,Galen NSG 3800 Exam 4 | Nursing Practice – Adult
Health II (2026) Actual Q&A PDF
1. The nurse educator asks a student to differentiate leukemia from lymphoma.
Which response indicates correct understanding?
A) “Leukemia originates in lymph nodes; lymphoma originates in bone marrow.”
B) “Leukemia always forms solid tumors; lymphoma presents with circulating
cancer cells.”
C) “Leukemia originates in bone marrow; lymphoma originates in lymphatic
tissue.”
D) “Both originate in the spleen.”
Correct Answer: “Leukemia originates in bone marrow; lymphoma originates in
lymphatic tissue.”
Rationale: Leukemia begins in the bone marrow, causing abnormal white blood
cells to circulate. Lymphoma arises in the lymphatic system, often forming solid
tumors in lymph nodes. The other options incorrectly reverse these origins or
suggest a splenic source.
2. A client newly diagnosed with Hodgkin lymphoma asks how the diagnosis is
confirmed. Which cell type is pathognomonic?
A) Blast cells
B) Bence-Jones cells
C) Philadelphia chromosome cells
D) Reed-Sternberg cells
,Correct Answer: Reed-Sternberg cells
Rationale: Reed-Sternberg cells are large abnormal B lymphocytes that define
Hodgkin lymphoma. Blast cells are seen in acute leukemias, Bence-Jones protein
indicates multiple myeloma, and the Philadelphia chromosome is characteristic
of CML.
3. A 4-year-old child is diagnosed with the most common childhood cancer.
Which type of leukemia does the nurse expect?
A) Acute myeloid leukemia
B) Chronic lymphocytic leukemia
C) Chronic myeloid leukemia
D) Acute lymphoblastic leukemia
Correct Answer: Acute lymphoblastic leukemia
Rationale: ALL peaks between ages 2 and 5 and is the most common childhood
cancer. AML is more common in adults, CLL affects older adults, and CML
primarily occurs in middle-aged adults.
4. The nurse is discussing the genetic basis of chronic myeloid leukemia with a
client. Which chromosomal abnormality is primarily responsible?
A) Deletion 5q
B) Philadelphia chromosome
C) Trisomy 21
D) 11q23 rearrangement
, Correct Answer: Philadelphia chromosome
Rationale: The Philadelphia chromosome (t(9;22)) produces the BCR-ABL fusion
gene, driving uncontrolled cell growth in CML. The other genetic changes are
associated with different hematologic or congenital disorders.
5. A client with suspected multiple myeloma has a urine test for which
diagnostic protein?
A) Albumin
B) Hemoglobin
C) Myoglobin
D) Bence-Jones protein
Correct Answer: Bence-Jones protein
Rationale: Bence-Jones protein (free immunoglobulin light chains) in urine is a
hallmark of multiple myeloma. Albumin is linked to nephrotic syndrome,
hemoglobin to hemolysis, and myoglobin to rhabdomyolysis.
6. A client is scheduled for a bone marrow biopsy from the iliac crest. The nurse
prepares the client for which sensations during the procedure?
A) A burning sensation for several minutes
B) Sharp pain followed by pressure
C) Numbness and tingling
D) Only mild vibration
Health II (2026) Actual Q&A PDF
1. The nurse educator asks a student to differentiate leukemia from lymphoma.
Which response indicates correct understanding?
A) “Leukemia originates in lymph nodes; lymphoma originates in bone marrow.”
B) “Leukemia always forms solid tumors; lymphoma presents with circulating
cancer cells.”
C) “Leukemia originates in bone marrow; lymphoma originates in lymphatic
tissue.”
D) “Both originate in the spleen.”
Correct Answer: “Leukemia originates in bone marrow; lymphoma originates in
lymphatic tissue.”
Rationale: Leukemia begins in the bone marrow, causing abnormal white blood
cells to circulate. Lymphoma arises in the lymphatic system, often forming solid
tumors in lymph nodes. The other options incorrectly reverse these origins or
suggest a splenic source.
2. A client newly diagnosed with Hodgkin lymphoma asks how the diagnosis is
confirmed. Which cell type is pathognomonic?
A) Blast cells
B) Bence-Jones cells
C) Philadelphia chromosome cells
D) Reed-Sternberg cells
,Correct Answer: Reed-Sternberg cells
Rationale: Reed-Sternberg cells are large abnormal B lymphocytes that define
Hodgkin lymphoma. Blast cells are seen in acute leukemias, Bence-Jones protein
indicates multiple myeloma, and the Philadelphia chromosome is characteristic
of CML.
3. A 4-year-old child is diagnosed with the most common childhood cancer.
Which type of leukemia does the nurse expect?
A) Acute myeloid leukemia
B) Chronic lymphocytic leukemia
C) Chronic myeloid leukemia
D) Acute lymphoblastic leukemia
Correct Answer: Acute lymphoblastic leukemia
Rationale: ALL peaks between ages 2 and 5 and is the most common childhood
cancer. AML is more common in adults, CLL affects older adults, and CML
primarily occurs in middle-aged adults.
4. The nurse is discussing the genetic basis of chronic myeloid leukemia with a
client. Which chromosomal abnormality is primarily responsible?
A) Deletion 5q
B) Philadelphia chromosome
C) Trisomy 21
D) 11q23 rearrangement
, Correct Answer: Philadelphia chromosome
Rationale: The Philadelphia chromosome (t(9;22)) produces the BCR-ABL fusion
gene, driving uncontrolled cell growth in CML. The other genetic changes are
associated with different hematologic or congenital disorders.
5. A client with suspected multiple myeloma has a urine test for which
diagnostic protein?
A) Albumin
B) Hemoglobin
C) Myoglobin
D) Bence-Jones protein
Correct Answer: Bence-Jones protein
Rationale: Bence-Jones protein (free immunoglobulin light chains) in urine is a
hallmark of multiple myeloma. Albumin is linked to nephrotic syndrome,
hemoglobin to hemolysis, and myoglobin to rhabdomyolysis.
6. A client is scheduled for a bone marrow biopsy from the iliac crest. The nurse
prepares the client for which sensations during the procedure?
A) A burning sensation for several minutes
B) Sharp pain followed by pressure
C) Numbness and tingling
D) Only mild vibration
