Walden University NRNP 6552 Midterm Exam (pdf) | 2026/2027 |
Women's Health Q&A | Advanced Practice Nursing
**1. Sheila is pregnant and fearful of getting cervical cancer as her sister
recently did. She asks about receiving the HPV vaccine. How do you
respond?**
A) "As long as you're in your first trimester, the HPV vaccine is safe and
effective."
B) "Research has not shown this vaccine to be effective against preventing
cervical cancer."
C) "After the age of 20, the HPV vaccine is not recommended."
D) "You should not receive the vaccination when you are pregnant."
**Correct Answer: D**
**Rationale:** The HPV vaccine is not recommended during pregnancy. If a
woman is found to be pregnant, she should delay vaccination until after
delivery. There is no evidence of harm to the fetus from inadvertent
administration, but it is contraindicated intentionally during pregnancy.
---
**2. Jack and Jill present for a preconception health counseling session. Jack
is 34, Jill is 33, and they have a 5-year-old son, Jake. Jake has spina bifida
with a loss of function of his lower extremities. Jack and Jill want another
child and ask if there is anything they can do to prevent the recurrence of a
neural tube defect in future pregnancies. What is your best response?**
A) "Jill should take 60 mg/day of an iron supplement to enhance stores to
support fetal development."
B) "It is a matter of genetics, and there is nothing you can do."
,C) "Have a CVS performed at 12 to 14 weeks gestation to determine the
health of the fetus."
D) "Jill should take 4 mg/day of folic acid, beginning before conception."
**Correct Answer: D**
**Rationale:** Women with a previous pregnancy affected by a neural tube
defect should take a high-dose folic acid supplement (4 mg/day) beginning at
least one month before conception and continuing through the first trimester.
This dose is significantly higher than the standard 0.4 mg/day
recommendation for the general population.
---
**3. Aida, who is 29 weeks pregnant, received a blunt trauma to the
abdomen during an argument with her boyfriend. She has no obvious injuries
and denies pain. Aida needs to be monitored for the occurrence of:**
A) Abruptio placentae
B) Liver hemorrhage
C) Ruptured spleen
D) Placenta previa
**Correct Answer: A**
**Rationale:** Abruptio placentae (placental abruption) is a serious
complication that can occur following blunt abdominal trauma during
pregnancy. The trauma can cause shearing forces that separate the placenta
from the uterine wall, leading to bleeding and potential fetal distress. Even
without obvious injuries or pain, monitoring for placental abruption is
essential.
,---
**4. A 14-year-old appears with tender discoid breast tissue enlargement (2–
3 cm in diameter) beneath the areola. What is your next action?**
A) Perform watchful waiting for 1 year
B) Order a mammogram
C) Refer to a surgeon
D) Order an ultrasound
**Correct Answer: A**
**Rationale:** This presentation is consistent with gynecomastia, which is
common in adolescent males. It is usually benign and self-limited, typically
resolving within 6–12 months. Watchful waiting with reassurance is the
appropriate management unless there are concerning features (rapid growth,
asymmetry, or significant tenderness).
---
**5. The first sign of the onset of female puberty is usually:**
A) Menarche
B) Breast buds (thelarche)
C) Pubic hair growth (pubarche)
D) Growth spurt
, **Correct Answer: B**
**Rationale:** The first sign of female puberty is usually breast development
(thelarche), which typically occurs between ages 8 and 13. This is followed
by pubic hair growth, the growth spurt, and menarche (which occurs
approximately 2–2.5 years after breast budding).
---
**6. A small for gestational age, dysmorphic newborn infant has
microcephaly and sloping forehead, cutis aplasia (missing portion of the skin
and hair) of the scalp, polydactyly, microphthalmia, and omphalocele. Which
is the most likely diagnosis?**
A) Down syndrome (trisomy 21)
B) Edwards syndrome (trisomy 18)
C) Patau syndrome (trisomy 13)
D) Turner syndrome
**Correct Answer: C**
**Rationale:** Patau syndrome (trisomy 13) is characterized by severe
microcephaly, sloping forehead, cutis aplasia of the scalp, polydactyly,
microphthalmia, and omphalocele. These findings are classic for trisomy 13,
which has a very poor prognosis with most infants not surviving beyond the
first year of life.
---
Women's Health Q&A | Advanced Practice Nursing
**1. Sheila is pregnant and fearful of getting cervical cancer as her sister
recently did. She asks about receiving the HPV vaccine. How do you
respond?**
A) "As long as you're in your first trimester, the HPV vaccine is safe and
effective."
B) "Research has not shown this vaccine to be effective against preventing
cervical cancer."
C) "After the age of 20, the HPV vaccine is not recommended."
D) "You should not receive the vaccination when you are pregnant."
**Correct Answer: D**
**Rationale:** The HPV vaccine is not recommended during pregnancy. If a
woman is found to be pregnant, she should delay vaccination until after
delivery. There is no evidence of harm to the fetus from inadvertent
administration, but it is contraindicated intentionally during pregnancy.
---
**2. Jack and Jill present for a preconception health counseling session. Jack
is 34, Jill is 33, and they have a 5-year-old son, Jake. Jake has spina bifida
with a loss of function of his lower extremities. Jack and Jill want another
child and ask if there is anything they can do to prevent the recurrence of a
neural tube defect in future pregnancies. What is your best response?**
A) "Jill should take 60 mg/day of an iron supplement to enhance stores to
support fetal development."
B) "It is a matter of genetics, and there is nothing you can do."
,C) "Have a CVS performed at 12 to 14 weeks gestation to determine the
health of the fetus."
D) "Jill should take 4 mg/day of folic acid, beginning before conception."
**Correct Answer: D**
**Rationale:** Women with a previous pregnancy affected by a neural tube
defect should take a high-dose folic acid supplement (4 mg/day) beginning at
least one month before conception and continuing through the first trimester.
This dose is significantly higher than the standard 0.4 mg/day
recommendation for the general population.
---
**3. Aida, who is 29 weeks pregnant, received a blunt trauma to the
abdomen during an argument with her boyfriend. She has no obvious injuries
and denies pain. Aida needs to be monitored for the occurrence of:**
A) Abruptio placentae
B) Liver hemorrhage
C) Ruptured spleen
D) Placenta previa
**Correct Answer: A**
**Rationale:** Abruptio placentae (placental abruption) is a serious
complication that can occur following blunt abdominal trauma during
pregnancy. The trauma can cause shearing forces that separate the placenta
from the uterine wall, leading to bleeding and potential fetal distress. Even
without obvious injuries or pain, monitoring for placental abruption is
essential.
,---
**4. A 14-year-old appears with tender discoid breast tissue enlargement (2–
3 cm in diameter) beneath the areola. What is your next action?**
A) Perform watchful waiting for 1 year
B) Order a mammogram
C) Refer to a surgeon
D) Order an ultrasound
**Correct Answer: A**
**Rationale:** This presentation is consistent with gynecomastia, which is
common in adolescent males. It is usually benign and self-limited, typically
resolving within 6–12 months. Watchful waiting with reassurance is the
appropriate management unless there are concerning features (rapid growth,
asymmetry, or significant tenderness).
---
**5. The first sign of the onset of female puberty is usually:**
A) Menarche
B) Breast buds (thelarche)
C) Pubic hair growth (pubarche)
D) Growth spurt
, **Correct Answer: B**
**Rationale:** The first sign of female puberty is usually breast development
(thelarche), which typically occurs between ages 8 and 13. This is followed
by pubic hair growth, the growth spurt, and menarche (which occurs
approximately 2–2.5 years after breast budding).
---
**6. A small for gestational age, dysmorphic newborn infant has
microcephaly and sloping forehead, cutis aplasia (missing portion of the skin
and hair) of the scalp, polydactyly, microphthalmia, and omphalocele. Which
is the most likely diagnosis?**
A) Down syndrome (trisomy 21)
B) Edwards syndrome (trisomy 18)
C) Patau syndrome (trisomy 13)
D) Turner syndrome
**Correct Answer: C**
**Rationale:** Patau syndrome (trisomy 13) is characterized by severe
microcephaly, sloping forehead, cutis aplasia of the scalp, polydactyly,
microphthalmia, and omphalocele. These findings are classic for trisomy 13,
which has a very poor prognosis with most infants not surviving beyond the
first year of life.
---
