In evaluating a patient who has been raped, which examination is most appropriate to perform first?

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

Answer: (A)

In evaluating a patient who has been raped, the first step is a careful external examination of the genital area. This noninvasive assessment allows you to identify visible injuries, bleeding, or trauma and to begin documenting findings for medical care and for potential forensic evidence. It sets up appropriate next steps, such as safeguarding evidence, taking photos with consent, and deciding if and when an internal exam or forensic collection is needed, all while preserving the patient’s dignity and safety.

Packing the vagina with a sterile dressing would contaminate or destroy evidence and is not an appropriate initial action. Massaging the uterus is an obstetric procedure unrelated to rape evaluation. Giving the patient a pad is not an examination and does not address medical assessment or evidence collection.