NAMS Menopause Certification Exam
Actual Real Exam Test Bank with 2 Currently Testing Versions | 100
Questions Each
,Question 1
A 52-year-old woman presents with frequent hot flashes occurring 10 times daily and disrupting
sleep. She underwent hysterectomy 5 years ago. She has no history of VTE, breast cancer, or
cardiovascular disease. What is the most appropriate treatment?
A. Combined estrogen-progestogen therapy
B. Estrogen-only therapy
C. Testosterone therapy
D. Bisphosphonate therapy
Correct Answer:
B. Estrogen-only therapy
Rationale:
Women without a uterus do not require progestogen because there is no risk of endometrial
hyperplasia. Estrogen-only therapy is appropriate for symptomatic menopausal patients without
contraindications.
● A is incorrect because progestogen is unnecessary after hysterectomy.
● C is incorrect because testosterone is not first-line for vasomotor symptoms.
● D is incorrect because bisphosphonates treat osteoporosis, not hot flashes.
Question 2
Which patient is the BEST candidate for systemic menopausal hormone therapy?
A. 68-year-old woman, 18 years postmenopause with CAD
B. 55-year-old woman, 3 years postmenopause with severe hot flashes
C. 62-year-old smoker with prior stroke
D. 70-year-old woman with active liver disease
Correct Answer:
B. 55-year-old woman, 3 years postmenopause with severe hot flashes
,Rationale:
Hormone therapy has the most favorable benefit-risk profile in women:
● Younger than 60 years
● Within 10 years of menopause onset
The other patients have significant contraindications or elevated risks.
Question 3
Which route of estrogen administration is preferred in women at increased risk for venous
thromboembolism?
A. Oral conjugated estrogen
B. Oral estradiol
C. Transdermal estrogen
D. Intramuscular estrogen
Correct Answer:
C. Transdermal estrogen
Rationale:
Transdermal estrogen bypasses hepatic first-pass metabolism and is associated with lower VTE
risk compared with oral estrogen.
Question 4
A 57-year-old woman complains of vaginal dryness and dyspareunia but denies hot flashes.
What is the MOST appropriate first-line prescription therapy?
A. Oral estrogen therapy
B. Vaginal estrogen therapy
C. Testosterone injections
D. Bisphosphonates
, Correct Answer:
B. Vaginal estrogen therapy
Rationale:
Localized GSM symptoms are best treated with local vaginal estrogen rather than systemic
therapy.
Question 5
Which statement regarding genitourinary syndrome of menopause (GSM) is TRUE?
A. GSM resolves spontaneously without treatment
B. GSM affects only the vagina
C. GSM is chronic and progressive without treatment
D. GSM is caused primarily by infection
Correct Answer:
C. GSM is chronic and progressive without treatment
Rationale:
GSM results from estrogen deficiency affecting vaginal and urinary tissues and usually worsens
over time if untreated.
Question 6
A woman with an intact uterus is started on systemic estrogen therapy. Why is progestogen
added?
A. Prevent osteoporosis
B. Reduce vasomotor symptoms
C. Protect the endometrium
D. Improve libido
Actual Real Exam Test Bank with 2 Currently Testing Versions | 100
Questions Each
,Question 1
A 52-year-old woman presents with frequent hot flashes occurring 10 times daily and disrupting
sleep. She underwent hysterectomy 5 years ago. She has no history of VTE, breast cancer, or
cardiovascular disease. What is the most appropriate treatment?
A. Combined estrogen-progestogen therapy
B. Estrogen-only therapy
C. Testosterone therapy
D. Bisphosphonate therapy
Correct Answer:
B. Estrogen-only therapy
Rationale:
Women without a uterus do not require progestogen because there is no risk of endometrial
hyperplasia. Estrogen-only therapy is appropriate for symptomatic menopausal patients without
contraindications.
● A is incorrect because progestogen is unnecessary after hysterectomy.
● C is incorrect because testosterone is not first-line for vasomotor symptoms.
● D is incorrect because bisphosphonates treat osteoporosis, not hot flashes.
Question 2
Which patient is the BEST candidate for systemic menopausal hormone therapy?
A. 68-year-old woman, 18 years postmenopause with CAD
B. 55-year-old woman, 3 years postmenopause with severe hot flashes
C. 62-year-old smoker with prior stroke
D. 70-year-old woman with active liver disease
Correct Answer:
B. 55-year-old woman, 3 years postmenopause with severe hot flashes
,Rationale:
Hormone therapy has the most favorable benefit-risk profile in women:
● Younger than 60 years
● Within 10 years of menopause onset
The other patients have significant contraindications or elevated risks.
Question 3
Which route of estrogen administration is preferred in women at increased risk for venous
thromboembolism?
A. Oral conjugated estrogen
B. Oral estradiol
C. Transdermal estrogen
D. Intramuscular estrogen
Correct Answer:
C. Transdermal estrogen
Rationale:
Transdermal estrogen bypasses hepatic first-pass metabolism and is associated with lower VTE
risk compared with oral estrogen.
Question 4
A 57-year-old woman complains of vaginal dryness and dyspareunia but denies hot flashes.
What is the MOST appropriate first-line prescription therapy?
A. Oral estrogen therapy
B. Vaginal estrogen therapy
C. Testosterone injections
D. Bisphosphonates
, Correct Answer:
B. Vaginal estrogen therapy
Rationale:
Localized GSM symptoms are best treated with local vaginal estrogen rather than systemic
therapy.
Question 5
Which statement regarding genitourinary syndrome of menopause (GSM) is TRUE?
A. GSM resolves spontaneously without treatment
B. GSM affects only the vagina
C. GSM is chronic and progressive without treatment
D. GSM is caused primarily by infection
Correct Answer:
C. GSM is chronic and progressive without treatment
Rationale:
GSM results from estrogen deficiency affecting vaginal and urinary tissues and usually worsens
over time if untreated.
Question 6
A woman with an intact uterus is started on systemic estrogen therapy. Why is progestogen
added?
A. Prevent osteoporosis
B. Reduce vasomotor symptoms
C. Protect the endometrium
D. Improve libido
