Community Exam 1 9th ed

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.

A A cross-sectional study collects information on current health status, personal characteristics, and potential risk factors or exposures all at once. 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. An ecological model considers the multiple factors that contribute to disease development.

A nurse plans to contact a multilateral organization. Which of the following would the nurse most likely contact? a. United Nations (UN) b. United States Agency for International Development (USAID) c. Project Hope d. Catholic Relief Services

A A multilateral organization is one that receives funding from multiple governments and nongovernmental sources, which describes the UN. Project Hope and Catholic Relief Services are private voluntary organizations. USAID is funded by one country, the United States.

A visitor from Japan comes to the United States for a 2-week vacation. Which of the following best describes this person? a. Nonimmigrant b. Refugee c. Legal immigrant d. Lawful permanent resident

A A nonimmigrant is admitted for a limited duration for a specific purpose. Refugees are people who seek protection in the United States because of fear of persecution in their homeland. Legal immigrants are people who are not citizens but are legally allowed to live and work in United States, usually because they fulfill labor demands or have family ties. Lawful permanent resident is another name for legal immigrants.

Research has shown that Asian men tend to have a greater sensitivity than white Europeans to codeine, and they experience significantly weaker effects from the drug. Which of the following types of cultural variations is being demonstrated? a. Biological variations b. Personal space c. Social organization d. Perception of time

A Biological variations are the physical, biological, and physiological differences that exist between racial groups and distinguish one group from another. Personal space is the physical distance between two individuals during an interaction. Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions. Perception of time is the duration or period between successive events, where some cultures assign greater or lesser emphasis to events that occur in the past, present, or future.

A nurse examines birth and death certificates during an epidemiologic investigation. Which of the following data categories 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

A Birth and death certificates are considered to be vital records and are examples of data collected routinely. Data collected for other purposes would be hospital, physician, health department, laboratory, and insurance records. Original data is that which is collected by the National Center for Health Statistics for specific health surveys. Surveillance data is used to assess and prioritize the health needs of populations, design public health and clinical services to address those needs, and evaluate the effectiveness of public health programs.

The blueprint or code that is used to construct other components of cells is called the: a. DNA. b. gene. c. chromosome. d. base.

A The DNA is the chemical inside the nucleus of the cell that has the genetic instructions for making living organisms. This can be compared to a blueprint or code that is used to construct other components of cells. Genes are the DNA segments that carry the genetic information. DNA is organized into long structures called chromosomes within the cells. DNA is comprised of four bases.

A nurse is applying genetic and genomic knowledge when completing a client assessment. Which of the following actions is most likely being taken by the nurse? a. Constructing a pedigree from a collected family history b. Identifying a client who may benefit from genetic counseling c. Referring a client to specialized genetic services d. Incorporating knowledge of genomic risk factors

A Constructing a pedigree from a collected family history demonstrates assessment in the nursing process. Identification is demonstrated by identifying a client who may benefit from genetic counseling. Referral is demonstrated by referring a client to specialized genetic services. Provision of education, care, and support is demonstrated by incorporating knowledge of genomic risk factors.

To meet a client's needs, it is sometimes necessary to integrate into the client's care a culturally relevant practice that lacks scientific utility. Which of the following best describes this action? a. Cultural accommodation b. Cultural awareness c. Cultural preservation d. Cultural repatterning

A Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help people of a particular culture to accept nursing strategies, or to negotiate with nurses to achieve satisfying health care outcomes. Cultural awareness refers to the self-examination and in-depth exploration of one's own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups. Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values so they can maintain, promote, and restore health. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

A nurse is working with an immigrant population. Which of the following should be the first action taken by the nurse? a. Be aware of one's own culture b. Become familiar with traditional practices of the immigrants c. Try to see things from the immigrant's viewpoint d. Learn to speak the language of the immigrant population

A Cultural competence is one of the core attributes of public health nurses. Nurses come from a variety of cultural backgrounds and have their own cultural traditions. Nurses also bring their biomedical beliefs and values to the practice environment that may differ from the client's own beliefs and values. Because nurses recognize their own culture, they are better able to understand that there are differences among cultures. Being aware of one's own culture should be done before completing the other tasks of increasing familiarity with traditional practices, trying to see things from the other's point of view, or learning to speak the language.

Which health problem is in need of control in developed countries? a. Hepatitis b. Malaria c. Polio d. Smallpox

A Current health concerns in more developed countries are hepatitis, infectious diseases, and new viral strains such as hantavirus, SARS (severe acute respiratory syndrome), H1N1, and avian flu. Malaria, polio, and smallpox are more commonly found in lesser-developed countries.

A nurse believes that the best treatment for illness is the use of Western medicine and alternative therapies should not be used for healing. Which of the following best describes what has happened? a. Ethnocentrism b. Cultural imposition c. Racism d. Stereotyping

A Ethnocentrism is the belief that one's own cultural group determines the standards by which another group's behavior is judged. Cultural imposition is the act of imposing one's cultural beliefs, values, and practices on individuals from another culture. Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior on the basis of intelligence, morals, beauty, inheritance, and self-worth. Stereotyping is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences.

A nurse states that the client has exhibited an explicit cultural behavior. Which of the following has the nurse most likely observed? a. Verbal communication b. Body language c. Use of titles d. Perception of health and illness

A Explicit behaviors are straightforward and do not leave room for misinterpretation of what the person wants to communicate, such as when using verbal communication. Implicit behaviors are less exact and may be difficult to interpret, including body language, use of titles, and perception of health and illness.

The Genetic Information Nondiscrimination Act (GINA): a. protects individuals from discrimination based on their genetic information. b. allows health insurance companies to deny coverage for preexisting conditions. c. states employers may collect genetic information from employees as needed. d. requires employees to report genetic disorders to their employer.

A GINA was designed to prohibit the improper use of genetic information in health insurance and employment. It protects individuals from discrimination based on their genetic information, prevents denial of coverage based solely on genetic predisposition to disease, and limits disclosure of genetic information.

The increasing knowledge about genetics and genomics will influence nursing practice by changing how: a. nurses collect and use health histories. b. nursing students complete clinical experiences. c. referrals to other disciplines are made. d. ethical dilemmas are solved.

A Genetics and genomics will change future practice in several areas including: how students are educated, how nurses collect and use health histories, how nurses learn and apply innovative biotechnology, how prevention and health education is provided, administration of new therapies, and public health debates.

A clinic nurse working in the 1970s was employed by a primary care physician. Which of the following describes how the nurse would have applied genetic concepts? a. Providing genetic counseling to those with genetic disorders b. Educating clients about using genetic testing for risk identification c. Explaining the purposes of the Human Genome Project to clients d. Facilitating referrals for specialized genetic services for clients

A In the 1970s, nurses working in genetics provided genetic counseling to persons with genetic diseases or risk factors for such disorders. The other activities performed by the nurse did not occur until the 1990s.

John Snow is called the "father of epidemiology" because of his work with: a. cholera. b. malaria. c. polio. d. germ theory.

A John Snow investigated the spread of cholera in the mid-nineteenth century. John Snow did not investigate the other examples.

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.

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. Because the population changes during the course of a year, typically an estimate of the population at midyear is taken as the denominator for annual rates, because the midyear population approximates the amount of person-time contributed by the population during a given year.

Multilateral organizations: a. receive funding from multiple sources. b. control the spread of disease. c. feed the people of the world. d. use nurses as their main source of information.

A Multilateral organizations are those that receive funding from multiple government and nongovernment sources. The other items are specific to the agencies listed, but do not include all of the organizations.

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

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. Immunizations are an example of primary prevention. Secondary prevention interventions are designed to increase the probability that a person with a disease will have that condition diagnosed at a stage when treatment is likely to result in cure. Tertiary prevention includes interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Multifactorial prevention is not possible with a disease like influenza, which has one cause.

A nurse is striving to be culturally competent. Which of the following actions would most likely be taken by the nurse? a. Respect individuals from different cultures and value diversity b. Immerse themselves in different cultures c. Design care for special ethnic groups d. Give explicit instructions to avoid client decision making

A Nurses who strive to be culturally competent respect individuals from different cultures and value diversity. Immersing oneself in a different culture, designing care for special ethnic groups, and giving explicit instructions so the client does not have to make a decision does not demonstrate cultural competence.

A screening for diabetes revealed 20 previously diagnosed diabetics and 10 probable new cases, which were later confirmed, for a total of 30 cases. Which of the following best describes what is being measured? a. Prevalence b. Incidence c. Attack rate d. Morbidity rate

A Prevalence is the measure of existing disease in a population at a particular time. Incidence quantifies the rate of development of new cases in a population at risk, whereas an incidence proportion indicates the proportion of the population at risk who experience the event over some period of time. Attack rate is defined as the proportion of persons who are exposed to an agent and develop the disease. Morbidity rate is the incidence of disease.

A PHN conducts an immunization clinic for measles. Which of the following is being implemented? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Immunizations are an example of primary prevention. Secondary prevention interventions are designed to increase the probability that a person with a disease will have that condition diagnosed at a stage when treatment is likely to result in cure. Tertiary prevention includes interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Health promotion is a specific primary prevention strategy.

Which is a disease that was once isolated and rare but is now widespread throughout the world? a. Acquired immunodeficiency syndrome (AIDS) b. Smallpox c. Malaria d. Measles

A Smallpox has been eradicated; malaria and measles were not isolated and rare throughout the world. AIDS was once isolated and rare, but is now worldwide.

The nurse labels a patient an alcoholic because of his ethnicity. Which of the following best describes this action by the nurse? a. Stereotyping b. Prejudice c. Racism d. Ethnocentrism

A Stereotyping is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences. Prejudice is the emotional manifestation of deeply held beliefs about a group. Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior in, for example, intelligence, morals, beauty, and self-worth. Ethnocentrism is the belief that one's own cultural group determines the standards by which another group's behavior is judged.

An intervention that focuses on the tertiary level of prevention is implemented by the nurse? Which of the following did the nurse most likely complete? a. Rehabilitative job training b. Parenting education c. Testicular self-examination d. Family counseling

A Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Rehabilitative job training would be an example of tertiary prevention. Parenting education is an example of primary prevention. Testicular self-examination and family counseling are examples of secondary prevention.

A nurse is using the Codes of Ethics developed by the International Council of Nurses and the American Nurses Association. Which of the following describes the action being taken by the nurse? a. Providing confidential genetic testing for a client b. Advocating for the inclusion of genetic content in a nursing curriculum c. Considering the pros and cons of an ethical dilemma d. Becoming competent in genomics

A The Codes of Ethics include in this mandate the right that people have to seek and receive genomic heath care that is nondiscriminatory, confidential, private, and that enables those served to make informed decisions. Being competent in genomics, considering pros and cons of ethical dilemmas, and advocating for the inclusion of genetic content in a nursing curriculum are not part of the Code of Ethics.

A nurse understands the significant impact that genetic testing can have on an individual and family. This competency is best described by which of the following organizations? a. NCHPEG b. Centers for Disease Control and Prevention (CDC) c. American Nurses Association d. International Council of Nurses

A The NCHPEG identifies one competency of health care professionals as being able to understand that health-related genetic information can have social and psychological implications for individuals and families. The CDC, American Nurses Association, and International Council of Nurses do not address any competencies specifically related to genetic testing.

Which statement about the nursing workforce is true? a. The nursing workforce is overwhelmingly white. b. The number of minority nurses meets the needs of the country's demographics. c. The nursing workforce is becoming increasingly diverse with increasing minorities. d. Refugees make up a large part of the nursing workforce in some areas.

A The nursing workforce is 83% white. Because of the large percentage of white nurses this does not meet the needs of the country's demographics. Unauthorized immigrants and refugees do not make up a part of the nursing workforce.

A Mexican American mother insists on using special candles to help her daughter's ear infection. The nurse asks the mother if she would also give her daughter antibiotics. Which of the following best describes the action of the nurse? a. Cultural accommodation b. Cultural repatterning c. Culture brokering d. Cultural awareness

A This means that the nurse supports and facilitates the use of cultural practices with interventions from the biomedical health care system. Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial. Culture brokering is advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients. Cultural awareness refers to the self-examination and in-depth exploration of one's own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups.

A large portion of foreign-born residents of the United States: a. work in service-producing and blue-collar sectors. b. reside in rural areas. c. have a high school education. d. are refugees and nonimmigrants.

A Two-thirds of the foreign-born population lives in or around major metropolitan areas and works in mainly service-producing and blue-collar sectors. They are also more likely to be poorer. The majority of foreign born are legal immigrants (85%). More than 54% of the foreign-born adults in the labor force have completed high school, which would not be considered a large portion.

According to the CDC's "Genomic competencies for the public health workforce," which of the following should all public health workers be able to do? (Select all that apply.) a. Demonstrate basic knowledge of the role that genomics play in disorders. b. Make appropriate referrals to those with more genomic experience. c. Counsel individuals about their genetic susceptibility for particular disorders. d. Recommend appropriate genetic screening tests for clients. e. Plan appropriate care for those who have positive genetic tests.

A, B The CDC's "Genomic competencies for the public health workforce" apply to all public health professionals. All public health workers should demonstrate basic knowledge and be able to make appropriate referrals. The other statements would not be true of competencies of all public health workers.

A nurse is studying the recent increase in Type I diabetes in the community. Which of the following factors should the nurse consider when examining the development of disease? (Select all that apply.) a. Genetics b. Lifestyle c. Environment d. Technology e. Communication patterns

A, B, C The knowledge of human genetics can improve the safety, quality, and effectiveness of care for clients. It is important for nurses to understand the predisposition to disease as well as the impact of behavior and social conditions on overall community health and wellbeing. Many genetic disorders have an environmental link. Technology and communication patterns do not have a strong association with the development of genetic disorders.

A nurse is planning a refugee outreach clinic at the neighborhood health center. Which of the following considerations should be made by the nurse in order to provide culturally competent care? (Select all that apply.) a. Their own background, beliefs, and knowledge may be significantly different from those of the people receiving care. b. Language barriers may interfere with efforts to provide assistance. c. Certain risk factors may be present for a given population. d. Certain groups may use nontraditional healing practices. e. Introduction of the American culture will be an important part of the encounter.

A, B, C, D When working with immigrants, it is important to be aware of one's own beliefs while realizing that language barriers may exist, that different populations experience different risk factors and illnesses, and that nontraditional healing practices may be used. It would not be appropriate to impose the American culture into the encounter.

A nurse is counseling a client who has just learned that she is a carrier of the BRCA-2 gene. Which of the following best describes potential reactions by this client? (Select all that apply.) a. Feelings of guilt b. Fear of loss of insurance coverage c. Feelings of anxiety d. Fear for children e. Feelings of insecurity

A, C, D Feelings of guilt, anxiety, and fear for future susceptibility for children are all potential reactions this client may have. The GINA protects clients from losing insurance benefits based upon genetic information. The feeling of insecurity is not a common reaction experienced from those diagnosed with a genetic disorder.

A nurse is studying the characteristics of an agent as part of the epidemiologic triangle. Which of the following is the nurse most likely studying? a. Human population distribution b. Salmonella c. Genetic susceptibility d. Climate

B An agent includes infectious organisms, such as Salmonella, chemical agents, and physical agents. Genetic susceptibility is considered to be a characteristic of a host. Human population distribution and climate are considered to be characteristics of the environment.

An epidemiologist wants to know what caused severe diarrhea and vomiting in several people at a local banquet. Which of the following principles is being applied in this situation? a. Descriptive epidemiology b. Analytic epidemiology c. Distribution d. Determinants

B Analytic epidemiology is directed toward understanding the etiology of the disease. Descriptive epidemiology seeks to describe the occurrence of a disease in terms of person, place, and time. Distribution describes who has the disease and where and when the disease occurs. Determinants are the factors, exposures, characteristics, and behaviors that determine patterns of disease, which may be individual, relational, social, communal, or environmental.

A nurse is unable to provide culturally competent care to a population within the community. Which of the following is an effect of this type of care? a. Enhanced communication b. Increased cost of health care c. Achievement of health indicators d. Improvement in client compliance

B Care that is not culturally competent may increase health care costs and decrease positive client outcomes. Communication is inhibited through care that is not culturally competent. It is not possible to achieve health indicators if culturally competent care is not given. Client compliance decreases if culturally competent care is not provided.

A nurse advocates and intervenes between the health care system and the client's cultural beliefs on behalf of the client. Which of the following best describes the nurse's action? a. Cultural accommodation b. Culture brokering c. Cultural preservation d. Cultural repatterning

B Culture brokering is advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients. Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes. Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values, so they can maintain, promote, and restore health. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

A nurse is observing behaviors that may be defined by culture. Which of the following is the nurse most likely to observe? a. Speaking a dialect of a language in a local region b. Standing when an older adult gets on the bus to give him a seat c. Immigrating to the United States and seeking work d. An organizational structure of a cultural group

B Culture is a set of beliefs, values, and assumptions about life that are widely held among a group of people and is transmitted intergenerationally. Behaviors may be culturally determined, as illustrated in the correct response. This behavior is based on the value of respect of elderly people. Speaking a particular dialect in a local area would not fit the definition of culture. An organizational structure of a group is not an observable behavior. Immigrating to the United States does not demonstrate culture.

A client shares with the nurse that her grandparents immigrated to the United States from Germany. Which of the following best describes what she has disclosed? a. Multiculturalism b. Ethnicity c. Race d. Culture

B Ethnicity represents the identifying characteristics of culture, such as race, religion, or natural origin. Multiculturalism is the blending of diverse cultures. Race is primarily a social classification that relies on physical markers. Culture is a set of beliefs, values, and assumptions about life that are widely held among a group of people and transmitted intergenerationally.

A nurse learns more about the Human Genome Project to better counsel families about the process of genetic testing. Which of the following terms best describes what the nurse is learning? a. Genetics b. Genomics c. Genes d. Genetic susceptibility

B Genomics refers to the study of individual genes to understand the structure of the genome, including the mapping of genes and sequencing the DNA. Genetics refers to the study of the function and effect of single genes that are inherited by children from their parents. Genes are the DNA segments that carry the genetic information. Genetic susceptibility is the likelihood of developing a disease based on the presence of a genetic mutation.

The father of genetics is: a. Charles Darwin. b. Gregor Mendel. c. James Watson. d. Francis Galton.

B Gregor Mendel is considered to be the father of genetics. Charles Darwin expounded on theories of evolution. Francis Galton performed family studies using twins to understand the influence of heredity on various human characteristics. James Watson was the co-discoverer of DNA.

The health priorities in HEALTH21 are based on the concept of: a. eradication of communicable disease worldwide. b. social justice and solidarity with an emphasis on the responsibility for health. c. world trade and knowledge sharing about health concerns. d. provisions for the creation of the United Nations Children's Fund (UNICEF).

B HEALTH21 is not a single, finite goal but a strategic process that can lead to progressive improvement in the health of people. In essence, it is a call for social justice and solidarity with an emphasis on individual, family, and community responsibility for health. The concepts of eradication of communicable disease worldwide, world trade and knowledge sharing about health concerns, and provisions for the creation of UNICEF are not part of these health priorities.

A nurse states that she has been reading about an epidemic that has been occurring in the world. Which of the following is she most likely referring to? 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

B It is estimated that 30% of the adults in the United States are obese. According to the Centers for Disease Control and Prevention, this is an epidemic. The other examples are not epidemics.

A nurse considers that clients may not want to have genetic testing done because of the impact that it may have on future life decisions. Which of the following best describes how the nurse is incorporating genetics/genomics into practice? a. Assessment b. Identification c. Referral d. Provision of education, care, and support

B One of the ways that a nurse uses identification is by identifying ethical, cultural, and societal issues related to genetic and genomic information and technologies. Assessment is not being performed here because the nurse is not assessing a particular client's needs or history. Referral is not taking place, nor is education, care, or support of a patient.

A nurse is investigating an outbreak of a gastrointestinal illness from a food-borne pathogen. Which of the following terms is being applied? a. Attack rate b. Point epidemic c. Secular trend d. Event-related cluster

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. Attack rate is defined as the proportion of persons who are exposed to an agent and develop the disease. Secular trends are long-term patterns of morbidity or mortality rates. Event-related clusters are patterns in which time is not measured from fixed dates on the calendar but from the point of some exposure or event, presumably experienced in common by affected persons, although not occurring at the same time.

A nurse is counseling a client whose genetic test results show a genetic susceptibility for breast cancer. Which of the following would be the most appropriate statement by the nurse? a. "You should discuss hormone replacement therapy with your physician." b. "You are at an increased risk to develop breast cancer." c. "You should have a bilateral mastectomy as soon as possible." d. "You should tell all of your siblings and children to get tested."

B Persons with a genetic susceptibility are at increased risk for developing the disease. Although the client may choose to have a bilateral mastectomy and recommend genetic testing to other family members, the most important thing to relay to the client is that having a genetic susceptibility does not mean that one will automatically have the disease.

Population health is an approach and perspective that focuses on: a. control of the spread of the HIV virus worldwide. b. the broad range of factors and conditions that influence health. c. community-based care for all citizens. d. prevention and diagnosis of disease worldwide.

B Population health is a holistic approach that considers the total health system. The focus of population health is broader than only considering spread of the HIV virus. Population health considers more than the community-based care in the community. Population health examines spread of disease on a smaller scale.

The probability an event will occur within a specified period of time is called: a. rate. b. risk. c. epidemiology. d. epidemic.

B Risk is the probability an event will occur within a specified period of time. Rate is a measure of the frequency of a health event in a defined population, usually in a specified period of time. Epidemiology is the study of the occurrence and distribution of health-related states or events in specified populations, including the study of the determinants influencing such states, and the application of this knowledge to control the health problems. Epidemic occurs when the rate of disease, injury, or other condition exceeds the usual level of that condition.

A nurse offers a screening for hearing defects at a local community center. Which of the following best describes the action of the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

B Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Screenings are part of secondary prevention interventions. Primary prevention refers to interventions aimed at preventing the occurrence of disease, injury, or disability. Tertiary prevention includes interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Health promotion is a specific primary prevention strategy.

A nurse is considering the potential for selection bias. Which of the following best describes the situation that is the nurse has encountered? 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

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. Determining the population to be studied relates to the design of the study. Studying cause and effect relationship has to do with ecological studies. Documenting the results of the study is completed at the end of the study after the participants have been selected.

A nurse is counseling a client who is considering having genetic testing completed to determine whether she is a carrier of the gene linked to Huntington's disease. Which of the following would be the first step the nurse would take when assessing this client? a. Assess vital signs b. Assess family history of this disorder c. Assess client's past medical history d. Assess current medications

B Taking a family history is a useful place to begin when considering a genetic connection prior to the onset of testing. The best way to identify whether there is a mutation in a family where a hereditary disease is suspected is to test the person who displays the most evidence of being a mutation carrier. This would take precedent over assessing vital signs, current medications, and past medical history.

The Refugee Act of 1980 had what effect on refugees who were immigrating into the United States? a. Allowed specific provisions for refugees from Southern and Eastern Europe b. Provided a uniform procedure for refugees to be admitted into the United States c. Permitted refugees to set up communities in or around major metropolitan areas d. Allowed refugees access to "green cards" that would allow them to work in the United States

B The Refugee Act of 1980 provided a uniform procedure for refugees to be admitted into the United States. Refugees were immediately eligible to receive Temporary Assistance for Needy Families, Supplemental Security Income, and Medicaid. This procedure was in effect for all refugees not just those from specific countries. It did not provide "green card" access or permit development of specific communities for refugees.

A PHN reports that she is able to demonstrate the minimum competencies set forth by the National Coalition of Health Professional Education in Genetics (NCHPEG). Which of the following describes the action that is taken by the nurse? a. Organizing a meeting to discuss the care of cystic fibrosis clients b. Making a referral to a genetics specialist c. Advocating for legislation to support stem cell research d. Educating a client about the results of genetic testing

B The minimum competencies for health care professionals set forth by NCHPEG are: be able to examine competence of practice, understand the social and psychological implications of health-related genetic information, and know how and when to make referrals to a genetics professional. Making a referral is the only example that is described in these competencies.

The most important predictor of overall mortality is: a. race. b. age. c. gender. d. income.

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. Race, gender, and income are not the most important predictor for overall mortality.

A nurse is counseling a client who is considering purchasing a genetic testing kit from a vendor advertised on the Internet. Which of the following would be the response by the nurse? a. "It is illegal to purchase genetic testing kits from Internet vendors." b. "It will be important to follow up with a health care provider after receiving your results." c. "Many times online vendors experience inaccuracies with their results." d. "Internet vendors use the latest technology to perform these tests."

B The most important aspect of genetic testing is the counseling that occurs with the testing. Purchasing genetic testing kits on the Internet makes it easy for the public to access, but leaves a health care professional out of the testing process. Meeting with a health care professional is important to counsel a client about the implications and indications for such testing. It is not illegal to purchase genetic testing kits from the Internet. The accuracy and technology used by the Internet vendor may vary depending on the vendor that is used.

A nurse states that he has incorporated epidemiology into his practice and functions in epidemiologic roles. Which of the following best describes the actions taken by the nurse? (Select all that apply.) a. Policy making b. Collection, reporting, analysis, and interpretation of data c. Environmental risk communication d. Documentation on patient charts and records e. Law enforcement

B, C, D Collection, reporting, analysis, and interpretation of data, environmental risk communication, and documentation on patient charts and records are examples of the use of epidemiology in practice. Policy making and law enforcement do not apply to epidemiology.

During the twentieth century, a nurse participated in research that examined the epidemiology of various diseases. Which of the following best describes the factors that influenced these studies? (Select all that apply.) a. Increasing rate of poverty b. Declining child mortality rates c. Overcrowding in major cities d. Development of new vaccinations e. Advancements in medical equipment

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 advancements in medical technology have not influenced the examination of the epidemiology of various diseases.

A nurse will be using an interpreter during a client encounter. Which of the following considerations should be made by the nurse? (Select all that apply.) a. It is appropriate to use family members as interpreters. b. Written materials should be available in the client's primary language. c. Observe the interpreter's gestures to assure client understanding. d. The gender, age, and educational level of the interpreter should be evaluated. e. The nurse should face the interpreter when speaking.

B, D Family members should be used with caution. The client's gestures and nonverbal messages should be observed to assure understanding. Written materials should be available in the client's primary language. The gender, age, educational level, socioeconomic status, religion, and dialect should all be considered when selecting the proper interpreter. The nurse should face the client during the dialogue, not the interpreter.

A nurse is eliciting information about a client's genetic history. Which of the following questions would be most appropriate for the nurse to ask? a. "Have any of your family members ever completed genetic testing?" b. "Do any of your family members have a genetic disorder?" c. "What medical problems have your parents and grandparents experienced?" d. "What environmental exposures have you had?"

C A client's family medical history is important to obtain in order to consider the client's potential risk for genetic diseases and disorders. The best way to obtain this information is to ask an open-ended question about past medical history of parents and grandparents. Asking about completion of genetic testing by others, familial history specific only to genetic disorders, and environmental exposures do not address the importance of obtaining a family history.

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.

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 case-control study uses a sample from the cohort rather than following the entire cohort over time. A cross-sectional study provides a snapshot of a population or group at one point in time. An experimental study is one in which the investigator initiates some treatment or intervention that may influence the risk or course of the disease.

Voters have recently decided to have fluoride added to the city water system. Epidemiologists now want to study the effect of fluoride on dental caries in this population. Which of the following would be conducted by the epidemiologists? a. Ecological study b. Double-blind study c. Community trial d. Screening

C A community trial is similar to a clinical trial, but the issue is often health promotion and disease prevention rather than treatment of existing disease. An ecological model considers the multiple factors that contribute to disease development. A double-blind study is one in which neither the subject nor the investigator knows who is receiving the treatment. A screening involves the testing of groups of individuals who are at risk for a certain condition but are not yet symptomatic.

Which is referred to as a lesser-developed country? a. France b. Japan c. Indonesia d. Sweden

C A country that is not yet stable with respect to its economy and technological development is lesser developed, which describes Indonesia. France, Japan, and Sweden are considered developed countries.

Which statement regarding mutations is true? a. Mutations in the DNA sequence occur on a regular basis. b. Mutagens are a result of a mutation. c. Environmental factors can be linked to many mutations. d. Spontaneous mutations occur because of environmental exposure.

C A large number of agents are known to cause mutations. These mutations are attributed to known environmental causes. DNA replication is very accurate, thus, mutations do not occur on a regular basis. Mutagens are the factors that cause mutations. Spontaneous mutations occur naturally during DNA replication.

A nurse is considering seeking employment in a career as a genomic nurse. Which of the following roles would be most important role of the nurse in this setting? a. Direct caregiver b. Educator c. Advocate d. Referral agent

C Although the nurse will use all of these roles when providing genomic nursing care, the most important role will be that of advocate. Nurses will increasingly provide guidance on policy discussions and ethical issues that relate to confidentiality, privacy, and commercialization. This is the nursing role of advocate.

A nurse wants to obtain information on the alternative methods of health care her 45-year-old female client uses. Who would be the best person to ask about this? a. The husband of the client b. A community leader of the ethnic group c. The client herself d. The religious leader of the ethnic group

C Clients provide a rich source of information about their own cultures. The client would be the preferred person to collect this information instead of the husband, community leader, or religious leader.

The tendency to ignore all differences between cultures and to act as though the differences do not exist is defined as: a. cultural conflict. b. culture shock. c. cultural blindness. d. cultural imposition.

C Cultural blindness occurs when people state that everyone is treated the same, regardless of their cultural orientation. Cultural conflict is a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual's cultural practice because of unfamiliarity with the practice. Culture shock is the feeling of helplessness, discomfort, and disorientation experienced by an individual attempting to understand or effectively adapt to a cultural group whose beliefs and values are radically different from the individual's culture. Cultural imposition is the act of imposing one's cultural beliefs, values, and practices on individuals from another country.

A nurse demonstrates cultural desire to provide culturally competent care. Which of the following actions would be taken by the nurse? a. Relying on a textbook for information about an ethnic group b. Bringing a translator to the local community clinic c. Taking Spanish classes in the evening at a local college d. Judging others using his or her own cultural values

C Cultural desire refers to the nurse's intrinsic motivation to want to engage in the elements necessary to provide culturally competent care. The activity that suits the definition of cultural desire is one that a nurse would want to do instead of being directed to do so, referring to the intrinsic motivation of the nurse. Relying on a textbook for information, bringing a translator, and judging others do not demonstrate the definition of cultural desire as they are not demonstrating the intrinsic motivation of the nurse.

A nurse supports the use of traditional home remedies in conjunction with Western medicine to promote healthy behaviors. Which of the following is being demonstrated by the nurse? a. Cultural accommodation b. Cultural awareness c. Cultural preservation d. Cultural repatterning

C Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values, so they can maintain, promote, and restore health. Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes. Cultural awareness refers to the self-examination and in-depth exploration of one's own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

A nurse resigns from a position in a hospital to accept a job in a community setting. After starting the new job, the nurse feels helpless and confused, wondering if this was the right career choice. Which of the following terms best describes how the nurse is feeling? a. Cultural conflict b. Cultural relativism c. Culture shock d. Culture brokering

C Culture shock can happen to individuals within their own culture when they are having experiences such as starting a new job or career. Culture shock is brought on by anxiety from losing familiar signs and symbols of social interaction. Feelings associated with culture shock are helplessness, discomfort, and disorientation. Cultural conflict is a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual's cultural practice because of unfamiliarity with the practice. Cultural relativism recognizes that clients have different approaches to health, and that each culture should be judged on its own merit and not on the nurse's personal beliefs. Culture brokering is advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients.

Which of the following statements about race is true? a. In the United States, children of biracial parents are usually assigned the race of the father. b. Ethnicity and race are synonymous terms. c. Individuals may be of the same race but of different cultures. d. No social significance is usually placed on race.

C It is often a misconception that persons of the same race have the same culture. For example, African Americans may have been born in Africa, the Caribbean, North America, or elsewhere and have very different cultures. In the United States, children of biracial parents are usually assigned the race of the mother. Ethnicity is a contrasting term to race. Race is a characteristic that allows for some groups to be separated, treated as superior, and given access to power and other valued resources, while others are treated as inferior and have limited access to power and resources.

A nurse is working with colonias. Which of the following considerations should be made by the nurse? a. They have developed roads, transportation, and electrical services. b. They are frequently driven off, only to return to the same area. c. Their settlements have led to an increase in several disease conditions. d. Their contributions have improved the local economy.

C Many immigrants have settled on unincorporated land, known as colonias, outside the major metropolitan areas in California, Arizona, New Mexico, and Texas. These colonies may not have developed roads, transportation, water, or electrical services. Conditions in these settlements have led to an increase in disease conditions such as amebiasis, respiratory, and diarrheal diseases. Environmental health hazards in the colonias are associated with poverty, poor sanitation, and overcrowded conditions.

A nurse who is studying chronic disease considers the multifactorial etiology of illness. 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.

C Multifactorial etiology implies a focus on combinations and levels of factors. There are many factors to consider other than only genetics or single organisms with multifactorial etiologies. The focus of studying multifactorial etiology is on chronic disease.

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.

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. Sensitivity quantifies how accurately the test identifies those with the condition or trait. Specificity indicates how accurately the test identifies those without the condition or trait. Negative predictive value is the proportion of persons with a negative test who are actually disease free.

A PHN implements a primary prevention intervention in the community. Which of the following is most likely being implemented? a. Pap smear b. Blood pressure screening c. Diet and exercise d. Physical therapy

C Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Blood pressure screening and pap smears are secondary prevention interventions. Physical therapy is a tertiary prevention intervention.

A nurse implements nursing interventions considering the uniqueness of the person's culture. Which of the following best describes this action? a. Cultural diversity b. Cultural knowledge c. Cultural competence d. Cultural awareness

C Providing care based on the uniqueness of the client's cultural norms and values is one of the three guiding principles of culturally competent nursing care. Cultural diversity refers to the degrees of variation represented among populations based on lifestyle, ethnicity, race, interest, across place, and place of origin across time. Cultural knowledge refers to the process of searching for and obtaining a sound educational understanding about culturally diverse groups. Cultural awareness refers to the self- examination and in-depth exploration of one's own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups.

A nurse is working with a population that exhibits a large amount of diversity. The nurse recognizes that skin color of individuals within this population is an example of: a. multiculturalism. b. ethnicity. c. race. d. culture.

C Race is primarily a social classification that relies on physical markers. Multiculturalism is the blending of diverse cultures. Ethnicity is the shared feeling of peoplehood among a group of individuals and relates to cultural factors, such as nationality, geographic region, culture, ancestry, language, beliefs, and traditions. Culture is a set of beliefs, values, and assumptions about life that are widely held among a group of people and transmitted intergenerationally.

A city council discusses how former city laws promoted segregation in the community years ago. Which of the following was being demonstrated when segregation occurred? a. Prejudice b. Cultural imposition c. Racism d. Stereotyping

C Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior in, for example, intelligence, morals, beauty, and self-worth. Prejudice is the emotional manifestation of deeply held beliefs about a group. Cultural imposition is the act of imposing one's cultural beliefs, values, and practices on individuals from another country. Stereotyping is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences.

A 35-year-old man from Russia comes to the United States seeking asylum because of religious persecution in his native country. Which of the following best describes this type of immigrant? a. Legal immigrant b. Lawful permanent resident c. Refugee d. Unauthorized immigrant

C Refugees are people who seek protection in the United States because of fear of persecution in their homeland. Legal immigrants are people who are not citizens but are legally allowed to live and work in United States, usually because they fulfill labor demands or have family ties. Lawful permanent resident is another name for legal immigrants. Unauthorized immigrants may have crossed a border into the United States illegally, or their legal permission to stay in the United States may have expired.

Hispanics tend to believe that the needs of the family take priority over those of the individual. Which of the following types of cultural variations is being demonstrated? a. Communication b. Personal space c. Social organization d. Environmental control

C Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions. Communication is the means by which culture is shared (verbal and nonverbal). Personal space is the physical distance between two individuals during an interaction. Environmental control refers to the person's relationship with nature and to plan and direct factors in the environment that affect them.

A nurse is told that a screening test has high specificity. Which of the following is the best interpretation of this information? a. The test provides precise and consistent readings. b. The test accurately identifies those with the condition or trait. c. The test accurately identifies those without the trait. d. The test has a high level of false positives.

C Specificity refers to the test accurately identifying those without the trait. High specificity is needed when rescreening is impractical and when reduction of false positives is important. The test would have a low level of false positives.

A nurse refers a client with a neuromuscular disease to a vocational rehabilitation program. Which of the following best describes the action of the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

C Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Referral of a client with a disease is an example of tertiary prevention. Primary prevention refers to interventions aimed at preventing the occurrence of disease, injury, or disability. Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Health promotion is a specific primary prevention strategy.

One of the main goals of the Human Genome Project was: a. providing physicians with a national database for information related to genetic disorders. b. developing new medications that can be used in genetics research. c. addressing ethical, legal, and social issues related to this research. d. improving the ability to accurately test for genetic disorders.

C The goals of the Human Genome Project were to determine the sequences of the base pairs in human DNA; improve tools for data analysis; transfer related technologies to the private sector; and address the ethical, legal, and social issues that may arise. The Human Genome Project did not provide physicians with a national database of information for genetic disorders, develop new medications related to genetics research, or improve the ability to accurately test for genetic disorders.

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.

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. The epidemiologic triangle consists of the interaction between an agent, a host, and the environment. The web of causality reflects the more complex interrelationship among the numerous factors interacting, sometimes in subtle ways, to increase (or decrease) risk of disease. The surveillance process involves the systematic collection, analysis, and interpretation of data related to the occurrence of disease and the health status of a given population.

A nurse is assisting a family in compiling a family health history. Which of the following statements would be most appropriate for the nurse to make? a. "When you have completed this history, it will not need to be updated." b. "Looking back at two generations of biological relatives will be sufficient." c. "The purpose of completing a family history is to decrease genetic susceptibility." d. "A family history is a useful tool when considering your future health risks."

D A family history is a useful tool to help families know about their health risks and prevent disease in themselves and their close relatives. It is recommended that families develop a three generation history and update it on a regular basis. Completion of a family history will not decrease genetic susceptibility; rather it will make families more aware of what that susceptibility may be.

A public health nurse (PHN) reports an attack rate. Which of the following has most likely been reported? a. Number of cases of cancer recorded at a medical center b. Number of people who died of Ebola 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

D Attack rates are often specific to exposures, such as food-specific attack rates. The number of cases of cancer, exposure to Ebola, and beef cattle are not significant without knowing the total number of people so that a proportion can be calculated.

While collecting a medical history, a client reports having a family history positive for Huntington's disease. However, the client states he does not want to have genetic testing performed. Which of the following best describes why the client may refuse genetic testing? a. Impact it may have on obtaining health insurance in the future b. Legal consequences that may result c. Inaccuracy of the results that are obtained d. Decreased quality of life that may occur if the results are positive

D Barriers to genetic testing are: some individuals do not have an insurance carrier that reimburses for genetic testing, a high-deductible insurance policy, and feelings that testing may decrease the quality of life and increase anxiety for the future if the results were positive. Others may also feel guilty about passing along a disease to children and grandchildren. Health insurance cannot be denied to individuals because of genetic testing results. There are no legal implications for genetic testing. There is not a high inaccuracy of results that are obtained through genetic testing.

A nurse has experienced a cultural encounter. Which of the following best describes what has happened? a. Sharing significant assessment findings with members of a racial minority b. Visiting the native land of the clients served at a community health center c. Telephoning the priest at a Hispanic church to discuss the health issues of a client d. Learning about traditional healing practices from an American Indian client

D Cultural encounter refers to the process that permits nurses to seek opportunities to directly engage in cross-cultural interactions with clients of diverse cultures to modify existing beliefs about a specific cultural group and possibly avoid stereotyping. Learning about traditional healing practices is an example of a direct cultural encounter. This occurs when a nurse engages in cross-cultural interactions. Sharing significant assessment findings demonstrates the nurse sharing information, not an engagement with the population. When visiting a native land, there may not be interaction with any other culture. Telephoning a priest at a Hispanic church does not demonstrate an interaction, but rather the nurse calling the priest to accomplish a nursing task.

A nurse is examining the income levels and social networks of individuals in a community. Which of the following is the nurse investigating? a. Culture b. Development c. Community d. Determinants

D Determinants are conditions and factors that are important considerations in population health. Culture refers to the beliefs and customs of a certain group. Development refers to something that is being created. Community is a group of people living in the same geographic location.

The factors, exposures, characteristics, and behaviors that determine patterns of disease are described using: a. descriptive epidemiology. b. analytic epidemiology. c. distribution. d. determinants.

D Determinants are the factors, exposures, characteristics, and behaviors that determine patterns of disease, which may be individual, relational, social, communal, or environmental. Descriptive epidemiology seeks to describe the occurrence of a disease in terms of person, place, and time. Analytic epidemiology focuses on the investigation of causes and associations. Distribution describes who has the disease and where and when the disease occurs.

A nurse is caring for a client who has been diagnosed with a multifactorial disease. Which of the following best describes the client's diagnosis? a. Measles b. Hepatitis B c. Eczema d. Type I diabetes

D Disorders that are influenced by multiple factors including genetics/genomics, environment, lifestyle, and other factors are considered to be multifactorial. Type I diabetes is considered to be a multifactorial disease. The others are not multifactorial diseases.

Asians may perceive illness as disharmony with other forces and that medicine is only able to relieve the symptoms rather than cure the disease. They may look to naturalistic solutions and acupuncture to resolve or cure health problems. Which of the following types of cultural variations is being demonstrated? a. Communication b. Personal space c. Social organization d. Environmental control

D Environmental control refers to the ability of individuals to control nature and to influence factors in the environment that affect them. Communication is the means by which culture is shared (verbal and nonverbal). Personal space is the physical distance between two individuals during an interaction. Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions.

To understand the causes of health and disease, epidemiology studies: a. individuals. b. families. c. groups. d. populations.

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. Epidemiology does not focus on individuals, families, and groups.

A nurse is investigating a serious epidemic of influenza. Which of the following best describes the amount of cases that are being examined? a. 50 cases b. 100 cases c. 500 cases d. Unable to determine

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

In the Vietnamese culture, individuals may focus on wishes and memories of their ancestors and look to them to provide direction for current situations. Which of the following types of cultural variations is being demonstrated? a. Communication b. Personal space c. Social organization d. Perception of time

D Perception of time is the duration or period between successive events, where some cultures assign greater or lesser emphasis to events that occur in the past, present, or future. Communication is the means by which culture is shared (verbal and nonverbal). Personal space is the physical distance between two individuals during an interaction. Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions

A nurse implements a program that focuses on secondary prevention. Which of the following is most likely the topic of this program? a. Rehabilitation b. Avoidance of high-risk behaviors c. Immunization d. Mammogram

D Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Mammograms are a screening test. Avoidance of high-risk behaviors and immunizations are examples of primary prevention. Rehabilitation is an example of tertiary prevention.

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.

D The epidemiologic triangle consists of the interaction between an agent, a host, and the environment. The natural history of disease is the course of the disease process from onset to resolution. Risk is the probability an event will occur within a specified period of time. The web of causality reflects the more complex interrelationship among the numerous factors interacting, sometimes in subtle ways, to increase (or decrease) risk of disease.

The key to achieving the goals of Health for All in the 21st Century (HEALTH21) is the worldwide: a. cure of communicable disease. b. technological development of all nations. c. availability of health care insurance. d. implementation of primary health care.

D The major key to attaining Health for All by the Year 2000 was the worldwide implementation of primary health care; this has extended into the next century with the document HEALTH21. The World Health Assembly in 1977 stated that all citizens of the world should enjoy a level of health that would permit them to lead a socially and economically productive life. Curing communicable disease, technological developments of all nations, and availability of health care insurance are not part of the key strategies to achieve the goals of HEALTH21.

A public health nurse (PHN) is implementing the objectives related to genetics from Healthy People 2020. Which of the following best describes the action that is being taken by the nurse? a. Educating clients that multiple factors influence the development of disease b. Counseling clients about the results of genetic testing c. Lobbying for legislation to support genetic research d. Providing screening and genetic testing for specific groups of individuals

D The objectives of Healthy People 2020 related to genetics suggest that screening and genetic testing for specific groups still remain the standard of practice while other routine screenings or tests are questioned for their impact on morbidity and mortality. Healthy People 2020 objectives do not address client education, client counseling, or legislation for genetics.

A client comes into the clinic and tells the nurse he goes to an acupuncturist for pain. The nurse says he should take pain medication instead. Which of the following best describes the action taken by the nurse? a. Cultural conflict b. Cultural blindness c. Cultural relativism d. Cultural imposition

D This is an example of cultural imposition—the act of imposing one's cultural beliefs, values, and practices on individuals from another culture. Cultural conflict is a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual's cultural practice because of unfamiliarity with the practice. Cultural blindness occurs when people state that everyone is treated the same, regardless of their cultural orientation. Cultural relativism recognizes that clients have different approaches to health, and that each culture should be judged on its own merit and not on the nurse's personal beliefs.