NURS 612 Exam 2 – Maryville University Advanced Health
Assessment – 2026/2027 Actual Exam with 250 Questions
and Correct Detailed Answers
SECTION 1: LYMPHATIC SYSTEM (Questions 1–15)
Question 1
A 19-year-old male presents with a severe infection of the left fifth digit. Which lymph nodes
should the examiner expect to be enlarged and tender?
A) Axillary nodes
B) Inguinal nodes
C) Popliteal nodes
D) Epitrochlear nodes
Answer
Answer: D
Rationale
The epitrochlear nodes, located in the antecubital fossa between the biceps and triceps near the
medial condyle of the humerus, drain the hand and forearm. Infections of the ulnar aspect of the hand
(fifth digit) typically result in epitrochlear lymphadenopathy.
Question 2
During a lymph node examination, which finding is most suggestive of a malignant process
rather than an infection?
A) A soft, matted node with overlying erythema
B) A firm, rubbery, fixed node that is painless
C) A tender, mobile node that appeared suddenly
D) A soft, flat node that is difficult to palpate
Answer
Answer: B
,Rationale
Malignant nodes are typically described as hard or firm, rubbery, nontender, and fixed to underlying
tissue (immobile). Inflammatory nodes are typically tender, soft, and mobile.
Question 3
While palpating the supraclavicular lymph nodes, the examiner should ask the patient to:
A) Hold their breath and bear down (Valsalva maneuver)
B) Turn their head to the contralateral side
C) Take a deep breath and relax their shoulders
D) Extend their neck and swallow
Answer
Answer: C
Rationale
To effectively palpate the deep supraclavicular nodes, the examiner should have the patient hunch
their shoulders forward to relax the trapezius muscle and take a deep breath. The deep breath helps
bring deep structures closer to the surface.
Question 4
A patient with tuberculosis is most likely to present with lymph nodes characterized as:
A) Hot, red, and fluctuant
B) Matted and fixed to the skin
C) "Cold" abscesses (matted and nontender)
D) Shotty, small, and non-palpable
Answer
Answer: C
Rationale
Tuberculous lymphadenitis (scrofula) often presents as matted, nontender lymph nodes. Because they
lack the classic signs of inflammation (heat, redness), they are historically referred to as "cold"
abscesses.
2
,Question 5
Which statement is true regarding normal lymph nodes in a healthy adult?
A) Small, palpable inguinal nodes are always a sign of pathology.
B) Easily palpable lymph nodes are generally not a normal finding.
C) All lymph nodes should be non-palpable.
D) Shotty nodes are indicative of an acute infection.
Answer
Answer: B
Rationale
In healthy adults, lymph nodes are usually small (<1 cm), soft, and often non-palpable. While small,
mobile "shotty" nodes from past infections can be normal in some areas (e.g., inguinal), easily
palpable nodes warrant further investigation.
Question 6
An enlarged lymph node that is fixed in its setting is cause for concern because it suggests:
A) An acute inflammatory process
B) A recent viral illness
C) Infiltration of the node into surrounding tissues (malignancy)
D) A calcified granuloma
Answer
Answer: C
Rationale
Mobility is a key characteristic. A node that is fixed (non-mobile) suggests it is adhered to underlying
structures or overlying skin, which is a classic sign of malignancy.
Question 7
To palpate the epitrochlear lymph nodes, the examiner should place the patient's arm in which
position?
A) Abducted 90 degrees with the palm facing up
3
, B) Flexed approximately 90 degrees at the elbow with the forearm relaxed
C) Extended fully at the elbow with the palm facing down
D) Raised above the head
Answer
Answer: B
Rationale
The epitrochlear nodes are best palpated with the patient's elbow flexed about 90 degrees and the
forearm relaxed, allowing the examiner to feel the groove between the biceps and triceps in the
antecubital fossa.
Question 8
Which lymph node group is most commonly affected in a patient with a hand infection?
A) Cervical
B) Axillary
C) Epitrochlear
D) Supraclavicular
Answer
Answer: C
Rationale
The epitrochlear nodes drain the hand and forearm, making them the most likely site of
lymphadenopathy in hand infections.
Question 9
A 45-year-old patient presents with a painless, hard, fixed supraclavicular lymph node. This
finding is most concerning for:
A) Local infection
B) Lymphoma
C) Metastatic malignancy (e.g., Virchow's node)
D) Autoimmune disease
4
Assessment – 2026/2027 Actual Exam with 250 Questions
and Correct Detailed Answers
SECTION 1: LYMPHATIC SYSTEM (Questions 1–15)
Question 1
A 19-year-old male presents with a severe infection of the left fifth digit. Which lymph nodes
should the examiner expect to be enlarged and tender?
A) Axillary nodes
B) Inguinal nodes
C) Popliteal nodes
D) Epitrochlear nodes
Answer
Answer: D
Rationale
The epitrochlear nodes, located in the antecubital fossa between the biceps and triceps near the
medial condyle of the humerus, drain the hand and forearm. Infections of the ulnar aspect of the hand
(fifth digit) typically result in epitrochlear lymphadenopathy.
Question 2
During a lymph node examination, which finding is most suggestive of a malignant process
rather than an infection?
A) A soft, matted node with overlying erythema
B) A firm, rubbery, fixed node that is painless
C) A tender, mobile node that appeared suddenly
D) A soft, flat node that is difficult to palpate
Answer
Answer: B
,Rationale
Malignant nodes are typically described as hard or firm, rubbery, nontender, and fixed to underlying
tissue (immobile). Inflammatory nodes are typically tender, soft, and mobile.
Question 3
While palpating the supraclavicular lymph nodes, the examiner should ask the patient to:
A) Hold their breath and bear down (Valsalva maneuver)
B) Turn their head to the contralateral side
C) Take a deep breath and relax their shoulders
D) Extend their neck and swallow
Answer
Answer: C
Rationale
To effectively palpate the deep supraclavicular nodes, the examiner should have the patient hunch
their shoulders forward to relax the trapezius muscle and take a deep breath. The deep breath helps
bring deep structures closer to the surface.
Question 4
A patient with tuberculosis is most likely to present with lymph nodes characterized as:
A) Hot, red, and fluctuant
B) Matted and fixed to the skin
C) "Cold" abscesses (matted and nontender)
D) Shotty, small, and non-palpable
Answer
Answer: C
Rationale
Tuberculous lymphadenitis (scrofula) often presents as matted, nontender lymph nodes. Because they
lack the classic signs of inflammation (heat, redness), they are historically referred to as "cold"
abscesses.
2
,Question 5
Which statement is true regarding normal lymph nodes in a healthy adult?
A) Small, palpable inguinal nodes are always a sign of pathology.
B) Easily palpable lymph nodes are generally not a normal finding.
C) All lymph nodes should be non-palpable.
D) Shotty nodes are indicative of an acute infection.
Answer
Answer: B
Rationale
In healthy adults, lymph nodes are usually small (<1 cm), soft, and often non-palpable. While small,
mobile "shotty" nodes from past infections can be normal in some areas (e.g., inguinal), easily
palpable nodes warrant further investigation.
Question 6
An enlarged lymph node that is fixed in its setting is cause for concern because it suggests:
A) An acute inflammatory process
B) A recent viral illness
C) Infiltration of the node into surrounding tissues (malignancy)
D) A calcified granuloma
Answer
Answer: C
Rationale
Mobility is a key characteristic. A node that is fixed (non-mobile) suggests it is adhered to underlying
structures or overlying skin, which is a classic sign of malignancy.
Question 7
To palpate the epitrochlear lymph nodes, the examiner should place the patient's arm in which
position?
A) Abducted 90 degrees with the palm facing up
3
, B) Flexed approximately 90 degrees at the elbow with the forearm relaxed
C) Extended fully at the elbow with the palm facing down
D) Raised above the head
Answer
Answer: B
Rationale
The epitrochlear nodes are best palpated with the patient's elbow flexed about 90 degrees and the
forearm relaxed, allowing the examiner to feel the groove between the biceps and triceps in the
antecubital fossa.
Question 8
Which lymph node group is most commonly affected in a patient with a hand infection?
A) Cervical
B) Axillary
C) Epitrochlear
D) Supraclavicular
Answer
Answer: C
Rationale
The epitrochlear nodes drain the hand and forearm, making them the most likely site of
lymphadenopathy in hand infections.
Question 9
A 45-year-old patient presents with a painless, hard, fixed supraclavicular lymph node. This
finding is most concerning for:
A) Local infection
B) Lymphoma
C) Metastatic malignancy (e.g., Virchow's node)
D) Autoimmune disease
4
