A Pap test shows abnormal cytology. Which procedure should the nurse anticipate for further evaluation?

• A. Colposcopy
• B. Rectovaginal palpation by the provider
• C. hCG test
• D. Dilation and curettage

Answer: (A)

When a Pap smear shows abnormal cytology, the goal is to pinpoint where changes are on the cervix and obtain tissue to determine how serious they are. The next step is colposcopy, a focused, magnified examination of the cervix performed after applying dilute acetic acid. Abnormal areas stand out as acetowhite regions and can be biopsied directly during the same visit, providing a histologic diagnosis that guides treatment.

Other options don’t fit as the immediate next step. A rectovaginal palpation is a general pelvic exam maneuver and doesn’t assess cervical tissue changes or provide tissue for diagnosis. A pregnancy test (hCG) isn’t related to evaluating cervical cytology. Dilation and curettage is more invasive and is reserved for situations where colposcopy is inadequate or endometrial sampling is needed, not as the first follow-up after an abnormal Pap. Colposcopy is the best, targeted method to evaluate cervical abnormalities identified on cytology.