An 18-year-old patient is having her first pelvic examination. Which action by the nurse is appropriate?

A) Inviting her mother to be present during the examination.
B) Avoiding the lithotomy position for this first time because it can be uncomfortable and embarrassing.
C) Raising the head of the examination table and giving her a mirror so that she can view the examination.
D) Fully draping her, leaving the drape between her legs elevated to avoid embarrassing her with eye contact.

The techniques of the educational or mirror pelvic examination should be used. This is a routine examination with some modifications in attitude, position, and communication. First, the woman is considered an active participant, one who is interested in learning and in sharing decisions about her own health care. The woman props herself up on one elbow, or the head of the table is raised. Her other hand holds a mirror between her legs, above the examiner's hands. The young woman can see all that the examiner is doing and has a full view of her genitalia. The mirror works well for teaching normal anatomy and its relationship to sexual behavior. The examiner can ask her if she would like to have a family member, friend, or chaperone present for the examination. The drape should be pushed down between the patient's legs so that the nurse can see her face.