NR602 / NR-602 Midterm Exam Primary Care of the Childbearing
& Childrearing Family Practicum – Chamberlain Actual Exam –
Complete Questions and Answers with Detailed Rationales –
Pass Guaranteed – A+ Graded
Foundations: Women's Health & Gynecology
Q1: A 24-year-old G0 presents for a well-woman examination. She has never had an
abnormal Pap smear. According to current guidelines, when should her next cervical
cancer screening occur?
A. In 1 year with a Pap smear and high-risk HPV co-testing
B. In 3 years with cytology (Pap smear) alone [CORRECT]
C. In 5 years with high-risk HPV testing alone
D. She does not need cervical cancer screening until age 30
Correct Answer: B
Rationale: The best answer is B because for women ages 21 to 29, current guidelines
recommend cervical cytology alone every 3 years, and co-testing isn't initiated until age
30. This is standard well-woman care that every FNP needs to know for routine health
maintenance.
Q2: A 32-year-old patient requests combined oral contraceptives. Her medical history
includes migraine with aura two to three times per month. Which statement by the nurse
practitioner is most accurate?
A. Combined oral contraceptives are safe because her migraines are not frequent
B. She should use a progestin-only method due to the increased risk of ischemic stroke
with estrogen-containing contraceptives [CORRECT]
C. A vaginal ring would be safer since it has lower estrogen exposure than oral pills
D. The patch is preferred because it avoids first-pass hepatic metabolism
Correct Answer: B
Rationale: This is correct because migraine with aura is an absolute contraindication to
estrogen-containing contraceptives due to the significantly increased risk of thrombotic
,stroke, so progestin-only methods like the implant, IUD, or mini-pill are much safer
alternatives.
Q3: A 28-year-old postpartum patient who is exclusively breastfeeding asks about
contraception options. She wants something effective but is concerned about milk
supply. Which method is most appropriate?
A. Combined oral contraceptives started at 2 weeks postpartum
B. A progestin-only pill or etonogestrel implant [CORRECT]
C. A copper IUD, which must be avoided until 12 weeks postpartum
D. A diaphragm fitted at the 6-week visit as the only option
Correct Answer: B
Rationale: The best answer is B because progestin-only contraceptives are safe during
breastfeeding and do not suppress milk production, whereas estrogen-containing
methods can reduce supply. The implant is highly effective and can be placed
immediately postpartum.
Q4: A 19-year-old sexually active female is diagnosed with chlamydia. She has no drug
allergies. Which treatment regimen is recommended?
A. Ceftriaxone 500 mg IM once
B. Azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7
days [CORRECT]
C. Metronidazole 2 g orally in a single dose
D. Benzathine penicillin G 2.4 million units IM once
Correct Answer: B
Rationale: This aligns with CDC STI treatment guidelines where azithromycin
single-dose or doxycycline for 7 days are first-line regimens for uncomplicated
chlamydial infection. The best answer is B because both options are
guideline-concordant, and you would also want to test for gonorrhea since co-infection
is common.
Q5: A 26-year-old patient presents with vaginal discharge and dysuria. A wet mount
reveals motile, flagellated organisms and a strawberry cervix on examination. Which
treatment is indicated?
A. Azithromycin 1 g orally once
B. Metronidazole 2 g orally in a single dose or tinidazole [CORRECT]
, C. Ceftriaxone 500 mg IM once
D. Fluconazole 150 mg orally once
Correct Answer: B
Rationale: The best answer is B because motile flagellated organisms on wet mount
with a strawberry cervix are pathognomonic for Trichomonas vaginalis, which requires
treatment with metronidazole or tinidazole. You would also treat the partner to prevent
reinfection.
Q6: A 35-year-old patient is interested in long-acting reversible contraception. She wants
a non-hormonal option that lasts the longest. Which method meets her needs?
A. Levonorgestrel intrauterine system
B. Copper IUD, effective for 10 to 12 years [CORRECT]
C. Etonogestrel implant, effective for 3 years
D. Depot medroxyprogesterone acetate injection
Correct Answer: B
Rationale: The copper IUD is completely non-hormonal and provides highly effective
contraception for up to 10 to 12 years, making it the best choice for a patient who
specifically wants to avoid hormones. This is a great option for patients who want
set-it-and-forget-it protection without systemic effects.
Q7: A 45-year-old patient asks about human papillomavirus vaccination. She has never
received the vaccine. Which statement is most accurate?
A. She is too old to benefit from HPV vaccination
B. Gardasil 9 is approved through age 45 and requires a 3-dose series if started at this
age [CORRECT]
C. Only women who have never been sexually active should receive the vaccine
D. The vaccine treats existing cervical dysplasia
Correct Answer: B
Rationale: This is correct because the FDA expanded Gardasil 9 approval to age 45, and
adults starting the series at age 15 or older need three doses. While the greatest benefit
comes before sexual debut, it can still provide protection against new HPV types.
Q8: A 38-year-old patient reports irregular heavy menstrual bleeding for the past 6
months. An ultrasound reveals multiple intramural uterine masses. Using the
PALM-COEIN classification system, which category applies?
& Childrearing Family Practicum – Chamberlain Actual Exam –
Complete Questions and Answers with Detailed Rationales –
Pass Guaranteed – A+ Graded
Foundations: Women's Health & Gynecology
Q1: A 24-year-old G0 presents for a well-woman examination. She has never had an
abnormal Pap smear. According to current guidelines, when should her next cervical
cancer screening occur?
A. In 1 year with a Pap smear and high-risk HPV co-testing
B. In 3 years with cytology (Pap smear) alone [CORRECT]
C. In 5 years with high-risk HPV testing alone
D. She does not need cervical cancer screening until age 30
Correct Answer: B
Rationale: The best answer is B because for women ages 21 to 29, current guidelines
recommend cervical cytology alone every 3 years, and co-testing isn't initiated until age
30. This is standard well-woman care that every FNP needs to know for routine health
maintenance.
Q2: A 32-year-old patient requests combined oral contraceptives. Her medical history
includes migraine with aura two to three times per month. Which statement by the nurse
practitioner is most accurate?
A. Combined oral contraceptives are safe because her migraines are not frequent
B. She should use a progestin-only method due to the increased risk of ischemic stroke
with estrogen-containing contraceptives [CORRECT]
C. A vaginal ring would be safer since it has lower estrogen exposure than oral pills
D. The patch is preferred because it avoids first-pass hepatic metabolism
Correct Answer: B
Rationale: This is correct because migraine with aura is an absolute contraindication to
estrogen-containing contraceptives due to the significantly increased risk of thrombotic
,stroke, so progestin-only methods like the implant, IUD, or mini-pill are much safer
alternatives.
Q3: A 28-year-old postpartum patient who is exclusively breastfeeding asks about
contraception options. She wants something effective but is concerned about milk
supply. Which method is most appropriate?
A. Combined oral contraceptives started at 2 weeks postpartum
B. A progestin-only pill or etonogestrel implant [CORRECT]
C. A copper IUD, which must be avoided until 12 weeks postpartum
D. A diaphragm fitted at the 6-week visit as the only option
Correct Answer: B
Rationale: The best answer is B because progestin-only contraceptives are safe during
breastfeeding and do not suppress milk production, whereas estrogen-containing
methods can reduce supply. The implant is highly effective and can be placed
immediately postpartum.
Q4: A 19-year-old sexually active female is diagnosed with chlamydia. She has no drug
allergies. Which treatment regimen is recommended?
A. Ceftriaxone 500 mg IM once
B. Azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7
days [CORRECT]
C. Metronidazole 2 g orally in a single dose
D. Benzathine penicillin G 2.4 million units IM once
Correct Answer: B
Rationale: This aligns with CDC STI treatment guidelines where azithromycin
single-dose or doxycycline for 7 days are first-line regimens for uncomplicated
chlamydial infection. The best answer is B because both options are
guideline-concordant, and you would also want to test for gonorrhea since co-infection
is common.
Q5: A 26-year-old patient presents with vaginal discharge and dysuria. A wet mount
reveals motile, flagellated organisms and a strawberry cervix on examination. Which
treatment is indicated?
A. Azithromycin 1 g orally once
B. Metronidazole 2 g orally in a single dose or tinidazole [CORRECT]
, C. Ceftriaxone 500 mg IM once
D. Fluconazole 150 mg orally once
Correct Answer: B
Rationale: The best answer is B because motile flagellated organisms on wet mount
with a strawberry cervix are pathognomonic for Trichomonas vaginalis, which requires
treatment with metronidazole or tinidazole. You would also treat the partner to prevent
reinfection.
Q6: A 35-year-old patient is interested in long-acting reversible contraception. She wants
a non-hormonal option that lasts the longest. Which method meets her needs?
A. Levonorgestrel intrauterine system
B. Copper IUD, effective for 10 to 12 years [CORRECT]
C. Etonogestrel implant, effective for 3 years
D. Depot medroxyprogesterone acetate injection
Correct Answer: B
Rationale: The copper IUD is completely non-hormonal and provides highly effective
contraception for up to 10 to 12 years, making it the best choice for a patient who
specifically wants to avoid hormones. This is a great option for patients who want
set-it-and-forget-it protection without systemic effects.
Q7: A 45-year-old patient asks about human papillomavirus vaccination. She has never
received the vaccine. Which statement is most accurate?
A. She is too old to benefit from HPV vaccination
B. Gardasil 9 is approved through age 45 and requires a 3-dose series if started at this
age [CORRECT]
C. Only women who have never been sexually active should receive the vaccine
D. The vaccine treats existing cervical dysplasia
Correct Answer: B
Rationale: This is correct because the FDA expanded Gardasil 9 approval to age 45, and
adults starting the series at age 15 or older need three doses. While the greatest benefit
comes before sexual debut, it can still provide protection against new HPV types.
Q8: A 38-year-old patient reports irregular heavy menstrual bleeding for the past 6
months. An ultrasound reveals multiple intramural uterine masses. Using the
PALM-COEIN classification system, which category applies?
