A client comes to the clinic with concerns about an enlarged left testicle and heaviness in his lower abdomen. Which diagnostic test would the nurse expect to be ordered?

Choice A rationale Alpha-fetoprotein (AFP) is a tumor marker that is typically elevated in non-seminomatous germ cell tumors of the testes, such as yolk sac tumors and embryonal carcinomas, which commonly present as a painless testicular mass or feeling of heaviness. Measuring serum levels of AFP is a standard and essential component of the initial diagnostic work-up and staging for suspected testicular cancer. Choice B rationale Prostate-specific antigen (PSA) is a glycoprotein enzyme produced by the prostate gland and is primarily used as a screening tool for prostate cancer and to monitor its recurrence. It is not typically elevated in cases of primary testicular malignancy, and therefore, it would not be the primary diagnostic test ordered for a client presenting with symptoms localized to the testicle. Choice C rationale Serum acid phosphatase (PAP) is an enzyme found in the prostate gland and is elevated in some cases of metastatic prostate cancer, especially when the cancer has spread to the bone. It is not generally used for the diagnosis or staging of testicular masses, as the primary concerns for this presentation are related to germ cell tumors that do not consistently elevate this marker. Choice D rationale C-reactive protein (CRP) is a non-specific acute-phase reactant protein that is elevated in response to inflammation, infection, or tissue injury anywhere in the body. While it could be slightly elevated with a rapidly growing malignancy, it is a general inflammatory marker and is not specific enough to diagnose testicular cancer, nor is it a primary tumor marker for this condition.