1
WOMEN’S HEALTH CARE IN ADVANCED PRACTICE
NURSING 2ND EDITION IVY M. ALEXANDER WHNP,
FNP, APRN EXAM PREP LATEST 2026-2027 VERSION B:
300 ALL-NEW COMPLEX QUESTIONS WITH DETAILED
RATIONALES
SECTION 1: CARDIOVASCULAR AND METABOLIC HEALTH IN WOMEN
(QUESTIONS 1–40)
Question 1
A 58-year-old postmenopausal woman presents with a 2-week history of
exertional chest pressure that radiates to her jaw. She has a history of
type 2 diabetes and hypertension. Her resting EKG is normal. Which of
the following is the most important next step in her evaluation?
A. Reassurance and outpatient follow-up in 6 months.
B. Exercise stress testing or pharmacologic stress imaging.
C. Immediate initiation of hormone therapy.
D. CT coronary angiography.
Answer: B. Exercise stress testing or pharmacologic stress imaging.
Rationale: The patient has classic anginal symptoms with multiple
cardiovascular risk factors (diabetes, hypertension, postmenopausal
status). Despite a normal resting EKG, stress testing is indicated to
evaluate for inducible ischemia. Women often present with atypical
symptoms, and diabetes increases the risk of silent ischemia. Hormone
therapy is not indicated for cardiovascular prevention. CT angiography
may be considered but is not the initial preferred test for stable angina
evaluation.
, 2
Question 2
A 45-year-old woman with a BMI of 38 presents with a fasting glucose of
118 mg/dL and a blood pressure of 138/88 mmHg. Her waist
circumference is 40 inches, and her triglycerides are 180 mg/dL. Which of
the following is the most accurate diagnosis?
A. Metabolic syndrome
B. Type 2 diabetes mellitus
C. Polycystic ovary syndrome
D. Cushing syndrome
Answer: A. Metabolic syndrome
Rationale: The patient meets the criteria for metabolic syndrome:
abdominal obesity (waist >35 inches in women), elevated fasting glucose
(≥100 mg/dL), elevated blood pressure (≥130/85 mmHg), and elevated
triglycerides (≥150 mg/dL). Type 2 diabetes requires a fasting glucose
≥126 mg/dL. PCOS and Cushing syndrome are not diagnosed based solely
on these findings.
, 3
Question 3
A 62-year-old woman with a history of heart failure with preserved
ejection fraction (HFpEF) presents with worsening dyspnea and edema.
Her BNP is elevated. Which of the following is the most appropriate
initial pharmacological therapy?
A. An ACE inhibitor
B. A beta-blocker
C. A diuretic
D. A calcium channel blocker
Answer: C. A diuretic
Rationale: For acute decompensated heart failure with volume overload
(edema, dyspnea), diuretics are the first-line therapy to relieve
congestion. ACE inhibitors, beta-blockers, and calcium channel blockers
are important for chronic management but do not provide immediate
symptom relief in acute decompensation.
Question 4
A 34-year-old woman with a history of migraine with aura is considering
combined oral contraceptive pills (COCs) for contraception. What is the
most significant risk associated with COC use in this patient?
A. Hypertension
B. Ischemic stroke
C. Venous thromboembolism
D. Breast cancer
, 4
Answer: B. Ischemic stroke
Rationale: Migraine with aura is an absolute contraindication to
estrogen-containing contraceptives due to a significantly increased risk
of ischemic stroke. While VTE risk is also elevated with COCs, the
combination of migraine with aura and estrogen creates a synergistic
risk for stroke.
Question 5
A 55-year-old woman with a history of hypertension and diabetes
presents with a blood pressure of 178/102 mmHg. She has no symptoms
of end-organ damage. Which of the following is the most appropriate
initial management?
A. Immediate hospitalization for intravenous antihypertensives.
B. Initiation of oral antihypertensive therapy and close outpatient
follow-up.
C. Observation and lifestyle modification only.
D. Referral for renal denervation.
Answer: B. Initiation of oral antihypertensive therapy and close
outpatient follow-up.
Rationale: This is stage 2 hypertension without evidence of acute end-
organ damage (hypertensive urgency). The appropriate management is
initiation of oral antihypertensive therapy and close follow-up.
Hospitalization and intravenous therapy are reserved for hypertensive
emergencies with end-organ damage. Lifestyle modification alone is
insufficient for stage 2 hypertension.
WOMEN’S HEALTH CARE IN ADVANCED PRACTICE
NURSING 2ND EDITION IVY M. ALEXANDER WHNP,
FNP, APRN EXAM PREP LATEST 2026-2027 VERSION B:
300 ALL-NEW COMPLEX QUESTIONS WITH DETAILED
RATIONALES
SECTION 1: CARDIOVASCULAR AND METABOLIC HEALTH IN WOMEN
(QUESTIONS 1–40)
Question 1
A 58-year-old postmenopausal woman presents with a 2-week history of
exertional chest pressure that radiates to her jaw. She has a history of
type 2 diabetes and hypertension. Her resting EKG is normal. Which of
the following is the most important next step in her evaluation?
A. Reassurance and outpatient follow-up in 6 months.
B. Exercise stress testing or pharmacologic stress imaging.
C. Immediate initiation of hormone therapy.
D. CT coronary angiography.
Answer: B. Exercise stress testing or pharmacologic stress imaging.
Rationale: The patient has classic anginal symptoms with multiple
cardiovascular risk factors (diabetes, hypertension, postmenopausal
status). Despite a normal resting EKG, stress testing is indicated to
evaluate for inducible ischemia. Women often present with atypical
symptoms, and diabetes increases the risk of silent ischemia. Hormone
therapy is not indicated for cardiovascular prevention. CT angiography
may be considered but is not the initial preferred test for stable angina
evaluation.
, 2
Question 2
A 45-year-old woman with a BMI of 38 presents with a fasting glucose of
118 mg/dL and a blood pressure of 138/88 mmHg. Her waist
circumference is 40 inches, and her triglycerides are 180 mg/dL. Which of
the following is the most accurate diagnosis?
A. Metabolic syndrome
B. Type 2 diabetes mellitus
C. Polycystic ovary syndrome
D. Cushing syndrome
Answer: A. Metabolic syndrome
Rationale: The patient meets the criteria for metabolic syndrome:
abdominal obesity (waist >35 inches in women), elevated fasting glucose
(≥100 mg/dL), elevated blood pressure (≥130/85 mmHg), and elevated
triglycerides (≥150 mg/dL). Type 2 diabetes requires a fasting glucose
≥126 mg/dL. PCOS and Cushing syndrome are not diagnosed based solely
on these findings.
, 3
Question 3
A 62-year-old woman with a history of heart failure with preserved
ejection fraction (HFpEF) presents with worsening dyspnea and edema.
Her BNP is elevated. Which of the following is the most appropriate
initial pharmacological therapy?
A. An ACE inhibitor
B. A beta-blocker
C. A diuretic
D. A calcium channel blocker
Answer: C. A diuretic
Rationale: For acute decompensated heart failure with volume overload
(edema, dyspnea), diuretics are the first-line therapy to relieve
congestion. ACE inhibitors, beta-blockers, and calcium channel blockers
are important for chronic management but do not provide immediate
symptom relief in acute decompensation.
Question 4
A 34-year-old woman with a history of migraine with aura is considering
combined oral contraceptive pills (COCs) for contraception. What is the
most significant risk associated with COC use in this patient?
A. Hypertension
B. Ischemic stroke
C. Venous thromboembolism
D. Breast cancer
, 4
Answer: B. Ischemic stroke
Rationale: Migraine with aura is an absolute contraindication to
estrogen-containing contraceptives due to a significantly increased risk
of ischemic stroke. While VTE risk is also elevated with COCs, the
combination of migraine with aura and estrogen creates a synergistic
risk for stroke.
Question 5
A 55-year-old woman with a history of hypertension and diabetes
presents with a blood pressure of 178/102 mmHg. She has no symptoms
of end-organ damage. Which of the following is the most appropriate
initial management?
A. Immediate hospitalization for intravenous antihypertensives.
B. Initiation of oral antihypertensive therapy and close outpatient
follow-up.
C. Observation and lifestyle modification only.
D. Referral for renal denervation.
Answer: B. Initiation of oral antihypertensive therapy and close
outpatient follow-up.
Rationale: This is stage 2 hypertension without evidence of acute end-
organ damage (hypertensive urgency). The appropriate management is
initiation of oral antihypertensive therapy and close follow-up.
Hospitalization and intravenous therapy are reserved for hypertensive
emergencies with end-organ damage. Lifestyle modification alone is
insufficient for stage 2 hypertension.
