A pelvic exam may not be performed on which patient without written consent?

• A. An awake, alert adult.
• B. An anesthetized or unconscious patient.
• C. A patient with a court order.
• D. A patient with stable vitals.

Answer: (B)

Informed consent is required for invasive examinations because the patient must autonomously authorize procedures done to their body. A person must have the capacity to understand the procedure, risks, and alternatives and to give written consent or have consent documented.

An anesthetized or unconscious patient cannot provide that understanding or decision-making, so the exam cannot be performed without someone legally authorized to consent on their behalf, or under a valid legal exception. Without written consent or an appropriate surrogate authorization, proceeding would violate the patient’s autonomy.

The other scenarios fit because an awake, alert adult can understand and consent to the exam, and a court order can authorize examinations without the patient’s direct consent. Having stable vitals doesn’t waive the need for consent, since capacity and authorization—not the patient’s vital status—determine whether the exam may occur.