A 16-year-old female who was raped presents with vaginal bleeding and bright red blood running down her leg. Which action is appropriate?

• A. Pack her vagina with a sterile dressing.
• B. Massage her fundus.
• C. Give her another pad to apply over the first.
• D. Examine her external genitalia.

Answer: (D)

In a sexual-assault scenario, the priority is to assess injuries and provide care while preserving evidence and avoiding invasive examination. The appropriate action is to perform an external examination of the genital area to identify injuries and assess bleeding without entering the vaginal canal. This approach helps document findings and guide further management without disturbing possible forensic evidence or causing additional harm. Internal vaginal examination or packing the vagina could contaminate evidence and is not indicated in the field. Briefly addressing other options: packing the vagina or massaging the uterus would not be appropriate in this context, and simply giving a pad does not address the need to assess and document injuries.