During a scrotal examination, the nurse finds a nodule. Which action is the next best step?

• A. Notify the physician
• B. Change the client's position and repeat the examination
• C. Perform a rectal examination
• D. Transilluminate the scrotum

Answer: (D)

Transillumination of the scrotum is the quickest way to distinguish fluid-filled from solid masses. When light passes through a fluid-filled area, such as a hydrocele or a simple epididymal cyst, the scrotal contents glow. A solid mass, like a testicular tumor, does not transilluminate. Therefore, performing this bedside test right after noticing a nodule helps determine how urgently to act and what kind of workup is needed. If the scrotum lights up, you’re likely dealing with a fluid-filled process (hydrocele or cyst), and the plan would involve routine follow-up or referral as indicated. If there is no glow, a solid mass is suspected, and prompt physician evaluation with imaging (such as scrotal ultrasound with Doppler) is warranted to assess for malignancy or other serious conditions. This approach provides immediate, noninvasive information to guide subsequent management.