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APEA Women's Health Final Exam Practice Test (100 Questions)
Based on the APEA Women's Health exam blueprint, the following 100 practice questions
cover all major domains: reproductive anatomy and physiology, contraception, menstrual
disorders, PCOS, gynecologic infections, STIs, breast health, cervical screening, obstetric
care, and menopause.
Section 1: Reproductive Anatomy, Physiology & Contraception (Questions 1–20)
1. A 24-year-old patient asks about the timing of ovulation. Which hormone surge triggers
the release of the mature oocyte from the dominant follicle?
A. Estrogen peak on day 7
B. Luteinizing hormone (LH) surge approximately 24–36 hours before ovulation
C. Progesterone peak during the luteal phase
D. Follicle-stimulating hormone (FSH) surge during menses
Answer: B
2. A patient with primary amenorrhea has normal breast development but no pubic or
axillary hair. Which enzyme deficiency should be suspected?
A. 21-hydroxylase deficiency
B. 5-alpha-reductase deficiency
C. Androgen insensitivity syndrome
D. Aromatase deficiency
Answer: C
3. During a pelvic examination, a firm, muscular structure is palpated between the bladder
and rectum. This structure is the:
A. Broad ligament
B. Cardinal ligament
C. Uterus
D. Uterosacral ligament
Answer: C
4. Which statement most accurately describes the function of the fallopian tubes?
A. Secrete progesterone
B. Site of fertilization and transport of the early embryo to the uterus
C. Store mature oocytes
D. Secrete cervical mucus
Answer: B
5. Which layer of the uterus is responsible for cyclic shedding during menstruation?
A. Myometrium
B. Serosa
,2
C. Endometrium (functional layer)
D. Basal layer
Answer: C
6. A patient reports cyclic breast tenderness. Luteal-phase breast changes are primarily
caused by which hormones?
A. Estrogen alone
B. Progesterone alone
C. Estrogen and progesterone stimulating lobuloalveolar proliferation
D. Prolactin and oxytocin
Answer: C
7. The primary source of circulating estrogen in premenopausal women is:
A. Adrenal cortex
B. Ovarian theca and granulosa cells
C. Adipose tissue
D. Pituitary gland
Answer: B
8. Which cervical mucus characteristic is consistent with the ovulatory phase?
A. Thick, opaque, and sticky
B. Clear, spinnbarkeit, watery with ferning
C. Absent or scanty
D. Blood-tinged or brown
Answer: B
9. A 28-year-old woman is diagnosed with PCOS. What is the first-line pharmacologic
treatment for hirsutism?
A. Spironolactone 100 mg/day
B. Combined oral contraceptives
C. Metformin 500 mg twice daily
D. Eflornithine cream twice daily
Answer: B
10. A 45-year-old woman with a history of venous thromboembolism (VTE) requests
hormonal contraception. Which method is absolutely contraindicated?
A. Levonorgestrel IUD
B. Etonogestrel subdermal implant
C. Combined oral contraceptives
D. Depot medroxyprogesterone acetate injection
Answer: C
11. A patient on combined oral contraceptives reports new-onset migraine with aura.
According to the U.S. MEC, what is the correct recommendation?
, 3
A. Continue COCs and prescribe triptans
B. Switch to a progestin-only pill
C. Increase estrogen dose
D. No adjustment needed
Answer: B
12. A 26-year-old woman has a history of migraines with visual scintillations and
temporary blind spots. According to CDC MEC, the most appropriate contraceptive
recommendation is:
A. Combined oral contraceptives
B. Contraceptive patch
C. Depot medroxyprogesterone acetate injection
D. Vaginal contraceptive ring
Answer: C
13. Depot medroxyprogesterone acetate (Depo-Provera) is administered at least every:
A. 4 weeks
B. 8 weeks
C. 10 weeks
D. 12 weeks
Answer: D
14. A patient taking oral contraceptives does NOT need backup contraception when taking
which of the following medications?
A. Ampicillin
B. Ketoconazole
C. Phenytoin
D. Metformin
Answer: D
15. A patient asks about cervical mucus changes during the menstrual cycle. Which
description is consistent with ovulatory mucus?
A. Thick, opaque, sticky
B. Clear, spinnbarkeit, watery with ferning
C. Absent or scanty
D. Blood-tinged
Answer: B
16. A 32-year-old woman with PCOS and insulin resistance is seeking a second-line agent
to improve ovulation. Which medication is most appropriate?
A. Clomiphene
B. Letrozole
C. Metformin
APEA Women's Health Final Exam Practice Test (100 Questions)
Based on the APEA Women's Health exam blueprint, the following 100 practice questions
cover all major domains: reproductive anatomy and physiology, contraception, menstrual
disorders, PCOS, gynecologic infections, STIs, breast health, cervical screening, obstetric
care, and menopause.
Section 1: Reproductive Anatomy, Physiology & Contraception (Questions 1–20)
1. A 24-year-old patient asks about the timing of ovulation. Which hormone surge triggers
the release of the mature oocyte from the dominant follicle?
A. Estrogen peak on day 7
B. Luteinizing hormone (LH) surge approximately 24–36 hours before ovulation
C. Progesterone peak during the luteal phase
D. Follicle-stimulating hormone (FSH) surge during menses
Answer: B
2. A patient with primary amenorrhea has normal breast development but no pubic or
axillary hair. Which enzyme deficiency should be suspected?
A. 21-hydroxylase deficiency
B. 5-alpha-reductase deficiency
C. Androgen insensitivity syndrome
D. Aromatase deficiency
Answer: C
3. During a pelvic examination, a firm, muscular structure is palpated between the bladder
and rectum. This structure is the:
A. Broad ligament
B. Cardinal ligament
C. Uterus
D. Uterosacral ligament
Answer: C
4. Which statement most accurately describes the function of the fallopian tubes?
A. Secrete progesterone
B. Site of fertilization and transport of the early embryo to the uterus
C. Store mature oocytes
D. Secrete cervical mucus
Answer: B
5. Which layer of the uterus is responsible for cyclic shedding during menstruation?
A. Myometrium
B. Serosa
,2
C. Endometrium (functional layer)
D. Basal layer
Answer: C
6. A patient reports cyclic breast tenderness. Luteal-phase breast changes are primarily
caused by which hormones?
A. Estrogen alone
B. Progesterone alone
C. Estrogen and progesterone stimulating lobuloalveolar proliferation
D. Prolactin and oxytocin
Answer: C
7. The primary source of circulating estrogen in premenopausal women is:
A. Adrenal cortex
B. Ovarian theca and granulosa cells
C. Adipose tissue
D. Pituitary gland
Answer: B
8. Which cervical mucus characteristic is consistent with the ovulatory phase?
A. Thick, opaque, and sticky
B. Clear, spinnbarkeit, watery with ferning
C. Absent or scanty
D. Blood-tinged or brown
Answer: B
9. A 28-year-old woman is diagnosed with PCOS. What is the first-line pharmacologic
treatment for hirsutism?
A. Spironolactone 100 mg/day
B. Combined oral contraceptives
C. Metformin 500 mg twice daily
D. Eflornithine cream twice daily
Answer: B
10. A 45-year-old woman with a history of venous thromboembolism (VTE) requests
hormonal contraception. Which method is absolutely contraindicated?
A. Levonorgestrel IUD
B. Etonogestrel subdermal implant
C. Combined oral contraceptives
D. Depot medroxyprogesterone acetate injection
Answer: C
11. A patient on combined oral contraceptives reports new-onset migraine with aura.
According to the U.S. MEC, what is the correct recommendation?
, 3
A. Continue COCs and prescribe triptans
B. Switch to a progestin-only pill
C. Increase estrogen dose
D. No adjustment needed
Answer: B
12. A 26-year-old woman has a history of migraines with visual scintillations and
temporary blind spots. According to CDC MEC, the most appropriate contraceptive
recommendation is:
A. Combined oral contraceptives
B. Contraceptive patch
C. Depot medroxyprogesterone acetate injection
D. Vaginal contraceptive ring
Answer: C
13. Depot medroxyprogesterone acetate (Depo-Provera) is administered at least every:
A. 4 weeks
B. 8 weeks
C. 10 weeks
D. 12 weeks
Answer: D
14. A patient taking oral contraceptives does NOT need backup contraception when taking
which of the following medications?
A. Ampicillin
B. Ketoconazole
C. Phenytoin
D. Metformin
Answer: D
15. A patient asks about cervical mucus changes during the menstrual cycle. Which
description is consistent with ovulatory mucus?
A. Thick, opaque, sticky
B. Clear, spinnbarkeit, watery with ferning
C. Absent or scanty
D. Blood-tinged
Answer: B
16. A 32-year-old woman with PCOS and insulin resistance is seeking a second-line agent
to improve ovulation. Which medication is most appropriate?
A. Clomiphene
B. Letrozole
C. Metformin
