Please Read the Clinical Scenario, and Then Answer the Question

question 45

Multiple Choice

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?

• A)This is a normal examination of the posterior cervical chain lymph nodes.
• B)Mary probably has a systemic infection.
• C)This examination is consistent with a localized infection.
• D)The other lymph nodes probably are not functioning properly if they are not inflamed as well.

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