Neonatal Nurse Practitioner Practice Exam

What is the next step in the evaluation of a neonate presenting with a firm scrotal mass?

1. Transillumination

2. Ultrasound

3. X-ray

4. Blood tests

The correct answer is: Transillumination

In the evaluation of a neonate presenting with a firm scrotal mass, transillumination is an important first step. Transillumination is a simple and non-invasive physical examination technique used to differentiate between various types of scrotal masses based on whether they allow light to pass through them or not. Fluid-filled lesions, such as hydroceles, will typically transilluminate, appearing clear when a light source is placed behind the scrotum. In contrast, solid masses like tumors or incarcerated hernias will not transilluminate, indicating a different management approach. While other imaging modalities and tests such as ultrasound or blood tests may be necessary later in the evaluation depending on the results of the transillumination, the immediate use of transillumination helps to guide the next steps effectively and evaluate the nature of the mass. Therefore, it serves as a critical initial assessment for determining whether further imaging or intervention is required based on the characteristics of the mass discovered.