Chapter 10: Lymphatic System
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Which organ does not have lymphatic vessels?
a. Brain
b. Kidneys
c. Liver
d. Lungs
ANS: A
Lymphatic tissues are found abundantly throughout the body except in two places, the placenta
and the brain (central nervous system). Lymphatic tissues are found abundantly in the kidneys,
liver, and lungs.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. Cells that line the lymph node sinuses perform the specific function of:
a. fat absorption.
b. fetal immunization.
c. hematopoiesis.
d. phagocytosis.
ANS: D
Lymph nodes defend against the invasion of microorganisms by phagocytosis.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Lymph flows faster in response to:
a. increased metabolic activity.
b. decreased blood volume.
c. decreased metabolic rate.
d. decreased permeability of the capillary walls.
ANS: A
Lymph flow increases with mounting capillary pressure, greater permeability of the capillary
walls, or increased metabolic rate.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. An organ that is essential to the development of protective immune function in the infant but
has little or no demonstrated function
in the adult is the:
a. spleen.
b. liver.
c. thymus.
, d. pancreas.
ANS: C
In the adult, the thymus atrophies and, in the older adult, is replaced by fat and connective tissue.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Mr. Shea is a 45-year-old patient who presents to the office for multiple complaints. The
examination of the upper left quadrant of
the abdominal cavity is essential to the evaluation of the immune system because of the location
of which organ?
a. Spleen
b. Liver
c. Stomach
d. Pancreas
ANS: A
The spleen is the largest of the lymphatic organs. It is located in the upper left portion of the
abdomen.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Mrs. Farrel brings in her 6-year-old son with complaints of a sore throat and fever. As the
healthcare provider, you are concerned
about his tonsils and adenoids. Enlarged tonsils and adenoids may obstruct the:
a. thoracic duct.
b. esophagus.
c. nasopharyngeal passageway.
d. external auditory meatus.
ANS: C
The palatine tonsils are located on either side of the pharynx; the adenoids (pharyngeal tonsils)
are found on the posterior wall of
the pharynx and superior to the soft palate. If these structures become enlarged, they block the
passage between the pharynx and
nasal cavity.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. Mrs. Sing is a 44-year-old patient who presents to the office with a complaint of enlarged
lymph nodes. When enlarged, which
lymph nodes are most likely to be a sign of pathology (e.g., malignancy)?
a. Occipital
b. Anterior cervical
c. Supraclavicular
d. Femoral
ANS: C
Supraclavicular nodal enlargement is of special concern because it suggests a malignancy, even
in children; an enlarged
supraclavicular lymph node may be the sentinel node of Hodgkin disease.
DIF: Cognitive Level: Analyzing (Analysis)
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Which organ does not have lymphatic vessels?
a. Brain
b. Kidneys
c. Liver
d. Lungs
ANS: A
Lymphatic tissues are found abundantly throughout the body except in two places, the placenta
and the brain (central nervous system). Lymphatic tissues are found abundantly in the kidneys,
liver, and lungs.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. Cells that line the lymph node sinuses perform the specific function of:
a. fat absorption.
b. fetal immunization.
c. hematopoiesis.
d. phagocytosis.
ANS: D
Lymph nodes defend against the invasion of microorganisms by phagocytosis.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Lymph flows faster in response to:
a. increased metabolic activity.
b. decreased blood volume.
c. decreased metabolic rate.
d. decreased permeability of the capillary walls.
ANS: A
Lymph flow increases with mounting capillary pressure, greater permeability of the capillary
walls, or increased metabolic rate.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. An organ that is essential to the development of protective immune function in the infant but
has little or no demonstrated function
in the adult is the:
a. spleen.
b. liver.
c. thymus.
, d. pancreas.
ANS: C
In the adult, the thymus atrophies and, in the older adult, is replaced by fat and connective tissue.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Mr. Shea is a 45-year-old patient who presents to the office for multiple complaints. The
examination of the upper left quadrant of
the abdominal cavity is essential to the evaluation of the immune system because of the location
of which organ?
a. Spleen
b. Liver
c. Stomach
d. Pancreas
ANS: A
The spleen is the largest of the lymphatic organs. It is located in the upper left portion of the
abdomen.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Mrs. Farrel brings in her 6-year-old son with complaints of a sore throat and fever. As the
healthcare provider, you are concerned
about his tonsils and adenoids. Enlarged tonsils and adenoids may obstruct the:
a. thoracic duct.
b. esophagus.
c. nasopharyngeal passageway.
d. external auditory meatus.
ANS: C
The palatine tonsils are located on either side of the pharynx; the adenoids (pharyngeal tonsils)
are found on the posterior wall of
the pharynx and superior to the soft palate. If these structures become enlarged, they block the
passage between the pharynx and
nasal cavity.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. Mrs. Sing is a 44-year-old patient who presents to the office with a complaint of enlarged
lymph nodes. When enlarged, which
lymph nodes are most likely to be a sign of pathology (e.g., malignancy)?
a. Occipital
b. Anterior cervical
c. Supraclavicular
d. Femoral
ANS: C
Supraclavicular nodal enlargement is of special concern because it suggests a malignancy, even
in children; an enlarged
supraclavicular lymph node may be the sentinel node of Hodgkin disease.
DIF: Cognitive Level: Analyzing (Analysis)
