Question 1

During a screening, a test with a high specificity and low sensitivity is utilized.Which of the following issues could arise by using this test?

Accepted Answer

Misinterpretation caused by screening instruments is of great ethical concern.A difficult ethical issue in screening is determining whether the benefits received by those who receive correct results are worth the problems experienced by those who receive incorrect results.In this case, the high specificity of the test would result in low false-positive rates and would correctly identify nondiseased individuals.However, the low sensitivity would result in a high false-negative rate and therefore would miss a large number of people who are actually positive, resulting in ethical issues.

Question 2

A nurse is creating a hypertension screening program.Which of the following methods would be the best way to design a successful program?

Accepted Answer

Partnerships are essential to developing health programs and screening programs.The primary rule is to never assume that what is appropriate and effective for one community will be appropriate and effective for another community.A community assessment conducted as a partnership with key stakeholders provides information about the high-risk population, available health care resources, and the high-risk population's health needs.By conducting the assessment, the nurse can identify the necessary community resources and mobilize them to achieve maximal benefits and positive outcomes.

Question 3

Which of the following is a disadvantage of screening?

Accepted Answer

The primary disadvantages of screening stem largely from uncertainties in scientific evidence, which sets normal testing ranges and therefore, also ranges of error for screening tests.When effectiveness depends on the screening program's ability to distinguish those who probably have the disease from those who do not, any margin of error can result in serious consequences.Some individuals who do not have the condition will be referred for further tests and some who do have the disease will not get needed referrals.Those incorrectly referred (false positive) suffer needless anxiety and unnecessary medical interventions, some of which can be harmful, while awaiting more definitive diagnosis (e.g., high levels of prostate-specific antigen [PSA]).False-positive osteoporosis screens can lead to unnecessary bone building medication treatment that may have adverse effects.Tests with high sensitivity and high specificity are desirable tests and would not represent a disadvantage-these types of tests are highly accurate.Autonomy is not an issue since patients consent to screening-they may decline or not participate, if they wish.There is not evidence to support a perspective that most care recipients have a negative view of screening.Any care recipient who is so disposed is free to decline recommendations for screening.

Question 4

A nurse is using a sweat test to screen people for cystic fibrosis.Which of the following results demonstrates poor sensitivity?

Accepted Answer

Sensitivity refers to the proportion of people with a condition who correctly test positive when screened.A test with poor sensitivity will miss individuals with the condition, and there will be a large number of false-negative results; individuals actually have the condition but were told they were disease free.Thus when 6 out of every 10 sweat tests performed are negative but the six individuals actually have cystic fibrosis, it is an example of poor sensitivity.

Question 5

The proportion of people with a condition who correctly test positive when screened is known as

Accepted Answer

Sensitivity refers to the proportion of people with a condition who correctly test positive when screened.

Question 6

The nurse is examining the ability of a phenylketonuria (PKU) screening test to distinguish correctly between newborns who have and who do not have the disease.Which of the following measures of accuracy of the instrument is being evaluated?

Accepted Answer

Validity is defined as a test's ability to distinguish correctly between diseased and nondiseased individuals.

Question 7

Which of the following is an example of a screenable population for hypertension?

Accepted Answer

The objective of identifying a screenable population is to identify a high-risk group that, when tested, will yield a significant number of diseased individuals.The main criterion used to define an appropriate population is the definitive presence of risk factors related to the disorder.Most high-level business executives are middle-aged men with stressful jobs, placing them at high risk for heart disease.Thus, this would be the best example of a screenable population for hypertension.

Question 8

Which type of cases tends to be expressed in terms of incidence?

Accepted Answer

Key factors in assessing the need for screening criteria are quantifying measures of disease frequency.Two measures most used in epidemiology are incidence and prevalence.Incidence indicates the rate of a new population problem and estimates the risk of an individual developing a disease or condition during a specific period or over a lifetime.Prevalence is the proportion of a given population with the disease or condition at any one point in time.It provides the best estimate of whether a person is likely to become ill during a specific period of time.In short, incidence is new cases, and prevalence is all cases within a set period of time.Usually chronic conditions are measured by their prevalence (generally existing), whereas acute conditions are assessed by their incidence (rate of new occurrences).Whether the disease affects children and whether full recovery is expected are not relevant considerations to the concept of incidence.

Question 9

Which of the following analyses is used to determine the optimal use of resources to reach a predetermined constant end-point or the desired health outcome?

Accepted Answer

An analysis that determines the optimal use of resources to reach a predetermined, constant end-point or the desired health outcome is known as cost-effectiveness analysis.

Question 10

A nurse is planning to offer a depression screening at a local community center.Which of the following should be considered prior to implementation of the program?

Accepted Answer

Constraints affecting the operation of a screening program include financial concerns, political issues, cultural constraints, follow-up and referral services, and accessible treatment facilities.An efficient referral system should link the follow-up resources to the screening program, providing continuity of care.A method must be devised to encourage the participant to take positive action on the referral.Depression screening for adults is a covered preventive service for adults.

Question 11

Researchers are studying a particular disease which occurs among Americans at a rate of 36 per 100 annually.What type of rate is this statement describing?

Accepted Answer

Incidence rate is the rate of a new population problem and estimates the risk of an individual developing the specific disease or condition during a specific period or over a lifetime.Prevalence is the proportion of a given population with the disease or condition at any one point in time.Usually acute conditions are assessed by their incidence (rate of occurrence), whereas chronic conditions are measured by their prevalence (generally existing).

Question 12

A nurse determined the interobserver reliability of a blood pressure reading.Which of the following describes the method that was used by the nurse?

Accepted Answer

Reliability is an assessment of the reproducibility of the test's results when different individuals with the same level of skill perform the test during different periods and under different conditions.If the same result emerges when two individuals perform the test, interobserver reliability is shown.Therefore, a care recipient with a blood pressure reading of 124/82 two days in a row by two different nurses is an example of interobserver reliability.

Question 13

Which represents a disadvantage of screening?

Accepted Answer

Group screening and multiple test screening are advantages of screening programs.A disadvantage of screening occurs when the test is unable to distinguish those who probably have the disease from those who do not.Tests with low sensitivity produce a large number of false-negative tests and leave those screened with a false sense of a healthful state, resulting in them losing the opportunity to receive early treatments that could prevent irreversible damage.

Question 14

A nurse is examining the incidence, prevalence, and mortality rates of colon cancer in the community.Which of the following measures of life is being investigated?

Accepted Answer

Measures of quantity of life affected by a disease are more readily attainable than quality of life measures.Quantity of life can be measured by using incidence and prevalence rates as well as disease-specific mortality rates.

Question 15

An occupational health nurse is planning a cholesterol screening with the employees at the factory.Which of the following would be an advantage of conducting this screening?

Accepted Answer

Screenings create an opportunity for providing health education to a group of individuals who may not otherwise receive it.This allows the nurse to take advantage of a teachable moment with the employees in the factory.

Question 16

A nurse is educating a group of community members about how hypertension screening is effective in reducing the rate of cardiovascular disease, thus reducing the expenses that are spent on management of this disease.Which of the following ratios is being described?

Accepted Answer

Cost-benefit ratio analysis allows the comparison of various outcomes in monetary terms.The cost of the screening versus the cost of chronic care management is considered.

Question 17

A nurse is implementing a test that screens for hypercholesterolemia.Which of the following parameters should this test have?

Accepted Answer

The goal of a screening program, identifying an individual as high risk or not, depends on the numerical value of the screening instrument.When the parameter for this distinction is not clear, a cutoff point is set.Above this point, the person is considered disease positive; below this point, the individual is considered disease negative.Thus, if the disease were potentially life-threatening or if a disease is relatively benign in terms of stigmatization, anxiety, and problems with treatment, the lower cutoff would be preferred.High cholesterol, if left untreated, could contribute to life-threatening cardiac disease.Additionally, it is benign in terms of stigmatization.Therefore, a lower cutoff point should be set.

Question 18

The Denver Developmental Screening Test (DDST) has been said to have excellent test specificity.What does this statement mean?

Accepted Answer

Specificity measures a test's ability to recognize negative reactions or nondiseased individuals.A test with excellent specificity will rarely be positive if the disease is not present.

Question 19

A nurse is assessing a low-income population in a community.Which of the following would be most appropriate for this population?

Accepted Answer

According to a 2010 Gallup poll, "Low-income Americans are more likely than their high-income counterparts to say they have been diagnosed with each of the chronic conditions.The differences are largest for depression, high blood pressure, and diabetes.The high level of obesity among low-income Americans is likely a contributing factor in these differences."

Question 20

Which is an example of asymptomatic pathogenesis?

Accepted Answer

The primary objective of screening is the detection of a disease in its early stages, to treat it and deter its progression.The screening process is based on the principle that disease is preceded by a period of asymptomatic pathogenesis when risk factors predisposing a person to the pathological condition are building momentum toward manifestation of the disease.Therefore, someone with an elevated PSA without any symptoms is an example of asymptomatic pathogenesis.The other three examples demonstrate manifestation of disease (headaches, blood in stool, and tiredness).

Quiz 9: Screening