Question 1

An instructor is discussing the worldwide distribution of AIDS with a group of nursing students. The instructor should categorize this situation as a(n) :

Accepted Answer

Pandemic is the term used to describe an epidemic that is distributed worldwide. An epidemic refers to a disease occurrence that clearly exceeds the normal or expected frequency in a community or region. Endemic is used to describe the continuing presence of a disease or infectious agent in a given geographic area. Pathogenicity refers to an agent's capacity to cause disease in a host.

Question 2

After a class describing the contributions of Florence Nightingale to epidemiology, the instructor determines that the class needs additional instruction when they state that which accomplishment is associated with Nightingale?

Accepted Answer

Nightingale's colleague, William Farr, is credited for developing a more sophisticated system for coding medical conditions. Nightingale's contributions included establishing the need for a clean environment, properly cleaning wounds and bandaging them, and separating infected soldiers from those who were injured.

Question 3

When applying the epidemiologic triad model to a community's plan of care, which would the community health nurse address?

Accepted Answer

The purpose of this model is to demonstrate the relationship among host, agent, and environment. Each component has to be present to a certain degree in order for any disease, illness, or injury to exist or happen. If one component is missing, illness or injury will not occur. Incidence, prevalence, case fatality, health, illness, injury, immunity, causation, and risk are terms used in epidemiology but do not refer to the epidemiologic triad model.

Question 4

Which would the community health nurse identify as a key component of the host?

Accepted Answer

The host, a susceptible human or animal, can sometimes have an ability to resist pathogens. This is called inherent resistance. Infectivity, antigenicity, and virulence are characteristics of the agent.

Question 5

Which statements apply to the concept of causality? Select all that apply.

Accepted Answer

Causality is the relationship between cause and effect. The web of causation theory is the most recent theory of causality. Epidemiology has changed its view of causality over time. The chain of causation was the first theory of causality. The chain of causation could not sufficiently explain causation in noninfectious disease because the chain of causation is too linear.

Question 6

A community health nurse is explaining the chain of causation to a family that includes a child who has developed Lyme disease. The nurse correctly describes the opening in the child's skin caused by the actual tick bite as the:

Accepted Answer

The opening in the child's skin caused by the actual tick bite is the portal of entry in the chain of causation. The mode of transmission would be the tick biting the child. The reservoir would refer to the tick. The host would be the child who has been bitten by the tick.

Question 7

Which would the community health nurse include when integrating epidemiology of wellness into practice?

Accepted Answer

Today, there is an increased focus on lifestyle behaviors and how they relate to a person's state of wellness or illness. It is a basic component of a wellness model. Communicable disease control focuses on an illness state, not a wellness state, and is not part of a wellness model. The four states of the natural history of a disease or health condition is not part of the wellness model. Vital statistics and reportable diseases are not part of the wellness model.

Question 8

The nurse is examining the possibility that multiple factors are involved in the development of cerebral palsy. Which is the nurse is applying?

Accepted Answer

The web of causation is being used to apply the concept of multiple causes to explain the existence of health and illness states. It was a refinement of the chain of causation, such that it looked at the combination of multiple factors as implicated in the development of poor outcomes. The chain of causation focuses on one factor in the development of a condition. The strength of association is an element of causation in noninfectious disease that refers to the ratio of disease rates in those with and without the causal factor. Temporality, also involved with the causation of noninfectious disease, is an element in which the exposure to the suspected factor must precede the onset of the disease.

Question 9

The nurse is reviewing a research article that describes the use of the bacille Calmette-Guérin (BCG) vaccine to prevent tuberculosis that was given to individuals who were exposed to leprosy. The individuals did not develop the leprosy. The nurse interprets this as most accurately demonstrating which type of immunity?

Accepted Answer

Cross-immunity refers to a situation in which a person's immunity to one agent provides immunity to a related agent as well. This immunity can be active or passive. Herd immunity describes the immunity level present in a population group. Passive immunity refers to short-term resistance acquired naturally or artificially. Active immunity is long term and can be acquired naturally or artificially.

Question 10

The nurse educator knows that a nursing student understands the basics of immunity when the student nurse states:

Accepted Answer

Active immunity can be attained via the use of vaccines. Passive immunity is immunity that is given to a person, either by maternally provided protection for newborn infants or from antibody products that provide temporary resistance. Herd immunity describes the immunity level that is present in a population group. Cross-immunity is immunity that causes a person who is immune to one disease to be also immune to a related infectious agent.

Question 11

When assessing several populations, the nurse notes each population's relative risk. Using the relative risk ratio below, which population would require a major emphasis for risk reduction intervention?

Accepted Answer

A relative risk >1.0 indicates that those with the risk factor have a greater likelihood of acquiring the disease than do those without it. For example, a relative risk ratio of 2.45 means that the exposed group is 2.45 times more likely to acquire the disease than the unexposed group. Therefore, interventions to reduce this population's risk would be most important.

Question 12

A community health nurse is discussing populations at risk with a student nurse. Which statements made by the student nurse indicates a need for further education about risk? Select all that apply.

Accepted Answer

Risk does not mean that the person who has the most negative influences will definitely develop the disease or unfavorable health condition, but it refers to the probability that the person will develop the disease or unfavorable health condition. The relative risk ratio assists in determining the most effective points for community health intervention in regard to particular health problems. Risk is the probability that a disease or unfavorable health condition will develop. Risk also refers to positive and negative influences on a person's likelihood of developing a specific disease. Relative risk ratio is a calculation of risk consisting of the ratio of incidence in an exposed group to incidence rate in unexposed group.

Question 13

While visiting a family's home, the community health nurse finds out that the two children in the home were exposed to chickenpox. Assessment of the children reveals no signs of fever or lesions. The nurse determines that the children may be in which stage of the disease?

Accepted Answer

The children have been exposed but have not yet developed the signs of chickenpox. Therefore, they are in the subclinical disease stage. During the susceptibility stage, the disease is not present and individuals have not been exposed. During the clinical stage, signs and symptoms are beginning to develop. During the resolution stage, the disease causes sufficient anatomic or functional changes to produce recognizable signs and symptoms.

Question 14

During which stage of the natural history of a communicable disease would quarantine be most effective?

Accepted Answer

Quarantine is the isolation of persons who are susceptible to a communicable disease and have been exposed to that communicable disease until the incubation period of the subclinical disease stage has passed. Quarantining persons during the susceptibility stage itself is not indicated as individuals have not been exposed. The proper action for persons who are in the clinical disease stage and beyond is isolation until the danger of spreading the communicable disease has passed.

Question 15

The nurse is reviewing actual census data for information for use in an epidemiologic study. Which information would the nurse be least likely to find?

Accepted Answer

Vital statistic data provide information about the number of births recorded. Census data include information about age, sex, race, ethnic background, type of occupation, income gradient, marital status, educational level, and other standards such as housing quality. If the nurse is reviewing actual census data, the nurse would be least likely to find births recorded, which is vital statistics.

Question 16

A community health nurse is looking for data on the use of nursing home services and the common diagnoses of those using these services. Which source of information would be most appropriate for the nurse to investigate?

Accepted Answer

The National Center for Health Statistics furnishes valuable health prevalence data from surveys of Americans. Among the information available is the National Nursing Home Survey, which provides information on those who are using these services and the diagnoses and other characteristics. The Consumer Product Safety Commission and Environmental Protection Agency would provide information about environmental issues. Cancer disease registries would provide information specific to the diagnosis of cancer.

Question 17

Which statements are true about incidence and prevalence? Select all that apply.

Accepted Answer

Incidence is the number of new cases of a disease or health condition. Prevalence refers to all of the people with a particular health condition existing in a given population at a given point in time. When determining if a disease is endemic in a specific area, the statistic that is most helpful is prevalence.

Question 18

A community health nurse is preparing to carry out an experimental epidemiologic study. Which action would be most important for the nurse to take?

Accepted Answer

Experimental studies are carried out under carefully controlled conditions. In human populations, experimental studies should focus on disease prevention or health promotion rather than testing the cause of disease. The investigator exposes an experimental group to some factor and simultaneously observes a control group similar in characteristics to the experimental group but without the exposure factor. An experimental study need not be elaborate to provide important data.

Question 19

A community health nurse is participating in a case-control observational study. Which statement best explains this type of study?

Accepted Answer

Comparing persons with and without a certain condition is known as a case-control study. A study that describes patterns of occurrence in a population is a descriptive study. Following people over a long period of time is a longitudinal study. And cohorts are groups studied over time.

Question 20

After teaching a group of students about the various types of epidemiologic research studies that can be done, the instructor determines that the teaching was effective when the students describe a community trial as:

Accepted Answer

A community trial is conducted as an experimental study design with large populations. Some of the community receives a treatment, while the other part does not. This is probably the most expensive type of experimental study. It involves a great number of subjects, the support of the governmental forces as well as the population involved, a large number of staff over a long period of time, and the cost of the intervention itself. When a whole community is involved, individuals are not approached to be volunteers. What makes it a community study is that the entire community is part of the study. The health problem is identified prior to the implementation of the study. The introduction of an intervention in one community with no introduction in a similar community forms the study population, and the health problem being studied is then monitored between the two populations. The health problem has to be identified first in this type of study.

Quiz 7: Epidemiology in the Community