Copper intrauterine device
C. Combined oral contraceptives
D. Male condoms
CORRECT ANSWER: D. Male condoms
Reproductive Health Exam Study Guide, Advanced Reproductive
Health Care, Women’s Health, Primary Care, Contraception,
Menstrual Disorders, STIs, Breast Health, Pregnancy, Menopause,
Practice Questions, Answers & Rationales
Question 1: A 28-year-old woman presents with a 3-day history of vaginal
discharge and vulvar irritation. On speculum examination, a frothy, greenish-
yellow discharge is noted. Which organism is the most likely causative agent?
A. Candida albicans
B. Gardnerella vaginalis
C. Trichomonas vaginalis
D. Neisseria gonorrhoeae
CORRECT ANSWER: C. Trichomonas vaginalis
Rationale: The classic presentation of trichomoniasis includes a frothy, greenish-
yellow, malodorous vaginal discharge with vulvar irritation. Candida typically
presents with thick, white, cottage cheese-like discharge. Gardnerella is
associated with thin, gray discharge and a fishy odor. Gonorrhea may present
with purulent discharge but is less commonly frothy.
Question 2: A 52-year-old woman reports experiencing hot flashes, night
sweats, and irregular menstrual periods over the past 8 months. Which term
best describes her current reproductive stage?
A. Premenopause
B. Perimenopause
C. Menopause
D. Postmenopause
CORRECT ANSWER: B. Perimenopause
Rationale: Perimenopause is the transitional phase before menopause
characterized by fluctuating hormone levels, vasomotor symptoms, and irregular
menstrual cycles. Menopause is defined retrospectively after 12 consecutive
months of amenorrhea. Postmenopause follows menopause.
Question 3: Which hormone is responsible for the surge that triggers ovulation
in the menstrual cycle?
,A. Follicle-stimulating hormone
B. Estrogen
C. Luteinizing hormone
D. Progesterone
CORRECT ANSWER: C. Luteinizing hormone
Rationale: A sharp surge in luteinizing hormone (LH) approximately 24-36 hours
before ovulation triggers the release of the mature oocyte from the ovarian
follicle. While FSH stimulates follicular growth, it is the LH surge that directly
causes ovulation.
Question 4: A 34-year-old woman asks about emergency contraception. She had
unprotected intercourse 48 hours ago. Which method is most effective for her
at this time?
A. Combined oral contraceptive pills
B. Copper intrauterine device
C. Levonorgestrel emergency contraceptive pill
D. Ulipristal acetate
CORRECT ANSWER: B. Copper intrauterine device
Rationale: The copper IUD is the most effective form of emergency contraception,
with a failure rate of less than 0.1%. It can be inserted up to 5 days after
unprotected intercourse. While levonorgestrel and ulipristal are effective, the
copper IUD has superior efficacy.
Question 5: A 45-year-old woman presents with heavy menstrual bleeding
lasting 10 days each cycle for the past 6 months. Which term best describes her
condition?
A. Menorrhagia
B. Metrorrhagia
C. Menometrorrhagia
D. Polymenorrhea
CORRECT ANSWER: A. Menorrhagia
,Rationale: Menorrhagia refers to abnormally heavy or prolonged menstrual
bleeding occurring at regular intervals. Metrorrhagia is bleeding between periods.
Menometrorrhagia is heavy bleeding at irregular intervals. Polymenorrhea refers
to cycles shorter than 21 days.
Question 6: According to the USPSTF, at what age should routine breast cancer
screening with mammography begin for average-risk women?
A. 30 years
B. 35 years
C. 40 years
D. 50 years
CORRECT ANSWER: C. 40 years
Rationale: The USPSTF recommends that average-risk women begin biennial
screening mammography at age 40 and continue through age 74. This represents
a shift from previous recommendations that offered flexibility for starting
between ages 40 and 50 .
Question 7: A 26-year-old woman presents with a painful, vesicular lesion on
her vulva. She reports similar episodes in the past. Which medication is most
appropriate for acute treatment?
A. Metronidazole
B. Acyclovir
C. Fluconazole
D. Doxycycline
CORRECT ANSWER: B. Acyclovir
Rationale: Acyclovir is an antiviral medication used to treat herpes simplex virus
infections, including genital herpes. Metronidazole treats bacterial vaginosis and
trichomoniasis. Fluconazole treats candidiasis. Doxycycline treats chlamydia and
other bacterial infections.
Question 8: Which screening test is recommended for cervical cancer in women
aged 21-29 years?
, A. HPV testing alone
B. Cytology alone every 3 years
C. Co-testing every 5 years
D. Visual inspection with acetic acid
CORRECT ANSWER: B. Cytology alone every 3 years
Rationale: For women aged 21-29, cervical cancer screening should be performed
with cytology alone every 3 years. HPV testing is not recommended as primary
screening in this age group due to the high prevalence of transient HPV infections
in young women.
Question 9: A 38-year-old woman reports a 6-month history of irregular cycles,
acne, and excessive hair growth on her face and chest. Which diagnosis is most
likely?
A. Hypothyroidism
B. Polycystic ovary syndrome
C. Cushing syndrome
D. Premature ovarian failure
CORRECT ANSWER: B. Polycystic ovary syndrome
Rationale: PCOS is characterized by ovulatory dysfunction (irregular cycles),
hyperandrogenism (acne, hirsutism), and often polycystic ovaries on ultrasound.
Hypothyroidism can cause menstrual irregularities but not typically hirsutism.
Cushing syndrome would present with additional features such as central obesity
and striae .
Question 10: Which contraceptive method has the highest typical-use failure
rate?
A. Etonogestrel implant
B. Copper intrauterine device
C. Combined oral contraceptives
D. Male condoms
CORRECT ANSWER: D. Male condoms
