Environmental/Occupational Health Nursing- Exam 3
Which one of the following statements about assessment (one of the core public health functions) and how it can be applied to environmental health is most accurate? A) Assessment includes the investigation of health hazards, surveillance of health issues, examining causes, and assessing needs. B) Assessment is least valuable when related to where the person attends school. C) It is not necessary for nurses to have a background in the environmental health sciences. D) Assessment should be limited to the general population and should not include the increased vulnerability of certain groups.
A Feedback: Assessment includes the investigation of health hazards, surveillance of health issues, examining causes, and assessing needs. With assessment, priority should be given to locations where people spend the majority of their time (home, work, school). Where persons attend school is too limiting as many people do not go to school and the priority should be given to home and work. The ability to perform critical assessments for environmental health requires background in the environmental health sciences. Public health nurses must also be aware of the increased vulnerability of certain groups.
An occupational and environmental health nurse recently treated approximately 20 employees for hand injuries. The employees all work on the factory assembly line. The nurse decides to implement a program for primary prevention. Which of the following activities would be appropriate? A) Institute an orientation for employees about the equipment B) Conduct hearing screening tests of the employees C) Institute whirlpool treatments for injured extremities D) Ensure adherence to physical therapy regimen for injured workers
A Feedback: Instituting an orientation program reflects primary prevention, that is, preventing an illness or injury from occurring. Conducting hearing screening would reflect secondary level of prevention. Whirlpool treatments and physical therapy would reflect tertiary level activities.
A community health nursing student is interviewing several occupational and environmental health nurses about their experiences. Each of the nurses works in a small organization and is the only nurse for the company. Which of the following would the student most likely note as being similar among the nurses? A) Use of critical thinking skills B) Collegial relationships C) Decrease in workload D) Role certainty
A Feedback: The occupational and environmental health nurse, especially in smaller organizations, may be the only nurse in the company. As a result, she or he has none of the on-site consultation and direction that are needed for comfortable, competent, and independent decision making. Nurses who use critical thinking skills to develop a framework for independent problem-solving enhance their efficiency. In addition, the nurse may feel isolated because of being the only health professional. The corporate culture and leadership may foster work overload, be nonsupportive, and have limited career opportunities for the nurse. The nurse may experience role ambiguity due to a lack of professional preparation or inadequate orientation and continuing education.
Which of the following are adverse working conditions that may impact the health status of nurses. Select all that apply. A) Physical hazards B) Radiation hazards C) Biological hazards D) Chemical hazards E) Low pay
A, B, C, D Feedback: Nurses may be exposed to physical, radiation, biological, and chemical hazards. Nursing is not considered to be a low-paying job.
Which of the following are variables that occur in nature and could have a negative impact on humans? Select all that apply. A) The effect of climate change upon weather extremes (droughts, floods, and storms) B) Changes in rainfall and water supply for soil C) Ecology of microbial growth D) Risks for waterborne and food-borne pathogens in drinking water, seafood, and fresh produce because of climate variability E) There is adequate food supply and always will be.
A, B, C, D Feedback: The variables related to the food supply that occur in nature and could have a negative impact on humans include the effect of climate change upon weather extremes (droughts, floods, and storms); changes in rainfall and water supply for soil; ecology of microbial growth; risks for water-borne and food-borne pathogens in drinking water, seafood, and fresh produce because of climate variability. There are currently food shortages in parts of the world, and this is likely to continue and may worsen.
Which of the following groups of persons have increased vulnerability to environmental hazards to human health related to food? Select all that apply. A) Pregnant women are likely to transmit their exposure to chemicals, pesticides, and toxins to the unborn fetus. B) Persons who have altered immunity are more likely to be affected by food exposures. C) Middle-aged males D) Children are more susceptible to hazards due to their immature gastrointestinal systems and increased food intake per size. E) Adult women who are nonchildbearing
A, B, D Feedback: Pregnant women are likely to transmit their exposure to chemicals, pesticides, and toxins to the unborn fetus. Persons who have altered immunity are more likely to be affected by food exposures. Children are more susceptible to hazards due to their immature gastrointestinal systems and increased food intake per size. Middle-aged males and adult women who are nonchildbearing are not especially vulnerable to environmental hazards to human health.
A community health nurse is enacting policy development by preparing a presentation for a group of state health officials about the issue of water pollution in the United States. Which of the following would the nurse include? Select all that apply. A) Globally, the availability of clean water is becoming a very serious threat to human survival. B) Water pollutants consist solely of chemicals. C) Recently, there has been an increase in the concern about pharmaceuticals contaminating water supplies. D) All water that is to be consumed is regulated through the EPA. E) The people most vulnerable to serious health problems are the very young, the very old, and the immune-compromised.
A, C, E Feedback: Globally, the availability of clean water is becoming a very serious threat to human survival. Recently, there has been an increase in the concern about pharmaceuticals contaminating water supplies. The people most vulnerable to serious health problems are the very young, the very old, and the immune-compromised. Water pollutants consist of organic and inorganic chemicals, contamination with microbes, pharmaceuticals, pesticides and insecticides, and radionuclides. The EPA only regulates public water systems.
A public health nurse who uses the upstream approach would likely focus on which one of the following contributors to unhealthy diets in the community? A) Consumer preference for sweet, greasy, and salty foods B) Marketing strategies of fast food businesses C) Busy lifestyles within the community D) Individual acceptance of obesity
B Feedback: A public health nurse who uses the upstream approach would likely focus on factors that are at the institutional and system level rather than looking solely at healthy lifestyle issues. Consumer preference for sweet, greasy, and salty foods; busy lifestyles within the community and individual acceptance of obesity are lifestyle issues. The marketing strategies of fast food businesses are one root cause of unhealthy diets in the community.
After teaching a group of community health nursing students about the trends affecting occupational and environmental health nursing, the instructor determines that more teaching is needed when the students identify which of the following as a trend? A) Continued escalation of health care costs B) Upturn in the global economy C) Increase in worldwide competition D) Increase in technologic hazards
B Feedback: Four critical issues affect the practice of occupational and environmental health nursing. First, the downturn in the global economy, and in the economy of the United States specifically, has skeletonized many worksites, shut down companies, eliminated night or evening shifts, or moved companies to less expensive communities. Second, increasing worldwide competition requires businesses to remain competitive by reducing or controlling operating costs at the lowest level possible. Third, there has been an increase in technologic hazards that require a sophisticated approach as well as knowledge of toxicology, epidemiology, ergonomics, and public health principles. Fourth, health care costs continue to escalate at faster rates than most company profits do.
When describing the major functions of an occupational and environmental health nurse, which of the following would the nurse identify as being the most time consuming? A) Activities involving safety education B) Care of injured employees C) Programs for improved working conditions D) Teaching activities for healthy nutrition
B Feedback: In addition to emergency care and nursing of ill employees, the activities of many industrial nurses involved safety education, hygiene, nutrition, and improvement of working conditions. Yet, a significantly high number of industrial injuries and sick employees kept many nurses too busy to do anything but care for the ill.
A community health nurse is working with the local health departments to educate the citizens about the effects of radon exposure and its link to possible illness. Which of the following would the nurse identify as being a major health concern associated with radon? A) Skin cancer B) Lung cancer C) Diarrhea D) Cardiovascular disease
B Feedback: Radon is a leading cause of death from lung cancer. Skin cancer is associated with sun exposure. Diarrhea and cardiovascular disease are not associated with radon exposure.
After discussing the effects of shift work on workers' health, the nurse educator knows that the nursing students understand this concept when the nursing students make which of the following comments? A) "It is beneficial for workers to have their circadian rhythms disturbed." B) "Rotating shifts negatively impacts sleep and rest cycles." C) "Shift work interferes with a person's social life." D) "Insufficient sleep is associated with respiratory problems and weight loss."
B Feedback: Rotating shifts negatively impacts sleep and rest cycles. It is not beneficial for workers to have their circadian rhythms disturbed. Shift work may interfere with a person's social life but that is not a primary effect on health. Insufficient sleep is associated with obesity and diabetes.
Which of the following concepts is used by public health professionals to illustrate that the determinants of health interact to affect health? A) Precautionary principle B) Ecological perspective C) Sustainability D) Upstream focus
B Feedback: The ecological perspective is used by public health professionals to illustrate that the determinants of health interact to affect health. The precautionary principle states that in the absence of clear data that indicates the safety of an action, chemical or material that poses a threat to human health, it should not be used. Sustainability is "the ability to meet the needs of the present without compromising the ability of future generations to meet their own needs." Upstream focus identifies the root causes of disease and manufacturers of illness.
Which of the following statements about an upstream focus is the most accurate? A) The upstream approach does not focus on socioeconomic factors and the environmental origins of disease and health problems. B) The focus of an upstream approach is the institution and system level. C) The upstream approach pertains to the purity of water supplies. D) The focus of an upstream approach is healthy lifestyle issues.
B Feedback: The focus of an upstream approach is the institution and system level, and not just healthy lifestyle issues. The upstream approach does focus on socioeconomic factors and the environmental origins of disease and health problems. The upstream approach does not pertain to the purity of water supplies.
.Which of the following are the main categories of occupational health nursing practice? Select all that apply. A) Safety B) Compliance C) Health promotion D) Care
B, C, D Feedback: Occupational health nursing practice can be divided into three main categories: compliance, care, and health promotion.
The nursing student is preparing a report for class relating to Healthy People 2020 and environmental health. Which of the following should be included in this report? Select all that apply. A) The agency that prepared this initiative is the World Health Organization. B) The overall goal is to "promote health for all through a healthy environment." C) The document provides instructions for persons in the community regarding how to protect their own health. D) One of the six focus areas is global environmental health. E) The document provides guidance for nurses to identify targets for health.
B, D, E Feedback: The overall goal of Healthy People 2020 is to "promote health for all through a healthy environment." The document does provide guidance for nurses to identify targets for health (not instructions for individuals). The six areas that are focused on include outdoor air quality, surface and ground water quality, toxic substances and hazardous wastes, homes and communities, infrastructure and surveillance, and global environmental health. The agency that prepared this initiative is the U.S. Department of Health and Human Services.
Which of the following about the educational preparation for occupational and environmental health nursing is most accurate? A) Any licensed nurse can provide the services necessary. B) Because it is a specialty of nursing, a Bachelor's degree in nursing is required. C) Ideally, a nurse would be prepared for these specialties at the graduate level. D) This career option is restricted to advanced practice nurses.
C Feedback: Ideally, a nurse would be prepared for these specialties at the graduate level. It is a minimum requirement that the nurse be licensed but there is a special knowledge set and skill set required for this position. A Bachelor's degree in nursing is not required for this job but would be a good start. This career option is not restricted to advanced practice nurses.
A community health nurse is presenting an in-service for a group of other community health nurses about ecological perspective of environmental health. Which of the following would the nurse incorporate into the program when describing this concept? A) The study of governmental and private sector regulations of the environment B) A technological view of strategies for preventing illness and injury C) Identification of not only the physical environment but also the social and cultural factors that exist for populations D) The role of the community health nurse in preventing injury, disease, and illness
C Feedback: The ecological perspective identifies not only the physical environment but also the social and cultural factors that exist for populations. Nurses who display this type of approach provide a more comprehensive level of care. It is not a study of the governmental and private sector regulations, a technological view, or the nurse's role in preventing injury, disease, and illness.
The core public health function of policy development related to environmental health includes which one of the following? A) Policy development is best left to legislators. B) To be an effective advocate for change, it is only necessary that the nurse speak out. C) There are many ways for public health nurses to participate in policy development related to environmental health. D) Public health nurses are public servants and therefore cannot advocate for public policy.
C Feedback: There are many ways for a public health nurses to participate in policy development related to environmental health that start with the nurse being informed about the hazards in the community, existing legislation that protects people in the community, and governmental and nongovernmental groups in communities that can be partners in the efforts to protect health. They may write letters to their legislators, inform community members, and write letters to the editors of local newspapers and periodicals. Nurses can also present testimony at public forums or hearings. Policy development is not best left to legislators. It is important for nurses to advocate for policy development to care for the environment. Public health nurses are public servants and that is why they must advocate for policy development that favors the environment.
Which of the following would an occupational and environmental health nurse need to keep in mind when selecting the field of nursing? A) The workplace is very similar to a health care institution. B) The nurse focuses on health not workforce productivity. C) Production or service is a primary goal. D) The nurse functions in a supervisory position.
C Feedback: Unlike hospitals or ambulatory care centers, the workplace is a non-health care institution in which production or service (not health care) is the primary goal. The occupational and environmental health nurse participates in the organization's goals through activities that contribute to the productivity of the workforce. An occupational and environmental health nurse in the organization is in a staff position, taking on the role of a consultant, educator, or role model in the workplace, but has no supervisory responsibilities or power to hire or fire workers.
When applying the ecological perspective to environmental health, a community health nurse integrates which of the following concepts as most essential? A) Primary prevention is limited in this area. B) The need for foresight in designing innovations C) No one factor can be viewed in isolation. D) Implications of scientific advances are fully understood.
C Feedback: With the ecological perspective, no one factor can be viewed in isolation. The preventive approach involves all three levels of prevention, of which primary prevention is the most important. This approach also requires foresight in designing innovations and involves implications associated with the unprecedented advances in science and technology.
Which activity would an occupational and environmental health nurse expect to perform in the future based on current trends? A) Supervise care for emergency illnesses B) Counsel employees about health risks C) Perform periodic health assessments D) Suggest cost-effective in-house health services
D Feedback: Future occupational health nurse activities will involve recommending more efficient and cost-effective in-house health services. Supervising care for emergency illnesses, counseling employees about health risks, and performing periodic health assessments are current occupational and environmental health nursing activities.
An instructor is reviewing the evolution of environmental health and the development of various agencies designed to protect health. As part of the review, the instructor includes the Environmental Protection Agency (EPA), describing its primary goal as which of the following? A) Identify and address world health issues B) Protect occupational safety and health C) Monitor food and drug production and availability D) Set standards and monitor and enforce environmental protection
D Feedback: The EPA was established for the purpose of standard setting, monitoring, and enforcement of environmental protection. The World Health Organization (WHO) identifies and addresses world health issues. The Occupational Safety and Health Administration (OSHA) protects occupational safety and health. The Food and Drug Administration (FDA) is responsible for monitoring food and drug production and availability.
When the public health nurse uses an upstream approach to improve heart health, the nurse would examine which one of the following factors? A) Unhealthy diets B) Decreased physical activity C) Smoking tobacco D) Lack of safe places to exercise
D Feedback: The upstream approach focuses on the factors at the institutional and system level rather than looking at healthy lifestyle issues. Healthy diets, increased physical activity, and smoking cessation are all healthy lifestyle issues. The root causes of the decreased physical activity would include lack of safe places to exercise.
During a community program about food safety, a participant asks, "I know it is important to use safe food practices to avoid microbial contamination, but what other possible risks are there with our food supply?" Which response by the nurse would be most appropriate? A) "Nothing is more of a problem than food-borne illness." B) "Risks occur only at food production and not handling or consumption." C) "Radiating food is something that really doesn't occur in the United States." D) "A recent concern has been raised about genetically modified foods being marketed."
D Feedback: There are many possible risks to the food supply, some even having more serious effects than food-borne illness. Risks occur at all points from food production to food consumption. Radiating food does occur in the United States. A recent concern has been raised about genetically modified foods being marketed. Genetically modified foods may interfere with the safety of food for human consumption and also questions about the ecological impact and sustainability have been raised.