NR 602 – Primary Care of Women Final Exam |
2025/2026 Verified NP Q&A with Rationales
1. First-line screening for cervical cancer in a 28-year-old woman is: Answer: HPV
testing with cytology (co-testing) every 5 years OR primary HPV testing
every 5 years OR cytology alone every 3 years Rationale: USPSTF & ACS
2021–2025 guidelines (all acceptable for ages 25–65).
2. At what age can cervical cancer screening be discontinued in average-risk
women? Answer: Age 65 with adequate negative prior screening and no
history of CIN2+ Rationale: USPSTF/ASCCP.
3. The contraceptive method with the highest Pearl Index (failure rate) is: Answer:
Fertility awareness-based methods (~24%) Rationale: Typical-use failure
highest among behavioral methods.
4. Absolute contraindication to combined hormonal contraceptives (UKMEC 4)
includes: Answer: Current breast cancer, migraine with aura, history of VTE
with risk factors, SLE with positive antiphospholipid antibodies Rationale:
CDC/WHO MEC.
5. First-line emergency contraception for a 19-year-old who had unprotected
intercourse 96 hours ago is: Answer: Copper IUD (effective up to 120 hours)
OR ulipristal acetate (Ella) Rationale: Most effective options; levonorgestrel less
effective after 72h.
6. A patient on rifampin needs contraception. The only methods that remain reliable
are: Answer: Copper IUD, LNG-IUD, progestin implant, DMPA Rationale:
Rifampin induces CYP450 and reduces efficacy of estrogen/progestin pills,
patch, ring.
7. Most effective long-acting reversible contraceptive (LARC): Answer:
Etonogestrel implant (Nexplanon) and LNG-IUDs (~0.05–0.2% failure)
Rationale: Lowest typical-use failure rates.
8. A 42-year-old G3P3 requests permanent sterilization. The most effective method
is: Answer: Bilateral salpingectomy Rationale: Superior to tubal ligation; also
reduces ovarian cancer risk.
9. Diagnostic test of choice for a 28-year-old with postcoital bleeding and friable
cervix on exam: Answer: Colposcopy with directed biopsies Rationale:
Highest risk for cervical cancer.
10.First-line treatment for bacterial vaginosis: Answer: Metronidazole 500 mg PO
BID × 7 days OR metronidazole 0.75% gel intravaginally × 5 days Rationale:
CDC 2021 STI guidelines.
11–60 (continued, no skips):
2025/2026 Verified NP Q&A with Rationales
1. First-line screening for cervical cancer in a 28-year-old woman is: Answer: HPV
testing with cytology (co-testing) every 5 years OR primary HPV testing
every 5 years OR cytology alone every 3 years Rationale: USPSTF & ACS
2021–2025 guidelines (all acceptable for ages 25–65).
2. At what age can cervical cancer screening be discontinued in average-risk
women? Answer: Age 65 with adequate negative prior screening and no
history of CIN2+ Rationale: USPSTF/ASCCP.
3. The contraceptive method with the highest Pearl Index (failure rate) is: Answer:
Fertility awareness-based methods (~24%) Rationale: Typical-use failure
highest among behavioral methods.
4. Absolute contraindication to combined hormonal contraceptives (UKMEC 4)
includes: Answer: Current breast cancer, migraine with aura, history of VTE
with risk factors, SLE with positive antiphospholipid antibodies Rationale:
CDC/WHO MEC.
5. First-line emergency contraception for a 19-year-old who had unprotected
intercourse 96 hours ago is: Answer: Copper IUD (effective up to 120 hours)
OR ulipristal acetate (Ella) Rationale: Most effective options; levonorgestrel less
effective after 72h.
6. A patient on rifampin needs contraception. The only methods that remain reliable
are: Answer: Copper IUD, LNG-IUD, progestin implant, DMPA Rationale:
Rifampin induces CYP450 and reduces efficacy of estrogen/progestin pills,
patch, ring.
7. Most effective long-acting reversible contraceptive (LARC): Answer:
Etonogestrel implant (Nexplanon) and LNG-IUDs (~0.05–0.2% failure)
Rationale: Lowest typical-use failure rates.
8. A 42-year-old G3P3 requests permanent sterilization. The most effective method
is: Answer: Bilateral salpingectomy Rationale: Superior to tubal ligation; also
reduces ovarian cancer risk.
9. Diagnostic test of choice for a 28-year-old with postcoital bleeding and friable
cervix on exam: Answer: Colposcopy with directed biopsies Rationale:
Highest risk for cervical cancer.
10.First-line treatment for bacterial vaginosis: Answer: Metronidazole 500 mg PO
BID × 7 days OR metronidazole 0.75% gel intravaginally × 5 days Rationale:
CDC 2021 STI guidelines.
11–60 (continued, no skips):
