NRNP 6552
Advanced Nurse Practice in
Reproductive Health Care
Complete Midterms Review
(Questions & Solutions)
2025
1
,1. A 32-year-old G2P1 presents at 36 weeks with symptomatic
polyhydramnios and fasting glucose of 140 mg/dL. Which
assessment best predicts fetal hyperglycemia?
A. Nonstress test showing late decelerations
B. Amniotic fluid glucose concentration
C. Biophysical profile score of 6
D. Cordocentesis for fetal glucose measurement
ANS: D
Rationale: Direct fetal blood sampling (cordocentesis) provides
the most accurate measurement of fetal glucose levels when
concerned about hyperglycemia.
2. A 25-year-old requesting contraception has migraine without aura.
Which option is safest?
A. Combined oral contraceptive pill
B. Transdermal estrogen/progestin patch
C. Levonorgestrel IUD
D. Depot medroxyprogesterone injection
ANS: C
Rationale: A levonorgestrel IUD minimizes systemic estrogen
exposure and is safe in patients with migraine headaches.
3. A 45-year-old with irregular, heavy menstrual bleeding and
endometrial stripe of 16 mm on ultrasound. Next step?
A. Hysteroscopic polypectomy
B. Endometrial biopsy
C. Trial of high-dose progestin therapy
D. Saline‐infusion sonohysterography
ANS: B
Rationale: Endometrial biopsy is indicated to rule out hyperplasia
2
, or malignancy in perimenopausal bleeding with thickened
endometrium.
4. A teenager reports primary amenorrhea at 15 years, normal breast
development, and blind vaginal pouch on exam. Which diagnostic
test is most appropriate first?
A. Serum FSH and LH levels
B. Karyotype analysis
C. Pelvic ultrasound
D. MRI of the pelvis
ANS: C
Rationale: Pelvic ultrasound distinguishes Müllerian agenesis or
vaginal agenesis from endocrine causes before invasive testing.
5. A 29-year-old diagnosed with PCOS has oligomenorrhea and
hirsutism. According to Rotterdam criteria, which finding confirms
diagnosis?
A. Elevated DHEA-S level
B. Ovarian volume >10 mL on ultrasound
C. Serum testosterone >0.8 ng/mL
D. FSH:LH ratio >2:1
ANS: B
Rationale: Polycystic ovarian morphology (ovarian volume >10 mL)
plus clinical hyperandrogenism and oligo-ovulation meet two of three
Rotterdam criteria.
6. A pregnant patient at 20 weeks is found to have bacterial vaginosis
on wet mount. Best treatment?
A. Metronidazole 500 mg PO twice daily for 7 days
B. Clindamycin cream intravaginally for 5 days
C. Single-dose tinidazole 2 g PO
D. No treatment during pregnancy
3
Advanced Nurse Practice in
Reproductive Health Care
Complete Midterms Review
(Questions & Solutions)
2025
1
,1. A 32-year-old G2P1 presents at 36 weeks with symptomatic
polyhydramnios and fasting glucose of 140 mg/dL. Which
assessment best predicts fetal hyperglycemia?
A. Nonstress test showing late decelerations
B. Amniotic fluid glucose concentration
C. Biophysical profile score of 6
D. Cordocentesis for fetal glucose measurement
ANS: D
Rationale: Direct fetal blood sampling (cordocentesis) provides
the most accurate measurement of fetal glucose levels when
concerned about hyperglycemia.
2. A 25-year-old requesting contraception has migraine without aura.
Which option is safest?
A. Combined oral contraceptive pill
B. Transdermal estrogen/progestin patch
C. Levonorgestrel IUD
D. Depot medroxyprogesterone injection
ANS: C
Rationale: A levonorgestrel IUD minimizes systemic estrogen
exposure and is safe in patients with migraine headaches.
3. A 45-year-old with irregular, heavy menstrual bleeding and
endometrial stripe of 16 mm on ultrasound. Next step?
A. Hysteroscopic polypectomy
B. Endometrial biopsy
C. Trial of high-dose progestin therapy
D. Saline‐infusion sonohysterography
ANS: B
Rationale: Endometrial biopsy is indicated to rule out hyperplasia
2
, or malignancy in perimenopausal bleeding with thickened
endometrium.
4. A teenager reports primary amenorrhea at 15 years, normal breast
development, and blind vaginal pouch on exam. Which diagnostic
test is most appropriate first?
A. Serum FSH and LH levels
B. Karyotype analysis
C. Pelvic ultrasound
D. MRI of the pelvis
ANS: C
Rationale: Pelvic ultrasound distinguishes Müllerian agenesis or
vaginal agenesis from endocrine causes before invasive testing.
5. A 29-year-old diagnosed with PCOS has oligomenorrhea and
hirsutism. According to Rotterdam criteria, which finding confirms
diagnosis?
A. Elevated DHEA-S level
B. Ovarian volume >10 mL on ultrasound
C. Serum testosterone >0.8 ng/mL
D. FSH:LH ratio >2:1
ANS: B
Rationale: Polycystic ovarian morphology (ovarian volume >10 mL)
plus clinical hyperandrogenism and oligo-ovulation meet two of three
Rotterdam criteria.
6. A pregnant patient at 20 weeks is found to have bacterial vaginosis
on wet mount. Best treatment?
A. Metronidazole 500 mg PO twice daily for 7 days
B. Clindamycin cream intravaginally for 5 days
C. Single-dose tinidazole 2 g PO
D. No treatment during pregnancy
3
