REGIS NU 665D: PRIMARY CARE ADULT WOMAN II EXAM BANK
(EXAM 1, 2 AND FINAL) PRACTICE EXAM PACKAGE QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES EACH | CURRENTLY
TESTING AND FREQUENTLY TESTED QUESTIONS | GUARANTEED PASS
STUDY GUIDE |EXPERT VERIFIED
TABLE OF CONTENTS
PRACTICE EXAM 1
Section 1: Gynecologic Differentials & Abdominal Pain ................ Q 1–30
Section 2: Vulvovaginal Atrophy & Menopause .......................... Q 31–60
Section 3: PCOS, Androgen Excess & Reproductive Endocrinology ....... Q 61–90
Section 4: Contraception & Reproductive Health ....................... Q 91–120
Section 5: Breast Health, Cancer Screening & Preventive Care ......... Q 121–150
PRACTICE EXAM 2
Section 1: Contraception and Family Planning ......................... Q 1–40
Section 2: Sexually Transmitted Infections ........................... Q 41–80
Section 3: Abnormal Uterine Bleeding and Menopause ................... Q 81–120
Section 4: Breast Disorders and Cancer Screening ..................... Q 121–150
PRACTICE FINAL EXAM
Section 1: Comprehensive Gynecology .................................. Q 1–40
Section 2: Contraception and Sexually Transmitted Infections ......... Q 41–80
Section 3: Breast Disorders, Cancer Screening & Preventive Care ...... Q 81–120
Section 4: Integrative and Clinical Reasoning ........................ Q 121–150
EXAM 1
SECTION 1: GYNECOLOGIC DIFFERENTIALS & ABDOMINAL PAIN (Questions 1–30)
1. A 34-year-old woman presents with acute right lower quadrant pain. Which of
the following gynecologic differentials should be considered FIRST?
A) Appendicitis
B) Diverticulitis
C) Crohn's disease
1
,D) Ovarian torsion
Answer: D
Rationale: Ovarian torsion is a gynecologic emergency that must be ruled out
immediately in any woman presenting with acute pelvic pain. While appendicitis
is a common non-gynecologic cause of RLQ pain, ovarian torsion is a critical
gynecologic emergency that can result in loss of the ovary if not diagnosed and
treated promptly. Ovarian torsion presents with sudden, severe, unilateral pelvic
pain, often with nausea and vomiting. Diverticulitis and Crohn's disease are
gastrointestinal conditions that typically present with LLQ pain and systemic
symptoms, respectively.
2. A patient presents with abdominal pain. Which of the following questions is
MOST important for differentiating gynecologic from gastrointestinal causes?
A) "What did you eat before the pain started?"
B) "When was your last menstrual period?"
C) "Do you have a family history of colon cancer?"
D) "Have you recently traveled internationally?"
Answer: B
Rationale: Asking about the last menstrual period (LMP) is critical in any woman
of reproductive age presenting with abdominal pain. It helps determine if the
patient could be pregnant, which significantly changes the differential diagnosis
and urgency of care. A positive pregnancy test in a patient with abdominal pain
raises concern for ectopic pregnancy, a life-threatening condition. While dietary
history and travel are relevant for gastrointestinal causes, LMP is the most
essential initial question for gynecologic differentiation.
3. A 28-year-old woman presents with pelvic pain, fever, and purulent vaginal
discharge. Which diagnosis should be HIGH on the differential?
A) Endometriosis
B) Pelvic inflammatory disease (PID)
C) Ovarian cyst
D) Uterine fibroids
2
,Answer: B
Rationale: The triad of pelvic pain, fever, and purulent cervical/vaginal discharge
is highly suggestive of pelvic inflammatory disease (PID). PID is typically caused by
ascending infection from sexually transmitted pathogens such as Chlamydia
trachomatis and Neisseria gonorrhoeae. Prompt diagnosis and treatment are
essential to prevent complications including tubo-ovarian abscess, infertility, and
chronic pelvic pain. Endometriosis typically presents with cyclic pain and
dysmenorrhea, not fever and purulent discharge. Ovarian cysts and fibroids do
not typically cause fever.
4. Which diagnostic test is MOST appropriate for a reproductive-age woman
presenting with pelvic pain and a positive urine pregnancy test?
A) CT scan of the abdomen and pelvis
B) Transvaginal ultrasound
C) MRI of the pelvis
D) Diagnostic laparoscopy
Answer: B
Rationale: Transvaginal ultrasound is the first-line imaging modality for a pregnant
patient with pelvic pain. It can confirm intrauterine pregnancy, detect ectopic
pregnancy, and evaluate for ovarian cysts, masses, or free fluid in the pelvis. CT
scanning is generally avoided in pregnancy due to radiation exposure. MRI may be
used as a secondary modality if ultrasound is inconclusive. Laparoscopy is invasive
and reserved for surgical emergencies or when imaging is non-diagnostic.
5. A 42-year-old woman presents with chronic pelvic pain that worsens during
menstruation. She also reports dyspareunia and infertility. Which diagnosis is
MOST likely?
A) Endometriosis
B) Uterine fibroids
C) Polycystic ovary syndrome (PCOS)
D) Chronic pelvic inflammatory disease
Answer: A
Rationale: The classic triad of endometriosis is dysmenorrhea, dyspareunia, and
infertility. Endometriosis is a chronic gynecologic condition in which endometrial-
like tissue grows outside the uterus, causing inflammation, scarring, and pain.
3
, Symptoms typically worsen during menstruation because the ectopic tissue
responds to hormonal fluctuations. Uterine fibroids can cause heavy bleeding and
pelvic pressure but are less strongly associated with dyspareunia and infertility.
PCOS presents with irregular cycles, hirsutism, and metabolic features. PID is
typically acute, not chronic.
6. What is the gold standard for diagnosing endometriosis?
A) Transvaginal ultrasound
B) MRI of the pelvis
C) Laparoscopy with biopsy
D) CA-125 blood test
Answer: C
Rationale: Laparoscopy with direct visualization and biopsy of endometriotic
implants is the gold standard for diagnosing endometriosis. Direct visualization
allows the clinician to see the characteristic "powder burn" or "chocolate" lesions,
and biopsy provides histologic confirmation. Ultrasound and MRI may suggest
endometriosis but cannot definitively diagnose it. CA-125 is elevated in some
cases of endometriosis but is not specific or diagnostic.
7. A patient presents with sudden-onset, severe, unilateral pelvic pain and
nausea. Ultrasound shows an enlarged ovary with decreased Doppler flow. What
is the MOST likely diagnosis?
A) Ruptured ovarian cyst
B) Ovarian torsion
C) Ectopic pregnancy
D) Acute appendicitis
Answer: B
Rationale: Ovarian torsion presents with sudden, severe, unilateral pelvic pain,
often accompanied by nausea and vomiting. Ultrasound findings include an
enlarged, edematous ovary with decreased or absent Doppler flow, indicating
compromised blood supply. This is a surgical emergency requiring detorsion to
preserve ovarian function. A ruptured ovarian cyst would show free fluid in the
pelvis. Ectopic pregnancy would be associated with a positive pregnancy test and
adnexal mass. Appendicitis presents with RLQ pain and periumbilical migration.
4
(EXAM 1, 2 AND FINAL) PRACTICE EXAM PACKAGE QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES EACH | CURRENTLY
TESTING AND FREQUENTLY TESTED QUESTIONS | GUARANTEED PASS
STUDY GUIDE |EXPERT VERIFIED
TABLE OF CONTENTS
PRACTICE EXAM 1
Section 1: Gynecologic Differentials & Abdominal Pain ................ Q 1–30
Section 2: Vulvovaginal Atrophy & Menopause .......................... Q 31–60
Section 3: PCOS, Androgen Excess & Reproductive Endocrinology ....... Q 61–90
Section 4: Contraception & Reproductive Health ....................... Q 91–120
Section 5: Breast Health, Cancer Screening & Preventive Care ......... Q 121–150
PRACTICE EXAM 2
Section 1: Contraception and Family Planning ......................... Q 1–40
Section 2: Sexually Transmitted Infections ........................... Q 41–80
Section 3: Abnormal Uterine Bleeding and Menopause ................... Q 81–120
Section 4: Breast Disorders and Cancer Screening ..................... Q 121–150
PRACTICE FINAL EXAM
Section 1: Comprehensive Gynecology .................................. Q 1–40
Section 2: Contraception and Sexually Transmitted Infections ......... Q 41–80
Section 3: Breast Disorders, Cancer Screening & Preventive Care ...... Q 81–120
Section 4: Integrative and Clinical Reasoning ........................ Q 121–150
EXAM 1
SECTION 1: GYNECOLOGIC DIFFERENTIALS & ABDOMINAL PAIN (Questions 1–30)
1. A 34-year-old woman presents with acute right lower quadrant pain. Which of
the following gynecologic differentials should be considered FIRST?
A) Appendicitis
B) Diverticulitis
C) Crohn's disease
1
,D) Ovarian torsion
Answer: D
Rationale: Ovarian torsion is a gynecologic emergency that must be ruled out
immediately in any woman presenting with acute pelvic pain. While appendicitis
is a common non-gynecologic cause of RLQ pain, ovarian torsion is a critical
gynecologic emergency that can result in loss of the ovary if not diagnosed and
treated promptly. Ovarian torsion presents with sudden, severe, unilateral pelvic
pain, often with nausea and vomiting. Diverticulitis and Crohn's disease are
gastrointestinal conditions that typically present with LLQ pain and systemic
symptoms, respectively.
2. A patient presents with abdominal pain. Which of the following questions is
MOST important for differentiating gynecologic from gastrointestinal causes?
A) "What did you eat before the pain started?"
B) "When was your last menstrual period?"
C) "Do you have a family history of colon cancer?"
D) "Have you recently traveled internationally?"
Answer: B
Rationale: Asking about the last menstrual period (LMP) is critical in any woman
of reproductive age presenting with abdominal pain. It helps determine if the
patient could be pregnant, which significantly changes the differential diagnosis
and urgency of care. A positive pregnancy test in a patient with abdominal pain
raises concern for ectopic pregnancy, a life-threatening condition. While dietary
history and travel are relevant for gastrointestinal causes, LMP is the most
essential initial question for gynecologic differentiation.
3. A 28-year-old woman presents with pelvic pain, fever, and purulent vaginal
discharge. Which diagnosis should be HIGH on the differential?
A) Endometriosis
B) Pelvic inflammatory disease (PID)
C) Ovarian cyst
D) Uterine fibroids
2
,Answer: B
Rationale: The triad of pelvic pain, fever, and purulent cervical/vaginal discharge
is highly suggestive of pelvic inflammatory disease (PID). PID is typically caused by
ascending infection from sexually transmitted pathogens such as Chlamydia
trachomatis and Neisseria gonorrhoeae. Prompt diagnosis and treatment are
essential to prevent complications including tubo-ovarian abscess, infertility, and
chronic pelvic pain. Endometriosis typically presents with cyclic pain and
dysmenorrhea, not fever and purulent discharge. Ovarian cysts and fibroids do
not typically cause fever.
4. Which diagnostic test is MOST appropriate for a reproductive-age woman
presenting with pelvic pain and a positive urine pregnancy test?
A) CT scan of the abdomen and pelvis
B) Transvaginal ultrasound
C) MRI of the pelvis
D) Diagnostic laparoscopy
Answer: B
Rationale: Transvaginal ultrasound is the first-line imaging modality for a pregnant
patient with pelvic pain. It can confirm intrauterine pregnancy, detect ectopic
pregnancy, and evaluate for ovarian cysts, masses, or free fluid in the pelvis. CT
scanning is generally avoided in pregnancy due to radiation exposure. MRI may be
used as a secondary modality if ultrasound is inconclusive. Laparoscopy is invasive
and reserved for surgical emergencies or when imaging is non-diagnostic.
5. A 42-year-old woman presents with chronic pelvic pain that worsens during
menstruation. She also reports dyspareunia and infertility. Which diagnosis is
MOST likely?
A) Endometriosis
B) Uterine fibroids
C) Polycystic ovary syndrome (PCOS)
D) Chronic pelvic inflammatory disease
Answer: A
Rationale: The classic triad of endometriosis is dysmenorrhea, dyspareunia, and
infertility. Endometriosis is a chronic gynecologic condition in which endometrial-
like tissue grows outside the uterus, causing inflammation, scarring, and pain.
3
, Symptoms typically worsen during menstruation because the ectopic tissue
responds to hormonal fluctuations. Uterine fibroids can cause heavy bleeding and
pelvic pressure but are less strongly associated with dyspareunia and infertility.
PCOS presents with irregular cycles, hirsutism, and metabolic features. PID is
typically acute, not chronic.
6. What is the gold standard for diagnosing endometriosis?
A) Transvaginal ultrasound
B) MRI of the pelvis
C) Laparoscopy with biopsy
D) CA-125 blood test
Answer: C
Rationale: Laparoscopy with direct visualization and biopsy of endometriotic
implants is the gold standard for diagnosing endometriosis. Direct visualization
allows the clinician to see the characteristic "powder burn" or "chocolate" lesions,
and biopsy provides histologic confirmation. Ultrasound and MRI may suggest
endometriosis but cannot definitively diagnose it. CA-125 is elevated in some
cases of endometriosis but is not specific or diagnostic.
7. A patient presents with sudden-onset, severe, unilateral pelvic pain and
nausea. Ultrasound shows an enlarged ovary with decreased Doppler flow. What
is the MOST likely diagnosis?
A) Ruptured ovarian cyst
B) Ovarian torsion
C) Ectopic pregnancy
D) Acute appendicitis
Answer: B
Rationale: Ovarian torsion presents with sudden, severe, unilateral pelvic pain,
often accompanied by nausea and vomiting. Ultrasound findings include an
enlarged, edematous ovary with decreased or absent Doppler flow, indicating
compromised blood supply. This is a surgical emergency requiring detorsion to
preserve ovarian function. A ruptured ovarian cyst would show free fluid in the
pelvis. Ectopic pregnancy would be associated with a positive pregnancy test and
adnexal mass. Appendicitis presents with RLQ pain and periumbilical migration.
4
