A nurse in the emergency department is assessing an adolescent who reports sudden and severe testicular pain. Which of the following actions should the nurse take?
Obtain a urology consult for immediate evaluation.
Apply heat to the affected area for relief.
Recommend the client take over-the-counter pain relievers and monitor pain over the next few days.
Determine if the adolescent has had exposure to the mumps recently?
The Correct Answer is A
A. Obtain a urology consult for immediate evaluation: Sudden, severe testicular pain in an adolescent is highly concerning for testicular torsion, a surgical emergency. Prompt urologic evaluation is critical to restore blood flow and prevent irreversible testicular ischemia and loss.
B. Apply heat to the affected area for relief: Heat application is inappropriate in acute scrotal pain and may delay diagnosis and treatment of testicular torsion, potentially worsening ischemic injury.
C. Recommend the client take over-the-counter pain relievers and monitor pain over the next few days: Delaying evaluation in the setting of acute testicular pain risks permanent damage or loss of the testicle. Observation and analgesics alone are unsafe without ruling out torsion.
D. Determine if the adolescent has had exposure to the mumps recently: Mumps orchitis typically presents with gradual onset of testicular pain and swelling, often with systemic symptoms. While history is relevant, immediate evaluation for torsion takes priority.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "Children break the most bones during their toddler years due to falls. Toddlers should wear a helmet to protect their head in case of a fall.": While falls are common, helmets are typically recommended for activities such as riding tricycles or bikes, not for general fall prevention, so this does not address the leading cause of injury-related death in toddlers.
B. "Stairs are a leading cause of injury related death in toddlers. Children should not be permitted on stairs until they are 4 years old.": Stairs can cause injuries, but they are not the leading cause of death, and restricting stair access entirely until age 4 is not practical; safety gates are the standard preventive measure.
C. "The leading cause of death related to injury during toddlerhood is drowning. Children can drown in small amounts of water such as bathtubs, toilets, and buckets.": This statement accurately identifies drowning as the leading cause of injury-related death in toddlers and emphasizes the importance of constant supervision and water safety even with small amounts of water.
D. "Cleaning products and medications should be placed in a cabinet so children can't get access to them.": While this is important for poisoning prevention, it addresses safety hazards rather than the leading cause of death, making it secondary in priority to drowning prevention.
Correct Answer is C
Explanation
A. Increased muscle tone: Hypertonia may occur later in recovery, but acute spinal cord injury often initially presents with flaccid paralysis rather than increased muscle tone.
B. Heightened reflex activity: Reflexes are typically diminished or absent below the level of injury in the acute phase, so heightened reflexes are not an early indicator of spinal cord injury.
C. Loss of function and reflexes below the affected area of the spine: Acute spinal cord injury commonly results in loss of motor and sensory function as well as absent reflexes below the level of injury, making this a primary clinical cue for assessment.
D. Normal bowel function: Bowel function is often impaired in spinal cord injury due to disruption of autonomic control. Normal function would not indicate the presence of spinal cord injury.
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