Deck 21: Public Health Surveillance and Outbreak Investigation

Question 1

Data come from many sources. Clinicians, health care agencies, and laboratories report cases to state health departments. Which of the following would be considered a source of morbidity data?

A) Vital statistics reports
B) Birth records
C) Death certificates
D) Specialized disease registries

Answer 1

Specialized disease registries

Question 2

Bioterrorism is an example of an event creating a critical public health concern that involves environmental exposures that must be monitored. Which of the following describes biological terrorism?

A) The intentional release of hazardous chemicals into the environment
B) Environmental and occupational exposure to biological toxins
C) Immunity to toxins related to repeated exposures
D) An intentional release of viruses, bacteria, or their toxins

Answer 2

An intentional release of viruses, bacteria, or their toxins

Question 3

The SARS (severe acute respiratory syndrome) outbreak was an epidemic that spread over several countries. By definition this is considered a:

A) Hyperendemic
B) Pandemic
C) Mixed outbreak
D) Holoendemic

Answer 3

Pandemic

Question 4

Disease surveillance has been part of public health protection since the investigation of the Bubonic Plague in Europe. In the United States, national reporting began with:

A) The national reporting of morbidity cases in 1925
B) Mortality and Morbidity weekly in 1961
C) Plague surveillance among the early colonists
D) Food poisoning surveillance during World War 1

Question 5

A college student goes to the Student Health Center with an extremely swollen neck. The advanced practice nurse determines that he has mumps. His roommate also is experiencing malaise and a sore throat. These two students by definition are considered a:

A) Mixed outbreak
B) Common source
C) Point source
D) Propagated outbreak

Question 6

Criteria for defining cases of different disease are essential for having a uniform, standardized method of reporting and monitoring diseases. Case definitions may include:

A) The precise point of contact
B) Laboratory confirmation
C) Source of contamination
D) Clinical symptoms, laboratory values, and epidemiologic criteria.

Question 7

The Minnesota Model of Public Health Interventions: Applications for Public Health Nursing Practice suggests that surveillance is one of the interventions related to public health nursing practice. This model gives seven steps of surveillance that nurses should follow. The first step is:

A) Analyze data
B) Consider whether surveillance as an intervention is appropriate to the situation
C) Evaluate the impact of the surveillance
D) Collect data

Question 8

Public health surveillance has many features. One of these is:

A) The sharing of the results with others
B) Defining pubic health policy
C) Evaluating interventions
D) Planning national programs

Question 9

Surveillance data focuses on the collection of process and outcome data. Outcome data focuses on:

A) What is done-services provided for protocols for health care
B) Data about the proportion of the eligible population vaccinated against influenza in one year
C) Changes in health status
D) Biological terrorism

Question 10

Each state has notifiable diseases mandated by law or regulation. State requirements differ in that not all nationally notifiable diseases are legally mandated for reporting in a state. What does each state do with the information it receives?

A) Keeps its own records for surveillance purposes.
B) Reports the information to the local branch of the World Health Organization.
C) Transmits the data electronically, weekly, to the CDC.
D) There is no need to do anything with the information.

Question 11

Informatics is essential to the mission of protecting the public's health. There are several types of surveillance systems used today. A nurse practitioner reports a case of gonorrhea to the local health department. The type of surveillance system being used is:

A) Active
B) Passive
C) Sentinel
D) Special

Question 12

State and local "police powers" provide surveillance activities. Health departments usually have legal authority to investigate unusual:

A) Pandemics
B) Clusters of illness
C) World trends of disease
D) Cases of the common cold and pneumonia

Question 13

Surveillance data are analyzed and interpretations are used to develop policies. Surveillance can occur within local organizations (e.g., infection control systems in hospitals). The purpose of this surveillance is to:

A) Protect the public against isolated patients
B) Rid the hospital of pathogens
C) Improve quality of care and outcomes
D) Remove pseudomonas bacterium from a facility

Question 14

A large amount of data related to hypertension rates is collected in a community. The data is analyzed. The next step in the surveillance process would be:

A) Collecting data from multiple valid sources
B) Evaluating the impact on the surveillance system
C) Interpreting the data and disseminating it to decision makers
D) Asking political officials to finance a hypertension clinic

Question 15

Many diseases are designated as notifiable at the national level. If a person returns from overseas and it is determined that he has cholera, what must occur?

A) This is not a disease that is on the notifiable list: nothing need be reported.
B) The case must be reported to the state and local health department.
C) The patient must be isolated immediately.
D) The patient will probably die, so it is not reportable.

Question 16

Surveillance activities can be related to the core functions of public health assessment, policy development, and assurance. Surveillance made it possible to respond early to a mumps outbreak in 2006 among college students. What other purpose does surveillance have?

A) Eradicate a disease before it starts
B) Establish a baseline rate of disease occurrence and patterns of spread
C) Target populations for triage
D) Stop heart disease and obesity in a community

Question 17

Quality surveillance involves collaboration among partners. The type of information often shared is:

A) How to use algorithms to identify which events should be investigated
B) Who is to blame for a disease outbreak
C) What shelters will be used and by whom
D) How political action will be necessary to ensure public health

Question 18

A community monitors the obesity rate in children in their schools. From this data they decide to institute an after-school exercise program. The purpose of this type of surveillance is to:

A) Protect the children from diseases that affect obese children
B) Teach parents that obesity will not be tolerated in this community
C) Educate children on surveillance techniques
D) Show that new clinical and effective protocols need to be developed

Question 19

In 1990 the CDC assembled the first list of standard case definitions for notifiable diseases. What was the purpose of this venture?

A) Some diseases were underreported and others were overreported.
B) There was no central office to collect data.
C) Some people refused to notify officials when diseases were seen.
D) No one knew who to report to.

Question 20

In 2001 there several cases of Anthrax. Case definitions exist in the literature and in government documents. A clinically compatible case without isolation of the pathogen is known as a:

A) Suspected case
B) Confirmed case
C) Prolonged case
D) Identified case

Question 21

Factors that must be considered as causes of outbreak are categorized as agents, hosts, and environmental factors. There are several types of agents. Viruses, fungi, and parasites are considered:

A) Physical agents
B) Chemical agents
C) Biological agents
D) Nutrients

Question 22

Any unusual increase in disease new cases or unusual event in the community should be investigated. Which of the following are objectives of an investigation? Select all that apply.

A) To enhance the knowledge of the nurse working in public health
B) To control and prevent disease and death
C) To identify factors that contribute to the disease outbreak/even occurrence
D) To implement measures to prevent occurrences

Question 23

An unusual increase in a disease should be investigated. Epidemiologic clues that may signal a bioterrorism attack include:

A) A large number of cases of the flu
B) A case of cholera following a trip to India by a local politician
C) Dengue fever in a group of students who just returned from a mission trip
D) Unusual illness in a population

Question 24

Which of the following are uses of public surveillance? Select all that apply.

A) Estimate the magnitude of a problem.
B) Determine geographical distribution of an illness.
C) Detect epidemics.
D) Monitor changes in infectious agents.
E) None of the above

Question 25

To be a participant in surveillance and investigation activities the staff nurse must have which of the following competencies (related to the core competencies for public health professionals)? Select all that apply.

A) Analytic assessment skills
B) Communication skills
C) Community dimensions of practice
D) Intensive care nursing skills