NUR 6111 Advanced Practice Nursing I Guide Exam 3
Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | Pass Guaranteed –
A+ Graded
SECTION 1: Women's Health (Menopause, STIs, Cervical Cancer
Screening, Vaginitis)
Q1: A 48-year-old woman presents with irregular menses, night sweats, and mood
changes. She reports that her symptoms fluctuate from week to week. Which underlying
pathophysiology best explains this clinical presentation?
A. Complete ovarian failure with undetectable estrogen levels
B. Fluctuating estrogen levels during perimenopause [CORRECT]
C. Elevated FSH with consistently high estradiol production
D. Primary pituitary dysfunction with low LH secretion
Correct Answer: B
Rationale: Correct because perimenopause is characterized by erratic ovarian function
and fluctuating estrogen levels, which produce variable symptoms including irregular
cycles, hot flashes, and mood changes before final menstrual transition.
,Q2: During a well-woman examination, a 65-year-old patient is noted to have a new
inverted nipple on the left breast. She denies pain or discharge. Which action is most
appropriate?
A. Reassure the patient and schedule routine mammography in 2 years
B. Document the finding and plan observation at next annual visit
C. Order diagnostic mammography and breast ultrasound [CORRECT]
D. Prescribe topical estrogen cream and recheck in 3 months
Correct Answer: C
Rationale: Correct because a new inverted nipple in a postmenopausal woman is a
physical exam finding warranting further evaluation to rule out underlying malignancy;
diagnostic imaging is indicated per breast cancer screening protocols.
Q3: According to current ACOG and ACS cervical cancer screening guidelines, at what
age should routine cervical cancer screening be initiated in an asymptomatic,
immunocompetent patient?
A. Age 18, or at onset of sexual activity
B. Age 21 [CORRECT]
C. Age 25 with HPV co-testing
D. Age 30 with cytology alone
Correct Answer: B
,Rationale: Correct because guidelines recommend initiating cervical cancer screening
at age 21 regardless of sexual history, as earlier screening does not reduce cancer
incidence but increases unnecessary interventions.
Q4: A 28-year-old man presents with a painless ulcer on the penis. He is diagnosed with
primary syphilis. Which clinical manifestation is NOT expected in this stage?
A. Regional lymphadenopathy
B. Chancre at the site of inoculation
C. Flu-like symptoms [CORRECT]
D. Spontaneous resolution of the chancre within 3–6 weeks
Correct Answer: C
Rationale: Correct because flu-like symptoms are characteristic of secondary syphilis,
not primary syphilis; primary syphilis presents with a painless chancre and nontender
lymphadenopathy without systemic symptoms.
Q5: A 24-year-old woman is diagnosed with trichomoniasis and prescribed
metronidazole (Flagyl). Which patient teaching is essential to prevent a disulfiram-like
reaction?
A. Avoid grapefruit juice during treatment
B. Avoid alcohol during treatment and for 24–48 hours after completion [CORRECT]
C. Take the medication with food to reduce nausea
D. Use backup contraception during treatment
, Correct Answer: B
Rationale: Correct because metronidazole inhibits aldehyde dehydrogenase, producing
a disulfiram-like reaction when combined with alcohol; patients must abstain from
alcohol during therapy and for at least 24–48 hours after the last dose.
Q6: A 22-year-old sexually active woman presents with mucopurulent cervical discharge
and cervical friability. Which organism is the most likely causative agent?
A. Candida albicans
B. Trichomonas vaginalis
C. Chlamydia trachomatis [CORRECT]
D. Gardnerella vaginalis
Correct Answer: C
Rationale: Correct because chlamydia infection typically presents with vaginal
discharge and cervical changes including friability and mucopurulent discharge; this
matches the clinical presentation described.
Q7: A patient presents with painful genital vesicles and systemic symptoms consistent
with a first episode of genital herpes. Which pharmacologic regimen is first-line for
primary herpes infection?
A. Valacyclovir 1 g daily for 5 days
B. Acyclovir 400 mg three times daily for 7–10 days [CORRECT]
C. Famciclovir 250 mg twice daily for 3 days
Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | Pass Guaranteed –
A+ Graded
SECTION 1: Women's Health (Menopause, STIs, Cervical Cancer
Screening, Vaginitis)
Q1: A 48-year-old woman presents with irregular menses, night sweats, and mood
changes. She reports that her symptoms fluctuate from week to week. Which underlying
pathophysiology best explains this clinical presentation?
A. Complete ovarian failure with undetectable estrogen levels
B. Fluctuating estrogen levels during perimenopause [CORRECT]
C. Elevated FSH with consistently high estradiol production
D. Primary pituitary dysfunction with low LH secretion
Correct Answer: B
Rationale: Correct because perimenopause is characterized by erratic ovarian function
and fluctuating estrogen levels, which produce variable symptoms including irregular
cycles, hot flashes, and mood changes before final menstrual transition.
,Q2: During a well-woman examination, a 65-year-old patient is noted to have a new
inverted nipple on the left breast. She denies pain or discharge. Which action is most
appropriate?
A. Reassure the patient and schedule routine mammography in 2 years
B. Document the finding and plan observation at next annual visit
C. Order diagnostic mammography and breast ultrasound [CORRECT]
D. Prescribe topical estrogen cream and recheck in 3 months
Correct Answer: C
Rationale: Correct because a new inverted nipple in a postmenopausal woman is a
physical exam finding warranting further evaluation to rule out underlying malignancy;
diagnostic imaging is indicated per breast cancer screening protocols.
Q3: According to current ACOG and ACS cervical cancer screening guidelines, at what
age should routine cervical cancer screening be initiated in an asymptomatic,
immunocompetent patient?
A. Age 18, or at onset of sexual activity
B. Age 21 [CORRECT]
C. Age 25 with HPV co-testing
D. Age 30 with cytology alone
Correct Answer: B
,Rationale: Correct because guidelines recommend initiating cervical cancer screening
at age 21 regardless of sexual history, as earlier screening does not reduce cancer
incidence but increases unnecessary interventions.
Q4: A 28-year-old man presents with a painless ulcer on the penis. He is diagnosed with
primary syphilis. Which clinical manifestation is NOT expected in this stage?
A. Regional lymphadenopathy
B. Chancre at the site of inoculation
C. Flu-like symptoms [CORRECT]
D. Spontaneous resolution of the chancre within 3–6 weeks
Correct Answer: C
Rationale: Correct because flu-like symptoms are characteristic of secondary syphilis,
not primary syphilis; primary syphilis presents with a painless chancre and nontender
lymphadenopathy without systemic symptoms.
Q5: A 24-year-old woman is diagnosed with trichomoniasis and prescribed
metronidazole (Flagyl). Which patient teaching is essential to prevent a disulfiram-like
reaction?
A. Avoid grapefruit juice during treatment
B. Avoid alcohol during treatment and for 24–48 hours after completion [CORRECT]
C. Take the medication with food to reduce nausea
D. Use backup contraception during treatment
, Correct Answer: B
Rationale: Correct because metronidazole inhibits aldehyde dehydrogenase, producing
a disulfiram-like reaction when combined with alcohol; patients must abstain from
alcohol during therapy and for at least 24–48 hours after the last dose.
Q6: A 22-year-old sexually active woman presents with mucopurulent cervical discharge
and cervical friability. Which organism is the most likely causative agent?
A. Candida albicans
B. Trichomonas vaginalis
C. Chlamydia trachomatis [CORRECT]
D. Gardnerella vaginalis
Correct Answer: C
Rationale: Correct because chlamydia infection typically presents with vaginal
discharge and cervical changes including friability and mucopurulent discharge; this
matches the clinical presentation described.
Q7: A patient presents with painful genital vesicles and systemic symptoms consistent
with a first episode of genital herpes. Which pharmacologic regimen is first-line for
primary herpes infection?
A. Valacyclovir 1 g daily for 5 days
B. Acyclovir 400 mg three times daily for 7–10 days [CORRECT]
C. Famciclovir 250 mg twice daily for 3 days
