Chamberlain University NR-602
Primary Care of the Childbearing and
Childrearing Family
Comprehensive Final Exam Test Bank
100 Questions with Detailed Rationales
FOR THE NURSE GRADE
,DOMAIN 1: WOMEN'S HEALTH AND GYNECOLOGY
(Questions 1-25)
Question 1
A 25-year-old female presents with complaints of dysmenorrhea that has
worsened over the past year. She reports heavy, painful periods with clots and
pain during intercourse. On examination, you note a tender, fixed, retroverted
uterus with nodularity in the cul-de-sac. What is the most likely diagnosis?
A. Endometriosis
B. Pelvic inflammatory disease
C. Adenomyosis
D. Uterine fibroids
Correct Answer: A
Rationale: The classic triad of dysmenorrhea, dyspareunia, and a fixed,
retroverted uterus with nodularity is highly suggestive of endometriosis.
Pelvic inflammatory disease (B) would present with fever and cervical motion
tenderness. Adenomyosis (C) presents with an enlarged, boggy uterus.
Uterine fibroids (D) present with an irregularly enlarged uterus .
,Question 2
A 32-year-old G2P1 at 38 weeks gestation presents with sudden onset of
severe, sharp abdominal pain and vaginal bleeding. On examination, the
uterus is firm and tender, and the fetal heart rate shows late decelerations.
What is the most likely diagnosis?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Vasa previa
Correct Answer: B
Rationale: The combination of sudden sharp abdominal pain, vaginal
bleeding, a tender uterus, and fetal distress is classic for abruptio
placentae (placental abruption). Placenta previa (A) presents with painless
bleeding. Uterine rupture (C) typically occurs in patients with a prior uterine
scar. Vasa previa (D) presents with painless bleeding after membrane rupture
.
Question 3
A 28-year-old female presents with a complaint of "painful periods" that
started 6 months ago. She reports using ibuprofen with minimal relief. On
examination, you note a palpable, tender nodule in the cul-de-sac. What is the
most appropriate next step?
A. Start oral contraceptive pills
B. Order a pelvic ultrasound
C. Refer for laparoscopy
D. Prescribe naproxen
, Correct Answer: B
Rationale: A palpable nodule in the cul-de-sac in a patient with
dysmenorrhea raises concern for endometriosis. The appropriate next step
is pelvic ultrasound to evaluate for endometriomas and other findings. Oral
contraceptives (A) and naproxen (D) are treatments but not diagnostic.
Laparoscopy (C) is the gold standard for diagnosis but is invasive and not the
first step .
Question 4
A 35-year-old female presents with a complaint of "heavy bleeding" for the
past 6 months. She reports soaking through a pad every hour for several days
during her period. She denies pelvic pain. What is the most appropriate next
step?
A. Iron supplementation
B. Endometrial biopsy
C. Pelvic ultrasound
D. Hysteroscopy
Correct Answer: C
Rationale: The initial evaluation for abnormal uterine bleeding
includes pelvic ultrasound to assess for structural causes (fibroids, polyps,
endometrial thickness). Iron supplementation (A) is supportive but not
diagnostic. Endometrial biopsy (B) is indicated for patients with risk factors
for endometrial cancer (age >45, obesity, unopposed estrogen). Hysteroscopy
(D) is invasive and not first-line .
Primary Care of the Childbearing and
Childrearing Family
Comprehensive Final Exam Test Bank
100 Questions with Detailed Rationales
FOR THE NURSE GRADE
,DOMAIN 1: WOMEN'S HEALTH AND GYNECOLOGY
(Questions 1-25)
Question 1
A 25-year-old female presents with complaints of dysmenorrhea that has
worsened over the past year. She reports heavy, painful periods with clots and
pain during intercourse. On examination, you note a tender, fixed, retroverted
uterus with nodularity in the cul-de-sac. What is the most likely diagnosis?
A. Endometriosis
B. Pelvic inflammatory disease
C. Adenomyosis
D. Uterine fibroids
Correct Answer: A
Rationale: The classic triad of dysmenorrhea, dyspareunia, and a fixed,
retroverted uterus with nodularity is highly suggestive of endometriosis.
Pelvic inflammatory disease (B) would present with fever and cervical motion
tenderness. Adenomyosis (C) presents with an enlarged, boggy uterus.
Uterine fibroids (D) present with an irregularly enlarged uterus .
,Question 2
A 32-year-old G2P1 at 38 weeks gestation presents with sudden onset of
severe, sharp abdominal pain and vaginal bleeding. On examination, the
uterus is firm and tender, and the fetal heart rate shows late decelerations.
What is the most likely diagnosis?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Vasa previa
Correct Answer: B
Rationale: The combination of sudden sharp abdominal pain, vaginal
bleeding, a tender uterus, and fetal distress is classic for abruptio
placentae (placental abruption). Placenta previa (A) presents with painless
bleeding. Uterine rupture (C) typically occurs in patients with a prior uterine
scar. Vasa previa (D) presents with painless bleeding after membrane rupture
.
Question 3
A 28-year-old female presents with a complaint of "painful periods" that
started 6 months ago. She reports using ibuprofen with minimal relief. On
examination, you note a palpable, tender nodule in the cul-de-sac. What is the
most appropriate next step?
A. Start oral contraceptive pills
B. Order a pelvic ultrasound
C. Refer for laparoscopy
D. Prescribe naproxen
, Correct Answer: B
Rationale: A palpable nodule in the cul-de-sac in a patient with
dysmenorrhea raises concern for endometriosis. The appropriate next step
is pelvic ultrasound to evaluate for endometriomas and other findings. Oral
contraceptives (A) and naproxen (D) are treatments but not diagnostic.
Laparoscopy (C) is the gold standard for diagnosis but is invasive and not the
first step .
Question 4
A 35-year-old female presents with a complaint of "heavy bleeding" for the
past 6 months. She reports soaking through a pad every hour for several days
during her period. She denies pelvic pain. What is the most appropriate next
step?
A. Iron supplementation
B. Endometrial biopsy
C. Pelvic ultrasound
D. Hysteroscopy
Correct Answer: C
Rationale: The initial evaluation for abnormal uterine bleeding
includes pelvic ultrasound to assess for structural causes (fibroids, polyps,
endometrial thickness). Iron supplementation (A) is supportive but not
diagnostic. Endometrial biopsy (B) is indicated for patients with risk factors
for endometrial cancer (age >45, obesity, unopposed estrogen). Hysteroscopy
(D) is invasive and not first-line .
