Unit 8 - Environmental Health

a newly hired occupational health nurse is assessing hazards in the work environment.which of the following actions will help the nurse detect potential physical hazards? 1. track rates of illness caused by infection among employees 2. survey workers about job related emotional stress 3. identify industrial toxins that are present in the environment 4. measure noise levels at various locations in the facility

4. measure noise levels at various locations in the facility

A nurse is using the I Prepare mnemonic to assess a client's potential environmental exposures. Which of the following questions should the nurse ask when assessing for "a" in the mnemonic? A. "What do you like to do for fun?" B. "What year was your residence built?" C. "What jobs have you had in the past?" D. "What industries are near where you live?"

A. CORRECT: The "a" in the I‑Prepare mnemonic represents activities. The nurse should ask this question to determine hobbies and interests that might cause harm or expose the client to harmful substances. B. The nurse should ask this question to assess the first "r," which represents residence in the mnemonic. C. The nurse should ask this question to assess the second "P," which represents past work in the mnemonic. D. The nurse should ask this question to assess the first "e," which represents environmental concerns in the mnemonic.

When assisting specific aggregates, which of the following should be included in the community health nurse's outcomes? A. Helping people learn from their own experiences and analyzing the world with the intention to change it B. Honesty, fairness, and mutuality in the interactions C. Intervening in mutual exchanges with community members and citing the current literature D. Asking critical questions of the aggregates involved

A. Helping people learn from their own experiences and analyzing the world with the intention to change it

An occupational health nurse is educating employees about work-related hazards. Which of the following hazards would the nurse most likely discuss in the presentation? a. Workplace stress leading to hypertension and cardiovascular disease b. Asbestos, plastics, lead, and solvents leading to dermatitis c. Cement dust and metals leading to bronchitis d. Hormones and nitroglycerine leading to reproductive effects

ANS: A Work-related stress or burnout has been defined as an important problem for many individuals. Responses to negative interpersonal relationships, particularly those with authority figures in the workplace, are often the cause of vague health symptoms and increased absenteeism. Education about stress would be pertinent to all workers, regardless of specific job or setting.

A city has announced its plans to build a city dump near a community of poor and predominantly African-American citizens. Which of the following principles would the nurse be using when vocalizing opposition for this plan? a. Environmental justice b. Environmental epidemiology c. Tertiary prevention d. Risk communication

ANS: A Environmental justice is the goal of campaigns seeking to improve the unequal burden of environmental risks borne by impoverished and minority communities. The Environmental Justice Act would be used in support of the nurse's position. Environmental epidemiology is concerned with the discovery of environmental exposures that contribute or protect against disease or illness which is not accomplished by the nurse vocalizing opposition to the plan. Vocalizing opposition to the plan would not be a tertiary prevention strategy as the nurse is addressing a problem that does not yet exist. Risk communication includes general principles of good communication (right information, to the right people, at the right time). In this scenario, the nurse is vocalizing opposition, not communicating risks

Which of the following actions represents the use of secondary prevention to reduce environmental health risks? a. Collecting blood specimens from preschool children to check for lead levels b. Meeting with local government officials to request that the city clean up a hazardous vacant lot c. Referring a child with toxic lead levels to a neurologist d. Teaching parents of a 2-year-old about the dangers of lead-based paint in older homes

ANS: A Secondary prevention refers to actions such as surveillance and screening, which are undertaken so that problems may be detected at early stages. Meeting with local government officials to request that the city clean up a hazardous vacant lot and referring child with toxic lead levels to a neurologist are examples of tertiary prevention as the problem already exists. Education to avoid exposure is part of primary prevention which relates to teaching parents about the dangers of lead-based paint in older homes.

An occupational health nurse is assessing workplace hazards. Which of the following would be the best method for the nurse to use? a. Review incident reports. b. Walk through the worksite. c. Interview key employees. d. Read the Standard Industrial Classification (SIC) Code.

ANS: B One of the best methods an occupational health nurse can use in assessing workplace hazards is to walk through the worksite. Reviewing incident reports, interviewing key employees, and reading the SIC Code do not provide the nurse with as much information as walking through the worksite.

A college health nurse is working with students, faculty, and staff to improve environmental air quality. To address the primary cause of air pollution on campus, the nurse plans a precautionary intervention. Which of the following interventions best demonstrates an appropriate approach? a. Encourage the use of electric cars and scooters on campus b. Increase the use of bicycles, foot-powered scooters, rollerblades, and walking as the primary mode of transportation on campus c. Make the entire campus a no-smoking zone d. Establish a policy to reduce electricity consumption in university buildings by raising the thermostat to 78° in the summer and lowering the thermostat to 70°in the winter

ANS: B The burning of fossil fuels to power automobiles and buses and to generate electricity is the single greatest source of air pollution in the United States.

A community health nurse manager has integrated exposure history elements into the assessment practices of the health department that are relevant to the urban industrial community served. This strategy indicates that the nurse manager is aware of the relationship between: a. community strengths and weaknesses. b. environment and human health/disease. c. toxicology studies conducted by the Environmental Protection Agency and the environment. d. federal and state environmental regulations.

ANS: B Understanding the relationship between the environment and human health and disease has become more important over the years.

When applying the nursing process to environmental health, the nurse would: a. conduct an assessment focused on the client's presenting problem. b. coordinate interventions with the primary care provider of record. c. examine criteria that are limited to the client's immediate responses. d. include outcome measures that involve mitigation and elimination of the contributing factors.

ANS: D If the nurse suspects that the client's health problem is being influenced by environmental factors, the nurse should follow the nursing process and note the environmental aspects of the problem in every step of the nursing process.

An emergency department nurse assesses a 25-year-old patient with tachycardia, headache, and nausea. The patient denies drug use, heart problems, and smoking. She works from her house and states that everyone in her house has had the "flu" but that she is the only one who has not been feeling better. The nurse notices that the patient lives in the historic section of the town. What environmental hazard should the nurse be primarily concerned about? A. Food quality B. Housing quality C. Water

B

A nurse is caring for a client who is from a different culture than himself. When beginning the cultural assessment, which of the following actions should the nurse take first? A. Determine the client's perception of his current health status. B. Gather data about the client's cultural beliefs. C. Determine how the client's culture can affect the effectiveness of nursing actions. D. Gather information about previous client interactions with the health care system.

B. CORRECT The nurse's first action when beginning a cultural assessment is to collect self‑identifying data about the client, including specific information about how the client's cultural beliefs influence family structure, food patterns, religious preferences, and health practices

A nurse is conducting health screenings at a statewide health fair and identifies several clients who require referral to a provider. Which of the following statements by a client indicates a barrier to accessing health care? A. "I don't drive, and my son is only available to take me places in the mornings." B. "I can't take off during the day, and the local after‑hours clinic is no longer in operation." C. "Only one doctor in my town is a designated provider by my health maintenance organization." D. "I would like to schedule an appointment with the local doctor in my town who speaks Spanish and English."

B. CORRECT: Inconvenient hours make scheduling a follow‑up appointment challenging, and indicates a barrier to accessing health care for this client

Which of the following interventions would be the most appropriate to implement for a community that has a high risk for environmental health hazards? A. Facilitate the evaluation of ongoing community health interventions. B. Document participation levels of families in environmental issues. C. Involve citizens in decision-making processes about proposed activities that could pose an environmental threat. D. Screen at-risk populations for asthma and test blood levels for air pollutants.

C. Involve citizens in decision-making processes about proposed activities that could pose an environmental threat.

A community health nurse is teaching a group of clients about environmental health hazards. Which of the following examples should the nurse include as a possible source of carbon monoxide exposure a. Washing machines b. Gas ranges c. Air conditioners d. Electric space heaters

b. Gas ranges Carbon monoxide is an odorless, colorless, tasteless gas that is emitted into the air. Gas ranges, motor vehicles, and fire places are potential sources for carbon monoxide exposure.

a community health nurse observes the accumulation of garbage at a neighborhood playground. which of the following actions should the nurse take first to promote a clean and safe environment? 1. meet with community members to discuss methods of playground maintenance 2. partner city officials with community members to improve the playground condition 3. work with local businesses to sponsor more trash receptacles in the playground 4. engage neighborhood families to monitor the playground for further trash buildup

1. meet with community members to discuss methods of playground maintenance

Which of the following statements about children and environmental hazards is correct? a. The prevalence of autism is directly related to the increase in environmental toxins. b. Children are more susceptible to environmental toxins because of their smaller size. c. The incidence of asthma among children has been decreasing. d. Children are more susceptible to cancer if they have a family history of the disease.

ANS: B Because of the smaller size of children, they are exposed to higher doses of pesticide residues in the foods they eat and drink. Infants and young children drink more fluids per body weight than adults, and this increases the dose of contaminants in their drinking water, milk (hormones and antibiotics), and juices (particularly pesticides). Only a small percentage of childhood cancers are associated with heredity. However, exposure to ionizing radiation increases the risk of childhood leukemia and possibly other cancers. All of the causes of autism spectrum disorder are not currently known. Environmental factors are thought to be a possible cause, as are biologic and genetic factors. Asthma is common among children, and the strongest risk factors are genetic factors and inhaled substances and particles that provoke an allergic reaction or irritate the airways. Indoor air quality is a growing concern because of the alarming rise in the incidence of asthma in the United States,

A nurse is assessing potential environmental health risks in the community. Which of the following would be the first step that the nurse should take? a. Conduct health risk assessments of randomly selected individuals. b. Perform a windshield survey. c. Review facility permits and consumer confidence reports. d. Survey community members.

ANS: B Conducting a windshield survey is a useful first step to understanding potential environmental health risks. This provides firsthand information about the community and areas of concern that must be investigated. Conducting health risk assessments of randomly selected individuals or surveying community members does not give the nurse a good assessment of potential environmental health risks of the entire community. Reviewing facility permits and consumer confidence reports would not provide enough information to assess the environment of a community.

An occupational health nurse has conducted a walk-through assessment and has identified potential hazards in the workplace. The nurse recognizes that it will be easiest to modify exposure to which hazard? a. Bacteria b. Aerosols c. Noise d. Burnout

ANS: C Controlling physical agents, such as noise, can usually be accomplished through engineering strategies and personal protective equipment. It is much harder to change biological agents (bacteria), chemical agents (aerosols), and psychosocial agents (burnout).

Which types of industries are noted for high degrees of hazards associated with the work? a. Data entry, animal rescue, and hospice b. Engineering, science, and laboratories c. Manufacturing, mining, and agriculture d. Aeronautics, plastics, and nursing

ANS: C Manufacturing, mines, construction, and agriculture are noted for their high degree of hazards associated with their work. However, no worksite is free of occupational health and safety hazards.

A nurse is assessing host factors as part of the epidemiologic triad. Which of the following factors would the nurse most likely assess? a. Crowding b. Shift work c. Worker's family d. Chemical exposure

ANS: C The worker's family is considered a part of the host factor. Crowding and shift work are environmental factors, and chemical exposure is the agent factor.

A nurse is completing a basic health assessment. Which of the following questions should be asked by an environmentally aware nurse? a. "Is anyone else in your family having these symptoms?" b. "How many people live in your home?" c. "What jobs have you held the longest?" d. "Where did you live 10 years ago?"

ANS: C An exposure history should identify current and past exposures, have a preliminary goal of reducing or eliminating current exposures, and have a long-term goal of reducing adverse health effects. The "I PREPARE" mnemonic consigns the important questions to categories that can be easily remembered. Asking about previous employment helps to answer the "P" of past work. The other questions do not address the topics identified in the "I PREPARE" mnemonic (investigate potential exposures, present work, residence, environmental concerns, past work, activities, referrals, and resources, and educate).

An occupational health nurse at a local factory is using primary prevention strategies to reduce the environmental health risks among the employees. Which of the following activities would the nurse most likely implement? a. Checking radiation detectors to monitor for unsafe levels of radiation exposure b. Irrigating the eyes of an employee who has had a chemical splash to the face c. Teaching new employees who will work outdoors about the signs and symptoms of heat-related illness d. Using spirometry

ANS: C Education is a primary preventive strategy. When examining the sources of environmental health risks in communities and planning intervention strategies, it is important to apply the basic principles of disease prevention. Checking radiation detectors and using spirometry are both examples of screening for potential exposure which is part of secondary prevention. Irrigating the eyes of an employee who had a chemical splash to the face addresses tertiary prevention as a problem has already occurred.

An occupational health nurse practitioner's physical assessment of a factory worker identifies an acute-onset pruritic dermatitis extending over the face, hands, neck, and forearms. The nurse's priorities should be to: a. contact factory senior management, educate workers about their exposure, and clean the area. b. contact the Occupational Safety and Health Administration immediately and remove the offending chemical in the work environment. c. immediately evacuate the worker's nearby workspace and treat the worker and other exposed workers. d. treat the client and obtain a comprehensive exposure history; if an on-site environmental exposure is suspected as the cause, screen other at-risk workers and ensure that the environmental risk is identified and eliminated.

ANS: D A careful history should be taken using the I PREPARE (Investigate potential exposures, Present work, Residence, Environmental concerns, Past work, Activities, Referrals and resources, Educate) model.

Campaigns to decrease the inequitable burden of environmental risks on the poor and people of color in the United States strive to apply the ethical principle of: a. societal justice. b. nonmaleficence. c. compliance and enforcement of the Environmental Protection Agency Regulatory Act. d. environmental justice.

ANS: D Environmental health risks notably have disproportionately affected poor people and people of color in the United States.