A dermatologist treating a 16-year-old girl with a history of severe acne has ordered that she be started on a course of isotretinoin. The teen’s caregiver has said that her daughter is a virgin and refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse?

Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing.

Speak with the teen alone to ask her if she is sexually active. If she says she is not sexually active, let the provider know that it is okay to write the prescription.

Acknowledge the caregiver’s discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication.

Arrange for the daughter to have the pregnancy testing without the caregiver’s knowledge.