CNM Certified Nurse Midwife

Answer: C - Pelvic ultrasound is ordered for further evaluation and diagnosis. Based on the history and signs and symptoms, the client is likely experiencing ovarian torsion, or twisting of the ovary. This condition is also known as adnexal torsion. A pelvic ultrasound is the diagnostic tool of choice as it can accurately and easily evaluate adnexal masses. A Doppler ultrasound may be used to help determine if the blood flow is impaired. A computed tomography or magnetic resonance imaging is not definitive when evaluating adnexal masses. Ovarian torsion is manifested by extreme, abrupt lower abdominal pain. It is caused by the existence of another disease or by a congenital abnormality. Ovarian torsion commonly occurs in females in their mid-twenties and postmenopausal women.