The nurse is assessing the reproductive history of a 68-year-old postmenopausal woman. Which finding is cause for immediate action by the nurse?

Rationale: A. Urinary incontinence is common in older, postmenopausal women due to weakened pelvic muscles and decreased estrogen levels. While it requires evaluation and management, it is not an immediate threat. B. Although cervical cancer screening should be updated according to guidelines, this does not require emergency action. The nurse should encourage scheduling a Pap test, but it is not urgent. C. Postmenopausal vaginal bleeding is never normal and should be evaluated immediately. It may indicate endometrial hyperplasia or carcinoma, which are potentially serious or life-threatening conditions. The nurse should promptly notify the healthcare provider so diagnostic testing, such as transvaginal ultrasound or endometrial biopsy, can be performed. D. This is a common symptom of decreased estrogen levels after menopause and can be managed with lubricants or topical estrogen creams. It is not urgent.