NRNP 6552 ADVANCED NURSE PRACTICE IN REPRODUCTIVE HEALTH CARE WEEK 6 MIDTERM ACTUAL EXAM PREP 2026 ALL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY A GRADED WITH EXPERT FEEDBACK |NEW AND REVISED|WALDEN UNIVERSITY

1|Page


NRNP 6552 ADVANCED NURSE PRACTICE IN
REPRODUCTIVE HEALTH CARE WEEK 6 MIDTERM
ACTUAL EXAM PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT FEEDBACK
|NEW AND REVISED|WALDEN UNIVERSITY


1. A 28-year-old woman presents for her annual gynecologic
examination. She reports that she is sexually active with multiple
partners and has never had a Pap test. Which of the following is the
MOST appropriate screening recommendation?
 A. Perform cervical cancer screening with Pap testing
 B. Defer cervical cancer screening until age 30
 C. Perform cervical cancer screening with HPV testing only
 D. Recommend HPV vaccination before screening
Rationale: Cervical cancer screening should begin at age 21
regardless of sexual history. For women aged 21-29, Pap testing every
3 years is recommended. HPV testing is not recommended as a
primary screening method for women under 30. HPV vaccination is
recommended but does not replace the need for screening.
2. A 32-year-old woman presents with a 6-month history of irregular
menstrual periods and hirsutism. She has a BMI of 32. Laboratory
testing reveals an elevated free testosterone level. Which of the
following is the MOST likely diagnosis?
 A. Cushing's syndrome
 B. Polycystic ovary syndrome
 C. Adrenal tumor

,2|Page


 D. Ovarian tumor
Rationale: The combination of irregular menstrual periods, hirsutism,
obesity, and elevated free testosterone is classic for PCOS. PCOS is
characterized by hyperandrogenism, ovulatory dysfunction, and
polycystic ovaries. Cushing's syndrome typically presents with central
obesity, striae, and hypertension. Adrenal and ovarian tumors are rare
causes of hyperandrogenism.
3. A 45-year-old woman presents with a 3-month history of
postmenopausal bleeding. She has not had a period for 14 months.
Which of the following is the MOST appropriate initial evaluation?
 A. Transvaginal ultrasound
 B. Endometrial biopsy
 C. Hysteroscopy
 D. Pelvic examination only
Rationale: The initial evaluation of postmenopausal bleeding should
include a transvaginal ultrasound to assess endometrial thickness. An
endometrial thickness of <4 mm has a high negative predictive value
for endometrial cancer. Endometrial biopsy is indicated if the
endometrial thickness is ≥4 mm or if there are other risk factors.
4. A 24-year-old woman presents with a 2-week history of vaginal
discharge, dysuria, and intermenstrual bleeding. She reports a new
sexual partner 3 weeks ago. On examination, there is cervical motion
tenderness and mucopurulent discharge. Which of the following is the
MOST appropriate initial management?
 A. Treat empirically for chlamydia and gonorrhea after obtaining
cultures
 B. Obtain cervical swabs for NAAT testing and treat
empirically for chlamydia and gonorrhea

,3|Page


 C. Obtain cervical swabs for NAAT testing and wait for results
before treating
 D. Treat for bacterial vaginosis
Rationale: This patient has signs of cervicitis and possible pelvic
inflammatory disease (PID). Empiric treatment for chlamydia and
gonorrhea should be initiated at the time of testing, without waiting for
results, to prevent complications. NAAT testing is the preferred
diagnostic method. Bacterial vaginosis does not typically cause
cervical motion tenderness or intermenstrual bleeding.
5. A 41-year-old woman presents with a 3-month history of hot flashes,
night sweats, and mood swings. She has not had a period for 12 months.
Which of the following is the MOST appropriate management?
 A. Discuss treatment options for menopausal symptoms
 B. Prescribe hormone replacement therapy
 C. Recommend lifestyle modifications only
 D. Order FSH and estradiol levels
Rationale: This patient is menopausal (amenorrhea for 12 months).
Management should include a discussion of treatment options for
vasomotor symptoms, including lifestyle modifications, non-hormonal
therapies, and hormone replacement therapy. FSH and estradiol levels
are not necessary for diagnosis in a woman over 40 with 12 months of
amenorrhea.
6. A 26-year-old woman presents with a 2-week history of a non-
healing, painless ulcer on her labia. She has no other symptoms. Which
of the following is the MOST appropriate diagnostic test?
 A. Darkfield microscopy and serologic testing for syphilis
 B. Viral culture for herpes simplex virus

, 4|Page


 C. Wet mount for Trichomonas
 D. Gram stain for bacterial vaginosis
Rationale: A painless, non-healing ulcer is characteristic of primary
syphilis. The diagnosis is confirmed by darkfield microscopy of the
ulcer exudate and serologic testing (RPR or VDRL). Viral culture
would be appropriate for HSV, which presents with painful vesicles
and ulcers.
7. A 27-year-old woman presents for contraceptive counseling. She has
a history of a deep vein thrombosis (DVT) 2 years ago while taking
combined oral contraceptives. She is a nonsmoker and has no other
medical conditions. Which of the following contraceptive methods is
MOST appropriate for this patient?
 A. Progestin-only pill
 B. Combined oral contraceptive pill
 C. Transdermal contraceptive patch
 D. Vaginal ring
Rationale: Combined hormonal contraceptives (pills, patch, ring) are
contraindicated in women with a history of DVT or pulmonary
embolism due to the increased risk of recurrent thromboembolism.
Progestin-only methods (pill, implant, injection) are safe alternatives
as they do not increase the risk of VTE.
8. A 35-year-old woman at 34 weeks gestation presents with a blood
pressure of 138/86 mmHg. She has no proteinuria and no symptoms.
Which of the following is the MOST appropriate management?
 A. Monitor blood pressure and reassess in 1 week
 B. Initiate labetalol 100 mg BID
 C. Admit for induction of labor