NRNP6552 MIDTERM WEEK 6 STUDY GUIDE
2026 – COMPLETE CONCEPT REVIEW &
PRACTICE MATERIALS (LATEST EDITION)
Menopause & Hormone Therapy
1. Q: What is the clinical definition of menopause?
A: The permanent cessation of menses, confirmed after 12
consecutive months of amenorrhea.
2. Q: What is perimenopause?
A: The transitional period leading up to menopause, marked by
hormonal fluctuations and variable cycle length, often with
vasomotor symptoms.
3. Q: Name the three most common vasomotor symptoms (VMS) of
menopause.
A: Hot flashes, night sweats, and sleep disturbances.
4. Q: What is the primary indication for systemic Menopausal
Hormone Therapy (MHT)?
A: Treatment of moderate-to-severe vasomotor symptoms in
appropriate candidates.
5. Q: What is the "golden rule" for initiating MHT?
A: Use the lowest effective dose for the shortest duration needed
to meet treatment goals.
, 6. Q: A woman with an intact uterus requires what type of MHT to
prevent endometrial hyperplasia?
A: Estrogen must be combined with a progestogen.
7. Q: What is the primary benefit of vaginal estrogen for
genitourinary syndrome of menopause (GSM)?
A: Local relief of vaginal dryness, dyspareunia, and urinary
symptoms with minimal systemic absorption.
8. Q: What is the most significant contraindication to systemic
MHT?
A: A personal history of estrogen-dependent cancer (e.g., breast,
endometrial), thromboembolic disease, or active liver disease.
9. Q: What non-hormonal medication is a first-line FDA-approved
treatment for VMS?
A: Paroxetine (Brisdelle) 7.5 mg, a low-dose SSRI.
10. Q: What lifestyle modification is strongly recommended for
managing menopausal symptoms?
A: Regular aerobic exercise and structured weight management.
Gynecological Conditions & Cancer Screening
11. Q: What is the most common type of vaginal infection in
postmenopausal women?
A: Atrophic vaginitis (part of GSM), not bacterial vaginosis.
12. Q: A postmenopausal woman with new postcoital bleeding
requires what initial workup?
, A: A pelvic exam and endometrial sampling/transvaginal
ultrasound to rule out endometrial cancer.
13. Q: What is the first-line, most accurate diagnostic test for
abnormal uterine bleeding in a postmenopausal woman?
A: Endometrial biopsy.
14. Q: At what age can average-risk women
typically stop cervical cancer screening (Pap/HPV)?
A: Age 65, with adequate prior negative screening history.
15. Q: The USPSTF recommends against screening for ovarian
cancer in asymptomatic, average-risk women. (True/False)
A: True.
16. Q: What is the most common gynecologic cancer in older
women?
A: Endometrial cancer.
17. Q: A persistent, thin, watery vaginal discharge in a
postmenopausal woman should raise suspicion for what?
A: Fallopian tube carcinoma or serous endometrial cancer.
18. Q: What is the primary risk factor for endometrial cancer?
A: Unopposed estrogen exposure (e.g., obesity, nulliparity, late
menopause).
19. Q: What pelvic floor disorder is characterized by protrusion
of the bladder into the vaginal wall?
A: Cystocele.
, 20. Q: What is the first-line conservative management for
symptomatic pelvic organ prolapse (POP)?
A: Insertion of a vaginal pessary.
Urological & Sexual Health
21. Q: Differentiate between Stress Urinary Incontinence (SUI)
and Urge Urinary Incontinence (UUI).
A: SUI: Leakage with exertion (cough, laugh). UUI: Leakage
preceded by a sudden, compelling urge.
22. Q: What is the first-line treatment for uncomplicated Stress
Urinary Incontinence?
A: Pelvic floor muscle training (Kegels), ideally with formal physical
therapy.
23. Q: What medication class is first-line for Overactive Bladder
(OAB) with UUI?
A: Antimuscarinics (e.g., oxybutynin, tolterodine) or Beta-3
agonists (mirabegron).
24. Q: What is a major anticholinergic side effect of older OAB
medications that is a concern in the elderly?
A: Cognitive impairment, confusion, increased fall risk, and dry
mouth.
25. Q: What bedside test is a simple initial assessment for SUI?
A: The cough stress test.
26. Q: What is the most common cause of recurrent UTIs in
older women?
2026 – COMPLETE CONCEPT REVIEW &
PRACTICE MATERIALS (LATEST EDITION)
Menopause & Hormone Therapy
1. Q: What is the clinical definition of menopause?
A: The permanent cessation of menses, confirmed after 12
consecutive months of amenorrhea.
2. Q: What is perimenopause?
A: The transitional period leading up to menopause, marked by
hormonal fluctuations and variable cycle length, often with
vasomotor symptoms.
3. Q: Name the three most common vasomotor symptoms (VMS) of
menopause.
A: Hot flashes, night sweats, and sleep disturbances.
4. Q: What is the primary indication for systemic Menopausal
Hormone Therapy (MHT)?
A: Treatment of moderate-to-severe vasomotor symptoms in
appropriate candidates.
5. Q: What is the "golden rule" for initiating MHT?
A: Use the lowest effective dose for the shortest duration needed
to meet treatment goals.
, 6. Q: A woman with an intact uterus requires what type of MHT to
prevent endometrial hyperplasia?
A: Estrogen must be combined with a progestogen.
7. Q: What is the primary benefit of vaginal estrogen for
genitourinary syndrome of menopause (GSM)?
A: Local relief of vaginal dryness, dyspareunia, and urinary
symptoms with minimal systemic absorption.
8. Q: What is the most significant contraindication to systemic
MHT?
A: A personal history of estrogen-dependent cancer (e.g., breast,
endometrial), thromboembolic disease, or active liver disease.
9. Q: What non-hormonal medication is a first-line FDA-approved
treatment for VMS?
A: Paroxetine (Brisdelle) 7.5 mg, a low-dose SSRI.
10. Q: What lifestyle modification is strongly recommended for
managing menopausal symptoms?
A: Regular aerobic exercise and structured weight management.
Gynecological Conditions & Cancer Screening
11. Q: What is the most common type of vaginal infection in
postmenopausal women?
A: Atrophic vaginitis (part of GSM), not bacterial vaginosis.
12. Q: A postmenopausal woman with new postcoital bleeding
requires what initial workup?
, A: A pelvic exam and endometrial sampling/transvaginal
ultrasound to rule out endometrial cancer.
13. Q: What is the first-line, most accurate diagnostic test for
abnormal uterine bleeding in a postmenopausal woman?
A: Endometrial biopsy.
14. Q: At what age can average-risk women
typically stop cervical cancer screening (Pap/HPV)?
A: Age 65, with adequate prior negative screening history.
15. Q: The USPSTF recommends against screening for ovarian
cancer in asymptomatic, average-risk women. (True/False)
A: True.
16. Q: What is the most common gynecologic cancer in older
women?
A: Endometrial cancer.
17. Q: A persistent, thin, watery vaginal discharge in a
postmenopausal woman should raise suspicion for what?
A: Fallopian tube carcinoma or serous endometrial cancer.
18. Q: What is the primary risk factor for endometrial cancer?
A: Unopposed estrogen exposure (e.g., obesity, nulliparity, late
menopause).
19. Q: What pelvic floor disorder is characterized by protrusion
of the bladder into the vaginal wall?
A: Cystocele.
, 20. Q: What is the first-line conservative management for
symptomatic pelvic organ prolapse (POP)?
A: Insertion of a vaginal pessary.
Urological & Sexual Health
21. Q: Differentiate between Stress Urinary Incontinence (SUI)
and Urge Urinary Incontinence (UUI).
A: SUI: Leakage with exertion (cough, laugh). UUI: Leakage
preceded by a sudden, compelling urge.
22. Q: What is the first-line treatment for uncomplicated Stress
Urinary Incontinence?
A: Pelvic floor muscle training (Kegels), ideally with formal physical
therapy.
23. Q: What medication class is first-line for Overactive Bladder
(OAB) with UUI?
A: Antimuscarinics (e.g., oxybutynin, tolterodine) or Beta-3
agonists (mirabegron).
24. Q: What is a major anticholinergic side effect of older OAB
medications that is a concern in the elderly?
A: Cognitive impairment, confusion, increased fall risk, and dry
mouth.
25. Q: What bedside test is a simple initial assessment for SUI?
A: The cough stress test.
26. Q: What is the most common cause of recurrent UTIs in
older women?
