NUR 660 FINAL PAPER 2026
CERTIFICATION EVALUATION EXAMS
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
⩥ Epididymitis Diagnosis. Answer: Prehn's sign-reduction of pain when
scrotum is elevated above pubis symphysis
UA-shows pyruia and leukocytosis
Test for STI
⩥ Epididymitis Treatment. Answer: Scrotal Elevation-warm sitz bath/ice
packs
NSAIDs
Have partner treated
Urology referral if symptoms don't improve
Gonorrhea/chlamydia--ceftraixone 500 mg IM x 1 dose, doxy 100 mg
BID x 10 days
Acute gonorrhea/chlamydia or enteric organisms--ceftriaxone 500 mg
IM x 1 plus levofloxacin 500 mg PO daily x 10 days
Acute enteric organisms-Levofloxacin 500 mg daily x 10 days over
ceftriaxone 1000 mg
,⩥ Testicular Torsion. Answer: twisting or rotation of testes, resulting in
acute ischemia
UROLOGIC EMERGENCY
⩥ Causes of Testicular Torsion. Answer: Trauma 20% of cases
Contraction of cremaster muscle-can occur during sleep
exercise, extreme cold, sexual stimulation
Undescended testicle
congenital clapper anomaly
⩥ Testicular Torsion Symptoms. Answer: acute onset of pain w/ swelling
⩥ Testicular Torsion Physical Exam. Answer: absence of cremasteric
reflex
testicle can be high in scrotum, transverse known as bell clapper
deformity
edema in testicle
abdominal pain w/ NV
possible fever
⩥ Testicular Torsion Diagnosis. Answer: hx/physical
color doppler US of testes is 100% sensitive in detecting blood flow
compression
,⩥ Testicular Torsion Treatment. Answer: compression can lead to
ischemic necrosis in 6 hours
immediate referral to ED
In ED-manual reduction-blood flow restored
manual reduction immediately followed by surgery
⩥ Hydrocele. Answer: collection of peritoneal fluid within the scrotum
around testes, between parietal and visceral layers of the tunica vaginalis
⩥ Hydrocele Causes. Answer: congenital-patent processus vaginalis
reactive inflammatory condition in scrotum
idiopathic-chronic leaking
parasitic infx
⩥ Hydrocele Symptoms. Answer: swelling in scrotum or inguinal canal
usually painless, although patients report heaviness in scrotum
pain-if present can radiate to back
⩥ Hydrocele Diagnosis. Answer: Edema in scrotum
Trans-illumination-appears pale pink/yellow color translucent
Scrotal US
, AXR series to rule out incarcerated hernia
⩥ Hydrocele Management. Answer: No treatment required unless
complications-such as tumor
surgical removal of hydrocele sac warranted if significant pain or
compromise of scrotal skin
⩥ Varicocele. Answer: Abnormal degree of venous dilation of
papiniform plexus above testes, usually results in pain and engorgement
of testes
varicose veins of testes
⩥ Varicocele Causes. Answer: a weak wall in spermatic vein and
excessive pressure leading cause
most commonly on left side
can cause infertility
⩥ Varicocele Symptoms. Answer: Pain
Engorgement of testes
sensation as feeling bag of worms
present most often on left testes
⩥ Varicocele Diagnostics. Answer: palpate each testicle, again with
valsalva maneuver
CERTIFICATION EVALUATION EXAMS
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
⩥ Epididymitis Diagnosis. Answer: Prehn's sign-reduction of pain when
scrotum is elevated above pubis symphysis
UA-shows pyruia and leukocytosis
Test for STI
⩥ Epididymitis Treatment. Answer: Scrotal Elevation-warm sitz bath/ice
packs
NSAIDs
Have partner treated
Urology referral if symptoms don't improve
Gonorrhea/chlamydia--ceftraixone 500 mg IM x 1 dose, doxy 100 mg
BID x 10 days
Acute gonorrhea/chlamydia or enteric organisms--ceftriaxone 500 mg
IM x 1 plus levofloxacin 500 mg PO daily x 10 days
Acute enteric organisms-Levofloxacin 500 mg daily x 10 days over
ceftriaxone 1000 mg
,⩥ Testicular Torsion. Answer: twisting or rotation of testes, resulting in
acute ischemia
UROLOGIC EMERGENCY
⩥ Causes of Testicular Torsion. Answer: Trauma 20% of cases
Contraction of cremaster muscle-can occur during sleep
exercise, extreme cold, sexual stimulation
Undescended testicle
congenital clapper anomaly
⩥ Testicular Torsion Symptoms. Answer: acute onset of pain w/ swelling
⩥ Testicular Torsion Physical Exam. Answer: absence of cremasteric
reflex
testicle can be high in scrotum, transverse known as bell clapper
deformity
edema in testicle
abdominal pain w/ NV
possible fever
⩥ Testicular Torsion Diagnosis. Answer: hx/physical
color doppler US of testes is 100% sensitive in detecting blood flow
compression
,⩥ Testicular Torsion Treatment. Answer: compression can lead to
ischemic necrosis in 6 hours
immediate referral to ED
In ED-manual reduction-blood flow restored
manual reduction immediately followed by surgery
⩥ Hydrocele. Answer: collection of peritoneal fluid within the scrotum
around testes, between parietal and visceral layers of the tunica vaginalis
⩥ Hydrocele Causes. Answer: congenital-patent processus vaginalis
reactive inflammatory condition in scrotum
idiopathic-chronic leaking
parasitic infx
⩥ Hydrocele Symptoms. Answer: swelling in scrotum or inguinal canal
usually painless, although patients report heaviness in scrotum
pain-if present can radiate to back
⩥ Hydrocele Diagnosis. Answer: Edema in scrotum
Trans-illumination-appears pale pink/yellow color translucent
Scrotal US
, AXR series to rule out incarcerated hernia
⩥ Hydrocele Management. Answer: No treatment required unless
complications-such as tumor
surgical removal of hydrocele sac warranted if significant pain or
compromise of scrotal skin
⩥ Varicocele. Answer: Abnormal degree of venous dilation of
papiniform plexus above testes, usually results in pain and engorgement
of testes
varicose veins of testes
⩥ Varicocele Causes. Answer: a weak wall in spermatic vein and
excessive pressure leading cause
most commonly on left side
can cause infertility
⩥ Varicocele Symptoms. Answer: Pain
Engorgement of testes
sensation as feeling bag of worms
present most often on left testes
⩥ Varicocele Diagnostics. Answer: palpate each testicle, again with
valsalva maneuver
