WHNP-BC — Women’s Health Nurse
Practitioner Board Certified,, WITH
CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS
LATEST ALREADY GRADED A+
(2025/2026)
Question 1
A 24-year-old G0 presents with a 3-month history of irregular
menstrual cycles occurring every 21–45 days. She reports acne on
her face and chest, and increased facial hair. Her BMI is 31. On
physical exam, you note acanthosis nigricans on the back of her
neck. What is the MOST likely diagnosis?
• A) Hypothalamic amenorrhea
• B) Polycystic ovary syndrome (PCOS)
• C) Hyperprolactinemia
• D) Thyroid dysfunction
Correct ,,,,Answer,,,,: B) Polycystic ovary syndrome (PCOS)
Rationale: PCOS is the most common endocrine disorder in
reproductive-aged women. The diagnostic criteria (Rotterdam)
require two of three: oligo-ovulation or anovulation (irregular
cycles), clinical or biochemical signs of hyperandrogenism (acne,
,hirsutism), and polycystic ovaries on ultrasound. Acanthosis
nigricans is a marker of insulin resistance, common in PCOS .
Question 2
A 32-year-old G2P2 presents with a 6-month history of heavy
menstrual bleeding (soaking through a super-plus tampon every 1-2
hours for the first 2 days of her cycle). Her hemoglobin is 9.2 g/dL.
Pelvic ultrasound reveals a 4 cm submucosal fibroid. What is the
MOST appropriate next step?
• A) Endometrial biopsy
• B) Saline infusion sonography (SIS)
• C) Hysteroscopy with biopsy
• D) CA-125 blood test
Correct ,,,,Answer,,,,: C) Hysteroscopy with biopsy
Rationale: Submucosal fibroids are a common cause of heavy
menstrual bleeding (menorrhagia) and anemia. Hysteroscopy is the
gold standard for visualizing the endometrial cavity, confirming the
location and size of the fibroid, and obtaining an endometrial biopsy
if needed. SIS is less invasive but does not allow biopsy .
Question 3
A 45-year-old perimenopausal woman presents with a 3-month
history of hot flashes, night sweats, and vaginal dryness. She has a
history of estrogen receptor-positive breast cancer treated with
,mastectomy and tamoxifen 2 years ago. What is the MOST
appropriate next step?
• A) Order serum FSH and estradiol levels
• B) Perform a bone density scan
• C) Document symptom severity and discuss non-hormonal
treatment options
• D) Prescribe low-dose vaginal estrogen cream
Correct ,,,,Answer,,,,: C) Document symptom severity and discuss
non-hormonal treatment options
Rationale: This patient has irreversible contraindication to estrogen
therapy (ER+ breast cancer). Hormonal therapy (including vaginal
estrogen, though low systemic absorption) is generally avoided or
used with extreme caution and oncology consultation after ER+
cancer. The priority is to assess severity and offer evidence-based
non-hormonal treatments (SSRIs/SNRIs, gabapentin, oxybutynin,
lifestyle) .
Question 4
A 22-year-old G0 presents with a 2-week history of a thin, gray-
white, fishy-smelling vaginal discharge. She denies itching or
dysuria. Wet mount shows clue cells and a positive whiff test (fishy
odor with KOH). What is the MOST likely diagnosis?
• A) Bacterial vaginosis (BV)
• B) Trichomoniasis
• C) Candidiasis
• D) Atrophic vaginitis
, Correct ,,,,Answer,,,,: A) Bacterial vaginosis (BV)
Rationale: BV is the most common cause of vaginal discharge in
reproductive-aged women. Diagnostic criteria (Amsel criteria)
require 3 of 4: thin, homogenous gray-white discharge; pH >4.5;
positive whiff test (fishy odor with 10% KOH); clue cells on wet
mount (>20% of epithelial cells). BV is not an STI but is associated
with sexual activity .
Question 5
A 35-year-old G2P2 presents with a 1-year history of cyclic pelvic
pain beginning 3 days before menses and resolving 2 days after
menses. She also reports deep dyspareunia and pain with bowel
movements during her period. Pelvic exam reveals tender
nodularity in the uterosacral ligaments. What is the MOST likely
diagnosis?
• A) Pelvic inflammatory disease
• B) Endometriosis
• C) Ovarian cyst
• D) Irritable bowel syndrome
Correct ,,,,Answer,,,,: B) Endometriosis
Rationale: Endometriosis classically presents with cyclic pelvic pain,
dysmenorrhea, deep dyspareunia, and dyschezia during menses.
Uterosacral ligament nodularity on exam is highly suggestive. The
gold standard for diagnosis is laparoscopy .
Practitioner Board Certified,, WITH
CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS
LATEST ALREADY GRADED A+
(2025/2026)
Question 1
A 24-year-old G0 presents with a 3-month history of irregular
menstrual cycles occurring every 21–45 days. She reports acne on
her face and chest, and increased facial hair. Her BMI is 31. On
physical exam, you note acanthosis nigricans on the back of her
neck. What is the MOST likely diagnosis?
• A) Hypothalamic amenorrhea
• B) Polycystic ovary syndrome (PCOS)
• C) Hyperprolactinemia
• D) Thyroid dysfunction
Correct ,,,,Answer,,,,: B) Polycystic ovary syndrome (PCOS)
Rationale: PCOS is the most common endocrine disorder in
reproductive-aged women. The diagnostic criteria (Rotterdam)
require two of three: oligo-ovulation or anovulation (irregular
cycles), clinical or biochemical signs of hyperandrogenism (acne,
,hirsutism), and polycystic ovaries on ultrasound. Acanthosis
nigricans is a marker of insulin resistance, common in PCOS .
Question 2
A 32-year-old G2P2 presents with a 6-month history of heavy
menstrual bleeding (soaking through a super-plus tampon every 1-2
hours for the first 2 days of her cycle). Her hemoglobin is 9.2 g/dL.
Pelvic ultrasound reveals a 4 cm submucosal fibroid. What is the
MOST appropriate next step?
• A) Endometrial biopsy
• B) Saline infusion sonography (SIS)
• C) Hysteroscopy with biopsy
• D) CA-125 blood test
Correct ,,,,Answer,,,,: C) Hysteroscopy with biopsy
Rationale: Submucosal fibroids are a common cause of heavy
menstrual bleeding (menorrhagia) and anemia. Hysteroscopy is the
gold standard for visualizing the endometrial cavity, confirming the
location and size of the fibroid, and obtaining an endometrial biopsy
if needed. SIS is less invasive but does not allow biopsy .
Question 3
A 45-year-old perimenopausal woman presents with a 3-month
history of hot flashes, night sweats, and vaginal dryness. She has a
history of estrogen receptor-positive breast cancer treated with
,mastectomy and tamoxifen 2 years ago. What is the MOST
appropriate next step?
• A) Order serum FSH and estradiol levels
• B) Perform a bone density scan
• C) Document symptom severity and discuss non-hormonal
treatment options
• D) Prescribe low-dose vaginal estrogen cream
Correct ,,,,Answer,,,,: C) Document symptom severity and discuss
non-hormonal treatment options
Rationale: This patient has irreversible contraindication to estrogen
therapy (ER+ breast cancer). Hormonal therapy (including vaginal
estrogen, though low systemic absorption) is generally avoided or
used with extreme caution and oncology consultation after ER+
cancer. The priority is to assess severity and offer evidence-based
non-hormonal treatments (SSRIs/SNRIs, gabapentin, oxybutynin,
lifestyle) .
Question 4
A 22-year-old G0 presents with a 2-week history of a thin, gray-
white, fishy-smelling vaginal discharge. She denies itching or
dysuria. Wet mount shows clue cells and a positive whiff test (fishy
odor with KOH). What is the MOST likely diagnosis?
• A) Bacterial vaginosis (BV)
• B) Trichomoniasis
• C) Candidiasis
• D) Atrophic vaginitis
, Correct ,,,,Answer,,,,: A) Bacterial vaginosis (BV)
Rationale: BV is the most common cause of vaginal discharge in
reproductive-aged women. Diagnostic criteria (Amsel criteria)
require 3 of 4: thin, homogenous gray-white discharge; pH >4.5;
positive whiff test (fishy odor with 10% KOH); clue cells on wet
mount (>20% of epithelial cells). BV is not an STI but is associated
with sexual activity .
Question 5
A 35-year-old G2P2 presents with a 1-year history of cyclic pelvic
pain beginning 3 days before menses and resolving 2 days after
menses. She also reports deep dyspareunia and pain with bowel
movements during her period. Pelvic exam reveals tender
nodularity in the uterosacral ligaments. What is the MOST likely
diagnosis?
• A) Pelvic inflammatory disease
• B) Endometriosis
• C) Ovarian cyst
• D) Irritable bowel syndrome
Correct ,,,,Answer,,,,: B) Endometriosis
Rationale: Endometriosis classically presents with cyclic pelvic pain,
dysmenorrhea, deep dyspareunia, and dyschezia during menses.
Uterosacral ligament nodularity on exam is highly suggestive. The
gold standard for diagnosis is laparoscopy .
