,NSG 3800 Exam 4 | Adult Health II (2026/2027)
PDF | Nursing | Galen
1. A client with chronic kidney disease has a serum potassium of 6.2 mEq/L.
Which intervention is the priority?
A) Prepare for hemodialysis
B) Administer oral potassium supplements
C) Encourage a high-potassium diet
D) Restrict fluid intake only
Correct Answer: A) Prepare for hemodialysis
Rationale: A potassium of 6.2 mEq/L is critically elevated and can cause life-
threatening dysrhythmias. Hemodialysis is the definitive treatment to remove
excess potassium. Potassium supplements or a high-potassium diet worsen the
condition. Fluid restriction alone is insufficient.
2. Which cell type is pathognomonic for Hodgkin lymphoma?
A) Blast cells
B) Reed-Sternberg cells
C) Plasma cells
D) Philadelphia chromosome-positive cells
Correct Answer: B) Reed-Sternberg cells
,Rationale: Reed-Sternberg cells are large, abnormal B lymphocytes that are the
hallmark of Hodgkin lymphoma. They are not found in non-Hodgkin lymphoma,
leukemia, or multiple myeloma. Their presence confirms the diagnosis on
biopsy.
3. A 4-year-old child is diagnosed with the most common childhood cancer.
Which type is most likely?
A) Acute myeloid leukemia
B) Chronic lymphocytic leukemia
C) Acute lymphoblastic leukemia
D) Chronic myeloid leukemia
Correct Answer: C) Acute lymphoblastic leukemia
Rationale: Acute lymphoblastic leukemia is the most common childhood cancer,
with peak incidence between ages 2 and 5. Acute myeloid leukemia is more
common in adults, chronic lymphocytic leukemia in older adults, and chronic
myeloid leukemia in middle-aged adults.
4. A client with cirrhosis develops confusion and asterixis. Which lab finding
explains this?
A) Low serum albumin
B) Decreased platelet count
C) Elevated liver enzymes
D) Elevated serum ammonia
Correct Answer: D) Elevated serum ammonia
, Rationale: Elevated ammonia levels cause hepatic encephalopathy, presenting
with confusion and asterixis in cirrhosis. Low albumin causes ascites, decreased
platelets increase bleeding risk, and liver enzymes indicate hepatocellular injury
but do not cause encephalopathy.
5. Which clinical manifestation is most characteristic of acute
glomerulonephritis?
A) Periorbital edema and tea-colored urine
B) Polyuria and polydipsia
C) Flank pain radiating to the groin
D) Urinary frequency and dysuria
Correct Answer: A) Periorbital edema and tea-colored urine
Rationale: Acute glomerulonephritis presents with periorbital edema,
hematuria (tea-colored urine), proteinuria, and hypertension. Polyuria and
polydipsia occur in diabetes, flank pain radiating to the groin suggests
nephrolithiasis, and dysuria indicates lower urinary tract infection.
6. A client with hyperthyroidism develops rapid fever, tachycardia, and crackles.
Which condition is most likely?
A) Myxedema coma
B) Thyroid storm
C) Addisonian crisis
D) Cushing syndrome
PDF | Nursing | Galen
1. A client with chronic kidney disease has a serum potassium of 6.2 mEq/L.
Which intervention is the priority?
A) Prepare for hemodialysis
B) Administer oral potassium supplements
C) Encourage a high-potassium diet
D) Restrict fluid intake only
Correct Answer: A) Prepare for hemodialysis
Rationale: A potassium of 6.2 mEq/L is critically elevated and can cause life-
threatening dysrhythmias. Hemodialysis is the definitive treatment to remove
excess potassium. Potassium supplements or a high-potassium diet worsen the
condition. Fluid restriction alone is insufficient.
2. Which cell type is pathognomonic for Hodgkin lymphoma?
A) Blast cells
B) Reed-Sternberg cells
C) Plasma cells
D) Philadelphia chromosome-positive cells
Correct Answer: B) Reed-Sternberg cells
,Rationale: Reed-Sternberg cells are large, abnormal B lymphocytes that are the
hallmark of Hodgkin lymphoma. They are not found in non-Hodgkin lymphoma,
leukemia, or multiple myeloma. Their presence confirms the diagnosis on
biopsy.
3. A 4-year-old child is diagnosed with the most common childhood cancer.
Which type is most likely?
A) Acute myeloid leukemia
B) Chronic lymphocytic leukemia
C) Acute lymphoblastic leukemia
D) Chronic myeloid leukemia
Correct Answer: C) Acute lymphoblastic leukemia
Rationale: Acute lymphoblastic leukemia is the most common childhood cancer,
with peak incidence between ages 2 and 5. Acute myeloid leukemia is more
common in adults, chronic lymphocytic leukemia in older adults, and chronic
myeloid leukemia in middle-aged adults.
4. A client with cirrhosis develops confusion and asterixis. Which lab finding
explains this?
A) Low serum albumin
B) Decreased platelet count
C) Elevated liver enzymes
D) Elevated serum ammonia
Correct Answer: D) Elevated serum ammonia
, Rationale: Elevated ammonia levels cause hepatic encephalopathy, presenting
with confusion and asterixis in cirrhosis. Low albumin causes ascites, decreased
platelets increase bleeding risk, and liver enzymes indicate hepatocellular injury
but do not cause encephalopathy.
5. Which clinical manifestation is most characteristic of acute
glomerulonephritis?
A) Periorbital edema and tea-colored urine
B) Polyuria and polydipsia
C) Flank pain radiating to the groin
D) Urinary frequency and dysuria
Correct Answer: A) Periorbital edema and tea-colored urine
Rationale: Acute glomerulonephritis presents with periorbital edema,
hematuria (tea-colored urine), proteinuria, and hypertension. Polyuria and
polydipsia occur in diabetes, flank pain radiating to the groin suggests
nephrolithiasis, and dysuria indicates lower urinary tract infection.
6. A client with hyperthyroidism develops rapid fever, tachycardia, and crackles.
Which condition is most likely?
A) Myxedema coma
B) Thyroid storm
C) Addisonian crisis
D) Cushing syndrome
