Question 1

What has been the result of passage of the Toxic Substances Control Act (TSCA) of 1976?
A. A mandate for corporations to disclose known toxic chemicals
B. A requirement that all manufactured chemicals undergo toxicity testing
C. Authorization of the EPA to require testing and reporting of some chemicals
D. Development of a mechanism to report reactions to toxic chemicals

Accepted Answer

The Toxic Substances Control Act (TSCA) of 1976 authorized the EPA to require testing and reporting of some chemicals. While the act did require the reporting of some chemicals, it did not mandate disclosure of all known toxic chemicals or require all manufactured chemicals to undergo toxicity testing. Additionally, the act did not establish a mechanism for reporting reactions to toxic chemicals.

Question 2

Many European nations use the &#34;precautionary principle&#34; to help regulate potentially toxic chemicals. What does this mean?&#10;A. Chemicals must be proven to be safe before being introduced into the environment.&#10;B. Corporations may be exempt from testing if their costs in doing so are too high.&#10;C. Regulators must demonstrate risk to the public before banning a chemical.&#10;D. Without a strong risk, corporations need not release data about their products.

Accepted Answer

The precautionary principle places the burden of proof on manufacturers and requires that chemicals are proven safe before being released into the environment. This is a preventative approach intended to reduce potential harm rather than a reactive one that only addresses harm once it has been demonstrated.

Question 3

A parent desires to buy only organic produce to avoid exposing a child to
pesticides but complains that these foods are expensive. The primary care pediatric nurse practitioner provides a list of foods that are relatively safe whether they are organic or not. Which foods are on this list?
A. Apples, celery, and peaches
B. Potatoes, cherry tomatoes, and peaches
C. Strawberries, grapes, and cucumbers
D. Sweet corn, cantaloupe, and kiwi

Sweet corn, cantaloupe, and kiwi

Accepted Answer

Sweet corn, cantaloupe, and kiwi are on the Environmental Working Group's "Clean Fifteen" list, meaning they have the lowest levels of pesticide residues when conventionally grown. Therefore, it is relatively safe to consume them even if they are not organic.

Question 4

A parent asks about ways to limit exposure to risks associated with plastics.
Besides avoiding using plastic containers when possible, what else will the primary care pediatric nurse practitioner recommend?
A. Avoid heating foods and liquids in plastic containers.
B. Clean plastic containers well using the dishwasher.
C. Use only plastics stamped with "#7" on the bottom.
D. Used canned food products whenever possible.

Accepted Answer

Heating foods and liquids in plastic containers can cause chemicals to leach into the food or beverage, thereby increasing exposure to the risks associated with plastics. It is best to avoid using plastics for heating food and beverages.

Question 5

During a clinic visit, a child's rapid capillary screening test for lead reveals a
level of 11 mcg/dL. What will the primary care pediatric nurse practitioner do next?
A. Institute lead abatement measures in the child's home.
B. Monitor lead levels monthly until decreased.
C. Order a venous sample to test for lead levels.
D. Test the child's siblings and parents for lead.

Accepted Answer

The next step after a positive rapid capillary screening test for lead is to confirm the result with a venous sample. Venous testing reflects current lead levels more accurately than capillary testing. Depending on the result of the venous sample, further action may be necessary.

Question 6

A child has a lead level of 25 mcg/dL. Once lead abatement measures are
instituted, what is an important intervention to help prevent permanent damage in this child?
A. Chelation therapy
B. Dietary changes
C. Followup testing
D. Testing family members

Accepted Answer

Follow-up testing is important to monitor the child's lead level and ensure that it is decreasing.

Question 7

When counseling a mother who smokes about preventing exposure to
smokingrelated risks to her nursing newborn, what will the primary care pediatric nurse practitioner tell her?
A. If she quits now, her child will not have longterm effects from exposure.
B. Prenatal smoke exposure does not cause respiratory effects after the infant is born.
C. Smoking outdoors or near an open window prevents exposure to tobacco smoke.
D. Thirdhand smoke exposure risks may last for years even if the mother quits now.

Accepted Answer

Third-hand smoke can linger on surfaces and in carpets, clothing, and hair, posing a risk of exposure to the newborn even if the mother quits smoking now. The nurse practitioner should counsel the mother to avoid smoking indoors, wash her hands and change her clothes before holding the baby, and ask others not to smoke around the baby. The other options are incorrect. The infant may still have long-term effects from smoking exposure, and prenatal smoke exposure can increase the risk of respiratory problems after birth. Smoking near an open window or outdoors does not prevent exposure to smoke particles.

Question 8

A child who has been playing in a public park is brought to the clinic with
wheezing, vomiting, diarrhea, and drooling. A physical exam reveals a low heart rate and diaphoresis. What will the primary care pediatric nurse practitioner suspect as a cause for these symptoms?
A. Arsenic consumption
B. Lead poisoning
C. Organophosphate exposure
D. Phthalate ingestion

Accepted Answer

The combination of symptoms (wheezing, vomiting, diarrhea, drooling, low heart rate, and diaphoresis) are indicative of organophosphate exposure. Organophosphates are commonly used in pesticides, and exposure can occur through ingestion, inhalation, or skin contact. Symptoms can range from mild to severe and may include respiratory distress, gastrointestinal symptoms, neurological symptoms, and cardiac abnormalities. Arsenic consumption can cause similar symptoms, but this is less likely in a public park setting. Lead poisoning and phthalate ingestion are associated with different symptoms and would be less likely to present with wheezing or drooling.

Question 9

A child whose parent works in a factory presents with swelling of the
extremities, pain and weakness in the pelvis, and an erythematous maculopapular rash. Which industrial toxin will the primary care pediatric nurse practitioner suspect in this child?
A. Lead
B. Mercury
C. Organophosphates
D. Phthalates

Accepted Answer

The answer of A child whose parent works in a...

Deck 42: Environmental Health Issues