Cleo’s presentation includes a firm mandibular lymph node. Which statement best describes this finding?

• A. A firm mandibular lymph node enlargement
• B. Bilateral nasal discharge
• C. Nasal stertor
• D. Epistaxis

Answer: (A)

Lymphadenopathy is described by the size and consistency of a lymph node; a firm enlargement of the mandibular node is the precise way to describe what’s felt when you examine it. The firmness suggests a solid, possibly pathologic node, and the enlargement points to an active local process such as dental disease, oral infection, or even neoplasia. The other options describe nasal signs (discharge, noise from the nose, bleeding from the nose) and do not describe a palpable mandibular lymph node, so they don’t fit the finding being described.