HERZING UNIVERSITY
Course Code: NU 647
Instructor:
Date: 2026
FINAL EXAM – WOMEN’S HEALTH NURSE
PRACTITIONER I
A 32-year-old woman presents with severe dysmenorrhea and dyspareunia.
Imaging reveals endometriotic lesions involving the uterosacral ligaments.
What is the most appropriate initial pharmacologic treatment? A) Oral
combined contraceptives B) GnRH agonists C) NSAIDs only D) Hormone
replacement therapy
Answer: A) Oral combined contraceptives Rationale: Combined oral
contraceptives help suppress ovulation, reducing estrogen stimulation of
endometrial implants and improving symptoms of endometriosis, making
them first-line therapy before progressing to GnRH agonists.
A postmenopausal woman presents with vaginal bleeding 2 years after
cessation of menses. The most critical next step would be: A) Observation
for spontaneous resolution B) Endometrial biopsy C) Pelvic ultrasound only
D) Hormone replacement therapy
Answer: B) Endometrial biopsy Rationale: Postmenopausal bleeding can
signal endometrial pathology including carcinoma. Endometrial biopsy is
required urgently to rule out malignancy.
True or False: The administration of magnesium sulfate is primarily indicated
for seizure prophylaxis in women with pre-eclampsia. Answer: True
Rationale: Magnesium sulfate is used to prevent eclamptic seizures by
acting as a central nervous system depressant and anticonvulsant.
Fill in the blank: The hormone responsible for maintaining the corpus luteum
1
,and progesterone production during early pregnancy is __________.
Answer: human chorionic gonadotropin (hCG) Rationale: hCG supports the
corpus luteum until placental progesterone secretion is sufficient.
A 28-year-old pregnant patient at 32 weeks gestation presents with painless
vaginal bleeding and a normal fetus on ultrasound. The most likely diagnosis
is: A) Placenta previa B) Placental abruption C) Vasa previa D) Uterine
rupture
Answer: A) Placenta previa Rationale: Painless vaginal bleeding in third
trimester with normal fetal monitoring suggests placenta previa,
characterized by placental implantation over the cervical os.
Fill in the blank: The first stage of labor is defined as the period from the
onset of regular contractions until the cervix is __________ cm dilated.
Answer: 10 Rationale: The first stage of labor ends when the cervix is fully
dilated to 10 cm, allowing fetal descent.
True or False: Polycystic ovary syndrome (PCOS) is characterized primarily
by elevated FSH levels.
Answer: False Rationale: PCOS typically shows normal or low FSH with
elevated LH and androgens.
Multiple choice question: Which uterine fibroid type is most associated with
infertility and recurrent pregnancy loss? A) Subserosal B) Intramural C)
Submucosal D) Pedunculated
Answer: C) Submucosal Rationale: Submucosal fibroids distort the
endometrial cavity affecting implantation and increasing miscarriage risk.
A patient with suspected bacterial vaginosis presents with a fishy odor after
applying potassium hydroxide to vaginal discharge. This is a positive
__________ test.
Answer: whiff Rationale: The whiff test detects amine odors produced by
anaerobic bacteria indicating bacterial vaginosis.
True or False: The antenatal administration of corticosteroids reduces the
risk of neonatal respiratory distress syndrome in preterm labor.
Answer: True Rationale: Corticosteroids accelerate fetal lung maturation,
decreasing respiratory distress risk.
In a case of suspected deep vein thrombosis (DVT) in a postpartum patient,
which diagnostic test is preferred initially? A) Venography B) Doppler
ultrasonography C) MRI D) CT angiography
Answer: B) Doppler ultrasonography Rationale: Doppler ultrasound is non-
2
, invasive and the primary imaging method for DVT diagnosis in postpartum.
Fill in the blank: The primary mechanism causing preeclampsia is abnormal
development of the __________ of the placenta.
Answer: spiral arteries Rationale: Inadequate remodeling of spiral arteries
leads to placental ischemia and preeclampsia.
True or False: Hormone replacement therapy is absolutely contraindicated in
all women with a history of hormone receptor-positive breast cancer.
Answer: True Rationale: Estrogen and progesterone can stimulate residual
cancer cells, so HRT is contraindicated.
Multiple choice: Which marker is most sensitive and specific for diagnosing
ovarian cancer? A) CA-125 B) AFP C) hCG D) LDH
Answer: A) CA-125 Rationale: CA-125 is used primarily to monitor ovarian
cancer; although not perfect, it is most clinically applied.
Fill in the blank: The definitive surgical treatment for uterine prolapse is
__________.
Answer: hysterectomy Rationale: Hysterectomy removes the uterus and
can provide permanent correction in advanced prolapse.
True or False: Intrauterine fetal demise occurs more commonly during the
second trimester than the first trimester.
Answer: True Rationale: First trimester losses are classified as
miscarriages, while intrauterine fetal demise is typically a second-trimester or
later event.
In a patient with hyperemesis gravidarum, the first-line treatment is: A)
Intravenous hydration and antiemetics B) Immediate termination of
pregnancy C) Surgical intervention D) High-dose steroids
Answer: A) Intravenous hydration and antiemetics Rationale: Supportive
care with fluids and medications is the first step to correct dehydration and
control symptoms.
Fill in the blank: The physiological increase in __________ during pregnancy
leads to a hypercoagulable state.
Answer: fibrinogen Rationale: Elevated fibrinogen contributes to increased
clotting tendency to reduce hemorrhage risk.
True or False: Postmenopausal women frequently present with vulvovaginal
atrophy due to decreased estrogen levels.
Answer: True Rationale: Estrogen decline causes thinning of vulvovaginal
3
Course Code: NU 647
Instructor:
Date: 2026
FINAL EXAM – WOMEN’S HEALTH NURSE
PRACTITIONER I
A 32-year-old woman presents with severe dysmenorrhea and dyspareunia.
Imaging reveals endometriotic lesions involving the uterosacral ligaments.
What is the most appropriate initial pharmacologic treatment? A) Oral
combined contraceptives B) GnRH agonists C) NSAIDs only D) Hormone
replacement therapy
Answer: A) Oral combined contraceptives Rationale: Combined oral
contraceptives help suppress ovulation, reducing estrogen stimulation of
endometrial implants and improving symptoms of endometriosis, making
them first-line therapy before progressing to GnRH agonists.
A postmenopausal woman presents with vaginal bleeding 2 years after
cessation of menses. The most critical next step would be: A) Observation
for spontaneous resolution B) Endometrial biopsy C) Pelvic ultrasound only
D) Hormone replacement therapy
Answer: B) Endometrial biopsy Rationale: Postmenopausal bleeding can
signal endometrial pathology including carcinoma. Endometrial biopsy is
required urgently to rule out malignancy.
True or False: The administration of magnesium sulfate is primarily indicated
for seizure prophylaxis in women with pre-eclampsia. Answer: True
Rationale: Magnesium sulfate is used to prevent eclamptic seizures by
acting as a central nervous system depressant and anticonvulsant.
Fill in the blank: The hormone responsible for maintaining the corpus luteum
1
,and progesterone production during early pregnancy is __________.
Answer: human chorionic gonadotropin (hCG) Rationale: hCG supports the
corpus luteum until placental progesterone secretion is sufficient.
A 28-year-old pregnant patient at 32 weeks gestation presents with painless
vaginal bleeding and a normal fetus on ultrasound. The most likely diagnosis
is: A) Placenta previa B) Placental abruption C) Vasa previa D) Uterine
rupture
Answer: A) Placenta previa Rationale: Painless vaginal bleeding in third
trimester with normal fetal monitoring suggests placenta previa,
characterized by placental implantation over the cervical os.
Fill in the blank: The first stage of labor is defined as the period from the
onset of regular contractions until the cervix is __________ cm dilated.
Answer: 10 Rationale: The first stage of labor ends when the cervix is fully
dilated to 10 cm, allowing fetal descent.
True or False: Polycystic ovary syndrome (PCOS) is characterized primarily
by elevated FSH levels.
Answer: False Rationale: PCOS typically shows normal or low FSH with
elevated LH and androgens.
Multiple choice question: Which uterine fibroid type is most associated with
infertility and recurrent pregnancy loss? A) Subserosal B) Intramural C)
Submucosal D) Pedunculated
Answer: C) Submucosal Rationale: Submucosal fibroids distort the
endometrial cavity affecting implantation and increasing miscarriage risk.
A patient with suspected bacterial vaginosis presents with a fishy odor after
applying potassium hydroxide to vaginal discharge. This is a positive
__________ test.
Answer: whiff Rationale: The whiff test detects amine odors produced by
anaerobic bacteria indicating bacterial vaginosis.
True or False: The antenatal administration of corticosteroids reduces the
risk of neonatal respiratory distress syndrome in preterm labor.
Answer: True Rationale: Corticosteroids accelerate fetal lung maturation,
decreasing respiratory distress risk.
In a case of suspected deep vein thrombosis (DVT) in a postpartum patient,
which diagnostic test is preferred initially? A) Venography B) Doppler
ultrasonography C) MRI D) CT angiography
Answer: B) Doppler ultrasonography Rationale: Doppler ultrasound is non-
2
, invasive and the primary imaging method for DVT diagnosis in postpartum.
Fill in the blank: The primary mechanism causing preeclampsia is abnormal
development of the __________ of the placenta.
Answer: spiral arteries Rationale: Inadequate remodeling of spiral arteries
leads to placental ischemia and preeclampsia.
True or False: Hormone replacement therapy is absolutely contraindicated in
all women with a history of hormone receptor-positive breast cancer.
Answer: True Rationale: Estrogen and progesterone can stimulate residual
cancer cells, so HRT is contraindicated.
Multiple choice: Which marker is most sensitive and specific for diagnosing
ovarian cancer? A) CA-125 B) AFP C) hCG D) LDH
Answer: A) CA-125 Rationale: CA-125 is used primarily to monitor ovarian
cancer; although not perfect, it is most clinically applied.
Fill in the blank: The definitive surgical treatment for uterine prolapse is
__________.
Answer: hysterectomy Rationale: Hysterectomy removes the uterus and
can provide permanent correction in advanced prolapse.
True or False: Intrauterine fetal demise occurs more commonly during the
second trimester than the first trimester.
Answer: True Rationale: First trimester losses are classified as
miscarriages, while intrauterine fetal demise is typically a second-trimester or
later event.
In a patient with hyperemesis gravidarum, the first-line treatment is: A)
Intravenous hydration and antiemetics B) Immediate termination of
pregnancy C) Surgical intervention D) High-dose steroids
Answer: A) Intravenous hydration and antiemetics Rationale: Supportive
care with fluids and medications is the first step to correct dehydration and
control symptoms.
Fill in the blank: The physiological increase in __________ during pregnancy
leads to a hypercoagulable state.
Answer: fibrinogen Rationale: Elevated fibrinogen contributes to increased
clotting tendency to reduce hemorrhage risk.
True or False: Postmenopausal women frequently present with vulvovaginal
atrophy due to decreased estrogen levels.
Answer: True Rationale: Estrogen decline causes thinning of vulvovaginal
3
