How to Answer Year Male Presents Questions (Complete Guide)

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Original Question

44-year-old male presents to the emergency department by EMS after he was hit by a motor vehicle while bicycling. He was helmeted and a cervical collar was placed in the field. Vital signs include temperature of 98.6°F, pulse of 92 beats/min, respiratory rate of 16 breaths/min, blood pressure of 135/85 mmg and oxygen saturation of 96% on 2L of oxygen by nasal cannula. On physical examination, he is in pain but able to answer questions. Clear breath sounds are present bilaterally. There is tenderness over the left anterior chest wall without crepitus or palpable deformity. Cardiac exam is normal. Peripheral pulses are palpable. Strength and sensation are intact to the distal upper and lower extremities. Ecchymosis and tenderness are noted over the left lower quadrant of the abdomen, the left hip and the scrotum. Genitourinary exam shows blood at the urethral meatus. Portable x-rays and computed tomography scans reveal nondisplaced fractures of left-sided ribs 10-12 anteriorly and a nondisplaced fracture of the left iliac wing. No acute intraabdominal process is identified. Which of the following is the next best step in the management of this patient? (A) Foley catheter placement (B) Suprapubic catheter placement (C) Retrograde cystogram (D) Retrograde urethrogram (E) Surgery for urologic repair

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