A college student presents with a sore throat, fever, and fatigue for several days. You notice exudates on her enlarged tonsils. You do a careful lymphatic examination and notice some scattered small, mobile lymph nodes just behind her sternocleidomastoid muscles bilaterally. What group of nodes is this?

Correct Answer: D

Rationale: The correct answer is D: Posterior cervical nodes. These nodes are located just behind the sternocleidomastoid muscles, which is consistent with the student's presentation of sore throat and enlarged tonsils. The posterior cervical nodes drain the posterior neck, scalp, and parts of the head and neck region, making them likely to be involved in an infection of the tonsils. The other choices are incorrect because: A: Submandibular nodes are located under the mandible, B: Tonsillar nodes are not a distinct group of lymph nodes, and C: Occipital nodes are located at the back of the head.

Correct Answer: A

Rationale: The correct answer is A because a patient with viral meningitis requiring IV antibiotics may have rapidly changing conditions that necessitate close monitoring and prompt intervention. The floated RN from the medical unit may have experience managing infectious diseases and IV medications. Choice B: The 23-year-old with a recent craniotomy is stable post-surgery and may not require immediate ICU-level care. Choice C: The 30-year-old with an ICP monitor after a head injury a week ago is likely stable and may not need the specialized care of the ICU. Choice D: The 61-year-old with increased ICP and hyperventilation therapy requires specialized care and expertise in managing neurocritical care, which the floated RN may not have.

Correct Answer: D

Rationale: The correct answer is D because cerebrospinal fluid (CSF) typically separates into concentric rings when placed on a white pad due to its high protein content. This phenomenon is known as the "halo sign." Additionally, CSF should test positive for glucose as it is a clear, colorless fluid that contains glucose. Choices A, B, and C are incorrect because CSF is clear and tests positive for glucose, not negative. It is not typically bloody in appearance with a pH of 6, clumping together with a pH of 7, or showing any other characteristics mentioned in the incorrect choices.

Correct Answer: C

Rationale: The correct answer is C: Peripheral edema. Peripheral edema is the accumulation of fluid in the extremities, indicating fluid volume overload. This is due to increased hydrostatic pressure in the capillaries. Dry mucous membranes (A) suggest dehydration, decreased skin turgor (B) is also a sign of dehydration, and postural hypotension (D) is often associated with hypovolemia. Peripheral edema is the most specific finding for fluid volume overload as it directly reflects an excess of fluid in the body.

Correct Answer: C

Rationale: The correct technique for assessing the carotid arteries is to auscultate for bruits before palpating. This is important because listening for bruits can indicate the presence of any abnormal sounds or blockages in the arteries, which can affect the palpation results. Palpating before auscultating may disrupt any potential bruits that should be detected. Auscultating both arteries simultaneously (Choice A) is not recommended as it may lead to missing subtle differences between the two sides. Palpating both arteries simultaneously (Choice B) is not ideal as it may not allow for accurate assessment of each artery individually. Palpating the arteries firmly to assess for strength (Choice D) is not recommended as excessive pressure can lead to inaccurate results and potential harm.