| Course | DNP 641 Advanced Health Assessment Pediatrics |
|---|---|
| Module | Module 3 |
| Paper type | Group case study analysis in SOAP format with differential diagnoses |
| Length | About 688 words, 5 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for DNP 641 Module 3
A Lump in a Five-Year-Old's Neck: Organizing the Findings, Building the Differential and Deciding What to Ask and Examine Next
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
DNP 641: Advanced Health Assessment Pediatrics
Instructor Name
Month Day, Year
A Lump in a Five-Year-Old's Neck: Organizing the Findings, Building the Differential and Deciding What to Ask and Examine Next
The Case as Given
A 5-year-old boy is brought in by his father for a "lump on the left side of his neck" first noticed 10 days ago. It has grown slightly and is tender. He had a runny nose and sore throat two weeks ago. Temperature at home has been up to 100.6 F on and off. He is eating less but drinking well. Examination shows a 3 by 2.5 cm tender, mobile, slightly warm node in the left anterior cervical chain without fluctuance. The pharynx is mildly red without exudate.
Organized in SOAP Format
Subjective: 5-year-old boy, 10 days of an enlarging, tender left neck mass after an upper respiratory illness; intermittent low-grade fever; decreased appetite; father as historian.
Objective: Temperature 100.2 F, heart rate 104, respiratory rate 22. Single 3 by 2.5 cm tender, mobile, mildly warm, nonfluctuant left anterior cervical node. Mild pharyngeal erythema without exudate. Other findings not yet documented.
Assessment: Unilateral acute cervical lymphadenopathy; differential below.
Plan: Complete the history and examination below before deciding on testing and treatment.
Potential Causes and Differential Diagnoses
Cervical lymphadenopathy in young children is common and usually reactive, but a node larger than 2 cm, a node that keeps growing or one with systemic signs needs a structured approach (Weinstock et al., 2018).
1. Reactive lymphadenopathy after a viral upper respiratory infection. Supporting: recent cold and sore throat. Against: size of 3 cm and continued growth at 10 days are more than typical.
2. Acute bacterial lymphadenitis, most often Staphylococcus aureus or group A streptococcus. Supporting: unilateral, tender, warm, enlarging, with fever. This is the leading diagnosis.
3. Cat scratch disease (Bartonella henselae). Supporting: unilateral node in a child. Needs: cat or kitten exposure and a scratch or papule.
4. Kawasaki disease. Supporting: fever and unilateral cervical node of 1.5 cm or more. Needs: fever duration and the other principal features, since the node is the least common of them (McCrindle et al., 2017).
5. Nontuberculous mycobacterial lymphadenitis. Supporting: age 1 to 5 and unilateral node. Against: tenderness and warmth; these nodes are usually painless, with violet discoloration of the overlying skin (Kliegman et al., 2024).
6. Malignancy, such as lymphoma or leukemia. Against at present: tender, mobile, short duration. Needs: systemic symptoms and examination of other node groups, liver and spleen.
Additional History Questions
Fever: exact duration and peak, and whether it has been daily, which matters for Kawasaki disease. Eyes, lips, hands and rash: any red eyes without discharge, cracked lips, swollen hands or feet or rash. Animal exposure: cats or kittens, scratches. Dental: toothache or recent dental problems. Systemic: night sweats, weight loss, bruising, bone pain, fatigue. Exposures: tuberculosis contacts, travel, unpasteurized milk. Response to any antibiotic already given. Immunizations and recurrent infections.
Systems to Review
Constitutional, eyes, mouth and oropharynx including teeth, skin, hematologic and lymphatic, musculoskeletal (bone pain, limp) and abdominal.
Physical Examination Components to Add
All lymph node groups, including occipital, preauricular, supraclavicular, axillary and inguinal, since a supraclavicular node is a red flag. Careful oral and dental examination. Conjunctivae, lips, tongue, hands and feet for Kawasaki features. Skin for rash, scratches, papules and petechiae. Abdomen for liver and spleen size. Repeat palpation of the node for fluctuance, which would suggest an abscess.
Red Flags for Urgent Evaluation
Supraclavicular location, a hard or fixed node, a node larger than 3 cm that keeps growing despite treatment, systemic symptoms such as weight loss or night sweats, hepatosplenomegaly, abnormal blood counts or fever of five days or more with Kawasaki features (Weinstock et al., 2018; McCrindle et al., 2017).
Group Conclusion
The leading diagnosis is acute bacterial lymphadenitis after a viral infection. If the completed history and examination show no Kawasaki features, no cat exposure and no red flags, an oral antibiotic covering S. aureus and group A strep with recheck in 48 to 72 hours would be reasonable, with ultrasound if the node becomes fluctuant or fails to improve. Any red flag changes the plan to laboratory testing and specialist referral.
References
Kliegman, R. M., St. Geme, J. W., Blum, N. J., Tasker, R. C., Wilson, K. M., Schuh, A. M., & Mack, C. L. (Eds.). (2024). Nelson textbook of pediatrics (22nd ed.). Elsevier.
McCrindle, B. W., Rowley, A. H., Newburger, J. W., Burns, J. C., Bolger, A. F., Gewitz, M., Baker, A. L., Jackson, M. A., Takahashi, M., Shah, P. B., Kobayashi, T., Wu, M.-H., Saji, T. T., & Pahl, E. (2017). Diagnosis, treatment, and long-term management of Kawasaki disease: A scientific statement for health professionals from the American Heart Association. Circulation, 135(17), e927-e999. https://doi.org/10.1161/CIR.0000000000000484
Weinstock, M. S., Patel, N. A., & Smith, L. P. (2018). Pediatric cervical lymphadenopathy. Pediatrics in Review, 39(9), 433-443. https://doi.org/10.1542/pir.2017-0249
What the DNP 641 Module 3 instructions ask for
The case study is worth 50 points and is due in Week 7, when DNP 641 covers assessment of the head, neck and regional lymphatics. It is completed in groups that include students from DNP 605, and preliminary work is due in Week 5. The syllabus asks groups to analyze a case involving abnormal findings, organize the patient's information in SOAP format, identify potential causes of the symptoms, develop a list of differential diagnoses and propose additional health history questions, systems to review and physical exam components. Its stated aim is to strengthen clinical reasoning, documentation and targeted assessment. The case itself comes from the course, so the sample uses a composite with the same tasks, built around the week's lymphatic content.
How this DNP 641 Module 3 example is built
The analysis moves through the syllabus's tasks in order. It first restates the case as given, then organizes the data into SOAP format, ending the objective section with what has not yet been examined. Six differential diagnoses follow, from common to serious, each with supporting features, features against and what is missing. Separate sections then list the additional history questions, the systems to review and the examination components to add, each tied to a diagnosis on the list. A red flag section names the findings that would call for urgent work-up, with sources. A short group conclusion states the leading diagnosis and the conditional plan that would follow once the gaps are filled.
DNP 641 Module 3 rubric: what earns full marks
At 50 points, the case study is the largest single assignment outside the OSCE and final exam, and its rubric is posted in Canvas. Group case analyses like this are typically graded on correct organization of data into SOAP format, a differential that is plausible, prioritized and justified, additional history and examination items that are specific and linked to the differentials, recognition of red flags, accurate pediatric content and documentation quality. Weak analyses list differentials without reasons or propose generic questions that would apply to any child. Strong ones show that each proposed question or exam step could confirm or exclude a specific diagnosis. Because the group includes DNP 605 students, coordination and a single consistent voice matter.
DNP 641 Module 3 help with common mistakes
Groups often write long differential lists with no reasoning. For each diagnosis, say what fits, what does not and what you still need. Another weakness is mixing interpretation into the objective section; keep findings and conclusions apart. Make the additional questions specific, such as fever duration for Kawasaki disease, rather than "ask about symptoms." Include a full lymph node survey, since the location of other nodes changes the picture. Name red flags explicitly. Divide the work, but have one person edit for consistency. The syllabus rules out UpToDate and StatPearls as references. If your group shares its case and draft differential with the desk, it can check the reasoning for each item.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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DNP 641 Module 3 questions, answered
Where can I find a free DNP 641 Module 3 sample paper?
The DNP 641 Module 3 sample here is a full abnormal findings case study on cervical lymphadenopathy in a 5-year-old, organized in SOAP format with six differentials and next steps.
What does the DNP 641 abnormal findings case study ask?
Groups organize a case in SOAP format, identify causes, develop differential diagnoses and propose additional history questions, systems to review and examination components.
What are red flags in a child's swollen neck node?
A supraclavicular node, a hard or fixed node, continued growth despite treatment, weight loss or night sweats, an enlarged liver or spleen and prolonged fever with Kawasaki features.
Who completes the DNP 641 case study?
DNP 641 students work in groups with DNP 605 students, submit preliminary work in Week 5 and the completed case study in Week 7.
How much is the DNP 641 case study worth?
The Case Study: Abnormal Findings and Differential Diagnoses is worth 50 points, part of the assignments category in the course grade.