The nurse in the student health center at a large university received student telephone messages. Which return telephone call is the priority?

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Sexual assault is a medical emergency requiring a thorough head-to-toe physical examination by a specially trained health care provider (eg, sexual assault nurse examiner) to identify and treat injuries. A student reporting potential sexual assault (eg, waking in a strange room, signs of physical assault) should be instructed to seek immediate medical attention and not to bathe, brush teeth, urinate, douche, or change clothes. These activities can delay a medical-forensic examination and interfere with evidence retrieval and preservation. Many college and university health centers have providers for this specialized physical and emotional care, but if they do not, the student should be referred to a local hospital emergency department. (Option A) The student should be reassured that although contracting viral meningitis is possible, it is unlikely as the incubation period is 1 week and typical symptoms include headache, fever, photophobia, and stiff neck. (Option B) The student most likely has a rotator cuff injury and should be instructed to rest, apply ice and heat, take a nonsteroidal anti-inflammatory drug, and seek medical evaluation. (Option D) The student's vaginal discharge is most likely related to a candidiasis (ie, yeast) fungal infection. The student should be instructed to seek medical attention and refrain from sexual activity until testing for sexually transmitted diseases is completed. Educational objective: Sexual assault is a medical emergency requiring immediate, specialized examination to identify and treat any physical injuries and emotional trauma. Delaying a medical-forensic examination can interfere with evidence retrieval and preservation.

The Nurse in the Student Health Center at a Large