Community Health Exam 2
A study that uses information on current health status, personal characteristics, and potential risk factors or exposures all at once is referred to by what term? a. Cross-sectional b. Ecological c. Case-control d. Cohort
A Rationale: A cross-sectional study collects information on current health status, personal characteristics, and potential risk factors or exposures all at once. A cohort study is the type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome. An ecological model considers the multiple factors that contribute to disease development.
A nurse is providing education to a mother about the importance of having her infant immunized for measles, mumps, and rubella. Which of the following best describes the type of immunity that will be provided? a. Active b. Passive c. Natural d. Acquired
A Rationale: Active immunity refers to the immunization of an individual by administration of an antigen (infectious agent or vaccine) and is usually characterized by the presence of an antibody produced by the individual host. Passive immunity refers to immunization through the transfer of a specific antibody from an immunized individual to a non-immunized individual. Natural immunity refers to species-determined, innate resistance to an infectious agent. Acquired immunity is the resistance acquired by a host as a result of previous natural exposure to an infectious agent.
A nurse examines birth and death certificates during an epidemiologic investigation. Which of the following data categories is being used? a. Routinely collected data b. Data collected for other purposes but useful for epidemiologic research c. Original data collected for specific epidemiologic studies d. Surveillance data
A Rationale: Birth and death certificates are considered to be vital records and are examples of data collected routinely. Data collected for other purposes would be hospital, physician, health department, laboratory, and insurance records. Original data is that which is collected by the National Center for Health Statistics for specific health surveys. Surveillance data is used to assess and prioritize the health needs of populations, design public health and clinical services to address those needs and evaluate the effectiveness of public health programs.
What causes food intoxication? a. Toxins produced by bacterial growth and chemical contaminants b. Bacterial, viral, or parasitic invasion of food c. Overcooking of meat and produce d. Adding too many spices or ingredients to food
A Rationale: Food intoxication is caused by toxins produced by bacterial growth, chemical contaminants, and a variety of disease-producing substances found naturally in certain foods such as mushrooms and some seafood. Bacterial, viral, or parasitic invasion of food is not a cause of food intoxication. Food intoxication is not caused by overcooking meat or adding too many ingredients to food.
What is the best method for preventing health care-associated infections? a. Perform good hand washing before and after approaching every patient. b. Prevention is almost impossible due to the high infection rates in hospitals. c. Isolate every patient having surgery. d. Use contact isolation for every patient at risk.
A Rationale: Hand washing is the best way to prevent infection. If good hand washing is in place, it is not necessary to isolate patients or implement contact isolation. Prevention is possible with the use of good hand washing.
John Snow is called the "father of epidemiology" because of his work with which disease? a. Cholera b. Malaria c. Polio d. Smallpox
A Rationale: John Snow investigated the spread of cholera in the mid-nineteenth century. John Snow did not investigate the other examples.
Which statement is true about mortality rates? a. They are informative only for fatal diseases. b. They provide information about existing disease in the population. c. They are calculated using a population estimate at year-end. d. They reveal the risk of getting a particular disease.
A Rationale: Mortality rates are informative only for fatal diseases and do not provide direct information about the level of existing disease or the risk of getting a particular disease. Because the population changes during the course of a year, typically an estimate of the population at midyear is taken as the denominator for annual rates, because the midyear population approximates the amount of person-time contributed by the population during a given year.
Because of an outbreak of influenza in a community, a nurse encourages members of the community to receive the influenza vaccine. Which of the following levels of prevention is being used? Primary prevention Secondary prevention Tertiary prevention Multifactorial prevention
A Rationale: Nurses are involved in epidemiologic surveillance by monitoring the potential for disease outbreaks. Primary prevention refers to interventions aimed at preventing the occurrence of disease, injury, or disability. Immunizations are an example of primary prevention. Secondary prevention interventions are designed to increase the probability that a person with a disease will have that condition diagnosed at a stage when treatment is likely to result in cure. Tertiary prevention includes interventions aimed at disability, limitation and rehabilitation from disease, injury or disability, multifactorial prevention is not possible with a disease like influenza, which has one cause.
A screening for diabetes revealed 20 previously diagnosed diabetics and 10 probable new cases, which were later confirmed, for a total of 30 cases. Which of the following best describes what is being measured? a. Prevalence b. Incidence c. Attack rate d. Morbidity rate
A Rationale: Prevalence is the measure of existing disease in a population at a particular time. Incidence quantifies the rate of development of new cases in a population at risk, whereas an incidence proportion indicates the proportion of the population at risk who experience the event over some period of time. Attack rate is defined as the proportion of persons who are exposed to an agent and develop the disease. Morbidity rate is the incidence of disease.
A public health nurse (PHN) conducts an immunization clinic for measles. Which of the following is being implemented? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion
A Rationale: Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Immunizations are an example of primary prevention. Secondary prevention interventions are designed to increase the probability that a person with a disease will have that condition diagnosed at a stage when treatment is likely to result in cure. Tertiary prevention includes interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Health promotion is a specific primary prevention strategy.
A nurse promotes the use of universal precautions by all health care workers. Which of the following best describes the action that was taken by the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health care-associated infection
A Rationale: Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Secondary prevention seeks to prevent the spread of infection and/or disease once it occurs. Tertiary prevention reduces complications through treatment and rehabilitation. Health care-associated infections are prevented by good hand washing practices.
A nurse is presenting information to the county health department about potential bioterrorism threats. Which of the following agents would the nurse discuss in this presentation? a. Smallpox b. West Nile Virus c. Severe acute respiratory syndrome (SARS) d. Novel influenza A (H1N1)
A Rationale: Susceptibility to smallpox is 100% in the unvaccinated and fatality rate is estimated at 20% to 40% or higher. The agents of highest concern are anthrax, plague, smallpox, botulism, tularemia, and selected hemorrhagic viruses. West Nile Virus, SARS, and H1N1 are not viruses that would be used for bioterrorism.
An intervention that focuses on the tertiary level of prevention is implemented by the nurse. Which of the following did the nurse most likely complete? a. Rehabilitative job training b. Parenting education c. Testicular self-examination d. Family counseling
A Rationale: Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Rehabilitative job training would be an example of tertiary prevention. Parenting education is an example of primary prevention. Testicular self-examination and family counseling are examples of secondary prevention.
A nurse is teaching members of the community about vertical transmission of a disease. Which route would the nurse most likely discuss? a. Breast milk b. Sexual contact c. Mosquito bites d. Contaminated food
A Rationale: Vertical transmission is the passing of infection from parent to offspring via sperm, placenta, milk, or contact in the vaginal canal at birth. Transmission through sexual contact is horizontal transmission. Transmission from mosquito bites is vector transmission. Transmission from contaminated food is common vehicle transmission.
Which elements of surveillance does a nurse use? (Select all that apply.) a. Mortality registration b. Epidemic field investigation c. Laboratory reporting d. Individual case investigation e. Application of research
A, B, C, D
A nurse is studying the characteristics of an agent as part of the epidemiologic triangle. Which of the following is the nurse most likely studying? a. Human population distribution b. Salmonella c. Genetic susceptibility d. Climate
B Rationale: An agent includes infectious organisms, such as Salmonella, chemical agents, and physical agents. Genetic susceptibility is a characteristic of a host. Human population distribution and climate are characteristics of the environment.
A nurse is investigating the role of the agent in the cause of an illness. Which of the following best describes what the nurse is examining? a. Host resilience b. Virus c. Infectiousness d. Insect bite
B Rationale: An agent is described by its ability to cause disease and the nature and the severity of the disease. The four major categories of agents are: (1) bacteria, (2) parasites, (3) fungi, and (4) viruses. Host resilience is a host factor. Infectiousness is the measure of the potential ability of an infected host to transmit the infection to other hosts. Environmental factors facilitate the transmission of an infectious agent from an infected host to other susceptible hosts, such as an insect bite.
An epidemiologist wants to know what caused severe diarrhea and vomiting in several people at a local banquet. Which of the following principles is being applied in this situation? a. Descriptive epidemiology b. Analytic epidemiology c. Distribution d. Determinants
B Rationale: Analytic epidemiology is directed toward understanding the etiology of the disease. Descriptive epidemiology seeks to describe the occurrence of a disease in terms of person, place, and time. Distribution describes who has the disease and where and when the disease occurs. Determinants are the factors, exposures, characteristics, and behaviors that determine patterns of disease, which may be individual, relational, social, communal, or environmental.
A public health nurse (PHN) understands that the emergence of new infectious diseases is influenced by the what? a. Increased availability of immunizations b. Globalization of food supplies c. Decreased use of child care facilities d. Creation of sanitation systems in third world countries
B Rationale: Globalization of food supplies is one of the many factors that can influence the emergence of infectious diseases. The increased use of childcare facilities could contribute to the emergence of new infectious diseases. The lack of sanitation systems in third world countries could contribute to the emergence of new infectious diseases. The increased availability of immunizations should decrease the emergence of diseases.
What is immunity a characteristic of? a. An agent factor b. A host factor c. An environmental factor d. An epidemiologic triad
B Rationale: Immunity refers to species-determined resistance to an infectious agent and is determined by the characteristics of the host. The agent is the infection that is causing the infection/disease. Environmental factors may influence the susceptibility of the host. The epidemiologic triad involves the interaction of the host, agent, and environment.
A nurse is working in a health department when a patient arrives who has been traveling to South America and has been diagnosed with malaria. Which of the following considerations should be made by the nurse? a. The Morbidity and Mortality Weekly Report should be consulted to investigate the rate of malaria in the United States. b. This is a disease that must be reported to the state health department. c. The nurse should take precautions to wear a mask and gown to avoid exposure. d. The patient is very ill and should be sent to the hospital immediately.
B Rationale: Malaria is on the list of infectious diseases notifiable at the national level. The Morbidity and Mortality Weekly Report is published weekly with the rates of disease; however, this would not be the first consideration by the nurse. Malaria is not spread by direct contact, rather from a bite from an infected mosquito. Malaria begins with flu-like symptoms, or the client may have very few symptoms.
A nurse is investigating an outbreak of a gastrointestinal illness from a foodborne pathogen. The process associated with which of the following terms is being applied? a. Attack rate b. Point epidemic c. Secular trend d. Event-related cluster
B Rationale: One temporal and spatial pattern of disease distribution is the point epidemic. A point epidemic is most clearly seen when the frequency of cases is plotted against time. The sharp peak characteristic of such graphs indicates a concentration of cases in some short interval of time. Attack rate is defined as the proportion of persons who are exposed to an agent and develop the disease. Secular trends are long-term patterns of morbidity or mortality rates. Event-related clusters are patterns in which time is not measured from fixed dates on the calendar but from the point of some exposure or event, presumably experienced in common by affected persons, although not occurring at the same time.
The probability an event will occur within a specified time period is referred to by what term? a. Rate b. Risk c. Epidemiology d. Epidemic
B Rationale: Risk is the probability an event will occur within a specified period of time. Rate is a measure of the frequency of a health event in a defined population, usually in a specified period of time. Epidemiology is the study of the occurrence and distribution of health-related states or events in specified populations, including the study of the determinants influencing such states, and the application of this knowledge to control the health problems. Epidemic occurs when the rate of disease, injury, or other condition exceeds the usual level of that condition.
A nurse administers a rabies immunization post-exposure to an animal bite. Considering the interventions used with infectious disease, which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment
B Rationale: Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Primary prevention seeks to reduce the incidence of disease by preventing occurrence. Tertiary prevention reduces complications through treatment and rehabilitation. Assessment refers to the systematic collection of data.
A nurse offers a screening for hearing defects at a local community center. Which of the following best describes the action of the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion
B Rationale: Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Screenings are part of secondary prevention interventions. Primary prevention refers to interventions aimed at preventing the occurrence of disease, injury, or disability. Tertiary prevention includes interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Health promotion is a specific primary prevention strategy.
A nurse is considering the potential for selection bias. Which of the following best describes the situation that is the nurse has encountered? a. Determining the population to be studied b. Considering how the participants will enter the study c. Studying cause and effect relationships d. Documenting results of the study
B Rationale: Selection bias is attributable to the way subjects enter a study. It has to do with selection procedures and the population from which subjects are drawn. Determining the population to be studied relates to the design of the study. Studying cause and effect relationship has to do with ecological studies. Documenting the results of the study is completed at the end of the study after the participants have been selected.
A community health nurse has recently become involved in surveillance. Which of the following describes the situation that the nurse is in? a. Educating clients about influenza immunizations b. Collecting information about occurrence of measles c. Evaluating the effectiveness of an HIV/AIDS prevention program d. Advocating for changes in the national disease reporting requirements
B Rationale: Surveillance gathers the "who, when, where, and what"; these elements are then used to answer "why." Nurses are frequently involved in surveillance by collecting data, making diagnoses, investigating and reporting cases, and providing information to the public. Client education, program evaluation, and advocating for changes are not part of the surveillance process.
What is the time interval between invasion by an infectious agent and the first appearance of signs and symptoms of the disease called? a. Communicable period b. Incubation period c. Infectiousness d. Endemic
B Rationale: The incubation period is the time interval between invasion by an infectious agent and the first appearance of signs and symptoms. The communicable period is the interval during which an infectious agent may be transferred directly or indirectly from an infected person to another person. Infectiousness is the measure of the potential ability of an infected host to transmit the infection to other hosts. Endemic refers to the constant presence of a disease within a geographic area or a population.
What is the most important predictor of overall mortality? a. Race b. Age c. Gender d. Income
B Rationale: The mortality curve by age drops sharply during and after the first year of life to a low point in childhood, then begins to increase through adolescence and young adulthood and then increases sharply through middle and older ages. Race, gender, and income are not the most important predictor for overall mortality.
One case of smallpox occurs in a population in which it was previously eliminated. Which of the following best describes what has occurred? a. Endemic b. Epidemic c. Pandemic d. Infectivity
B Rationale: The occurrence of one case of smallpox in a population in which it was previously eliminated is an epidemic. Endemic refers to the constant presence of a disease within a geographic area or population. Pandemic refers to an epidemic occurring worldwide and affecting large populations. Infectivity is the ability to enter and multiply in the host.
A nurse is discussing the role of a vector in the spread of disease. Which of the following is the nurse most likely referring to? a. Contaminated water b. A tick c. A dirty needle d. An infected person
B Rationale: Vectors are arthropods such as ticks and mosquitoes that transmit the infectious agent by biting or depositing the infective material near the host. Contaminated water, a dirty needle, and an infected person would be common vehicles.
A nurse is caring for a client who has been diagnosed with West Nile Virus. Which of the following types of illness does the client have? a. Foodborne b. Vector-borne c. Waterborne d. Zoonoses
B Rationale: West Nile virus is carried by a mosquito, which is a vector. Foodborne illnesses are carried by food. Waterborne illnesses are transmitted through water. Zoonoses are infections that are transmitted from vertebrate animal to a human under natural conditions.
Requirements for disease reporting in the United States are mandated by what entity? a. The Centers for Disease Control and Prevention (CDC) b. Federal laws c. State laws and regulations d. The World Health Organization (WHO)
C Rationale: Requirements for disease reporting in the United States are mandated by state laws and regulations. These diseases are then reported to the CDC. State public health officials collaborate with the CDC to determine which diseases should be nationally notifiable. The federal government and WHO are not involved in disease reporting.
A nurse states incorporating epidemiology into practice and functions in epidemiologic roles. Which of the following best describes the actions taken by the nurse? (Select all that apply.) a. Policy making b. Collection, reporting, analysis, and interpretation of data c. Environmental risk communication d. Documentation on patient charts and records e. Law enforcement
B, C, D Rationale: Collection, reporting, analysis, and interpretation of data, environmental risk communication, and documentation on patient charts and records are examples of the use of epidemiology in practice. Policy making, and law enforcement do not apply to epidemiology.
During the twentieth century, a nurse participated in research that examined the epidemiology of various diseases. Which of the following best describes the factors that influenced these studies? (Select all that apply.) a. Increasing rate of poverty b. Declining child mortality rates c. Overcrowding in major cities d. Development of new vaccinations e. Advancements in medical equipment
B, D Rationale: Factors contributing to the development and application of epidemiologic methods in the twentieth century were: improved nutrition, new vaccines, better sanitation, the advent of antibiotics and chemotherapies, and declining infant and child mortality and birth rates. A rise in the standard of living occurred for many following the Great Depression and World War II. The advancements in medical technology have not influenced the examination of the epidemiology of various diseases.
What term is used to identify the type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period to observe some health outcome? a. Case-control study b. Cross-sectional study c. Cohort study d. Experimental study
C Rationale: A cohort study is the type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period to observe some health outcome. A case-control study uses a sample from the cohort rather than following the entire cohort over time. A cross-sectional study provides a snapshot of a population or group at one point in time. An experimental study is one in which the investigator initiates some treatment or intervention that may influence the risk or course of the disease.
Voters have recently decided to have fluoride added to the city water system. Epidemiologists now want to study the effect of fluoride on dental caries in this population. Which of the following would be conducted by the epidemiologists? a. Ecological study b. Double-blind study c. Community trial d. Screening
C Rationale: A community trial is similar to a clinical trial, but the issue is often health promotion and disease prevention rather than treatment of existing disease. An ecological model considers the multiple factors that contribute to disease development. A double-blind study is one in which neither the subject nor the investigator knows who is receiving the treatment. A screening involves the testing of groups of individuals who are at risk for a certain condition but are not yet symptomatic.
The nurse teaches food handlers to wash utensils after contact with raw meat. Which of the following best describes the focus of this education? a. Agent b. Host c. Environment d. Food handler
C Rationale: Environmental factors facilitate the transmission of an infectious agent from an infected host to other susceptible hosts. Teaching food handlers to wash utensils after contact with raw meat is a prevention that focuses on the environment. An agent is described by its ability to cause disease and the nature and the severity of the disease. The four major categories of agents are: (1) bacteria, (2) parasites, (3) fungi, and (4) viruses. A food handler is an example of a host, which is a human or animal that can harbor an infectious agent.
What is the most common vector-borne disease in the United States? a. Malaria b. Yellow fever c. Lyme disease d. Rocky Mountain spotted fever
C Rationale: Lyme disease is the most common vector-borne disease in the United States, with over 30,000 confirmed cases and probable cases reported to CDC in 2012. Yellow fever and Rocky Mountain spotted fever are both vector-borne diseases but are not the most common. Malaria is most prevalent vector-borne disease worldwide.
A nurse who is studying chronic disease considers the multifactorial etiology of illness. What does this imply? a. Genetics and molecular structure of disease is paramount. b. Single organisms that cause a disease, such as cholera, must be studied in more detail c. Focus should be on the factors or combinations and levels of factors contributing to disease. d. The recent rise in infectious disease is the main focus.
C Rationale: Multifactorial etiology implies a focus on combinations and levels of factors. There are many factors to consider other than only genetics or single organisms with multifactorial etiologies. The focus of studying multifactorial etiology is on chronic disease.
A nurse is caring for a client who has been diagnosed with a parasitic infection. Which of the following information should the nurse know when caring for this client? a. The medication to prescribe to treat these infections b. The nature and symptoms of all parasitic illnesses c. What specimens to collect and how and when to collect them d. Public policy about parasitic infections
C Rationale: Nurses need to be cognizant about what specimens to collect, how and when to collect, and what laboratory techniques to use. Proper specimen collection is necessary so that the clinical diagnosis can be confirmed. It is not necessary for the nurse to know the signs and symptoms for all parasitic infections in order to provide care for the client. Public policy about parasitic infections is not important to know when providing care for the client.
What term is used to identify the proportion of persons with positive test results who have a disease, interpreted as the probability that an individual with a positive test result has the disease? a. Sensitivity b. Specificity c. Positive predictive value d. Negative predictive value
C Rationale: Positive predictive value refers to the proportion of persons with positive test results who actually have the disease, interpreted as the probability that an individual with a positive test result has the disease. Sensitivity quantifies how accurately the test identifies those with the condition or trait. Specificity indicates how accurately the test identifies those without the condition or trait. Negative predictive value is the proportion of persons with a negative test who are disease free.
A public health nurse (PHN) implements a primary prevention intervention in the community. Which of the following is most likely being implemented? a. Pap smear b. Blood pressure screening c. Diet and exercise d. Physical therapy
C Rationale: Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Blood pressure screening and pap smears are secondary prevention interventions. Physical therapy is a tertiary prevention intervention.
A nurse is told that a screening test has high specificity. Which of the following is the best interpretation of this information? a. The test provides precise and consistent readings. b. The test accurately identifies those with the condition or trait. c. The test accurately identifies those without the trait. d. The test has a high level of false positives.
C Rationale: Specificity refers to the test accurately identifying those without the trait. High specificity is needed when rescreening is impractical and when reduction of false positives is important. The test would have a low level of false positives.
A nurse refers a client diagnosed with a neuromuscular disease to a vocational rehabilitation program. Which of the following best describes the action of the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion
C Rationale: Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Referral of a client with a disease is an example of tertiary prevention. Primary prevention refers to interventions aimed at preventing the occurrence of disease, injury, or disability. Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Health promotion is a specific primary prevention strategy.
The nurse provides footwear and gloves to leprosy clients to prevent trauma to their insensitive and deformed hands and feet. Which of the following best describes the intervention used by the nurse? a. Primary level of prevention b. Secondary level of prevention c. Tertiary level of prevention d. Primary health care
C Rationale: Tertiary prevention reduces complications through treatment and rehabilitation. Primary prevention seeks to reduce the incidence of disease by preventing occurrence. Secondary prevention seeks to prevent the spread of infection and/or disease once it occurs. Primary health care is the essential health care services provided by physicians and other health care providers.
A nurse is providing information to a local newspaper about the presence of infectious diseases in the United States. Which of the following statements by the nurse is accurate? a. "It is the goal of the WHO to prevent the transmission of the plague by avoiding direct contact with inflicted individuals." b. "Rabies is easily spread by contact with animals." c. "The United States is a certified polio-free country." d. "The onset of tularemia is characterized by a distinct skin lesion often called a bull's-eye lesion."
C Rationale: The Americas are certified polio free. The plague is a vector-borne disease and cannot be spread by direct contact with inflicted individuals. Rabies is a rare event because of the widespread vaccination of dogs in the 1950s. The Americas were certified as polio free in 1994. The onset of Lyme's disease is characterized by a bull's-eye lesion.
Public health professionals refer to three levels of prevention as tied to specific stages in what related factor? a. An epidemiologic triangle b. A web of causation c. The natural history of disease d. The surveillance process
C Rationale: The natural history of disease is the course of the disease process from onset to resolution. The three levels of prevention provide a framework commonly used in public health practice to depict this process. The epidemiologic triangle consists of the interaction between an agent, a host, and the environment. The web of causality reflects the more complex interrelationship among the numerous factors interacting, sometimes in subtle ways, to increase (or decrease) risk of disease. The surveillance process involves the systematic collection, analysis, and interpretation of data related to the occurrence of disease and the health status of a given population.
A public health nurse (PHN) would like to increase the immunization coverage of infants and toddlers. Which of the following strategies would be appropriate for the nurse to use? a. Read the Mortality and Morbidity Weekly Report to learn about vaccinations. b. Require that children have all their immunizations before going to public school. c. Track children known to be at risk for under-immunization. d. Lead teams of health care workers to enforce laws related to immunizations.
C Rationale: Tracking children known to be at risk for under-immunization is a function of PHNs who work in health departments where immunizations are given and tracked. Reading the Mortality and Morbidity Weekly Report, requiring that children have all their immunizations before attending school, and leading teams of health care workers would not be as effective in increasing immunization coverage for this population.
A community health nurse investigates an outbreak of pinworm at a local daycare center. To minimize the spread of infection, which of the following suggestions would the nurse provide to the daycare workers? a. Close the daycare until all surfaces are cleaned. b. No action is necessary because it is easily treated with oral vermicides. c. Using good hand washing is important to prevent the transmission. d. Every child in the daycare should be treated because they all are probably infected.
C Rationale: Transmission of pinworm occurs through the fecal-oral route, so good hand washing after toileting is essential. It is not necessary to treat all children or close the daycare. It is necessary that action be taken, as without any action being taken, the pinworm outbreak will continue.
A public health nurse (PHN) reports an attack rate. Which of the following has most likely been reported? a. Number of cases of cancer recorded at a medical center. b. Number of people who died of Ebola in a given year. c. Number of beef cattle inoculated against mad-cow disease on a farm. d. Proportion of people becoming ill after eating at a fast-food restaurant.
D Rationale: Attack rates are often specific to exposures, such as food-specific attack rates. The number of cases of cancer, exposure to Ebola, and beef cattle are not significant without knowing the total number of people so that a proportion can be calculated.
What is used to determine patterns of disease using existing factors, exposures, characteristics, and behaviors? a. Descriptive epidemiology b. Analytic epidemiology c. Distribution d. Determinants
D Rationale: Determinants are the factors, exposures, characteristics, and behaviors that determine patterns of disease, which may be individual, relational, social, communal, or environmental. Descriptive epidemiology seeks to describe the occurrence of a disease in terms of person, place, and time. Analytic epidemiology focuses on the investigation of causes and associations. Distribution describes who has the disease and where and when the disease occurs.
A community health nurse is caring for a client with methicillin-resistant Staphylococcus aureus (MRSA). Which of the following should the nurse be aware of? a. Persons with MRSA usually have a chronic illness. b. MRSA is a hospital-acquired infection and not often seen in the community. c. Vancomycin-resistant Staphylococcus aureus (VRE) follows MRSA. d. MRSA is becoming more common in the community.
D Rationale: MRSA is being seen more and more in the community with outbreaks frequently associated with school athletic programs and prison populations. MRSA is still largely a health care-associated infection, but it is becoming more common. VRE was found before MRSA. MRSA is not associated with chronic illness.
A nurse is investigating a serious epidemic of influenza. Which of the following best describes the amount of cases that are being examined? a. 50 cases b. 100 cases c. 500 cases d. Unable to determine
D Rationale: One cannot tell the degree of seriousness without a denominator, which represents the total population at risk.
A nurse implements a program that focuses on secondary prevention. Which of the following is most likely the topic of this program? a. Rehabilitation b. Avoidance of high-risk behaviors c. Immunization d. Mammogram
D Rationale: Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Mammograms are a screening test. Avoidance of high-risk behaviors and immunizations are examples of primary prevention. Rehabilitation is an example of tertiary prevention.
The ability of an agent to produce a severe pathologic reaction is known by what term? a. Antigenicity b. Invasiveness c. Toxicity d. Virulence
D Rationale: The ability of an agent to produce a severe pathologic reaction is known as virulence. Antigenicity is the ability to stimulate an immunological response. Invasiveness is the ability to penetrate and spread throughout a tissue. Toxicity is the ability to produce a poisonous reaction.
What is the interaction between an agent, a host, and the environment called? a. Natural history of disease b. Risk c. Web of causality d. The epidemiologic triangle
D Rationale: The epidemiologic triangle consists of the interaction between an agent, a host, and the environment. The natural history of disease is the course of the disease process from onset to resolution. Risk is the probability an event will occur within a specified period of time. The web of causality reflects the more complex interrelationship among the numerous factors interacting, sometimes in subtle ways, to increase (or decrease) risk of disease.
To understand the causes of health and disease, epidemiology studies which population? a. Individuals b. Families c. Groups d. Populations
D Rationale: The goals of epidemiology are to monitor health of populations, understand determinants of health and disease in communities, and investigate and evaluate interventions to prevent disease and maintain health. Epidemiology does not focus on individuals, families, and groups.
