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WHNP-BC study materials
WHNP-BC study resources

WHNP-BC: Reproductive Health, Contraception, and Sexually Transmitted Infections

WHNP-BC · Work through your exam, one topic at a time.

All guide sections

Reproductive Health, Contraception, and Sexually Transmitted Infections

What the exam tests

Contraception and STI items are high-yield and rule-based. Know the US MEC categories (1, no restriction, through 4, unacceptable risk) and current first-line STI regimens.

Core concepts

  • Effectiveness: LARC (implant, IUDs) exceeds injectables, which exceed pills, patch, and ring, which exceed barrier methods. Typical-use failure matters more than perfect-use failure.
  • Estrogen is the problem drug. Combined hormonal contraception is MEC 4 with migraine with aura, smoking at age 35 or older, prior VTE, known thrombophilia, breast cancer, uncontrolled hypertension, and complicated diabetes.
  • Progestin-only methods and LARC are usually appropriate when estrogen is contraindicated.
  • Emergency contraception: copper IUD up to 5 days (most effective), ulipristal up to 120 hours, levonorgestrel up to 72 hours (less effective with higher body weight). Quick-start any method the day it is requested.
  • STI treatment anchors: gonorrhea, ceftriaxone 500 mg IM (1 g if 150 kg or more) plus doxycycline 100 mg twice daily for 7 days if chlamydia is not excluded; chlamydia, doxycycline for 7 days (azithromycin or amoxicillin in pregnancy); syphilis, benzathine penicillin G 2.4 million units IM; trichomoniasis, metronidazole 2 g; bacterial vaginosis, metronidazole 500 mg twice daily for 7 days; PID, ceftriaxone plus doxycycline plus metronidazole.
  • HIV prevention: PrEP, plus retesting at 3 months and partner notification.

Traps

  • Doxycycline is avoided in pregnancy; substitute azithromycin or amoxicillin.
  • Fluoroquinolones are no longer first-line for gonorrhea.
  • A negative nucleic acid test does not exclude syphilis; order serology.
  • Hormonal contraception does not protect against STIs.

Worked example

A 28-year-old with migraine with aura requests the pill. Estrogen-containing methods are MEC 4 for her; offer a progestin-only pill, DMPA, implant, or levonorgestrel IUD, and document the aura history.