Family Nurse Practitioner Exam

What is the best initial intervention for a female with severe right-sided pelvic pain and vaginal bleeding?

1. Follicle-stimulating hormone (FSH) test

2. Serum quantitative pregnancy test

3. Pelvic ultrasound

4. CBC with white cell differential

The correct answer is: Serum quantitative pregnancy test

The best initial intervention for a female with severe right-sided pelvic pain and vaginal bleeding is a serum quantitative pregnancy test. This test is crucial in this scenario as it aids in determining if the patient is pregnant, which is important because pelvic pain and vaginal bleeding can indicate a range of conditions, including ectopic pregnancy—a potentially life-threatening situation if not diagnosed and treated promptly. By confirming whether or not the patient is pregnant, the healthcare provider can make informed decisions about subsequent diagnostic steps and potential interventions. If the pregnancy test is positive, further evaluation with imaging or surgical intervention may be necessary, depending on the specific situation. Understanding the pregnancy status is essential to appropriately managing the patient's case. Other options, while useful in certain contexts, do not serve as priority interventions in the presence of severe pelvic pain and bleeding. For example, a pelvic ultrasound can provide valuable information regarding the state of the reproductive organs, but it typically follows the confirmation of pregnancy status. Similarly, hormone testing does not address the immediate need to rule out pregnancy-related issues. A complete blood count (CBC) can help identify infection or anemia but does not provide critical, immediate information regarding the possibility of pregnancy, which is a key consideration in this scenario.