The school nurse is interviewing a 13-year-old girl who wants to go home from school because of "back pain." Which question should the nurse ask the adolescent first?

A. "Have you taken any medications to relieve the pain?" While this is important for understanding symptom management, it does not provide insight into the cause of the pain, which should be the priority in an initial assessment. B. "Do you remember ever having this type of pain in the past?" This question helps determine if the pain is recurrent or chronic, but identifying the immediate cause of the current pain episode should come first. C. "Does changing your position make the pain worse?" This question assesses whether movement influences the pain, which is useful for identifying musculoskeletal causes, but the priority is to determine how the pain started. D. "What were you doing when you first noticed the problem?" This is the best initial question because it helps identify potential triggers for the back pain, such as injury, poor posture, or carrying a heavy backpack. Understanding the onset of symptoms is key to determining the next steps in assessment and care.