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Physician Assistant Certification

NCCPA Obstetrics and Gynecology CAQ Examination Practice Test

Obstetrics and gynecology clinical practice brings together prenatal assessment, pregnancy-related complications, reproductive health, and common gynecologic conditions. Cases in this practice bank use presentations such as pregnancy with bleeding or pelvic pain, abnormal uterine bleeding, breast masses, urinary incontinence, and suspected pelvic infection to frame clinical decisions.

Exam overview

Exam providerNational Commission on Certification of Physician Assistants
Exam codeNot listed
CategoryPhysician Assistant Certification

About the NCCPA Obstetrics and Gynecology CAQ Examination Exam

The cases call for selecting diagnostic steps and initial management based on pregnancy status, gestational age, symptoms, examination findings, and imaging. Obstetric decisions include evaluating possible ectopic pregnancy, recognizing when placenta previa affects examination safety, and identifying routine prenatal interventions from blood type and antibody-screen results. Gynecologic reasoning includes choosing age-appropriate breast imaging, assessing endometrial cancer risk in patients with abnormal bleeding, and recognizing indications for cervical screening. Other scenarios address conservative treatment of stress urinary incontinence and initial management of suspected pelvic inflammatory disease. Across these problems, practice interpreting clinical clues, distinguishing urgent from routine evaluation, and selecting a safe next step while accounting for pregnancy and reproductive history.

Sample Practice Questions

Review a selection from this exam's published US Practice Tests practice bank.

Question 1

A 30-year-old at 28 weeks’ gestation has a routine prenatal visit. Her blood type is O negative, and her antibody screen is negative. She has had no bleeding, trauma, or invasive procedures during pregnancy. Which intervention is generally indicated now?

  1. AAdminister Rh(D) immune globulin at approximately 28 weeks
  2. BAdminister Rh(D) immune globulin only after delivery
  3. CRepeat the antibody screen after delivery and treat only if it becomes positive
  4. DNo Rh(D) immune globulin is indicated because the antibody screen is negative
Show answerCorrect answer: A

An unsensitized Rh(D)-negative pregnant patient is generally offered Rh(D) immune globulin at about 28 weeks, with postpartum dosing if the newborn is Rh(D)-positive. Additional doses may be indicated after sensitizing events.

Question 2

A 27-year-old with a positive pregnancy test has persistent unilateral pelvic pain. Transvaginal ultrasound does not show a definite intrauterine or extrauterine pregnancy, and she is stable without peritoneal signs. Which approach is generally appropriate?

  1. ATreat immediately with methotrexate based solely on the nondiagnostic scan
  2. BArrange serial quantitative beta-hCG measurements and repeat ultrasound as clinically appropriate
  3. CPerform uterine evacuation in every case before additional assessment
  4. DReassure her that an ectopic pregnancy is excluded by the absence of an adnexal mass
Show answerCorrect answer: B

A pregnancy of unknown location in a stable patient requires follow-up, commonly with serial quantitative beta-hCG and repeat transvaginal ultrasonography, guided by symptoms and findings. A nondiagnostic scan alone neither confirms nor excludes ectopic pregnancy.

Question 3

A 26-year-old at 10 weeks’ gestation has a painless, bright-red vaginal bleed. The uterus is nontender, and fetal cardiac activity is present. What is the most appropriate next step before performing a digital cervical examination?

  1. APerform a digital cervical examination to assess dilation
  2. BObtain transvaginal ultrasonography to determine placental location
  3. CBegin induction of labor
  4. DAdminister methotrexate
Show answerCorrect answer: B

Painless bleeding in pregnancy raises concern for placenta previa. Ultrasound should establish placental location before a digital cervical examination, which could provoke severe hemorrhage if the placenta overlies the cervix.

Question 4

A patient with a positive pregnancy test at approximately 7 weeks has unilateral pelvic pain and light vaginal bleeding. Which diagnostic study is most appropriate to evaluate for an ectopic pregnancy?

  1. ATransvaginal ultrasonography with quantitative serum beta-hCG assessment
  2. BAbdominal radiography
  3. CNoncontrast head CT
  4. DRoutine urine culture alone
Show answerCorrect answer: A

In a symptomatic early pregnancy, transvaginal ultrasonography and quantitative beta-hCG are used together to assess pregnancy location and guide follow-up. Hemodynamic instability or signs of rupture require urgent intervention rather than waiting for serial testing.

Question 5

A 36-year-old with a singleton pregnancy at 31 weeks has painless vaginal bleeding. Ultrasound shows a placenta covering the internal cervical os. Which examination should be avoided until placenta previa has been excluded or delivery planning is underway?

  1. AAbdominal examination for uterine tenderness
  2. BDigital cervical examination
  3. CFetal heart-rate assessment
  4. DTransvaginal ultrasound performed by an experienced clinician
Show answerCorrect answer: B

Digital cervical examination can disrupt placental tissue overlying the cervical os and precipitate severe hemorrhage. Ultrasound, including appropriately performed transvaginal ultrasound, is used to assess placental location.

Question 6

A 37-year-old with no symptoms asks about cervical cancer screening. She has an intact cervix and no history of cervical precancer, immunocompromise, or in-utero diethylstilbestrol exposure. Which statement is most appropriate?

  1. AScreening is unnecessary because she has no symptoms
  2. BScreening should follow the recommended age- and test-based interval for average-risk patients
  3. CAnnual colposcopy is indicated
  4. DScreening should stop at age 40
Show answerCorrect answer: B

Cervical cancer screening is preventive and is recommended for eligible asymptomatic patients according to age and the selected screening method. The appropriate interval varies by guideline and test; special risk factors can change recommendations.

Question 7

A 26-year-old presents with a 2-cm, mobile, nontender breast lump that persists after her menstrual period. She is not pregnant or lactating. What is the most appropriate initial imaging study?

  1. AScreening mammography only
  2. BTargeted breast ultrasound
  3. CBreast MRI with contrast
  4. DNo imaging unless the lump becomes painful
Show answerCorrect answer: B

For a palpable breast mass in a patient younger than 30, targeted ultrasound is generally the initial imaging test. Further evaluation depends on imaging findings and clinical assessment; a persistent mass should not be dismissed solely because it is painless.

How to use this practice test

The free US Practice Tests bank contains 50 published questions for this exam. Each practice session presents up to 20 random questions, then shows your results. Use missed items to identify specific decisions to revisit, such as evaluating early-pregnancy pain, avoiding unsafe examinations with bleeding, or choosing initial testing for a breast mass.

Preparation tips

  • For pregnancy-related pain or bleeding, organize the differential around gestational age, hemodynamic stability, ultrasound findings, and the possibility of ectopic pregnancy or placenta previa.
  • Practice choosing safe examination and imaging steps, including when ultrasound should precede cervical examination and how age and pregnancy status affect breast-mass imaging.
  • For abnormal uterine bleeding, connect endometrial sampling decisions to risk factors such as obesity and chronic anovulation, as well as pregnancy-test results.
  • Review initial management of common gynecologic presentations, including pelvic inflammatory disease and stress urinary incontinence, and distinguish treatment from situations requiring further evaluation.
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