NURS 5338 Final Exam Official Practice Exam
Actual Exam 2026/2027 with Detailed Rationales
| Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Family & Women's Health | Q1 – Q13
Section 2 | Pediatric & Adolescent Health | Q14 – Q25
Section 3 | Adult Health — Chronic Disease Management | Q26 – Q35
Section 4 | Adult Health — Acute & Complex Conditions | Q36 – Q43
Section 5 | Psychosocial, Behavioral & Health Promotion | Q44 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
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SECTION 1: FAMILY & WOMEN'S HEALTH Q1 – Q13
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Question 1 of 50
A 26-year-old woman presents with irregular menses, hirsutism, and acne. Labs reveal an elevated
LH/FSH ratio and mild hyperandrogenism. The most appropriate initial pharmacologic management for
this patient is a combined oral contraceptive. Spironolactone is a common trap because it is teratogenic
and must be used with concurrent contraception.
A. Initiate a combined oral contraceptive ✓ CORRECT
B. Initiate spironolactone monotherapy
C. Initiate metformin
D. Initiate a levonorgestrel IUD
,Correct Answer: A
Rationale: Combined oral contraceptives are first-line for PCOS to regulate menses and decrease
androgen levels. Spironolactone is often a tempting choice but is teratogenic and must be used with
contraception. On exams, always pair anti-androgens with contraception in reproductive-age women.
Question 2 of 50
A 52-year-old woman with severe vasomotor symptoms and an intact uterus requests hormone therapy.
The correct prescription must include both estrogen and progestin to prevent endometrial hyperplasia.
Estrogen alone is a dangerous trap for women with an intact uterus.
A. Conjugated estrogen only
B. Conjugated estrogen plus medroxyprogesterone ✓ CORRECT
C. Medroxyprogesterone only
D. Low-dose vaginal estrogen
Correct Answer: B
Rationale: Estrogen plus progestin is required for menopausal hormone therapy in women with an intact
uterus to prevent endometrial hyperplasia. Estrogen alone is a common trap that only applies to women
who have had a hysterectomy. Know the uterus status before prescribing HRT.
Question 3 of 50
A 14-week pregnant Rh-negative woman with no prior sensitization presents for routine prenatal care.
RhoGAM is indicated at 28 weeks gestation to prevent Rh sensitization. Administering RhoGAM at 14
weeks without a sensitizing event is an incorrect application of the guidelines.
A. Administer RhoGAM today
B. Administer RhoGAM at 28 weeks gestation ✓ CORRECT
C. Administer RhoGAM at 36 weeks gestation
D. Administer RhoGAM only at delivery
Correct Answer: B
, Rationale: RhoGAM is administered at 28 weeks gestation to prevent Rh sensitization in Rh-negative
women. Administering RhoGAM at 14 weeks is incorrect unless there is a sensitizing event like bleeding
or trauma. Timing of RhoGAM at 28 weeks is a standard prenatal care milestone.
Question 4 of 50
A 35-year-old G2P2 presents with heavy menstrual bleeding, a normal pelvic exam, and a normal
endometrial biopsy. A levonorgestrel-releasing IUD is the most appropriate first-line treatment.
Endometrial ablation is a tempting trap but is reserved for women who have completed childbearing and
failed medical management.
A. Perform an endometrial ablation
B. Initiate oral contraceptive pills
C. Initiate oral tranexamic acid
D. Insert a levonorgestrel-releasing IUD ✓ CORRECT
Correct Answer: D
Rationale: A levonorgestrel-releasing IUD is a highly effective first-line treatment for heavy menstrual
bleeding in women with normal endometrial biopsies. Endometrial ablation is a tempting surgical option
but is reserved for women who have completed childbearing and failed medical management. Always
start with the least invasive medical therapy for AUB.
Question 5 of 50
A 29-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and dyspareunia unresponsive to
NSAIDs. Empiric treatment with a combined oral contraceptive is appropriate for suspected
endometriosis. Empiric doxycycline is a trap for pelvic inflammatory disease, which lacks the cyclic
nature of this presentation.
A. Initiate a combined oral contraceptive ✓ CORRECT
B. Initiate empiric doxycycline
C. Order a pelvic MRI
D. Perform a diagnostic laparoscopy
Actual Exam 2026/2027 with Detailed Rationales
| Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Family & Women's Health | Q1 – Q13
Section 2 | Pediatric & Adolescent Health | Q14 – Q25
Section 3 | Adult Health — Chronic Disease Management | Q26 – Q35
Section 4 | Adult Health — Acute & Complex Conditions | Q36 – Q43
Section 5 | Psychosocial, Behavioral & Health Promotion | Q44 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
══════════════════════════════════════
SECTION 1: FAMILY & WOMEN'S HEALTH Q1 – Q13
══════════════════════════════════════
Question 1 of 50
A 26-year-old woman presents with irregular menses, hirsutism, and acne. Labs reveal an elevated
LH/FSH ratio and mild hyperandrogenism. The most appropriate initial pharmacologic management for
this patient is a combined oral contraceptive. Spironolactone is a common trap because it is teratogenic
and must be used with concurrent contraception.
A. Initiate a combined oral contraceptive ✓ CORRECT
B. Initiate spironolactone monotherapy
C. Initiate metformin
D. Initiate a levonorgestrel IUD
,Correct Answer: A
Rationale: Combined oral contraceptives are first-line for PCOS to regulate menses and decrease
androgen levels. Spironolactone is often a tempting choice but is teratogenic and must be used with
contraception. On exams, always pair anti-androgens with contraception in reproductive-age women.
Question 2 of 50
A 52-year-old woman with severe vasomotor symptoms and an intact uterus requests hormone therapy.
The correct prescription must include both estrogen and progestin to prevent endometrial hyperplasia.
Estrogen alone is a dangerous trap for women with an intact uterus.
A. Conjugated estrogen only
B. Conjugated estrogen plus medroxyprogesterone ✓ CORRECT
C. Medroxyprogesterone only
D. Low-dose vaginal estrogen
Correct Answer: B
Rationale: Estrogen plus progestin is required for menopausal hormone therapy in women with an intact
uterus to prevent endometrial hyperplasia. Estrogen alone is a common trap that only applies to women
who have had a hysterectomy. Know the uterus status before prescribing HRT.
Question 3 of 50
A 14-week pregnant Rh-negative woman with no prior sensitization presents for routine prenatal care.
RhoGAM is indicated at 28 weeks gestation to prevent Rh sensitization. Administering RhoGAM at 14
weeks without a sensitizing event is an incorrect application of the guidelines.
A. Administer RhoGAM today
B. Administer RhoGAM at 28 weeks gestation ✓ CORRECT
C. Administer RhoGAM at 36 weeks gestation
D. Administer RhoGAM only at delivery
Correct Answer: B
, Rationale: RhoGAM is administered at 28 weeks gestation to prevent Rh sensitization in Rh-negative
women. Administering RhoGAM at 14 weeks is incorrect unless there is a sensitizing event like bleeding
or trauma. Timing of RhoGAM at 28 weeks is a standard prenatal care milestone.
Question 4 of 50
A 35-year-old G2P2 presents with heavy menstrual bleeding, a normal pelvic exam, and a normal
endometrial biopsy. A levonorgestrel-releasing IUD is the most appropriate first-line treatment.
Endometrial ablation is a tempting trap but is reserved for women who have completed childbearing and
failed medical management.
A. Perform an endometrial ablation
B. Initiate oral contraceptive pills
C. Initiate oral tranexamic acid
D. Insert a levonorgestrel-releasing IUD ✓ CORRECT
Correct Answer: D
Rationale: A levonorgestrel-releasing IUD is a highly effective first-line treatment for heavy menstrual
bleeding in women with normal endometrial biopsies. Endometrial ablation is a tempting surgical option
but is reserved for women who have completed childbearing and failed medical management. Always
start with the least invasive medical therapy for AUB.
Question 5 of 50
A 29-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and dyspareunia unresponsive to
NSAIDs. Empiric treatment with a combined oral contraceptive is appropriate for suspected
endometriosis. Empiric doxycycline is a trap for pelvic inflammatory disease, which lacks the cyclic
nature of this presentation.
A. Initiate a combined oral contraceptive ✓ CORRECT
B. Initiate empiric doxycycline
C. Order a pelvic MRI
D. Perform a diagnostic laparoscopy
