Chapter 12: Epidemiology (Stanhope: Public Health Nursing, 8th Ed)

Immunization for measles is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

A study that uses information on current health status, personal characteristics, and potential risk factors or exposures all at once is called: a. Cross-sectional b. Ecological c. Case-control d. Cohort

ANS: A A cross-sectional study collects information on current health status, personal characteristics, and potential risk factors or exposures all at once.

John Snow is called the father of epidemiology because of his work with: a. Cholera b. Malaria c. Polio d. Germ theory

ANS: A John Snow investigated the spread of cholera in the mid-nineteenth century.

Which statement is true about mortality rates? Mortality rates: a. Are informative only for fatal diseases b. Provide information about existing disease in the population c. Are calculated using a population estimate at year-end d. Reveal the risk of getting a particular disease

ANS: A Mortality rates are informative only for fatal diseases and do not provide direct information about the level of existing disease or the risk of getting a particular disease.

As a result of an outbreak of influenza in a community, a nurse encourages members of the community to receive the influenza vaccine. Which level of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Multifactorial prevention

ANS: A Nurses are involved in epidemiologic surveillance by monitoring the potential for disease outbreaks. Primary prevention refers to interventions aimed at preventing the occurrence of disease, injury, or disability.

A screening for diabetes revealed 20 previously diagnosed diabetics and 10 probable new cases, which were later confirmed, for a total of 30 cases. This is called: a. Prevalence b. Incidence c. Attack d. Morbidity

ANS: A Prevalence is the measure of existing disease in a population at a particular time.

An example of tertiary prevention is: a. Rehabilitative job training b. Parenting education c. Testicular self-examination d. Family counseling

ANS: A Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

When a nurse examines birth and death certificates during an epidemiologic investigation, what data category is being used? a. Routinely collected data b. Data collected for other purposes but useful for epidemiologic research c. Original data collected for specific epidemiologic studies d. Surveillance data

ANS: A These are examples of data collected routinely.

Which is an example of an agent in the epidemiologic triangle? a. Human population distribution b. Salmonella c. Genetic susceptibility d. Climate

ANS: B An agent includes infectious organisms.

An epidemiologist wanting to know what caused severe diarrhea and vomiting in several people at a local banquet would be using: a. Descriptive epidemiology b. Analytic epidemiology c. Distribution d. Determinants

ANS: B Analytic epidemiology is directed toward understanding the etiology of the disease.

Which is an example of an epidemic? a. Bird flu in China b. Adult obesity in the United States c. An isolated case of smallpox in Africa d. The nursing shortage in the United States

ANS: B It is estimated that 30% of the adults in the United States are obese. According to the CDC, this is an epidemic.

An outbreak of a gastrointestinal illness from a food-borne pathogen is an example of a(n): a. Attack rate b. Point epidemic c. Secular trend d. Event-related cluster

ANS: B One temporal and spatial pattern of disease distribution is the point epidemic. A point epidemic is most clearly seen when the frequency of cases is plotted against time. The sharp peak characteristic of such graphs indicates a concentration of cases in some short interval of time.

The probability an event will occur within a specified period of time is called: a. Rate b. Risk c. Epidemiology d. Epidemic

ANS: B Risk is the probability an event will occur within a specified period of time.

Screening for hearing defects is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: B Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

In which situation does the nurse need to be aware of the potential for selection bias? a. Determining the population to be studied b. Considering how the participants will enter the study c. Studying cause and effect relationships d. Documenting results of the study

ANS: B Selection bias is attributable to the way subjects enter a study. It has to do with selection procedures and the population from which subjects are drawn.

The most important predictor of overall mortality is: a. Race b. Age c. Gender d. Income

ANS: B The mortality curve by age drops sharply during and after the first year of life to a low point in childhood, then begins to increase through adolescence and young adulthood and then increases sharply through middle and older ages.

Nurses incorporate epidemiology into their practice and function in epidemiologic roles through (select all that apply): a. Policy making and enforcement b. Collection, reporting, analysis, and interpretation of data c. Environmental risk communication d. Documentation on patient charts and records

ANS: B, C, D The 2nd, 3rd, and 4th options are examples of the use of epidemiology in practice. The first option does not apply to epidemiology.

Epidemiologic studies of diseases conducted by nurses during the twentieth century were influenced by the (select all that apply): a. Increasing rate of poverty b. Declining child mortality rates c. Overcrowding in major cities d. Development of new vaccinations

ANS: B, D Factors contributing to the development and application of epidemiologic methods in the twentieth century were: improved nutrition, new vaccines, better sanitation, the advent of antibiotics and chemotherapies, and declining infant and child mortality and birth rates. A rise in the standard of living occurred for many following the Great Depression and World War II.

. The type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome is a(n): a. Case control study b. Cross-sectional study c. Cohort study d. Experimental study

ANS: C A cohort study is the type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome.

A nurse is told that a screening test has high specificity. This means that the test: a. Provides precise and consistent readings b. Accurately identifies those with the condition or trait c. Accurately identifies those without the trait d. Has a high level of false positives

ANS: C Specificity refers to the test accurately identifying those without the trait.

Vocational rehabilitation of a person with a neuromuscular disease is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: C Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

When studying chronic disease, the multifactorial etiology of illness is considered. What does this imply? a. Genetics and molecular structure of disease is paramount. b. Single organisms that cause a disease, such as cholera, must be studied in more detail. c. Focus should be on the factors or combinations and levels of factors contributing to disease. d. The recent rise in infectious disease is the main focus.

ANS: C Multifactorial etiology implies a focus on combinations and levels of factors.

The proportion of persons with positive test results who actually have a disease, interpreted as the probability that an individual with a positive test result has the disease, is the: a. Sensitivity b. Specificity c. Positive predictive value d. Negative predictive value

ANS: C Positive predictive value refers to the proportion of persons with positive test results who actually have the disease, interpreted as the probability that an individual with a positive test result has the disease.

An example of primary prevention is: a. Pap smear b. Blood pressure screening c. Diet and exercise d. Physical therapy

ANS: C Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

Public health professionals refer to three levels of prevention as tied to specific stages in the: a. Epidemiologic triangle b. Web of causation c. Natural history of disease d. Surveillance process

ANS: C The natural history of disease is the course of the disease process from onset to resolution. The three levels of prevention provide a framework commonly used in public health practice to depict this process.

Voters have recently decided to have fluoride added to the city water system. Epidemiologists wanting to study the effect of fluoride on dental caries would be conducting a(n): a. Ecological study b. Double-blind study c. Community trial d. Screening

ANS: C This is similar to clinical trials, but the issue is often health promotion and disease prevention rather than treatment of existing disease.

An example of an attack rate is the: a. Number of cases of cancer recorded at a medical center b. Number of people who died of cholera in India in a given year c. Number of beef cattle inoculated against mad-cow disease on a farm d. Proportion of people becoming ill after eating at a fast-food restaurant

ANS: D Attack rates are often specific to exposures, such as food-specific attack rates.

The factors, exposures, characteristics, and behaviors that determine patterns of disease are described using: a. Descriptive epidemiology b. Analytic epidemiology c. Distribution d. Determinants

ANS: D Determinants may be individual, relational, social, communal, or environmental.

To understand the causes of health and disease, epidemiology studies: a. Individuals b. Families c. Groups d. Populations

ANS: D Epidemiology monitors health of populations, understands determinants of health and disease in communities, and investigates and evaluates interventions to prevent disease and maintain health.

Which would be considered a serious epidemic of influenza? a. 50 cases b. 100 cases c. 500 cases d. Unable to determine

ANS: D One cannot tell the degree of seriousness without a denominator, which represents the total population.

An example of secondary prevention is: a. Rehabilitation b. Avoidance of high-risk behaviors c. Immunization d. Mammogram

ANS: D Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

The interaction between an agent, a host, and the environment is called: a. Natural history of disease b. Risk c. Web of causality d. The epidemiologic triangle

ANS: D The epidemiologic triangle consists of the interaction between an agent, a host, and the environment.