NUR 6111 / NUR6111 (2025/2026) Advanced Practice Nursing I Exam 3: 150 Verified Questions with
Multiple Answers, Detailed Rationales, and Clinical Management Strategies for Primary Care,
Women's Health, Infectious Disease, and Complex Patient Assessment – A Grade A+ Comprehensive
Study Guide (William Paterson University & Maryville University)
Below is the complete set of 150 multiple-choice and select-all-that-apply questions with verified
answers and detailed rationales, compiled from the latest 2025/2026 NUR 6111 Exam 3 resources .
Each rationale explains the why behind the correct answer to support clinical reasoning.
Section 1: Women’s Health & Menopause (Questions 1–15)
1. "Hot flashes" that occur during perimenopause are thought to be related to:
A) High progesterone levels
B) Fluctuating estrogen levels
C) Excess testosterone
D) Thyroid failure
Correct Answer: B – Fluctuating estrogen levels affect the hypothalamic thermoregulatory center,
causing vasomotor symptoms .
2. Which physical exam finding in a 65-year-old woman warrants further evaluation for breast
cancer?
A) Breast tenderness
B) Bilateral nipple discharge
C) New inverted nipple
D) Cyclical breast pain
Correct Answer: C – A newly inverted nipple is a red flag for malignancy; bilateral discharge and
cyclical pain are typically benign .
3. The recommended age to initiate cervical cancer screening in women is:
A) 18 years
B) 21 years
C) 25 years
D) Upon onset of sexual activity
Correct Answer: B – Guidelines recommend starting at age 21 regardless of sexual activity to avoid
over-screening .
4. Which treatment is appropriate for a patient with thick, white, curd-like vaginal discharge and
vulvar itching after antibiotics?
A) Metronidazole 500 mg BID
B) Fluconazole 800 mg single dose
C) Clindamycin cream
D) Doxycycline 100 mg BID
,Correct Answer: B – Findings are consistent with vulvovaginal candidiasis; fluconazole 800 mg once is
first-line .
5. A 31-year-old woman has a normal Pap smear with negative HPV co-testing. When is her next
screening?
A) 1 year
B) 3 years
C) 5 years
D) 10 years
Correct Answer: C – Co-testing (Pap + HPV) every 5 years for women aged 30–65 with normal results .
6. A 53-year-old on HRT (conjugated estrogen + MPA) has bothersome atrophic vaginitis. What is
the best addition?
A) Increase oral estrogen dose
B) Topical vaginal estrogen
C) Switch to progesterone-only
D) No intervention
Correct Answer: B – Topical vaginal estrogen is most effective for local symptoms with fewer systemic
effects .
7. Which finding is most consistent with chlamydia infection? (Select all that apply)
A) Thick white discharge
B) Frothy green discharge
C) Vaginal discharge with cervical inflammation
D) Mucopurulent cervicitis
Correct Answers: C, D – Chlamydia often presents with mucopurulent discharge and cervical friability;
frothy discharge indicates trichomoniasis .
8. How should chlamydia be treated in both partners?
A) Only symptomatic partner treated
B) Both treated with doxycycline 100 mg BID × 7 days
C) Only female treated
D) No treatment for partner
Correct Answer: B – Both partners must be treated to prevent reinfection; doxycycline is first-line .
9. A patient presents with foul-smelling, frothy, yellow-green discharge and cervical petechiae
("strawberry cervix"). Treatment includes:
A) Fluconazole
B) Metronidazole
C) Clindamycin
D) Azithromycin
Correct Answer: B – These are classic for trichomoniasis; metronidazole is first-line .
10. A 38-year-old with non-odorous, thick, white, curd-like discharge and vulvar itching is in a
monogamous relationship. Most likely treatment:
A) Fluconazole 800 mg single dose
B) Metronidazole 500 mg BID × 7 days
C) Clotrimazole cream
, D) Oral doxycycline
Correct Answer: A – Consistent with candidiasis; 800 mg fluconazole orally once is standard .
11. Which is NOT representative of primary syphilis?
A) Painless chancre
B) Regional lymphadenopathy
C) Flu-like symptoms
D) Ulcerated lesion at inoculation site
Correct Answer: C – Flu-like symptoms are typical of secondary syphilis, not primary .
12. A patient with trichomoniasis is prescribed metronidazole (Flagyl). Which teaching will the NP
include? (Select all that apply)
A) Take with food to reduce nausea
B) Do not drink alcohol during therapy and for 48 hours after
C) Avoid sexual activity until symptoms resolve
D) Increase sun exposure
Correct Answers: A, B, C – Alcohol causes disulfiram-like reaction; food reduces GI upset; abstinence
prevents reinfection .
13. What is the first-line treatment for primary genital herpes infection?
A) Metronidazole 500 mg BID
B) Acyclovir 400 mg TID for 7–10 days
C) Fluconazole single dose
D) Doxycycline 100 mg BID
Correct Answer: B – Acyclovir reduces symptom duration and viral shedding .
14. A patient with bacterial vaginosis (fishy odor, positive whiff test, pH > 4.5) should be treated
with:
A) Fluconazole
B) Metronidazole
C) Clindamycin
D) Oral doxycycline
Correct Answer: B – Metronidazole is first-line for BV .
15. A 65-year-old woman has a new painless, pearly nodule with telangiectasia on her upper lip.
Most likely diagnosis:
A) Squamous cell carcinoma
B) Basal cell carcinoma
C) Melanoma
D) Actinic keratosis
Correct Answer: B – Classic description of basal cell carcinoma, the most common skin cancer .
Section 2: Infectious Disease & STIs (Questions 16–30)
Multiple Answers, Detailed Rationales, and Clinical Management Strategies for Primary Care,
Women's Health, Infectious Disease, and Complex Patient Assessment – A Grade A+ Comprehensive
Study Guide (William Paterson University & Maryville University)
Below is the complete set of 150 multiple-choice and select-all-that-apply questions with verified
answers and detailed rationales, compiled from the latest 2025/2026 NUR 6111 Exam 3 resources .
Each rationale explains the why behind the correct answer to support clinical reasoning.
Section 1: Women’s Health & Menopause (Questions 1–15)
1. "Hot flashes" that occur during perimenopause are thought to be related to:
A) High progesterone levels
B) Fluctuating estrogen levels
C) Excess testosterone
D) Thyroid failure
Correct Answer: B – Fluctuating estrogen levels affect the hypothalamic thermoregulatory center,
causing vasomotor symptoms .
2. Which physical exam finding in a 65-year-old woman warrants further evaluation for breast
cancer?
A) Breast tenderness
B) Bilateral nipple discharge
C) New inverted nipple
D) Cyclical breast pain
Correct Answer: C – A newly inverted nipple is a red flag for malignancy; bilateral discharge and
cyclical pain are typically benign .
3. The recommended age to initiate cervical cancer screening in women is:
A) 18 years
B) 21 years
C) 25 years
D) Upon onset of sexual activity
Correct Answer: B – Guidelines recommend starting at age 21 regardless of sexual activity to avoid
over-screening .
4. Which treatment is appropriate for a patient with thick, white, curd-like vaginal discharge and
vulvar itching after antibiotics?
A) Metronidazole 500 mg BID
B) Fluconazole 800 mg single dose
C) Clindamycin cream
D) Doxycycline 100 mg BID
,Correct Answer: B – Findings are consistent with vulvovaginal candidiasis; fluconazole 800 mg once is
first-line .
5. A 31-year-old woman has a normal Pap smear with negative HPV co-testing. When is her next
screening?
A) 1 year
B) 3 years
C) 5 years
D) 10 years
Correct Answer: C – Co-testing (Pap + HPV) every 5 years for women aged 30–65 with normal results .
6. A 53-year-old on HRT (conjugated estrogen + MPA) has bothersome atrophic vaginitis. What is
the best addition?
A) Increase oral estrogen dose
B) Topical vaginal estrogen
C) Switch to progesterone-only
D) No intervention
Correct Answer: B – Topical vaginal estrogen is most effective for local symptoms with fewer systemic
effects .
7. Which finding is most consistent with chlamydia infection? (Select all that apply)
A) Thick white discharge
B) Frothy green discharge
C) Vaginal discharge with cervical inflammation
D) Mucopurulent cervicitis
Correct Answers: C, D – Chlamydia often presents with mucopurulent discharge and cervical friability;
frothy discharge indicates trichomoniasis .
8. How should chlamydia be treated in both partners?
A) Only symptomatic partner treated
B) Both treated with doxycycline 100 mg BID × 7 days
C) Only female treated
D) No treatment for partner
Correct Answer: B – Both partners must be treated to prevent reinfection; doxycycline is first-line .
9. A patient presents with foul-smelling, frothy, yellow-green discharge and cervical petechiae
("strawberry cervix"). Treatment includes:
A) Fluconazole
B) Metronidazole
C) Clindamycin
D) Azithromycin
Correct Answer: B – These are classic for trichomoniasis; metronidazole is first-line .
10. A 38-year-old with non-odorous, thick, white, curd-like discharge and vulvar itching is in a
monogamous relationship. Most likely treatment:
A) Fluconazole 800 mg single dose
B) Metronidazole 500 mg BID × 7 days
C) Clotrimazole cream
, D) Oral doxycycline
Correct Answer: A – Consistent with candidiasis; 800 mg fluconazole orally once is standard .
11. Which is NOT representative of primary syphilis?
A) Painless chancre
B) Regional lymphadenopathy
C) Flu-like symptoms
D) Ulcerated lesion at inoculation site
Correct Answer: C – Flu-like symptoms are typical of secondary syphilis, not primary .
12. A patient with trichomoniasis is prescribed metronidazole (Flagyl). Which teaching will the NP
include? (Select all that apply)
A) Take with food to reduce nausea
B) Do not drink alcohol during therapy and for 48 hours after
C) Avoid sexual activity until symptoms resolve
D) Increase sun exposure
Correct Answers: A, B, C – Alcohol causes disulfiram-like reaction; food reduces GI upset; abstinence
prevents reinfection .
13. What is the first-line treatment for primary genital herpes infection?
A) Metronidazole 500 mg BID
B) Acyclovir 400 mg TID for 7–10 days
C) Fluconazole single dose
D) Doxycycline 100 mg BID
Correct Answer: B – Acyclovir reduces symptom duration and viral shedding .
14. A patient with bacterial vaginosis (fishy odor, positive whiff test, pH > 4.5) should be treated
with:
A) Fluconazole
B) Metronidazole
C) Clindamycin
D) Oral doxycycline
Correct Answer: B – Metronidazole is first-line for BV .
15. A 65-year-old woman has a new painless, pearly nodule with telangiectasia on her upper lip.
Most likely diagnosis:
A) Squamous cell carcinoma
B) Basal cell carcinoma
C) Melanoma
D) Actinic keratosis
Correct Answer: B – Classic description of basal cell carcinoma, the most common skin cancer .
Section 2: Infectious Disease & STIs (Questions 16–30)
