,NU 646 Exam 2 Primary Care for Women Questions And Answers
2026/2027 Herzing University
Q1. A 52-year-old has had no menstrual bleeding for 12 consecutive
months without another identifiable cause. Which interpretation is
most appropriate?
A) She has entered early perimenopause
B) She has secondary amenorrhea requiring fertility testing
C) She meets the clinical definition of natural menopause
D) She has premature ovarian insufficiency
Correct Answer: C) She meets the clinical definition of natural menopause
Rationale: Natural menopause is identified retrospectively after 12
consecutive months without menstruation when another physiologic or
pathologic cause does not explain the amenorrhea.
Q2. A 51-year-old reports frequent severe hot flashes and night
sweats that substantially impair sleep and daily functioning. Which
therapy is generally the most effective treatment for vasomotor
menopausal symptoms when no contraindication exists?
A) Vaginal moisturizer alone
B) Routine antibiotic therapy
C) Calcium supplementation
D) Systemic menopausal hormone therapy
Correct Answer: D) Systemic menopausal hormone therapy
Rationale: Systemic estrogen-containing hormone therapy is highly
effective for moderate-to-severe vasomotor symptoms such as hot flashes
and night sweats.
Q3. A patient with an intact uterus is prescribed systemic estrogen
for significant menopausal symptoms. Which additional therapy is
generally needed?
A) A progestogen to reduce endometrial stimulation
B) Testosterone to prevent osteoporosis
C) Antibiotic prophylaxis
D) Thyroid hormone
Correct Answer: A) A progestogen to reduce endometrial stimulation
, Rationale: Systemic estrogen without adequate progestogen can stimulate
the endometrium and increase the risk of hyperplasia and malignancy in a
patient who retains her uterus.
Q4. A postmenopausal patient reports only vaginal dryness and
discomfort with intercourse and has no significant vasomotor
symptoms. Which approach may be appropriate after individualized
assessment?
A) Consider a targeted local vaginal therapy rather than automatically using
systemic hormone therapy
B) Begin systemic estrogen in every patient
C) Treat with an antimicrobial agent
D) Recommend no treatment because the symptoms are expected with
aging
Correct Answer: A) Consider a targeted local vaginal therapy rather than
automatically using systemic hormone therapy
Rationale: Local therapy can effectively target genitourinary symptoms
while avoiding unnecessary systemic treatment when symptoms are
confined primarily to vaginal tissues.
Q5. Which history would generally make systemic menopausal
hormone therapy inappropriate or require substantial
reconsideration of risk?
A) Seasonal allergic rhinitis
B) Uncomplicated myopia
C) Previous appendectomy
D) Previous venous thromboembolism
Correct Answer: D) Previous venous thromboembolism
Rationale: A history of blood clots is an important contraindication or major
risk consideration for systemic menopausal hormone therapy.
Q6. A 58-year-old using menopausal hormone therapy develops new
vaginal bleeding after having been amenorrheic for several years.
What is the best response?
A) Increase the estrogen dose
B) Reassure her that all bleeding on hormone therapy is harmless
C) Evaluate the bleeding rather than automatically attributing it to hormone
2026/2027 Herzing University
Q1. A 52-year-old has had no menstrual bleeding for 12 consecutive
months without another identifiable cause. Which interpretation is
most appropriate?
A) She has entered early perimenopause
B) She has secondary amenorrhea requiring fertility testing
C) She meets the clinical definition of natural menopause
D) She has premature ovarian insufficiency
Correct Answer: C) She meets the clinical definition of natural menopause
Rationale: Natural menopause is identified retrospectively after 12
consecutive months without menstruation when another physiologic or
pathologic cause does not explain the amenorrhea.
Q2. A 51-year-old reports frequent severe hot flashes and night
sweats that substantially impair sleep and daily functioning. Which
therapy is generally the most effective treatment for vasomotor
menopausal symptoms when no contraindication exists?
A) Vaginal moisturizer alone
B) Routine antibiotic therapy
C) Calcium supplementation
D) Systemic menopausal hormone therapy
Correct Answer: D) Systemic menopausal hormone therapy
Rationale: Systemic estrogen-containing hormone therapy is highly
effective for moderate-to-severe vasomotor symptoms such as hot flashes
and night sweats.
Q3. A patient with an intact uterus is prescribed systemic estrogen
for significant menopausal symptoms. Which additional therapy is
generally needed?
A) A progestogen to reduce endometrial stimulation
B) Testosterone to prevent osteoporosis
C) Antibiotic prophylaxis
D) Thyroid hormone
Correct Answer: A) A progestogen to reduce endometrial stimulation
, Rationale: Systemic estrogen without adequate progestogen can stimulate
the endometrium and increase the risk of hyperplasia and malignancy in a
patient who retains her uterus.
Q4. A postmenopausal patient reports only vaginal dryness and
discomfort with intercourse and has no significant vasomotor
symptoms. Which approach may be appropriate after individualized
assessment?
A) Consider a targeted local vaginal therapy rather than automatically using
systemic hormone therapy
B) Begin systemic estrogen in every patient
C) Treat with an antimicrobial agent
D) Recommend no treatment because the symptoms are expected with
aging
Correct Answer: A) Consider a targeted local vaginal therapy rather than
automatically using systemic hormone therapy
Rationale: Local therapy can effectively target genitourinary symptoms
while avoiding unnecessary systemic treatment when symptoms are
confined primarily to vaginal tissues.
Q5. Which history would generally make systemic menopausal
hormone therapy inappropriate or require substantial
reconsideration of risk?
A) Seasonal allergic rhinitis
B) Uncomplicated myopia
C) Previous appendectomy
D) Previous venous thromboembolism
Correct Answer: D) Previous venous thromboembolism
Rationale: A history of blood clots is an important contraindication or major
risk consideration for systemic menopausal hormone therapy.
Q6. A 58-year-old using menopausal hormone therapy develops new
vaginal bleeding after having been amenorrheic for several years.
What is the best response?
A) Increase the estrogen dose
B) Reassure her that all bleeding on hormone therapy is harmless
C) Evaluate the bleeding rather than automatically attributing it to hormone
