Intimate partner violence and sexual assault Quiz: Ace Your Exams

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A 28-year-old woman presents to the emergency department after a sexual assault at her residence. The patient reports vaginal penetration and significant pain, swelling, and bleeding from the vulvar area over the past 30 minutes. There is no history of medical conditions, medications, or allergies. The patient is not aware of being pregnant and is unsure of the date of her last menstrual period. Temperature is 37.0°C (98.6°F), pulse is 120/min, respirations are 16/min, blood pressure is 88/60 mmHg, and oxygen saturation is 98% on room air. Physical examination reveals a painful, tense, 8 cm purple mass in the right labia majora with overlying skin tautness and oozing dark blood, along with marked bruising and tenderness. The patient appears anxious but alert. Which of the following is the most appropriate initial step in management?

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Bleeding and laceration management

Empiric antibiotics for chlamydia, gonorrhea, and trichomonas

Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV)

Pregnancy test

Specimen collection for forensic examination