NR 602 PRIMARY CARE CHILDBEARING CHILDREARING
FAMILY FINAL EXAM REVIEW 2026/2027 | Questions and
Verified Answers | Pass Guaranteed - A+ Graded
Part I: Women's Health & Reproductive Primary Care
Q1: A 28-year-old patient presents for her annual well-woman visit. She has no
complaints, family history of breast cancer in maternal grandmother at age 72, and
otherwise unremarkable history. According to current USPSTF recommendations, which
screening should you prioritize as Grade A or B for this visit?
A. Clinical breast examination by provider every 6 months due to family history
B. Mammography starting now due to family history of breast cancer [CORRECT]
C. BRCA genetic testing based on single second-degree relative with postmenopausal
breast cancer
D. Breast MRI annually beginning at age 30 due to family history
Correct Answer: B
Rationale: USPSTF recommends biennial mammography for women aged 40-74 (Grade
B). Starting at age 40 is appropriate for average-risk women; family history of
postmenopausal breast cancer in one second-degree relative doesn't significantly alter
risk to warrant earlier screening or genetic testing. Clinical breast exam isn't routinely
recommended (insufficient evidence), and breast MRI is reserved for high-risk patients
(BRCA carriers or strong family history patterns). The single grandmother with cancer at
72 doesn't meet BRCA testing criteria.
,Q2: A 34-year-old G2P2 requests long-acting reversible contraception. She wants the
most effective method with rapid return to fertility when removed. She has normal blood
pressure, non-smoker, no migraines. Which option best fits her criteria?
A. Depot medroxyprogesterone acetate (Depo-Provera) injection every 12 weeks
B. Levonorgestrel 52mg intrauterine system (Mirena) [CORRECT]
C. Copper T 380A intrauterine device (Paragard)
D. Combined oral contraceptive pills with 30mcg ethinyl estradiol
Correct Answer: B
Rationale: The levonorgestrel IUD is highly effective (0.1-0.4% failure rate), provides 5-8
years of contraception, and fertility returns immediately upon removal. While copper IUD
is also highly effective and hormone-free, it often causes heavier periods. Depo-Provera
has delayed return to fertility (average 10 months), and combined oral contraceptives
require daily adherence and have lower typical-use effectiveness. The LNG-IUD offers
the best balance of efficacy, longevity, and rapid fertility return she requested.
Q3: A 22-year-old college student presents with vaginal discharge and dysuria. On
speculum exam, you note frothy yellow-green discharge with "strawberry cervix"
appearance. Wet mount shows motile protozoa. Which treatment is appropriate?
A. Azithromycin 1g orally single dose
B. Ceftriaxone 250mg IM single dose plus doxycycline 100mg BID x 7 days
C. Metronidazole 500mg orally BID x 7 days [CORRECT]
D. Fluconazole 150mg orally single dose
,Correct Answer: C
Rationale: The presentation (frothy discharge, strawberry cervix, motile protozoa on wet
mount) is classic for Trichomonas vaginalis. Metronidazole or tinidazole is the
treatment of choice. Azithromycin treats chlamydia, ceftriaxone/doxycycline treats
gonorrhea/chlamydia, and fluconazole treats candidiasis. The strawberry cervix and
motile organisms are pathognomonic for trichomoniasis, making metronidazole the
correct choice.
Q4: According to CDC STI screening guidelines, which asymptomatic patient requires
routine screening for gonorrhea and chlamydia?
A. 35-year-old married woman in monogamous relationship for 10 years
B. 25-year-old woman with new sexual partner in past 6 months [CORRECT]
C. 40-year-old woman who had chlamydia treated 5 years ago, no partners since
D. 19-year-old woman who has never been sexually active
Correct Answer: B
Rationale: CDC recommends annual screening for sexually active women under 25, and
women 25+ with risk factors (new partner, multiple partners, partner with STI). The
25-year-old with a new partner meets screening criteria. The 35-year-old in long-term
monogamous relationship doesn't require screening without risk factors. Prior infection
5 years ago with no subsequent partners doesn't indicate current risk. Never sexually
active patients don't need STI screening.
Q5: A 45-year-old perimenopausal woman reports hot flashes, night sweats, and vaginal
dryness affecting sexual function. She has no contraindications to hormone therapy.
, Her last menstrual period was 8 months ago. Which is the most appropriate initial
management?
A. Testosterone supplementation for libido enhancement
B. Low-dose combined oral contraceptives continuously
C. Transdermal 17-beta estradiol with oral progesterone if uterus intact [CORRECT]
D. Black cohosh and soy isoflavones as first-line therapy
Correct Answer: C
Rationale: Systemic menopausal hormone therapy (MHT) is the most effective
treatment for vasomotor symptoms and genitourinary syndrome of menopause.
Transdermal estradiol avoids first-pass hepatic metabolism and may have lower
thrombotic risk than oral formulations. Progesterone is required if uterus is present to
prevent endometrial hyperplasia. Combined OCPs aren't appropriate for women over 35
who smoke or have cardiovascular risk factors. Testosterone isn't FDA-approved for
women. Alternative therapies like black cohosh have limited evidence and shouldn't
replace proven therapy for moderate-severe symptoms.
Q6: A 30-year-old patient asks about cervical cancer screening. She had normal Pap
smear and negative HPV test 3 years ago. When should she return for next screening?
A. Annual Pap smear every year regardless of prior results
B. Co-testing (Pap + HPV) in 3 years, or primary HPV testing in 5 years [CORRECT]
C. Pap smear alone in 5 years
D. She can stop screening until age 40 since both tests were negative
FAMILY FINAL EXAM REVIEW 2026/2027 | Questions and
Verified Answers | Pass Guaranteed - A+ Graded
Part I: Women's Health & Reproductive Primary Care
Q1: A 28-year-old patient presents for her annual well-woman visit. She has no
complaints, family history of breast cancer in maternal grandmother at age 72, and
otherwise unremarkable history. According to current USPSTF recommendations, which
screening should you prioritize as Grade A or B for this visit?
A. Clinical breast examination by provider every 6 months due to family history
B. Mammography starting now due to family history of breast cancer [CORRECT]
C. BRCA genetic testing based on single second-degree relative with postmenopausal
breast cancer
D. Breast MRI annually beginning at age 30 due to family history
Correct Answer: B
Rationale: USPSTF recommends biennial mammography for women aged 40-74 (Grade
B). Starting at age 40 is appropriate for average-risk women; family history of
postmenopausal breast cancer in one second-degree relative doesn't significantly alter
risk to warrant earlier screening or genetic testing. Clinical breast exam isn't routinely
recommended (insufficient evidence), and breast MRI is reserved for high-risk patients
(BRCA carriers or strong family history patterns). The single grandmother with cancer at
72 doesn't meet BRCA testing criteria.
,Q2: A 34-year-old G2P2 requests long-acting reversible contraception. She wants the
most effective method with rapid return to fertility when removed. She has normal blood
pressure, non-smoker, no migraines. Which option best fits her criteria?
A. Depot medroxyprogesterone acetate (Depo-Provera) injection every 12 weeks
B. Levonorgestrel 52mg intrauterine system (Mirena) [CORRECT]
C. Copper T 380A intrauterine device (Paragard)
D. Combined oral contraceptive pills with 30mcg ethinyl estradiol
Correct Answer: B
Rationale: The levonorgestrel IUD is highly effective (0.1-0.4% failure rate), provides 5-8
years of contraception, and fertility returns immediately upon removal. While copper IUD
is also highly effective and hormone-free, it often causes heavier periods. Depo-Provera
has delayed return to fertility (average 10 months), and combined oral contraceptives
require daily adherence and have lower typical-use effectiveness. The LNG-IUD offers
the best balance of efficacy, longevity, and rapid fertility return she requested.
Q3: A 22-year-old college student presents with vaginal discharge and dysuria. On
speculum exam, you note frothy yellow-green discharge with "strawberry cervix"
appearance. Wet mount shows motile protozoa. Which treatment is appropriate?
A. Azithromycin 1g orally single dose
B. Ceftriaxone 250mg IM single dose plus doxycycline 100mg BID x 7 days
C. Metronidazole 500mg orally BID x 7 days [CORRECT]
D. Fluconazole 150mg orally single dose
,Correct Answer: C
Rationale: The presentation (frothy discharge, strawberry cervix, motile protozoa on wet
mount) is classic for Trichomonas vaginalis. Metronidazole or tinidazole is the
treatment of choice. Azithromycin treats chlamydia, ceftriaxone/doxycycline treats
gonorrhea/chlamydia, and fluconazole treats candidiasis. The strawberry cervix and
motile organisms are pathognomonic for trichomoniasis, making metronidazole the
correct choice.
Q4: According to CDC STI screening guidelines, which asymptomatic patient requires
routine screening for gonorrhea and chlamydia?
A. 35-year-old married woman in monogamous relationship for 10 years
B. 25-year-old woman with new sexual partner in past 6 months [CORRECT]
C. 40-year-old woman who had chlamydia treated 5 years ago, no partners since
D. 19-year-old woman who has never been sexually active
Correct Answer: B
Rationale: CDC recommends annual screening for sexually active women under 25, and
women 25+ with risk factors (new partner, multiple partners, partner with STI). The
25-year-old with a new partner meets screening criteria. The 35-year-old in long-term
monogamous relationship doesn't require screening without risk factors. Prior infection
5 years ago with no subsequent partners doesn't indicate current risk. Never sexually
active patients don't need STI screening.
Q5: A 45-year-old perimenopausal woman reports hot flashes, night sweats, and vaginal
dryness affecting sexual function. She has no contraindications to hormone therapy.
, Her last menstrual period was 8 months ago. Which is the most appropriate initial
management?
A. Testosterone supplementation for libido enhancement
B. Low-dose combined oral contraceptives continuously
C. Transdermal 17-beta estradiol with oral progesterone if uterus intact [CORRECT]
D. Black cohosh and soy isoflavones as first-line therapy
Correct Answer: C
Rationale: Systemic menopausal hormone therapy (MHT) is the most effective
treatment for vasomotor symptoms and genitourinary syndrome of menopause.
Transdermal estradiol avoids first-pass hepatic metabolism and may have lower
thrombotic risk than oral formulations. Progesterone is required if uterus is present to
prevent endometrial hyperplasia. Combined OCPs aren't appropriate for women over 35
who smoke or have cardiovascular risk factors. Testosterone isn't FDA-approved for
women. Alternative therapies like black cohosh have limited evidence and shouldn't
replace proven therapy for moderate-severe symptoms.
Q6: A 30-year-old patient asks about cervical cancer screening. She had normal Pap
smear and negative HPV test 3 years ago. When should she return for next screening?
A. Annual Pap smear every year regardless of prior results
B. Co-testing (Pap + HPV) in 3 years, or primary HPV testing in 5 years [CORRECT]
C. Pap smear alone in 5 years
D. She can stop screening until age 40 since both tests were negative
