APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 2026 question and
answers
Question 1
A 52-year-old woman with HER2-positive invasive breast cancer is scheduled to begin
trastuzumab therapy. Which assessment is most important before initiating treatment?
A) Serum calcium level
B) Liver ultrasound
C) Echocardiogram to evaluate left ventricular ejection fraction (LVEF)
D) Pulmonary function testing
Correct Answer: C) Echocardiogram to evaluate left ventricular ejection fraction (LVEF)
Rationale:
Trastuzumab can cause cardiomyopathy. Baseline and periodic assessment of cardiac function
using echocardiography or MUGA scan is recommended.
Question 2
A woman taking trastuzumab reports increasing shortness of breath, fatigue, and ankle swelling.
The nurse practitioner should suspect:
A) Hyperthyroidism
B) Congestive heart failure
C) Nephrotic syndrome
D) Pulmonary embolism
Correct Answer: B) Congestive heart failure
Rationale:
These symptoms suggest trastuzumab-induced cardiotoxicity requiring prompt evaluation.
,APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 2026 question and
answers
Question 3
A 45-year-old woman with ER-positive breast cancer is prescribed tamoxifen. Which adverse
effect requires immediate evaluation?
A) Mild nausea
B) Vaginal bleeding
C) Hot flashes
D) Weight gain
Correct Answer: B) Vaginal bleeding
Rationale:
Tamoxifen increases the risk of endometrial hyperplasia and endometrial cancer. Any abnormal
uterine bleeding warrants prompt evaluation.
Question 4
Tamoxifen acts by:
A) Blocking estrogen receptors in all tissues
B) Stimulating estrogen receptors throughout the body
C) Blocking estrogen receptors in breast tissue while stimulating them in the endometrium
D) Suppressing ovarian function completely
Correct Answer: C) Blocking estrogen receptors in breast tissue while stimulating them in
the endometrium
Rationale:
Tamoxifen is a selective estrogen receptor modulator (SERM).
,APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 2026 question and
answers
Question 5
Which medication is generally preferred for postmenopausal women with hormone receptor-
positive breast cancer?
A) Clomiphene
B) Aromatase inhibitor
C) Medroxyprogesterone
D) Combined oral contraceptive
Correct Answer: B) Aromatase inhibitor
Rationale:
Aromatase inhibitors are commonly preferred in postmenopausal women with ER-positive breast
cancer.
Question 6
Which patient receiving tamoxifen requires immediate medical attention?
A) Mild hot flashes
B) Night sweats
C) Unilateral leg swelling and pain
D) Breast tenderness
Correct Answer: C) Unilateral leg swelling and pain
Rationale:
Tamoxifen increases the risk of deep vein thrombosis and pulmonary embolism.
, APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 2026 question and
answers
Question 7
A patient taking an aromatase inhibitor should be monitored closely for:
A) Hypoglycemia
B) Osteoporosis
C) Renal failure
D) Hyperkalemia
Correct Answer: B) Osteoporosis
Rationale:
Reduced estrogen levels accelerate bone loss.
Question 8
Which finding suggests trastuzumab therapy should be temporarily withheld?
A) Mild nausea
B) Decreased left ventricular ejection fraction
C) Alopecia
D) Dry mouth
Correct Answer: B) Decreased left ventricular ejection fraction
Rationale:
Significant reduction in LVEF increases the risk of heart failure.
& PRACTICE EXAM 2026 question and
answers
Question 1
A 52-year-old woman with HER2-positive invasive breast cancer is scheduled to begin
trastuzumab therapy. Which assessment is most important before initiating treatment?
A) Serum calcium level
B) Liver ultrasound
C) Echocardiogram to evaluate left ventricular ejection fraction (LVEF)
D) Pulmonary function testing
Correct Answer: C) Echocardiogram to evaluate left ventricular ejection fraction (LVEF)
Rationale:
Trastuzumab can cause cardiomyopathy. Baseline and periodic assessment of cardiac function
using echocardiography or MUGA scan is recommended.
Question 2
A woman taking trastuzumab reports increasing shortness of breath, fatigue, and ankle swelling.
The nurse practitioner should suspect:
A) Hyperthyroidism
B) Congestive heart failure
C) Nephrotic syndrome
D) Pulmonary embolism
Correct Answer: B) Congestive heart failure
Rationale:
These symptoms suggest trastuzumab-induced cardiotoxicity requiring prompt evaluation.
,APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 2026 question and
answers
Question 3
A 45-year-old woman with ER-positive breast cancer is prescribed tamoxifen. Which adverse
effect requires immediate evaluation?
A) Mild nausea
B) Vaginal bleeding
C) Hot flashes
D) Weight gain
Correct Answer: B) Vaginal bleeding
Rationale:
Tamoxifen increases the risk of endometrial hyperplasia and endometrial cancer. Any abnormal
uterine bleeding warrants prompt evaluation.
Question 4
Tamoxifen acts by:
A) Blocking estrogen receptors in all tissues
B) Stimulating estrogen receptors throughout the body
C) Blocking estrogen receptors in breast tissue while stimulating them in the endometrium
D) Suppressing ovarian function completely
Correct Answer: C) Blocking estrogen receptors in breast tissue while stimulating them in
the endometrium
Rationale:
Tamoxifen is a selective estrogen receptor modulator (SERM).
,APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 2026 question and
answers
Question 5
Which medication is generally preferred for postmenopausal women with hormone receptor-
positive breast cancer?
A) Clomiphene
B) Aromatase inhibitor
C) Medroxyprogesterone
D) Combined oral contraceptive
Correct Answer: B) Aromatase inhibitor
Rationale:
Aromatase inhibitors are commonly preferred in postmenopausal women with ER-positive breast
cancer.
Question 6
Which patient receiving tamoxifen requires immediate medical attention?
A) Mild hot flashes
B) Night sweats
C) Unilateral leg swelling and pain
D) Breast tenderness
Correct Answer: C) Unilateral leg swelling and pain
Rationale:
Tamoxifen increases the risk of deep vein thrombosis and pulmonary embolism.
, APEA WOMEN'S HEALTH FINAL EXAM
& PRACTICE EXAM 2026 question and
answers
Question 7
A patient taking an aromatase inhibitor should be monitored closely for:
A) Hypoglycemia
B) Osteoporosis
C) Renal failure
D) Hyperkalemia
Correct Answer: B) Osteoporosis
Rationale:
Reduced estrogen levels accelerate bone loss.
Question 8
Which finding suggests trastuzumab therapy should be temporarily withheld?
A) Mild nausea
B) Decreased left ventricular ejection fraction
C) Alopecia
D) Dry mouth
Correct Answer: B) Decreased left ventricular ejection fraction
Rationale:
Significant reduction in LVEF increases the risk of heart failure.
