NR 602 MIDTERM EXAM PRIMARY CARE OF
WOMEN 2026 CHAMBERLAIN ACTUAL QUESTIONS
AND ANSWERS
SECTION ONE: WELL WOMAN CARE AND PREVENTIVE SCREENING
Question 1
According to the 2024 USPSTF updated guidelines, what is the recommended age to
begin screening mammography for average-risk women, and what is the screening
interval?
A. Age 40, annually.
B. Age 40, biennially.
C. Age 50, biennially.
D. Age 45, annually.
Answer: B
Rationale: The United States Preventive Services Task Force (USPSTF) updated their
guidelines in 2024 to recommend that women at average risk for breast cancer initiate
screening mammography at age 40 and continue every two years (biennially) until age
74. This is a shift from the previous recommendation of starting at age 50.
,Question 2
A 26-year-old female presents for her well-woman exam. She is sexually active with a
new partner. According to the latest ASCCP guidelines, what is the preferred method
for cervical cancer screening in this patient?
A. Pap smear alone.
B. Primary HPV testing alone.
C. Co-testing with Pap smear and HPV.
D. No screening is needed until age 30.
Answer: A
Rationale: For individuals aged 21 to 24, cytology (Pap smear) alone is the
recommended screening method. Primary HPV testing alone is preferred for
individuals aged 25 to 29 (though cytology alone is acceptable). Co-testing is preferred
for individuals aged 30 to 65.
Question 3
A 35-year-old female undergoes cervical cancer screening. Her Pap smear shows
Low-Grade Squamous Intraepithelial Lesion (LSIL), and her HPV test is positive for
HPV 16. What is the recommended management based on ASCCP risk-based
management guidelines?
A. Repeat co-testing in 12 months.
B. Colposcopy.
C. Repeat Pap smear in 6 months.
D. Treatment with cryotherapy immediately.
Answer: B
Rationale: Under the 2019 ASCCP risk-based management guidelines, a finding of LSIL
with a positive HPV 16 or 18 result places the patient in an immediate colposcopy
management pathway due to the high-risk nature of these specific HPV genotypes,
even though LSIL alone might be managed conservatively in younger women.
Question 4
, A 32-year-old female asks about the human papillomavirus (HPV) vaccine. She has
never received it. What is the recommendation?
A. She is too old to receive the vaccine.
B. She should receive a 3-dose series of the 9-valent HPV vaccine.
C. She should receive a 2-dose series of the 9-valent HPV vaccine.
D. She only needs the 2-valent vaccine since she is over 26.
Answer: B
Rationale: The CDC and ACIP recommend the 9-valent HPV vaccine for all individuals
through age 26 who were not adequately vaccinated previously. For adults aged 27
through 45, shared clinical decision-making is recommended. Because she is 32 and
starting the series late, a 3-dose schedule is required (a 2-dose schedule is only for
those who start before age 15).
SECTION TWO: MENSTRUAL DISORDERS AND ABNORMAL UTERINE BLEEDING
Question 5
A 40-year-old female presents reporting heavy menstrual bleeding that is interfering
with her quality of life. She has regular cycles. The nurse practitioner uses the PALM-
COEIN system to categorize her bleeding. What does the acronym PALM-COEIN
represent?
A. Polyps, Adenomyosis, Leiomyoma, Malignancy and hyperplasia, Coagulopathy,
Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified.
B. Pregnancy, Anovulation, Leiomyoma, Malignancy, Coagulopathy, Ovulatory,
Endometriosis, Infection, Neoplasm.
C. Polyps, Adenomyosis, Leiomyoma, Malignancy, Coagulopathy, Ovulatory,
Endometrial, Iatrogenic, Not yet classified.
D. Polyps, Adenomyosis, Leiomyoma, Malignancy, Chronic disease, Ovulatory,
Endometrial, Iatrogenic, Not yet classified.
Answer: A
WOMEN 2026 CHAMBERLAIN ACTUAL QUESTIONS
AND ANSWERS
SECTION ONE: WELL WOMAN CARE AND PREVENTIVE SCREENING
Question 1
According to the 2024 USPSTF updated guidelines, what is the recommended age to
begin screening mammography for average-risk women, and what is the screening
interval?
A. Age 40, annually.
B. Age 40, biennially.
C. Age 50, biennially.
D. Age 45, annually.
Answer: B
Rationale: The United States Preventive Services Task Force (USPSTF) updated their
guidelines in 2024 to recommend that women at average risk for breast cancer initiate
screening mammography at age 40 and continue every two years (biennially) until age
74. This is a shift from the previous recommendation of starting at age 50.
,Question 2
A 26-year-old female presents for her well-woman exam. She is sexually active with a
new partner. According to the latest ASCCP guidelines, what is the preferred method
for cervical cancer screening in this patient?
A. Pap smear alone.
B. Primary HPV testing alone.
C. Co-testing with Pap smear and HPV.
D. No screening is needed until age 30.
Answer: A
Rationale: For individuals aged 21 to 24, cytology (Pap smear) alone is the
recommended screening method. Primary HPV testing alone is preferred for
individuals aged 25 to 29 (though cytology alone is acceptable). Co-testing is preferred
for individuals aged 30 to 65.
Question 3
A 35-year-old female undergoes cervical cancer screening. Her Pap smear shows
Low-Grade Squamous Intraepithelial Lesion (LSIL), and her HPV test is positive for
HPV 16. What is the recommended management based on ASCCP risk-based
management guidelines?
A. Repeat co-testing in 12 months.
B. Colposcopy.
C. Repeat Pap smear in 6 months.
D. Treatment with cryotherapy immediately.
Answer: B
Rationale: Under the 2019 ASCCP risk-based management guidelines, a finding of LSIL
with a positive HPV 16 or 18 result places the patient in an immediate colposcopy
management pathway due to the high-risk nature of these specific HPV genotypes,
even though LSIL alone might be managed conservatively in younger women.
Question 4
, A 32-year-old female asks about the human papillomavirus (HPV) vaccine. She has
never received it. What is the recommendation?
A. She is too old to receive the vaccine.
B. She should receive a 3-dose series of the 9-valent HPV vaccine.
C. She should receive a 2-dose series of the 9-valent HPV vaccine.
D. She only needs the 2-valent vaccine since she is over 26.
Answer: B
Rationale: The CDC and ACIP recommend the 9-valent HPV vaccine for all individuals
through age 26 who were not adequately vaccinated previously. For adults aged 27
through 45, shared clinical decision-making is recommended. Because she is 32 and
starting the series late, a 3-dose schedule is required (a 2-dose schedule is only for
those who start before age 15).
SECTION TWO: MENSTRUAL DISORDERS AND ABNORMAL UTERINE BLEEDING
Question 5
A 40-year-old female presents reporting heavy menstrual bleeding that is interfering
with her quality of life. She has regular cycles. The nurse practitioner uses the PALM-
COEIN system to categorize her bleeding. What does the acronym PALM-COEIN
represent?
A. Polyps, Adenomyosis, Leiomyoma, Malignancy and hyperplasia, Coagulopathy,
Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified.
B. Pregnancy, Anovulation, Leiomyoma, Malignancy, Coagulopathy, Ovulatory,
Endometriosis, Infection, Neoplasm.
C. Polyps, Adenomyosis, Leiomyoma, Malignancy, Coagulopathy, Ovulatory,
Endometrial, Iatrogenic, Not yet classified.
D. Polyps, Adenomyosis, Leiomyoma, Malignancy, Chronic disease, Ovulatory,
Endometrial, Iatrogenic, Not yet classified.
Answer: A
