**Women's Health NP Surge: 2024 Certification
Readiness** (Theme: Women's Health Nurse
Practitioner Certification Exam 2024)
---
1. Pt age 25, G0, wants contraception. Medical history: migraine with aura. Which method is
contraindicated?
💫RATIONALE✔️✔️: Combined oral contraceptives increase stroke risk in migraine with aura.
💫ANSWER✔️✔️: D. Combined OCP.
---
2. Pt age 32, G3P2, BMI 38, oligomenorrhea, hirsutism, acanthosis nigricans. Most likely diagnosis?
💫RATIONALE✔️✔️: PCOS (hyperandrogenism, ovulatory dysfunction, metabolic syndrome).
💫ANSWER✔️✔️: C. PCOS.
---
3. Pt age 28, irregular menses, infertility. Labs: LH 18, FSH 4, testosterone 80, DHEAS normal. Diagnosis?
💫RATIONALE✔️✔️: LH/FSH ratio >2, hyperandrogenism, anovulation = PCOS.
💫ANSWER✔️✔️: B. PCOS.
---
4. Pt with PCOS, BMI 34, hirsutism, acanthosis nigricans. First-line treatment for hirsutism?
💫RATIONALE✔️✔️: Combined OCP + lifestyle modification; spironolactone second-line.
💫ANSWER✔️✔️: A. Combined OCP.
---
5. Pt age 22, G0, annual exam. HPV vaccine history: none. Which vaccine is recommended?
💫RATIONALE✔️✔️: 9-valent HPV vaccine (Gardasil-9) up to age 26; catch-up to 45 shared decision.
💫ANSWER✔️✔️: D. Gardasil-9 series.
---
, 6. Pt age 30, G2P2, cervical cytology: LSIL, HPV 16 positive. Next step?
💫RATIONALE✔️✔️: Colposcopy for LSIL + high-risk HPV (16/18).
💫ANSWER✔️✔️: C. Colposcopy.
---
7. Pt age 45, G3P3, cervical cytology: ASC-H. Next step?
💫RATIONALE✔️✔️: ASC-H (atypical squamous cells cannot exclude HSIL) needs colposcopy.
💫ANSWER✔️✔️: B. Colposcopy.
---
8. Pt age 35, HPV negative, cytology: NILM. Next Pap interval?
💫RATIONALE✔️✔️: Co-testing q5 years if HPV negative + NILM age 30-65.
💫ANSWER✔️✔️: D. 5 years.
---
9. Pt age 52, postmenopausal, mammogram: BI-RADS 4 (suspicious abnormality). Next step?
💫RATIONALE✔️✔️: BI-RADS 4 requires biopsy (core needle or excisional).
💫ANSWER✔️✔️: A. Core needle biopsy.
---
10. Pt age 60, on tamoxifen for breast cancer. Which endometrial finding requires biopsy?
💫RATIONALE✔️✔️: Tamoxifen increases endometrial cancer risk; any bleeding or thickened lining
(>8mm).
💫ANSWER✔️✔️: C. Endometrial stripe 12 mm.
---
11. Pt age 40, breast lump, mammogram negative. Next step?
💫RATIONALE✔️✔️: Negative mammogram with palpable lump needs ultrasound or biopsy.
💫ANSWER✔️✔️: B. Breast ultrasound.
---
12. Pt age 55, postmenopausal, vaginal dryness, dyspareunia, no contraindication to estrogen. Which
treatment?
💫RATIONALE✔️✔️: Low-dose vaginal estrogen (cream, ring, tablet) safe without systemic progestin.
💫ANSWER✔️✔️: A. Vaginal estrogen cream.
Readiness** (Theme: Women's Health Nurse
Practitioner Certification Exam 2024)
---
1. Pt age 25, G0, wants contraception. Medical history: migraine with aura. Which method is
contraindicated?
💫RATIONALE✔️✔️: Combined oral contraceptives increase stroke risk in migraine with aura.
💫ANSWER✔️✔️: D. Combined OCP.
---
2. Pt age 32, G3P2, BMI 38, oligomenorrhea, hirsutism, acanthosis nigricans. Most likely diagnosis?
💫RATIONALE✔️✔️: PCOS (hyperandrogenism, ovulatory dysfunction, metabolic syndrome).
💫ANSWER✔️✔️: C. PCOS.
---
3. Pt age 28, irregular menses, infertility. Labs: LH 18, FSH 4, testosterone 80, DHEAS normal. Diagnosis?
💫RATIONALE✔️✔️: LH/FSH ratio >2, hyperandrogenism, anovulation = PCOS.
💫ANSWER✔️✔️: B. PCOS.
---
4. Pt with PCOS, BMI 34, hirsutism, acanthosis nigricans. First-line treatment for hirsutism?
💫RATIONALE✔️✔️: Combined OCP + lifestyle modification; spironolactone second-line.
💫ANSWER✔️✔️: A. Combined OCP.
---
5. Pt age 22, G0, annual exam. HPV vaccine history: none. Which vaccine is recommended?
💫RATIONALE✔️✔️: 9-valent HPV vaccine (Gardasil-9) up to age 26; catch-up to 45 shared decision.
💫ANSWER✔️✔️: D. Gardasil-9 series.
---
, 6. Pt age 30, G2P2, cervical cytology: LSIL, HPV 16 positive. Next step?
💫RATIONALE✔️✔️: Colposcopy for LSIL + high-risk HPV (16/18).
💫ANSWER✔️✔️: C. Colposcopy.
---
7. Pt age 45, G3P3, cervical cytology: ASC-H. Next step?
💫RATIONALE✔️✔️: ASC-H (atypical squamous cells cannot exclude HSIL) needs colposcopy.
💫ANSWER✔️✔️: B. Colposcopy.
---
8. Pt age 35, HPV negative, cytology: NILM. Next Pap interval?
💫RATIONALE✔️✔️: Co-testing q5 years if HPV negative + NILM age 30-65.
💫ANSWER✔️✔️: D. 5 years.
---
9. Pt age 52, postmenopausal, mammogram: BI-RADS 4 (suspicious abnormality). Next step?
💫RATIONALE✔️✔️: BI-RADS 4 requires biopsy (core needle or excisional).
💫ANSWER✔️✔️: A. Core needle biopsy.
---
10. Pt age 60, on tamoxifen for breast cancer. Which endometrial finding requires biopsy?
💫RATIONALE✔️✔️: Tamoxifen increases endometrial cancer risk; any bleeding or thickened lining
(>8mm).
💫ANSWER✔️✔️: C. Endometrial stripe 12 mm.
---
11. Pt age 40, breast lump, mammogram negative. Next step?
💫RATIONALE✔️✔️: Negative mammogram with palpable lump needs ultrasound or biopsy.
💫ANSWER✔️✔️: B. Breast ultrasound.
---
12. Pt age 55, postmenopausal, vaginal dryness, dyspareunia, no contraindication to estrogen. Which
treatment?
💫RATIONALE✔️✔️: Low-dose vaginal estrogen (cream, ring, tablet) safe without systemic progestin.
💫ANSWER✔️✔️: A. Vaginal estrogen cream.
