Community Exam 2 Questions
A public health nurse is surveying a population of coal miners. Which of the following questions would elicit information about related risk to a miner's children?
"How close do you live to your workplace?" Environmental health effects can be immediate, long term, or intergenerational. Although often overlooked, a parent's occupation may put his or her children in danger. Living close to a coal mine could increase the children's risk for exposure to water or ground contamination from the mine, among other environmental hazards. The other options do not assess the proximity of the environmental hazard.
Which statement indicates that further teaching is needed for a patient involved in family planning?
"I can't get human papilloma virus (HPV) from my boyfriend because he doesn't have genital warts." Option 1 indicates the patient needs more teaching. HPV is viral, and the virus may shed or transmitted with or without the presence of warts. The other statements are true
Which of the following describes a NA-TECH (natural technological) type of disaster?
A tornado resulting in flood and destruction of electrical systems for a community A NA-TECH disaster is a natural disaster that creates or results in a widespread technological problem. A flood covering crops and recreational areas of a geographic area does not mention a technological problem, and a terrorism attack and a nuclear accident are not natural disasters.
Which of the following environmental stressors directly assaults human health?
Air pollution Air pollution and poisoning directly assault human health. Noise and litter affect quality of life. Global warming affects the ecologic balance
The community health nurse is working in an emergency shelter with displaced families. Which of the following clients have risk factors for posttraumatic stress disorder (PTSD)?
An 18-year-old client with a previous gunshot wound, A 50-year-old client who saw people die in the disaste, A 23-year-old client experiencing extreme fear, A 35-year-old client with a history of schizophrenia Risks for PTSD include living through dangerous events or traumas; having a history of mental illness; getting hurt; seeing people hurt or killed; feeling horror, helplessness, or extreme fear; having little or no social support after the event; and dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.
An epidemic is occurring in a public health nurse's community, and the nurse is working with the epidemiologist and other health professionals seeking to identify the causative agent. What phrase best describes such efforts?
Analytic epidemiology Analytic epidemiology may be defined as close examination of identified possible causes of disease using advanced epidemiologic methods. Cohort studies obtain information about the cause of disease by establishing a relationship between the presumed causal factors and the effect. The study of the amount and distribution of disease constitutes descriptive epidemiology. When prevalence rates describe the number of people with the disease at a specific point in time, they are sometimes called point prevalences.
Which of the following occupational health nursing interventions would be appropriate secondary prevention strategies?
Arrange for the collection of baseline liver function tests if the employee will be working with a chemical known to cause liver toxicity. Provide vision, blood pressure, hearing, and cancer screenings on an annual basis. Coordinate periodic evaluations to ensure workers are placed in the safest worksite setting. Secondary prevention strategies are aimed at early diagnosis, early treatment interventions, and attempts to prevent disability. All three choices focus on identification of health needs, health problems, and employees at risk
Important historical events leading to the development of occupational health nursing as a specialty practice include which of the following?
Betty Moulder was employed by a group of companies to care for coal miners and their families, Ada Mayo Stewart was hired by the Vermont Marble Company to care for the company's workers, A nursing service was established for employees of the Frederick Loeser department store in Brooklyn, New York, Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home. Occupational health nursing dates to the late 1800s with the employment of Betty Moulder by a coal mining company and Ada Mayo Stewart by a marble company. After that, the Fredrick Loeser department store hired a nursing service for employees and Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home. Lillian Wald was instrumental in the development of public health nursing.
What element of a community disaster plan investigates the citizen's reliance on telephone systems or cell phones during disasters?
Communication Communication is one of the biggest problems during a disaster. The reliance on telephone systems or cell phones should not be the only plan for communication during a disaster. Authority focuses on the people in charge, logistical includes focuses on storage of equipment and location of key responders, and search and rescue focuses on the search and rescue of victims.
The public health nurse is working with a specific population and is preparing to participate in a descriptive epidemiology study. Which of the statements apply to descriptive epidemiology?
Descriptive epidemiology seeks to answer questions about the AMOUNT of disease in a given population. Descriptive epidemiology seeks to answer questions about the DISTRIBUTION of disease in a given population. The study of the amount and distribution of disease constitutes descriptive epidemiology. Patterns identified through descriptive epidemiology may indicate possible causes. When these possible causes are investigated with different and more advanced epidemiologic methods, this is analytic epidemiology.
A family of five people presented to a hospital after the flooding of their urban home. These family members are classified as which of the following?
Displaced persons Displaced persons are those who have to evacuate their home, school, or business as a result of a disaster. An indirect victim may be a family member or friend of the victim or a first responder. A mass casualty event is one in which 100 or more individuals are involved. Poverty is not considered a disaster classification.
Which agency has a mission to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all?
Federal Emergency Management Agency (FEMA) FEMA's mission is to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all. The other agencies may be peripherally involved in national disasters but it is not their primary focus
The first nurse to establish international links and networks was:
Florence Nightingale. Florence Nightingale's legacy serves as the foundation for community health nursing in the global health care arena. She channeled her energy into all aspects of health from the care of wounded soldiers at Scutari to the broad public policies that affected health in her time. The other three women were instrumental primarily for their contributions in the United States
Four-month-old Lucy is in for immunizations at the local health department. The Vaccine Information Sheet is given to Lucy's mother, and informed consent is obtained. However, the mother then states, "Lucy did have a temperature around 99.1 degrees the night of her last immunizations." After this statement, the nurse should do which of the following?
Give the immunizations. A low-grade fever is not a contraindication to immunizations. The nurse should give the immunizations. It is not necessary to contact the child's pediatrician. Vaccination should be postponed in cases of moderate or severe febrile illness to avoid any confusion between a vaccine side effect and an unknown underlying cause.
The nurse at the disaster site is using the SMART triage system. What color triage tag would be provided to an ambulatory individual with a superficial cut on the left elbow and bruise to the right hand?
Green Green is for the wounded or individuals with minor injuries who are able to walk and to wait several hours before receiving medical treatment. Red is for those with life-threatening injuries but have a high probability of survival, yellow is for those with systemic but non-life-threatening complications, and black is for the deceased or those with non-survivable injuries.
Approaching health at the aggregate level is the initiative of which agency or document?
Healthy People 2020 An attempt to approach health at the aggregate level is the Healthy People 2020 initiative. It deals with issues ranging from decreasing ozone levels to decreasing Escherichia coli outbreaks. All of these issues deal with the broader environmental origins of disease, not just deleterious personal habits. OSHA, Clean Air for All, and the CDC have a more narrow focus.
When assisting specific aggregates, which of the following should be included in the community health nurse's outcomes?
Helping people learn from their own experiences and analyzing the world with the intention to change It Nursing's role in the community is to create a context from which people can learn and identify health-damaging problems from within their environment. It is essential that the affected people participate in the process of identifying and working to solve environmental problems. The other options do not allow the people to participate in the process that affects their ability to learn and thus make change.
Which phase of the community response to disaster includes medical personnel contributing long hours of volunteer work helping unfamiliar people after a disaster?
Heroic phase The heroic phase of a community's reaction to a disaster involves people feeling the need to rush to help people survive the disaster. Medical personnel may volunteer to work long hours without sleep and in dangerous conditions to care for patients. During the honeymoon phase, people who have survived the disaster get together to talk about their experiences. People begin to look to the future during the reconstruction phase and during the disillusionment phase people recognize that many things are different, and much needs to be done to adjust to the current situation
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?
Housing quality Older homes and buildings often have poor ventilation and harbor hazardous materials. The signs and symptoms this patient is experiencing may be a result of "sick building syndrome." Gastrointestinal symptoms might indicate an issue with food or water quality. Occupational risks do not take into consideration the environmental hazard related to housing.
A community nurse is reviewing health statistics to gain a better understanding of a population's health needs. Crude rates are available for several health occurrences. What statement accurately describes crude rates?
In calculating a crude rate, the average population size may be used as denominator. Crude rates are calculated by using the number of events as the numerator. The denominator used may be the average population size or the population size at midyear and not the population at risk. Crude rates are subject to certain biases in interpretation.
The nurse working in the community is aware that there are different models for studying the epidemiology of a health condition in a population. One model of investigation of the interrelationships and characteristics of disease is the epidemiologic triangle. This model analyzes what three elements?
Incidence, prevalence, and etiology The epidemiologic triangle considers the extent of the host's exposure to the agent, the virulence of the agent, and the host's genetic or immunologic susceptibility to the agent. Environmental conditions at the time of exposure are also considered. Examination of these three elements allows assessment of the problem, determination of protective factors, and evaluation of the vulnerability of the host to disease. The person-place-time model organized epidemiologists' investigations of the disease pattern in the community.
Population overcrowding can result in which of the following?
Increased incidence of disease Overcrowding leads to pollution, stress, disease, and violence. Mortality rates are increased, and quality of life decreases.
Katie, a 2-year-old child, is brought to the doctor's office after 2 days of vomiting and diarrhea. Upon completion of the medical history, the mother tells the nurse that several of the other children at the daycare who played with the same toys as Katie have the same symptoms. The mode of transmission for the pathogen more likely was which of the following?
Indirect The stem of the question indicates that the children played with the same toys. This would indicate the indirect mode of transmission. The other modes of transmission do occur through the sharing of toys.
Which of the following factors causes primary vaccine failure?
Inefficient storage, An intramuscular vaccine injection given subcutaneously, Light-sensitive vaccines exposed to light, and Seroconversion Primary vaccine failure is the failure of a vaccine to stimulate any immune response. It can be caused by improper storage that renders the vaccines ineffective, an improper administration route, or light-sensitive vaccines exposed to light. Additionally, some immunized persons never seroconvert, either because of failure of their own immune system or for some other unknown reason. Secondary vaccine failure is the waning of immunity after an initial immune response.
Which of the following interventions would be the most appropriate to implement for a community that has a high risk for environmental health hazards?
Involve citizens in decision-making processes about proposed activities that could pose an environmental threat. Community health nurses have a mandate to assist vulnerable aggregates who have fewer options in protecting themselves from pollution, inadequate housing, toxic poisoning, unsafe products, and other hazards. An appropriate nursing intervention would be to involve citizens in decision-making processes about proposed activities that could pose an environmental threat. Evaluating ongoing health interventions, documenting participation levels of families, and screening at-risk populations are important evaluation methods for determining the needs of the community but are not the most appropriate intervention.
In the 1850s, a researcher studied a cholera epidemic among people living in different sections of London. The researcher who used epidemiologic methods to study the epidemic and used rates as an epidemiologic tool was:
John Snow John Snow is recognized as the researcher who applied epidemiologic methods in the investigation of a cholera epidemic in London in the 1850s. Joseph Lister is considered the pioneer of antiseptic surgery. William Farr was a 19th century British epidemiologist who is regarded as a founder of medical statistics. Edward Jenner developed the smallpox vaccine
Which of the following is classified as a vector of disease?
Mosquitoes Vectors can be animals or arthropods and can transmit disease through biological and mechanical routes. The other options are not vectors.
Which of the following occupational health nursing interventions is an appropriate tertiary level strategy?
Negotiation of workplace accommodation for a worker with a disability On a tertiary level, the occupational health nurse plays a key role in the rehabilitation of a worker to the optimal level of functioning and includes such strategies as negotiation of workplace accommodation and counseling and support for workers who will continue to be affected by chronic disease. The other options are primary level strategies.
Which of the following activities implemented by an occupational health nurse would be considered primary prevention?
Negotiation with an employer for an onsite fitness program for all employees Promoting physical activity is an example of health promotion activities at the primary prevention level. Blood pressure, diabetes, and cholesterol screenings and mammograms are all secondary prevention strategies aimed at early diagnosis and early treatment. Weight loss programs for the severely obese would be considered tertiary prevention.
A community health nurse participating in planning programs for the coming year considers incidence rates to better understand the needs of the community. Which statement below is the most accurate explanation of incidence rates?
New cases of a disease or condition in a community over a period of time are included in incidence rates. Incidence rates describe the occurrence of new cases of a disease or condition in a community during a period of time relative to the size of the population at risk for that disease or condition during that same time period. In calculating this rate, the numerator is the number of new cases during the specific period of time, and the denominator consists only of those who are at risk for developing the disease or condition during the specific period of time. A prevalence rate is the number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time. Attack rates document the number of new cases of a disease in those exposed to the disease. The percentage of deaths in a specific period of time from a specific cause refers to the mortality rate.
Legislation passed in the early 1970s that requires employers to provide a place of employment free from recognized hazards to the employees is correctly referred to as the:
Occupational Safety and Health Act. The Occupational Safety and Health Act was enacted in 1970. The general clause of the Act states that employers must "furnish a place of employment free from recognized hazards that are causing or likely to cause death or serious physical harm to employees." The Act also identified the role of various government agencies such as the Occupational Safety and Health Administration under the jurisdiction of the Department of Labor.
The health literature accessed by the community health nurse often addresses the probability of an adverse event. What term refers to the likelihood that healthy people exposed to a specific factor will experience a specific health condition?
Prevalence The term risk refers to the probability of an adverse event. Prevalence is the number of all cases of a specific disease or condition in a population. Rates are arithmetic expressions that help practitioners consider a count of an event relative to the size of the population from which it is extracted. Incidence describes the occurrence of new cases of a disease or condition in a community over a period of time.
You teach a community disaster preparedness class on how to find shelter during and after a disaster situation. This is an example of what kind of prevention?
Primary Primary prevention occurs in the nondisaster and predisaster stages. Actions during these stages includes developing local, state, and federal disaster plans; conducting drill tests; training volunteers and health care providers; and providing educational programs. Secondary measures are those taken after the disaster has occurred and tertiary measures are aimed at rehabilitation. Disaster prevention is a broad term covering all types.
Through epidemiologic investigations, effective prevention measures are often identified. When the nurse is engaged in providing prevention for the community before disease has developed, the prevention activities meet the definition for what level of prevention?
Primary Primary prevention occurs when intervention activities take place before disease development. Immunization is an example of primary prevention that provides specific protection. Secondary prevention occurs after pathogenesis, namely screening and physical examinations that are aimed at early diagnosis. Tertiary prevention focuses on rehabilitation and limitation of disability. Pathogenic does not describe a type of prevention.
The percentage of deaths resulting from a specific cause provides the nurse with information about areas in which public health programs might make significant contributions in reducing deaths. Select the statistic often used for this purpose.
Proportionate mortality rate calculated using the number of deaths resulting from a specific cause in a specific time period as the numerator and the total number of deaths in the same time period as the denominator. In crude death rates, the numerator is the number of deaths, and the denominator is the average population size or the population size at midyear multiplied by a constant. Age adjustment or standardization reduces bias when there is a difference between the age distributions of two populations
By the middle of the 21st century, the world population is expected to do which of the following?
Reach 10 to 12 billion The world's population soared to 4 billion between 1960 and 1974 and then to 5 billion between 1974 and 1987. In 1999, the world population was 6 billion; in 2005, it was nearly 7 billion. The population is projected to reach 8 billion by 2025 and 10 to 12 billion by midcentury
How would a community health nurse use Executive Order 12898?
Recognize that it would help achieve environmental justice. Executive Order 12898 (signed by President Clinton in 1994) required all federal agencies to develop comprehensive strategies to achieve environmental justice. The focus of Executive Order 12898 is not to decrease urban sprawl. Sick building syndrome describes a phenomenon in which public structures and homes cause occupants to experience a variety of symptoms, such as headache, fatigue, and exacerbation of allergies. Executive Order 12898 is not citable as law to decrease carbon dioxide emissions.
An essential strategy to deal with the complexities of the workplace and workforce is for the occupational health nurse to do which of the following?
Recognize the need to work as a part of an interdisciplinary team. As workplaces have continued to change over the past few decades, the role of the occupational health nurse had become even more diversified and complex. It is essential that the occupational health nurse functions as a part of an interdisciplinary team collaborating with workers, employers, and other professionals to identify health needs, prioritize interventions, develop and implement programs, and evaluate services delivered.
Which of the following actions of the occupational health nurse is NOT mandated by state or federal regulations?
Reporting accusations of sexual harassment to local police Maintaining confidentiality of medical records, reporting occupational injuries and illnesses, and providing personal protective equipment training are all mandated by law. Sexual harassment allegations are routinely reported to administrative officials
Investigating all contacts of a person infected with a sexually transmitted disease is an example of what?
Secondary prevention Secondary prevention includes the investigation of contacts to sexually transmitted disease cases. Secondary prevention includes activities to ensure early detection of infection and effective treatment of persons who are infected. Not only does this prevent progression of the infectious disease, but it also prevents transmission of the pathogen to others. Primary prevention of communicable diseases involves measures to prevent transmission of an infectious agent and to prevent pathology in the person exposed to an infection. Tertiary prevention includes activities involved in caring for persons with an infectious disease to ensure that they are cured or that their quality of life is maintained.
Seven cases of hepatitis A are diagnosed in a community over a period of 2 weeks. An investigation results in a determination that all of the infected individuals ate at a local restaurant. Which of the following statements explains the possible connection between hepatitis A and a restaurant?
The route of transmission for hepatitis A is fecal-oral Hepatitis A is transmitted by fecal-oral route. Coughing or bleeding would not transmit hepatitis A. Option D does not have enough information to form a conclusion about hepatitis A transmission.
Which of the following is the purpose of the staging area in a disaster plan?
To act as command station for disaster responders to report to and get assignments The staging area is the onsite command station. Dispatch responders should report to this area and check-in. This allows everyone to be accounted for and to gather assignments. The other options are not appropriate uses for the staging area in a disaster.
The global health organization that works for children's survival, development, and protection is the
United Nations International Children Emergency Fund (UNICEF). UNICEF works for children's survival, development, and protection by developing and implementing community-based programs. UNICEF achievements are well documented in child health, nutrition, education, water, sanitation, and progress for women. PAHO is an international public health agency that works to improve the health and living standards of the Americas. The WHO introduced the goal of "health for all." The CDC strives to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats.
Chemical warfare agents such as pulmonary agents and cyanides are classified as which of the following?
Weapons of mass destruction Weapons of mass destruction refer to any weapon that is designed or intended to cause death or serious bodily injury through release, dissemination, or impact of toxic or poisonous chemicals or their precursors. Chemical warfare agents are classified as nerve agents, vesicants, pulmonary agents, and cyanides.
When chronic disease became a more important cause of death in developed countries, different epidemiologic models were developed to study the many factors involved in the development of these health conditions. Which of the following is an example of such a model?
Web of causation Chronic disease is marked by a complexity of relationships among causal factors. The web of causation model illustrates the interrelationships. The person-place-time model organized epidemiologists' investigations of the disease pattern in the community. The epidemiologic triangle considers the extent of the host's exposure to the agent, the virulence of the agent, and the host's genetic or immunological susceptibility to the agent. The wheel model is an example of a model that stresses the multiplicity of host and environmental interactions
When building a collective strategy by framing an environmental problem, the community health nurse should ask which of the following questions?
Who is affected by the problem? Dialogue from critical thinking should facilitate community involvement and is not focused on a single individual. Asking about role or diagnosis does not facilitate community involvement.
A community health nurse would include which of the following in her assessment of environmental health?
Work-related exposures, radiation risks, and atmospheric quality Environmental health is a vast field of subcategories, including living patterns, work risks, atmospheric quality, water quality, housing, food quality, waste control, and radiation risks. Families and job availability are not environmentally related.
The concept of "health for all by the year 2000" was initially introduced by which of the following international organizations?
World Health Organization (WHO) The WHO introduced the goal of "health for all." The CDC strives to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats. UNICEF focuses on child and women's health.
All of the following are challenges currently facing occupational health nursing practice except:
a younger workforce. Escalating health care cost, increased women and minorities in the workforce, and a competitive international marketplace all contribute to the challenges of occupational health nursing practice. In addition, an aging workforce also presents a challenge.
Using critical theory when exploring issues of environmental health ultimately allows the nurse to:
alter the precursors of poor health. Critical theory is used to help community health nurses think about social, cultural, economic and political factors of health, thereby assisting them to attack the problem at its source and alter community-wide precursors of poor health. The community health nurse can develop a community nursing diagnosis and design interventions by using the nursing process.
Transmission of an infectious disease can be efficiently controlled by:
breaking only one link in the transmission chain. Breaking just one link of the chain can control transmission of an infectious agent. Destroying all reservoirs of infectious agents and maintaining high levels of herd immunity are two of several ways to break a link in the chain of transmission.
A primary role of the community health nurse in facilitating community participation and partnership is:
educating about environmental health hazards. Educating the public about environmental health hazards is the first step in engaging the community problems of the environment. Environmental hazards are complex and interconnected; therefore, increasing the public's knowledge of the hazards leads not only to individual action but also public action. The other options are not the primary focus of the community health nurse.
Through improved sanitation, developed countries have significantly reduced high mortality rates from:
infectious diseases. Improved sanitation has led to reduced mortality rates from infectious diseases. Respiratory disease, cancer, and cardiovascular diseases are the primary causes of death in developed countries.
People who live in developing countries are at risk for a variety of health threats as a result of all of the following factors except:
lack of interest in health issues and health care. In developing countries, people are more likely to be exposed to communicable diseases as a result of a number of factors, including high population density, lack of accessible health care and treatment, and poor or limited sanitation. In addition, although tobacco use is decreasing in most developed countries, it is increasing in many underdeveloped ones. Although people in developed countries often lack resources and information, they are nonetheless interested in health promotion, disease prevention, and many aspects of health care delivery
The life-threatening parasitic disease that causes at least one million deaths annually is:
malaria. Malaria is a life-threatening parasitic disease transmitted by mosquitoes. Malaria causes more than 300 million acute illnesses and at least 1 million deaths annually. AIDS is a disease caused by the HIV virus. Tuberculosis is an infectious disease caused by the tubercle bacillus. Hepatitis is inflammation of the liver
Occupational health nursing is best described as a specialty practice that focuses on:
promoting, preventing, and restoring health within the context of a safe and healthy environment.
A pathogen lives and multiplies in a __ and transfers from one host to another by a __.
reservoir, mode of transmission A pathogen lives and multiplies in the reservoir and transfers from one host to another by a mode of transmission.
There was an increase in the number and voice of occupational health nurses during the years of 1938 to 1943. All of the following occurrences explain the rationale for this change except:
the U.S. Department of Health and Human Services mandated occupational health nurses be hired for industrial settings that employed more than 350 people. The focus of health care for employees changed as a result of the two world wars, which changed the demographics of the workforce and increased the need for health services for employees, and the birth of the first national association for this specialty. The federal government never required companies to employ occupational health nurses.
Women have a higher risk of contracting a sexually transmitted disease (STD) than men because:
the anatomical structure of women promotes transmission of STDs. Women are at higher risk for contracting STDs than men because they have anatomical differences that enhance transmission of disease and make diagnosis difficult. The other statements are not true.
After the implementation of various policies to reduce tobacco use, the tobacco industry has begun targeting:
youths and young adults and international markets. The tobacco industry has now started targeting youths and dramatically increased international exports. Tobacco sales among American adults is down.
