Epidemiology Midterm and Final Practice

Which statement would be heard during the refreezing stage of change? "I really want to eat a healthier diet and feel better." "I've started to exercise a little." "I'm so glad I stopped drinking." "I need to quit smoking so I'm around to see my grandkids."

"I'm so glad I stopped drinking."

When considering a change, the nurse understands the importance of selecting the appropriate goal. Which should the nurse ask first? "Who can you rely on to provide support?" "How much time will it take to implement this change?" "How will you determine if the goal is met?" "Is this something you want to do?"

"Is this something you want to do?"

A community health nurse working with a local support group for parents who have lost a child to suicide demonstrates an understanding of the principle of proper timing for effecting positive change by identifying which community member as being most ready to change? "Some days I just look through old pictures of my son and cry." "We've been thinking about adopting." "I'm not even sure where to begin honestly." "We've left her room exactly the same."

"We've been thinking about adopting."

Match the appropriate definition to the provided disease control terminology.

*Elimination* reduction in disease incidence to zero in a defined locale *Eradication* reduction in disease incidence to zero worldwide *Extinction* the infectious agent no longer exists in nature or the lab

Match each element of Kingdon's Framework to the appropriate examples of that element.

*Policy problems* A new data report out by the CDC shows a sharp increase in deaths associated with opioid use. *Policy solutions* A newly proposed policy would be a massive overhaul of the health care system that would likely take lots of time and money *Policy politics* The three largest professional nursing organizations in the U.S. have endorsed the policy.

Place the steps of an outbreak investigation in the correct sequence.

1. Establish the existence of an outbreak 2. Verify the diagnosis & create a case definition 3. Find & document cases systematically 4. Perform descriptive epidemiology 5. Develop & evaluate hypotheses 6. Implement control & prevention measures 7. Evaluate efforts & readjust as needed 8. Communicate findings

Place the following steps of the planned change process is their correct, sequential order.

1. Recognize symptoms 2. Diagnose need 3. Analyze alternative solutions 4. Select a change 5. Plan the change 6. Implement the change 7. Evaluate the change 8. Stabilize the change Response Feedback: Remember that each new step relies on what was achieved in the prior step - they build off each other towards establishing behavior change.

Which of the following examples of essential public health services falls within the core function of assessment? The state health department opens new satellite clinics to increase access to care in rural counties A population health nurse works with a local health agency to develop a new policy proposal A population health nurse makes home health visits to investigate toxic exposures from a nearby park A community forum is held to educate community members about a local Zika outbreak

A population health nurse makes home health visits to investigate toxic exposures from a nearby park

Which of the following are characteristics commonly found in blue zones? (Select all that apply.) A sense of purpose Regular physical activity Right tribe Mindful eating Binge drinking

A sense of purpose Regular physical activity Right tribe Mindful eating

A population health nurse has identified an increase incidence in cases of myocardial infarction in her community in the last year. He/she is working on an initiative to improve the population's access to primary care clinics so that services like screenings for hypertension and hyperlipidemia can be more easily procured. The essence of this initiative falls under which core function of public health? Assessment Policy development Assurance Quality Improvement

Assurance

A nurse has referred a community member and her family to a local dietitian who will provide a grocery store tour and cooking class to teach the family how to select and prepare healthy meals. The nurse has recommended these activities because she/he/they has identified a need to enhance which of the following constructs of the social cognitive theory? Select the most appropriate answer. Reinforcement Emotional coping strategies Expectancies Behavioral capacity

Behavioral capacity

NASA reports drastic increases in the atmospheric concentration of which of the following as responsible for global warming? Sulfur oxide Carbon dioxide Carbon monoxide Nitrogen dioxide

Carbon dioxide

A nurse who is working with a community member to identify the importance of factors that can promote or hinder behavior change is engaging in which of the following activities? Carrying out a force field analysis Identifying change talk Making a behavior change contract Recognizing sustain talk

Carrying out a force field analysis

A population health nurse wants to determine the cause of a rare neurological disorder. Which study design would be most appropriate? Cohort study Cross-sectional study Case-control study Experimental study

Case-control study

When speaking at a forum on community health, the public health nurse expresses concern over chronic disease because: (Select all that apply.) Chronic disease morbidity is on the rise Some chronic disease is appearing at younger ages Approximately half of the population has at least one chronic condition Many individuals with chronic illness have more than one chronic condition Chronic illnesses are very costly for the community

Chronic disease morbidity is on the rise Some chronic disease is appearing at younger ages Approximately half of the population has at least one chronic condition Many individuals with chronic illness have more than one chronic condition Chronic illnesses are very costly for the community

As a result of the hard work of the population health nurse and his/her staff at the local health department, new evaluation data shows that control measures were successful and the recent outbreak is now over. What is the final step of the outbreak investigation that the nurse must now complete? Implement additional control measures as a precaution Revisit the case definition Develop and evaluate hypotheses Communicate the investigation findings

Communicate the investigation findings

A windshield survey is a tool used for assessing which of the following? Individuals Communities Homes Families

Communities

A new graduate is exploring various options in public health nursing employment. The nurse recognizes a major difference between a rural and urban setting is determined by which factor. Federal legislation Complexity State legislation Leadership

Complexity

You are helping a very stressed community member that has been trying to lose weight for more than 6 months. He reports still struggling with emotional eating when he's stressed. You recommend that he drink unsweetened green tea and meditate for 5 minutes as an alternative to consuming his usual sugar-sweetened soda and potato chips whenever he's stressed. Which process of change have you employed? Counter-conditioning Reinforcement management Consciousness-raising Self liberation

Counter-conditioning

Which of the following epidemiological study designs does not account for temporality? Cross-sectional Experimental Cohort Case-control

Cross-sectional

Which of the following occurrences could result in an increased incidence of disease? The opening of a new community garden A needle-exchange program for drug users at risk for contracting HIV Defunding of a hand-washing campaign directed at hospital-based healthcare providers School-based violence prevention programs

Defunding of a hand-washing campaign directed at hospital-based healthcare providers

Which of the following represents health impacts of climate change that can adversely affect a community? (SELECT ALL THAT APPLY) Elevated risk of wildfires Extreme weather events Reduced outdoor air quality Increased incidence of vector-borne diseases

Elevated risk of wildfires Extreme weather events Reduced outdoor air quality Increased incidence of vector-borne diseases

Match each step of the health impact assessment (HIA) to its correct explanation.

Evaluation - Monitor the impact of the HIA Scoping - Develop a plan for the HIA Recommendations - Identify actions that would protect health and prevent harm Screening - Determine whether an HIA is needed

Which level of public health agencies is best equipped to address the destruction caused by Hurricane Irma across the Southeast region of the U.S.? Local government Regional government State government Federal government

Federal government

A population health nurse reads a health education brochure that states, "The RR of giving birth to a baby with neural tube defects among pregnant women who consume 400 mcg of folic acid daily is 0.75." The nurse explains that this statement means: Folic acid is a protective factor; pregnant women who consume the RDA for folic acid are 75% less likely to give birth to a baby with neural tube defects. There is no association between maternal folic acid intake and an infant's development of neural tube defects. Folic acid is a risk factor; pregnant women who consume the RDA for folic acid are 75% more likely to give birth to a baby with neural tube defects. Folic acid is a protective factor; pregnant women who consume the RDA for folic acid are 25% less likely to give birth to a baby with neural tube defects.

Folic acid is a protective factor; pregnant women who consume the RDA for folic acid are 25% less likely to give birth to a baby with neural tube defects.

When discussing the health disparities arising from environmental injustice in the United States, a public health nurse shares all of the following information EXCEPT: Gentrification has proven helpful in providing additional resources and higher quality of life for low-income and minority communities Low-income and minority communities often lack social capital to achieve mutual goals Waste management facilities and toxic emissions have disproportionately impacted low-income and minority communities Food deserts that provide limited access to affordable & nutritious food are more common in low-income and minority communities

Gentrification has proven helpful in providing additional resources and higher quality of life for low-income and minority communities

John Snow's observations of the distribution of cholera cases during the 1854 cholera outbreak supported which of the following theories? Germ theory Multiple causation theory Social cognitive theory Miasma theory

Germ theory

Which of the following is a criteria pollutant? Hydrofluorocarbons Radon Carbon dioxide Ground-level ozone Volatile organic compounds

Ground-level ozone

Which of the following is NOT a core function of public health? Health promotion Assessment Assurance Policy Development

Health promotion

Risk of an environmental exposure is assessed by collecting information on which of the following? (Select all that apply.) How many people come into contact with the exposure What doses of an exposure are harmful How long people are in contact with the exposure Hazards or health problems that an exposure can cause

How many people come into contact with the exposure What doses of an exposure are harmful How long people are in contact with the exposure Hazards or health problems that an exposure can cause

Which activity would the community health nurse be involved with at the primary level of prevention? Partner notification Immunization Isolation Screening

Immunization

A community health nurse is preparing to meet with a group of students. Which statements should the nurse include when discussing how trends and issues have influenced health care? (SELECT ALL THAT APPLY) The United States has the most cost-effective health care system in the world. One explanation for the high cost of U.S. Health Care System is the need to practice defensive medicine by ordering excessive tests and x-rays. In the U.S., the health-related quality of life is lower than for most other countries. The U.S. ranks low among developed countries on a measure of how respectfully clients are treated. Most U.S. physicians identified that their health care system worked well.

In the U.S., the health-related quality of life is lower than for most other countries. One explanation for the high cost of U.S. Health Care System is the need to practice defensive medicine by ordering excessive tests and x-rays.

To prevent the spread of communicable diseases that enter the United States as a result of international travel, the public health nurse advocates for which of the following policies? Select all that apply. Isolation of all individuals exposed to an infected individuals Increased access to and affordability of travel medicine services Isolation of infected individuals at the point of entry into the U.S. Quarantine of infected individuals at the point of entry into the U.S. Quarantine of all individuals exposed to an infected individuals

Increased access to and affordability of travel medicine services Isolation of infected individuals at the point of entry into the U.S. Quarantine of all individuals exposed to an infected individuals

Which of the following communicable diseases is believed to have the largest prevalence in the United States? Malaria Pneumonia Influenza Chlamydia

Influenza

Which of the following conditions is considered endemic to the United States? Smallpox Influenza Malaria Polio

Influenza

Irma isn't feeling well and goes to her primary care provider (PCP) to get checked out. She pays $20 to see her PCP, who prescribes some medications that costs $75. Before her health insurance covered the cost of the medication, she must pay $300. Which of the following is correct? Irma's co-pay is $75 Irma's co-insurance is $20 Irma's deductible is $300 Irma's premium is $20

Irma's deductible is $300

Which of the following is true regarding communities of common interest? It is a group of people who come together to solve a problem It is a group of people that lives in the same geographic area It is a group of people that have common interests that bind them together It is a group of people that does not necessarily interact with one another

It is a group of people that have common interests that bind them together

Which of the following is a characteristic of community health nursing? It is grounded in social justice It focuses on individuals It aims at restoring health and function It manages resources at hand

It is grounded in social justice

The 'donut hole' is a problem encountered in which insurance plan? Medicare Medicaid CHIP COBRA

Medicare

Which of the following groups is considered to be at higher risk or more vulnerable based on reported rates of HIV diagnosis? Hispanics individuals living in the Midwest People who inject drugs Men who have sex with men

Men who have sex with men

Which source of air pollution is attributed to the most environment-associated mortality? Area sources Mobile sources Point sources Natural sources

Mobile sources

A population health nurse conducts a case-control study to determine what may be causing community members to develop asthma. The nurse identifies community members with and without asthma and then asks them questions about whether they've been exposed to potential asthma-causing agents. In this study, the control group is which of the following? Asthmatic community members Community members not exposed to potential asthma-causing agents Community members exposed to potential asthma-causing agents Non-asthmatic community members

Non-asthmatic community members

A community health nurse is developing a teaching plan about Medicare to present at a community event. Which points will be important to include in the presentation? (SELECT ALL THAT APPLY) A state health insurance program for elderly and the disabled. Part A covers medically necessary hospitalization. Part D covers prescription drug costs. Part A is supplementary and voluntary

Part A covers medically necessary hospitalization. Part D covers prescription drug costs. Federal program, not state! Medicaid and CHIP are state!

Which of the following is a SMART goal? Select all that apply. Participating community members will be able to recall three benefits of physical activity by the end of the workshop. Blood pressure will decrease at a 1-year follow-up visit. Parents will be able to identify and demonstrate 2 appropriate strategies of non-violence discipline after the third workshop. Dietary knowledge (i.e., recommended intake of fruits, vegetables, protein, fiber, and fats) will increase by 5% among community members.

Participating community members will be able to recall three benefits of physical activity by the end of the workshop. Parents will be able to identify and demonstrate 2 appropriate strategies of non-violence discipline after the third workshop.

Florida CHARTS can be used to find data collected via which of the following methods? Passive surveillance Active surveillance Outbreak investigation Contact tracing

Passive surveillance

City ordinances that designate indoor smoking as illegal are an example of which core function of public health? Health promotion Assessment Assurance Policy development

Policy development

After an unsuccessful poster campaign encouraging self-enforcement of the smoke-free campus policy, the community health nurse recommended that the University issue citations and fees to individuals found smoking on campus. What planned change strategy is the nurse now using? Normative-reeducative Power-coercive Persuasive-coercive Empiric-rational

Power-coercive

Which health care funding source requires a patient to pay more for seeing out-of-network health care providers? Defined contribution plan COBRA Health maintenance organization Preferred provider organization

Preferred provider organization

The population health nurse notes that the total number of cases of diabetes in a community remained stable during the last year. What type of data is the nurse analyzing? Incidence rate Prevalence rate Case fatality rate Survival rate

Prevalence rate

A nurse teaches the importance of folic acid to a group of pregnant women. This is considered which level of preventive care? Primary prevention Secondary prevention Tertiary prevention Quaternary prevention

Primary prevention

A population health nurse is working to distribute clean syringes to drug abusing sex workers. This is an example of which of the following? Primary prevention Tertiary prevention Secondary prevention Quaternary prevention

Primary prevention

Fluoridation of water would be an example of a population-level: Primary prevention strategy Secondary prevention strategy Tertiary prevention strategy Quaternary prevention strategy

Primary prevention strategy

Which of the following is the largest source of health care funding overall? Private insurance Out-of-pocket payments Medicare Medicaid

Private insurance

Which of the following are characteristics of chronic disease? (Select all that apply.) Prolonged illness Long latency period Multiple risk factors Simple etiologies

Prolonged illness Long latency period Multiple risk factors

A population health nurse has made a personal goal of working to educate pregnant women about having healthy pregnancies and proper care of newborns. This example aligns most appropriately with which of the goals of Healthy People 2020? Attain high quality, longer lives free of preventable disease, disability, injury, and premature death. Achieve health equity, eliminate disparities, and improve the health of all groups. Create social and physical environments that promote good health for all. Promote quality of life, healthy development and health behaviors across all life stages.

Promote quality of life, healthy development and health behaviors across all life stages.

Which of the following examples represents the core function of assessment? Reporting a new case of cancer to the national cancer registry Advocating for more stringent regulations on nutrition labels Providing health education classes to inmates with chronic conditions Training healthcare providers to counsel community members on healthy behaviors

Reporting a new case of cancer to the national cancer registry

Which of the following statements about chronic physical health conditions is FALSE? Reporting of chronic physical health problems is mandatory Rates of chronic physical health problems are likely underestimated Chronic physical health problems can adversely affect familial relationships Societal effects of chronic physical health problems include increased mortality, morbidity, and financial costs

Reporting of chronic physical health problems is mandatory

A client visits a local clinic to have cold symptoms assessed. After the doctor performs the client's assessment, the client also has blood drawn and a chest x-ray completed while at the clinic. The patient returns home and later receives an itemized bill for the doctor's visit, a laboratory test, and a radiologic exam. This is an example of: Prospective reimbursement Pay-for-performance Retrospective reimbursement Per diem payment

Retrospective reimbursement

To uphold the principle of environmental justice, the population health nurse takes which of the following actions when working with a new community? (Select all that apply.) Reviews a new proposal to build a new garbage dump in the area to ensure that vulnerable populations will not experience a higher burden of exposure than others in the community Makes decisions on behalf of community members in an area where a new garbage dump is slated for development Encourages community members to contact their local government representatives to voice their concerns over plans to build a new garbage dump in the area Invites community members to participate in discussions about plans to build a garbage bump in the area

Reviews a new proposal to build a new garbage dump in the area to ensure that vulnerable populations will not experience a higher burden of exposure than others in the community Encourages community members to contact their local government representatives to voice their concerns over plans to build a new garbage dump in the area Invites community members to participate in discussions about plans to build a garbage bump in the area

The community health nurse is conducting screening for hearing defects at a local health fair. This is an example of: Primary prevention Secondary prevention Tertiary prevention Quaternary prevention

Secondary prevention

During a community advisory board meeting, a population health explains several challenges that make increasing immunization levels in communities a difficult task. These challenges include: (Select all that apply.) Some individuals express concerns about the safety of ingredients in vaccines Many low-income community members are unable to afford vaccinations Publix now offers influenza shots in their in-store pharmacies Immunizations are not mandatory Several myths claim that vaccines cause autism

Some individuals express concerns about the safety of ingredients in vaccines Many low-income community members are unable to afford vaccinations Immunizations are not mandatory Several myths claim that vaccines cause autism

Relative risk can best be used to assess which of the following criteria for causality: Experiment Temporal Relationship Consistency Strength

Strength

Using your knowledge of the natural history of a condition, at which stage of the condition would you target primary prevention efforts? Recurrence stage Susceptibility stage Resolution stage Preclinical stage Clinical stage

Susceptibility stage

Which of the following statements accurately characterizes motivational interviewing? Discrepancy is avoided to prevent a client's discomfort Change talk is de-emphasized when summarizing a client's comments Close-ended questions are asked to facilitate quick counseling intervention Sustain talk helps to identify resistance to change

Sustain talk helps to identify resistance to change

Using your knowledge of the natural history of a condition, which of the following levels of prevention would be most appropriate to use with a patient currently in the resolution stage? Primary prevention Quaternary prevention Secondary prevention Tertiary prevention

Tertiary prevention

Exposure to the Ebola virus commonly leads to the development of the actual disease and, since there are no approved treatments currently available, also commonly leads to the death of the exposed individual. Based on this information, the Ebola virus can be described in the following terms. The Ebola virus has high toxigenicity The Ebola virus has low pathogenicity The Ebola virus has high virulence The Ebola virus has low antigenicity

The Ebola virus has high virulence

Which of the following political considerations is important to consider when identifying a window of opportunity for policy implementation? a. The power and influence of stakeholders b. The feasibility of the policy solution c. The costs associated with policy solutions d. The acceptability of potential policy solutions

The power and influence of stakeholders

Which of the following is NOT associated with the high cost of U.S. healthcare? More elderly individuals with chronic conditions The shift from for-profit to non-profit hospitals Use of electronic medical records & other technology An emphasis on sick care

The shift from for-profit to non-profit hospitals

A population health nurse is responsible for allocating funding for cancer prevention and treatment services and must decide which of two communities will receive the funding. Funding will go to the community currently experiencing the greater burden of disease. To determine which community receives the funding, what information will the nurse need? (Select all that apply.) The total number of deaths in each community The total number of incident cases in each community The total size of each community The total number of prevalent cases in each community The total population at risk in each community

The total number of prevalent cases in each community The total population at risk in each community The total number of incident cases in each community

Public health surveillance can be used for which of the following? (Select all that apply.) To describe and monitor health events To identify health emergencies early To help set priorities for addressing heath concerns To provide justification for funding allocation and policy creation To assist in planning disease prevention and control programming

To describe and monitor health events To identify health emergencies early To help set priorities for addressing heath concerns To provide justification for funding allocation and policy creation To assist in planning disease prevention and control programming

community member meeting with the resident public health nurse has reviewed the pros and cons of medication adherence and is now expressing an interest in exploring and choosing an adherence strategy. Upon hearing this information, the nurse knows that the community member is now in what level of the affective learning domain? Valuing level Receptive level Internal consistency level Adoption level

Valuing level

A new study reveals that women who drink 7-10 alcoholic beverages in a week have a relative risk of developing oral cancer of 2.0. The population health nurse knows that this statement means: There is no relationship between the consumption of alcoholic beverages and oral cancer Women who drink 7-10 alcoholic beverages per week are 2% less likely to develop oral cancer than women who drink less than 7-10 alcoholic beverages a week Women who drink 7-10 alcoholic beverages per week are 2 times more likely to develop oral cancer than women who drink less than 7-10 alcoholic beverages a week Women who drink 7-10 alcoholic beverages per week are 20% more likely to develop oral cancer than men.

Women who drink 7-10 alcoholic beverages per week are 2 times more likely to develop oral cancer than women who drink less than 7-10 alcoholic beverages a week

While explaining communicable disease transmission to a group of aspiring nurses, the population health nurse identifies which of the following as an example of a fomite? a tissue a mosquito a dog a tick

a tissue

A community health nurse uses a home health checklist to identify potential harmful exposures while visiting with a family in the local community. This effort falls under which core function of public health? policy development health promotion assurance assessment

assessment

Which of the following policies would have an indirect impact on health? a. Medicaid expansions at the state level b. Zoning for a new casino in the community's downtown area c. Quarantine protocols for individuals entering the U.S. d. Funding immunization clinics prior to flu season

b. Zoning for a new casino in the community's downtown area

A coal-fired energy plant and a water treatment plant would be considered elements of the: built environment natural environment ecological environment social environment

built environment

The community health nurse explains that a focusing event is: a. A committee hearing in the house or the senate to discuss problems identified in a legislative bill b. Mass-casualties resulting from a lack of terrorism preparedness c. A sudden, relatively uncommon event that raises awareness and concern about an issue d. A community event aimed at identifying priorities for addressing health issues

c. A sudden, relatively uncommon event that raises awareness and concern about an issue

To fulfill the "health in all policies" approach recommended by the National Academy of Medicine, a population health nurse would most likely do which of the following FIRST? contact their congressional representatives about an upcoming vote conduct a health impact assessment campaign for a political candidate who is supportive of the American Nursing Association's values discuss the implications of a policy on local news

conduct a health impact assessment

One of the fundamental premises underlying the study of epidemiology is... disease and illness originate from "bad air," commonly referred to as miasmas disease and illness prevention efforts at varying levels are largely ineffective disease and illness are randomly distributed in a population disease and illness patterns can be measured

disease and illness patterns can be measured

Which of the following chronic illnesses results in the greatest mortality in the U.S.? diabetes stroke heart disease cancer

heart disease

The resistance of a population to an attack by a disease to which a large proportion of the members of the group are immune is referred to as... herd immunity the Panum Effect population immunogenesis collective resistance

herd immunity

In the context of the epidemiologic triad model, age, race, and immune status would be considered which of the following? agents environmental factors host factors causality factors

host factors

When explaining the criteria for causality to a high school class, the population health nurse identifies specificity as a weak criterion for causality given that: many prevalent health conditions seen today have multiple contributing factors it is not possible to manipulate all contributing factors to assess their causality our understanding of the biological mechanism of a condition may not be sufficient to determine causation some risk factors have an initial threshold that must be met before demonstrating risk

many prevalent health conditions seen today have multiple contributing factors

A community health nurse explains to new parents that they will eventually need to get their newborn vaccinated to protect against several vaccine-preventable diseases since the ________________ provided by the mother through the placenta only provides short-term resistance. natural passive immunity artificial passive immunity natural active immunity artificial active immunity

natural passive immunity

A new screening test is developed to identify early stage pancreatic cancer. Unfortunately, the condition is still considered incurable. What are potential consequences of this new test? (Select all that apply.) incidence will decrease prevalence will increase incidence will increase prevalence will decrease

prevalence will increase incidence will increase

The precautionary principle aligns with which level of prevention? primary prevention quaternary prevention tertiary prevention secondary prevention

primary prevention