2026/2027 PRACTICE QUESTIONS ACCURATE EXAM
COMPLETE REAL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) CURRENTLY UPDATED VERSION 2026
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1. A 32-year-old pregnant client at 10 weeks gestation is taking
carbamazepine for a seizure disorder. The nurse practitioner should
counsel her that this medication is associated with which fetal risk?
A. Fetal alcohol syndrome
B. Neural tube defects
C. Cardiac anomalies
D. Limb reduction defects
CORRECT ANSWER: B. Neural tube defects
Rationale: Carbamazepine is a known teratogen associated with an
increased risk of neural tube defects when used during pregnancy.
Women taking carbamazepine should be counseled about this risk
and advised to take high-dose folic acid (4 mg daily)
preconceptionally and during early pregnancy to reduce the risk.
,2. Sheila is pregnant and fearful of getting cervical cancer as her
sister recently did. She asks about receiving the HPV vaccine. How
should the nurse practitioner respond?
A. "As long as you're in your first trimester, the HPV vaccine is safe
and effective."
B. "The HPV vaccine is contraindicated during pregnancy, so we
will need to wait until after you deliver."
C. "You can receive the HPV vaccine at any point during pregnancy;
it is category B."
D. "The HPV vaccine is only recommended for women under age
26, regardless of pregnancy status."
CORRECT ANSWER: B. The HPV vaccine is contraindicated
during pregnancy, so we will need to wait until after you deliver.
Rationale: The HPV vaccine is not recommended during pregnancy.
If a woman is found to be pregnant after initiating the vaccine series,
the remaining doses should be delayed until after pregnancy.
However, pregnancy testing is not required before vaccination. The
vaccine can be given to women up to age 45 based on shared clinical
decision-making.
3. A 28-year-old woman presents with complaints of heavy
menstrual bleeding, pelvic pain, and dysmenorrhea. She has a
history of multiple sexual partners. Which of the following is the
most likely diagnosis?
,A. Endometriosis
B. Pelvic inflammatory disease
C. Polycystic ovary syndrome
D. Uterine fibroids
CORRECT ANSWER: B. Pelvic inflammatory disease
Rationale: Pelvic inflammatory disease (PID) is an infection of the
upper female genital tract that commonly presents with pelvic pain,
abnormal vaginal discharge, and heavy menstrual bleeding. Risk
factors include multiple sexual partners and a history of sexually
transmitted infections. Endometriosis typically presents with
progressive dysmenorrhea and infertility. PCOS presents with
oligomenorrhea and signs of hyperandrogenism. Uterine fibroids can
cause heavy bleeding but are less commonly associated with pelvic
pain and multiple sexual partners.
4. A 45-year-old perimenopausal woman reports hot flashes, night
sweats, and mood swings. She is interested in hormone therapy.
Which of the following is the most appropriate initial step before
prescribing hormone therapy?
A. Prescribe a low-dose estrogen patch immediately
B. Order a baseline mammogram and assess cardiovascular risk
C. Recommend black cohosh as first-line therapy
, D. Order serum FSH and LH levels to confirm menopause
CORRECT ANSWER: B. Order a baseline mammogram and assess
cardiovascular risk
Rationale: Before initiating hormone therapy, it is essential to assess
the patient's cardiovascular risk, perform a baseline mammogram,
and evaluate for contraindications such as history of breast cancer,
thromboembolic disease, or liver disease. Serum FSH and LH levels
are not required for diagnosis in women over 45 with typical
symptoms. Black cohosh may be considered for symptom relief but is
not first-line therapy.
5. A 24-year-old woman presents for her annual well-woman exam.
She reports she is sexually active with one male partner and uses
condoms inconsistently. She has never had a Pap smear. What is the
appropriate cervical cancer screening recommendation for this
patient?
A. Initiate Pap smear at age 21, so she should have one today
B. Initiate Pap smear at age 25, so no screening is needed today
C. Initiate Pap smear at age 30 with HPV co-testing
D. No Pap smear is needed until age 30 if she has no symptoms
CORRECT ANSWER: A. Initiate Pap smear at age 21, so she
should have one today