1
Barkley WHNP Diagnostic Readiness Test (DRT) #1 \ 100
Practice Questions & Detailed Rationales for Women’s
Health Nurse Practitioner Certification
Welcome to the Barkley WHNP Diagnostic Readiness Test (DRT) #1 – a 100-question test bank designed to
simulate the difficulty and content coverage of the National Certification Corporation (NCC) Women’s Health
Nurse Practitioner (WHNP) certification exam. Each question is followed by the correct answer and a detailed,
evidence-based rationale to help you master the most frequently tested and most challenging concepts.
SECTION 1 – CONTRACEPTION & FAMILY PLANNING (Questions 1–15)
Q1. A 32-year-old woman with a history of deep vein thrombosis (DVT) 2 years
ago asks about contraception. She is a smoker (5 cigarettes/day). Which
contraceptive method is contraindicated?
A) Copper intrauterine device (IUD)
B) Progestin-only pill
C) Combined oral contraceptive (COC)
D) Etonogestrel implant
: Correct Answer : C
Rationale: Combined oral contraceptives (estrogen-containing) are
contraindicated in women with a history of DVT, pulmonary embolism, or known
thrombophilia, regardless of smoking status. The risk is further increased in
smokers over age 35. The copper IUD, progestin-only pill, and implant do not
contain estrogen and are safe options.
Q2. A 28-year-old woman wants to use the etonogestrel implant (Nexplanon). She
asks about the most common side effect. What should the NP tell her?
A) Weight gain of >10 lbs
B) Irregular bleeding patterns
C) Acne
D) Mood swings
pg. 1
,2
: Correct Answer : B
Rationale: Irregular bleeding (spotting, prolonged bleeding, or amenorrhea) is the
most common side effect of the etonogestrel implant. It occurs in up to 60% of
users, especially in the first 6-12 months. Weight gain is possible but not the most
common.
Q3. A 22-year-old woman requests emergency contraception 48 hours after
unprotected intercourse. She has no contraindications. Which method is most
effective?
A) Copper IUD
B) Levonorgestrel 1.5 mg orally (Plan B)
C) Ulipristal acetate (Ella)
D) Yuzpe method (combined OCPs)
: Correct Answer : A
Rationale: The copper IUD is the most effective emergency contraception (>99%
effective) and can be placed up to 5 days after unprotected intercourse. It also
provides ongoing contraception. Ulipristal acetate is more effective than
levonorgestrel but less effective than the copper IUD.
Q4. A 35-year-old woman with a history of migraines with aura asks about
contraception. Which method is contraindicated?
A) Copper IUD
B) Progestin-only pill
C) Combined oral contraceptive (COC)
D) Etonogestrel implant
: Correct Answer : C
Rationale: Combined oral contraceptives (estrogen-containing) are
contraindicated in women with migraines with aura because of an increased risk
of ischemic stroke. Progestin-only methods (pill, implant, IUD) and the copper IUD
are safe alternatives.
pg. 2
,3
Q5. A 24-year-old woman started a combined oral contraceptive 3 weeks ago. She
now reports breast tenderness and mild nausea. What is the most appropriate
recommendation?
A) Discontinue the pill immediately
B) Reassure her that these symptoms usually resolve within 3 months
C) Switch to a different pill
D) Add a progestin-only pill to counteract symptoms
: Correct Answer : B
Rationale: Common early side effects of COCs (nausea, breast tenderness,
breakthrough bleeding) typically resolve within 3 cycles. Reassurance and
continued use are appropriate; switching pills is not indicated unless symptoms
persist.
Q6. A 19-year-old woman is prescribed a combined oral contraceptive. She has
acne and heavy, painful menses. Which of the following is a non-contraceptive
benefit of COCs?
A) Reduced risk of ovarian cancer
B) Increased risk of breast cancer
C) Improved bone density
D) Increased libido
: Correct Answer : A
Rationale: Long-term use of combined oral contraceptives reduces the risk of
ovarian and endometrial cancer. Other non-contraceptive benefits include lighter
menses, reduced dysmenorrhea, and improvement in acne.
Q7. A 30-year-woman is 6 weeks postpartum and exclusively breastfeeding.
Which contraceptive method is most appropriate?
A) Combined oral contraceptive
B) Progestin-only pill (POP)
C) Vaginal ring
D) Transdermal patch
pg. 3
, 4
: Correct Answer : B
Rationale: Progestin-only pills do not affect milk supply and are safe during
breastfeeding. Estrogen-containing methods (COCs, vaginal ring, patch) may
reduce milk production and are generally avoided until 6 weeks postpartum.
Q8. A 26-year-woman has a copper IUD inserted. Which statement indicates she
understands the counseling?
A) “I will need to check my IUD strings daily.”
B) “I cannot use tampons with the IUD.”
C) “The IUD will make my periods lighter and less painful.”
D) “I may have heavier and more painful periods for the first few months.”
: Correct Answer : D
Rationale: The copper IUD is associated with increased menstrual bleeding and
dysmenorrhea, especially in the first 3-6 months. This effect is the opposite of
levonorgestrel IUDs, which reduce bleeding.
Q9. A 33-year-old woman is considering the levonorgestrel intrauterine system
(LNG-IUS). What is the most common reason for early discontinuation?
A) Unscheduled bleeding and spotting
B) Pain during insertion
C) Weight gain
D) Hormonal side effects
: Correct Answer : A
Rationale: Unscheduled bleeding/spotting is common in the first 3-6 months after
LNG-IUS insertion and is the most frequent reason for discontinuation. Most
women experience significantly reduced bleeding after 6 months.
Q10. A 40-year-old woman with hypertension (well-controlled on lisinopril) and
no other risk factors asks about contraception. Which method is most
appropriate?
A) Combined oral contraceptive
pg. 4
Barkley WHNP Diagnostic Readiness Test (DRT) #1 \ 100
Practice Questions & Detailed Rationales for Women’s
Health Nurse Practitioner Certification
Welcome to the Barkley WHNP Diagnostic Readiness Test (DRT) #1 – a 100-question test bank designed to
simulate the difficulty and content coverage of the National Certification Corporation (NCC) Women’s Health
Nurse Practitioner (WHNP) certification exam. Each question is followed by the correct answer and a detailed,
evidence-based rationale to help you master the most frequently tested and most challenging concepts.
SECTION 1 – CONTRACEPTION & FAMILY PLANNING (Questions 1–15)
Q1. A 32-year-old woman with a history of deep vein thrombosis (DVT) 2 years
ago asks about contraception. She is a smoker (5 cigarettes/day). Which
contraceptive method is contraindicated?
A) Copper intrauterine device (IUD)
B) Progestin-only pill
C) Combined oral contraceptive (COC)
D) Etonogestrel implant
: Correct Answer : C
Rationale: Combined oral contraceptives (estrogen-containing) are
contraindicated in women with a history of DVT, pulmonary embolism, or known
thrombophilia, regardless of smoking status. The risk is further increased in
smokers over age 35. The copper IUD, progestin-only pill, and implant do not
contain estrogen and are safe options.
Q2. A 28-year-old woman wants to use the etonogestrel implant (Nexplanon). She
asks about the most common side effect. What should the NP tell her?
A) Weight gain of >10 lbs
B) Irregular bleeding patterns
C) Acne
D) Mood swings
pg. 1
,2
: Correct Answer : B
Rationale: Irregular bleeding (spotting, prolonged bleeding, or amenorrhea) is the
most common side effect of the etonogestrel implant. It occurs in up to 60% of
users, especially in the first 6-12 months. Weight gain is possible but not the most
common.
Q3. A 22-year-old woman requests emergency contraception 48 hours after
unprotected intercourse. She has no contraindications. Which method is most
effective?
A) Copper IUD
B) Levonorgestrel 1.5 mg orally (Plan B)
C) Ulipristal acetate (Ella)
D) Yuzpe method (combined OCPs)
: Correct Answer : A
Rationale: The copper IUD is the most effective emergency contraception (>99%
effective) and can be placed up to 5 days after unprotected intercourse. It also
provides ongoing contraception. Ulipristal acetate is more effective than
levonorgestrel but less effective than the copper IUD.
Q4. A 35-year-old woman with a history of migraines with aura asks about
contraception. Which method is contraindicated?
A) Copper IUD
B) Progestin-only pill
C) Combined oral contraceptive (COC)
D) Etonogestrel implant
: Correct Answer : C
Rationale: Combined oral contraceptives (estrogen-containing) are
contraindicated in women with migraines with aura because of an increased risk
of ischemic stroke. Progestin-only methods (pill, implant, IUD) and the copper IUD
are safe alternatives.
pg. 2
,3
Q5. A 24-year-old woman started a combined oral contraceptive 3 weeks ago. She
now reports breast tenderness and mild nausea. What is the most appropriate
recommendation?
A) Discontinue the pill immediately
B) Reassure her that these symptoms usually resolve within 3 months
C) Switch to a different pill
D) Add a progestin-only pill to counteract symptoms
: Correct Answer : B
Rationale: Common early side effects of COCs (nausea, breast tenderness,
breakthrough bleeding) typically resolve within 3 cycles. Reassurance and
continued use are appropriate; switching pills is not indicated unless symptoms
persist.
Q6. A 19-year-old woman is prescribed a combined oral contraceptive. She has
acne and heavy, painful menses. Which of the following is a non-contraceptive
benefit of COCs?
A) Reduced risk of ovarian cancer
B) Increased risk of breast cancer
C) Improved bone density
D) Increased libido
: Correct Answer : A
Rationale: Long-term use of combined oral contraceptives reduces the risk of
ovarian and endometrial cancer. Other non-contraceptive benefits include lighter
menses, reduced dysmenorrhea, and improvement in acne.
Q7. A 30-year-woman is 6 weeks postpartum and exclusively breastfeeding.
Which contraceptive method is most appropriate?
A) Combined oral contraceptive
B) Progestin-only pill (POP)
C) Vaginal ring
D) Transdermal patch
pg. 3
, 4
: Correct Answer : B
Rationale: Progestin-only pills do not affect milk supply and are safe during
breastfeeding. Estrogen-containing methods (COCs, vaginal ring, patch) may
reduce milk production and are generally avoided until 6 weeks postpartum.
Q8. A 26-year-woman has a copper IUD inserted. Which statement indicates she
understands the counseling?
A) “I will need to check my IUD strings daily.”
B) “I cannot use tampons with the IUD.”
C) “The IUD will make my periods lighter and less painful.”
D) “I may have heavier and more painful periods for the first few months.”
: Correct Answer : D
Rationale: The copper IUD is associated with increased menstrual bleeding and
dysmenorrhea, especially in the first 3-6 months. This effect is the opposite of
levonorgestrel IUDs, which reduce bleeding.
Q9. A 33-year-old woman is considering the levonorgestrel intrauterine system
(LNG-IUS). What is the most common reason for early discontinuation?
A) Unscheduled bleeding and spotting
B) Pain during insertion
C) Weight gain
D) Hormonal side effects
: Correct Answer : A
Rationale: Unscheduled bleeding/spotting is common in the first 3-6 months after
LNG-IUS insertion and is the most frequent reason for discontinuation. Most
women experience significantly reduced bleeding after 6 months.
Q10. A 40-year-old woman with hypertension (well-controlled on lisinopril) and
no other risk factors asks about contraception. Which method is most
appropriate?
A) Combined oral contraceptive
pg. 4
