The outpatient clinic nurse has assessed a woman who reports a month-long history of feeling full, urinary frequency, and bloating, What action by the nurse is best?

Rationale: A. Although bloating and fullness could be related to dietary intake, these symptoms persisting for a month are not typical of simple gastrointestinal causes. Focusing on diet may delay appropriate diagnostic testing for potentially serious conditions like ovarian cancer. B. Urinary frequency could suggest a urinary tract infection (UTI), but when it occurs alongside early satiety (feeling full quickly) and abdominal bloating, the symptoms are more suspicious for pelvic pathology, not infection. A urine test would not address the underlying concern. C. While CA-125 is a tumor marker sometimes elevated in ovarian cancer, it is not diagnostic on its own and can be elevated in benign conditions (e.g., endometriosis, menstruation, pelvic inflammatory disease). It is not the first diagnostic step; imaging should be done first. D. This is the best and most appropriate action. A pelvic or transvaginal ultrasound is the initial diagnostic test for evaluating pelvic masses and identifying potential ovarian enlargement or tumors. The client’s symptoms — bloating, early satiety, and urinary frequency — are classic subtle signs of ovarian cancer, often referred to as the “silent symptoms.” Early detection is critical since ovarian cancer is frequently diagnosed at a late stage.