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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 b 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 in 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

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 abdominal cavity is essential to the evaluation of the immune system because of the location of whic 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

7. Mrs. Sing is a 44-year-old patient who presents to the office with a complaint of enlarged lymph nodes.

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 childr supraclavicular lymph node may be the sentinel node of Hodgkin disease. DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 8. As adults age, their ability to resist infection is reduced because of the lymphatic nodes becoming more: a. fibrotic. b. mucoid. c. porous. d. profuse. ANS: A

Older adults’ lymph nodes diminish in both number and size and are replaced with more fibrotic and fat DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 9. Equipment for examining the lymphatic system includes a: a. caliper. b. centimeter ruler. c. goniometer. d. syringe and needle. ANS: B

The centimeter ruler and marking pencil are the only equipment needed for examination of the lymphati measure and outline the borders of the nodes. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 10. Which nodes are most often associated with inflammation? a. Shotty b. Movable c. Fixed d. Tender ANS: D

Tenderness is almost always indicative of inflammation. Shotty nodes (feel like the tip of an eraser) that concern. Shotty, movable, or fixed nodes are not usually associated with inflammation. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 11. Which nodes are also called Virchow nodes? a. Internal mammary b. Anterior axillary c. Deep cervical d. Supraclavicular ANS: D

The supraclavicular nodes are also referred to as Virchow nodes. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 12. The harder and more discrete a node, the more likely that there is a(n):

a. b. c.

innocent cause. infection. malignancy....