AANP Family Nurse Practitioner (FNP) Certification ExamAssessmentEasy
A 68-year-old male presents to the clinic with a chief complaint of a new onset, painless, swollen testicle. On physical examination, the nurse practitioner notes a firm, non-transilluminating mass that is irreducible. The patient denies any trauma or fever. What is the most appropriate initial diagnostic test?
- AUrinalysis with culture
- BComplete blood count (CBC)
- CScrotal ultrasound with Doppler
- DSerum tumor markers (AFP, beta-hCG, LDH)
Show answer & explanationAnswer & explanation
Correct answer: C. Scrotal ultrasound with Doppler
A painless, firm, irreducible testicular mass is highly suspicious for testicular cancer. Scrotal ultrasound with Doppler is the gold standard for differentiating solid from cystic masses and evaluating testicular blood flow, making it the most appropriate initial diagnostic test.
Why the other options are wrong
- A. Urinalysis with culture might be relevant for infection, but not for a painless, firm mass without dysuria or frequency.
- B. CBC is a general lab test and would not specifically diagnose a testicular mass.
- D. Serum tumor markers are important for staging and monitoring testicular cancer but are not the initial diagnostic test to identify the mass itself.
Testicular Mass Evaluation
Initial evaluation of a testicular mass primarily involves imaging to differentiate between benign and malignant etiologies.
- Painless, firm mass is highly suspicious for malignancy.
- Scrotal ultrasound is the first-line diagnostic imaging.
- Doppler helps assess blood flow and viability.
Memory trick: Painless Swelling? Ultrasound is the first call!