Ace the ANCC Exam 2026 – Ignite Your Nursing Superpowers!

An enlarged lymph node in the left supraclavicular region, particularly in a 65-year-old woman, raises a significant clinical concern that warrants further investigation. This area, known as Virchow's node, can be an indication of potential malignancy, especially related to abdominal or thoracic cancers.

The appropriate next step in management involves obtaining a definitive diagnosis, which is best achieved through a lymph node biopsy. This procedure allows for histological examination of the lymph tissue to determine the underlying cause of the enlargement, whether it be benign or malignant. Referral to a surgeon for this biopsy is crucial, as it provides necessary information that will guide further treatment.

In contrast, ordering a throat culture and monospot test, or prescribing antibiotic therapy, could be more suitable for lymphadenopathy due to infections like viral or bacterial processes. However, given the patient's age and the specific location of the lymph node, these options may delay critical diagnostic evaluation. Furthermore, a two-step tuberculin skin test is specifically used to detect latent TB infection, but it doesn't address the immediate need to evaluate for malignancy, especially in a patient presenting with a concerning lymphadenopathy. Therefore, referring the patient for a lymph node biopsy is the most clinically appropriate course