Before inserting the speculum, which steps should be performed?

• A. Inform The Patient And Separate The Labia Minora
• B. Lubricate The Speculum With Water Only
• C. Have The Patient Bear Down During Insertion
• D. Place The Patient In Lithotomy Position

Answer: (A)

The first thing to do before inserting the speculum is to orient the patient and create access to the vaginal opening. Informing the patient about what will happen and addressing questions helps reduce anxiety and gain cooperation. Then gently separate the labia to expose the vaginal entrance so the examiner can visualize the opening and approach the instrument smoothly. This step sets up a safe, comfortable start to the exam.

Lubrication is important for a smooth insertion, but it’s typically done with a water-based lubricant on the speculum rather than “water only.” Bearing down during insertion can tighten the pelvic floor and make entry more difficult. The lithotomy position is part of the setup and should be established before instrument insertion, but the immediate preparatory action before inserting the instrument is to inform the patient and separate the labia to gain access.