Study Set 2 NRS 460

Identify the three components of an Epi Triangle: a.)agent, host, environment b.) portal of exit, transmission path, and portal of entry c.) airborne, mechanical, biological

A

The principal of multi-causation states that an infectious agent alone is not sufficient to cause disease, the agent must also be: a.) transmitted in the environment to a susceptible host b.) transmitted in the environment to a susceptible vehicle c.) transmitted in the environment to a susceptible vector d.) transmitted in the environment to a susceptible fomite

A

The purpose of epidemiology is to: a.) develop measures to prevent or control disease in a community b.) to gain immortality c.) to improve man's material existence

A

Upstream thinking actions are focused on modifying: a.) economic, political, and environmental factors b.) levels of water pollution to improve health outcomes c.) levels of air pollution to improve health outcomes d.) smoking rates

A

Which is not a valid contraindication? a.) for MMR, allergy to eggs b.) for varicella vaccine, pregnancy in the vaccine recipient c.) for DTP/DTaP, encephalopathy within 7 days of a previous DTP/DTaP dose d.) for MMR, current, prolonged use of high-dose systemic steroids e.) all are valid contraindications

A

Which of the following DTaP immunization records, although late at times, is otherwise entirely within the recommended guidelines: a.) 3,4,6, and 15 months b.) 4.6.8, and 11 months c.) 1,2,4,7, and 17 months d.) 2 weeks, 3 weeks, 7 months, and 15 months

A

According to the American Public Health Association (APHA) website, in 2019 the number of cents in a dollar spent of Public Health was: 1 72 33 9

1

In a particular community, the rate of new cases of hypertension and the rate of new cases of measles during the month of January were precisely the same. Which disease would have the higher prevalence rate? a.) as a chronic condition, hypertension would have a higher prevalence rate b.) measles would have the higher prevalence rate because people can get measles more than once c.) measles would have the higher prevalence rate because it is so contagious

A

Incidence is defined as: a.) # of new cases of disease over specific time period over # of persons at risk of disease over that specific period of time b.) # of cases people in the population

A

The nurse in an outpatient clinic is supervising student nurses administering influenza vaccinations. The nurse should question the administration of the vaccine to which of the following clients? a.) A 60-year-old female who says she has a sore throat b.) a 45-year-old male who is allergic to shellfish c.) a 66-year-old female who lives in a group home d.) a 70-year-old female with congestive heart failure

A

A client did not return for a follow-up appointment after having major abdominal surgery. When using a macroscopic theoretical approach, what might the nurse appropriately conclude? a.) the healthcare system failed to meet the client's perceived needs b.) the client does not care about his health care needs c.) the patient does not trust the healthcare system d.) the doctor did not appropriately stress the importance of a follow-up visit

A

A mother accompanies her 12 month old child to the health clinic for his scheduled immunizations. What statement by the mother would cause the nurse to question immunization administration at this visit? a.) "Joey had a slight temperature this morning but it went away after I gave him some Tylenol" b.) "my child has had a runny nose for the past week" c.) Joey hates getting these shots, it makes him so mad- watch yourself" d.) "last time Joey got a shot, his little thigh was red and sore afterwards for two days"

A

According to the article "Mosquito, Tick Populations Unchecked Amid COVID-19" what has been an unintended consequence of the COVID-19 pandemic? a.) less prevention = more bugs b.) a significant decrease in the number of tick borne illness cases c.) more prevention = more bugs d.) a significant decrease in the number of cases of ALL mosquito borne illnesses

A

Aggregate is a term used in community health, it means: a.) a group within a larger population having some characteristic in common b.) a geopolitical community c.) a phenomenological community d.) a nuclear community

A

At the end of 2018, the Food and Drug Administration banned the sale of flavored E-cigs to kids. Identify the level of prevention the FDA utilized. a.) primordia b.) primary c.) secondary d.) tertiary

A

Bellack stated that when working in the community, success depends upon ALL of the following except: a.) empathy b.) listening c.) being patient d.) providing accurate and scientifically sound information e.) respecting the experiences of community members

A

Identify the 6 criteria that establish the existence of a cause-and-effect relationship: a.) strength of association, dose-response relationship, temporally correct relationship, biological plausibility, consistent with other studies, and specificity b.) Weak association, dose-response relationship, temporally correct relationship, biological plausiblity, inconsistency with other studies, sensitivity c.) strength of association, dose-response relationship, exposure to casual factor occurred after disease development, bilogical plausibility, consistent with other studies, sensitivity d.) Fragile association, response independent of dose, exposure to causal factor occurred before disease development, biological unplausable, consistent with other studies, sensitivity

A

Identify the most challenging ethical principal for a nurse to achieve in the community? a.) justice b.) nonmaleficence c.) beneficence d.) fidelity e.) autonomy f.) principles of totality & integrity

A

Which of the following definitions is the correct definition for Epidemiology? a.) Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems b.) Epidemiology is a process of collecting data then transforming this data into knowledge, insights, skills and values that help people to change behavior

A

Which of the following is a contraindication to further doses of DTaP vaccine? a.) Anaphylaxis after DTaP b.) hypotonic-hyporesponsive episode within 48 hours of DTaP c.) seizures within 3 days of DTaP d.) persistent, inconsolable crying lasting = hours within 48 hours of DTaP e.) Temperature of = 40.5C (105F) within 48 hours of DTaP

A

Which of the following is false? a.) missed vaccination opportunities are a minor contributor to low vaccination rates b.) missed vaccination opportunities occur when the firt dose of MMR is needed but only the fourth dose of DTP/DTaP is given c.) missed vaccination opportunities occur when vaccinations are not administered during visits for mild acute illnesses d.) missed vaccination opportunities occur when providers limit the number of injections e.) missed vaccination opportunities could occur when the last dose of Hib vaccine is needed but only varicella vaccine is given

A

Which statement about the routine schedule is false? a.) the first dose of MMR is ideally given from 15-19 months of age b.) the first dose of hepatitis B vaccine is recommended from birth to 2 months of age c.) the second dose of Hib vaccine is ideally given at 4 moths of age d.) the fourth dose of DTaP is ideally given at 15 to 18 months of age

A

Critical Social Theory

A nurse would use this theory when the goal is to identify the social inequalities surrounding a client's health

Risk Assessment

A systematic way of distinguishing the risk posed by potentially harmful exposures (or other attributes or characteristics)

Lisa, a public nurse educator, is teaching about Chagas disease in the neighborhood. Which of the following statements made by residents indicates that Lisa needs to provide additional teaching? (select all that apply): a.) Chagas disease is transmitted by shaking hands b.) Chagas disease is transmitted by rubbing kissing bug's feces on wound site. c.) Chagas disease is potentially deadly d.) Infants are less likely to be infected by Chagas disease e.) Chagas disease is well controlled in South America

A,D,E

What microorganism causes RMSF? a.) Rickettsia rickettsii b.) Borrelia burgdorferi c.) Rickettsia helvetica d.) Ehrlichia chaffeensis

A: Rickettsia rickettsii

A 5-year-old child is hospitalized with Rocky Mountain spotted fever. The health record reveals documentation that the child was bitten by a tick 2 weeks ago. The child prevents with complaints of headache, fever, and anorexia, and the nurse notes a rash on the palms of the hands and soles of the feet. The nurse reviews the physcian's orders and anticipates that which of the following will be prescribed? a.) Tetracycline (Achromycin) b.) Amphotericin B (Ketoconazole) c.) Ganciclovir (Foscarnet) d.) Amantadine (symmetrel)

A: Tetracycline (Achromycin)

Non-Modifiable Risk Factor

Age

Risk Factor

Any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury

Identify one of the most profound failures in Infectious Disease Control in not only the US but throughout the world: a.) in many countries throughout the world, the poor and minorities do not have access to healthcare b.) infectious diseases continue to be differentially distributed by income and ethnic groups, with the poor and minorities experiencing the greater burden c.) in many developing countries, the poor do not have access to clean water d.) in many developing countries, the poor do not have access to immunizations

B

Identify the "Father of Epidemiology" a.) Hippocrates b.) John Snow c.) Richard Doll d.) John Graunt

B

Identify two characteristics that are imperative to a nurse's success when working in the community. a.) know the communities needs and be very methodical about the care provided b.) show respect and listen effectively c.) at minimum, have a BSN and engage in continuing education frequently d.) be an empathetic and caring person

B

The Harvard Nurse's study followed the health of nurses into the future. This is a great example of which of the following studies? a.) case-control b.) prospective cohort study c.) retrospective cohort study d.) cross sectional study

B

The article "Vector-Borne Disease Cases Have Tripled in the United States since 2004" noted that vector-borne disease cases have tripled in the United States between 2004 and 2016, underscoring the need for stronger prevention and control efforts. Identify the # of vaccines currently available to combat these disease and then identify the reason for this escalation in rates provided by the article: a.) no vaccines and rainy weather b.) 1 vaccine and warmer weather c.) 1 vaccine and colder weather d.) 2 vaccines and rainy weather

B

Which administration route is incorrect? a.) varicella vaccine subcutaneously in the deltoid region of a child b.) Hepatitis B intramuscularly in the upper outer quadrant of the buttock of a child c.) Hib intramuscularly in the anterolateral thigh of an infant d.) DTaP intramuscularly in the anterolateral thigh of an infant

B

Which of the following is incorrect: a.) pneumococcal vaccine is an inactivated, bacterial vaccine b.) hepatitis B is an attenuated, live viral vaccine c.) IPV is an inactivated, viral vaccine d.) pertussis vaccine is an inactivated bacterial vaccine e.) MMR is an attenuated, live viral vaccine

B

Appropriate nursing diagnoses for clients with Chikungunya would be which of the following? a.) potential for injury related to GI toxicity and a decrease in bleeding time b.) impaired skin integrity related to cutaneous manifestations c.) altered protection related to GI bleeding and increasing platelet aggregation d.) risk for injury related to thrombocytosis prolonged prothrombin

B: impaired skin integrity related to cutaneous manifestations

Identify the risk factor least subject to modification: a.) life style choices b.) diet c.) environmental exposure d.) exercise

C

Which of the following procedures is least likely to improve vaccination rates over several years? a.) evaluation by nursing staff of vaccination status when vitals are taken, and then addressing missing vaccines b.) telephone reminders about needed vaccinations c.) providing posters in the waiting room about vaccinations in general d.) setting numerical goals for raising vaccination rates e.) evaluation of the practice's vaccination rates and causes of low rates in the practice

C

What would be the LEAST appropriate treatment intervention for a patient recovering from COVID-19? a.) having the patient sit on the edge of the bed multiple times throughout the day b.) having the patient exercise at a mild-moderate RPE to increase aerobic capacity c.) performing bed level exercises to converse energy d.) increasing treatment duration to 20 minutes before increasing intensity

C: Performing bed level exercises to conserve energy

The patient is a 70 y.o. male with a history of smoking, emphysema, and recent COVID hospitalization. Today in therapy he is dizzy when sitting up too quickly. The best thing to do in this situation is: a.) call a rapid response b.) immediately lay the patient back down and wait for the dizziness to subside c.) sit at the edge of bed and monitor symptoms until dizziness subsides d.) tell the patient to ignore the symptoms and proceed with therapy

C: sit at the edge of bed and monitor symptoms until dizziness subsides

Ecological Framework

Considers the complex interplay between individual, relationships, community, and societal factors in health outcomes

A client had been into the clinic several times for treatment of his elevated blood sugars. Each visit, the nurse spent over 20 minutes sharing patient education, but the client never changed behavior. What had the nurse forgotten? a.) patient's only listen to MDs, they ignore what nurses say b.) people need to hear a message at least 7 times before they will change behavior c.) there are many other issues in the client's life that are more important d.) information is a component, but will not motivate someone to change behavior

D

A public Health Department has the funding for one more health promotion program this year. Two topics were selected (healthy eating and activity). Select the group that would benefit the most: a.) senior citizens b.) young adults at the YMCA c.) high school students d.) elementary students/invite their parents

D

Identify the type of study performed in the article titled "Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and US." a.) experimental prospective cohort b.) experimental retrospective cohort c.) experimental cross-sectional d.) observational cross-sectional

D

When working with a COVID-19 patient, what would be a reason to pause or stop your intervention? a.) decrease in O2 saturation to 90% b.) RPE of 11 c.) an increase in HR and BP during physical activity d.) O2 saturation of 87%

D: O2 saturation of 87%

Macroscopic Approach

Delineates factors in the population that perpetuate development of illness or foster development of health. Emphasizes social, economic, and enviornmental precursors of illness (including policy). may involve social or political action including policies

Health Belief Model 2

Driven by the perception of the threat of illness if the behavior is NOT chosen

Health Promotion

Enable people to exercise control over their own well being

T/F: A hypothesis must be written with a narrow focus initially and then broadened to include all possibilities.

False

T/F: An exception fallacy occurs when you make conclusions about individuals based only on analyses of group data

False

T/F: Analytical Epidemiology deals with the questions of who, what, when, and where. Descriptive Epidemiology deals with the questions of why and how.

False

T/F: Determining the prevalence of disease is useful for determining the likelihood of what cause the disease.

False

Artificial Passive Immunity

temporary immunity provided by an immune globulin. An example is when varicella immune globulin (VZIG) is administered to a non-immune pregnant woman exposed to an individual with active chickenpox

Health Belief Model

Motivates people to cahnge behavior to avoid a negative health outcome

Orem's Self-Care Theory of Nursing

Nursing is a response to the inability to care for ones self

Modifiable Risk Factor

Putting make-up on while driving

Milio's Framework

Stresses the importance of making health-promoting choices readily available and less costly than health-damaging choices through national-level policy change

Pender's Health Promotion Model

this model cannot predict a behavior outcome, it is useful to assist the healthcare provider and the client determine the barriers and possible assets

Risk

The probability that a specific event will occur in a given time frame

T/F: Analytic epidemiology is used to determine the cause of disease. This type of epidemiology will utilize an Epi Triangle when considering the cause of disease. It involves testing a hypothesis and incorporating measures of association and statistical testing.

True

T/F: an MMR given 2 days before a child's first birthday is countered as a valid vaccine.

True

T/F: pregnancy is not a contraindication for immunization using inactivated vaccines, antitoxins, or immune globulins.

True

Carrier

Typhoid Mary

Critical Interactionism

When nurses use both upstream and downstream approaches to address health issues

Identify the action most likely to result in the most significant change in healthcare outcomes for persons living in the United States: a.) shift a significant portion of federal funding from acute care to health promotion activities b.) expand the number of neighborhood health clinics c.) dump a significant amount of money into healthcare agencies to improve Electronic Health Records d.) increase the number of scholarships provided to healthcare professionals

a

the three levels of practice of the Minnesota Wheel are: a.) communities, systems, and individuals/families b.) levels of practice, color wedges, and interventions c.) levels of practice, populations at risk, and populations of interest d.) levels of practice, public health interventions, and population based

a

Health Promoting Strategy

a city puts in paved sidewalks that are lighted

Health

a goal and resource for living

Latent Period

a period of replication before shedding

Herd Immunity

a state in which those not immune to an infectious agent will be protected if ~80% of the population is immune to the communicable disease, if the 80% is evenly distributed

Health Protection

activities that a person engages in to prevent disease, detect disease in early stages, or to maximize their health within the constraints of a disease state

Subclinical infection

an infection that usually has no signs or symptoms

Outbreak

an unexpected occurrence of an infectious disease in a limited geographic area during a limited period of time

In the 20th century, the focus of epidemiology shifted from acute and contagious disease to chronic and non-contagious disease in developed countries. Identify some of the reasons for this shift: a.) increased pollution, increased world population, and a decrease in food supply b.) increased access to clean water, access to birth control, greater access to healthier foods, increase in educational opportunities c.) increased global conflicts, development of multidrug resistant organisms, less time to spend with family and friends

b

Theory of Reasoned Action

based on the individual's intention to perform or not perform a given activity. The key to this theory is the individual's "INTENT"

Transtheoretical Model

behavior change takes time, moving through sequential stages. The stages are fluid, so a person may move back and forth among stages

Identify the one way Epidemiology is used in Public Health from the below options: a.) assure a competent public health and personal health care workforce b.) link people to needed personal health services and assure the provision of health care when otherwise unavailable c.) enforce laws and regulations that protect health and ensure safety d.) evaluate effectiveness, accessibility, and quality of personal and population-based health services

d

Identify the source of the Hepatitis A Outbreak in San Diego California in late 2016? a.) strawberries b.) spinach c.) milk d.) unvaccinated drug addicts

d

Infection

entry and multiplication of an infectious agent in a host

Nightingale's Environmental Theory

environment, person, health and nursing

Microscopic Approach

examines individual and sometimes a families responses to health and illness

Vector

examples include mosquitoes, fleas, and ticks. May carry an infectious agent through purely mechanical means or may support growth or changes in the agent

Communicable Period

frequently begins before symptoms are present

Natural Active Immunity

immunity to chicken pox after having had the disease

Artificial Active Immunity

immunity to vaccine preventable disease after having had the immunizations

Vehicle

may indirectly transmit (i.e., passively carry) an infectious agent these include food, water, and biologic products such as blood

Health Protective Strategy

men at the barber shop having their blood pressures checked by the student nurses

Primary Vaccine Failure

occurs when a vaccine fails to stimulate an immune response

Fomite

one type of vehicle, but are inanimate objects such as handkerchiefs, bedding, or surgical scalpels

Innate Immunity

present at birth- found in skin, linings of our respiratory and GI tracts

Incubation Period

refers to the time from invasion to the time when disease symptoms first appear

Natural Passive Immunity

short term immunity passed from mother to neonate trasplacentally

Active Illness

symptoms are present