Font size
WorksheetsEpidemiology and Environment
Total questions: 140
Worksheet time: 1hrs 10mins
Which term describes the study of occurrence and distribution of health-related states in populations?
Incidence in defined time frames
Epidemiology of health states
Prevalence at a single point
Sensitivity for true positives
What does incidence measure in epidemiology?
Ability to detect true negatives
Ability to detect true positives
New cases in a specific period
All existing cases at one time
Prevalence is best defined as which of the following?
New cases within a month
All existing cases at a point
Rate of false positive tests
Progression without intervention
Sensitivity refers to a test’s ability to detect which outcome?
New cases emerging
Existing cases counted
True positives correctly
True negatives accurately
Specificity primarily measures a test’s capacity to do what?
Describe distribution
Track new cases
Capture true positives
Identify true negatives
Which set correctly lists the components of the Epidemiologic Triangle?
Agent, policy, behavior
Host, vector, policy
Vector, agent, reservoir
Agent, host, environment
The Natural History of Disease describes which process?
Surveillance after intervention
Progression without intervention
Investigation of outbreaks
Policy development stages
Surveillance in public health primarily involves which activity?
Modeling pathogen spread
Developing new policies
Systematically monitoring
Treating individual cases
Which sequence groups core public health processes named in the guide?
Detection, isolation, vaccination, cure
Surveillance, investigation, evaluation, policy
Treatment, prevention, therapy, recovery
Observation, experiment, theory, proof
A test with high sensitivity but low specificity will most likely produce what pattern?
Few true positives detected
Many false negatives overall
Balanced errors across groups
Many false positives reported
If an intervention is introduced early, which aspect of the Natural History of Disease is directly altered?
Triangle component list
Uninterrupted progression
Incidence within the period
Surveillance terminology
Which statement best defines epidemiology in public health?
Study of hospital management practices
Study of occurrence and distribution of health states
Study of individual patient counseling techniques
Study of laboratory methods for disease cultures
Surveillance in epidemiology primarily involves which ongoing activity?
Annual vaccination scheduling for schools
Collection and interpretation of population data
One-time community health survey
Randomized clinical trial enrollment
Which agency conducts national health surveillance for the United States?
WHO
NIH
FDA
CDC
Endemic level of disease refers to which pattern?
Baseline expected presence in a population
Spread across multiple countries widely
Localized outbreak traced to one source
Sudden surge above expected levels
Which description matches a pandemic?
Epidemic that has spread to a larger scale
Single-source outbreak in a single facility
Baseline expected presence within one community
Presence of disease above the expected level regionally
Investigation in epidemiology is best described as what process after surveillance detects a disease?
Ad hoc media communication planning
Routine annual clinic quality auditing
Systematic inquiry to trace infections to source
Immediate mass vaccination without evidence
Analytic studies typically require which key element to draw valid inferences?
Convenience sampling only
A valid comparison group
Non-systematic observations
Single-case narrative reports
Evaluation in epidemiology focuses on which primary question?
How to expand laboratory testing capacity
How to identify initial cases quickly
How to determine effectiveness of an intervention
How to estimate baseline endemic prevalence
A city reports influenza cases persist at the usual winter level without spikes. Which level of disease is most accurate?
Sporadic cases without pattern
Epidemic exceeding expected levels
Pandemic level across continents
Endemic baseline presence
Which component is NOT part of the epidemiologic triangle?
Agent
Host
Environment
Intervention
The epidemiologic triangle displays relationships among which three elements?
Population, sample, variable
Agent, host, environment
Cause, effect, treatment
Exposure, immunity, recovery
Natural history of disease describes what scenario?
Progression without intervention
Course after immediate treatment
Spread limited by vaccination
Trajectory under strict quarantine
Which is an observational study type?
Laboratory experiment
Randomized controlled trial
Quasi-experimental design
Cohort study
Which best distinguishes case-control from cohort studies?
Start with outcomes then exposures
Begin with exposures then outcomes
Measure only cross-sectional prevalence
Randomize participants into groups
Incidence counts which events?
Total cases at one time
Deaths from all causes
Negative test results
New cases in a time period
When calculating incidence, who belongs in the denominator?
Only those at risk for disease
Only existing cases at baseline
Only laboratory-confirmed positives
Entire population regardless risk
Prevalence is defined as:
New cases over time
All existing and new cases
Deaths from specific causes
True negatives in screening
Crude mortality rate uses which denominator?
Hospitalized patients only
Population at risk only
Total population overall
Only diseased individuals
Cause-specific mortality rate measures:
Deaths from a specific cause
All deaths in one year
New cases per month
Prevalent cases today
Sensitivity refers to a test’s ability to detect:
True positive results
False negative outcomes
False positive outcomes
True negative results
Specificity refers to a test’s ability to detect:
True positive results
True negative results
False negative outcomes
False positive outcomes
In screening, a high negative predictive value most strongly suggests:
Disease absent when test negative
Prevalence increases after testing
Disease present when test positive
Test detects all false negatives
Which statement about fetal fibronectin (fFN) is accurate?
Antibody neutralizing infections
Enzyme accelerating cervical dilation
Protein binding fetal sac to uterus
Hormone regulating maternal blood
Which statement best defines a disaster in emergency preparedness?
Localized incident with no societal impact
Planned drill enhancing healthcare readiness
Routine event improving public safety systems
Hazardous event disrupting community function
What is triage in the context of emergencies?
Selecting only patients with minor injuries
Assigning care by arrival order at the scene
Prioritizing care based on severity and survivability
Providing equal care to all injured persons
Which phase focuses on actions taken before a disaster to lessen its impact?
Prevention/Mitigation phase activities
Response phase operations on scene
Recovery phase long-term rebuilding
Preparedness phase staff orientation
Which phase centers on planning, training, and supplies ready for emergencies?
Response phase urgent interventions
Preparedness phase tasks and drills
Mitigation phase hazard elimination
Recovery phase infrastructure repair
What is the main focus of the response phase?
Education campaigns for hazard awareness
Immediate actions to protect life and property
Long-term services to restore stability
Policy analysis to reduce future risk
Which phase emphasizes restoring systems and community function after an event?
Mitigation phase risk mapping projects
Preparedness phase resource staging
Recovery phase reconstruction efforts
Response phase field triage steps
Which triage system is primarily designed for adult mass-casualty victims?
ABCDE hospital assessment framework
START triage rapid adult algorithm
JumpSTART pediatric-focused protocol
SALT method community shelter model
Which triage approach adapts START specifically for children?
JumpSTART pediatric triage criteria
SALT scene global gathering process
START adult respiratory status checks
Manchester five-category color scheme
Which method groups and prioritizes patients using global sorting and life-saving interventions?
SALT triage method structure
START breathing-first sequence
JumpSTART child pulse guideline
ECPR hospital rescue protocol
Which nursing role is most directly tied to preventing disease spread during disasters?
Recovery support case management
Infection control practices and precautions
First aid bandaging and splinting
Assessment initial scene survey
Which set lists standard nursing roles in emergency preparedness?
Accounting, Inventory Audits, Recruitment, Legal Counsel, Catering
Public Relations, Media Interviews, Fundraising, Scheduling, Marketing
Documentation, Billing, Triage Tags, Dietary Services, Transportation
Assessment, Communication, Infection Control, First Aid, Recovery Support
Which statement best defines a disaster in a community context?
Any hazardous event disrupting community functions
A routine event with minor inconvenience
A seasonal weather change without damage
A local incident affecting only one household
Which consequence commonly results from disasters?
Improved public health outcomes
Expansion of recreational services
Increase in available resources
Threats to people’s health and safety
Which example describes a human-made disaster?
Earthquake along a fault line
Bioterrorism using a communicable agent
Wildfire from lightning strike
Monsoon causing regional flooding
Which action is required when a communicable biological agent causes an incident such as smallpox?
Open public gatherings immediately
Prioritize rapid construction projects
Initiate quarantine and isolation measures
Suspend all emergency communications
A comprehensive community disaster plan must include which group as vulnerable?
Tourists with short-term visas
Residents with chronic diseases or disabilities
Middle-aged athletic adults
Pet owners with adequate supplies
Which population is often at higher risk due to language barriers during emergencies?
People working as professional interpreters
People who speak the dominant regional language
People who do not speak the dominant regional language
People enrolled in advanced translation courses
Which phase focuses on assessing threats to prevent or lessen disaster impacts?
Recovery rebuilding and long-term support
Preparedness training and planning
Response coordination and relief actions
Prevention or mitigation of risks
Which activity belongs to disaster preparedness rather than mitigation?
Repairing identified structural vulnerabilities
Reinforcing levees and flood barriers
Removing hazards from public spaces
Developing family disaster plans
Which set of actions demonstrates effective preparedness at the household level?
Reducing communication channels to a single point
Delaying evacuation route identification indefinitely
Stockpiling food, water, medication, and first-aid supplies
Scheduling festivals and community parades
Which action typically initiates disaster response when a state lacks adequate resources?
Request aid from federal government
Activate the local shelter network
Refer victims to mental health services
Open recovery assistance centers
During disaster response, which key activity focuses on identifying outbreaks or bioterrorism?
Activating the disaster plan
Providing triage and ongoing care
Establishing disease surveillance
Evaluating public health needs
In disaster triage, what principle guides decisions to use resources efficiently for many people?
A precautionary approach
A humanitarian approach
A utilitarian approach
An individualized approach
Which triage system is specifically designed for pediatric patients?
JumpSTART triage
START triage
Rapid SORT triage
SALT algorithm
Practice scenario: A patient walks to you seeking help. They have a large head laceration, possible arm fracture, shortness of breath, and pallor. Using START, what is your next step?
Treat the laceration and splint their arm
Ask them to move to walking wounded area
Call a team member to ask for help
Complete START assessment and tag accordingly
Practice scenario: After moving ambulatory patients, you assess the first remaining patient. Respirations are 25 per minute, capillary refill exceeds 2 seconds, faint radial pulse, and only the right foot wiggles. Which tag should you assign?
Green tag for minor
Yellow tag for delayed
Black tag for expectant
Red tag for immediate
Which sequence best matches the SALT mass casualty steps?
Sort, Assess, Lifesaving, Treatment/Transport
Survey, Aid, Lift, Transport
Screen, Allocate, Limit, Transfer
Search, Act, Link, Triage
Disaster recovery begins at which point in an incident?
When triage is complete
When the threat no longer exists
When shelters are opened
When federal aid is approved
Which activity is part of disaster recovery rather than response?
Activating the disaster plan
Providing ongoing victim triage
Establishing disease surveillance
Resuming previous activities
Which core competency in disaster nursing focuses on coordinating roles and resources during emergencies?
Safety and security
Preparation and planning
Incident Management Systems
Communication
Which competency best describes maintaining a personal and professional preparedness plan and participating in drills?
Demonstrates crisis communication during emergency events
Maintains preparedness plan and participates in drills
Executes disaster plan including chain of command
Uses infection control practices and PPE
During an emergency, which action reflects basic crisis communication skills by a nurse?
Deliver clear, coordinated messages to stakeholders
Perform triage and first aid as needed
Document PPE use in patient records
Activate federal resource request channels
Which competency involves implementing the specific disaster plan, including the chain of command at a school or workplace?
Assists patients to resume functioning after event
Practices within disaster laws and procedures
Executes disaster plan including chain of command
Maintains ongoing assessment as event evolves
What is the primary role of the federal government (FEMA) during disasters?
Provide routine local public health services
Manage all disasters regardless of severity
Step in when local and state resources are exceeded
Coordinate only private-sector volunteers
Which statement best captures the National Preparedness Goal initiative?
Fund only state-level emergency operations centers
Limit disaster response to nonprofit organizations
Train nurses exclusively in infection control practices
Ensure the whole community is prepared for all disasters
What is a core focus of nongovernmental organizations (NGOs) in disaster response?
Include nonprofit and volunteer groups providing necessities
Conduct mandatory drills for all hospitals
Control chain of command at workplaces
Lead federal policy development and legislation
Which competency emphasizes helping the patient, family, or community resume or maintain functioning during and after the event?
Practices within disaster laws and procedures
Maintains ongoing assessment of assigned patients
Implements basic first aid as needed
Assists functioning during and after the event
In START triage, what tag is assigned first if a client can walk?
Red, immediate tag
Green, minor tag
Yellow, delayed tag
Black, expectant tag
In START triage, after opening the airway, the client breathes spontaneously. What tag is given?
Immediate red tag
Delayed yellow tag
Expectant black tag
Minor green tag
In START triage, which finding leads directly to an immediate red tag when assessing respiratory rate?
Rate over 30 breaths
Rate under 30 breaths
Irregular but under 30
Breath sounds diminished
During START triage, what outcome triggers a red tag when checking perfusion?
Absent radial pulse
Both pulse absent and refill slow
Present pulse with refill under 2 seconds
Capillary refill over 2 seconds
In START triage, what tag is given if the client follows commands after perfusion and breathing are adequate?
Expectant black tag
Delayed yellow tag
Immediate red tag
Minor green tag
In JumpSTART, after positioning the airway, the child remains apneic. What is the next step?
Give five rescue breaths
Tag as immediate red
Check pulse for palpation
Assign a black expectant tag
In JumpSTART, after five rescue breaths the child breathes spontaneously. Which tag applies?
Delayed yellow tag
Expectant black tag
Immediate red tag
Minor green tag
In JumpSTART, which respiratory rates result in an immediate red tag?
Less than 15 or greater than 45
Exactly 30 or exactly 45
Between 15 and 45
Between 15 and 30
In JumpSTART, a palpable pulse is absent. What tag should be assigned?
Expectant black tag
Delayed yellow tag
Immediate red tag
Minor green tag
In JumpSTART neurological assessment, which response earns a delayed yellow tag?
Alert and responds appropriately
Only responds to pain stimuli
Unresponsive to painful stimuli
Inappropriate response to pain
In SALT Mass Casualty Steps, which group is assessed first during global sorting?
Those calling for help
Purposeful movement group
Walking wounded group
Still with obvious life threat
Which lifesaving intervention is listed in SALT steps before transport?
Provide detailed diagnostics
Apply full immobilization
Administer IV fluids
Control major hemorrhage
In the SALT triage algorithm, if breathing is absent, what tag is assigned?
Delayed yellow tag
Minor green tag
Immediate red tag
Expectant black tag
In SALT algorithm box 2, which combined criteria must be met to proceed to minor injury determination?
Purposeful movement, strong pulse, minimal distress
Obeys commands, normal vitals, minor bleeding only
Has pulse, any movement, respiratory rate normal, pain controlled
Obeys commands, purposeful movement, peripheral pulse, no distress, hemorrhage controlled
In SALT algorithm, if injuries are minor only, which tag is assigned?
Yellow delayed tag
Green minor tag
Red immediate tag
Black expectant tag
In SALT algorithm Box 3b, failure to survive with current resources leads to which tag?
Minor green tag
Expectant black tag
Immediate red tag
Delayed yellow tag
When deciding Evacuate vs. Shelter-in-Place vs. Lockdown, what action follows if the building is safe but danger is outside?
Assemble outside
Initiate lockdown
Evacuate grounds
Shelter in place
In a modified lockdown, which actions are required?
Lock exterior doors, lock and cover windows
Shelter in interior rooms until cleared
Evacuate to exterior assembly points
Leave doors open for responders
If the building is not safe and grounds are safe, what is the next step?
Initiate full lockdown
Return to shelter in place
Assemble outside safely
Remain inside classrooms
Which statement best defines a disaster in a community context?
A temporary inconvenience with no health risk
A planned emergency drill for residents
A hazardous event disrupting community function
A routine event with minimal disruption
Which phase focuses on stopping hazards from occurring or reducing their impact?
Recovery services and rebuilding
Prevention and mitigation efforts
Response actions and triage
Preparedness activities and drills
Which triage description aligns with prioritizing care by severity and survivability?
Grouping by age and occupation
Sorting by arrival time order
Prioritizing by severity and survivability
Assigning by geographic residence
Which example fits a human-made disaster category?
Seasonal flooding in lowlands
Earthquake along a fault line
Bioterrorism using a pathogen
Hurricane making landfall
A communicable biological agent like smallpox is used. Which immediate public health action is most appropriate?
Quarantine and isolation measures
Relocate only elected officials
Open public celebrations citywide
Discontinue all medical services
Which preparedness activity strengthens readiness before an incident occurs?
Deploying search and rescue teams
Conducting post-event counseling
Performing regular emergency drills
Repairing identified vulnerabilities
Which action is part of preparedness rather than response or recovery?
Providing antidotes during exposure
Developing a communication chain
Clearing debris after the event
Issuing damage claims assessments
Which action occurs during the immediate disaster response phase when local resources are insufficient?
Rebuild damaged critical structures
Begin long-term mental health therapy
Pause all triage activities briefly
Request aid from federal government
Which is a key activity in disaster response for health teams?
Scheduling community festivals
Activating the disaster plan
Drafting new building codes
Negotiating insurance settlements
During mass casualty triage, what ethical approach guides decisions to use resources efficiently?
Utilitarian approach
Deontological approach
Care ethics framework
Virtue ethics model
Which methods are commonly used to conduct disaster triage?
CPR and AED
MRI and ultrasound
ABCDE and SBAR
START and JumpSTART
In the START system, what is the best next step when a patient walks to you with obvious injuries and is talking?
Send to area for walking wounded
Call a team member to request help
Treat laceration and splint immediately
Complete the START assessment and tag
Using START, a patient has respirations at 25 per minute, capillary refill over 2 seconds, a faint pulse, and limited movement in one foot. Which tag should be assigned?
Green (minor care)
Yellow (delayed care)
Red (immediate care)
Black (expectant care)
Which pediatric-focused triage system adapts START for children?
SALT
METHANE
SMART
JumpSTART
Which acronym outlines the mass casualty steps that include sorting and lifesaving interventions?
SOAP
SALT
RACE
DRSABCD
When does disaster recovery begin for a community?
When the threat no longer exists
When first sirens are heard
When triage starts on scene
When media coverage decreases
Which activity is part of disaster recovery efforts by health services?
Evacuating unaffected neighborhoods
Halting ongoing clinical assessments
Initiating bioterror surveillance protocols
Referring victims to mental health services
Which domain is included among core competencies for disaster nursing?
High-frequency stock trading
Luxury resource allocation
Advanced genome editing
Incident Management Systems
Which competency aligns with Domain 4 for nurses in disasters?
Use basic infection control and PPE
Design municipal evacuation routes
Lead international treaty negotiations
Publish annual economic forecasts
Which statement best describes agency participation at the onset of most disasters?
Private sector acts without coordination
International NGOs manage early operations
Federal agencies lead immediate response
Local organizations need established plans
When local and state resources are exceeded, which entity steps in to coordinate support?
County school boards
FEMA at the federal level
Private hospital networks
International Red Cross
Which initiative clarifies expectations for public and private sectors in health security?
Emergency Response Mandate
Community Resilience Compact
Global Shelter Initiative
National Health Security Strategy
Which service is commonly provided by nongovernmental organizations during disasters?
Tax audits and permits
Meals and clean water
Airport runway repairs
Military escort services
Which action is most appropriate when hazards make staying inside more dangerous than moving out?
Shelter-in-place quietly
Evacuate the area promptly
Wait for official curfew
Initiate facility lockdown
In the START triage flowchart, what is the first assessment step?
Assess mental status
Check capillary refill
Determine ability to walk
Measure respiratory rate
Under START, a client who can walk is assigned which tag and direction?
Delayed yellow, to treatment
Expectant black, to morgue
Immediate red, to transport
Minor green, to secondary
In START, what tag is given after airway positioning if apnea persists?
Expectant black tag
Delayed yellow tag
Minor green tag
Immediate red tag
Which pair of findings in START indicates immediate tag due to perfusion?
Palpable pulse with regular rhythm
Absent radial pulse or refill over two seconds
Slow capillary refill under one second
Warm skin and normal blood pressure
For pediatric JumpSTART, what is done when a palpable pulse exists but no breathing?
Place in delayed yellow area
Proceed directly to perfusion check
Assign expectant black tag
Administer five rescue breaths
In JumpSTART, which respiratory rates warrant an immediate red tag?
Less than 15 or greater than 45
Exactly 20 and symmetrical
Over 30 but under 40
Between 16 and 24 only
Which neurological response under JumpSTART leads to delayed yellow tag?
Alert and appropriate to stimuli
Apnea after rescue breaths
No response to noxious stimuli
Agitated with poor commands
In SALT global sorting, which client should be assessed first?
Calling for help while mobile
Making purposeful movements
Walking with minor wounds
Still with obvious life threat
Which lifesaving intervention is included in SALT before transport?
Control major hemorrhage
Schedule elective surgery
Initiate physical therapy
Administer long-term antibiotics
In the flowchart, what is the first assessment that determines whether you consider lockdown or shelter-in-place?
Check if transportation is immediately available
Check if building is safe for occupants
Check if danger is outside the building
Check if grounds are safe around the campus
According to the diagram, if the building is safe and the danger is outside, which immediate action is indicated?
Evacuate to off-site location promptly
Shelter in place until authorities release
Request transportation for relocation
Assemble outside and account for people
When the building is unsafe, what is the next decision point after evacuating?
Determine if transportation is available
Determine if danger is outside the building
Determine if grounds are safe for assembly
Determine if windows can be covered
If the building is safe but danger is not outside, which modified procedure is listed?
Modified shelter-in-place with open doors
Modified off-site relocation with buses
Modified lockdown with locked exterior doors
Modified evacuation with staged assembly
Which source most directly contributes to respiratory health problems for families living near a major highway?
Indoor dust from household cleaning
Industrial noise from construction sites
Pollen from nearby green buffers
Vehicle emissions with nitrogen dioxide
In an urban heat island, which group is most vulnerable during extreme summer heat?
Teenagers who play evening sports
Elderly and people without air conditioning
Middle-aged joggers with fitness trackers
Office workers with indoor jobs
Which intervention best reduces exposure for homes near highways during peak traffic hours?
Use indoor air purifiers and keep windows closed
Add decorative lights to improve visibility
Open windows to increase airflow
Install louder fans to mask traffic noise
What is the primary health screening priority for children living near heavy traffic corridors?
Test for hearing loss from traffic sounds
Check for skin rashes from sun exposure
Screen for respiratory conditions including asthma
Assess vision changes from vehicle headlights
A neighborhood with limited green space reports poor sleep and heat illness. Which community-level action addresses this scenario?
Replace sidewalks with dark asphalt surfaces
Collaborate with city planners to increase shade
Require residents to buy personal generators
Ban evening outdoor activities entirely
Agricultural runoff in a rural area causes water contamination. Which population should be prioritized for screening?
Long-distance truck drivers passing through
Pregnant women and infants relying on local wells
College students visiting for a weekend
Tourists camping with bottled water
Which resident education point most directly prevents heat-related illness in low-income neighborhoods?
Hydration and access to cooling centers
Daily carpooling to reduce traffic
Avoiding evening news about weather
Choosing dark clothing for sun protection
Which advocacy step helps mitigate highway pollution exposure at the neighborhood boundary?
Petition for green buffers of trees and shrubs
Install brighter streetlights near the roadway
Encourage longer commute routes for drivers
Promote weekend street festivals by the highway
Which measure indicates the number of existing cases of a disease at a given time in a population?
Incidence rate at onset
Prevalence at a point
Sensitivity of testing
Specificity of screening
Arrange the typical disaster management phases in the logical order of occurrence.
Prevention, preparedness, response, recovery
Mitigation, recovery, response, preparedness
Response, recovery, prevention, preparedness
Preparedness, response, recovery, prevention
A community near farms relies on well water and reports illness. Which nursing action best reduces exposure risk for vulnerable groups?
Rely solely on self-reported symptoms
Increase hospital admissions rapidly
Advise boiling and use water filters
Suspend all agricultural activity
Which triage systems are referenced for prioritizing care during mass-casualty events?
ABCDE, C-STAT, RED
NIMS, ICS, HAZ
SMART, GOLD, BLUE
START, JumpSTART, SALT
Why is collaboration among local, state, federal, and NGO partners emphasized in emergency preparedness?
It guarantees zero disaster fatalities
It replaces clinical care during crises
It coordinates resources for effective management
It eliminates the need for community plans
