Neonatal Nurse Practitioner Practice Exam

What method can help facilitate the differential diagnosis of a 4 cm nontender mass in the right testicle of a neonate?

1. Palpation

2. Transillumination

3. Ultrasound evaluation

4. Visual inspection

The correct answer is: Transillumination

Transillumination is a useful technique for helping to differentiate various types of masses in the testicular area. In neonates, a nontender mass in the right testicle could potentially be a hydrocele or a solid tumor such as a teratoma. Using a transilluminator, a healthcare provider can shine a light through the mass to determine its nature. If the mass glows, it suggests that it may be a fluid-filled structure, such as a hydrocele, while a solid mass typically will not transmit light. This can assist in the initial assessment and guide further diagnostic imaging or intervention. Other options, while potentially useful, do not offer the same immediate differential diagnostic capability. Palpation can help assess the mass's consistency but may not clarify its nature, especially since nontender masses can present with various underlying conditions. Ultrasound evaluation provides a definitive means to characterize the mass but is more involved than the immediate insight offered through transillumination. Visual inspection is important for overall assessment but does not provide specific information about the underlying nature of the mass. Thus, transillumination stands out as a primary method that provides quick and substantial information for differential diagnosis.