WHNP Comprehensive Women’s Health
Mastery Exam – 150 High-Yield Board-Style
Questions, Answers And Rationale
(2025/2026)
1. A 28-year-old woman presents with abnormal uterine bleeding.
Which of the following is the most appropriate first-line
evaluation?
A) Endometrial biopsy
B) Transvaginal ultrasound
C) Pregnancy test
D) Hysteroscopy
Answer: C) Pregnancy test
Rationale: Pregnancy must be ruled out in any woman of reproductive
age presenting with abnormal uterine bleeding before other
investigations are pursued.
2. Which contraceptive method has the highest efficacy in typical
use?
A) Condoms
B) Oral contraceptives
C) Intrauterine device (IUD)
D) Diaphragm
Answer: C) Intrauterine device (IUD)
Rationale: IUDs are among the most effective reversible contraceptive
methods with less than 1% failure rate.
3. A 35-year-old woman presents with cyclical breast pain. Which of
the following is the most appropriate initial management?
A) Tamoxifen
, B) Supportive bra and NSAIDs
C) Fine-needle aspiration
D) Mammography
Answer: B) Supportive bra and NSAIDs
Rationale: Cyclical mastalgia is common and usually managed
conservatively with supportive measures and NSAIDs before invasive
testing.
4. Which of the following vaccines is contraindicated in pregnancy?
A) Influenza (inactivated)
B) Tdap
C) MMR
D) COVID-19 mRNA
Answer: C) MMR
Rationale: MMR is a live attenuated vaccine and is contraindicated
during pregnancy due to the risk of fetal infection.
5. A 42-year-old woman presents with hot flashes, night sweats, and
irregular periods. She has no contraindications to hormone
therapy. Which therapy is most appropriate?
A) Combined oral contraceptives
B) Systemic estrogen therapy
C) Gabapentin
D) SSRIs
Answer: B) Systemic estrogen therapy
Rationale: Systemic estrogen therapy is the most effective treatment
for vasomotor symptoms in peri- and postmenopausal women
without contraindications.
6. The first-line treatment for bacterial vaginosis in a non-pregnant
woman is:
, A) Clindamycin cream
B) Oral metronidazole
C) Fluconazole
D) Terconazole
Answer: B) Oral metronidazole
Rationale: Metronidazole orally or intravaginally is the standard first-
line therapy for bacterial vaginosis.
7. Which of the following is a common complication of untreated
chlamydia infection?
A) Ovarian cysts
B) Pelvic inflammatory disease
C) Fibroids
D) Endometriosis
Answer: B) Pelvic inflammatory disease
Rationale: Untreated chlamydia can ascend to the upper reproductive
tract, causing PID and potential infertility.
8. A 30-year-old woman has irregular menses, hirsutism, and acne.
Which laboratory test is most useful for diagnosis?
A) FSH
B) LH and testosterone
C) Prolactin
D) Estradiol
Answer: B) LH and testosterone
Rationale: Elevated LH and testosterone levels help diagnose
polycystic ovary syndrome (PCOS), the most common cause of
hyperandrogenism.
9. A 25-year-old sexually active woman requests emergency
contraception after unprotected intercourse. The most effective
, option within 72 hours is:
A) Copper IUD
B) Levonorgestrel pill
C) Combined oral contraceptive pills
D) Diaphragm
Answer: A) Copper IUD
Rationale: Copper IUD is the most effective form of emergency
contraception and can be used up to 5 days after unprotected
intercourse.
10. The most common cause of secondary amenorrhea in
women of reproductive age is:
A) Thyroid disease
B) PCOS
C) Pregnancy
D) Hyperprolactinemia
Answer: C) Pregnancy
Rationale: Pregnancy is the most common cause of secondary
amenorrhea and must be ruled out first.
11. A patient presents with dysmenorrhea that is unresponsive
to NSAIDs. Which condition should be suspected?
A) Endometriosis
B) Fibroids
C) Ovarian cyst
D) Adenomyosis
Answer: A) Endometriosis
Rationale: NSAID-resistant dysmenorrhea, especially with chronic
pelvic pain, suggests endometriosis.
Mastery Exam – 150 High-Yield Board-Style
Questions, Answers And Rationale
(2025/2026)
1. A 28-year-old woman presents with abnormal uterine bleeding.
Which of the following is the most appropriate first-line
evaluation?
A) Endometrial biopsy
B) Transvaginal ultrasound
C) Pregnancy test
D) Hysteroscopy
Answer: C) Pregnancy test
Rationale: Pregnancy must be ruled out in any woman of reproductive
age presenting with abnormal uterine bleeding before other
investigations are pursued.
2. Which contraceptive method has the highest efficacy in typical
use?
A) Condoms
B) Oral contraceptives
C) Intrauterine device (IUD)
D) Diaphragm
Answer: C) Intrauterine device (IUD)
Rationale: IUDs are among the most effective reversible contraceptive
methods with less than 1% failure rate.
3. A 35-year-old woman presents with cyclical breast pain. Which of
the following is the most appropriate initial management?
A) Tamoxifen
, B) Supportive bra and NSAIDs
C) Fine-needle aspiration
D) Mammography
Answer: B) Supportive bra and NSAIDs
Rationale: Cyclical mastalgia is common and usually managed
conservatively with supportive measures and NSAIDs before invasive
testing.
4. Which of the following vaccines is contraindicated in pregnancy?
A) Influenza (inactivated)
B) Tdap
C) MMR
D) COVID-19 mRNA
Answer: C) MMR
Rationale: MMR is a live attenuated vaccine and is contraindicated
during pregnancy due to the risk of fetal infection.
5. A 42-year-old woman presents with hot flashes, night sweats, and
irregular periods. She has no contraindications to hormone
therapy. Which therapy is most appropriate?
A) Combined oral contraceptives
B) Systemic estrogen therapy
C) Gabapentin
D) SSRIs
Answer: B) Systemic estrogen therapy
Rationale: Systemic estrogen therapy is the most effective treatment
for vasomotor symptoms in peri- and postmenopausal women
without contraindications.
6. The first-line treatment for bacterial vaginosis in a non-pregnant
woman is:
, A) Clindamycin cream
B) Oral metronidazole
C) Fluconazole
D) Terconazole
Answer: B) Oral metronidazole
Rationale: Metronidazole orally or intravaginally is the standard first-
line therapy for bacterial vaginosis.
7. Which of the following is a common complication of untreated
chlamydia infection?
A) Ovarian cysts
B) Pelvic inflammatory disease
C) Fibroids
D) Endometriosis
Answer: B) Pelvic inflammatory disease
Rationale: Untreated chlamydia can ascend to the upper reproductive
tract, causing PID and potential infertility.
8. A 30-year-old woman has irregular menses, hirsutism, and acne.
Which laboratory test is most useful for diagnosis?
A) FSH
B) LH and testosterone
C) Prolactin
D) Estradiol
Answer: B) LH and testosterone
Rationale: Elevated LH and testosterone levels help diagnose
polycystic ovary syndrome (PCOS), the most common cause of
hyperandrogenism.
9. A 25-year-old sexually active woman requests emergency
contraception after unprotected intercourse. The most effective
, option within 72 hours is:
A) Copper IUD
B) Levonorgestrel pill
C) Combined oral contraceptive pills
D) Diaphragm
Answer: A) Copper IUD
Rationale: Copper IUD is the most effective form of emergency
contraception and can be used up to 5 days after unprotected
intercourse.
10. The most common cause of secondary amenorrhea in
women of reproductive age is:
A) Thyroid disease
B) PCOS
C) Pregnancy
D) Hyperprolactinemia
Answer: C) Pregnancy
Rationale: Pregnancy is the most common cause of secondary
amenorrhea and must be ruled out first.
11. A patient presents with dysmenorrhea that is unresponsive
to NSAIDs. Which condition should be suspected?
A) Endometriosis
B) Fibroids
C) Ovarian cyst
D) Adenomyosis
Answer: A) Endometriosis
Rationale: NSAID-resistant dysmenorrhea, especially with chronic
pelvic pain, suggests endometriosis.
