MSN 610 Module 2 Lymph Node Assessment
Actual Exam & Specialized Examination
Guide
DOMAIN 1: LYMPH NODE ANATOMY & ASSESSMENT TECHNIQUE (Q1-12)
1. When examining the preauricular lymph nodes, the nurse practitioner should palpate:
A. Posterior to the ear, over the mastoid process
B. Anterior to the ear, in front of the tragus
C. Immediately anterior to the tragus, at the root of the zygomatic arch
D. Along the posterior border of the sternocleidomastoid muscle
Correct Answer: C
Rationale: C is correct. The preauricular lymph nodes are located immediately anterior
to the tragus of the ear, at the root of the zygomatic arch. These superficial nodes drain
the temporal scalp, eyelids, conjunctivae, and anterior ear. Posterior to the ear (A)
describes the postauricular nodes (drain posterior scalp and ear). Anterior to the ear (B)
is close but imprecise. The sternocleidomastoid (D) describes the posterior cervical
chain. Precise anatomical localization ensures accurate assessment and
documentation of drainage patterns.
2. The proper technique for palpating superficial cervical lymph nodes includes:
,A. Using the palmar surface of all four fingers with firm, circular pressure
B. Using the thumb to compress nodes against underlying bone
C. Using the pads of the index and middle fingers with gentle, rotating pressure in a
systematic pattern
D. Using the ulnar edge of the hand to assess for vibration
Correct Answer: C
Rationale: C is correct. Lymph node palpation requires the pads of the index and middle
fingers (most sensitive touch receptors) with gentle, rotating pressure to assess size,
shape, consistency, mobility, and tenderness. Systematic examination follows
anatomical chains (submental → submandibular → preauricular → postauricular →
occipital → superficial cervical → deep cervical → supraclavicular). The palmar surface
(A) lacks sensitivity. Thumb compression (B) misses deep nodes and causes patient
discomfort. The ulnar edge (D) assesses for fremitus, not lymph nodes.
3. When assessing the submental lymph nodes, the nurse practitioner should position
the fingers:
A. Superior to the mandible, in the parotid region
B. Posterior to the earlobe, along the mastoid
C. In the midline, under the chin, between the two bellies of the digastric muscle
D. Lateral to the sternocleidomastoid muscle in the posterior triangle
Correct Answer: C
, Rationale: C is correct. The submental nodes are located in the submental triangle,
bounded by the anterior bellies of the right and left digastric muscles and the hyoid
bone—palpated in the midline under the chin. These nodes drain the lower lip, floor of
mouth, gingivae, and anterior tongue. The parotid region (A) contains preauricular
nodes. The mastoid area (B) contains postauricular nodes. The posterior triangle (D)
contains the spinal accessory and transverse cervical nodes.
4. The occipital lymph nodes are best palpated by:
A. Placing fingers superior to the clavicle in the supraclavicular fossa
B. Palpating along the anterior border of the trapezius muscle
C. Placing fingers at the base of the skull, posterior to the occipital protuberance
D. Pressing firmly over the temporal bone bilaterally
Correct Answer: C
Rationale: C is correct. The occipital nodes are located at the base of the skull, posterior
to the occipital protuberance, along the insertion of the trapezius muscle. These nodes
drain the posterior scalp and are best palpated with the patient sitting or supine, using
bilateral finger placement at the nuchal ridge. Supraclavicular (A) is Virchow's node
territory. The anterior trapezius (B) describes the posterior cervical chain. The temporal
bone (D) is lateral and superior to the occipital region.
5. When examining the axillary lymph nodes, the nurse practitioner should:
A. Have the patient abduct the arm 90 degrees and palpate only the lateral chest wall
B. Palpate only the central axillary area visible on surface inspection
Actual Exam & Specialized Examination
Guide
DOMAIN 1: LYMPH NODE ANATOMY & ASSESSMENT TECHNIQUE (Q1-12)
1. When examining the preauricular lymph nodes, the nurse practitioner should palpate:
A. Posterior to the ear, over the mastoid process
B. Anterior to the ear, in front of the tragus
C. Immediately anterior to the tragus, at the root of the zygomatic arch
D. Along the posterior border of the sternocleidomastoid muscle
Correct Answer: C
Rationale: C is correct. The preauricular lymph nodes are located immediately anterior
to the tragus of the ear, at the root of the zygomatic arch. These superficial nodes drain
the temporal scalp, eyelids, conjunctivae, and anterior ear. Posterior to the ear (A)
describes the postauricular nodes (drain posterior scalp and ear). Anterior to the ear (B)
is close but imprecise. The sternocleidomastoid (D) describes the posterior cervical
chain. Precise anatomical localization ensures accurate assessment and
documentation of drainage patterns.
2. The proper technique for palpating superficial cervical lymph nodes includes:
,A. Using the palmar surface of all four fingers with firm, circular pressure
B. Using the thumb to compress nodes against underlying bone
C. Using the pads of the index and middle fingers with gentle, rotating pressure in a
systematic pattern
D. Using the ulnar edge of the hand to assess for vibration
Correct Answer: C
Rationale: C is correct. Lymph node palpation requires the pads of the index and middle
fingers (most sensitive touch receptors) with gentle, rotating pressure to assess size,
shape, consistency, mobility, and tenderness. Systematic examination follows
anatomical chains (submental → submandibular → preauricular → postauricular →
occipital → superficial cervical → deep cervical → supraclavicular). The palmar surface
(A) lacks sensitivity. Thumb compression (B) misses deep nodes and causes patient
discomfort. The ulnar edge (D) assesses for fremitus, not lymph nodes.
3. When assessing the submental lymph nodes, the nurse practitioner should position
the fingers:
A. Superior to the mandible, in the parotid region
B. Posterior to the earlobe, along the mastoid
C. In the midline, under the chin, between the two bellies of the digastric muscle
D. Lateral to the sternocleidomastoid muscle in the posterior triangle
Correct Answer: C
, Rationale: C is correct. The submental nodes are located in the submental triangle,
bounded by the anterior bellies of the right and left digastric muscles and the hyoid
bone—palpated in the midline under the chin. These nodes drain the lower lip, floor of
mouth, gingivae, and anterior tongue. The parotid region (A) contains preauricular
nodes. The mastoid area (B) contains postauricular nodes. The posterior triangle (D)
contains the spinal accessory and transverse cervical nodes.
4. The occipital lymph nodes are best palpated by:
A. Placing fingers superior to the clavicle in the supraclavicular fossa
B. Palpating along the anterior border of the trapezius muscle
C. Placing fingers at the base of the skull, posterior to the occipital protuberance
D. Pressing firmly over the temporal bone bilaterally
Correct Answer: C
Rationale: C is correct. The occipital nodes are located at the base of the skull, posterior
to the occipital protuberance, along the insertion of the trapezius muscle. These nodes
drain the posterior scalp and are best palpated with the patient sitting or supine, using
bilateral finger placement at the nuchal ridge. Supraclavicular (A) is Virchow's node
territory. The anterior trapezius (B) describes the posterior cervical chain. The temporal
bone (D) is lateral and superior to the occipital region.
5. When examining the axillary lymph nodes, the nurse practitioner should:
A. Have the patient abduct the arm 90 degrees and palpate only the lateral chest wall
B. Palpate only the central axillary area visible on surface inspection
