Walden University NRNP 6551 Midterm (pdf) | 2026/2027 | Primary
Care Women | Women's Health
**1. A 35-year-old woman presents with vaginal discharge that is thin,
grayish-white, and has a fishy odor. She reports no itching or burning. Which
of the following is the most likely diagnosis?**
A) Candidiasis
B) Trichomoniasis
C) Bacterial vaginosis
D) Atrophic vaginitis
**Correct Answer: C**
**Rationale:** Bacterial vaginosis (BV) is characterized by a thin, grayish-
white vaginal discharge with a fishy odor. It is the most common cause of
vaginitis in women of reproductive age. Unlike candidiasis, BV typically does
not cause itching or burning. Trichomoniasis often presents with a frothy,
yellow-green discharge and itching.
---
**2. A 28-year-old woman has been diagnosed with bacterial vaginosis.
Which of the following is the first-line treatment for bacterial vaginosis?**
A) Fluconazole 150 mg PO single dose
B) Metronidazole 500 mg PO BID for 7 days
C) Clindamycin 2% vaginal cream nightly for 7 days
D) Doxycycline 100 mg PO BID for 7 days
,**Correct Answer: B**
**Rationale:** Metronidazole 500 mg PO BID for 7 days is a first-line
treatment for bacterial vaginosis. Alternative regimens include metronidazole
gel 0.75% intravaginally once daily for 5 days, or clindamycin cream 2%
intravaginally at bedtime for 7 days. Fluconazole is used for candidiasis, and
doxycycline is not a first-line treatment for BV.
---
**3. How does vaginosis differ from vaginitis?**
A) It must be treated with metronidazole.
B) The discharge does not contain white blood cells.
C) The discharge does not have an odor.
D) It causes itching and/or burning.
**Correct Answer: B**
**Rationale:** In bacterial vaginosis, the discharge typically does not contain
white blood cells (polymorphonuclear leukocytes), whereas vaginitis often
involves an inflammatory response with white blood cells present. Bacterial
vaginosis is characterized by a fishy odor and thin discharge, while vaginitis
(e.g., candidiasis, trichomoniasis) often causes itching, burning, and
inflammation.
---
**4. Approximately what percentage of women with bacterial vaginosis are
asymptomatic?**
,A) 25%
B) 40%
C) 50%
D) 75%
**Correct Answer: C**
**Rationale:** Approximately 50% of women with bacterial vaginosis are
asymptomatic. Symptomatic women typically present with a thin, grayish-
white vaginal discharge with a fishy odor.
---
**5. What is now thought to be the most important causative agent in
cervical cancer?**
A) PCOS
B) Vulvar cancer
C) Herpes simplex
D) HPV
**Correct Answer: D**
**Rationale:** Human papillomavirus (HPV) is now recognized as the most
important causative agent in cervical cancer. Persistent infection with high-
risk HPV types, particularly HPV 16 and 18, is responsible for the majority of
cervical cancer cases. Routine HPV vaccination and cervical cancer screening
are key prevention strategies.
, ---
**6. A 25-year-old woman presents with painful genital ulcers and tender
inguinal lymphadenopathy. She reports the lesions appeared 3 days ago.
Which of the following is the most likely diagnosis?**
A) Syphilis
B) Genital herpes (HSV-2)
C) Chancroid
D) Lymphogranuloma venereum
**Correct Answer: B**
**Rationale:** Painful genital ulcers with tender inguinal lymphadenopathy
are characteristic of a primary genital herpes infection. The lesions typically
appear as grouped vesicles that ulcerate. An initial or primary genital herpes
infection characteristically lasts about 3 weeks. Syphilis typically presents
with a painless ulcer (chancre).
---
**7. BRCA1 and BRCA2 genetic mutations account for 5 to 10 percent of all
cancer cases. Which type of cancer is most associated with these mutations?
**
A) Breast
B) Ovarian
C) Uterine
Care Women | Women's Health
**1. A 35-year-old woman presents with vaginal discharge that is thin,
grayish-white, and has a fishy odor. She reports no itching or burning. Which
of the following is the most likely diagnosis?**
A) Candidiasis
B) Trichomoniasis
C) Bacterial vaginosis
D) Atrophic vaginitis
**Correct Answer: C**
**Rationale:** Bacterial vaginosis (BV) is characterized by a thin, grayish-
white vaginal discharge with a fishy odor. It is the most common cause of
vaginitis in women of reproductive age. Unlike candidiasis, BV typically does
not cause itching or burning. Trichomoniasis often presents with a frothy,
yellow-green discharge and itching.
---
**2. A 28-year-old woman has been diagnosed with bacterial vaginosis.
Which of the following is the first-line treatment for bacterial vaginosis?**
A) Fluconazole 150 mg PO single dose
B) Metronidazole 500 mg PO BID for 7 days
C) Clindamycin 2% vaginal cream nightly for 7 days
D) Doxycycline 100 mg PO BID for 7 days
,**Correct Answer: B**
**Rationale:** Metronidazole 500 mg PO BID for 7 days is a first-line
treatment for bacterial vaginosis. Alternative regimens include metronidazole
gel 0.75% intravaginally once daily for 5 days, or clindamycin cream 2%
intravaginally at bedtime for 7 days. Fluconazole is used for candidiasis, and
doxycycline is not a first-line treatment for BV.
---
**3. How does vaginosis differ from vaginitis?**
A) It must be treated with metronidazole.
B) The discharge does not contain white blood cells.
C) The discharge does not have an odor.
D) It causes itching and/or burning.
**Correct Answer: B**
**Rationale:** In bacterial vaginosis, the discharge typically does not contain
white blood cells (polymorphonuclear leukocytes), whereas vaginitis often
involves an inflammatory response with white blood cells present. Bacterial
vaginosis is characterized by a fishy odor and thin discharge, while vaginitis
(e.g., candidiasis, trichomoniasis) often causes itching, burning, and
inflammation.
---
**4. Approximately what percentage of women with bacterial vaginosis are
asymptomatic?**
,A) 25%
B) 40%
C) 50%
D) 75%
**Correct Answer: C**
**Rationale:** Approximately 50% of women with bacterial vaginosis are
asymptomatic. Symptomatic women typically present with a thin, grayish-
white vaginal discharge with a fishy odor.
---
**5. What is now thought to be the most important causative agent in
cervical cancer?**
A) PCOS
B) Vulvar cancer
C) Herpes simplex
D) HPV
**Correct Answer: D**
**Rationale:** Human papillomavirus (HPV) is now recognized as the most
important causative agent in cervical cancer. Persistent infection with high-
risk HPV types, particularly HPV 16 and 18, is responsible for the majority of
cervical cancer cases. Routine HPV vaccination and cervical cancer screening
are key prevention strategies.
, ---
**6. A 25-year-old woman presents with painful genital ulcers and tender
inguinal lymphadenopathy. She reports the lesions appeared 3 days ago.
Which of the following is the most likely diagnosis?**
A) Syphilis
B) Genital herpes (HSV-2)
C) Chancroid
D) Lymphogranuloma venereum
**Correct Answer: B**
**Rationale:** Painful genital ulcers with tender inguinal lymphadenopathy
are characteristic of a primary genital herpes infection. The lesions typically
appear as grouped vesicles that ulcerate. An initial or primary genital herpes
infection characteristically lasts about 3 weeks. Syphilis typically presents
with a painless ulcer (chancre).
---
**7. BRCA1 and BRCA2 genetic mutations account for 5 to 10 percent of all
cancer cases. Which type of cancer is most associated with these mutations?
**
A) Breast
B) Ovarian
C) Uterine
