A hospitalized adolescent with pelvic inflammatory disease (PID) asks why the nurse isn't repeating pelvic exams "to make sure the infection is going away?" The nurse responds that this reduces the risk of _________.

A. Infertility: Infertility is a long-term complication of PID due to scarring and damage to the fallopian tubes. While minimizing pelvic exams may reduce irritation, it does not directly prevent infertility. B. Ectopic pregnancy: Ectopic pregnancy can result from tubal scarring after PID, but avoiding repeated pelvic exams does not directly reduce this risk. The focus is on preventing further infection spread. C. Nausea and vomiting: These are nonspecific symptoms and not directly related to the performance of pelvic exams. Limiting exams would not significantly influence gastrointestinal side effects. D. Further ascending infection: Repeated pelvic manipulation can facilitate upward spread of pathogens in the reproductive tract. Minimizing pelvic exams reduces trauma and the chance of worsening or spreading the infection.