Question 1

In January, a nurse is listening to colleagues talk about the increase in depressed patients asking for help from their physicians recently. The incidence of complaints of depression was higher in the last month than in the previous 3 months. Based on this data, which of the following would be the next step for the nurse to take?

Accepted Answer

Typically, any unusual increase in incidence should be investigated. But in the majority of cases the increased incidence occurs naturally and/or is predictable when compared with the consistent patterns of previous outbreaks. Many illnesses are seasonal. Seasonal affective disorder (depression) often worsens during the shorter periods of daylight in the winter.

Question 2

The outpatient health care data show a notable increase in asthma over the numbers treated the previous year. Which of the following actions should the public health nurse take first? (Select all that apply.)

Accepted Answer

Before drawing any conclusions, further data should be sought, including confirmation of the current data and their meaning. Data can be inaccurate or collected differently than in the past. What might have led to an increase? Are there other valid sources that might have relevant data? Should surveillance specific to asthma be established?

Question 3

A child came to school coughing almost constantly. The next day, six other children in the same school room were coughing. Which of the following types of outbreak would the nurse suspect?

Accepted Answer

A common source outbreak refers to a group exposed to a common noxious influence, in this case, the ill child who was attending school. The cause of the illness being spread is obvious.

Question 4

In which of the following situations would the nurse most likely use active surveillance?

Accepted Answer

In active surveillance, the nurse may begin a search for cases to determine the magnitude of the problem (how widespread it is). An example would be when several school children become ill after eating lunch in the cafeteria or at the local hot dog stand, in which case, active surveillance would be used to investigate the possibility of food poisoning.

Question 5

Which of the following types of surveillance is being used when case reports are routinely sent to local health departments by health care providers and laboratories, where the data are then summarized and forwarded to those responsible for monitoring such reports?

Accepted Answer

It is passive surveillance when case reports are sent to local health departments by health care providers or laboratories. The case reports are summarized and forwarded to the state health department, national government, or organizations responsible for monitoring the problem, such as the CDC. In active surveillance, the health department nurse may begin a search for cases through contacts to determine the magnitude of the problem. Sentinel surveillance involves looking for trends. Special surveillance is developed when a particular type of data is sought.

Question 6

Which of the following describes the purpose of surveillance systems today? (Select all that apply.)

Accepted Answer

Although surveillance was initially devoted to monitoring and reducing the spread of infectious diseases, it is now used to monitor and reduce chronic diseases and injuries, as well as environmental and occupational exposures. With tight budgets, public health workers must know which programs should be developed and continued based on the most commonly occurring public health problems. Evaluation of the effectiveness of programs requires valid and reliable data.

Question 7

A nurse noted that of 18 children in a day care center room, 5 became ill. Which of the following best describes a host factor that may be associated with this illness and who became ill?

Accepted Answer

Factors that must be considered as causes of outbreak are categorized as agents, hosts, and environmental factors. Host factors may be age, sex, race, socioeconomic status, genetics, and lifestyle choices. The cause of the illness is an agent factor, and the difference in temperature in the room is an environmental factor.

Question 8

A nurse attends a conference to learn more about public health surveillance. Why is it so important that the nurse be knowledgeable about this topic?

Accepted Answer

Nurses are often in the forefront of responses to be made in the surveillance process whether working in a small rural agency or a large urban agency; within the health department, school, or urgent care center; or on the telephone performing triage services during a disaster. It is the nurse who sees the event first.

Question 9

A public health department becomes aware of an impending health problem before any problem is reported to the agency. Which of the following has most likely occurred within the community? (Select all that apply.)

Accepted Answer

Doctors feeling rushed and nurses calling in ill are not unusual events. Syndronic surveillance systems were developed to monitor illness syndromes or events, as seen in such indirect measures as increased numbers of medication purchases, trips to physicians or emergency departments, orders for cultures or x-rays, and rising levels of school or work absenteeism. These may indicate that an epidemic is developing.

Question 10

A nurse considered copying last month's surveillance report and changing the date because the number of occurrences per month had not noticeably changed. Which of the following best explains why the nurse should continue to spend time collecting and reporting data that is always nearly the same?

Accepted Answer

Disease surveillance helps establish baseline (endemic) rates of disease occurrence and patterns of spread. Surveillance makes it possible to initiate a rapid response to an outbreak of a disease or event that can cause a health problem.

Question 11

Several children were hospitalized for severe vomiting and diarrhea. Which of the following best explains why the nurse would continue to pursue the cause of the illness even after the children have been discharged from the hospital?

Accepted Answer

The objectives of an investigation are to control and prevent disease or death by identifying factors that contribute to the occurrence and implementing measures to prevent occurrences. In this case the nurse wanted to make sure children did not become ill again when it could be avoided.

Question 12

Which aspect of a biological agent is probably the most frightening to those exposed?

Accepted Answer

Infectivity refers to the capacity of an agent to enter a susceptible host and produce infection or disease. Invasiveness is the ability of an agent to get into a susceptible host. Pathogenicity measures the proportion of infected people who develop the disease. Virulence refers to the proportion of people with clinical disease who become severely ill or die. It is assumed people could cope with illness but possible death is truly frightening for most.

Question 13

A rural public health nurse is spending time reviewing death certificates. Which of the following best explains the purpose of this activity?

Accepted Answer

Mortality data are often the only source of health-related data available for small geographic areas. Vital statistics reports such as death certificates are reviewed. Useful information also comes from administrative data such as discharge reports and billing records.

Quiz 15: Surveillance and Outbreak Investigation