Deck 3: Epidemiology and Nursing Practice

Question 1

A young couple with a family history of cystic fibrosis meets with a nurse to ask about preconception testing using genetic markers for early identification of the disease to help them make childbearing decisions. The area of study that has helped health-care providers and families answer these questions is called:
1)The Human Genome Project
2)Behavioral Risk Factor Surveillance System (BRFSS)
3)Ecological epidemiology
4)Genomics

Answer 1

4

Question 2

Yin is a nurse in a rural primary care clinic. One of the issues that has arisen is how to address patients who come in asking about testing for BRCA1 and BRCA2, the tumor suppressing genes that, if mutated, may indicate hereditary breast and ovarian cancer. Yin reads up on the issue and tells her colleagues that there are arguments against genetic testing for BRCA1 and BRCA2 that include all of the following except:
1)The cost of the test is high.
2)The evidence to the effectiveness of the test is limited.
3)The test is difficult to perform.
4)Less than 10% of all breast cancers are genetically based.

Answer 2

3

Question 3

A public health nurse is comparing the prevalence of type 2 diabetes in two counties in Ohio. From an epidemiological perspective these are:
1)Independent rates.
2)Mortality rates.
3)Dependent rates.
4)Morbidity rates.

Answer 3

1

Question 4

Renee, a nurse working in a primary care clinic, is conducting a physical assessment of Adam, age 42, who reports multiple medical issues. Renee is concerned and wonders what might explain his poor health. During this visit, she asks Adam about his work history and discovers that he is working in a chemical plant. This information is not sufficient to a direct causal link between possible workplace exposure to toxins and his current medical issues because: (Select all that apply.)
1)Safety records of the plant do not pertain to the health records of the patient.
2)The patient has medical problems that could be caused by lifestyle decisions rather than by working in the plant.
3)Even if Adam has been exposed to toxic substances, the threshold required to have adverse or fatal consequences might not have been reached.
4)There has been little progress on researching the relationship between exposure to toxins and illness.

Question 5

The state public health department has been tracking syphilis, as mandated by the Centers for Disease Control and Prevention, with little change in the incidence rate over time. Recently, however, incidence rates indicate they may have an outbreak. They deploy health-care professionals, including nurses, to further investigate beginning with a review of medical records. The first type of surveillance conducted is an example of _______________ surveillance and the second type of surveillance conducted is an example of______________ surveillance.
1)Both are examples of passive surveillance.
2)Passive and active
3)Both are examples of active surveillance.
4)Active and passive

Question 6

To better understand the risk factors for the high prevalence of asthma in her school, the school nurse gets approval to send out an anonymous survey to the parents. She is seeking preliminary data on how many of the students who may have asthma are exposed to secondary smoke. Questions for the parents include information about their children's history of asthma and whether anyone living in the home smokes. Which study design best describes her study?
1)Case-control study
2)Cross-sectional study
3)Cohort study
4)Outbreak investigation

Question 7

The history and development of epidemiology has gone through several developmental phases. The nursing student learns that these phases came about in history in what order?
1)Risk factor phase, infectious disease phase, and sanitary phase
2)Infectious disease phase, risk factor phase, and sanitary phase
3)Sanitary phase, infectious disease phase, and risk factor phase
4)Agent phase, host phase, and environment phase

Question 8

An epidemiologist uses the epidemiological triangle to explain the occurrence of disease by looking at the three main components of the model: the host, the environment, and the agent. The PHN understands that the agent could be one of many types except:
1)Biological and chemical.
2)Nutritive.
3)Physical.
4)Ecological.

Question 9

John has just taken a job as a PHN at the local public health department in a high-income county adjacent to a large metropolitan area. He has been asked to work with the team that does outbreak investigations and conducts surveillance. As part of John's work in outbreak investigations, which three precipitating factors, also known as the epidemiological constants, should he consider to help guide these investigations?
1)Person, agent, and time
2)Host, agent, and time
3)Person, place, and environment
4)Person, place, and time

Question 10

Jane works for the public health department with the primary job of conducting outbreak investigations. There has been a recent outbreak of hepatitis A. She has collected data on the number of new cases among the contacts of initial (primary) cases, divided it by the number of people in the population at risk, and then multiplied it by a given multiplier. She is calculating the:
1)Prevalence.
2)Incidence.
3)Secondary attack rate.
4)Attack rate.

Question 11

A control or "no disease" group is needed for study on risk factors associated with oral cancer. The nurses conducting the study decide to use a group of patients with skin cancer as their controls because these patients are at the same facility. Having another type of cancer could itself be a risk factor and is a potential limitation in the study. This variable, having another type of cancer, would be called a(n):
1)Confounder.
2)Right censoring.
3)Case-control.
4)Odds ratio.

Question 12

John has just taken a job as a PHN at the local public health department in a high-income county adjacent to a large metropolitan area. He has been asked to work with the team that does outbreak investigations and conducts surveillance. John has also assumed responsibility for surveillance of sexually transmitted infections (STIs). The primary purpose of surveillance of STIs at the local public health department is to be able to:
1)Determine the prevalence of disease over time and provide reports to the state health department.
2)Study person-related variables or factors to help provide increased access to treatment.
3)Calculate percent change in a demographic variable to assess changes over time.
4)Identify a possible rise in cases above the endemic level and take action.

Question 13

A PHN recognizes that which of the following are types of cohort studies? (Select all that apply.)
1)Prospective
2)Retrospective
3)Historical
4)Longitudinal
5)Statistical

Question 14

A public health nurse (PHN) is asked by the hospital administration to find out why there are so many pediatric asthma patients coming to the emergency department (ED) for treatment and to develop a plan to reduce admissions by 10%. The PHN knows the first step, prior to developing an intervention, is to understand the multiple risk factors involved. Which framework would best help the PHN understand the multiple risk factors contributing to asthma in this population?
1)The epidemiological triangle
2)The ecological model
3)The epidemiological constants
4)The web of causation

Question 15

In a large urban public health department (PHD), Sam, the PHD's epidemiologist, is concerned about upward trends related to type 2 diabetes over the past 5 years. To help identify the key risk factors, Sam begins to examine three categories of risk central to epidemiology. These categories include all of the following except:
1)Prevalence
2)Behavioral
3)Environmental
4)Genetic

Question 16

When comparing the body mass index (BMI) of obese women in two cities, John found that the average BMI of City A was higher than that of City B. However, when he concluded that a woman in City A will have a higher BMI than a woman in City B, his conclusion was an example of ______________.
1)An odds ratio.
2)An ecological fallacy.
3)A causality.
4)A relative risk.

Question 17

John has just taken a job as a PHN at the local public health department in a high-income county adjacent to a large metropolitan area. He has been asked to work with the team that does outbreak investigations and conducts surveillance. There has been an outbreak of measles in the county that his public health department serves. John was asked to put together an alert to parents related to the outbreak. What is one aspect of this type of outbreak that presents substantial challenges to persons working in a local public health department like John's?
1)Poor access to medical care
2)Person-to-person transmission
3)Low economic status.
4)Inadequate sanitation systems

Question 18

John Snow, considered the founder of epidemiology, realized the source of the London's cholera epidemic through:
1)Developing a frequency distribution of deaths.
2)Mapping of the food supply.
3)Interviewing the families of the sick.
4)Performing autopsies.