WorksheetsNUR426 CH Exam 3 review (CH 3,8,9,11,12)
Total questions: 77
Worksheet time: 4hrs 59mins
John Snow, considered the founder of epidemiology, realized the source of the London’s cholera epidemic through:
A residential pattern of death
Mapping of the food supply
Interviewing the families of the sick
Performing autopsies
If a nurse takes the number of new cases of a disease or illness among the contacts of initial (primary) cases and divides it by the number of people in the population at risk, he or she is calculating the:
Prevalence
Incidence
Secondary attack rate
Attack rate
A public health official reports that the weekly influenza rate for a city in Oregon is 12.5%. This rate does not take into account smoking status, so it is a(n):
Independent rate
Mortality rate
Dependent rate
Morbidity rate
An epidemiologist uses the epidemiological triangle to explain the occurrence of disease by looking at the three main components of the model: the host, the environment, and the agent. The PHN understands that the agent could be one of many types except:
Biological and chemical
Nutritive
Physical
Ecological
The public health nursing student is studying outbreak investigations and disease trends. The student learns that the disease that has seen an increase in the last 30 years after a decline in the 1970s is:
West Nile virus
H1N1 virus
Influenza
Pertussis
A nurse is giving a lecture on communicable diseases and indicates that West Nile virus is spread by all of the following except:
Poor sanitation conditions
Insects
Poor hygiene
Tainted food
The PHN understands that chronic diseases have replaced communicable diseases as the major disease classification for:
A. Larger third world countries
B. Low-income countries
C. High-income countries
D. Smaller, more primitive countries
A PHN has a patient that has multiple medical issues that have developed over time. The nurse suspects that the issues are due to working in a chemical plant. The plant was monitored carefully, but a direct cause of his illness will be difficult to prove because:
Safety records of the plant do not pertain to the health records of the patient.
The patient has medical problems that could be caused by lifestyle decisions.
Toxic substances often have thresholds below which exposures do not present human health risks but above which can prove to have adverse and sometimes fatal consequences.
Some toxic substances are difficult to trace in medical tests.
A family does preconception testing for early identification of cerebral palsy to make childbearing decisions by using genetic markers. The PHN recognizes that this area of study is called:
The Human Genome Project
Behavioral Risk Factor Surveillance System (BRFSS)
Ecological epidemiology
Genomics
A PHN is looking into the high rate of diabetes in the community. The nurse knows that there are three categories of risk factors in the field of epidemiology to be considered in the investigation. These categories include all of the following except:
Prevalence
Behavioral
Environmental
Genetic
A nursing student learns that an outbreak investigation could be used in which of the following situations? Select all that apply.
High numbers of hip injuries at a local nursing home
Gastroenteritis illness investigations at a community daycare
Food borne illnesses resulting from salmonella at a restaurant
Employees with elevated levels of asbestosis
A community with an unexpectedly high number of infants with elevated blood lead levels
A nurse is preparing an education program on disease transmission for employees at a local day care facility. When discussing epidemiological triangle, the nurse should include which of the ff factors as agents? Select all that apply.
resource availability
ethnicity
toxins
bacteria
altered immunity
A nurse is preparing a community health program on communicable disease. When discussing mode of transmission, the nurse should include which of the ff illnesses as airborne?
cholera
malaria
influenza
salmonellosis
A nurse is planning measures to reduce the incidence of obesity. Which of the ff interventions affects the environment, according to the epidemiological triangle?
determine whether clients have a family history of obesity.
measure client's BMI
provide low-fat meal options at public schools
ask affected adults to keep diary of food intake
What was one of the first public health measures legislated by the U.S. federal government?
Funding local government provision of safe water
Using the power to impose quarantine
Requiring pasteurization of all milk
Regulating disposal of waste (garbage and feces)
In what way are antibiotics important in reducing the spread of communicable diseases?
They help keep the environment free of the infectious agent
They help the host resist the infection
The kill the entire infectious agent upon contact with it
They reduce the time during which the disease is contagious in the infected person.
Which of the following actions have had the most success in protecting the public’s health?
Creation of effective broad-spectrum antibiotics
National immunization campaigns to protect children
Growth of hospitals and medical and nursing schools in the twentieth century
Safe water and sewage systems, as well as milk pasteurization
Which of the following is the reason for mumps outbreaks among young adults?
People had stopped getting immunizations for mumps and other diseases.
The mumps vaccine is no longer effective against the agent because the virus had mutated.
The mumps vaccine does not provide lifetime immunity
Thousands of ineffective contaminated vaccine doses had unknowingly been injected.
A mother wanted her child vaccinated against measles. When she read the “benefits and risks” sheet, she changed her mind. Her child was the only one in the class who did not get immunized. What is the probable risk of her child getting measles in elementary school?
Fairly high, as there is no way to prevent being exposed to measles during childhood
Fairly low, as measles usually hits in late adolescence now
Low, as most of the child’s playmates have been immunized
Very high without the protection of immunization
A man had a viral upper respiratory tract infection and was seen by a family nurse practitioner (FNP). The FNP gave the man both verbal and written information about over-the-counter drugs to control symptoms. However, the patient insisted upon a prescription for an antibiotic. Which of the following would be the most appropriate response from the FNP?
“Antibiotics won’t be helpful in treating this infection, but they may allow bacteria that will be immune to antibiotics to develop, putting you at high risk for getting sicker.”
“I’ll write you a prescription for a special new research drug that works wonders with viral respiratory infections.” Then the FNP writes a prescription for a placebo.
“I’m the expert. I’ll decide when you need an antibiotic. And you do not need one.”
“Of course; I always try to meet the needs of my clients. Which antibiotic do you find works best for you?”
Which of the following persons would be most at risk for contracting an infectious disease?
The woman who has been taking antituberculosis medication for 3 months
The elderly woman who recently emigrated with her family from Asia
A full-time nurse at the local public health clinic
A volunteer nurse aide at the sexually transmitted disease clinic
A community/public health nurse is beginning an investigation of a communicable disease. What is the first action that the nurse will take?
Diagnose the disease, ask patients to name contacts, and then find those contacts.
Diagnose the problem, treat it, and then interview the client
Identify the disease, isolate the causative agent, and determine the method of transmission.
Use the media to share symptoms and causes and then have professionals available to answer telephone calls, being sure to obtain names of infected persons
Which of the following situations represents an accurate example of passive immunity?
The nurse who has received three doses of hepatitis B vaccine
b. The parents who took their child to a neighbor’s house to expose the child to the mumps
The adult who received three doses of live antigen polio vaccine
The newborn who had not yet received any immunizations
For the past 3 months, the nurse has been exchanging new needles for used needles at a homeless shelter frequented by drug users. How might the nurse know whether his or her time and effort were effective?
More people came each night with used needles, asking to exchange them
The local health department reported a downward trend in newly diagnosed human immunodeficiency virus (HIV) infection.
Persons who stayed at the shelter frequently expressed appreciation to the nurse.
The staff of the homeless shelter stated that they had been serving fewer clients.
Who is responsible for providing immunizations and direct care services?
The U.S. Department of Health and Human Services
The Centers for Disease Control and Prevention
The local health department
The state health department
Which of the following examples best represents effective primary prevention?
Attending a free community screening
Engaging in breast self-examination (women) or testicular self-examination (men)
Following up on any positive screening test
Immunization according to the recommended schedule
Which of the following is a major reason behind the continued increase in the incidence of tuberculosis? (Select all that apply.)
Concern over privacy means that many cases of infection are not identified.
Infectious agents are becoming drug-resistant and are not as susceptible to treatment.
Many persons are unwilling to name their contacts to public health nurses.
People are becoming very complacent about practicing good hygiene.
Infected persons are not always compliant with the long, costly treatment regimen.
Nurses working with diabetes patients know that this noncommunicable chronic disease (NCD) has which of the following characteristics? Select all that apply
It cannot be prevented by a vaccination.
It cannot be cured by a medication
It requires long-term management
It is not affected by weight.
It does not require lifestyle changes such as regular exercise
In caring for their chronic disease patients, nurses must do which of the following? Select all that apply.
Know others who have or have had the disease.
Know the pathophysiology of the disease.
Understand the disease from a public health perspective.
Help patients understand self-management techniques.
Work in a hospital setting.
Nurses working with chronic disease patients consider it important to know about the burden of disease associated with a specific disease because it does which of the following? Select all that apply.
Takes into account what impact the disease will have on the community as a whole
Provides an overview of the disease’s social and economic impact
Helps determine promotion and prevention efforts targeting most common chronic diseases
Does not impact treatment cost
Does not affect risk of injury
Nurses working with chronic disease patients assess them based on which of the following risk factors?
Nutrition
Both Nutrition, Alcohol and Tobacco use
Alcohol and tobacco use
Height
When a nurse treats a heart disease patient, he or she evaluates which of the patient’s risk factors to determine how modification might help bring about improvement?
Tobacco use
Both Tobacco use and Amount of exercise
Amount of exercise
Height
A nurse working in a hospital oncology unit notices that the number of lung cancer admissions has increased in a particular zip code. What steps should the nurse take to determine what is causing the increase? Select all that apply.
Notify the nurse manager
Call the CDC to present the findings.
Disregard admissions records for similar cases
Present the findings to the public health department for their review.
A cardiovascular nurse is treating a smoker with a high risk for cardiovascular disease. Which of the following should the nurse discuss with the patient?
A. Outline the health risks associated with smoking.
B. Share statistics about adverse health outcomes related to smoking.
C. Both A and B
D. Recommend smoking more.
A PHN concerned about the increase in NCDs in a community screens patients for which of the following?
Socioeconomic risk
Genetic predispositions
Behavioral factors
All of the above
A nurse working in a community clinic understands that morbidity and mortality related to NCD is affected by access to health care, so the nurse makes sure the patients:
A. Have access to preventive screenings
B. Ignore follow-up appointments
C. Both A and D
D. Get resources to help them manage care
Nurses working with persons at high risk for NCDs encourage their patients to prevent disease development by:
A. Incorporating healthy eating habits
B. Leading a sedentary lifestyle
C. Getting regular preventive screenings
D. Both A and C
To educate their patients about the risks of developing NCDs, nurses might share which of the following facts?
A. The five leading causes of death in the United States are NCDs .
B. Risk for NCD is not affected by individual behaviors, the environment, and socioeconomic factors
C. Prevention occurs across the continuum starting with primary prevention during the perinatal period through tertiary prevention measures such as CDSM programs.
D. Both A and C
When screening a patient for NCD risk, a nurse reviews the social determinants of health, including which of the following?
The social gradient
Early life
Work life
All of the above
When a nurse at a community clinic is checking a patient for the effects of psychoactive substances, he or she looks for which of the following signs?
A. Altered mood
B. Both A and C
C. Level of consciousness
D. None of the above
A student nurse studying substance use learns that in addition to stimulants, inhalants, depressants, and cannabis, psychoactive substances include which of the following? Select all that apply.
Dissociative anesthetics
CAMs
Hallucinogens
Non-narcotics
A public health nurse (PHN) researching risk factors for mortality found that and are among the top ten.
Alcohol and tobacco
Inhalants and stimulants
Cannabis and caffeine
None of the above
To find out how much alcohol a patient uses, a nurse asks about which of the following?
Quantity of alcohol consumed
Frequency of alcoholic beverage consumption
Duration of use
All of the above
A nurse whose teenage patient is showing signs of alcohol abuse reviews which of the following first to help the patient?
Universal level of prevention
Selective level of prevention
Indicated level of prevention
None of the above
A nurse studying substance use disorders learns that alcohol is a causal factor in ____ types of diseases and injuries.
60
80
20
10
Nurses at a local trauma center were involved in evaluating their hospital’s screening program for alcohol substance abuse. Which of the following steps were part of their plan?
Review files on patients admitted with a possible alcohol-related injury.
Evaluate the current screening system in use on their unit.
Review current screening techniques used in other hospitals.
All of the above
Nurses in a student health clinic used a program called Brief Alcohol Screening and Intervention for College Students (BASICS) to help students make better alcohol use decisions. The BASICS program consists of:
A. Two one-hour interviews
B. Both A and C
C. A feedback profile
D. An alcohol breathalyzer test
When a community health nurse explains the consequences of tobacco use to a patient who smokes, the nurse mentions which of the following adverse health consequences experienced by tobacco users?
Damage to the oral cavity and teeth
Chronic obstructive pulmonary disorders
Cancer
All of the above
A nurse working on a maternity unit became concerned when one of the pregnant patients admitted to smoking. Which of the following adverse effects might eventually affect her unborn child? Select all the apply.
A. Low birth weight
Increased risk for Sudden Infant Death Syndrome (SIDS)
Stunted growth
Lower rates of asthma
A nurse treating a new patient learns that he was a smoker. Which of the following questions will help determine if he still smokes and how much he smokes? Select all that apply.
Do you now use tobacco?
Have you ever used tobacco?
Are you interested in quitting tobacco use?
Do you smoke?
A nurse researching illicit drug use for a new job at a community clinic learns that the number one illicit drug in the United States as of 2010 is:
Cocaine
Hallucinogens
Marijuana
Inhalants
A 20-year-old man brought to the emergency room with hallucinations appeared euphoric, tremulous, and anorexic and had dilated pupils. The nurse who examined him found that the culprit was use.
Methamphetamine
Cocaine
Alcohol
None of the above
A nurse suspects one of the emergency room patients is an illicit drug user. Which screening methods should the nurse use to verify this conclusion?
A clinician’s guide
B. Both A and C
C. National Institute on Drug Abuse (NIDA) ASSIST tool
D. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
A PHN preparing a report on substance abuse would find that which of the following are true?
A. Substance use, especially use of tobacco and alcohol, is a serious public health issue, and policy initiatives exist at the global, national, state, and local levels aimed at reducing the harm associated with at-risk substance use
B. Both A and C
C. The cultural context for substance use has shifted overtime, but stigma continues to be a barrier for entrance into treatment for the person with at-risk use or a substance use disorder
D. At-risk substance use does not affect the overall health of the individual, the family, or the community.
A team of nurses for a medical surgical unit have been assigned to develop a Screening and Brief Intervention (SBI) alcohol program for their department. Which of the following steps should they take? Select all that apply.
Review current alcohol SBI recommendations from the Joint Commission on Accreditation.
Develop a plan to train health-personnel on the use of the alcohol SBI.
Device a new plan tailored to all patients in the unit.
Choose not to prepare an evaluation plan.
During a class lecture, a nursing student learned that which of the following are considered psychoactive substances? Select all that apply.
Depressants
Stimulants
NSAIDs
Antidepressants
A PHN follows which of these guiding principles on harm reduction when helping patients who are substance users?
Clients are responsive to culturally competent, non-judgmental services delivered in a manner that demonstrates respect for individual dignity, personal strength, and self determination
Service providers are responsible to the wider community for delivering interventions which attempt to reduce the economic, social, and physical consequences of drug- and alcohol-related harm and harms associated with other behaviors or practices that put individuals at risk
Because those engaged in unsafe health practices are often difficult to reach through traditional service venues, the service continuum must seek creative opportunities and develop new strategies to engage, motivate, and intervene with potential clients.
All of the above
. To help smoking patients improve their health, a nurse uses which of the following smoking cessation strategies? Select all that apply.
Advise all tobacco users to quit.
Assist tobacco users with a quit plan.
Ask them why they are relying on the tobacco product they use.
None of the above
A nurse working in the emergency department is treating a substance use disorder patient with accelerated heart rate and blood pressure. The nurse determines that which of the following substances is the culprit?
Stimulants
Narcotics
Depressants
Hallucinogens
A community health nurse is developing an education program on substance use disorders for a group of adolescents. Which of the following information should the nurse include when discussing nicotine and smoking?
Smoking is the 5th most preventable cause of death in the US
Nicotine is a CNS depressant
Withdrawal effects from smoking are minimal
Tolerance to nicotine can develop quickly
A nurse is educating new staff in the emergency department about the types of injuries and illness they might be treating. The nurse mentions that which population is at greatest risk for unintentional injuries?
Women under the age of 45
Women over the age of 45
Men under the age of 45
Men over the age of 45
. A nurse has volunteered with an organization treating women who were the victims of rape as a weapon of war in the Congo. This violence is considered:
Community violence
Collective violence
Stranger violence
Interpersonal violence
A nurse is reviewing car accident data to see how a city’s statistics compare with state and national data. Which of the following would provide the most comprehensive database of information?
National Violent Death Reporting System
Vital Statistics
Department of Motor Vehicles
Department of Transportation
A nurse has seen an increase in infant injuries during motor vehicle accidents due to poor car seat installation. The nurse wants to consider upstream policies at the population level to address this issue but doesn’t have the time to take on the project. How should the nurse proceed?
Reconsider the project at a different time when the workload at his or her primary job lightens.
. Delegate some of the project tasks to an unlicensed assistive personnel (UAP).
Quit the job to dedicate all of his or her time to the project.
Consider a collaborative relationship with the public health department and fire and police departments.
A nurse is providing fire prevention education to families in the community. Which of the following groups in the United States is not at a higher risk for suffering burns from a fire at home?
Men
Women
Children
Older adults
. A nurse is teaching water safety at the local community pool and mentions that which of the following is the most significant risk factor for drowning?
Gender
Income
Education
Age
A nurse is performing a home visit for a young mother that lives in the projects in Brooklyn, New York. There is a young child who is three years old living in the apartment as well. The nurse notices that the window guards on the bedroom window are hanging off the building. How does the nurse proceed?
Encourage the woman to call the landlord after the nurse leaves.
Call Child Protective Services to report an unsafe living situation.
Call the landlord directly to ensure the timely repair of the window guards and encourage the woman to keep the windows closed in the meantime.
Call the city to report a bad landlord.
A nurse is working at a high school when a young woman comes down to the nursing office concerned about her boyfriend whom she states is making suicidal comments. How does the nurse proceed?
Counsel the young woman about relationship issues.
Call the young woman’s parents about her concerns
Inform the school psychologist immediately and notify the boyfriend’s parents.
Call the young man down to the nurse’s office for a mental health evaluation.
A nurse is working at a suicide prevention hotline and is training new staff members. He or she informs the new nurses that the most important questions to ask callers include:
Whether they have a means or a plan to commit suicide, including whether they have access to a weapon, such as a gun
If they have been diagnosed with a mental illness
If they suffer from addiction
None of the above
A group of nurses is looking to design a home visitation program for parents who are at high risk for child maltreatment. What factors should the nurses focus on?
Parenting skills and access to educational support
Promoting family relationships and increasing child monitoring
Increasing access to nutrition and wellness programs
Assisting with parental education and financial assistance programs as needed
A nurse is caring for a young woman in a same sex relationship. The woman frequently presents to the ER with vague injuries and the nurse is beginning to suspect that the woman is being physically abused by her partner. How should the nurse proceed?
Inform the physician.
Give her a pamphlet about escaping domestic violence.
Notify the police
Refer her to a social worker and engage her in discussion about creating a safety plan.
A young woman presents to a community clinic. She states that she is having severe anxiety and insomnia after suffering an acquaintance rape at school last year. She is unable to go back to college and her grades are suffering as a result. What does the nurse suspect that this young woman is suffering from?
Post-traumatic stress disorder
Generalized anxiety disorder
Major depression
Personality Disorder
A nurse is performing a community assessment of an inner city neighborhood. The nurse is looking for physical risk factors in the community to determine if they might be contributing to the high level of violence and drug abuse in the neighborhood. Which of the following factors should be evaluated?
Youth activity
Dwelling types
Physical layout of the community
All of the above
A nurse is reviewing the safety procedures and protections in place at the community center where he or she works. Which of the following should he or she be most concerned about?
Presence of two regular doors next to the revolving door in the front of the center
Brightly lit exit signs
Absence of decorations on the walls
None of the above
A nurse is looking to implement new preventative measures to address the rate of drowning in young children in the community. All of the following policies are examples of primary prevention, except:
Swimming instruction for every child
Mandatory installation of locked child-safety fences around all community and private pools
Community-wide CPR instruction
Mandatory use of life jackets for all children on boats
A nurse is teaching a class about emergency preparedness and violence. Which of the following factors is associated with an increased risk of being the victim of violence or intentional harm? Select all that apply.
Age between 15 and 44
Poor mental health
Substance abuse
Male gender
Low socioeconomic status
A nurse is working with parents and community members to develop a chemical and medication safety class in their community. Techniques that they should discuss include which of the following? Select all that apply
Proper labeling of all household chemicals and medications
Keeping household chemicals outside
Storing all cleaning materials and medications out of the reach of children
Encouraging disposal of medications into the toilet
Informing parents not to share any medications with anyone whom the medication is not prescribed
