Community Health Exam 3
A reservoir of an infectious agent can be: A. An asymptomatic human B. A symptomatic human C. An animal D. The environment
A, B, C, D. A reservoir of an infectious agent is the habitat in which an agent normally lives, grows, and multiplies, which may include humans, animals, and the environment.
For the cruise ship scenario described in Question 7, if you suspected that the norovirus may have been transmitted by ice made or served aboard ship, how might you display "place"? A. Spot map by assigned dinner seating location B. Spot map by cabin C. Shaded map of United States by state of residence D. Shaded map by whether passenger consumed ship's ice or not
A, B, C. "Place" includes location of actual or suspected exposure as well as location of residence, work, school, and the like.
In the definition of epidemiology, "distribution" refers to: A. Who B. When C. Where D. Why
A, B, C. In the definition of epidemiology, "distribution" refers to descriptive epidemiology, while "determinants" refers to analytic epidemiology. So "distribution" covers time (when), place (where), and person (who), whereas "determinants" covers causes, risk factors, modes of transmission (why and how).
Disease control measures are generally directed at which of the following? A. Eliminating the reservoir B. Eliminating the vector C. Eliminating the host D. Interrupting mode of transmission E. Reducing host susceptibility
A, B, D, E. Disease control measures are generally directed at eliminating the reservoir or vector, interrupting transmission, or protecting (but not eliminating!) the host.
In the definition of epidemiology, "determinants" generally includes: A. Agents B. Causes C. Control measures D. Risk factors E. Sources
A, B, D, E. In the definition of epidemiology, "determinants" generally includes the causes (including agents), risk factors (including exposure to sources), and modes of transmission, but does not include the resulting public health action.
John Snow's investigation of cholera is considered a model for epidemiologic field investigations because it included a: A. Biologically plausible hypothesis B. Comparison of a health outcome among exposed and unexposed groups C. Multivariate statistical model D. Spot map E. Recommendation for public health action
A, B, D, E. John Snow's investigation of cholera is considered a model for epidemiologic field investigations because it included a biologically plausible (but not popular at the time) hypothesis that cholera was water-borne, a spot map, a comparison of a health outcome (death) among exposed and unexposed groups, and a recommendation for public health action. Snow's elegant work predated multivariate analysis by 100 years.
A key feature of a cross-sectional study is that: A. It usually provides information on prevalence rather than incidence B. It is limited to health exposures and behaviors rather than health outcomes C. It is more useful for descriptive epidemiology than it is for analytic epidemiology D. It is synonymous with survey
A, C, D. A cross-sectional study or survey provides a snapshot of the health of a population, so it assesses prevalence rather than incidence. As a result, it is not as useful as a cohort or case-control study for analytic epidemiology. However, a cross-sectional study can easily measure prevalence of exposures and outcomes.
Epidemiology, as defined in this lesson, would include which of the following activities? A. Describing the demographic characteristics of persons with acute aflatoxin poisoning in District A B. Prescribing an antibiotic to treat a patient with community-acquired methicillin-resistantStaphylococcus aureus infection C. Comparing the family history, amount of exercise, and eating habits of those with and without newly diagnosed diabetes D. Recommending that a restaurant be closed after implicating it as the source of a hepatitis A outbreak
A, C, D. Epidemiology includes assessment of the distribution (including describing demographic characteristics of an affected population), determinants (including a study of possible risk factors), and the application to control health problems (such as closing a restaurant). It does not generally include the actual treatment of individuals, which is the responsibility of health-care providers.
Which variables might you include in characterizing the outbreak described in Question 7 by person? A. Age of passenger B. Detailed food history (what person ate) while aboard ship C. Status as passenger or crew D. Symptoms
A, C. "Person" refers to demographic characteristics. It generally does not include clinical features characteristics or exposures.
Provisions of the Patient Protection and Affordable Care act include: (Select all that apply.) A. mandating that all citizens obtain health insurance. B. reducing Medicaid eligibility. C. subsidizing insurance premiums for all citizens. D. prohibiting denial of coverage for preexisting conditions. E. establishing health insurance exchanges.
A, D, E. The Patient Protection and Affordable Care Act provisions include mandating that all citizens obtain health insurance, expanding Medicaid eligibility, subsidizing insurance premiums for low income purchasers, prohibiting denial of coverage for preexisting conditions, and establishing health insurance exchanges.
A specific case definition is one that: A. Is likely to include only (or mostly) true cases B. Is considered "loose" or "broad" C. Will include more cases than a sensitive case definition D. May exclude mild cases
A, D. A specific or tight case definition is one that is likely to include only (or mostly) true cases, but at the expense of excluding milder or atypical cases.
A study in which children are randomly assigned to receive either a newly formulated vaccine or the currently available vaccine, and are followed to monitor for side effects and effectiveness of each vaccine, is an example of which type of study? A. Experimental B. Observational C. Cohort D. Case-control E. Clinical trial
A, E. A study in which subjects are randomized into two intervention groups and monitored to identify health outcomes is a clinical trial, which is type of experimental study. It is not a cohort study, because that term is limited to observational studies.
A number of passengers on a cruise ship from Puerto Rico to the Panama Canal have recently developed a gastrointestinal illness compatible with norovirus (formerly called Norwalk-like virus). Testing for norovirus is not readily available in any nearby island, and the test takes several days even where available. Assuming you are the epidemiologist called on to board the ship and investigate this possible outbreak, your case definition should include, at a minimum: (Choose one best answer) A. Clinical criteria, plus specification of time, place, and person B. Clinical features, plus the exposure(s) you most suspect C. Suspect cases D. The nationally agreed standard case definition for disease reporting
A. A case definition for a field investigation should include clinical criteria, plus specification of time, place, and person. The case definition should be independent of the exposure you wish to evaluate. Depending on the availability of laboratory confirmation, certainty of diagnosis, and other factors, a case definition may or may not be developed for suspect cases. The nationally agreed standard case definition for disease reporting is usually quite specific, and usually does not include suspect or possible cases.
Which term best describes the pattern of occurrence of the three diseases noted below in a single area? A. Endemic B. Outbreak C. Pandemic D. Sporadic ____ Disease 1: usually 40-50 cases per week; last week, 48 cases ____ Disease 2: fewer than 10 cases per year; last week, 1 case ____ Disease 3: usually no more than 2-4 cases per week; last week, 13 cases
A. Disease 1: usually 40-50 cases per week; last week, 48 cases D. Disease 2: fewer than 10 cases per year; last week, 1 case B. Disease 3: usually no more than 2-4 cases per week; last week, 13 cases
Through epidemiologic investigations, effective prevention measures are often identified. When the nurse is engaged in providing prevention for the community before disease has developed, the prevention activities meet the definition for what level of prevention? A. Primary B. Secondary C. Tertiary D. Pathogenic
A. Primary prevention occurs when intervention activities take place before disease development. Immunization is an example of primary prevention that provides specific protection. Secondary prevention occurs after pathogenesis, namely screening and physical examinations that are aimed at early diagnosis. Tertiary prevention focuses on rehabilitation and limitation of disability. Pathogenic does not describe a type of prevention.
The percentage of deaths resulting from a specific cause provides the nurse with information about areas in which public health programs might make significant contributions in reducing deaths. Select the statistic often used for this purpose. A. Proportionate mortality rate B. Crude death rate C. Age-adjusted death rate D. Standardized mortality rate
A. Proportionate mortality rate is calculated using the number of deaths resulting from a specific cause in a specific time period as the numerator and the total number of deaths in the same time period as the denominator. In crude death rates, the numerator is the number of deaths, and the denominator is the average population size or the population size at midyear multiplied by a constant. Age adjustment or standardization reduces bias when there is a difference between the age distributions of two populations.
The epidemiologic triad of disease causation refers to: (Choose one best answer) A. Agent, host, environment B. Time, place, person C. Source, mode of transmission, susceptible host D. John Snow, Robert Koch, Kenneth Rothman
A. The epidemiologic triad of disease causation refers to agent-host-environment.
The hallmark feature of an analytic epidemiologic study is: (Choose one best answer) A. Use of an appropriate comparison group B. Laboratory confirmation of the diagnosis C. Publication in a peer-reviewed journal D. Statistical analysis using logistic regression
A. The hallmark feature of an analytic epidemiologic study is use of an appropriate comparison group.
A cohort study differs from a case-control study in that: A. Subjects are enrolled or categorized on the basis of their exposure status in a cohort study but not in a case-control study B. Subjects are asked about their exposure status in a cohort study but not in a case-control study C. Cohort studies require many years to conduct, but case-control studies do not D. Cohort studies are conducted to investigate chronic diseases, case-control studies are used for infectious diseases
A. The key difference between a cohort and case-control study is that, in a cohort study, subjects are enrolled on the basis of their exposure, whereas in a case-control study subjects are enrolled on the basis of whether they have the disease of interest or not. Both types of studies assess exposure and disease status. While some cohort studies have been conducted over several years, others, particularly those that are outbreak-related, have been conducted in days. Either type of study can be used to study a wide array of health problems, including infectious and non-infectious.
Early public health nurse Lillian Wald and her associates were successful in addressing health and disease in the immigrant community by: A. supporting political activities to improve social and environmental conditions of immigrant families. B. administering bedside nursing care to immigrants and their families. C. teaching the immigrant family members to provide health care in the home. D. obtaining and administering medications to the immigrants and their family members.
AThese early public health nurses saw that neither administering bedside clinical nursing, including obtaining and administering medication, nor teaching family members to deliver care in the home adequately addressed the true determinants of health and disease. They resolved that collective political activity should focus on advancing the health of aggregates and improving social and environmental conditions by addressing the social and environmental determinants of health. Wald and her colleagues (1971) impacted the health of the community by organizing the community, establishing school nursing, and taking impoverished mothers to testify in Washington, DC.
Analytic epidemiology differs from descriptive epidemiology because it searches for: A. "when" of disease patterns. B. "where" of disease patterns. C. "why" of disease patterns. D. "who" of disease patterns.
Answer: "why" of disease patterns.Rationale: Descriptive epidemiology describes the distribution of disease, death, and other health outcomes in the population according to person, place, and time—the who, where, and when of disease patterns. Analytic epidemiology, on the other hand, searches for the determinants of the patterns observed—the how and why of disease patterns.
Nurses in community health often use epidemiology because in the community it is often difficult to control the environment. Which of the following statements demonstrates an epidemiologic strategy for monitoring disease trends? A. A nurse in community health conducts an education class for clients newly diagnosed with diabetes. B. A nurse in community health investigates a breakout of whooping cough in a local middle school. C. A nurse in community health organizes a health fair at the community health center. D. A nurse in community health participates on a county school board that addresses student health issues.
Answer: A nurse in community health investigates a breakout of whooping cough in a local middle school.Rationale: Nurses are a key part of the interdisciplinary team in community settings and often use epidemiology to look at health and at disease causation and how to both prevent and treat illness. Nurses use epidemiology in the community to examine factors that affect the individual, family, and population group because it is more difficult to control these factors in the community than in the hospital. Community health nurses who conduct education classes, organize health fairs and address student health issues are using prevention strategies.
A breast cancer screening program screened 8000 women and discovered 35 women previously diagnosed with breast cancer and 20 women with no history of breast cancer diagnosed as a result of the screening. The prevalence proportion would reflect: A. current and past breast cancer events in this population of women. B. newly diagnosed cases of breast cancer in this population of women. C. past breast cancer events in this population of women. D. the population of women that had no evidence of breast cancer.
Answer: current and past breast cancer events in this population of women.Rationale: The prevalence proportion is a measure of existing disease in a population at a particular time (i.e., the number of existing cases divided by the current population). A prevalence proportion is not an estimate of the risk of developing disease, because it is a function of both the rate at which new cases of the disease develop and how long those cases remain in the population. In this example, the prevalence of breast cancer in this population of women is a function of how many new cases develop and how long women live after the diagnosis of breast cancer.
A business executive develops symptoms of the flu 1 day after returning by air from a cross-Atlantic business trip that ran for 2 consecutive stressful 10-hour days. This individual's development of flu symptoms illustrates the relationship between: A. host and agent. B. host, agent, and environment. C. risk and causality. D. morbidity and disease.
Answer: host, agent, and environment.Rationale: Epidemiologists understand that disease results from complex relationships among causal agents, susceptible persons, and environmental factors. These three elements—agent, host, and environment—are called the epidemiologic triangle. Changes in one of the elements of the triangle can influence the occurrence of disease by decreasing or increasing a person's risk for disease. The associations between risk and causality, morbidity and disease do not demonstrate the relationship to the development of flu.
Clinical medicine and epidemiology differ from each other in the major aspect of: A. practice focus. B. health monitoring. C. determinants of health and disease. D. evaluation of interventions.
Answer: practice focus.Rationale: Epidemiology is the study of populations to monitor the health of the population, understand the determinants of health and disease in communities, and investigate and evaluate interventions to prevent disease and maintain health. Epidemiology focuses on populations, whereas clinical medicine focuses on the diagnosis and treatment of disease in individuals. Epidemiology studies populations to determine the causes of health and disease in communities and to investigate and evaluate interventions that will prevent disease and maintain health. Epidemiologic methods are used extensively to determine to what extent the goals of Healthy People 2020 (U.S. Department of Health and Human Services, 2010) have been met and to monitor the progress of those objectives not fully met at present.
One of the basic concepts in epidemiology is the concept of risk. Risk refers to the: A. prevalence of an event occurring. B. probability that an event will occur within a specified time period. C. population most likely to develop a disease. D. rate of development of new cases.
Answer: probability that an event will occur within a specified time period.Rationale: Risk refers to the probability that an event will occur within a specified time period. A population at risk is the population of persons for whom there is some finite probability (even if small) of that event occurring. Incidence rates and proportions measure the rate of new case development in a population and provide an estimate of the risk of disease.
A nurse in community health who teaches a client with asthma to recognize and avoid exposure to asthma triggers and assists the family in implementing specific protection strategies such as removing carpets and avoiding pets is intervening at the level of: A. assessment. B. primary prevention. C. secondary prevention. D. tertiary prevention.
Answer: secondary prevention.Rationale: Primary prevention refers to interventions that promote health and prevent the occurrence of disease, injury, or disability. Interventions at this level are aimed at individuals and groups who are susceptible to disease but have no discernable pathology (state of prepathogenesis). In this case, the client has already has asthma, so the nurse teaches the client to recognize and avoid exposure to asthma triggers. This is an example of secondary prevention. Health screenings are at the core of secondary prevention. Tertiary prevention includes interventions aimed at limiting disability and interventions that enhance rehabilitation from disease, injury, or disability. Assessment is a component of epidemiology.
A nurse is concerned about the accuracy of the PPD test in identifying cases of TB exposure for follow-up chest x-ray. The nurse's concern is addressing the validity measure of: A. reliability. B. sensitivity. C. specificity. D. variation.
Answer: sensitivity.Rationale: Validity of a screening test is measured by sensitivity and specificity. Sensitivity quantifies how accurately the test identifies those with the condition or trait. Sensitivity represents the proportion of persons with the disease whom the test correctly identifies as positive (true positives). High sensitivity is needed when early treatment is important and when identification of every case is important. Reliability is the consistency of repeating a measure and is affected by variation in results. Specificity indicates how accurately the test identifies those without the condition or trait.
Which of the following tools are used in analytic epidemiology? (Select all that apply.) A. cohort study B. case-control study C. cross-sectional study D. clinical trials E. community trials
Answer:cohort studycase-control studycross-sectional studyRationale: Analytic epidemiology deals with the factors that influence the observed patterns of health and disease and increase or decrease the risk of adverse outcomes. Analytic study designs include cohort studies, case-control studies, and cross-sectional studies. In experimental or intervention studies, the investigator initiates a treatment or intervention to influence the risk or course of disease. These studies test whether interventions can prevent disease or improve health. Clinical trials and community trials are examples of experimental studies.
Lillian Wald and Mary Brewster's Henry Street Settlement was a model of modern health care. Which of the following services was provided to people living in the Lower East Side of New York City by the Henry Street Settlement nurses? (Select all that apply.) A. Emergency care and first aid B. Home visits to ill mothers and children C. School health services D. Industrial health services to local workersE. Support programs for immigrants
B, C, D, EThe Henry Street Settlement was a model comprehensive health care center that provided many services, including home visits to mothers and children, support services for immigrants, the first school health and industrial health programs, and many other services. Emergency care and first aid were not provided services.
Indirect transmission includes which of the following? A. Droplet spread B. Mosquito-borne C. Foodborne D. Doorknobs or toilet seats
B, C, D. Indirect transmission refers to the transmission of an infectious agent by suspended airborne particles, inanimate objects (vehicles, food, water) or living intermediaries (vectors such as mosquitoes). Droplet spread is generally considered short-distance direct transmission.
Public health surveillance includes which of the following activities: A. Diagnosing whether a case of encephalitis is actually due to West Nile virus infection B. Soliciting case reports of persons with symptoms compatible with SARs from local hospitals C. Creating graphs of the number of dog bites by week and neighborhood D. Writing a report on trends in seat belt use to share with the state legislature E. Disseminating educational materials about ways people can reduce their risk of Lyme disease
B, C, D. Public health surveillance includes collection (B), analysis (C), and dissemination (D) of public health information to help guide public health decision making and action, but it does not include individual clinical diagnosis, nor does it include the actual public health actions that are developed based on the information.
The Iowa Women's Health Study, in which researchers enrolled 41,837 women in 1986 and collected exposure and lifestyle information to assess the relationship between these factors and subsequent occurrence of cancer, is an example of which type(s) of study? A. Experimental B. Observational C. Cohort D. Case-control E. Clinical trial
B, C. A study that assesses (but does not dictate) exposure and follows to document subsequent occurrence of disease is an observational cohort study.
British investigators conducted a study to compare measles-mumps-rubella (MMR) vaccine history among 1,294 children with pervasive development disorder (e.g., autism and Asperger's syndrome) and 4,469 children without such disorders. (They found no association.) This is an example of which type(s) of study? A. Experimental B. Observational C. Cohort D. Case-control E. Clinical trial
B, D. A study in which subjects are enrolled on the basis of having or not having a health outcome is an observational case-control study.
A risk factor refers to a(n): A. probability that a specific event will occur in a given time frame. B. exposure that is associated with a disease. C. systematic way of distinguishing the risks posed by potentially harmful exposures. D. proactive process in which individuals participate in behaviors that enable them to react to actual or potential threats to their health.
B. A risk factor is an exposure that is associated with incidence of a disease. Risk is the probability that a specific event will occur in a given time frame. A risk assessment is a systematic way of distinguishing the risks posed by potentially harmful exposures. A risk reduction is a proactive process in which individuals participate in behaviors that enable them to react to actual or potential threats to their health.
For the cruise ship scenario described in Question 7, how would you display the time course of the outbreak? (Choose one best answer) A. Endemic curve B. Epidemic curve C. Seasonal trend D. Secular trend
B. An epidemic curve, with date or time of onset on its x-axis and number of cases on the y-axis, is the classic graph for displaying the time course of an epidemic.
A community nurse is reviewing health statistics to gain a better understanding of a population's health needs. Crude rates are available for several health occurrences. What statement accurately describes crude rates? A. In calculating a crude rate, the numerator is the size of the population at risk. B. In calculating a crude rate, the average population size may be used as denominator. C. The denominator in a crude rate represents the population at risk for the event. D. Crude rates are used frequently because they avoid bias in interpretation.
B. Crude rates are calculated by using the number of events as the numerator. The denominator used may be the average population size or the population size at midyear and not the population at risk. Crude rates are subject to certain biases in interpretation.
Receiving immunizations, regular health screenings, and physical exams is an example of: A. health promotion. B. health protection. C. secondary prevention. D. health maintenance.
B. Health protection refers to behaviors in which the individual engages with the intent to prevent disease, detect disease in early stages, or maximize health. Immunizations and physical examinations are examples. Secondary prevention refers to early detection and prompt intervention during the period of early disease pathogenesis, such as checking the skin for signs of skin cancer or identifying and treating individuals who have been exposed to contagious diseases. Health maintenance occurs when the individual has changed overt behavior for more than 6 months and strives to prevent relapse.
Epidemiologic data can be useful in the planning phase of the community assessment process because they: A. help discover the patterns of health and illness distribution in a population. B. help construct benchmarks to gauge achievement of program objectives. C. identify the aggregate at risk. D. explain the nature of the health problem.
B. Inherent in the planning phase of the nursing process is a plan for the intervention and its evaluation. Epidemiologic data can be useful as a basis for determining success. By comparing baseline data, national and local data, and other relevant indicators, the nurse can construct benchmarks to gauge achievement of program objectives. The other options are useful in the assessment phase of the nursing process.
The nurse working in the community is aware that there are different models for studying the epidemiology of a health condition in a population. One model of investigation of the interrelationships and characteristics of disease is the epidemiologic triangle. This model analyzes what three elements? A. Incidence, prevalence, and etiology B. Agent, host, and environment C. Person, place, and time D. Virus, bacteria, and fungus
B. The epidemiologic triangle considers the extent of the host's exposure to the agent, the virulence of the agent, and the host's genetic or immunologic susceptibility to the agent. Environmental conditions at the time of exposure are also considered. Examination of these three elements allows assessment of the problem, determination of protective factors, and evaluation of the vulnerability of the host to disease. The person-place-time model organized epidemiologists' investigations of the disease pattern in the community. Answers A and D do not represent an epidemiologic model.
In which of the following historical ages would people have had an increased risk for contracting salmonella, anthrax, Q fever, or tuberculosis from the proximity of domesticated animals and herds? A. Hunting and gathering stage B. Settled village stage C. Preindustrial cities stage D. Industrial cities stage
BDuring the settled village stage of the Mesolithic period and Neolithic period, people became sedentary, formed villages, and domesticated herds of animals. They lived in close proximity to the animals and contracted diseases such as salmonella, anthrax, Q fever, and so forth because of cross-contamination of water and food supply. In the hunting and gathering stage, groups may have avoided many contagious diseases because the scattered aggregates were small, nomadic, and separated from other aggregates. In the preindustrial stage, large urban centers formed to support the expanding population. In the industrial cities stage, there was an increase in respiratory diseases such as tuberculosis, pneumonia, and bronchitis and in epidemics of infectious diseases such as diphtheria, smallpox, typhoid fever, typhus, measles, malaria, and yellow fever.
Disease prevention activities protect people from disease and the effects of disease. An example of primary disease prevention is: A. teaching people with diabetes how to prevent complications. B. administering vaccines to children before kindergarten. C. checking the skin of farm workers for signs of skin cancer. D. identifying and testing individuals exposed to someone with tuberculosis.
BPrimary prevention activities prevent a problem before it occurs; an immunization is given to prevent a disease before it occurs. Secondary prevention refers to early detection and prompt intervention during the period of early disease pathogenesis, such as checking the skin for signs of skin cancer or identifying and treating individuals who have been exposed to contagious diseases. Aims of tertiary prevention are to keep health problems from getting worse, reduce the effects of disease and injury, and restore individuals to their optimal level of functioning. Examples of tertiary prevention include teaching prevention of complications from disease or referring a patient with a stroke for rehabilitation.
When chronic disease became a more important cause of death in developed countries, different epidemiologic models were developed to study the many factors involved in the development of these health conditions. Which of the following is an example of such a model? A. Person-place-time model B. Epidemiologic triangle C. Web of causation D. Wheel model
C. Chronic disease is marked by a complexity of relationships among causal factors. The web of causation model illustrates the interrelationships. The person-place-time model organized epidemiologists' investigations of the disease pattern in the community. The epidemiologic triangle considers the extent of the host's exposure to the agent, the virulence of the agent, and the host's genetic or immunological susceptibility to the agent. The wheel model is an example of a model that stresses the multiplicity of host and environmental interactions.
Comparing numbers and rates of illness in a community, rates are preferred for: (Choose one best answer) A. Conducting surveillance for communicable diseases B. Deciding how many doses of immune globulin are needed C. Estimating subgroups at highest risk D. Telling physicians which strain of influenza is most prevalent
C. Rates assess risk. Numbers are generally preferred for identifying individual cases and for resource planning.
The health literature accessed by the community health nurse often addresses the probability of an adverse event. What term refers to the likelihood that healthy people exposed to a specific factor will experience a specific health condition? A. Prevalence B. Rates C. Risk D. Incidence
C. The term risk refers to the probability of an adverse event. Prevalence is the number of all cases of a specific disease or condition in a population. Rates are arithmetic expressions that help practitioners consider a count of an event relative to the size of the population from which it is extracted. Incidence describes the occurrence of new cases of a disease or condition in a community over a period of time.
A community health nurse in the assessment phase of the nursing process conducted research to identify the distribution pattern of breast cancer within a population and the associated risk factors. This is called: A. statistical analysis. B. needs assessment. C. census collection. D. epidemiology.
D Epidemiology involves the analysis of data to discover the patterns of health and illness distribution in a population. It also involves conducting research to explain the nature of health problems and identify aggregates at increased risk. Statistical analysis is a general term for the analysis of data. A needs assessment is completed by the community health nurse to gain understanding of the community's perspective on health status, the services used or required, and concerns. Census information is collected every 10 years by the U.S. Census Bureau to describe the population characteristics of the nation.
A propagated epidemic is usually the result of what type of exposure? A. Point source B. Continuous common source C. Intermittent common source D. Person-to-person
D. A propagated epidemic is one in which infection spreads from person to person.
An epidemic is occurring in a public health nurse's community, and the nurse is working with the epidemiologist and other health professionals seeking to identify the causative agent. What phrase best describes such efforts? A. Cohort study B. Descriptive epidemiology C. Point prevalence study D. Analytic epidemiology
D. Analytic epidemiology may be defined as close examination of identified possible causes of disease using advanced epidemiologic methods. Cohort studies obtain information about the cause of disease by establishing a relationship between the presumed causal factors and the effect. The study of the amount and distribution of disease constitutes descriptive epidemiology. When prevalence rates describe the number of people with the disease at a specific point in time, they are sometimes called point prevalences.
When analyzing surveillance data by age, which of the following age groups is preferred? (Choose one best answer) A. 1-year age groups B. 5-year age groups C. 10-year age groups D. Depends on the disease
D. Epidemiologists tailor descriptive epidemiology to best describe the data they have. Because different diseases have different age distributions, epidemiologists use different age breakdowns appropriate for the disease of interest.
What is the most common chemical dependence in the United States? A. Alcohol B. Cocaine C. Marijuana D. Nicotine
D. Nicotine addiction is the most common form of chemical dependence in the United States. Smokers who try to quit experience withdrawal symptoms, including anxiety, irritability, and difficulty concentrating. Alcohol use is very common in our society, but it is not the most common form of chemical dependence. Cocaine and marijuana are not the most common forms of chemical dependence in the United States.
Which of the following statements is true? a)Modern medicine has at times been responsible for causing health problems. b)Malnutrition has been essentially eliminated in the United States. c)Persistent undernourishment among children rarely results in serious health problems.
a)Modern medicine has at times been responsible for causing health problems.
A disease vector is a(n) ____________________ . a)organism that transmits a disease b)symptom of a disease c)environmental condition associated with a disease
a)organism that transmits a disease
An epidemic that becomes unusually widespread and even global in its reach is referred to as a _________________ a)pandemic b)hyperendemic c)Spanish flu
a)pandemic
Most of the major health problems in the poorer nations are due to ____________________ . a)parasitic worms and microorganisms b)psychological tension resulting from work c)air pollution
a)parasitic worms and microorganisms
Diseases that are due mostly to environmental changes, increased population densities, and pollution that result from modernization in third world nations are referred to as: a)diseases of poverty b)diseases of development c)schistosomiasis
b)diseases of development
Diseases that are always present in a community, usually at a low, more or less constant, frequency are classified as having an ____________ pattern. a)epidemic b)endemic c)pandemic
b)endemic
Which of the following things cause malaria? a)mosquitoes b)plasmodia (singular plasmodium) c)red blood cells
b)plasmodia (singular plasmodium)
Which of the following statements is true concerning epidemic diseases? a)They are usually not very contagious. b)At the end of an epidemic, a disease spreads at an increasing rate and then abruptly disappears. c)They usually appear and disappear seasonally.
c)They usually appear and disappear seasonally.
The prime cause of illness resulting in death in the poor countries of the tropical and subtropical regions today is __________________ . a)lyme disease b)plague c)malaria
c)malaria
Epidemiologists are interested in learning about ____________________ . a) the causes of diseases and how to cure or control them b) the frequency and geographic distribution of diseases c) the causal relationships between diseases d) all of the above
d) all of the above
