A 32-year-old uncircumcised male presents to the clinic with penile discomfort and swelling that began 24 hours ago. He reports that earlier in the day he retracted his foreskin for hygiene but has been unable to return it to its normal position. He now has increasing pain and swelling at the tip of the penis.  He denies fever, dysuria, or urethral discharge. He is sexually active with one partner. Past medical history is significant for poorly controlled type 2 diabetes.  On examination, the glans penis is erythematous and edematous. The foreskin is retracted and trapped proximal to the glans. The glans appears swollen and tender. There is no purulent discharge. Which of the following is the most likely diagnosis?

A 24-year-old male presents to the clinic with acute onset left-sided scrotal pain and swelling that began 8 hours ago. He reports progressive worsening pain and difficulty walking due to discomfort. He denies trauma. He is sexually active with one current partner and three partners in the last year. He reports mild nausea but no vomiting. On examination, the left hemiscrotum is erythematous, edematous, and tender to palpation. The affected testicle appears slightly elevated compared to the right. The cremasteric reflex is difficult to elicit due to guarding. Prehn sign is inconclusive due to severe tenderness. Which of the following conditions must be included in the original list of  differential diagnoses for this patient’s presentation?

A 58-year-old male presents with a right groin bulge that he first noticed 3 months ago. He reports that the bulge becomes more prominent when standing or coughing and decreases when lying down. He describes a dull ache in the area after prolonged standing but denies severe pain, nausea, vomiting, or bowel changes.  On physical examination, a soft mass is palpated in the right groin. The mass enlarges with Valsalva maneuver and is reducible when the patient lies supine. When the examiner invaginates the scrotal skin and advances a finger into the inguinal canal, a bulge is felt striking the fingertip during coughing. Which of the following is the most likely diagnosis?

A 46-year-old male presents with acute rectal pain that began suddenly 2 days ago after straining during a bowel movement. He describes severe, constant pain that makes sitting uncomfortable. He denies fever, abdominal pain, or changes in bowel habits. He reports a history of intermittent painless bright red blood on toilet paper in the past.  On examination, there is a 2-cm, tense, bluish, exquisitely tender nodule at the anal verge. No purulent drainage is noted. Digital rectal exam is deferred due to pain. Which of the following is the most likely diagnosis?

 A 31-year-old patient presents with rectal pain, urgency, and passage of mucus for 1 week. He reports small-volume bowel movements and a persistent sensation of incomplete evacuation. He has noticed streaks of bright red blood mixed with stool. He denies abdominal pain, fever, or recent travel.  Physical examination reveals mild perianal erythema. Digital rectal exam produces discomfort and mucus on the glove. No external hemorrhoids or fissures are visible.  You need to ask a few more questions to help rule in or rule out proctitis.   Based on this presentation, which of the following history questions is most important to further clarify the underlying cause of this patient’s symptoms?

A 32 year old security officer comes to your clinic, complaining of a firm, painless mass in his scrotum.  He found it 3 days ago during a testicular self exam. Palpation of his scrotum shows a soft cystic like lesion measuring 2 cm over his right testicle. It transilluminates upon exam.   There is no difficulty getting a gloved finger through either inguinal ring.  With weight bearing there are no bulges.  His prostate exam is unremarkable.  What disorder of the scrotum does he most likely have?

Christopher is a 14 year old male who presents to your office with severe scrotal pain of sudden onset about 2 hours ago.  He has experienced pelvic and groin pain and nausea and vomiting since onset.  Your physical exam reveals an exquisitely tender testicle that is higher than the other testicle. Ipsilateral cremasteric reflex is absent. What should be the most likely diagnosis and plan?

Which statement shows lack of understanding about mentoring?

Which strategy is used when a nurse reflects on a recent meeting for insight?

Which characteristic is needed for the nurse leader to be prepared to lead in the future? Select all that apply.