Chapter 9 - Epidemiology
A nurse is examining the various factors that lead to disease and suggests several areas where nurses could intervene to reduce future incidence of disease. Which of the following models would the nurse most likely use?
Web of Causality
A nurse has only a regular BP cuff when conducting a health screening for all of the residents of a community. Which of the following may be lacking when obtaining blood pressure readings?
Validity
Twenty people attended a church picnic the previous weekend. By Monday, four individuals exhibited symptoms of food poisoning. On Tuesday, the nurse in community health records the addition of two new cases. The incidence rate would be:
two new cases divided by 16 at risk
Which would be considered a serious epidemic of influenza?
unable to determine
Analytic Epidemiology differs from descriptive epidemiology, because it searches for:
"how & why" of disease patterns
A public health nurse found that out of the 70 people who ate the potato salad at a school picnic, 63 developed symptoms of food poisoning. Which of the following best describes the attack rate?
90% (63 / 70)
Statistics clearly demonstrate that there are significantly more cases of a disease in one particular neighborhood than in all the rest of the city. Assuming all else is the same, which of the following is the most likely explanation for single neighborhood having such a different pattern of illness?
A cultural or ethnic concentration in the neighborhood.
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 nurse in community health investigates a breakout of whooping cough in a local middle school.
Which of the following tools are used in analytic epidemiology?
A) Cohort study B) Case-control study C) Cross-sectional study
A nurse believes new mouth care procedure (MCP) is causing more mouth problems than it helping to avoid. Which of the following must be present for the nurse to go to administration with confidence that the new mouth care procedure (MCP) is causing problems? (select all that apply)
A) a plausible explanation of how the new MCP could cause harm B) consistently seeing mouth inflammation in many of the patients who received the MCP C) documentation from patient records that mouth inflammation in clients did not occur until after the new procedure was implemented
Which of the following explains why contagious infections are becoming a central focus of public health? (select all that apply)
A) americans are fearful of terrorists using biological agents B) drug resistant strains of 'old' disease have evolved
Nurses incorporate epidemiology into their practice and function in epidemiologic roles through (select all that apply):
A) collection, reporting, analysis, and interpretation of data B) environmental risk communication C) documentation on patient charts and records
Epidemiologic studies of diseases conducted by nurses during the twentieth century were influenced by the (select all that apply):
A) declining child mortality rates B) development of new vaccinations
A nurse is planning to host a health screening at a large urban mall. Which of the following variables will help the nurse determine which screenings should be included? (select all that apply)
A) health problems for which the specific population is at risk B) whether health care providers are available to follow up on any positive screening results
A nurse is concerned abut the high incidence of STDs in the community college population and sets up a special STD screening. Which of the following groups of students would be encouraged to attend?
A) sexually active students who had been screened the previous year B) students who claimed to not be sexually active and do not plan to become sexually active C) students who are sexually active but never go 'all the way'
Which is an example of an Epidemic?
Adult obesity in the United States
The most important predictor of overall mortality:
Age
An epidemiologist wanting to know what caused severe diarrhea and vomiting in several people at a local banquet would be using:
Analytic Epidemiology
Which of the following statistics is used by countries to compare the success of their health care systems?
Infant Mortality Rate
As a result of an outbreak of influenza in a community, a nurse encourages members of the community to receive the influenza vaccine. Which level of prevention is being used?
Primary Prevention
A man is diagnosed with prostate cancer. Which of the following data should the nurse know to answer the man when he asks, "What are the chances I'll survive this thing?"
Case Fatality Rate
John Snow is called the "Father of Epidemiology" because of his work with:
Cholera
Which of the following types of study should the nurse researcher choose if the goal is to identify the long-term benefits and risks of a particular nursing intervention for senior citizens living in the community?
Clinical Trial
The type of epidemiologic study that is used to describe a group of persons enrolled in study who share some characteristic of interest and who are followed over a period of time to observe some health outcome is a(n):
Cohort Study
Several small communities have applied for grant funding from the state department of health to help decrease their teenage pregnancy rate. Which of the following communities should the nurse suggest receive funding first?
Community D - with 90 single teenage pregnancies in a city of 1500
Voters have recently decided to have fluoride added to the city water system. Epidemiologists waning to study the effect of fluoride on dental caries would be conducting a(n):
Community trial
In which situation does the nurse need to be aware of the potential for selection bias?
Considering how the participants will enter the study
A study that uses information on current health status, personal characteristics, and potential risk factors or exposures all at once is called:
Cross-sectional
Immunizations for measles is an example of:
Primary Prevention
An example of an attack rate is the:
Proportion of people becoming ill after eating at a fast food restaurant.
A nurse is administering a TB skin test to a client who has AIDS. Which of the following results should the nurse anticipate when using this screening test?
Decreased sensitivity
The factors, exposures, characteristics, and behaviors that determine patterns of disease are described using:
Determinants
A nurse is using Analytic Epidemiology when conducting a research project. Which of the following projects is the nurse most likely completing?
Determining factors contributing to childhood obesity
An example of Primary Prevention:
Diet + Exercise
Which of the following actions would a nurse take to reduce the high incidence of coronary artery disease in a community?
Distribution of handouts, including age-appropriate games, self-assessments, and education on hear-healthy lifestyles; availability of community screenings for hyperlipidemia in persons age 35 and older; and walking programs for those affected with CAD
A nurse reports that in comparison to all the children in a particular school, the children who are members of the Cub Scouts have a 0.3 risk for obesity before entering the 6th grade. Which of the following recommendations would the nurse make to the new parents of two boys who had just moved into this school's neighborhood?
Encourage the parent to enroll their sons in Cub Scouts.
A nurse is examining all of the various factors which can lead to disease. Which of the following models would the nurse most likely use?
Epidemiologic Triangle
A nurse is employed as a Nurse Epidemiologist. Which of the following activities would most likely be completed by the nurse?
Evaluating the number of clients presenting with similar diseases.
An example of Tertiary Prevention:
Rehabilitative job training
When studying chronic disease, the multifactorial etiology of illness is considered. what does this imply?
Focus should be on the factors or combinations and levels of factors contributing to disease.
A nurse is investigating a bacterial illness that has caused a health problem in the community. Only some of the people exposed o the bacteria have become ill. Which of the following factors best explains why this would have happened?
Host factors
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 day. This individual's development of flu symptoms illustrates the relationship between:
Host, Agent, Environment
Which of the following statements describes how nursing in the community is more challenging than nursing in an acute care setting?
It is more challenging to control the environment in the community.
The administration at a local medical center examines the trends in health problems when developing long-range plans for staffing and space allocation. Which of the following sources of information would be most helpful?
Local data drawn from a professional survey in the city
An example of Secondary Prevention:
Mammogram
Public health professionals refer to 3 levels of prevention as tied to specific stages in the:
Natural history of disease
An outbreak of a GI illness from a food borne pathogen is an example of a(n):
Point Epidemic
To understand the causes of health and disease, Epidemiology studies:
Populations
The proportion of persons with positive test results who actually have a disease, interpreted as the probability that an individual with a positive test result has the disease, is the:
Positive Predictive Value
A screening for diabetes revealed 20 previously diagnosed diabetics and 10 probable new cases, which were later confirmed, for a total of 30 cases. This is called:
Prevalence
This year 600 of 8,000 young women ages 17 to 20 years at a university health center tested positive for a STD. Which of the following terms best describes this data?
Prevalence
A principal comments to the school nurse that it seems there are a lot more problems with asthma among students than there were before the school was remodeled a couple years ago. The nurse investigates the principal's observation by reviewing all the school records to determine visits to the health office because of asthma by week and month for the past 5 years. Which of he following best describes the type of study the nurse is conducting?
Retrospective Cohort Study
The probability an event will occur within a specified period of time is called:
Risk
When a nurse examines birth and death certificates during an epidemiologic investigation, what data category is being used?
Routinely collected data
Which is an example of an agent in the Epidemiologic triangle?
Salmonella
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:
Secondary Prevention
Screening for hearing defects is an example of:
Secondary Prevention
A nurse in concerned about the accuracy of the PPD test identifying cases of TB exposure for follow-up chest x-ray. The nurse's concern is addressing the validity measure of:
Sensitivity
Which of the following actions by Florence Nightingale demonstrates her role as an epidemiologist?
She demonstrated that a safer environment resulted in decreased mortality rate.
A nurse advises a client with osteoporosis to have three servings of milk or dairy products daily. Which of the following levels of prevention is being used by the nurse?
Tertiary Prevention
Vocational rehabilitation of a person with a neuromuscular disease is an example of:
Tertiary Prevention:
In a particular community several high school students were diagnosed wit diabetes mellitus type 2 during the annual high school health fair. Over the next few years, the nursing staff developed and implemented educational programs about the risk factors for DMII and proper nutrition. Which of the following would be most useful for the nurses to use to determine if they are having any impact?
The incidence of diabetes is slowly decreasing during screening events.
The nursing staff has attempted to screen the entire African American population in the community for diabetes. Which of the following would provide immediate verification of the success of the nursing staff's efforts?
The incidence of diabetes will increase in the community.
A woman is sitting in a corner of the clinical waiting room, crying audibly. The nurse asks, "What's wrong? Can I help?" The woman responds, "They just told me I have a positive mammogram and I need to see my doctor for follow-up tests. I know I'm going to die of cancer. How can I tell my family?" Which of the following information does the nurse need to know in order to help the wan cope with this finding?
The positive predictive value of mammography
A nursing staff has successfully screened for diabetes in the community. Which o the following might best persuade the health board to increase funding for diabetic clinics in this community?
The prevalence of diabetes is now higher than previously recognized in the community.
Between 2000 and 2005, 100 of 100,000 young women ages 17 to 20 years at a university tested positive for an STD. Of the 1,000 diagnosed, 300 were Gonorrhea and 500 were Chlamydia. Which of the following statements best summarizes these findings?
The proportion of STDs to the total population was 100 : 1000
Persons in an auditorium may have been exposed to a disease. If they are infected, it is crucial that they receive immediate treatment and not take the disease home to their families. Which of the following characteristics would be most important to consider when selecting the screening test to be used?
The sensitivity of the test
Two women seem to agree on almost everything from favorite music to favorite media stars to the best way to prepare a meal. Which of the following best explains this similarity in the two women?
They are both members of the same birth cohort.
A teacher recommends that surveys to obtain data on drug use be given to high school students when they meet for various school organizations. Which of the following best describes why the nurse would reject this suggestion?
This method of data collection would result in selection bias
A school nurse wants to decrease the incidence of obesity in elementary school children. Which of the following describes a secondary prevention intervention that the nurse could implement?
Weighing students to identify those who are overweight
A nurse is told that a screening test has high specificity. This means that the test:
accurately identifies those without the trait
Which statement is true about mortality rates? Mortality rates:
are informative only for fatal diseases
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:
current and past breast cancer events in this population of women.
Descriptive Epidemiology refers to the:
distribution of disease, death, and other health outcomes in the population according to person, place, and time --> who, where, when of disease patterns
Clinical medicine and epidemiology differ rom each other in the major aspect of:
practice focus.
One of the basic concepts in epidemiology is the concept of risk. Risk refers to the:
probability that an event will occur within a specified time period
The interaction between an agent, a host, and the environment is called:
the Epidemiologic Triangle