Deck 12: Epidemiology and Public Health

Question 1

Which statement is reflective of the use of analytic epidemiology?

A) There is increased risk for West Nile fever due to standing flood waters and mosquitos.
B) Fourteen adults have reported flu-like symptoms after eating at a local diner.
C) Ten percent of the children entering kindergarten this fall need immunizations.
D) Two hundred older county residents came to the health department for flu shots.

Answer 1

A

Question 2

The nurse is researching health concerns relative to young adults in a specific state. Which resource is most likely to assist the nurse with obtaining the necessary data?

A) County Health Department
B) Federal Health Documents
C) Center of Disease Control
D) World Health Organization

Answer 2

C

Question 3

The nurse manager in an acute healthcare setting becomes aware of an increased number of hospital-acquired infections for postoperative patients. Which specific type of epidemiology will the nurse manager initiate?

A) Clinical
B) Hospital
C) Infectious
D) Preventive

Answer 3

B

Question 4

The public health nurse reviews health statistics for county residents and discovers a high number of adults who smoke. Which type of preventive measure does the nurse the initiate with the development of a smoking cessation program?

A) Passive prevention
B) Tertiary prevention
C) Active prevention
D) Secondary prevention

Question 5

Pregnancy Risk Assessment Monitoring System (PRAMS), is a surveillance project of the CDC and state health departments. For which reason does the PRAMS project exist?

A) Identifying specific geographical locations where infant mortality rates are high
B) Deciding if educational programs need to be presented to sexually active adolescents
C) Learning about the impact of socio-economic status on projected infant survival rates
D) Developing programs and policies to prevent adverse outcomes for the mother and infant

Question 6

The CDC collects data from death certificates to determine pregnancy-related deaths for the Pregnancy Mortality Surveillance System. Which parameters are used to define a pregnancy-related death?

A) The death of the woman occurs during either labor or delivery.
B) The death of the woman is concurrent with the death of the fetus.
C) The death of the neonate is associated with the woman's cause of death.
D) The death of the woman is either during or within 1 year of the end of a pregnancy.

Question 7

The infant mortality rate is cited in a 2016 report by the CDC. Which regions of the U.S. exhibits higher rates than the national average?

A) Northern regions including Alaska
B) Eastern coastline including Florida
C) Southern and Midwest regions
D) Western coastline including Hawaii

Question 8

The Maternal Mortality Review Information Application (MMRIA) systematically investigates mortality. Which other increasing trend is covered by this report?

A) Socioeconomic status
B) Racial disparity
C) Healthcare access
D) Pre-existing conditions

Question 9

For which reason are the numbers of deaths from infectious diseases estimated since the rates are derived from data reported on death certificates?

A) The certificates are often completed inaccurately.
B) Previous studies identify discrepancies at a rate of 50%.
C) Some families refuse to have the cause of death reported.
D) Cause of death is not always obtainable without autopsy.

Question 10

The epidemiology triangle is comprised of an agent as the cause of disease, the host as the human or animal susceptible to a disease, and the environment as external surroundings or conditions that enable disease transmission to the human or animal. Which concern highlights the relevancy of the epidemiology triangle?

A) Re-emergence of previously eradicated organisms
B) Increases in the numbers of agents causing disease
C) Greater numbers of susceptible animals and humans
D) General deterioration of environmental conditions

Question 11

Much attention is given to the transmission of communicable infections such as SARS. Which phylogeny of SARS is identified through scientific research?

A) Human to human
B) Bats to humans
C) Palm civets to bats
D) Animal to humans

Question 12

Which information is effective in preventing the spread of SARS?

A) Isolate persons who are infected.
B) Cover nose and mouth in public.
C) Perform regular hand hygiene.
D) Finish prescribed medications.

Question 13

Which is the greatest concern with the emergence of a new disease?

A) The impact on healthcare providers
B) The lack of knowledge about transmission
C) The inability to identify the origin of the disease
D) The potential of the disease becoming resistant

Question 14

WHO acknowledges the focus on the social context of health was not as prominent in the 1950s and 1960s as it is currently. For which reason did the focus shift away from the social context of health in that timeframe?

A) Emphasis was placed on targeting specific diseases.
B) Social context of health was addressed on a limited scale.
C) Social hierarchies set the accessibility of health care in a society.
D) Income and education levels dictated the economics of health care.

Question 15

The nurse is aware that exposure of a fetus to lead can lead to a variety of adverse events. Which manifestation may exist from lead exposure prior to birth?

A) Deformity of extremities
B) Small for gestational age
C) Loss of hearing and vision
D) Cancer diagnosis in infancy

Question 16

The nurse is collecting information from the medical records in a private practice to determine the number of patients being treated for alcohol abuse who experience depression. Which type of statistics is the nurse using?

A) Analytical
B) Individual
C) Descriptive
D) Inferential

Question 17

The nurse is reviewing a research article and notes the power range of the study is .80. Which conclusion does the nurse draw regarding the statistical power related to the population being studied?

A) A Type II error has occurred.
B) Detecting a genuine effect is unlikely.
C) The power is at an acceptable level.
D) The effect will certainly be found.

Question 18

Which information does the public health nurse include as being definitive of descriptive epidemiology?

A) Older adults in the community exhibit signs of obesity.
B) More than half of school age children had a tonsillectomy.
C) Four adults had vomiting 4 hours after eating local mushrooms.
D) Neonatal health is adequate based on screening of 50% of newborns.

Question 19

The nurse is compiling information about the residents in an extended care facility. Which process does the nurse use to find the average age of the residents?

A) Arrange all the ages in ascending order and find the middle age.
B) Add all the ages together and divide the total by the number of residents.
C) Arrange the ages in descending order and identify the most common age.
D) Arrange the ages in ascending order and eliminate the high and low extreme.

Question 20

The nurse is using descriptive epidemiology to monitor an outbreak of measles among children. If a scatter chart indicates a specific area of heavy incidence, which term does the nurse use to describe the variable of time and/or place?

A) Secular trends
B) Cyclic trends
C) Point epidemic
D) Clustering

Question 21

The occupational health nurse notices an increased incidence of skin irritation, rashes, and itching among the employees working with vegetation control chemicals. How does the nurse classify the condition?

A) Infectious skin disease
B) Noninfectious skin disorder
C) Genetic related skin condition
D) Seasonal triggered skin irritation

Question 22

The Healthy People 2020 goal is 90% pneumococcal vaccination target for non-institutionalized adults aged 65 and older. Which type of study does the nurse use to gather information relevant to this goal?

A) A case report
B) A case series
C) A cross-sectional study
D) A demographic description

Question 23

A study is being launched to study the use of a clinic by migrant workers and their family members. Which limitation does the IRB identify as a probable ethical concern?

A) Participants will be tracked by family surnames.
B) Transportation will be provided to the clinic.
C) Workers will be paid for time away at the clinic.
D) Children will be accompanied by at least one parent.

Question 24

A research group is using a small community to study the impact of professional dental care on oral health and hygiene. Participants will be studied for one year and the findings reported regarding probable benefits. For which reason is the study most likely to face poor participation?

A) Mistrust about any services offered at no cost
B) Suspicion of anyone who is from outside the community
C) High levels of embarrassment about poor dental health
D) Participants wanting to avoid feeling like research subjects

Question 25

The public health nurse is aware of a high level of lead poisoning among children in a specific community. Which condition is considered to be an underlying factor contributing to this detriment to health?

A) Instability of available housing
B) Access to primary health care
C) Existing environmental conditions
D) Levels of language and literacy

Question 26

Evidence-based interventions can be implemented to address modifiable upstream factors surrounding the individual. Which modifiable upstream factor is likely to have the greatest positive impact on social discrepancies?

A) Employment and training
B) Housing regulations
C) Availability of health care
D) Easier access to commodities

Question 27

Epidemicity is relative to the usual frequency of an identified disease in the same area, among the specified population, at the same season of the year.

Question 28

The IMR is considered a major indicator of health, with the CDC noting the rate as an important marker of the health of a society.

Question 29

WHO collects and reports under-five mortality because in many developing countries and/or countries ravaged by civil disturbances, children under-5 are vulnerable to infectious diseases and dehydration resulting in death.

Question 30

A vector is an invertebrate animal, either dead or living, capable of passing a communicable disease to a susceptible host, its food, or immediate surroundings.

Question 31

Only one highly secure lab in the world is approved to have the smallpox virus for research purposes.

Question 32

A dichotomous variable is a variable with a yes or no response.

Question 33

There are three different levels of measurement, and a variable will fall into one of the following levels of measurement categories: nominal, ordinal, and interval.

Question 34

With its focus on groups, epidemiology is perceived as a population science, whereas the clinical sciences focus on the individual.

Question 35

The process of obtaining IRB approval for a study should initially be viewed as an adversarial event by the researcher until full approval is given.

Question 36

Persons with low ________ status are more likely to be affected by diabetes, hypertension, and human immunodeficiency virus (HIV) infection, are less likely to be screened for colorectal cancer, and less likely to be vaccinated against influenza.

Question 37

Using the data below, the median number is ____.
26 ,29, 30, 30, 32, 32, 32, 35, 35, 36, 37, 37, 38, 38, 39, 40, 42, 42, 42, 43, 45

Question 38

_______ selection means every person has an equal chance of being selected for the sample.

Question 39

The nurse is preparing a ______ ______ on a patient admitted for exhibiting unusual neuromuscular symptoms following treatment for an upper respiratory infection.

Question 40

The quality of data becomes an _______ issue when incomplete data is collected by researchers, which will affect an analysis and the results.

Question 41

Researchers are proposing a study to measure the impact of changing how patients are suctioned on the incidence of pneumonia. A _______ and ________ hypothesis will both need to be developed.

Question 42

Match the theory of an epidemiologic transition with the description of the transition.
-The Age of Degenerative and Man-Made Diseases

A) Survival rates for younger people improve; middle and older aged people succumb to chronic diseases.
B) Mortality is high with an average life span between 20 and 40 years.
C) Mortality progressively declines and the average life expectancy steadily increases.
D) Causes of death are associated with cardiovascular events and cancer.

Question 43

Match the theory of an epidemiologic transition with the description of the transition.
-The Age of Receding Pandemics

A) Survival rates for younger people improve; middle and older aged people succumb to chronic diseases.
B) Mortality is high with an average life span between 20 and 40 years.
C) Mortality progressively declines and the average life expectancy steadily increases.
D) Causes of death are associated with cardiovascular events and cancer.

Question 44

Match the theory of an epidemiologic transition with the description of the transition.
-The Age of Delayed Degenerative Diseases

A) Survival rates for younger people improve; middle and older aged people succumb to chronic diseases.
B) Mortality is high with an average life span between 20 and 40 years.
C) Mortality progressively declines and the average life expectancy steadily increases.
D) Causes of death are associated with cardiovascular events and cancer.

Question 45

Match the theory of an epidemiologic transition with the description of the transition.
-The Age of Pestilence and Famine

A) Survival rates for younger people improve; middle and older aged people succumb to chronic diseases.
B) Mortality is high with an average life span between 20 and 40 years.
C) Mortality progressively declines and the average life expectancy steadily increases.
D) Causes of death are associated with cardiovascular events and cancer.

Question 46

Obesity is a recognized contributor to coronary artery disease, which can be influenced by both upstream and downstream factors. Determine which factors in the second column can be identified as either upstream or downstream.
-Increase employment opportunities

A) Upstream Factor
B) Downstream Factor

Question 47

Obesity is a recognized contributor to coronary artery disease, which can be influenced by both upstream and downstream factors. Determine which factors in the second column can be identified as either upstream or downstream.
-Decrease dependency on automobiles

A) Upstream Factor
B) Downstream Factor

Question 48

Obesity is a recognized contributor to coronary artery disease, which can be influenced by both upstream and downstream factors. Determine which factors in the second column can be identified as either upstream or downstream.
-Attend an exercise class three times weekly

A) Upstream Factor
B) Downstream Factor

Question 49

Obesity is a recognized contributor to coronary artery disease, which can be influenced by both upstream and downstream factors. Determine which factors in the second column can be identified as either upstream or downstream.
-Seek smoking cessation assistance

A) Upstream Factor
B) Downstream Factor

Question 50

Obesity is a recognized contributor to coronary artery disease, which can be influenced by both upstream and downstream factors. Determine which factors in the second column can be identified as either upstream or downstream.
-Consult with a dietitian

A) Upstream Factor
B) Downstream Factor

Question 51

The Institute for Healthcare Improvement (IHI) defines one area of interest as regional/community populations, which are inclusive population segments, defined geographically. Briefly discuss one of the characteristics describing this population.

Question 52

Briefly discuss how climate change can impact planetary health.

Question 53

Define the term "pandemic."

Question 54

The Institute for Healthcare Improvement (IHI) and their Triple Aim framework was developed to optimize health systems performance through the development of new designs to simultaneously pursue three Triple Aims. Briefly discuss the three designated aims.

Question 55

Define the term "the Black Belt" and identify the associated factors that were detrimental to health there.

Question 56

Some researchers establish an advisory board when first planning a study to receive advice regarding how to best, and in a sensitive manner, collect information about sex/gender, race, ethnicity, and other classifications. Discuss the ethical issues and the impact gathering this information can have on the study.

Question 57

Discuss how an illness can affect an individual's social position.

Question 58

Epidemiologists are performing a research study about the effects on the health of a community built over a toxic waste disposal location. Which other factor is needed if the study is identified as a perspective cohort study?

A) A non-exposed population for comparison
B) A detailed history of all the exposed participants
C) A group of persons who lived in the area for over a year
D) A socioeconomic profile of the non-exposed population

Question 59

It is decided to monitor health developments for a large group of specific persons over an extended period of time and to compare findings with the general population. Which term appropriately characterizes the type of study being performed?

A) Retrospective cohort study
B) Occupation specific study
C) Prospective cohort study
D) Random population study

Question 60

Which is an example of a case-control study?

A) Identifying the incidence of type 2 diabetes mellitus in adults
B) Comparing the incidence of cancer between smokers and non-smokers
C) Searching county health records for persons with genetic linked illnesses
D) Gathering demographic information about persons who died from accidents

Question 61

The nurse is providing care for a newborn diagnosed with a rare genetic disorder. The parents suspect the disorder to be connected to medication prescribed during the first trimester of pregnancy. Which type of research study does the nurse anticipate?

A) A longitudinal study
B) A case-control study
C) A cohort study
D) A perspective study

Question 62

Administration in a long-term care facility is interested in the reduction of the number of resident falls. Which type of study will address this concern in this particular setting?

A) Cohort-control study
B) Case-crossover study
C) Hybrid-designed study
D) Nested case-control study

Question 63

A medical-surgical unit reports a high incidence of patient "wandering" during night time hours. Which type of study does the nurses conduct to look for a cause of the behavior?

A) Nested case-control
B) Cohort-control
C) Case-crossover
D) Case-control

Question 64

The nurse is using the large cohort studies from Nurses Health Studies and the Framingham Heart Study to support a report on the causalities of cardiovascular disease. Which factor causes doubt about the use of these studies in this manner?

A) Researchers reported associations among variables and not causality.
B) Researchers determined one or more variables caused a specific health outcome.
C) Researchers used an appropriate research design to support statements of causality.
D) Researchers performed additional studies to replicate the findings of the original studies.

Question 65

Which causative factor would change exposure to the Zika virus from a direct to an indirect association with microcephaly?

A) The pregnant female travels to an area where the virus is prevalent.
B) All exposed pregnant females were positive for the virus and anemic.
C) The fetuses exposed during the first trimester experienced microcephaly.
D) Fetuses not treated for the virus before birth exhibited microcephaly.

Question 66

The nurse is interested in researching the possibility of a connection between skin cancer and the use of tanning beds. Invitations to participate in the study are sent to a selected population. For which reason does the nurse need to be aware of selection bias?

A) Tanning bed use presents a restrictive number of participants.
B) Persons who did not use tanning beds are less likely to respond.
C) Primarily persons with diagnosed skin cancer will agree to participate.
D) The persons who use tanning beds do not want to know about skin cancer.

Question 67

In the above study, the nurse decides to use medical records from dermatologists to identify patients who are or have been treated for skin cancer after using tanning beds. Which situation is likely to result in information bias?

A) Any patients having skin cancer are included.
B) Patients must agree to the source of exposure.
C) Length of exposure time is not specified.
D) Patients are given the choice to participate.

Question 68

The nurse is planning to perform research on a specific population who have contracted lung cancer. All participants have an occupational history of coal mining. Which confounding information does the nurse include in addition to occupation?

A) Smoking history
B) Family history of cancer
C) Length of employment
D) Methods of treatment

Question 69

The researchers do not let the participants and the data collectors know details about the study to prevent what is termed experimenter expectancies. Which type of blinding will the researchers use?

A) Single blind
B) Double blind
C) Triple blind
D) Quadruple blind

Question 70

The nurse plans a study about the incidence of readmission for patients with CHF, which is currently at 70% within one month of discharge. Which type of study does the nurse select?

A) Population evaluation
B) Readmission criteria
C) Patient needs assessment
D) Discharge parameters

Question 71

The nurse is planning a needs assessment based on data gathered during first-grade-readiness screenings because of low scores on meeting physical milestones. Which need is most likely to be identified as a contributing factor?

A) There is a lack of nutritional programs to meet dietary needs of physical growth.
B) Access to programs for parents to learn how to stimulate learning at home is needed.
C) Existing playgrounds and equipment are located in unsafe areas for children.
D) Children are encouraged to limit screen-activity to a maximum of one hour daily.

Question 72

Considering the scenario in the previous question, which stakeholders does the nurse recognize as most important?

A) Parents of the children
B) Local law-enforcement
C) Neighborhood watch groups
D) Municipal administration

Question 73

The nurse is submitting a systematic review focused on preventing respirator-acquired pneumonia. Accompanying statistical results on 40 patients are recommended changes in clinical practice. An effect size of 0.6 is also reported. Which reason is most likely to cause the article to be rejected?

A) The weak effect size does not support clinical change.
B) The size of the population is not significant for change.
C) The statistical results of the study are not applicable.
D) The changes in clinical practice are not appropriate.

Question 74

Which proposed intervention is identified as primary prevention?

A) Weight loss programs
B) Prostate cancer screenings
C) Smoking cessation programs
D) Cardiac recovery exercise programs

Question 75

The nurse is involved in screening to investigate the effects of dioxin exposure in U.S. Air Force Veterans of the Vietnam War. Which type of research is best for identifying the need for evidence-based treatments?

A) Screenings for specific diseases
B) Interviews with veterans who were exposed
C) Lab studies of genetics and molecular changes
D) Military records validating personnel exposures

Question 76

A community is concerned about the high rate of teen pregnancies. Public health nurses have designed a harm reduction program, which involves making condoms readily available to adolescents. Which feedback does the nurses expect from people opposed to the program?

A) The adolescents will not take advantage of the program.
B) The program will promote sexual activity among teens.
C) Parents need better teaching information to present at home.
D) Religious communities should strongly support abstinence.

Question 77

For which reason does the nurse include graphs as visual aids when presenting information regarding the increasing incidence of a specific illness in the community?

A) To maintain the interest of the audience
B) To decrease the amount of verbal information
C) To promote easy and quick grasp of information
D) To meet all education levels of the attendees

Question 78

The CDC has outlined four different types of briefs for dissemination of information to stakeholders about proposed policy changes. Which type of brief is recommended when evaluations and evidence exist on the health or economic issues of the policy?

A) Issue brief
B) Policy brief
C) Information brief
D) Policy impact brief

Question 79

For which reason do many outbreaks fail to come to the attention of health authorities?

A) Healthcare providers are reluctant to report suspected illnesses.
B) People tend to self-treat illnesses and recover in their homes.
C) Many illness outbreaks tend to be the result of illicit behaviors.
D) The reporting process is complicated and time consuming.

Question 80

The school nurse becomes aware of a group of children who come to the clinic reporting itching and the presence of round red marks on their skin. The school nurse contacts the health department who initiates protocol for the treatment of bedbugs. Which event likely triggered the health department's action?

A) Syndromic surveillance by the school nurse
B) Medical reports from family healthcare providers
C) On site visits and examinations by public health nurses
D) Identification of skin scrapings sent to a local laboratory