Trauma Nurse Core Course (TNCC) Practice Exam

In the case of a young male with severe lower abdominal pain and scrotal ecchymosis, which order should the nurse question?

1. Fast exam

2. CT scan

3. Straight cath for urine sample

4. Ice and elevation of the scrotum

The correct answer is: Straight cath for urine sample

In the scenario presented, questioning the order for a straight catheterization for a urine sample is warranted due to the likelihood of significant anatomical or injury-related complications associated with scrotal ecchymosis and severe lower abdominal pain. These symptoms suggest a potential injury to the genitourinary tract, such as testicular torsion or other trauma, which could lead to complications such as bleeding or obstruction. In such situations, the first priority is often to evaluate and manage the source of pain and injury, including assessing for testicular viability and considering the need for immediate surgical intervention. The use of a straight catheter could risk further injury or exacerbate underlying conditions, especially if there is a concern for a traumatic event. On the other hand, other options can be deemed appropriate actions in this clinical scenario. A FAST exam could be beneficial for assessing for intra-abdominal bleeding, a CT scan may provide detailed imaging that assists in diagnosing potential complications, and ice with elevation of the scrotum is a conservative measure aimed at reducing swelling and pain. These interventions align with the necessary assessment and management protocols for trauma patients presenting with urogenital concerns.