NUR 684 WOMEN'S HEALTH FINAL EXAM 2026 | Questions
and Answers 2026/2027 | Verified Edition | Pass Guaranteed -
A+ Graded
Section 1: Reproductive Anatomy, Physiology & Lifespan Development
(Questions 1-15)
Q1: A 24-year-old female presents to the clinic for a routine well-woman exam. She
reports her last menstrual period (LMP) started 12 days ago. According to the standard
28-day ovarian cycle, in which phase is she currently?
A. Ovulatory phase
B. Luteal phase
C. Follicular phase [CORRECT]
D. Menstrual phase
Correct Answer: C
Rationale: ACOG and standard reproductive physiology define the follicular phase
(proliferative phase) as days 1 to 14 of a 28-day cycle, driven by rising estrogen and
FSH; ovulation occurs at day 14, followed by the luteal phase (days 15-28), making the
luteal and ovulatory phases incorrect for day 12.
Q2: A 13-year-old female accompanies her mother to the clinic. The mother is
concerned because her daughter has developed breast buds but has no pubic hair. The
nurse practitioner documents this as which Tanner stage?
A. Tanner Stage 1
B. Tanner Stage 2 [CORRECT]
C. Tanner Stage 3
D. Tanner Stage 4
Correct Answer: B
Rationale: Per pediatric gynecologic standards, Tanner Stage 2 breast development
(thelarche) is marked by the formation of breast buds without significant elevation of the
breast contour, while pubic hair typically appears slightly later; Stage 1 is prepubertal,
and Stages 3 and 4 require more advanced tissue development.
Q3: A 35-year-old patient reports having menstrual bleeding every 21 days. How should
the WHNP document this abnormality in her medical record?
A. Oligomenorrhea
B. Polymenorrhea [CORRECT]
C. Menorrhagia
D. Metrorrhagia
Correct Answer: B
,Rationale: ACOG terminology defines polymenorrhea as uterine bleeding occurring at
intervals of less than 21 days; oligomenorrhea is bleeding at intervals greater than 35
days, menorrhagia is excessive bleeding (>80 mL) at regular intervals, and metrorrhagia
is irregular bleeding between periods.
Q4: During which phase of the endometrial cycle does the secretory endometrium,
under the influence of progesterone, become highly vascularized to support potential
implantation?
A. Proliferative phase
B. Menstrual phase
C. Secretory phase [CORRECT]
D. Ischemic phase
Correct Answer: C
Rationale: NCC WHNP content outlines that the secretory phase begins post-ovulation
and is driven by progesterone from the corpus luteum, causing endometrial glands to
become tortuous and secretory; the proliferative phase is driven by estrogen and occurs
before ovulation.
Q5: A 17-year-old patient asks the WHNP what causes her menstrual cramps. The NP
explains that primary dysmenorrhea is primarily caused by an excess of which
substance in the endometrium?
A. Estrogen
B. Progesterone
C. Prostaglandins [CORRECT]
D. Follicle-stimulating hormone
Correct Answer: C
Rationale: ACOG Practice Bulletins state that primary dysmenorrhea is caused by
elevated levels of prostaglandin F2-alpha in the secretory endometrium, which
increases uterine contractility and intrauterine pressure, leading to ischemia and pain;
the other hormones do not directly cause uterine cramping.
Q6: A patient at 42 years of age reports irregular menstrual cycles and hot flashes over
the last three months. Her FSH level is drawn and returns at 28 mIU/mL. In which
reproductive lifespan stage is this patient?
A. Premenopause
B. Perimenopause [CORRECT]
C. Menopause
D. Postmenopause
Correct Answer: B
Rationale: The Stages of Reproductive Aging Workshop (STRAW) criteria and ACOG
define perimenopause as the transition characterized by irregular menstrual cycles and
,vasomotor symptoms (VMS), often with elevated FSH (>25 mIU/mL), but it is not
diagnosed as menopause until 12 months of amenorrhea have occurred.
Q7: The WHNP is teaching a group of nursing students about the ovarian cycle. Which
hormone is primarily responsible for triggering the LH surge that results in ovulation?
A. Progesterone
B. Inhibin
C. Estradiol [CORRECT]
D. Prolactin
Correct Answer: C
Rationale: ACOG and reproductive endocrinology standards establish that a sustained,
high level of estradiol from the dominant follicle exerts positive feedback on the anterior
pituitary, triggering the pre-ovulatory LH surge; progesterone and inhibin generally exert
negative feedback.
Q8: A 14-year-old female presents with severe, cyclic lower abdominal pain that is
causing her to miss school. She has no history of sexual activity. What is the most likely
diagnosis?
A. Endometriosis
B. Primary dysmenorrhea [CORRECT]
C. Pelvic inflammatory disease
D. Adenomyosis
Correct Answer: B
Rationale: NCC WHNP guidelines indicate that primary dysmenorrhea typically begins
in adolescence shortly after menarche, is cyclic, and has no identifiable pelvic
pathology; endometriosis and adenomyosis are causes of secondary dysmenorrhea,
and PID requires sexual activity/risk factors.
Q9: A 50-year-old woman presents reporting that she has not had a menstrual period
for 14 months. She complains of vaginal dryness and occasional sleep disturbances.
The WHNP correctly documents this as which stage?
A. Late perimenopause
B. Postmenopause [CORRECT]
C. Menopausal transition
D. Premature ovarian insufficiency
Correct Answer: B
Rationale: Per STRAW+10 criteria, postmenopause is defined as 12 consecutive
months of amenorrhea without an alternative pathological or physiological cause; late
perimenopause ends at the final menstrual period, so 14 months of amenorrhea firmly
places her in the postmenopausal stage.
, Q10: Which gland, located bilaterally at the posterior introitus, secretes mucus to
lubricate the vaginal vestibule and is homologous to the male prostate?
A. Bartholin's glands
B. Skene's glands [CORRECT]
C. Sebaceous glands
D. Apocrine sweat glands
Correct Answer: B
Rationale: WHNP anatomy curriculum identifies Skene's glands (paraurethral glands) as
homologous to the male prostate, located posterolaterally to the urethral meatus, and
responsible for lubrication; Bartholin's glands are located posterolaterally at the vaginal
introitus and also provide lubrication but are not homologous to the prostate.
Q11: A patient asks how an egg travels from the ovary to the uterus. The WHNP
explains that ovum capture and transport are primarily facilitated by the fimbriae of
which structure?
A. Uterine body
B. Fallopian tube [CORRECT]
C. Round ligament
D. Broad ligament
Correct Answer: B
Rationale: Anatomy and physiology standards state that the fimbriae are finger-like
projections at the distal end of the fallopian tubes (infundibulum) that sweep over the
ovary to capture the released ovum and guide it into the ampulla for fertilization.
Q12: During the menstrual phase of the endometrial cycle, which layer of the
endometrium is shed?
A. Basalis layer
B. Functionalis layer [CORRECT]
C. Myometrium
D. Serosa
Correct Answer: B
Rationale: ACOG defines the endometrium as consisting of two layers: the basalis
(deep, regenerative layer not shed) and the functionalis (superficial layer that responds
to hormones and is shed during menstruation); the myometrium is the muscular layer of
the uterus.
Q13: Adrenarche, the awakening of adrenal androgen production, typically precedes
thelarche by what timeframe in female pubertal development?
A. 1 year
B. 2 years [CORRECT]
C. 5 years
and Answers 2026/2027 | Verified Edition | Pass Guaranteed -
A+ Graded
Section 1: Reproductive Anatomy, Physiology & Lifespan Development
(Questions 1-15)
Q1: A 24-year-old female presents to the clinic for a routine well-woman exam. She
reports her last menstrual period (LMP) started 12 days ago. According to the standard
28-day ovarian cycle, in which phase is she currently?
A. Ovulatory phase
B. Luteal phase
C. Follicular phase [CORRECT]
D. Menstrual phase
Correct Answer: C
Rationale: ACOG and standard reproductive physiology define the follicular phase
(proliferative phase) as days 1 to 14 of a 28-day cycle, driven by rising estrogen and
FSH; ovulation occurs at day 14, followed by the luteal phase (days 15-28), making the
luteal and ovulatory phases incorrect for day 12.
Q2: A 13-year-old female accompanies her mother to the clinic. The mother is
concerned because her daughter has developed breast buds but has no pubic hair. The
nurse practitioner documents this as which Tanner stage?
A. Tanner Stage 1
B. Tanner Stage 2 [CORRECT]
C. Tanner Stage 3
D. Tanner Stage 4
Correct Answer: B
Rationale: Per pediatric gynecologic standards, Tanner Stage 2 breast development
(thelarche) is marked by the formation of breast buds without significant elevation of the
breast contour, while pubic hair typically appears slightly later; Stage 1 is prepubertal,
and Stages 3 and 4 require more advanced tissue development.
Q3: A 35-year-old patient reports having menstrual bleeding every 21 days. How should
the WHNP document this abnormality in her medical record?
A. Oligomenorrhea
B. Polymenorrhea [CORRECT]
C. Menorrhagia
D. Metrorrhagia
Correct Answer: B
,Rationale: ACOG terminology defines polymenorrhea as uterine bleeding occurring at
intervals of less than 21 days; oligomenorrhea is bleeding at intervals greater than 35
days, menorrhagia is excessive bleeding (>80 mL) at regular intervals, and metrorrhagia
is irregular bleeding between periods.
Q4: During which phase of the endometrial cycle does the secretory endometrium,
under the influence of progesterone, become highly vascularized to support potential
implantation?
A. Proliferative phase
B. Menstrual phase
C. Secretory phase [CORRECT]
D. Ischemic phase
Correct Answer: C
Rationale: NCC WHNP content outlines that the secretory phase begins post-ovulation
and is driven by progesterone from the corpus luteum, causing endometrial glands to
become tortuous and secretory; the proliferative phase is driven by estrogen and occurs
before ovulation.
Q5: A 17-year-old patient asks the WHNP what causes her menstrual cramps. The NP
explains that primary dysmenorrhea is primarily caused by an excess of which
substance in the endometrium?
A. Estrogen
B. Progesterone
C. Prostaglandins [CORRECT]
D. Follicle-stimulating hormone
Correct Answer: C
Rationale: ACOG Practice Bulletins state that primary dysmenorrhea is caused by
elevated levels of prostaglandin F2-alpha in the secretory endometrium, which
increases uterine contractility and intrauterine pressure, leading to ischemia and pain;
the other hormones do not directly cause uterine cramping.
Q6: A patient at 42 years of age reports irregular menstrual cycles and hot flashes over
the last three months. Her FSH level is drawn and returns at 28 mIU/mL. In which
reproductive lifespan stage is this patient?
A. Premenopause
B. Perimenopause [CORRECT]
C. Menopause
D. Postmenopause
Correct Answer: B
Rationale: The Stages of Reproductive Aging Workshop (STRAW) criteria and ACOG
define perimenopause as the transition characterized by irregular menstrual cycles and
,vasomotor symptoms (VMS), often with elevated FSH (>25 mIU/mL), but it is not
diagnosed as menopause until 12 months of amenorrhea have occurred.
Q7: The WHNP is teaching a group of nursing students about the ovarian cycle. Which
hormone is primarily responsible for triggering the LH surge that results in ovulation?
A. Progesterone
B. Inhibin
C. Estradiol [CORRECT]
D. Prolactin
Correct Answer: C
Rationale: ACOG and reproductive endocrinology standards establish that a sustained,
high level of estradiol from the dominant follicle exerts positive feedback on the anterior
pituitary, triggering the pre-ovulatory LH surge; progesterone and inhibin generally exert
negative feedback.
Q8: A 14-year-old female presents with severe, cyclic lower abdominal pain that is
causing her to miss school. She has no history of sexual activity. What is the most likely
diagnosis?
A. Endometriosis
B. Primary dysmenorrhea [CORRECT]
C. Pelvic inflammatory disease
D. Adenomyosis
Correct Answer: B
Rationale: NCC WHNP guidelines indicate that primary dysmenorrhea typically begins
in adolescence shortly after menarche, is cyclic, and has no identifiable pelvic
pathology; endometriosis and adenomyosis are causes of secondary dysmenorrhea,
and PID requires sexual activity/risk factors.
Q9: A 50-year-old woman presents reporting that she has not had a menstrual period
for 14 months. She complains of vaginal dryness and occasional sleep disturbances.
The WHNP correctly documents this as which stage?
A. Late perimenopause
B. Postmenopause [CORRECT]
C. Menopausal transition
D. Premature ovarian insufficiency
Correct Answer: B
Rationale: Per STRAW+10 criteria, postmenopause is defined as 12 consecutive
months of amenorrhea without an alternative pathological or physiological cause; late
perimenopause ends at the final menstrual period, so 14 months of amenorrhea firmly
places her in the postmenopausal stage.
, Q10: Which gland, located bilaterally at the posterior introitus, secretes mucus to
lubricate the vaginal vestibule and is homologous to the male prostate?
A. Bartholin's glands
B. Skene's glands [CORRECT]
C. Sebaceous glands
D. Apocrine sweat glands
Correct Answer: B
Rationale: WHNP anatomy curriculum identifies Skene's glands (paraurethral glands) as
homologous to the male prostate, located posterolaterally to the urethral meatus, and
responsible for lubrication; Bartholin's glands are located posterolaterally at the vaginal
introitus and also provide lubrication but are not homologous to the prostate.
Q11: A patient asks how an egg travels from the ovary to the uterus. The WHNP
explains that ovum capture and transport are primarily facilitated by the fimbriae of
which structure?
A. Uterine body
B. Fallopian tube [CORRECT]
C. Round ligament
D. Broad ligament
Correct Answer: B
Rationale: Anatomy and physiology standards state that the fimbriae are finger-like
projections at the distal end of the fallopian tubes (infundibulum) that sweep over the
ovary to capture the released ovum and guide it into the ampulla for fertilization.
Q12: During the menstrual phase of the endometrial cycle, which layer of the
endometrium is shed?
A. Basalis layer
B. Functionalis layer [CORRECT]
C. Myometrium
D. Serosa
Correct Answer: B
Rationale: ACOG defines the endometrium as consisting of two layers: the basalis
(deep, regenerative layer not shed) and the functionalis (superficial layer that responds
to hormones and is shed during menstruation); the myometrium is the muscular layer of
the uterus.
Q13: Adrenarche, the awakening of adrenal androgen production, typically precedes
thelarche by what timeframe in female pubertal development?
A. 1 year
B. 2 years [CORRECT]
C. 5 years
