NR 602 PRIMARY CARE CHILDBEARING CHILDREARING
FAMILY FINAL EXAM STUDY GUIDE 2026/2027 | Highly Rated
| Chamberlain College | Pass Guaranteed - A+ Graded
Women's Health Across the Lifespan
Q1: A 24-year-old nulliparous woman presents requesting contraception. She has a
history of migraine with aura and smokes 10 cigarettes daily. Which contraceptive
method would be the most appropriate recommendation?
A. Combined oral contraceptive pills with 20 mcg ethinyl estradiol
B. Progestin-only implant (Nexplanon) [CORRECT]
C. Transdermal contraceptive patch
D. Vaginal contraceptive ring
Rationale: Migraine with aura and smoking under age 35 are both absolute
contraindications to estrogen-containing contraceptives due to increased stroke risk.
The progestin-only implant provides highly effective contraception without estrogen.
Combined oral contraceptives, the patch, and the ring all contain estrogen and are
contraindicated in this patient.
Correct Answer: B
Q2: A 32-year-old woman presents for her annual well-woman visit. She is sexually
active with one male partner and has no symptoms. According to current CDC
guidelines, which STI screening is recommended for her?
,A. Gonorrhea and chlamydia screening only if she requests it
B. Annual syphilis serology for all sexually active women
C. Gonorrhea and chlamydia screening annually if under 25, or older with risk factors
[CORRECT]
D. Routine HSV-2 serologic screening
Rationale: The CDC recommends annual gonorrhea and chlamydia screening for all
sexually active women under age 25, and for women 25 and older with risk factors (new
partner, multiple partners, partner with STI). Syphilis screening is risk-based, not routine
for all. HSV-2 serologic screening is not recommended in asymptomatic patients due to
high false-positive rates and psychosocial harm.
Correct Answer: C
Q3: A 45-year-old woman presents for cervical cancer screening. Her last Pap smear 3
years ago was normal. She has no history of abnormal results. Which screening
approach is most appropriate?
A. Annual Pap smear beginning now
B. Pap smear with HPV co-testing every 5 years [CORRECT]
C. HPV testing alone annually
D. Discontinue screening as she is over 45
Rationale: For women ages 30-65, the preferred screening is Pap with HPV co-testing
every 5 years, or Pap alone every 3 years. Annual screening is no longer recommended.
HPV testing alone is an acceptable option but not required annually. Screening
,continues until age 65 if the woman has an intact cervix and doesn't meet criteria for
discontinuation.
Correct Answer: B
Q4: A 38-year-old woman presents with a 2-week history of vaginal discharge and
itching. On exam, you note thin, gray discharge with a fishy odor, pH >4.5, and clue cells
on wet mount. Which treatment is most appropriate?
A. Oral fluconazole 150 mg single dose
B. Metronidazole 500 mg PO BID for 7 days [CORRECT]
C. Clindamycin 2% vaginal cream for 7 days
D. Azithromycin 1 g PO single dose
Rationale: The presentation is classic for bacterial vaginosis (thin gray discharge, fishy
odor, clue cells, elevated pH). Metronidazole is first-line treatment. Fluconazole treats
candidiasis (thick white discharge, no odor). Azithromycin treats chlamydia.
Clindamycin cream is an alternative for BV but oral metronidazole is preferred first-line.
Correct Answer: B
Q5: A 29-year-old woman is interested in long-acting reversible contraception. She has
regular menses, no medical problems, and wants the most effective method available.
Which option provides the lowest failure rate?
A. Copper IUD (Paragard)
B. Levonorgestrel IUD 52 mg (Mirena) [CORRECT]
, C. Etonogestrel implant (Nexplanon)
D. Both B and C have equivalent lowest failure rates
Rationale: The levonorgestrel 52mg IUD and the etonogestrel implant both have failure
rates <1% (0.1-0.4%), making them the most effective reversible methods. The copper
IUD has a slightly higher failure rate (0.8%). Both the 52mg LNG-IUD and the implant are
considered equally effective with failure rates of 0.1-0.2%, though some studies show
the implant may have a marginally lower rate.
Correct Answer: B
Q6: A 52-year-old woman presents with hot flashes, night sweats, and vaginal dryness.
She had a hysterectomy at age 40 for fibroids. Her family history is negative for breast
cancer and cardiovascular disease. Which statement about menopausal hormone
therapy is most accurate?
A. Systemic estrogen is contraindicated without a uterus
B. Estrogen therapy alone is appropriate and carries lower risk than combined therapy
[CORRECT]
C. Hormone therapy should be avoided in all women over 50
D. Vaginal estrogen alone will resolve all her symptoms
Rationale: In women without a uterus, estrogen therapy alone is appropriate and does
not require progestin (which is needed to prevent endometrial hyperplasia in women
with intact uteri). Systemic estrogen is actually preferred when the uterus is absent.
Hormone therapy remains appropriate for symptomatic women under 60 or within 10
FAMILY FINAL EXAM STUDY GUIDE 2026/2027 | Highly Rated
| Chamberlain College | Pass Guaranteed - A+ Graded
Women's Health Across the Lifespan
Q1: A 24-year-old nulliparous woman presents requesting contraception. She has a
history of migraine with aura and smokes 10 cigarettes daily. Which contraceptive
method would be the most appropriate recommendation?
A. Combined oral contraceptive pills with 20 mcg ethinyl estradiol
B. Progestin-only implant (Nexplanon) [CORRECT]
C. Transdermal contraceptive patch
D. Vaginal contraceptive ring
Rationale: Migraine with aura and smoking under age 35 are both absolute
contraindications to estrogen-containing contraceptives due to increased stroke risk.
The progestin-only implant provides highly effective contraception without estrogen.
Combined oral contraceptives, the patch, and the ring all contain estrogen and are
contraindicated in this patient.
Correct Answer: B
Q2: A 32-year-old woman presents for her annual well-woman visit. She is sexually
active with one male partner and has no symptoms. According to current CDC
guidelines, which STI screening is recommended for her?
,A. Gonorrhea and chlamydia screening only if she requests it
B. Annual syphilis serology for all sexually active women
C. Gonorrhea and chlamydia screening annually if under 25, or older with risk factors
[CORRECT]
D. Routine HSV-2 serologic screening
Rationale: The CDC recommends annual gonorrhea and chlamydia screening for all
sexually active women under age 25, and for women 25 and older with risk factors (new
partner, multiple partners, partner with STI). Syphilis screening is risk-based, not routine
for all. HSV-2 serologic screening is not recommended in asymptomatic patients due to
high false-positive rates and psychosocial harm.
Correct Answer: C
Q3: A 45-year-old woman presents for cervical cancer screening. Her last Pap smear 3
years ago was normal. She has no history of abnormal results. Which screening
approach is most appropriate?
A. Annual Pap smear beginning now
B. Pap smear with HPV co-testing every 5 years [CORRECT]
C. HPV testing alone annually
D. Discontinue screening as she is over 45
Rationale: For women ages 30-65, the preferred screening is Pap with HPV co-testing
every 5 years, or Pap alone every 3 years. Annual screening is no longer recommended.
HPV testing alone is an acceptable option but not required annually. Screening
,continues until age 65 if the woman has an intact cervix and doesn't meet criteria for
discontinuation.
Correct Answer: B
Q4: A 38-year-old woman presents with a 2-week history of vaginal discharge and
itching. On exam, you note thin, gray discharge with a fishy odor, pH >4.5, and clue cells
on wet mount. Which treatment is most appropriate?
A. Oral fluconazole 150 mg single dose
B. Metronidazole 500 mg PO BID for 7 days [CORRECT]
C. Clindamycin 2% vaginal cream for 7 days
D. Azithromycin 1 g PO single dose
Rationale: The presentation is classic for bacterial vaginosis (thin gray discharge, fishy
odor, clue cells, elevated pH). Metronidazole is first-line treatment. Fluconazole treats
candidiasis (thick white discharge, no odor). Azithromycin treats chlamydia.
Clindamycin cream is an alternative for BV but oral metronidazole is preferred first-line.
Correct Answer: B
Q5: A 29-year-old woman is interested in long-acting reversible contraception. She has
regular menses, no medical problems, and wants the most effective method available.
Which option provides the lowest failure rate?
A. Copper IUD (Paragard)
B. Levonorgestrel IUD 52 mg (Mirena) [CORRECT]
, C. Etonogestrel implant (Nexplanon)
D. Both B and C have equivalent lowest failure rates
Rationale: The levonorgestrel 52mg IUD and the etonogestrel implant both have failure
rates <1% (0.1-0.4%), making them the most effective reversible methods. The copper
IUD has a slightly higher failure rate (0.8%). Both the 52mg LNG-IUD and the implant are
considered equally effective with failure rates of 0.1-0.2%, though some studies show
the implant may have a marginally lower rate.
Correct Answer: B
Q6: A 52-year-old woman presents with hot flashes, night sweats, and vaginal dryness.
She had a hysterectomy at age 40 for fibroids. Her family history is negative for breast
cancer and cardiovascular disease. Which statement about menopausal hormone
therapy is most accurate?
A. Systemic estrogen is contraindicated without a uterus
B. Estrogen therapy alone is appropriate and carries lower risk than combined therapy
[CORRECT]
C. Hormone therapy should be avoided in all women over 50
D. Vaginal estrogen alone will resolve all her symptoms
Rationale: In women without a uterus, estrogen therapy alone is appropriate and does
not require progestin (which is needed to prevent endometrial hyperplasia in women
with intact uteri). Systemic estrogen is actually preferred when the uterus is absent.
Hormone therapy remains appropriate for symptomatic women under 60 or within 10
