Question

A sexually active woman is complaining of amenorrhea and vaginal spotting. On exam, her left adnexa is tender and cervical motion tenderness is positive. Which test should the NP initially order?

Answer 1

Answer:

c. pregnancy test

Explanation:

This question is incomplete. The options for this question are:

A. Flat plate of the abdomen

B. CBC with diff

C. Pregnancy test

D. Pelvic ultrasound

Cervical motion tenderness is found on a gynecological pelvic examination and it suggests some kind of pelvic pathology. Usually it is an indicator or pelvic inflammatory disease or ectopic pregnancy.

Adnexal tenderness occurs when there is pain or general tenderness around the area where an adnexal mass is located (usually in the ovary or fallopian tubes). These adnexal masses can be ovarian cysts, tumors or ectopic pregnancies.

This patient has amenorrhea (missing periods) and vaginal spotting. We  can see that both cervical motion tenderness and adnexal tenderness can be signs of ectopic pregnancies. Also the fact that she is missing her period can indicate pregnancy. Therefore, the NP should initially order a pregnancy test to discard this option.