Final answer:
For a 17-year-old patient with a history of asthma complaining of lower abdominal pain and no signs of respiratory distress, performing a pelvic exam is the most appropriate next step to further investigate the cause of the abdominal pain.
Step-by-step explanation:
You have a 17-year-old patient with a history of asthma complaining of lower abdominal pain. With the provided vital signs (clear equal breath sounds, a respiratory rate of 28 breaths per minute, a heart rate of 96 beats per minute, and a blood pressure of 112/74 mmHg), the patient's asthma appears to be under control as there is no indication of respiratory distress. Since the patient's primary complaint is lower abdominal pain and there's no indication that the pain is related to her respiratory condition, the best next step would likely involve focusing on the abdominal complaint.
Considering this, the most appropriate next step among the options provided would be: 3) Perform a pelvic exam.
The pelvic exam would allow for the assessment of reproductive organs and could help determine if the pain is related to gynecological issues, gastrointestinal problems, or other causes in the lower abdomen. An order for a chest x-ray would be more appropriate if there were signs of respiratory issues, a beta-agonist inhaler would be given if there were symptoms of an asthma exacerbation, and obtaining a urine sample could provide important diagnostic information if a urinary tract infection or kidney issue is suspected. However, since the pain is in the lower abdomen and not necessarily related to the urinary tract, the pelvic exam is most pertinent to the symptoms.