A hijab is worn by some Muslim women. Some followers of this religious faith conform to restrictions about the gender of medical providers. In other words, men may not be able to perform medical/gynecologic care. With a complaint of vaginal bleeding, the nurse can anticipate a pelvic exam. As such, the nurse should determine if the patient would rather have a female physician. Citizenship documentation is irrelevant. Patients who are legally and mentally competent can make their own medical decisions—asking if her husband should speak for her is inappropriate. You may need to inquire about sexual activity, but this should not be asked first unless there is a medical emergency (e.g. hemodynamic instability, hemorrhage, possible ectopic pregnancy, etc.).