Deck 9: Epidemiological Applications

Question 1

The nursing staff has attempted to screen the entire African-American population in the community for diabetes. Which of the following would provide immediate verification of the success of the nursing staff's efforts?

A)An epidemic of diabetes will be recognized.
B)The incidence of diabetes will increase in the community.
C)The prevalence of diabetes will decrease in the community.
D)The risk for diabetes in the community will increase.

Answer 1

The incidence of diabetes will increase in the community.

Question 2

Which of the following actions would a nurse take to reduce the high incidence of coronary artery disease (CAD) in a community?

A)Introduction of a heart-healthy curriculum beginning in the first grade, presentations on diet and exercise for the community at large, and special education sessions for high-risk populations
B)Provision of online activities related to prevention of cardiac disease, smoking reduction programs, and blood pressure screenings
C)Distribution of handouts, including age-appropriate games, self-assessments, and education on heart-healthy lifestyles; availability of community screenings for hyperlipidemia in persons age 35 and older; and walking programs for those affected with CAD
D)Enrollment of clients with CAD into cardiac rehabilitation programs, routine evaluation of effectiveness of CAD treatment regimens, and participation in clinical trials that evaluate interventions for those diagnosed with CAD

Answer 2

Distribution of handouts, including age-appropriate games, self-assessments, and education on heart-healthy lifestyles; availability of community screenings for hyperlipidemia in persons age 35 and older; and walking programs for those affected with CAD

Question 3

A nurse is examining all of the various factors which can lead to disease. Which of the following models would the nurse most likely use?

A)Epidemiologic triangle
B)Health promotion
C)Levels of prevention
D)Natural history of disease

Answer 3

Epidemiologic triangle

Question 4

A nurse is examining the various factors that lead to disease and suggests several areas where nurses could intervene to reduce future incidence of disease. Which of the following models would the nurse most likely use?

A)Epidemiologic triangle
B)Health promotion
C)Levels of prevention
D)Web of causality

Question 5

A public health nurse found that out of the 70 people who ate the potato salad at a school picnic, 63 developed symptoms of food poisoning. Which of the following best describes the attack rate?

A)63%
B)70%
C)90%
D)100%

Question 6

A nurse is administering a tuberculosis skin test to a client who has AIDS. Which of the following results should the nurse anticipate when using this screening test?

A)Decreased positive predictive value
B)Decreased reliability
C)Decreased sensitivity
D)Decreased specificity

Question 7

Which of the following statistics is used by countries to compare the success of their health care systems?

A)Attack rate
B)Infant mortality rate
C)Cause-specific morbidity rate
D)Cause-specific mortality rate

Question 8

Which of the following actions by Florence Nightingale demonstrates her role as an epidemiologist?

A)She convinced other women to join her in giving nursing care to all the soldiers.
B)She demonstrated that a safer environment resulted in decreased mortality rate.
C)She obtained safe water and better food supplies and fought the lice and rats.
D)She met with each soldier each evening to say goodnight, thereby giving psychological support.

Question 9

A nurse is employed as a nurse epidemiologist. Which of the following activities would most likely be completed by the nurse?

A)Eliciting the health history of a client presenting with an illness
B)Evaluating the number of clients presenting with similar diseases
C)Performing a physical examination of an ill client
D)Providing treatment and health education to a client with a disease

Question 10

A nurse advises a client with osteoporosis to have three servings of milk or dairy products daily. Which of the following levels of prevention is being used by the nurse?

A)Primary prevention
B)Secondary prevention
C)Tertiary prevention
D)Treatment, but not prevention

Question 11

A school nurse wants to decrease the incidence of obesity in elementary school children. Which of the following describes a secondary prevention intervention that the nurse could implement?

A)Giving a presentation on the importance of exercise and physical fitness
B)Designing a game in which students select healthy food choices
C)Weighing students to identify those who are overweight
D)Putting students on a diet if they weigh greater than 20% of their ideal weight

Question 12

A nurse has only a regular blood pressure cuff when conducting a health screening for all of the residents of a community. Which of the following may be lacking when obtaining blood pressure readings?

A)Reliability
B)Sensitivity
C)Specificity
D)Validity

Question 13

Between 2000 and 2005, 1000 of 10,000 young women ages 17 to 20 years at a university tested positive for a sexually transmitted infection (STI). Of the 1000 diagnosed STIs, 300 were gonorrhea and 500 were chlamydia. Which of the following statements best summarizes these findings?

A)The proportion of cases of gonorrhea to all STIs was 300:1300.
B)The proportion of cases of gonorrhea to chlamydia was 300:500.
C)The proportion of cases of gonorrhea to all STIs was 50%.
D)The proportion of STIs to the total population was 100:1000.

Question 14

This year 600 of 8000 young women ages 17 to 20 years at a university health center tested positive for a sexually transmitted infection (STI). Which of the following terms best describes this data?

A)An epidemic
B)Incidence
C)Prevalence
D)Risk

Question 15

A nurse is using analytic epidemiology when conducting a research project. Which of the following projects is the nurse most likely completing?

A)Reviewing communicable disease statistics
B)Determining factors contributing to childhood obesity
C)Analyzing locations where family violence is increasing
D)Documenting population characteristics for healthy older citizens

Question 16

Several small communities have applied for grant funding from the state department of health to help decrease their teenage pregnancy rate. Which of the following communities should the nurse suggest receive funding first?

A)Community A-with 23 single teenage pregnancies in a city of 500
B)Community B-with 45 single teenage pregnancies in a city of 1000
C)Community C-with 90 single teenage pregnancies in a city of 2000
D)Community D-with 90 single teenage pregnancies in a city of 1500

Question 17

Which of the following statements describes how nursing in the community is more challenging than nursing in an acute care setting?

A)There is limited access to information useful to the nurse in giving care in the community.
B)More paperwork and forms are required when giving care in the home.
C)It is more challenging to control the environment in the community.
D)Specialization isn't possible in the community setting.

Question 18

A nursing staff has successfully screened for diabetes in the community. Which of the following might best persuade the health board to increase funding for diabetic clinics in this community?

A)An epidemic of diabetes is now recognized and must be addressed.
B)The incidence of diabetes is now higher than previously recognized in the community.
C)The prevalence of diabetes is now higher than previously recognized in the community.
D)The risk for diabetes in the community could decrease if funding is received.

Question 19

A man is diagnosed with prostate cancer. Which of the following data should the nurse know to answer the man when he asks, "What are the chances I'll survive this thing?"

A)Attack rate
B)Case fatality rate
C)Cause-specific morbidity rate
D)Crude mortality rate

Question 20

In a particular community, several high school students were diagnosed with diabetes mellitus Type 2 during the annual high school health fair. Over the next few years, the nursing staff developed and implemented educational programs about the risk factors for diabetes mellitus Type 2 and proper nutrition. Which of the following would be most useful for the nurses to use to determine if they are having any impact?

A)The epidemic of diabetes in the high school is gradually ending.
B)The incidence of diabetes is slowly decreasing during screening events.
C)The prevalence of diabetes is slowly decreasing during screening events.
D)The risk for diabetes is slowly increasing over time.

Question 21

A nurse is investigating a bacterial illness that has caused a health problem in the community. Only some of the people exposed to the bacteria have become ill. Which of the following factors best explains why this would have happened?

A)Chemical agent factors
B)Environmental factors
C)Host factors
D)Physical agent factors

Question 22

Two women seem to agree on almost everything from favorite music to favorite media stars to the best way to prepare a meal. Which of the following best explains this similarity in the two women?

A)They are both members of the same birth cohort.
B)They are close friends.
C)They attended the same school.
D)They both go the same church.

Question 23

Persons in an auditorium may have been exposed to a disease. If they are infected, it is crucial that they receive immediate treatment and not take the disease home to their families. Which of the following characteristics would be most important to consider when selecting the screening test to be used?

A)The negative predictive value
B)The positive predictive value
C)The sensitivity of the test
D)The specificity of the test

Question 24

Which of the following types of study should the nurse researcher choose if the goal is to identify the long-term benefits and risks of a particular nursing intervention for senior citizens living in the community?

A)Cross-sectional study
B)Ecologic study
C)Clinical trial
D)Retrospective analysis

Question 25

A nurse is planning to host a health screening at a large urban mall. Which of the following variables will help the nurse determine which screenings should be included? (Select all that apply.)

A)Adequate space for persons to lie down after testing until side effects are reduced
B)Health problems for which the specific population is at risk
C)Whether adequate privacy can be obtained for the invasive or embarrassing procedures
D)Whether health care providers are available to follow up on any positive screening results

Question 26

A nurse reports that in comparison to all the children in a particular school, the children who are members of the Cub Scouts have 0.3 risk for obesity before entering the sixth grade. Which of the following recommendations would the nurse make to the new parents of two boys who had just moved into this school's neighborhood?

A)Discourage the parents from enrolling their sons in Cub Scouts because of the risk.
B)Don't say anything about Cub Scouts, because it isn't relevant to nursing care.
C)Encourage the parents to enroll their sons in Cub Scouts.
D)Share the finding and let the parents draw whatever conclusions they feel appropriate.

Question 27

A woman is sitting in a corner of the clinical waiting room, crying audibly. The nurse asks, "What's wrong? Can I help?" The woman responds, "They just told me I have a positive mammogram and I need to see my doctor for follow-up tests. I know I'm going to die of cancer. How can I tell my family?" Which of the following information does the nurse need to know in order to help the woman cope with this finding?

A)The negative predictive value of mammography
B)The positive predictive value of mammography
C)The reliability of mammography
D)The validity of mammography

Question 28

A nurse is concerned about the high incidence of STDs in the community college population and sets up a special STD screening. Which of the following groups of students would be encouraged to attend? (Select all that apply.)

A)Sexually active students currently receiving treatment for an STD
B)Sexually active students who had been screened the previous year
C)Students who claimed to not be sexually active and do not plan to become sexually active
D)Students who are sexually active but never "go all the way"

Question 29

The administration at a local medical center examines the trends in health problems when developing long-range plans for staffing and space allocation. Which of the following sources of information would be most helpful?

A)Local data drawn from a professional survey in the city
B)The National Health Interview Survey
C)The National Hospital Discharge Survey
D)The state's vital statistics

Question 30

A principal comments to the school nurse that it seems there are a lot more problems with asthma among the students than there were before the school was remodeled a couple of years ago. The nurse investigates the principal's observation by reviewing all the school records to determine visits to the health office because of asthma by week and month for the past 5 years. Which of the following best describes the type of study the nurse is conducting?

A)Descriptive epidemiological study
B)Ecological study
C)Prospective cohort study
D)Retrospective cohort study

Question 31

A nurse believes a new mouth care procedure (MCP) is causing more mouth problems than it is helping to avoid. Which of the following must be present for the nurse to go to administration with confidence that the new mouth care procedure (MCP) is causing problems? (Select all that apply.)

A)A plausible explanation of how the new MCP could cause harm
B)A strong feeling that the MCP is the cause
C)Consistently seeing mouth inflammation in many of the patients who have received the MCP
D)Documentation from patient records that mouth inflammation in clients did not occur until after the new procedure was implemented

Question 32

A teacher recommends that surveys to obtain data on drug use be given to high school students when they meet for various school organizations. Which of the following best describes why the nurse would reject this suggestion?

A)This method of data collection would result in classification bias.
B)This method of data collection would result in confounding bias.
C)This method of data collection would result in personal bias.
D)This method of data collection would result in selection bias.

Question 33

Statistics clearly demonstrate that there are significantly more cases of a disease in one particular neighborhood than in all the rest of the city. Assuming all else is the same, which of the following is the most likely explanation for a single neighborhood having such a different pattern of illness?

A)A cultural or ethnic concentration in the neighborhood
B)The geographical location of the neighborhood within the city
C)A statistical fluke without meaning
D)The time of year the different statistics were collected throughout the city

Question 34

Which of the following explains why contagious infections are becoming a central focus of public health? (Select all that apply.)

A)Americans are fearful of terrorists using biological agents.
B)Awareness of human susceptibility to animal diseases has been publicized.
C)Drug-resistant strains of "old" diseases have evolved.
D)Media coverage exaggerates the dangers of exposure to crowds.