Please read the clinical scenario, and then answer the question that follow to become familiar with the traditional NCLEX question format.
The mother of 6-year-old Mary has brought her daughter into the pediatrician’s office where you work, complaining Mary has had a sore throat for several days and a fever. She has had a fever up to 104F that seems worse at night, but seems to respond to treatment with acetaminophen. Mary has not been eating or drinking as much either because she says “it hurts to swallow.” She is ill-appearing, and does not seem interested in playing with the toys or reading the books that are in the examination room. The doctor noted a thick, white exudate coating on both of Mary’s tonsils, which also seem enlarged. The doctor ordered a throat culture swab, as well as a complete blood count with differentials.
-You initially examine Mary for yourself,and discover that lymph nodes at the posterior cervical chain of her neck seem warm,tender,and slightly enlarged.However,the other lymph nodes are either nonpalpable or small,nontender,rubbery,and less than 2 mm in size.What is your interpretation of this finding?

Question

Please read the clinical scenario, and then answer the question that follow to become familiar with the traditional NCLEX question format.
  The mother of 6-year-old Mary has brought her daughter into the pediatrician’s office where you work, complaining Mary has had a sore throat for several days and a fever. She has had a fever up to 104F that seems worse at night, but seems to respond to treatment with acetaminophen. Mary has not been eating or drinking as much either because she says “it hurts to swallow.” She is ill-appearing, and does not seem interested in playing with the toys or reading the books that are in the examination room. The doctor noted a thick, white exudate coating on both of Mary’s tonsils, which also seem enlarged. The doctor ordered a throat culture swab, as well as a complete blood count with differentials.
-You initially examine Mary for yourself,and discover that lymph nodes at the posterior cervical chain of her neck seem warm,tender,and slightly enlarged.However,the other lymph nodes are either nonpalpable or small,nontender,rubbery,and less than 2 mm in size.What is your interpretation of this finding?

Quizplus · Accepted Answer

The warm, tender, and slightly enlarged lymph nodes in the posterior cervical chain are consistent with a localized infection, specifically in the tonsils and throat area. The other lymph nodes being nonpalpable or small, nontender, rubbery, and less than 2 mm in size is a normal finding. This does not indicate that they are not functioning properly. Option B is incorrect because a systemic infection would likely result in more generalized lymph node enlargement, not just in one specific area. Option D is also incorrect because the size and texture of the other lymph nodes are within normal limits.

Please Read the Clinical Scenario, and Then Answer the Question