Practice Questions: Assessment of Neck, Thyroid, and Lymph Nodes

Which gland lies in the anterior lower neck and regulates metabolism?
A. Pituitary gland
B. Adrenal gland
C. Thyroid gland
D. Parathyroid gland

Correct Answer: C. Thyroid gland
Rationale: The thyroid gland is located in the anterior lower neck and is responsible for regulating metabolism. The pituitary and adrenal glands are located elsewhere and serve different functions.

Which of the following physical characteristics are typically associated with normal lymph nodes? Select all that apply.
A. Non-palpable
B. Oval or bean shaped
C. Greater than 2 cm in size
D. Soft
E. Painful on palpation

Correct Answers: A, B, D
Rationale:

• A: Lymph nodes are usually not palpable unless enlarged.

• B: Normal nodes are oval or bean-shaped.

• D: Soft consistency is normal.

• C: Nodes larger than 2 cm can indicate pathology.

• E: Pain on palpation may indicate infection or inflammation.

A nurse is palpating a patient’s thyroid gland. The patient is instructed to tilt their head to the right and swallow. Which lobe is the nurse assessing during this step?
A. Right lobe
B. Left lobe
C. Isthmus
D. Entire thyroid gland

Correct Answer: A. Right lobe
Rationale: When the patient swallows and tilts the head to the right, the left lobe is displaced, allowing the right lobe to be palpated.

A patient presents with enlarged, tender lymph nodes and reports a recent upper respiratory infection. What is the most likely cause of the lymph node enlargement?
A. Normal aging process
B. Hypothyroidism
C. Infection
D. Medication side effect

Correct Answer: C. Infection
Rationale: Enlarged and tender lymph nodes often indicate an infectious process, especially in the presence of recent illness like a cold or virus.

A nurse palpates a thyroid gland that is enlarged and has nodules. Which actions should the nurse take? Select all that apply.
A. Document as normal finding
B. Notify the healthcare provider
C. Ask if the patient has had radiation exposure
D. Check for signs of hyperthyroidism
E. Reassure the patient it’s nothing to worry about

Correct Answers: B, C, D
Rationale:

• B: Enlargement and nodules should be reported.

• C: Radiation exposure is relevant to thyroid pathology.

• D: Symptoms of thyroid dysfunction may be present.

• A & E: These are inappropriate without further evaluation.

You are creating a patient education handout on thyroid self-awareness. What components should you include? Select all that apply.
A. Location of the thyroid gland
B. Normal appearance of the neck
C. How to palpate the gland daily
D. When to report changes in size or nodules
E. Signs of thyroid dysfunction such as mood changes or cold intolerance

Correct Answers: A, B, D, E
Rationale:

• A: Understanding location helps with awareness.

• B: A baseline of normal is important for comparison.

• D: Patients should know when to report concerns.

• E: Thyroid dysfunction symptoms are key.

• C: Daily self-palpation is not recommended; this could lead to anxiety or over-diagnosis.

1. What hormone does the thyroid gland secrete?
A. Insulin
B. Melatonin
C. Thyroxine
D. Cortisol

Correct Answer: C. Thyroxine
Rationale: The thyroid secretes hormones (like thyroxine) that regulate metabolism.

Where is the sternocleidomastoid muscle located?
A. Across the forehead
B. From the clavicle to the chin
C. Behind the ear to the clavicle
D. Down the back

Correct Answer: C. Behind the ear to the clavicle
Rationale: It divides each side of the neck into two triangles and serves as a landmark for neck assessment.

Which lymph node is located at the base of the skull?
A. Preauricular
B. Occipital
C. Submandibular
D. Supraclavicular

Correct Answer: B. Occipital
Rationale: The occipital node is found at the base of the skull.

Why is it helpful for a patient to sip water during thyroid inspection?
A. It relaxes the neck
B. It clears the throat
C. It allows better gland visualization during swallowing
D. It prevents choking

Correct Answer: C. It allows better gland visualization during swallowing
Rationale: The thyroid gland moves with swallowing, making it easier to assess.

Which of the following are normal characteristics of thyroid lobes when palpated? Select all that apply.
A. Hard and fixed
B. Smooth
C. Rubbery
D. Nodular
E. Equal in size

Correct Answers: B, C, E
Rationale: A normal thyroid is smooth, rubbery, and symmetrical. Nodules or hard/fixed areas are abnormal.

What does tenderness of the lymph nodes typically suggest?
A. Normal variant
B. Aging
C. Infection or inflammation
D. Metabolic dysfunction

Correct Answer: C. Infection or inflammation
Rationale: Tender lymph nodes are often a sign of immune response.

A nurse observes visible fullness at the base of the neck while the patient swallows. What should the nurse suspect?
A. Tracheal deviation
B. Normal finding
C. Thyroid gland enlargement
D. Jugular vein distention

Correct Answer: C. Thyroid gland enlargement
Rationale: The thyroid becomes more visible when enlarged, especially during swallowing.

During lymph node palpation, the nurse feels small, soft, mobile nodes under the jaw. What is the appropriate action?
A. Report immediately
B. Chart as normal
C. Perform a biopsy
D. Begin antibiotics

Correct Answer: B. Chart as normal
Rationale: Small, soft, non-tender lymph nodes, especially in the submandibular region, are common and normal.

A patient has a history of radiation exposure. What part of the neck exam is especially important?
A. Checking range of motion
B. Auscultation of carotid arteries
C. Thyroid palpation
D. Inspection of ears

Correct Answer: C. Thyroid palpation
Rationale: Radiation increases risk of thyroid abnormalities.

A 70-year-old patient has a thyroid gland that is not visible and has irregular edges. How should the nurse interpret this?
A. Sign of thyroid cancer
B. Normal age-related change
C. Result of hyperthyroidism
D. Sign of immune deficiency

Correct Answer: B. Normal age-related change
Rationale: Atrophy and irregular edges may occur as normal aging changes.

A nurse notes a patient has difficulty swallowing and an enlarged, nodular thyroid. What should be the next step?
A. Perform an ultrasound
B. Notify the provider
C. Schedule thyroidectomy
D. Reassure the patient

Correct Answer: B. Notify the provider
Rationale: Dysphagia with thyroid enlargement may indicate compression or nodular disease needing further evaluation.

A patient has multiple tender cervical lymph nodes and reports a recent sore throat. What is the most likely cause?
A. HIV
B. Cancer
C. Bacterial or viral infection
D. Medication reaction

Correct Answer: C. Bacterial or viral infection
Rationale: Tender, multiple, enlarged cervical nodes with infection history suggest a reactive process.

Which of the following findings require further evaluation? Select all that apply.
A. Visible thyroid movement when swallowing
B. Palpable, hard, fixed lymph node
C. Non-palpable thyroid gland
D. Thyroid nodules
E. Symmetrical thyroid lobes

Correct Answers: B, D
Rationale: Hard, fixed nodes and nodules should be reported. Non-palpable and symmetrical findings can be normal.

A nurse palpates a thyroid that is enlarged, tender, and asymmetrical. What action should be taken first?
A. Ask about family history
B. Call the provider
C. Reassess in one week
D. Refer to endocrinology

Correct Answer: B. Call the provider
Rationale: These abnormal findings warrant prompt evaluation.

You’re designing a checklist for student nurses performing neck and lymph node assessments. What should be included? Select all that apply.
A. Positioning the patient properly
B. Using a stethoscope for thyroid exam
C. Following correct palpation sequence
D. Inspecting neck symmetry
E. Asking patient to cough during thyroid exam

Correct Answers: A, C, D
Rationale: Correct positioning, inspection, and palpation sequence are essential. A stethoscope and coughing are not standard for thyroid assessment.

You're tasked with teaching patients about signs of thyroid dysfunction. Which symptoms should you include? Select all that apply.
A. Cold or heat intolerance
B. Change in mood
C. Increased thirst
D. Hair texture changes
E. Nail brittleness

Correct Answers: A, B, D, E
Rationale: All are common in thyroid dysfunction. Increased thirst is more associated with diabetes.

You’re creating a training module for new nurses on lymph node palpation. What key concepts should be included? Select all that apply.
A. Start with occipital nodes
B. Skip supraclavicular nodes in young adults
C. Assess for symmetry
D. Palpate with fingertips in circular motion
E. Palpation is only needed if nodes are visible

Correct Answers: A, C, D
Rationale: Always palpate systematically (including supraclavicular), even if nodes aren’t visible.

You're writing a care plan for an older adult with thyroid atrophy. What should be your focus?
A. Rehydration therapy
B. Monitoring for nodules
C. Daily thyroid palpation
D. Encourage thyroid exercises

Correct Answer: B. Monitoring for nodules
Rationale: Thyroid nodules become more common with age and should be monitored.

You're planning a health fair booth on self-monitoring neck symptoms. What should you include?
A. How to identify lymph node locations
B. When to report difficulty swallowing
C. Signs of normal thyroid visibility
D. Instruction on daily thyroid checks

Correct Answers: A, B
Rationale: Education should focus on recognizing abnormal signs, not encouraging unnecessary palpation.

You’re creating documentation prompts for thyroid assessment. Which items should you include? Select all that apply.
A. Size and shape
B. Patient’s thyroid medication
C. Tenderness and nodules
D. Auscultation of thyroid
E. Symmetry and consistency

Correct Answers: A, B, C, E
Rationale: All are relevant except auscultation, which is not typical in thyroid exams.

During a physical assessment, the nurse notes visible swelling at the base of the neck while the patient swallows. What is the nurse’s best interpretation of this finding?
A. Normal aging process
B. Enlarged thyroid gland
C. Enlarged carotid artery
D. Swollen parotid gland

Correct Answer: B. Enlarged thyroid gland
Rationale: The thyroid gland may become visible if enlarged, especially during swallowing.

. Which technique is used to palpate the thyroid gland from behind the patient?
A. Place fingers on the clavicle and have the patient swallow
B. Place hands behind the neck and press forward
C. Displace one lobe while palpating the opposite lobe as the patient swallows
D. Ask the patient to flex the neck and hold breath

Correct Answer: C. Displace one lobe while palpating the opposite lobe as the patient swallows
Rationale: This is the correct technique for posterior thyroid palpation.

Which statement indicates an understanding of normal lymph node characteristics?
A. "Lymph nodes are normally hard and fixed."
B. "Lymph nodes should be tender during infection."
C. "Lymph nodes are usually palpable and large."
D. "Lymph nodes are often non-palpable and soft."

Correct Answer: D. "Lymph nodes are often non-palpable and soft."
Rationale: Normal lymph nodes are soft, small, and often non-palpable.

What is the expected age-related change in the thyroid gland of an older adult?
A. Hyperplasia of the thyroid gland
B. Increased hormone secretion
C. Atrophy with potential for palpable nodules
D. Smooth and visibly enlarged thyroid

Correct Answer: C. Atrophy with potential for palpable nodules
Rationale: Aging is associated with thyroid atrophy and nodularity.

. A patient reports neck stiffness and tenderness with recent cold symptoms. Which assessment finding would support infection as the cause?
A. Symmetrical lymph nodes with soft texture
B. Enlarged, tender cervical lymph nodes
C. Non-palpable lymph nodes
D. Visible thyroid gland with nodules

Correct Answer: B. Enlarged, tender cervical lymph nodes
Rationale: Infection can lead to lymph node enlargement and tenderness.

Which of the following should the nurse assess when palpating lymph nodes?
A. Size
B. Shape
C. Moisture
D. Consistency
E. Tenderness

Correct Answers: A, B, D, E
Rationale: Key assessment features include size, shape, consistency, and tenderness. Moisture is not relevant.

Which findings during thyroid palpation should be reported to the healthcare provider?
A. Smooth, symmetrical lobes
B. Presence of nodules
C. Thyroid not palpable
D. Enlargement of one or both lobes
E. Tenderness upon palpation

Correct Answers: B, D, E
Rationale: Nodules, enlargement, and tenderness are abnormal and warrant further evaluation. A non-palpable thyroid may be normal.

When gathering health history data for thyroid assessment, which questions are appropriate to ask?
A. "Do you have trouble swallowing?"
B. "Have you had recent vaccinations?"
C. "Have you experienced mood swings or heat/cold intolerance?"
D. "Do you take any thyroid medications?"
E. "Do you wear glasses or contacts?"

Correct Answers: A, C, D
Rationale: These questions relate directly to thyroid function and potential disease.

. Which physical exam techniques are used when assessing the neck, thyroid, and lymph nodes?
A. Percussion
B. Auscultation
C. Inspection
D. Palpation
E. Range of motion testing

Correct Answers: C, D, E
Rationale: The exam includes inspection, palpation, and assessing mobility. Percussion and auscultation are not routine here.

Which of the following nodes are located in the cervical area? Select all that apply.
A. Preauricular
B. Supraclavicular
C. Posterior cervical
D. Deep cervical chain
E. Submental

Correct Answers: B, C, D
Rationale: These nodes are all located in or near the cervical region. Preauricular and submental are closer to the face or chin.

What is the most appropriate position for the nurse when palpating the thyroid from behind the patient?
A. Seated next to the patient
B. Standing in front of the patient
C. Standing behind the patient
D. Lying patient supine

Answer: C. Standing behind the patient
Rationale: This allows proper palpation technique while the patient swallows.

What is the primary purpose of having the patient swallow during thyroid inspection?
A. To relax the neck muscles
B. To displace the trachea
C. To visualize the gland as it moves
D. To hear any vascular sounds

Answer: C. To visualize the gland as it moves
Rationale: Swallowing allows upward thyroid movement for better visualization.

A hard, fixed lymph node palpated in the neck is most concerning for:
A. Viral infection
B. Dehydration
C. Malignancy
D. Fatigue

Answer: C. Malignancy
Rationale: Hard, fixed lymph nodes are abnormal and can be associated with cancer.

What structure divides each side of the neck into two triangles?
A. Carotid artery
B. Thyroid cartilage
C. Sternocleidomastoid muscle
D. Mandible

Answer: C. Sternocleidomastoid muscle
Rationale: It serves as an anatomical landmark for neck assessments.

Where is the thyroid gland located?
A. Over the clavicle
B. Behind the sternum
C. Anterior lower neck over the trachea
D. Lateral to the jawline

Answer: C. Anterior lower neck over the trachea
Rationale: It has two lobes located on either side of the trachea.

What is the function of lymph nodes?
A. Lubricate the skin
B. Filter lymphatic fluid
C. Secrete hormones
D. Store glucose

Answer: B. Filter lymphatic fluid
Rationale: Lymph nodes protect the body by filtering antigens.

What is a normal finding when palpating the thyroid gland?
A. Tenderness on palpation
B. Nodules felt in both lobes
C. Smooth, rubbery, and symmetrical lobes
D. Audible bruit

Answer: C. Smooth, rubbery, and symmetrical lobes
Rationale: These are characteristics of a healthy thyroid.

Which patient complaint should prompt further thyroid evaluation?
A. Slight ear pain
B. Heat intolerance and hair changes
C. Constipation for 2 days
D. Muscle twitching

Answer: B. Heat intolerance and hair changes
Rationale: These can be signs of hyperthyroidism.

Which lymph node is located just above the clavicle?
A. Submental
B. Supraclavicular
C. Submandibular
D. Retropharyngeal

Answer: B. Supraclavicular
Rationale: Supraclavicular nodes are above the clavicle and may indicate serious pathology if enlarged.

What is the best technique for palpating lymph nodes?
A. Deep pressure with both thumbs
B. Gentle circular motion with fingertips
C. Flat palm pressure
D. Percussion with the middle finger

Answer: B. Gentle circular motion with fingertips
Rationale: This technique is standard for identifying small or tender nodes.

A nurse palpates enlarged cervical nodes in a patient who reports recent fever and sore throat. What is the likely cause?
A. Hypothyroidism
B. Infection
C. Tumor
D. Normal variant

Answer: B. Infection
Rationale: Enlarged, tender lymph nodes often accompany infection.

. Which finding in an older adult is expected during thyroid palpation?
A. Large visible lobes
B. Nodules with irregular edges
C. Audible murmur
D. Bruising

Answer: B. Nodules with irregular edges
Rationale: Age-related changes include atrophy and palpable nodules.

Which of the following is NOT a reason for lymph node enlargement?
A. Inflammation
B. Cancer
C. Dehydration
D. Medications

Answer: C. Dehydration
Rationale: Lymph nodes enlarge due to infection, inflammation, or certain medications—not dehydration.

What condition might lead to long-term or permanent lymph node enlargement?
A. Ankle sprain
B. Exposure to chemicals or radiation
C. Poor nutrition
D. Excessive exercise

Answer: B. Exposure to chemicals or radiation
Rationale: Radiation and chemicals may cause persistent node enlargement.

Which statement by a student nurse indicates correct understanding of thyroid palpation?
A. "I should palpate deeply to feel the lobes clearly."
B. "The thyroid is always visible during assessment."
C. "If the gland is palpable, I’ll check for tenderness and nodules."
D. "I do not need to document symmetry."

Answer: C. "If the gland is palpable, I’ll check for tenderness and nodules."
Rationale: These are key abnormal findings that should be documented and reported.

Which are normal findings in a healthy lymph node?
A. Soft texture
B. Fixed in place
C. Less than 2 cm
D. Tenderness
E. Not easily palpable

Answers: A, C, E
Rationale: Nodes should be soft, small, and often non-palpable. Fixed or tender nodes suggest pathology.

Which patient history questions are relevant when assessing the thyroid?
A. “Do you have a family history of thyroid disease?”
B. “Have you had difficulty swallowing?”
C. “Are you allergic to shellfish?”
D. “Have you had thyroid surgery?”
E. “Do you take thyroid medications?”

Answers: A, B, D, E
Rationale: These help assess thyroid function and potential abnormalities.

What should the nurse inspect when examining the neck?
A. Scars or asymmetry
B. Range of motion
C. Lymph node pulsation
D. Thyroid movement with swallowing
E. Neck masses

Answers: A, B, D, E
Rationale: These are key visual elements during neck inspection.

. Which lymph nodes are located in the head and neck?
A. Preauricular
B. Submental
C. Anterior cervical
D. Axillary
E. Supraclavicular

Answers: A, B, C, E
Rationale: These nodes are found in the head and neck region. Axillary is located under the arm.

Which findings require notifying the healthcare provider?
A. Smooth thyroid lobes
B. Thyroid enlargement
C. Palpable thyroid nodules
D. Non-palpable thyroid
E. Tenderness during thyroid palpation

Answers: B, C, E
Rationale: These could indicate disease and need further evaluation.

Which techniques are used for physical assessment of the neck, thyroid, and lymph nodes?
A. Percussion
B. Inspection
C. Palpation
D. Auscultation
E. ROM assessment

Answers: B, C, E
Rationale: These are appropriate techniques. Auscultation and percussion are not routine for this exam.

What symptoms may indicate thyroid dysfunction in a patient?
A. Mood swings
B. Intolerance to heat or cold
C. Weight changes
D. Dry, brittle hair and nails
E. Joint swelling

Answers: A, B, C, D
Rationale: These are typical signs of hypo- or hyperthyroidism.

Which nodes are found along the sternocleidomastoid muscle?
A. Preauricular
B. Anterior cervical
C. Deep cervical chain
D. Posterior cervical
E. Occipital

Answers: B, C
Rationale: These are associated with the sternocleidomastoid.

. When palpating lymph nodes, what should be documented?
A. Location
B. Color
C. Tenderness
D. Size
E. Consistency

Answers: A, C, D, E
Rationale: These are standard documentation elements. Color is not applicable.

Which factors can lead to temporary lymph node enlargement?
A. Viral infections
B. Colds
C. Stress
D. Vaccinations
E. Antibiotics

Answers: A, B, D
Rationale: These stimulate immune response and cause temporary enlargement.

Age-related changes in lymph nodes may include:
A. Enlarged size
B. Increased immune response
C. Atrophy
D. Decreased palpability
E. More frequent infections

Answers: C, D
Rationale: Older adults experience lymphatic atrophy, making nodes less palpable.

Which changes are commonly seen in the thyroid of older adults?
A. Irregular shape
B. Increased secretion
C. Atrophy
D. Palpable nodules
E. Vascular bruit

Answers: A, C, D
Rationale: Atrophy and irregularity are age-related changes.

Which supplies are needed for neck and thyroid assessment?
A. Penlight or light source
B. Reflex hammer
C. Gloves
D. Stethoscope
E. Tongue blade

Answer: A
Rationale: A light source helps in visualizing the thyroid gland. Other tools are not necessary.

. What symptoms should the nurse report when evaluating possible thyroid dysfunction?
A. Intolerance to cold
B. New neck fullness
C. Symmetrical lobes
D. Visualized thyroid
E. Unintentional weight loss

Answers: A, B, D, E
Rationale: These findings could indicate dysfunction and need reporting.

During lymph node palpation, what are considered abnormal findings?
A. Firm texture
B. Mobile nodes
C. Fixed nodes
D. Tenderness
E. Size >2 cm

Answers: A, C, D, E
Rationale: Abnormal findings include firmness, fixation, tenderness, and size over 2 cm.