During an examination of a female patient, the nurse notes lymphadenopathy and suspects an acute infection. How do acutely infected lymph nodes typically appear?

A. Clumped: Clumped lymph nodes are more commonly seen in chronic infections such as tuberculosis or metastatic malignancies, where lymph nodes may fuse together due to prolonged immune stimulation or infiltration by cancerous cells. In acute infections, lymph nodes tend to be more discrete rather than clumped. B. Unilateral: Lymphadenopathy in acute infections can be either unilateral or bilateral, depending on the site and extent of the infection. While localized bacterial infections may cause unilateral lymph node enlargement, systemic infections such as viral illnesses frequently lead to bilateral lymphadenopathy. C. Soft and nontender: Normal lymph nodes are small, soft, and nonpalpable or slightly palpable without tenderness. In an acute infection, inflammatory processes lead to lymph node enlargement, making them firm and tender rather than soft and nontender. Soft, painless lymph nodes are more often associated with normal findings or slow-growing malignancies such as lymphomas. D. Firm, tender, but freely movable: In acute infections, lymph nodes become enlarged, firm, and tender due to inflammatory immune responses against invading pathogens. Despite their enlargement, they remain freely movable because the surrounding tissue is not invaded or fibrotic, unlike in malignancies where nodes may be fixed due to tumor infiltration or fibrosis. The tenderness results from stretching of the lymph node capsule due to rapid immune cell proliferation and increased fluid accumulation.