NURS 5432 FAMILY 1 MIDTERM EXAM: WOMEN'S
HEALTH COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NURS
Prepare with confidence using this NURS 5432 Family 1 Midterm Exam:
Women’s Health, designed to assess advanced nursing concepts in women’s
health care. It focuses on reproductive health, prenatal and postpartum care,
gynecologic conditions, and preventive screening guidelines. The exam
strengthens clinical reasoning and evidence-based management of women’s
health issues. Suitable for graduate nursing students preparing for exams and
clinical practice.
MULTIPLE CHOICE.
Subsection 1: Menstrual Cycle & Normal Variations (Questions 1–
15)
1. A 25-year-old woman reports her menstrual cycles occur every
28–32 days, lasting 5 days, with moderate flow. This is classified as:
A. Menorrhagia
B. Normal menstrual cycle (eumenorrhea)
C. Oligomenorrhea
D. Metrorrhagia
Answer: B. Normal menstrual cycle (eumenorrhea)
Explanation: Normal cycle length is 21–35 days, duration 2–7 days,
blood loss 20–80 mL. Eumenorrhea is regular, normal menstruation.
2. A 16-year-old presents with secondary amenorrhea (no menses
for 6 months). She is a competitive gymnast with low body fat. The
most likely etiology is:
A. Pregnancy
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B. Hypothalamic amenorrhea (functional hypothalamic amenorrhea due
to stress, exercise, low weight)
C. Polycystic ovary syndrome (PCOS)
D. Premature ovarian failure
Answer: B. Hypothalamic amenorrhea (functional hypothalamic
amenorrhea due to stress, exercise, low weight)
Explanation: Hypothalamic amenorrhea is common in athletes, low
BMI, or stress. GnRH pulsatility suppressed → low LH/FSH, low
estradiol.
3. A 30-year-old woman reports heavy menstrual bleeding with
clots and soaking through a pad every hour. This is termed:
A. Menorrhagia (heavy menstrual bleeding)
B. Oligomenorrhea
C. Polymenorrhea
D. Dysmenorrhea
Answer: A. Menorrhagia (heavy menstrual bleeding)
Explanation: Heavy menstrual bleeding (HMB) is defined as blood
loss >80 mL per cycle or interfering with quality of life. Causes: fibroids,
adenomyosis, anovulation, coagulopathy.
4. A 22-year-old has cycles every 45–60 days with hirsutism and
acne. The most likely diagnosis is:
A. Pregnancy
B. Polycystic ovary syndrome (PCOS)
C. Hypothyroidism
D. Hyperprolactinemia
Answer: B. Polycystic ovary syndrome (PCOS)
Explanation: PCOS (Rotterdam criteria): oligoovulation/anovulation,
hyperandrogenism (clinical or biochemical), polycystic ovaries on
ultrasound (2 of 3). Exclude other causes.
5. Mittelschmerz refers to:
A. Heavy menstrual bleeding
B. Midcycle ovulatory pain (usually unilateral, brief)
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C. Painful intercourse
D. Premenstrual breast tenderness
Answer: B. Midcycle ovulatory pain (usually unilateral, brief)
Explanation: Mittelschmerz is pain at ovulation (around day 14) due
to follicular distension or peritoneal irritation from follicular fluid.
6. A 28-year-old has predictable, cyclic breast pain and bloating
occurring 1 week before menses, resolving with onset of flow. This
is:
A. Cyclic mastalgia (normal, due to hormonal changes)
B. Fibrocystic changes
C. Breast cancer
D. Mastitis
Answer: A. Cyclic mastalgia (normal, due to hormonal changes)
Explanation: Cyclic mastalgia is common, benign, and managed with
reassurance, supportive bra, evening primrose oil, or hormonal
suppression if severe.
7. Which hormone maintains the endometrial lining during the
luteal phase?
A. Estrogen
B. Progesterone
C. FSH
D. LH
Answer: B. Progesterone
Explanation: Progesterone secreted by corpus luteum stabilizes and
transforms the endometrium for implantation. Withdrawal causes
menstruation.
8. A 32-year-old woman reports no menses for 3 months and a
positive home pregnancy test. On exam, the cervix is bluish-purple.
This sign is called:
A. Goodell sign (softening of cervix)
B. Chadwick sign (bluish discoloration of cervix and vagina due to
increased vascularity)
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C. Hegar sign (softening of uterine isthmus)
D. McDonald sign
Answer: B. Chadwick sign (bluish discoloration of cervix and
vagina due to increased vascularity)
Explanation: Chadwick sign appears at 6–8 weeks gestation. Goodell:
softening of cervix. Hegar: softening of isthmus.
9. The earliest sign of pregnancy that can be detected on
transvaginal ultrasound is:
A. Fetal heartbeat (6 weeks)
B. Gestational sac (4–5 weeks)
C. Yolk sac (5–6 weeks)
D. Fetal pole (6 weeks)
Answer: B. Gestational sac (4–5 weeks)
Explanation: Transvaginal ultrasound can see gestational sac at
~4.5–5 weeks (β-hCG ~1500–2000 mIU/mL), yolk sac at ~5.5 weeks,
fetal pole and cardiac activity at ~6 weeks.
10. A 22-year-old has a negative pregnancy test and reports cycles
every 35–40 days. She has mild facial acne. The most appropriate
initial workup includes:
A. Thyroid function tests, prolactin, total/free testosterone, 17-OHP
B. Immediate pelvic ultrasound
C. Hysterosalpingogram
D. Endometrial biopsy
Answer: A. Thyroid function tests, prolactin, total/free
testosterone, 17-OHP
Explanation: For oligomenorrhea, initial labs: β-hCG, TSH, prolactin,
and if signs of hyperandrogenism, testosterone, DHEA-S, 17-OHP (to
rule out nonclassic congenital adrenal hyperplasia).
11. During the follicular phase of the menstrual cycle, the
dominant hormone is:
A. Progesterone
B. Estrogen (rising, leading to LH surge)