NSG 3500 Exam 3 | NSG 3500 Maternal Health |
Questions and Answers with Rationales
2026/2027 Update
QUESTION 1 A nurse is assessing a client who presents with irregular menstrual
bleeding and is diagnosed with leiomyomas (uterine fibroids). Which
characteristic is most typical of these benign smooth muscle tumors?
A. They are malignant lesions that frequently metastasize to the lungs
B. They are typically estrogen-dependent and tend to shrink after menopause
C. They cause permanent atrophy of the endometrial lining
D. They are associated with abnormally low levels of progesterone throughout life
CORRECT ANSWER: B
RATIONALE: Uterine leiomyomas are benign smooth muscle tumors whose
growth is stimulated by estrogen and progesterone. Following menopause, when
ovarian hormone production declines, fibroids typically regress and shrink in size.
QUESTION 2 A nurse is providing discharge instructions to a client who underwent
a loop electrosurgical excision procedure (LEEP) for cervical dysplasia. Which
instruction should be included?
A. Use tampons for the next 4 weeks to absorb expected postoperative bleeding
B. Avoid sexual intercourse, douching, and using tampons for 3 to 6 weeks as
prescribed
C. Expect heavy arterial bleeding that requires immediate packing
D. Avoid all physical activity and bed rest completely for 2 months
CORRECT ANSWER: B
RATIONALE: Following a LEEP procedure, clients must avoid sexual intercourse,
douching, and tampons for several weeks to prevent infection and allow the
delicate cervical tissue to heal properly.
,QUESTION 3 A client is diagnosed with pelvic organ prolapse involving a cystocele.
What anatomical structure is herniating into the vaginal canal?
A. The rectum pushing against the posterior vaginal wall
B. The urinary bladder bulging into the anterior vaginal wall
C. The loops of the small intestine into the cul-de-sac
D. The uterus descending through the cervix
CORRECT ANSWER: B
RATIONALE: A cystocele is the downward displacement of the bladder against the
anterior vaginal wall, resulting from weakness of the supportive pubocervical
fascia during childbirth or aging.
QUESTION 4 A nurse is teaching a client about risk factors for developing
osteoporosis. Which lifestyle modification is most effective in preventing bone
mineral density loss?
A. Engaging in regular weight-bearing and resistance exercise combined with
adequate calcium and vitamin D intake
B. Eliminating all physical activity and remaining on strict bed rest
C. Consuming a high-sodium, low-protein diet
D. Smoking tobacco products regularly to stimulate bone turnover
CORRECT ANSWER: A
RATIONALE: Weight-bearing exercise, adequate dietary calcium, and vitamin D
intake stimulate osteoblastic activity, helping maintain bone mineral density and
prevent osteoporosis.
QUESTION 5 A nurse is reviewing the diagnostic reports of a client evaluated for
menopause. Which laboratory finding confirms the clinical transition into
menopause?
A. Persistently low follicle-stimulating hormone (FSH) and high estrogen levels
B. Persistently elevated follicle-stimulating hormone (FSH) levels and low estrogen
levels
,C. Undetectable levels of human chorionic gonadotropin
D. Elevated progesterone levels throughout the entire month
CORRECT ANSWER: B
RATIONALE: During menopause, ovarian follicular depletion leads to a drop in
estrogen, which removes negative feedback on the pituitary gland, resulting in
significantly elevated follicle-stimulating hormone (FSH) levels.
QUESTION 6 A nurse is caring for a client prescribed clomiphene citrate for
ovulation induction. What is the primary pharmacological action of this
medication?
A. To act as a direct uterine stimulant causing contractions
B. To block estrogen receptors in the hypothalamus, increasing the secretion of
gonadotropin-releasing hormone, FSH, and LH to stimulate follicular growth
C. To suppress all pituitary hormone production completely
D. To act as a potent systemic anticoagulant
CORRECT ANSWER: B
RATIONALE: Clomiphene citrate is a selective estrogen receptor modulator that
binds to estrogen receptors in the hypothalamus, tricking the brain into
perceiving low estrogen and prompting the release of FSH and LH to stimulate
ovulation.
QUESTION 7 A nurse is assessing a client with polycystic ovary syndrome (PCOS).
Which clinical finding is commonly associated with this endocrine disorder?
A. Hypoglycemia and rapid weight loss
B. Hirsutism, acne, irregular menses, and polycystic ovaries on ultrasound
C. Complete absence of any androgen hormones
D. Early onset of menopause at age 35
CORRECT ANSWER: B
, RATIONALE: Polycystic ovary syndrome is characterized by hyperandrogenism
(hirsutism, acne), chronic anovulation or oligo-omenorrhea, and multiple small
ovarian cysts visualized via ultrasound.
QUESTION 8 A nurse is providing education to a client diagnosed with
trichomoniasis. Which medication order should the nurse anticipate?
A. Fluconazole oral tablet
B. Metronidazole oral dose for both the client and sexual partner
C. Topical acyclovir cream
D. Intramuscular penicillin G
CORRECT ANSWER: B
RATIONALE: Trichomoniasis is a sexually transmitted infection caused by a
protozoan and is treated with oral metronidazole. To prevent reinfection, sexual
partners must be treated simultaneously.
QUESTION 9 A client presents with vulvovaginal candidiasis. Which physical
assessment finding is characteristic of this infection?
A. Frothy, yellow-green, foul-smelling discharge
B. Thick, white, curdy cottage cheese-like discharge with severe pruritus
C. Thin, gray discharge with a strong fishy odor
D. Painless hard chancre lesions
CORRECT ANSWER: B
RATIONALE: Vulvovaginal candidiasis classically presents with thick, white,
odorless discharge resembling cottage cheese, accompanied by intense
vulvovaginal itching and inflammation.
QUESTION 10 A nurse is counseling a client who has been prescribed combined
oral contraceptive pills. Which instruction is essential for the client to
understand?
A. Antibiotics and certain anticonvulsants can decrease the efficacy of hormonal
contraceptives, requiring backup barrier protection
Questions and Answers with Rationales
2026/2027 Update
QUESTION 1 A nurse is assessing a client who presents with irregular menstrual
bleeding and is diagnosed with leiomyomas (uterine fibroids). Which
characteristic is most typical of these benign smooth muscle tumors?
A. They are malignant lesions that frequently metastasize to the lungs
B. They are typically estrogen-dependent and tend to shrink after menopause
C. They cause permanent atrophy of the endometrial lining
D. They are associated with abnormally low levels of progesterone throughout life
CORRECT ANSWER: B
RATIONALE: Uterine leiomyomas are benign smooth muscle tumors whose
growth is stimulated by estrogen and progesterone. Following menopause, when
ovarian hormone production declines, fibroids typically regress and shrink in size.
QUESTION 2 A nurse is providing discharge instructions to a client who underwent
a loop electrosurgical excision procedure (LEEP) for cervical dysplasia. Which
instruction should be included?
A. Use tampons for the next 4 weeks to absorb expected postoperative bleeding
B. Avoid sexual intercourse, douching, and using tampons for 3 to 6 weeks as
prescribed
C. Expect heavy arterial bleeding that requires immediate packing
D. Avoid all physical activity and bed rest completely for 2 months
CORRECT ANSWER: B
RATIONALE: Following a LEEP procedure, clients must avoid sexual intercourse,
douching, and tampons for several weeks to prevent infection and allow the
delicate cervical tissue to heal properly.
,QUESTION 3 A client is diagnosed with pelvic organ prolapse involving a cystocele.
What anatomical structure is herniating into the vaginal canal?
A. The rectum pushing against the posterior vaginal wall
B. The urinary bladder bulging into the anterior vaginal wall
C. The loops of the small intestine into the cul-de-sac
D. The uterus descending through the cervix
CORRECT ANSWER: B
RATIONALE: A cystocele is the downward displacement of the bladder against the
anterior vaginal wall, resulting from weakness of the supportive pubocervical
fascia during childbirth or aging.
QUESTION 4 A nurse is teaching a client about risk factors for developing
osteoporosis. Which lifestyle modification is most effective in preventing bone
mineral density loss?
A. Engaging in regular weight-bearing and resistance exercise combined with
adequate calcium and vitamin D intake
B. Eliminating all physical activity and remaining on strict bed rest
C. Consuming a high-sodium, low-protein diet
D. Smoking tobacco products regularly to stimulate bone turnover
CORRECT ANSWER: A
RATIONALE: Weight-bearing exercise, adequate dietary calcium, and vitamin D
intake stimulate osteoblastic activity, helping maintain bone mineral density and
prevent osteoporosis.
QUESTION 5 A nurse is reviewing the diagnostic reports of a client evaluated for
menopause. Which laboratory finding confirms the clinical transition into
menopause?
A. Persistently low follicle-stimulating hormone (FSH) and high estrogen levels
B. Persistently elevated follicle-stimulating hormone (FSH) levels and low estrogen
levels
,C. Undetectable levels of human chorionic gonadotropin
D. Elevated progesterone levels throughout the entire month
CORRECT ANSWER: B
RATIONALE: During menopause, ovarian follicular depletion leads to a drop in
estrogen, which removes negative feedback on the pituitary gland, resulting in
significantly elevated follicle-stimulating hormone (FSH) levels.
QUESTION 6 A nurse is caring for a client prescribed clomiphene citrate for
ovulation induction. What is the primary pharmacological action of this
medication?
A. To act as a direct uterine stimulant causing contractions
B. To block estrogen receptors in the hypothalamus, increasing the secretion of
gonadotropin-releasing hormone, FSH, and LH to stimulate follicular growth
C. To suppress all pituitary hormone production completely
D. To act as a potent systemic anticoagulant
CORRECT ANSWER: B
RATIONALE: Clomiphene citrate is a selective estrogen receptor modulator that
binds to estrogen receptors in the hypothalamus, tricking the brain into
perceiving low estrogen and prompting the release of FSH and LH to stimulate
ovulation.
QUESTION 7 A nurse is assessing a client with polycystic ovary syndrome (PCOS).
Which clinical finding is commonly associated with this endocrine disorder?
A. Hypoglycemia and rapid weight loss
B. Hirsutism, acne, irregular menses, and polycystic ovaries on ultrasound
C. Complete absence of any androgen hormones
D. Early onset of menopause at age 35
CORRECT ANSWER: B
, RATIONALE: Polycystic ovary syndrome is characterized by hyperandrogenism
(hirsutism, acne), chronic anovulation or oligo-omenorrhea, and multiple small
ovarian cysts visualized via ultrasound.
QUESTION 8 A nurse is providing education to a client diagnosed with
trichomoniasis. Which medication order should the nurse anticipate?
A. Fluconazole oral tablet
B. Metronidazole oral dose for both the client and sexual partner
C. Topical acyclovir cream
D. Intramuscular penicillin G
CORRECT ANSWER: B
RATIONALE: Trichomoniasis is a sexually transmitted infection caused by a
protozoan and is treated with oral metronidazole. To prevent reinfection, sexual
partners must be treated simultaneously.
QUESTION 9 A client presents with vulvovaginal candidiasis. Which physical
assessment finding is characteristic of this infection?
A. Frothy, yellow-green, foul-smelling discharge
B. Thick, white, curdy cottage cheese-like discharge with severe pruritus
C. Thin, gray discharge with a strong fishy odor
D. Painless hard chancre lesions
CORRECT ANSWER: B
RATIONALE: Vulvovaginal candidiasis classically presents with thick, white,
odorless discharge resembling cottage cheese, accompanied by intense
vulvovaginal itching and inflammation.
QUESTION 10 A nurse is counseling a client who has been prescribed combined
oral contraceptive pills. Which instruction is essential for the client to
understand?
A. Antibiotics and certain anticonvulsants can decrease the efficacy of hormonal
contraceptives, requiring backup barrier protection
