NSG 6430 Women's Health Final Exam Study
Guide Actual Questions and Answers | South
University Graduate Nursing | Comprehensive
Final Exam Prep | 2026/2027 Academic Year |
A+ Grade Verified
SECTION 1: REPRODUCTIVE HEALTH & GYNECOLOGICAL CONDITIONS (14
QUESTIONS)
Q1: A 28-year-old nulligravida presents with cyclic pelvic pain that begins 1-2 days
before menses and peaks on day 1-2 of bleeding. She describes the pain as deep,
aching, and radiating to the back. Physical examination reveals a fixed, retroverted
uterus with nodularity in the uterosacral ligaments. Transvaginal ultrasound is
unremarkable. Which of the following is the MOST likely diagnosis?
A. Primary dysmenorrhea
B. Adenomyosis
C. Endometriosis
D. Chronic pelvic inflammatory disease
Correct Answer: C
,Rationale: The clinical presentation of cyclic pelvic pain beginning before menses, deep
dyspareunia (implied by deep aching pain), fixed retroverted uterus, and uterosacral
nodularity is classic for endometriosis. Primary dysmenorrhea (A) typically presents in
adolescents with normal pelvic examination findings. Adenomyosis (B) usually causes a
diffusely enlarged, tender uterus without nodularity. Chronic PID (D) would present with
irregular bleeding, fever history, and adnexal tenderness rather than cyclic pain patterns.
Laparoscopy remains the gold standard for definitive diagnosis.
Q2: A 24-year-old patient is diagnosed with polycystic ovary syndrome (PCOS). Which of
the following metabolic abnormalities is MOST commonly associated with this
condition and requires routine screening?
A. Type 1 diabetes mellitus
B. Insulin resistance and metabolic syndrome
C. Hyperthyroidism
D. Addison's disease
Correct Answer: B
Rationale: PCOS is strongly associated with insulin resistance and metabolic syndrome,
affecting approximately 50-70% of patients. The Endocrine Society recommends
screening for glucose intolerance and lipid abnormalities at diagnosis and every 3-5
years thereafter. Type 1 diabetes (A) is autoimmune and not associated with PCOS.
Hyperthyroidism (C) and Addison's disease (D) are unrelated endocrine disorders. Early
identification of metabolic abnormalities allows for lifestyle interventions and
metformin therapy to reduce cardiovascular and diabetes risks.
,Q3: A 35-year-old G0 presents with heavy menstrual bleeding (HMB) and a hemoglobin
of 9.2 g/dL. Pelvic ultrasound reveals a 4 cm submucosal leiomyoma distorting the
endometrial cavity. The patient desires future fertility. Which treatment option is MOST
appropriate as first-line therapy?
A. Hysteroscopic myomectomy
B. Total abdominal hysterectomy
C. Uterine artery embolization
D. Gonadotropin-releasing hormone (GnRH) agonist therapy alone
Correct Answer: A
Rationale: Hysteroscopic myomectomy is the treatment of choice for submucosal
fibroids causing HMB in patients desiring fertility preservation. This minimally invasive
approach removes the fibroid while preserving uterine integrity. Hysterectomy (B) is
inappropriate for a patient wanting future fertility. Uterine artery embolization (C) is
contraindicated in patients desiring pregnancy due to potential ovarian compromise and
uterine necrosis risks. GnRH agonists (D) provide temporary shrinkage but are not
definitive treatment; they may be used preoperatively to improve hemoglobin but
fibroids regrow after discontinuation.
Q4: A 22-year-old presents with vulvar pruritus, erythema, and a thick, white, cottage
cheese-like vaginal discharge. Vaginal pH is 4.2. Which of the following is the MOST
appropriate initial treatment?
A. Oral metronidazole 500 mg BID for 7 days
B. Intravaginal clotrimazole 200 mg suppository for 3 days
, C. Oral azithromycin 1 g single dose
D. Intravaginal metronidazole gel 0.75% for 5 days
Correct Answer: B
Rationale: The presentation of vulvar pruritus, cottage cheese-like discharge, and
normal vaginal pH (<4.5) is diagnostic for vulvovaginal candidiasis. Intravaginal azole
therapy (clotrimazole) is first-line treatment. Oral metronidazole (A) treats bacterial
vaginosis or trichomoniasis, which present with thin discharge and elevated pH (>4.5).
Azithromycin (C) treats chlamydia and would not address fungal infection. Intravaginal
metronidazole (D) treats bacterial vaginosis but would be ineffective for candidiasis and
potentially worsen symptoms.
Q5: A 26-year-old presents with a 3-day history of increased vaginal discharge with fishy
odor, especially after intercourse. Wet mount reveals clue cells and vaginal pH is 5.2.
Which organism is PRIMARILY responsible for this condition?
A. Candida albicans
B. Gardnerella vaginalis
C. Neisseria gonorrhoeae
D. Human papillomavirus
Correct Answer: B
Rationale: Bacterial vaginosis (BV) is characterized by replacement of normal vaginal
lactobacilli with anaerobic bacteria, primarily Gardnerella vaginalis. Clue cells (epithelial
cells studded with bacteria), elevated pH (>4.5), and amine odor are diagnostic. Candida
albicans (A) causes yeast infections with normal pH and budding yeast on KOH prep.
Guide Actual Questions and Answers | South
University Graduate Nursing | Comprehensive
Final Exam Prep | 2026/2027 Academic Year |
A+ Grade Verified
SECTION 1: REPRODUCTIVE HEALTH & GYNECOLOGICAL CONDITIONS (14
QUESTIONS)
Q1: A 28-year-old nulligravida presents with cyclic pelvic pain that begins 1-2 days
before menses and peaks on day 1-2 of bleeding. She describes the pain as deep,
aching, and radiating to the back. Physical examination reveals a fixed, retroverted
uterus with nodularity in the uterosacral ligaments. Transvaginal ultrasound is
unremarkable. Which of the following is the MOST likely diagnosis?
A. Primary dysmenorrhea
B. Adenomyosis
C. Endometriosis
D. Chronic pelvic inflammatory disease
Correct Answer: C
,Rationale: The clinical presentation of cyclic pelvic pain beginning before menses, deep
dyspareunia (implied by deep aching pain), fixed retroverted uterus, and uterosacral
nodularity is classic for endometriosis. Primary dysmenorrhea (A) typically presents in
adolescents with normal pelvic examination findings. Adenomyosis (B) usually causes a
diffusely enlarged, tender uterus without nodularity. Chronic PID (D) would present with
irregular bleeding, fever history, and adnexal tenderness rather than cyclic pain patterns.
Laparoscopy remains the gold standard for definitive diagnosis.
Q2: A 24-year-old patient is diagnosed with polycystic ovary syndrome (PCOS). Which of
the following metabolic abnormalities is MOST commonly associated with this
condition and requires routine screening?
A. Type 1 diabetes mellitus
B. Insulin resistance and metabolic syndrome
C. Hyperthyroidism
D. Addison's disease
Correct Answer: B
Rationale: PCOS is strongly associated with insulin resistance and metabolic syndrome,
affecting approximately 50-70% of patients. The Endocrine Society recommends
screening for glucose intolerance and lipid abnormalities at diagnosis and every 3-5
years thereafter. Type 1 diabetes (A) is autoimmune and not associated with PCOS.
Hyperthyroidism (C) and Addison's disease (D) are unrelated endocrine disorders. Early
identification of metabolic abnormalities allows for lifestyle interventions and
metformin therapy to reduce cardiovascular and diabetes risks.
,Q3: A 35-year-old G0 presents with heavy menstrual bleeding (HMB) and a hemoglobin
of 9.2 g/dL. Pelvic ultrasound reveals a 4 cm submucosal leiomyoma distorting the
endometrial cavity. The patient desires future fertility. Which treatment option is MOST
appropriate as first-line therapy?
A. Hysteroscopic myomectomy
B. Total abdominal hysterectomy
C. Uterine artery embolization
D. Gonadotropin-releasing hormone (GnRH) agonist therapy alone
Correct Answer: A
Rationale: Hysteroscopic myomectomy is the treatment of choice for submucosal
fibroids causing HMB in patients desiring fertility preservation. This minimally invasive
approach removes the fibroid while preserving uterine integrity. Hysterectomy (B) is
inappropriate for a patient wanting future fertility. Uterine artery embolization (C) is
contraindicated in patients desiring pregnancy due to potential ovarian compromise and
uterine necrosis risks. GnRH agonists (D) provide temporary shrinkage but are not
definitive treatment; they may be used preoperatively to improve hemoglobin but
fibroids regrow after discontinuation.
Q4: A 22-year-old presents with vulvar pruritus, erythema, and a thick, white, cottage
cheese-like vaginal discharge. Vaginal pH is 4.2. Which of the following is the MOST
appropriate initial treatment?
A. Oral metronidazole 500 mg BID for 7 days
B. Intravaginal clotrimazole 200 mg suppository for 3 days
, C. Oral azithromycin 1 g single dose
D. Intravaginal metronidazole gel 0.75% for 5 days
Correct Answer: B
Rationale: The presentation of vulvar pruritus, cottage cheese-like discharge, and
normal vaginal pH (<4.5) is diagnostic for vulvovaginal candidiasis. Intravaginal azole
therapy (clotrimazole) is first-line treatment. Oral metronidazole (A) treats bacterial
vaginosis or trichomoniasis, which present with thin discharge and elevated pH (>4.5).
Azithromycin (C) treats chlamydia and would not address fungal infection. Intravaginal
metronidazole (D) treats bacterial vaginosis but would be ineffective for candidiasis and
potentially worsen symptoms.
Q5: A 26-year-old presents with a 3-day history of increased vaginal discharge with fishy
odor, especially after intercourse. Wet mount reveals clue cells and vaginal pH is 5.2.
Which organism is PRIMARILY responsible for this condition?
A. Candida albicans
B. Gardnerella vaginalis
C. Neisseria gonorrhoeae
D. Human papillomavirus
Correct Answer: B
Rationale: Bacterial vaginosis (BV) is characterized by replacement of normal vaginal
lactobacilli with anaerobic bacteria, primarily Gardnerella vaginalis. Clue cells (epithelial
cells studded with bacteria), elevated pH (>4.5), and amine odor are diagnostic. Candida
albicans (A) causes yeast infections with normal pH and budding yeast on KOH prep.
