HERZING UNIVERSITY
Course Code: NU 648
Instructor:
Date: 2026
FINAL EXAM – WOMEN’S HEALTH NURSE
PRACTITIONER II
A 32-year-old woman presents with secondary amenorrhea and reports hot
flashes. Laboratory tests show elevated follicle-stimulating hormone (FSH)
levels. What is the most likely diagnosis?
A) Polycystic Ovary Syndrome (PCOS)
B) Premature Ovarian Insufficiency (POI)
C) Hypothalamic amenorrhea
D) Thyroid dysfunction
Answer: B) Premature Ovarian Insufficiency (POI)
Rationale: Elevated FSH with amenorrhea and menopausal symptoms
before age 40 suggests POI. PCOS usually shows normal or low FSH,
hypothalamic amenorrhea presents with low FSH, and thyroid dysfunction
requires thyroid function tests.
A post-menopausal woman undergoes a pelvic ultrasound revealing
endometrial thickness of 6 mm. What is the best next step according to
evidence-based guidelines?
A) Watchful waiting with repeat ultrasound in 3 months
B) Endometrial biopsy
C) Start hormonal replacement therapy
D) Ignore if asymptomatic
Answer: B) Endometrial biopsy
Rationale: In postmenopausal women with endometrial thickness >4-5 mm,
1
,an endometrial biopsy is necessary to rule out hyperplasia or cancer,
especially if bleeding is present.
True or False: The recommended first-line pharmacologic management for
gestational hypertension with no severe features includes labetalol,
nifedipine, or methyldopa.
Answer: True
Rationale: These medications have demonstrated safety profiles in
pregnancy and are recommended as first-line agents.
Fill in the blank: The hormone primarily responsible for cervical ripening
during labor is __________.
Answer: Prostaglandin
Rationale: Prostaglandins promote cervical softening and dilatation,
facilitating labor progression.
In a patient presenting with abnormal uterine bleeding perimenopause, which
diagnostic tool is considered gold standard to exclude malignancy?
A) Transvaginal ultrasound
B) Saline infusion sonohysterography (SIS)
C) Endometrial biopsy
D) MRI pelvis
Answer: C) Endometrial biopsy
Rationale: Endometrial biopsy directly samples the endometrium, enabling
diagnosis of hyperplasia or malignancy, which imaging alone cannot confirm.
True or False: The “three Rs” of prenatal care include Risk assessment,
Routine screening, and Reproductive counseling.
Answer: True
Rationale: Comprehensive prenatal care encompasses risk identification,
routine screenings (e.g., genetic, infectious), and counseling about
reproductive health and planning.
A nurse is educating a 45-year-old woman about hormone replacement
therapy (HRT). Which statement is accurate?
A) HRT is recommended indefinitely for symptom management
B) Combined estrogen-progestin therapy increases breast cancer risk more
than estrogen alone
C) HRT prevents cardiovascular disease in all postmenopausal women
2
, D) Progestin is given only if a woman has had hysterectomy
Answer: B) Combined estrogen-progestin therapy increases breast cancer
risk more than estrogen alone
Rationale: Adding progestin to estrogen increases breast cancer risk;
progestin is required in women with an intact uterus to prevent endometrial
hyperplasia.
Fill in the blank: In early pregnancy, the hormone __________ is detectable
in maternal serum and forms the basis of most pregnancy tests.
Answer: human chorionic gonadotropin (hCG)
Rationale: hCG is secreted by the trophoblast shortly after implantation and
rises rapidly, allowing early detection.
A 28-year-old pregnant woman at 24 weeks gestation reports episodic
headaches, visual changes, and proteinuria. What is the most appropriate
management?
A) Immediate delivery
B) Observation and routine prenatal care
C) Assessment for preeclampsia and hospitalization if severe
D) Start magnesium sulfate only
Answer: C) Assessment for preeclampsia and hospitalization if severe
Rationale: Symptoms suggest preeclampsia; evaluation and possible
hospitalization are warranted to monitor maternal and fetal well-being.
True or False: The transvaginal ultrasound is the preferred modality for early
detection and monitoring of ectopic pregnancies.
Answer: True
Rationale: Transvaginal ultrasound provides superior resolution to assess
adnexal structures early in pregnancy.
Multiple Choice
Which of the following is the most sensitive screening tool for cervical cancer
in women aged 30 and above according to current guidelines?
A) Pap smear alone every 3 years
B) HPV DNA testing alone every 5 years
C) Co-testing (Pap smear + HPV DNA) every 5 years
D) Pelvic examination only annually
3
Course Code: NU 648
Instructor:
Date: 2026
FINAL EXAM – WOMEN’S HEALTH NURSE
PRACTITIONER II
A 32-year-old woman presents with secondary amenorrhea and reports hot
flashes. Laboratory tests show elevated follicle-stimulating hormone (FSH)
levels. What is the most likely diagnosis?
A) Polycystic Ovary Syndrome (PCOS)
B) Premature Ovarian Insufficiency (POI)
C) Hypothalamic amenorrhea
D) Thyroid dysfunction
Answer: B) Premature Ovarian Insufficiency (POI)
Rationale: Elevated FSH with amenorrhea and menopausal symptoms
before age 40 suggests POI. PCOS usually shows normal or low FSH,
hypothalamic amenorrhea presents with low FSH, and thyroid dysfunction
requires thyroid function tests.
A post-menopausal woman undergoes a pelvic ultrasound revealing
endometrial thickness of 6 mm. What is the best next step according to
evidence-based guidelines?
A) Watchful waiting with repeat ultrasound in 3 months
B) Endometrial biopsy
C) Start hormonal replacement therapy
D) Ignore if asymptomatic
Answer: B) Endometrial biopsy
Rationale: In postmenopausal women with endometrial thickness >4-5 mm,
1
,an endometrial biopsy is necessary to rule out hyperplasia or cancer,
especially if bleeding is present.
True or False: The recommended first-line pharmacologic management for
gestational hypertension with no severe features includes labetalol,
nifedipine, or methyldopa.
Answer: True
Rationale: These medications have demonstrated safety profiles in
pregnancy and are recommended as first-line agents.
Fill in the blank: The hormone primarily responsible for cervical ripening
during labor is __________.
Answer: Prostaglandin
Rationale: Prostaglandins promote cervical softening and dilatation,
facilitating labor progression.
In a patient presenting with abnormal uterine bleeding perimenopause, which
diagnostic tool is considered gold standard to exclude malignancy?
A) Transvaginal ultrasound
B) Saline infusion sonohysterography (SIS)
C) Endometrial biopsy
D) MRI pelvis
Answer: C) Endometrial biopsy
Rationale: Endometrial biopsy directly samples the endometrium, enabling
diagnosis of hyperplasia or malignancy, which imaging alone cannot confirm.
True or False: The “three Rs” of prenatal care include Risk assessment,
Routine screening, and Reproductive counseling.
Answer: True
Rationale: Comprehensive prenatal care encompasses risk identification,
routine screenings (e.g., genetic, infectious), and counseling about
reproductive health and planning.
A nurse is educating a 45-year-old woman about hormone replacement
therapy (HRT). Which statement is accurate?
A) HRT is recommended indefinitely for symptom management
B) Combined estrogen-progestin therapy increases breast cancer risk more
than estrogen alone
C) HRT prevents cardiovascular disease in all postmenopausal women
2
, D) Progestin is given only if a woman has had hysterectomy
Answer: B) Combined estrogen-progestin therapy increases breast cancer
risk more than estrogen alone
Rationale: Adding progestin to estrogen increases breast cancer risk;
progestin is required in women with an intact uterus to prevent endometrial
hyperplasia.
Fill in the blank: In early pregnancy, the hormone __________ is detectable
in maternal serum and forms the basis of most pregnancy tests.
Answer: human chorionic gonadotropin (hCG)
Rationale: hCG is secreted by the trophoblast shortly after implantation and
rises rapidly, allowing early detection.
A 28-year-old pregnant woman at 24 weeks gestation reports episodic
headaches, visual changes, and proteinuria. What is the most appropriate
management?
A) Immediate delivery
B) Observation and routine prenatal care
C) Assessment for preeclampsia and hospitalization if severe
D) Start magnesium sulfate only
Answer: C) Assessment for preeclampsia and hospitalization if severe
Rationale: Symptoms suggest preeclampsia; evaluation and possible
hospitalization are warranted to monitor maternal and fetal well-being.
True or False: The transvaginal ultrasound is the preferred modality for early
detection and monitoring of ectopic pregnancies.
Answer: True
Rationale: Transvaginal ultrasound provides superior resolution to assess
adnexal structures early in pregnancy.
Multiple Choice
Which of the following is the most sensitive screening tool for cervical cancer
in women aged 30 and above according to current guidelines?
A) Pap smear alone every 3 years
B) HPV DNA testing alone every 5 years
C) Co-testing (Pap smear + HPV DNA) every 5 years
D) Pelvic examination only annually
3
