NSG 3800 Exam 4 Study tips: Understanding Leukemia and Lymphomas | 2026 Update with complete solutions - Galen College of Nursing.

NSG 3800 Exam 4 Study tips: Understanding
Leukemia and Lymphomas | 2026 Update with
complete solutions - Galen College of Nursing.



NSG 3800 Exam 4: Complete 100-Question Practice Exam
Understanding Leukemia and Lymphomas | Galen College of Nursing | 2026
Update | 100% Correct Answers with Explanations
Instructions: Choose the best answer for each question. This comprehensive
exam covers all major topics from the NSG 3800 Exam 4 study guide, including
leukemias, lymphomas, oncologic emergencies, treatment modalities, and nursing
interventions.


Section 1: Foundations and Classifications (Questions 1-15)
1. A nursing student is comparing leukemia and lymphoma. Which statement
accurately describes the primary difference between these two cancers?
a) Leukemia originates in lymph nodes; lymphoma originates in bone marrow
b) Leukemia originates in bone marrow; lymphoma originates in lymphatic tissue
c) Leukemia always presents with solid tumors; lymphoma presents with
circulating cancer cells
d) Leukemia affects only children; lymphoma affects only adults
Correct Answer = b) Leukemia originates in bone marrow; lymphoma originates
in lymphatic tissue
Explanation: Leukemia is a cancer of blood-forming tissues, primarily the bone
marrow, resulting in uncontrolled proliferation of abnormal white blood cells
(blasts). Lymphoma originates in the lymphatic system, specifically affecting
lymphocytes, and often presents with solid tumors in lymph nodes.

,2. Which of the following cell types is pathognomonic (diagnostic) for Hodgkin
lymphoma?
a) Blast cells
b) Reed-Sternberg cells
c) Philadelphia chromosome-positive cells
d) Plasma cells
Correct Answer = b) Reed-Sternberg cells
Explanation: The presence of Reed-Sternberg cells—large, abnormal B
lymphocytes—is the defining characteristic of Hodgkin lymphoma. These cells are
not found in Non-Hodgkin lymphoma or leukemias. Blast cells (a) indicate
leukemia. Philadelphia chromosome (c) is associated with CML. Plasma cells (d)
are associated with multiple myeloma.


3. A 4-year-old child is diagnosed with the most common childhood cancer.
Which type of leukemia is most likely?
a) Acute Myeloid Leukemia (AML)
b) Chronic Lymphocytic Leukemia (CLL)
c) Acute Lymphoblastic Leukemia (ALL)
d) Chronic Myeloid Leukemia (CML)
Correct Answer = c) Acute Lymphoblastic Leukemia (ALL)
*Explanation: ALL is the most common childhood cancer, with peak incidence
between 2-5 years of age. AML (a) is more common in adults. CLL (b) occurs
primarily in older adults (>70). CML (d) typically affects adults 50-60 years old.*


4. Which genetic abnormality is characteristic of Chronic Myeloid Leukemia
(CML)?
a) NPM1 mutation
b) FLT3-ITD
c) Philadelphia chromosome
d) 11q23 rearrangement
Correct Answer = c) Philadelphia chromosome
*Explanation: The Philadelphia chromosome (t(9;22) translocation) is present in

,approximately 95% of CML cases and results in the BCR-ABL fusion gene. This
abnormality is targeted by tyrosine kinase inhibitors like imatinib (Gleevec).*


5. A 72-year-old patient presents with lymphadenopathy and is found to have a
slowly progressive cancer of mature-appearing lymphocytes. This presentation
is most consistent with:
a) Acute Lymphoblastic Leukemia
b) Chronic Lymphocytic Leukemia
c) Hodgkin Lymphoma
d) Acute Myeloid Leukemia
Correct Answer = b) Chronic Lymphocytic Leukemia
*Explanation: CLL is characterized by slow progression, mature-appearing
lymphocytes, and typically occurs in older adults (>70). ALL (a) is acute and occurs
in children. HL (c) has a bimodal distribution. AML (d) is acute and more common
in adults >60 but involves myeloid blasts.*


6. Which of the following is a key characteristic of Non-Hodgkin Lymphoma
(NHL) compared to Hodgkin Lymphoma (HL)?
a) Presence of Reed-Sternberg cells
b) Orderly spread from one lymph node group to the next
c) Higher likelihood of extranodal involvement
d) Bimodal age distribution
Correct Answer = c) Higher likelihood of extranodal involvement
Explanation: NHL commonly involves extranodal sites (gastrointestinal tract, bone
marrow, CNS), while HL typically spreads contiguously between lymph node
groups. Reed-Sternberg cells (a) are found only in HL. Orderly spread (b) is
characteristic of HL. Bimodal distribution (d) is seen in HL, not NHL.


7. The nurse understands that "B symptoms" are important in staging
lymphomas. Which of the following are included in B symptoms?
a) Bradycardia, hypertension, hyperglycemia

, b) Fever, night sweats, weight loss
c) Bruising, bleeding, petechiae
d) Headache, visual changes, confusion
Correct Answer = b) Fever, night sweats, weight loss
Explanation: "B symptoms" include: unexplained fever >38°C (100.4°F), drenching
night sweats, and unexplained weight loss >10% of body weight over 6 months.
Their presence modifies staging (A vs. B) and may indicate more aggressive
disease.


8. Which type of leukemia is characterized by the presence of the Philadelphia
chromosome and is treated with tyrosine kinase inhibitors?
a) ALL
b) AML
c) CLL
d) CML
Correct Answer = d) CML
Explanation: CML is defined by the Philadelphia chromosome (BCR-ABL fusion).
Tyrosine kinase inhibitors (imatinib, dasatinib, nilotinib) target this abnormality
and have revolutionized CML treatment, turning it into a chronic manageable
condition for many patients.


9. A patient is diagnosed with a cancer that involves the bone marrow and has
>20% blasts on bone marrow biopsy. This finding is diagnostic for:
a) Lymphoma
b) Chronic leukemia
c) Acute leukemia
d) Myelodysplastic syndrome
Correct Answer = c) Acute leukemia
Explanation: The presence of ≥20% blasts in the bone marrow is the diagnostic
criterion for acute leukemia (both ALL and AML). Chronic leukemias have more
mature cells and lower blast percentages.