An irreducible groin hernia that is tender must be treated as strangulated until proven otherwise, so the next step is urgent operation: explore, inspect the contents for viability and deal with them, then repair. The notes say strangulation should be operated on within 6 hours and that reduction of a strangulated hernia should not be attempted. So forced reduction (B) is dangerous: it can push dead bowel back into the abdomen and cause peritonitis. Warm compresses with Trendelenburg (A) or admitting for conservative care (C) only delay surgery.