NAMS MENOPAUSE CERTIFICATION
PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS GRADED
A+
◍ Premarin Vaginal Cream.
Answer: (Conjugated Estrogen) - Indicated for VVA and dyspareunia
◍ Does VMS worsen in premenopause or post menopause?.
Answer: VMS prevalence increases in peri/postmenopause
◍ PALM COEIN causes of AUB.
Answer: P: Polyp, A: Adenomyosis, L: Leiomyoma, M:
Malignancy/hyperplasia, C: Coagulopathy, O: Ovulatory dysfunction, E:
Endometrial, I: Iatrogenic, N: Not yet classified.
◍ Calcium needs for dairy free diet.
Answer: 300mg calcium daily; needs 800-1200mg.
◍ Benefits of estrogen after stopping therapy.
Answer: The benefits of estrogen abate within a few months after stopping
therapy
◍ How to respond if a patient requests FSH lab?.
Answer: Many pitfalls, variable depending on the day of the cycle you draw
the lab.
◍ Non-Scarring Alopecia.
Answer: Disorders that reduce or slow hair growth without irreparably
damaging the hair follicle, primarily affect the hair shaft.
◍ Causes of Myalgia.
, Answer: Drug induced (statins, fibrates), endocrine (vit D deficiency,
thyroid, Cushing's), menopause, polymyalgia rheumatica.
◍ Triptans contraindication.
Answer: Patients with cardiovascular disease, as are NSAIDs.
◍ Late Menopause Transition (-1) Symptoms.
Answer: VMS likely
◍ Pharmacological Treatment for Restless Legs.
Answer: Parmipexole and ropinirole.
◍ HRT and dementia risk.
Answer: EPT replacement was shown to double the risk of developing
dementia.
◍ GnRH therapy for fibroids.
Answer: Addback therapy can be used to protect against VMS and bone
mineral density loss.
◍ treatment for gonorrhea.
Answer: 2021 guidelines: ceftriaxone 500 mg IM x1 or ceftriaxone 1g IM
x1 if > 150kg. If chlamydia not ruled out; doxy 100 BID 7 days.
◍ Use of PTH receptor agonists.
Answer: For someone incredibly high risk for vertebral fracture.
◍ Zoledronic acid (Reclast, Zometa).
Answer: Biphosphate. IV annually.
◍ Hormone Therapy for Headache.
Answer: Can be used to mitigate falling estrogen levels, no product FDA
approved; can add low-dose estrogen supplement during withdrawal phase
of oral contraceptive pill, use continuous hormone therapy; if progestogen
causes, switch to micronized.
◍ Topical estrogen use in ovarian cancer.
Answer: Can: HGSOC, Germ cell, Granulosa cell; Cannot: Endometrioid
, ◍ Common upset stomach & heartburn.
Answer: GI effects Nursing Implications & teaching: Take first thing in the
AM, before eating anything; then pt MUST remain upright for at least 30
mins! Take only with plain water. Monitor for GI side effects. Use
sunscreen to prevent photosensitivity reactions.
◍ Common thyroid disorder in women.
Answer: Hashimoto thyroiditis.
◍ HSDD and FSAD.
Answer: Combined into female sexual interest/arousal disorder.
◍ Antral follicle count (AFC).
Answer: Number of follicles detectable with ultrasound; sensitive to FSH
and represents the availability pool of follicles.
◍ Ethnicity with most bad hot flashes.
Answer: Black; more frequent, longer duration.
◍ HT and Osteoporosis.
Answer: ET prevents bone loss in postmenopausal womenNot indicated for
treatment of osteoporosis since it has not shown to reduce fracture risk in
women with known osteoporosis
◍ FPHL vs Telogen Effluvium.
Answer: FPHL is gradual, telogen effluvium is sudden and usually
precipitated by a life stressor.
◍ Hepatitis C screening start year.
Answer: 1992
◍ Adrenocorticotropic Hormone (ACTH).
Answer: Stimulates cortisol production from adrenal glands.
◍ Thyroid medication and oral ET.
Answer: TSH levels should be monitored 6-8 weeks later; anticipate that
dose of Levo may need to be increased; oral (not transdermal) estrogens
increase thyroid binding globulin which reduces FT4
PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS GRADED
A+
◍ Premarin Vaginal Cream.
Answer: (Conjugated Estrogen) - Indicated for VVA and dyspareunia
◍ Does VMS worsen in premenopause or post menopause?.
Answer: VMS prevalence increases in peri/postmenopause
◍ PALM COEIN causes of AUB.
Answer: P: Polyp, A: Adenomyosis, L: Leiomyoma, M:
Malignancy/hyperplasia, C: Coagulopathy, O: Ovulatory dysfunction, E:
Endometrial, I: Iatrogenic, N: Not yet classified.
◍ Calcium needs for dairy free diet.
Answer: 300mg calcium daily; needs 800-1200mg.
◍ Benefits of estrogen after stopping therapy.
Answer: The benefits of estrogen abate within a few months after stopping
therapy
◍ How to respond if a patient requests FSH lab?.
Answer: Many pitfalls, variable depending on the day of the cycle you draw
the lab.
◍ Non-Scarring Alopecia.
Answer: Disorders that reduce or slow hair growth without irreparably
damaging the hair follicle, primarily affect the hair shaft.
◍ Causes of Myalgia.
, Answer: Drug induced (statins, fibrates), endocrine (vit D deficiency,
thyroid, Cushing's), menopause, polymyalgia rheumatica.
◍ Triptans contraindication.
Answer: Patients with cardiovascular disease, as are NSAIDs.
◍ Late Menopause Transition (-1) Symptoms.
Answer: VMS likely
◍ Pharmacological Treatment for Restless Legs.
Answer: Parmipexole and ropinirole.
◍ HRT and dementia risk.
Answer: EPT replacement was shown to double the risk of developing
dementia.
◍ GnRH therapy for fibroids.
Answer: Addback therapy can be used to protect against VMS and bone
mineral density loss.
◍ treatment for gonorrhea.
Answer: 2021 guidelines: ceftriaxone 500 mg IM x1 or ceftriaxone 1g IM
x1 if > 150kg. If chlamydia not ruled out; doxy 100 BID 7 days.
◍ Use of PTH receptor agonists.
Answer: For someone incredibly high risk for vertebral fracture.
◍ Zoledronic acid (Reclast, Zometa).
Answer: Biphosphate. IV annually.
◍ Hormone Therapy for Headache.
Answer: Can be used to mitigate falling estrogen levels, no product FDA
approved; can add low-dose estrogen supplement during withdrawal phase
of oral contraceptive pill, use continuous hormone therapy; if progestogen
causes, switch to micronized.
◍ Topical estrogen use in ovarian cancer.
Answer: Can: HGSOC, Germ cell, Granulosa cell; Cannot: Endometrioid
, ◍ Common upset stomach & heartburn.
Answer: GI effects Nursing Implications & teaching: Take first thing in the
AM, before eating anything; then pt MUST remain upright for at least 30
mins! Take only with plain water. Monitor for GI side effects. Use
sunscreen to prevent photosensitivity reactions.
◍ Common thyroid disorder in women.
Answer: Hashimoto thyroiditis.
◍ HSDD and FSAD.
Answer: Combined into female sexual interest/arousal disorder.
◍ Antral follicle count (AFC).
Answer: Number of follicles detectable with ultrasound; sensitive to FSH
and represents the availability pool of follicles.
◍ Ethnicity with most bad hot flashes.
Answer: Black; more frequent, longer duration.
◍ HT and Osteoporosis.
Answer: ET prevents bone loss in postmenopausal womenNot indicated for
treatment of osteoporosis since it has not shown to reduce fracture risk in
women with known osteoporosis
◍ FPHL vs Telogen Effluvium.
Answer: FPHL is gradual, telogen effluvium is sudden and usually
precipitated by a life stressor.
◍ Hepatitis C screening start year.
Answer: 1992
◍ Adrenocorticotropic Hormone (ACTH).
Answer: Stimulates cortisol production from adrenal glands.
◍ Thyroid medication and oral ET.
Answer: TSH levels should be monitored 6-8 weeks later; anticipate that
dose of Levo may need to be increased; oral (not transdermal) estrogens
increase thyroid binding globulin which reduces FT4
