Free BCEN Certified Emergency Nurse (CEN) Practice Question

A 44-year-old female patient presents to the emergency department with a complaint of heavy vaginal bleeding and lightheadedness over the past several days. She reports her menstrual periods have been irregular and heavier than usual for the past six months. She denies any trauma or use of anticoagulant medications. Her vital signs on admission are BP 100/60 mmHg, HR 110 bpm, RR 18 breaths/min, and Temp 37°C. On examination, no source of active bleeding is noted other than the vaginal bleeding. Which of the following is the most appropriate initial intervention?

  • Consult gynecology for an emergent dilation and curettage (D&C)

  • Start an intravenous (IV) line and begin fluid resuscitation

  • Order a pelvic ultrasound immediately to look for anatomic causes of bleeding

  • Obtain a complete blood count (CBC) and type and screen

This question's topic:
BCEN Certified Emergency Nurse (CEN) / 
Gastrointestinal, Genitourinary, Gynecology, and Obstetrical
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