Immigration Law Questions? Ask an Immigration Lawyer.
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If your fiance entered on a K1, there is no need to do another medical exam. USCIS can use the results of the earlier medical exam, which should already be with the local field office.
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As long as the original exam was within a year, there is no need to do another one, so there is no need to file another I-693. However, the cover letter that is filed with the adjustment applications need to mention this fact and direct USCIS's attention to that prior I-693 (example: "The exam for I-693 was already taken on (date) in (place). USCIS should have this report. I understand then there is no need for the applicant to take another. If USCIS requires this still, please let us know."
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Okay. You are free to do of course whatever you wish to do. I am just telling you what I have observed before. All the best.