Final Exam: NR602/ NR 602 Primary Care of the Childbearing and
Childrearing Family Practicum COMPLETE FINAL EXAM REVIEW |
Questions and Verified
Women's Health & Reproductive Primary Care (Complete Review)
Q1: A 28-year-old patient presents for her annual well-woman visit. She has no
significant medical history and is interested in starting combined oral contraceptives.
Which of the following would be a contraindication to prescribing COCs according to the
CDC MEC guidelines?
A. History of migraines without aura, occurring twice monthly
B. Blood pressure of 138/86 mmHg measured today
C. Current smoking habit of 15 cigarettes daily at age 32
D. Family history of breast cancer in a maternal aunt diagnosed at age 45
Correct Answer: C
Rationale: Current smoking at age 35 or older is a Category 3/4 contraindication for
combined hormonal contraceptives due to increased cardiovascular risk. While
migraines without aura (A) are generally acceptable, smoking over age 35 significantly
elevates thromboembolic risk. Blood pressure of 138/86 (B) is elevated but not a
contraindication unless ≥160/100. Family history of breast cancer (D) is not a
contraindication.
,Q2: During a preconception counseling visit, a 34-year-old patient asks about folic acid
supplementation. Which recommendation aligns with current evidence-based guidelines
for preventing neural tube defects?
A. 400 mcg daily for all women of childbearing age, increasing to 800 mcg once
pregnancy is confirmed
B. 400 mcg daily starting at least one month before conception and continuing through
the first trimester
C. 4 mg daily for all women over age 35 or with family history of neural tube defects
D. 800 mcg daily only after a positive pregnancy test is obtained
Correct Answer: B
Rationale: The USPSTF and CDC recommend 400 mcg of folic acid daily starting at
least one month before conception and continuing through the first 12 weeks of
pregnancy. Neural tube closure occurs by 28 days post-conception, often before a
woman knows she is pregnant. Option A delays adequate supplementation; 4 mg (C) is
reserved for women with prior affected pregnancies; waiting until confirmation (D)
misses the critical window.
Q3: A 22-year-old college student requests emergency contraception after a condom
broke during intercourse 18 hours ago. She has a BMI of 32 and takes no regular
medications. Which option provides the highest efficacy for this patient?
A. Levonorgestrel 1.5 mg single dose (Plan B One-Step)
B. Ulipristal acetate 30 mg single dose (Ella)
C. Copper IUD insertion within 5 days
,D. Combined estrogen-progestin Yuzpe method
Correct Answer: C
Rationale: The copper IUD is the most effective emergency contraception (99%
effective) and provides ongoing contraception. While ulipristal (B) is more effective than
levonorgestrel (A) in overweight women, the copper IUD surpasses both. The Yuzpe
method (D) has the lowest efficacy and significant side effects. Given her BMI of 32,
levonorgestrel efficacy may be reduced.
Q4: A 29-year-old patient is considering long-acting reversible contraception. She wants
the most effective method with the quickest return to fertility after discontinuation.
Which option best meets her criteria?
A. Depot medroxyprogesterone acetate (Depo-Provera)
B. Levonorgestrel 52 mg intrauterine system (Mirena)
C. Copper T 380A intrauterine device (Paragard)
D. Etonogestrel 68 mg subdermal implant (Nexplanon)
Correct Answer: C
Rationale: The copper IUD is non-hormonal, allowing immediate return to fertility upon
removal. While all LARC methods are highly effective (>99%), the copper IUD's lack of
hormones means no delay in ovulation resumption. Depo-Provera (A) can delay fertility
9-10 months; hormonal IUDs (B) and implants (D) may have shorter delays but still
involve hormonal suppression.
, Q5: A 35-year-old patient presents with vaginal discharge and vulvar itching. Microscopy
reveals clue cells and a positive whiff test. The vaginal pH is 5.2. Which treatment
regimen is most appropriate?
A. Oral fluconazole 150 mg single dose
B. Metronidazole 500 mg PO BID for 7 days
C. Clindamycin 2% vaginal cream for 7 days
D. Oral azithromycin 1 g single dose
Correct Answer: B
Rationale: Bacterial vaginosis is diagnosed by Amsel criteria (three of four: thin
discharge, clue cells, positive whiff test, pH >4.5). Metronidazole 500 mg BID for 7 days
is first-line treatment. Fluconazole (A) treats candidiasis; clindamycin cream (C) is an
alternative but oral metronidazole is preferred for initial treatment. Azithromycin (D)
treats chlamydia, not BV.
Q6: According to current USPSTF guidelines, at what age should routine cervical cancer
screening with cytology (Pap smear) begin for average-risk women?
A. Age 18 or at onset of sexual activity, whichever comes first
B. Age 21 regardless of sexual history
C. Age 25 with HPV co-testing preferred
D. Age 30 with cytology alone or HPV co-testing
Correct Answer: B
Childrearing Family Practicum COMPLETE FINAL EXAM REVIEW |
Questions and Verified
Women's Health & Reproductive Primary Care (Complete Review)
Q1: A 28-year-old patient presents for her annual well-woman visit. She has no
significant medical history and is interested in starting combined oral contraceptives.
Which of the following would be a contraindication to prescribing COCs according to the
CDC MEC guidelines?
A. History of migraines without aura, occurring twice monthly
B. Blood pressure of 138/86 mmHg measured today
C. Current smoking habit of 15 cigarettes daily at age 32
D. Family history of breast cancer in a maternal aunt diagnosed at age 45
Correct Answer: C
Rationale: Current smoking at age 35 or older is a Category 3/4 contraindication for
combined hormonal contraceptives due to increased cardiovascular risk. While
migraines without aura (A) are generally acceptable, smoking over age 35 significantly
elevates thromboembolic risk. Blood pressure of 138/86 (B) is elevated but not a
contraindication unless ≥160/100. Family history of breast cancer (D) is not a
contraindication.
,Q2: During a preconception counseling visit, a 34-year-old patient asks about folic acid
supplementation. Which recommendation aligns with current evidence-based guidelines
for preventing neural tube defects?
A. 400 mcg daily for all women of childbearing age, increasing to 800 mcg once
pregnancy is confirmed
B. 400 mcg daily starting at least one month before conception and continuing through
the first trimester
C. 4 mg daily for all women over age 35 or with family history of neural tube defects
D. 800 mcg daily only after a positive pregnancy test is obtained
Correct Answer: B
Rationale: The USPSTF and CDC recommend 400 mcg of folic acid daily starting at
least one month before conception and continuing through the first 12 weeks of
pregnancy. Neural tube closure occurs by 28 days post-conception, often before a
woman knows she is pregnant. Option A delays adequate supplementation; 4 mg (C) is
reserved for women with prior affected pregnancies; waiting until confirmation (D)
misses the critical window.
Q3: A 22-year-old college student requests emergency contraception after a condom
broke during intercourse 18 hours ago. She has a BMI of 32 and takes no regular
medications. Which option provides the highest efficacy for this patient?
A. Levonorgestrel 1.5 mg single dose (Plan B One-Step)
B. Ulipristal acetate 30 mg single dose (Ella)
C. Copper IUD insertion within 5 days
,D. Combined estrogen-progestin Yuzpe method
Correct Answer: C
Rationale: The copper IUD is the most effective emergency contraception (99%
effective) and provides ongoing contraception. While ulipristal (B) is more effective than
levonorgestrel (A) in overweight women, the copper IUD surpasses both. The Yuzpe
method (D) has the lowest efficacy and significant side effects. Given her BMI of 32,
levonorgestrel efficacy may be reduced.
Q4: A 29-year-old patient is considering long-acting reversible contraception. She wants
the most effective method with the quickest return to fertility after discontinuation.
Which option best meets her criteria?
A. Depot medroxyprogesterone acetate (Depo-Provera)
B. Levonorgestrel 52 mg intrauterine system (Mirena)
C. Copper T 380A intrauterine device (Paragard)
D. Etonogestrel 68 mg subdermal implant (Nexplanon)
Correct Answer: C
Rationale: The copper IUD is non-hormonal, allowing immediate return to fertility upon
removal. While all LARC methods are highly effective (>99%), the copper IUD's lack of
hormones means no delay in ovulation resumption. Depo-Provera (A) can delay fertility
9-10 months; hormonal IUDs (B) and implants (D) may have shorter delays but still
involve hormonal suppression.
, Q5: A 35-year-old patient presents with vaginal discharge and vulvar itching. Microscopy
reveals clue cells and a positive whiff test. The vaginal pH is 5.2. Which treatment
regimen is most appropriate?
A. Oral fluconazole 150 mg single dose
B. Metronidazole 500 mg PO BID for 7 days
C. Clindamycin 2% vaginal cream for 7 days
D. Oral azithromycin 1 g single dose
Correct Answer: B
Rationale: Bacterial vaginosis is diagnosed by Amsel criteria (three of four: thin
discharge, clue cells, positive whiff test, pH >4.5). Metronidazole 500 mg BID for 7 days
is first-line treatment. Fluconazole (A) treats candidiasis; clindamycin cream (C) is an
alternative but oral metronidazole is preferred for initial treatment. Azithromycin (D)
treats chlamydia, not BV.
Q6: According to current USPSTF guidelines, at what age should routine cervical cancer
screening with cytology (Pap smear) begin for average-risk women?
A. Age 18 or at onset of sexual activity, whichever comes first
B. Age 21 regardless of sexual history
C. Age 25 with HPV co-testing preferred
D. Age 30 with cytology alone or HPV co-testing
Correct Answer: B
