NRNP 6552 ADVANCED NURSE PRACTICE IN REPRODUCTIVE HEALTH CARE WEEK 11 FINAL 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 11 FINAL
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 first prenatal visit at 10 weeks
gestation. She reports a history of type 1 diabetes mellitus. Which of the
following is the MOST appropriate initial management step for this
patient?
 A. Schedule a fetal echocardiogram at 32 weeks
 B. Refer for early ophthalmology and nephrology evaluation
 C. Initiate insulin therapy at 20 weeks gestation
 D. Recommend a low-carbohydrate diet
Rationale: Women with pre-existing diabetes should have early
evaluation for microvascular complications, including retinopathy and
nephropathy, as pregnancy can worsen these conditions. Early
ophthalmology and nephrology referrals are standard of care. Insulin
therapy should be managed throughout pregnancy, not initiated at 20
weeks, and dietary recommendations should be individualized.
2. A 32-year-old woman at 28 weeks gestation presents with a blood
pressure of 148/92 mmHg and 2+ proteinuria on dipstick. She reports
headache and blurred vision. Which of the following is the MOST
appropriate next step?
 A. Prescribe labetalol 200 mg PO daily

,2|Page


 B. Admit to labor and delivery for urgent evaluation and
management
 C. Schedule a follow-up appointment in 1 week
 D. Order a 24-hour urine protein collection as an outpatient
Rationale: This patient has signs of severe preeclampsia (blood
pressure ≥140/90 with proteinuria and end-organ symptoms including
headache and visual changes). Urgent evaluation and management in
a hospital setting is required to prevent maternal and fetal
complications. Outpatient management is not appropriate for this
presentation.
3. A 45-year-old woman presents with heavy menstrual bleeding, pelvic
pain, and a palpable pelvic mass on examination. Transvaginal
ultrasound reveals a 6 cm subserosal fibroid. Which of the following is
the MOST appropriate initial management?
 A. Refer for hysterectomy
 B. Discuss treatment options including watchful waiting,
medical therapy, and surgical interventions
 C. Prescribe oral contraceptive pills
 D. Recommend a myomectomy
Rationale: Management of uterine fibroids depends on symptom
severity, patient age, and fertility desires. Initial management should
include a discussion of all treatment options, including watchful
waiting (if asymptomatic), medical therapy (GnRH agonists, hormonal
contraceptives), and surgical options (myomectomy, hysterectomy).
Shared decision-making is essential.
4. A 25-year-old woman presents for her annual gynecologic
examination. She reports that she is sexually active with multiple

,3|Page


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 and HPV co-
testing
 B. Defer cervical cancer screening until age 30
 C. Perform cervical cancer screening with Pap 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. For women aged 30-65, co-testing with Pap
and HPV every 5 years is preferred. This patient is 25 and has never
been screened, so Pap testing (with or without HPV testing) is
indicated.
5. A 30-year-old woman at 36 weeks gestation presents with painless
vaginal bleeding. Her vital signs are stable and fetal heart tones are
reassuring. Which of the following is the MOST likely diagnosis?
 A. Placental abruption
 B. Placenta previa
 C. Uterine rupture
 D. Vasa previa
Rationale: Painless vaginal bleeding in the third trimester is
characteristic of placenta previa, where the placenta partially or
completely covers the cervical os. Placental abruption typically
presents with painful bleeding and uterine tenderness. Uterine rupture
is associated with severe pain and fetal distress. Vasa previa presents
with painless bleeding but is rare.

, 4|Page


6. A 22-year-old woman presents with a 3-day history of dysuria,
urinary frequency, and suprapubic pain. She reports no vaginal discharge
or fever. Urinalysis reveals positive nitrites and leukocyte esterase.
Which of the following is the MOST appropriate treatment?
 A. Nitrofurantoin 100 mg BID for 5 days
 B. Ciprofloxacin 500 mg daily for 3 days
 C. Doxycycline 100 mg BID for 7 days
 D. Fluconazole 150 mg single dose
Rationale: This patient has an uncomplicated urinary tract infection.
Nitrofurantoin is a first-line agent for uncomplicated UTI.
Fluoroquinolones should be reserved for more complicated infections.
Doxycycline is not indicated for UTI, and fluconazole is for fungal
infections.
7. A 38-year-old woman presents with a 6-month history of amenorrhea,
hot flashes, and night sweats. Her FSH level is 45 mIU/mL. Which of
the following is the MOST likely diagnosis?
 A. Polycystic ovary syndrome
 B. Perimenopause
 C. Primary ovarian insufficiency
 D. Pregnancy
Rationale: This patient's symptoms and elevated FSH level (>40
mIU/mL) are consistent with perimenopause or menopause.
Pregnancy should be ruled out, but the classic vasomotor symptoms
make perimenopause the most likely diagnosis. PCOS typically
presents with oligomenorrhea and hyperandrogenism. Primary
ovarian insufficiency presents with similar symptoms but occurs
before age 40.