A 19-year-old woman comes to the student health center after a sexual assault 2 days ago. She has no fevers, chills, abdominal pain, or abnormal vaginal discharge. The patient was sexually assaulted by a man she has seen multiple times, who also attends the university. Menses are regular and occur every 29 days; her last menstrual period was 2 weeks ago. She has no known medical conditions and has had no surgeries. The patient takes no medications and has no drug allergies. She smokes cigarettes and drinks alcohol socially. There is no family history of any illness. She is sexually active with a long-term male partner, and they use condoms for contraception. The patient has no history of sexually transmitted infections. Temperature is 36.7 C (98 F) , blood pressure is 110/70 mm Hg, and pulse is 65/min. BMI is 20 kg/m2. The abdomen is soft and nontender, with no palpable masses. Bruises and abrasions are present over the inner thighs, perineum, and vulva. Pelvic examination reveals a friable cervix that bleeds easily on contact. The vaginal mucosa is erythematous with no evidence of hematoma. The uterus is small and nontender on bimanual examination; no adnexal masses are palpated. Microscopy shows an abundance of polymorphonuclear leukocytes. Urine pregnancy test is negative.
A sexual assault forensic examination is performed and evidence is collected. In addition to providing psychosocial support, which of the following is the most appropriate next step in management of this patient?
A) Offer information about ulipristal
B) Offer placement of a copper intrauterine device
C) Offer placement of the etonogestrel subcutaneous implant
D) Order pelvic ultrasound
E) Prescribe combined hormonal contraceptives
Correct Answer:
Verified
Q316: A 27-year-old woman, gravida 3 para 3,
Q317: A 24-year-old woman comes to the office
Q318: A 46-year-old woman, gravida 3 para 3,
Q319: An 18-year-old woman comes to the emergency
Q320: A 28-year-old nulligravid woman comes to the
Q322: A 68-year-old woman comes to the office
Q323: A 17-year-old girl comes to the office
Q324: A 19-year-old woman comes to the student
Q325: A 26-year-old woman is brought to the
Q326: A 14-year-old girl is brought to the
Unlock this Answer For Free Now!
View this answer and more for free by performing one of the following actions
Scan the QR code to install the App and get 2 free unlocks
Unlock quizzes for free by uploading documents