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Care of Communities: Community Health Nursing EXAM Answers

An instructor is discussing the worldwide distribution of AIDS. Which term would the instructor use to describe this situation? Epidemic B) Pandemic C) Endemic D) Pathogenicity

B 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.

After a class describing the contributions of Florence Nightingale to epidemiology, the instructor determines that the class needs additional instruction when they state which of the following is associated with Nightingale? A) Establishment of the need for a clean environment B) A sophisticated coding system for medical conditions C) Proper wound cleansing and bandaging techniques D) Separation of infected individuals from those injured

B 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.

When applying the epidemiologic triad model to a community's plan of care, which of the following would the community health nurse address? A) Incidence, prevalence, and case fatality B) Health, illness, and injury C) Host, agent, and environment D) Immunity, causation, and risk

C 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.

Which of the following would the community health nurse identify as a key component of the host? A) Infectivity B) Antigenicity C) Virulence D) Inherent resistance

D 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.

Which of the following statements apply to the concept of causality? Select all that apply. A) Causality is the relationship between cause and effect. B) The chain of causation is the most recent theory of causality. C) The web of causation theory is the most recent theory of causality. D) The chain of causation clearly explains causation in noninfectious disease. E) Epidemiology has changed its view of causality over time.

ACE 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.

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 A) reservoir. B) mode of transmission. C) portal of entry. D) host.

C 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.

A community health nurse is integrating the epidemiology of wellness into practice. Which of the following would the nurse include? A) Lifestyle with its self-created risks B) Communicable disease control C) The natural history of disease D) Vital statistics and reportable diseases

A 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.

The nurse is examining the possibility that multiple factors are involved in the development of a disorder. The nurse is applying which of the following? A) Chain of causation B) Web of causation C) Strength of association D) Temporality

B 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.

The nurse educator knows that a nursing student understands the basics of immunity when the student nurse states A) herd immunity only pertains to cows. B) active immunity can be attained via the use of vaccines. C) passive immunity can be attained via the use of vaccines. D) cross-immunity is immunity that causes a person who is immune to one disease to be also immune to a completely different infectious agent.

B 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.

When assessing several populations, the nurse notes each population's relative risk. Using the relative risk ratios below, which population would require a major emphasis for risk reduction intervention? A) 0.59 B) 1.13 C) 1.79 D) 2.45

D Feedback: 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.

Which of the following statements about risk is true? Select all that apply. A) Risk is the probability that a disease or unfavorable health condition will develop. B) Risk means that the person who has the most negative influences will definitely develop the disease or unfavorable health condition. C) Risk refers to positive and negative influences on a person's likelihood of developing a specific disease. D) Risk can be measured using the relative risk ratio, which is based on the ratio of incidence in an exposed group to incidence rate in unexposed group. E) Risk is unimportant when determining the most effective points for community health intervention.

A, C, D Feedback: 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. 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.

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? A) Susceptibility B) Subclinical disease C) Clinical disease D) Resolution

B Feedback: 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.

During which stage of the natural history of a communicable disease would quarantine be most effective? A) Susceptibility stage B) Subclinical disease stage C) Clinical disease stage D) Resolution stage

A Feedback: 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.

The nurse is reviewing actual census data for information for use in an epidemiologic study. Which of the following would the nurse be least likely to find? A) Occupational status B) Housing quality C) Births recorded D) Educational level

C Feedback: Vital statistic data provides information about the number of births recorded. Census data includes 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.

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? A) National Center for Health Statistics B) Consumer Product Safety Commission C) Environmental Protection Agency D) Cancer disease registries

A Feedback: 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.

Which of the following is true about incidence and prevalence? Select all that apply. A) Prevalence is the number of new cases of a disease or health condition. B) Incidence is the number of new cases of a disease or health condition. C) Prevalence refers to all of the people with a particular health condition existing in a given population at a given point in time. D) Incidence refers to all of the people with a particular health condition existing in a given population at a given point in time. E) When determining if a disease is endemic in a specific area, the statistic that is most helpful is prevalence.

B, C, E Feedback: 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.

A community health nurse is preparing to carry out an experimental epidemiologic study. Which of the following would be most important for the nurse to do? A) Focus the study on evaluating the cause of a disease B) Ensure carefully controlled conditions during the study C) Expose both groups to the same factor or condition D) Ensure that there are a substantial number of subjects

B Feedback: 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.

A community health nurse is participating in a case-control observational study. Which of the following would most likely explain this type of study? A) Description of patterns of occurrence of illness and injury in a population B) Investigation of development of health-illness conditions over a long period of time C) Studying of a cohort with evaluation of variables associated with the disease or injury D) Comparison of persons with and without a health-illness condition

D Feedback: 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.

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 which of the following? A) A type of experimental study conducted at the community level B) An inexpensive type of analytic research study C) A study that gathers volunteers for the experimental group D) A way to locate health problems in a variety of communities

A Feedback: 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.

When using descriptive epidemiology, which type of study would the community health nurse expect to include? A) Prevalence study B) Case-control study C) Cohort study D) Count study

D Feedback: Descriptive epidemiology includes investigations that seek to observe and describe patterns of health-related conditions that occur naturally in a population. The simplest measure of a description is a count. Prevalence, case-control, and cohort studies are types of studies involved with analytical research.

Organize the following steps in the epidemiologic study from the first step to the last. A) Collect the data. B) Identify the problem. C) Analyze the findings. D) Disseminate the findings. E) Review the literature. F) Develop conclusions and applications. G) Design the study.

B, E, G, A, C, F, D Feedback: The proper order of the steps in the epidemiologic study from the first step to the last is to identify the problem, review the literature, design the study, collect the data, analyze the findings, develop conclusions and applications, and disseminate the findings.

When implementing an epidemiologic research study, which of the following would the community health nurse complete as the final step? A) Analyze the data B) Design the study C) Disseminate findings D) Review the literature

C Feedback: The last step in the research process is to disseminate the findings. After identifying the problem and reviewing the literature, the researcher designs the study, collects the data, analyzes the findings, and develops conclusions and applications.

10. The nurse educator knows that a nursing student understands the basics of immunity when the student nurse states A) herd immunity only pertains to cows. B) active immunity can be attained via the use of vaccines. C) passive immunity can be attained via the use of vaccines. D) cross-immunity is immunity that causes a person who is immune to one disease to be also immune to a completely different infectious agent.

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.

Terms in this set (29)

Original Alphabetical

An instructor is discussing the impact of the Shattuck Report on community health care. The instructor recognizes the students understand the information by which response? A) "It influenced the speed with which health-focused bills pass the legislature." B) "The report set up the organizational structure of the U.S. Public Health Service." C) "It emphasized sanitary progress forming the basis for current public health practice." D) "It de-emphasized the issues addressed in the Hebrew hygienic code."

Over the past century, many health-related changes have occurred affecting morbidity and mortality. As community health nurses assess and plan for services in the community, an understanding of which change would the nurses need to integrate into their plans? Select all that apply. A) High levels of chronic disease B) Shortened life spans C) Increased teen pregnancies D) Abuse of multiple substances E) Multidrug-resistant diseases

A C D E

During a presentation at a local health department, a community health nurse discusses how society has changed since the turn of the century and the influence that these changes have had on the community's health care needs. Which would the nurse include as a current societal event? A) Large disparity in male/female wages B) Rural to urban migration C) Rampant child labor D) Widespread violence

A new public health nurse graduate is evaluating the various options available for employment and decides to seek a position with an official health agency. The nurse recognizes these type of agencies differ from others in which way? A) Voluntary B) Publicly funded C) Proprietary D) Privately funded

A discussion group of students are discussing the public health system and its structuring and function. Which statement would indicate that the students need further discussion and clarification? A) It offers consultation through national advisory health councils and special advisory committees made up of lay experts. B) The Secretary of Health and Human Services is ultimately responsible for it. C) The Secretary of Health and Human Services is an elected position. D) A major function is to administer grants and contracts with other government agencies.

A community health nurse is engaged in provision of care to clients in a clinic setting at the local health department. This nurse is engaging in which core public health function? A) Clinical B) Assessment C) Policy development D) Assurance

A public health nurse is discussing the core public health functions with a group of student nurses. Which fact should the nurse include in the discussion? A) Public health nurses practice as partners with other public health professionals within these core functions. B) Assessment involves the actual provision of services. C) Policy development relates to assessment. D) Assurance means that the public health agency must directly provide the needed services.

Which group of actions fulfills the three core public health functions in their proper order? A) Counting the number of kindergarten students who are fully immunized, encouraging the school officials to exclude children who are not fully immunized, and offering immunization clinics at the school B) Identifying a source of pollution in the community, educating local residents about precautions that should be taken when the pollution exceeds minimum standards, and asking legislators to apply sanctions to the responsible party for the source of pollution C) Providing prenatal care for pregnant adolescents, determining how many pregnant adolescents currently attend the school, and encouraging school officials to provide an alternative school setting for the pregnant adolescents D) Lobbying for a citywide ban on smoking in public, providing smoking cessation services in the community, and reviewing mortality data to determine the number of people in the community who die each year from lung cancer

A community health nurse primarily works with mothers and their high-risk children. The nurse recognizes which local voluntary agencies can also provide services for these clients? Select all that apply. A) American Diabetes Association B) The U.S. Public Health Service C) The National Institutes of Health D) Women, Infant, and Children Program (WIC) E) National Society for Autistic Children

A E

An instructor is describing the various differences between government health agencies and private organizations. Which comment by the students would indicate understanding of the function of a public health agency? A) Most often have a very specific focus B) Responsible for promoting and protecting the health of everyone C) Limits employment to nurses and environmental health practitioners D) Works independently with complete autonomy

A student nurse is having difficulty understanding the differences between public health care agencies and private health care agencies. What is the best response from the instructor?

A) Private sector health services are complementary and supplementary to government health agencies.

B) Public sector health care agencies usually meet the needs of people with special needs.

C) Private sector health agencies usually are constrained in developing innovations in health care.

D) Public health sector agencies generally satisfy the health care needs of a community.

A group of students are preparing to debate about public health care agencies and private health care agencies. Which factor should the group representing the private sector include in the debate? A) Are ready for disasters B) More likely to promote health legislation C) Administers grants to provide care D) Usually focus on needs that are met

A group of student nurses are discussing the various international health organizations. Which statement at the end of the discussion indicates that the students understand the information? A) PAHO is a separate agency from WHO. B) UNICEF promotes child and maternal health and welfare globally. C) WHO focuses primarily on developing countries. D) UNICEF is a temporary emergency program.

A group of students are discussing the results of the various legislative acts affecting health care. Which legislation will the students recognize as resulting in decreasing federal government involvement? A) Social Security Act B) Medicare/Medicaid C) State Children's Health Insurance Program D) Omnibus Budget Reconciliation Act

An instructor is discussing the various legislative acts that have focused on health care. Which statement by the class indicates they understand the focus of the Social Security Act? A) Increased availability of public health programs B) Increased privacy of patient information C) Increased services to the poor D) Expanded coverage for children

A community health nurse working at the local level is attending an in-service program about health care economics. The nurse asks the presenter, “Why do I need to know this information? My focus is my clients.” Which response by the presenter would be most appropriate?

A) “You are required to know this information because your agency receives government funding.”

B) “You might be in management one day and have to deal with cost control and reimbursement.”

C) “Although it seems foreign to you, it's an important topic that you might have to deal with someday.”

D) “This knowledge is important to the success of your practice and for the agency's survival.”

The instructor is leading a class discussion on macroeconomics and its effect on today's health care. Which effect should the class identify as a result of macroeconomics on health care after the discussion? A) Quantity of services available B) Consumer's willingness to buy services C) Comparison of health care spending between two entities D) Allocation of the available resources

A community health nurse is developing a teaching plan about Medicare to present at a community event. Which points will be important to include in the presentation? Select all that apply. A) A state health insurance program for elderly and the disabled. B) Part A covers medically necessary hospitalization. abirb.com/test C) Part D covers prescription drug costs D) Part A is supplementary and voluntary. E) Beneficiaries can make changes at any time.

B C

A community health nurse is teaching a community group about the Medicaid program. Which statement from the group would indicate to the nurse that additional teaching is necessary? A) Medicaid has a monthly fee that recipients must pay. B) Medicaid is administered individually by each state. C) Medicaid will provide nursing home services to those over 21 years. D) It is possible to be on both Medicare and Medicaid.

A group of students are preparing a presentation to give to the class discussing retrospective payment plans. Which situation should the students include in the discussion? A) Spending was limited to the most necessary tests and treatments. B) Services for sickness were encouraged rather than wellness. C) Consumers had to bear the increased accountability for cost containment. D) Payments for services were based on rates calculated from predictions.

A community health nurse is preparing to meet with a group of students. Which statements should the nurse include when discussing how trends and issues have influenced health care? Select all that apply. A) The United States has the most cost-effective health care system in the world. B) One explanation for the high cost of U.S. Health Care System is the need to practice defensive medicine by ordering excessive tests and x-rays. C) In the United States, the health-related quality of life is lower than for most other countries. D) The United States ranks first among all WHO countries on a measure of how respectfully clients are treated. E) In a survey published in 2009, most US physicians identified that their health care system worked well.

B C D

During a lively class discussion on health care rationing, several students indicate that they find this upsetting. What is the best response from the instructor?

A) Rationing is the end result of today's market.

B) Fair rationing focuses on the needs of the population.

C) The main focus for rationing is to expand medical care to all.

D) Advances in knowledge and technological capabilities will eliminate the need for rationing in the future.

The community health nurse is concerned for the local community with the raising health care costs. The nurse recognizes that managed competition is a potential solution, based on which factor? A) Promotes cost containment and universal access to health care B) Eliminates burdensome government regulations C) Reduces state and federal control over health care delivery D) Discourages consumers from making responsible choices

A public health nurse is asked by a group of students why they should chose public health nursing as a career focus. What is the best response by the public health nurse?

A) Public health nursing focuses only on health care, not illness.

B) Financial resources for patients are more readily available in public health nursing, enabling more to be help.

C) Public health nurses can lead the effort in making health care more accessible to all citizens.

D) Public health agencies provide the main source of employment.

Terms in this set (22)

Original Alphabetical

When reporting the identification of a communicable disease and need for investigation, which of the following must be notified first? A) Centers for Disease Control (CDC) B) State health department C) Local health department D) National Reported Disease list

C. local health department

Which of the following are appropriate communicable disease prevention interventions that may be implemented by community health nurses? Select all that apply. A) Immunization of children and adults B) Disease investigation and case/contact finding C) Diagnosing cases of communicable diseases D) Prescribing treatment for communicable diseases E) Environmental interventions F) Community Education

A. immunization of children and adults B. disease investigation and case/contact finding E. environmental interventions F. community education

Which of the following statements accurately describes important steps that a community health nurse must take prior to contacting an individual for an interview regarding communicable disease? Select all that apply. A) Review the information received from the news media reporter for completeness B) Review disease information including the reservoir, incubation period, infectious period, symptoms, and treatment C) Take all appropriate treatments to the interview site D) Investigate only laboratory confirmed communicable diseases E) Eradicate the disease

A. review the information received from the news media reporter for completeness B. review disease information including the reservoir, incubation period, infectious period, symptoms, and treatment

Which of the following entities would the community health nurse know are required to report known or suspected cases of reportable diseases in every state in the United States? Select all that apply. A) Physicians, dentists, and nurses B) Laboratory directors C) Any individual who knows of or suspects the existence of a reportable disease D) Medical examiners E) Administrators of schools and child care centers

A. physicians, dentists, and nurses D. medical examiners E. administrators of schools and child care centers

A community health nurse is presenting a program about hepatitis prevention and risk reduction to a local community group. The nurse determines that the group has understood the program when they identify which method as the major mode of transmission for hepatitis B? A) Oral-fecal route B) Exposure to contaminated blood C) Airborne droplet nuclei D) Infected rodents, such as mice and rats

B. exposure to contaminated blood

When reviewing the trends in communicable diseases for a county, the community health nurse notes that there was an increased incidence of Lyme's disease. The nurse develops a plan for prevention and control integrating the understanding that this disease is most likely transmitted by which mode? A) Vector B) Airborne C) Vehicle-borne D) Direct

A. vector

After a community health nurse implements an educational program for a local community group about food safety, which statement indicates that the teaching was successful? A) "Handwashing is unnecessary if we use gloves." B) "After cooking the meat, we'll put it on the same platter that we used for the raw meat." C) "Our cooked foods should be cooled quickly." D) "If we peel the carrots, we don't need to wash them before eating."

C. "our cooked foods should be cooled quickly"

A community health nurse is teaching a group of clients about infection control and mentions the role of vectors in transmitting diseases. Which of the following would be examples of some common vectors? Select all that apply. A) Chemicals B) Mosquitoes C) Salmonella D) Fleas E) Roaches

B. mosquitoes D. fleas E. roaches

Which of the following statements about modes of transmission are true? Select all that apply. A) Direct transmission requires contact with a contaminated inanimate material. B) Indirect transmission is also known as vehicle-borne illness. C) Food- and water-related illnesses are considered to be spread by indirect transmission. D) Vector transmission requires contact with a nonhuman carrier such as an animal or insect. E) Airborne transmission commonly occurs from coughing and sneezing.

B. indirect transmission is also known as vehicle-borne illness C. food and water-related illnesses are considered to be spread by indirect transmission D. vector transmission requires contact with a nonhuman carrier such as an animal or insect E. airborne transmission commonly occurs from coughing and sneezing

Community health nurses practice within the three levels of prevention. Which of the following would the community health nurse engage in at the primary level of prevention for communicable disease control? Select all that apply. A) Providing TB skin test to children entering kindergarten B) Administering immunizations to senior citizens C) Teaching kindergarten students to wash their hands D) Encouraging parents to complete their children's immunizations E) Providing chest x-rays to people with positive TB skin tests F) Administering prompt treatment for the symptoms of gonorrhea

B. administering immunizations to senior citizens C. teaching kindergarten students to wash their hands D. encouraging parents to complete their children's immunizations

The nurse educator has just discussed education of aggregates using mass media with targeting health messages. Which of the following statements by the nursing student would demonstrate the student's ability to analyze and apply the information? A) Television would be the most important venue of mass media to educate the aggregate as everyone has a television. B) The target audience must be assessed for educational level, salience of the issue, involvement in the issue, and access to the media channel used. C) Pamphlets should be assessed to make sure they are at a twelfth grade reading level. D) It is unnecessary to consider culture when planning the health message

B. the target audience must by assessed for educational level, salience of the issue, involvement in the issue, and access to the media channel used

A community health nurse has identified the index case. The nurse is involved in which of the following? A) Contact investigation B) Screening C) Isolation D) Quarantine

A. contact investigation

The three main approaches to the tertiary prevention of communicable disease include which of the following? A) Education, immunization, and screening B) Screening, immunization, and isolation and quarantine C) Case and contact investigation, notification, and treatment D) Care and treatment, isolation and quarantine, and safe handling and control of infectious wastes

D. care and treatment, isolation and quarantine, and safe handling and control of infectious wastes

If an agency discards used needles and syringes in plastic milk jugs, which of the four key elements of an infectious waste management program that are applicable to community practice would the agency be violating? A) Health professionals must be able to correctly distinguish biohazardous waste from biomedical waste. B) The waste management program must have administrative support and authority to institute practice guidelines. C) Handling of the infectious wastes must be minimized. Containers should be rigid, leak resistant, and impervious to moisture. D) An enforcement or evaluation mechanism must be in place to ensure that the potential for exposure to infectious waste is met.

C. handling of the infectious wastes must be minimized. containers should be rigid, leak resistant, and impervious to moisture

The community health nurse determines that the adult population in the community has an increased incidence of vaccine preventable disease. Which of the following are factors that may contribute to low vaccination levels among adults? Select all that apply. A) Lack of comprehensive vaccine delivery systems to the public and private sectors for adults (similar to the Vaccines for Children program for children) B) Lack of statutory requirements for vaccination of adults C) Health care providers may lack current information about recommended adult immunizations and may miss opportunities to vaccinate adults during contacts in offices, outpatient clinics, and hospitals. D) Adults fear injections for immunizations but do not worry about adverse effects after vaccination. E) A multitude of comprehensive vaccination programs exist in settings where healthy adults congregate such as workplaces and other locations.

A. lack of comprehensive vaccine delivery systems to the public and private sectors for adults (similar to the vaccines for children program for children) B. lack of statutory requirements for vaccination of adults C. health care providers may lack current information about recommended adult immunizations and may miss opportunities to vaccinate adults during contacts in offices, outpatient clinics, and hospitals

A community health nurse would recommend pneumococcal vaccine for which group? A) 1-year-old children B) 30-year-old adults who have simple respiratory tract infections C) Adults over age 65 who have COPD D) Healthy adults in their 50s

C. adults over age 65 who have copd

Which of the following statements about immunization is most accurate? A) Immunization is helpful in the spread of all communicable diseases. B) Immunization cannot provide herd immunity. C) Immunization is the process of introducing a form of a disease-causing organism into a person's system to promote the development of antibodies that will resist the disease. D) Immunization is the process of administering antibodies to a person.

C. immunization is the process of introducing a form of a disease-causing organism into a person's system to promote the development of antibodies that will resist the disease

A family member has developed tuberculosis (TB) and the remainder of the family members are undergoing tuberculosis skin testing to determine their status. The nurse assesses the indurations and determines that a family member with which size induration is positive for TB? A) 2 mm B) 3 mm C) 4 mm D) 5 mm

D. 5mm

The community health nurse observes an increase in the development of multidrug- resistant tuberculosis. The nurse understands that a major reason for this occurrence for individual clients would most likely be A) political and social response to declining rates of TB over the past decade. B) a reduction in funding for surveillance and research. C) noncompliance with the therapy for the full, recommended period. D) a premature sense that TB has been defeated.

C. noncompliance with the therapy for the full, recommended period

Which of the following statements about the prevention of sexually transmitted diseases is true? Select all that apply. A) Many persons who have HIV infection can stave off AIDS by the use of medications during the HIV stage of the spectrum. B) Screening programs have actually reduced the incidence of Chlamydia as infected persons are identified and treated. C) The proper use of condoms prevents transmission of all sexually transmitted infections. D) Expedited partner treatment can prevent the spread of Chlamydia and gonorrhea. E) It is not possible for a person who has a HSV-2 infection to transmit the infection to other sex partners if sexual contact is only practiced when the person does not have any visible sores.

A. many persons who have HIV infection can stave off AIDS by the use of medications during the HIV stage of the spectrum B. screening programs have actually reduced the incidence of chlamydia as infected persons are identified and treated D. expedited partner treatment can prevent the spread of chlamydia and gonorrhea

Which one of the following statements is true about the consequences of biologic terrorism with anthrax and smallpox? A) Anthrax is not usually spread by person to person contact and so is not a good agent of biological terrorism. B) Smallpox is globally eradicated and therefore does not present a problem. C) Most adults are immune to smallpox due to routine immunization. D) As many as one in five persons who become ill with cutaneous anthrax die and inhalation anthrax can cause death in 3 to 5 days.

D. as many as one in five persons who become ill with cutaneous anthrax die and inhalation anthrax can cause death in 3 to 5 days

Which of the following statements about confidentiality, privacy, and discrimination is the most accurate? A) It is permissible for a community health nurse to reveal the name and any other personal health information of a person who has a communicable disease to the public health authorities. B) It is permissible for a community health nurse to tell the contacts of a person who is infected with a communicable disease which disease they have been exposed to and the name of the source. C) It is permissible for any health care provider to report any cases of known or suspected communicable diseases to the news media. D) Only the identity of the index case of a communicable disease needs to be protected

A. it is permissible for a community health nurse to reveal the name and any other personal health information of a person who has a communicable disease to the public health auth

Health care reform has brought changes to public health nursing that can benefit the community as a whole. How might the public health department clinics respond as ACA increases coverage of individuals throughout the communities? A) Claim private insurance reimbursement B) Decrease services available C) Increase competition with private agencies D) Increase participation in community assessments

A new graduate is exploring various options in public health nursing employment. The nurse recognizes a major difference between a rural and metropolitan setting is determined by which factor. A) Federal legislation B) Complexity C) State legislation D) Leadership

The public health nurse recognizes there are various resources available to the community for financing health care and providing services, many that are influenced by legislation. An act passed in the 1990s resulted in which major adjustment for Medicaid participants? A) Moved to managed care concept B) Decreased number of qualified participants C) Increased rate of reimbursement payments D) Decreased provider availability

A nurse is exploring the options of employment as an international public health nurse. If the nurse desires to assist others who are being denied health care, which is the best

option?

A) UNESCO

B) USAID

C) PAHO

D) Doctors without Borders

A) Increased life expectancy

B) Decrease in medical staff

C) Increase in health care insurance coverage

D) Decrease in preventive health measures

An instructor is discussing the worldwide distribution of AIDS with a group of nursing students. The instructor should categorize this situation as a(n): A) epidemic. B) pandemic. C) endemic. D) pathogenicity.

After a class describing the contributions of Florence Nightingale to epidemiology, the instructor determines that the class needs additional instruction when they state that whichaccomplishmentisassociatedwithNightingale? A) Establishment of the need for a clean environment B) A sophisticated coding system for medical conditions C) Proper wound cleansing and bandaging techniques D) Separation of infected individuals from those injured

When applying the epidemiologic triad model to a community's plan of care, which would the community health nurse address? A) Incidence, prevalence, and case fatality B) Health, illness, and injury C) Host, agent, and environment D) Immunity, causation, and risk

Which would the community health nurse identify as a key component of the host? A) Infectivity B) Antigenicity C) Virulence D) Inherent resistance

Which statements apply to the concept of causality? Select all that apply. A) Causality is the relationship between cause and effect. B) The chain of causation is the most recent theory of causality. C) The web of causation theory is the most recent theory of causality. D) The chain of causation clearly explains causation in noninfectious disease. E) Epidemiology has changed its view of causality over time.

A C E

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: A) reservoir. B) mode of transmission. C) portal of entry. D) host.

Which would the community health nurse include when integrating epidemiology of wellness into practice? A) Lifestyle with its self-created risks B) Communicable disease control C) The natural history of disease D) Vital statistics and reportable diseases

The nurse is examining the possibility that multiple factors are involved in the development of cerebral palsy. Which is the nurse is applying? A) Chain of causation B) Web of causation C) Strength of association D) Temporality

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?

A) Herd immunity

B) Passive immunity

C) Cross-immunity

D) Active immunity

The nurse educator knows that a nursing student understands the basics of immunity when the student nurse states: A) herd immunity only pertains to cows. B) active immunity can be attained via the use of vaccines. C) passive immunity can be attained via the use of vaccines. D) cross-immunity is immunity that causes a person who is immune to one disease to be also immune to a completely different infectious agent.

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. A) "Risk is the probability that a disease or unfavorable health condition will develop." B) "Risk means that the person who has the most negative influences will definitely develop the disease or unfavorable health condition." C) "Risk refers to positive and negative influences on a person's likelihood of developing a specific disease." D) "Risk can be measured using the relative risk ratio, which is based on the ratio of incidence in an exposed group to incidence rate in unexposed group." E) "Risk is unimportant when determining the most effective points for community health intervention."

B E

During which stage of the natural history of a communicable disease would quarantine

be most effective?

A) Susceptibility stage

B) Subclinical disease stage

C) Clinical disease stage

D) Resolution stage

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? A) Occupational status B) Housing quality C) Births recorded D) Educational level

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?

A) National Center for Health Statistics

B) Consumer Product Safety Commission

C) Environmental Protection Agency

D) Cancer disease registries

Which statements are true about incidence and prevalence? Select all that apply. A) Prevalence is the number of new cases of a disease or health condition. B) Incidence is the number of new cases of a disease or health condition. C) Prevalence refers to all of the people with a particular health condition existing in a given population at a given point in time. D) Incidence refers to all of the people with a particular health condition existing in a given population at a given point in time. E) When determining if a disease is endemic in a specific area, the statistic that is most helpful is prevalence.

B C E

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

A) Focus the study on evaluating the cause of a disease

B) Ensure carefully controlled conditions during the study

C) Expose both groups to the same factor or condition

D) Ensure that there are a substantial number of subjects

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

A) Description of patterns of occurrence of illness and injury in a population

B) Investigation of development of health–illness conditions over a long period of time

C) Studying of a cohort with evaluation of variables associated with the disease or injury

D) Comparison of persons with and without a health–illness condition

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: A) "A type of experimental study conducted at the community level." B) "An inexpensive type of analytic research study." C) "A study that gathers volunteers for the experimental group." D) "A way to locate health problems in a variety of communities."

When using descriptive epidemiology, which type of study would the community health nurse expect to include? A) Prevalence study B) Case-control study C) Cohort study D) Count study

Organize the following steps in the epidemiologic study from the first step to the last. 1. Collect the data. 2. Identify the problem. 3. Analyze the findings. 4. Disseminate the findings. 5. Review the literature. 6. Develop conclusions and applications. 7. Design the study. A) 2, 5, 7, 1, 3, 6, 4 B) 2, 7, 1, 5, 6, 3, 4 C) 5, 2, 7, 1, 3, 6, 4 D) 5, 2, 7, 1, 6, 3, 4

When implementing an epidemiologic research study, which would the community health nurse complete as the final step?A) Analyze the data. B) Design the study. C) Disseminate the findings. D) Review the literature.

The community health nurse is educating a group of missionaries planning to travel abroad about the Ebola virus. The nurse evaluates that no further education is needed when members of the group correctly associate which as a vector for the virus? A) Bats B) Bushmeat C) Chimpanzees D) Gorillas

The community health nurse is investigating an outbreak of a gastrointestinal illness from a food-borne pathogen in the local community. How would the nurse identify this outbreak occurrence? A) Pandemic B) Epidemic C) Secular trend D) Hyperendemic

The community health nurse is discussing the chain of causation with a student nurse. Which statement made by the student nurse indicates no further need for additional teaching on the chain of causation? A) "Humans can be considered a reservoir in the chain of causation." B) "Bats are the largest reservoir of malaria identified in the chain of causation." C) "The chain of causation begins with the portal of exit." D) "The last link in the chain of causation is the agent itself."

The community health nurse is discussing mortality rates with a student nurse. Which statement made by the student nurse indicates no further teaching is needed regarding the calculation of mortality rates? A) "Mortality rates are informative for fatal diseases." B) "Mortality rates provide information about existing disease in clustered areas." C) "Mortality rates are calculated using a population estimate every 10 years." D) "Mortality rates indicate the genetic risk of developing a particular disease."

The community health nurse is investigating how many cases of STDs have occurred in the local high school during the past month. Which approach is the nurse applying in the investigative process? A) Experimental epidemiology B) Analytical epidemiology C) Descriptive epidemiology D) Prevalence epidemiology

The community health nurse observes an increase in the development of multidrug-resistant tuberculosis. The nurse understands that a major reason for this occurrence for individual clients would most likely be: A. noncompliance with the therapy for the full, recommended period. B. political and social response to declining rates of TB over the past decade. C. a premature sense that TB has been defeated. D. a reduction in funding for surveillance and research.

A public health nurse is discussing the core public health functions with a group of student nurses. Which fact should the nurse include in the discussion? A. Assessment involves the actual provision of services. B. Assurance means that the public health agency must directly provide the needed services. C. Policy development relates to assessment. D. Public health nurses practice as partners with other public health professionals within these core functions.

The nurse recognizes the financial means of individuals often determines the amount of health care received. As health care has improved, the costs have increased. Which factor has contributed the most to rationing over the recent years? A. Increased life expectancy B. Decrease in medical staff C. Decrease in preventive health measures D. Increase in health care insurance coverage

A nurse is completing an exposure history using the mnemonic I PREPARE. What data would a nurse collect when asking questions about the first "P"? A. Previous pesticide exposure B. Potential exposures C. Present work D. Past work experience

A public health nurse who uses the upstream approach would likely focus on which contributor to unhealthy diets in the community? A. Individual acceptance of obesity B. Marketing strategies of fast-food businesses C. Busy lifestyles within the community D. Consumer preference for sweet, greasy, and salty foods

Which entities would the community health nurse know are required to report known or suspected cases of reportable diseases in every state in the United States? Select all that apply. A. Any individual who knows of or suspects the existence of a reportable disease B. Medical examiners C. Laboratory directors D. Physicians, dentists, and nurses E. Administrators of schools and child care centers

B, D, E

A community health nurse is presenting a program about hepatitis prevention and risk reduction to a local community group. The nurse determines that the group has understood the program when they identify which method as the major mode of transmission for hepatitis B? A. Infected rodents, such as mice and rats B. Airborne droplet nuclei C. Exposure to contaminated blood D. Oral-fecal route

The community health nurse is discussing the chain of causation with a student nurse. Which statement made by the student nurse indicates no further need for additional teaching on the chain of causation? A. "Humans can be considered a reservoir in the chain of causation." B. "The chain of causation begins with the portal of exit." C. "The last link in the chain of causation is the agent itself." D. "Bats are the largest reservoir of malaria identified in the chain of causation."

The nurse is examining the possibility that multiple factors are involved in the development of cerebral palsy. Which is the nurse is applying? A. Web of causation B. Chain of causation C. Temporality D. Strength of association

Health care reform has brought changes to public health nursing that can benefit the community as a whole. How might the public health department clinics respond as ACA increases coverage of individuals throughout the communities? A. Decrease services available B. Increase participation in community assessments C. Claim private insurance reimbursement D. Increase competition with private agencies

A public health nurse using an upstream approach to improve heart health would most likely focus on which contributing factors to improving heart health? A. Smoking tobacco B. Decreased physical activity C. Unhealthy diets D. Lack of safe places to exercise

Which would the community health nurse identify as a key component of the host? A. Inherent resistance B. Infectivity C. Virulence D. Antigenicity

A community health nurse is teaching a group of clients about infection control and mentions the role of vectors in transmitting diseases. Which would be examples of some common vectors? Select all that apply. A. Salmonella B. Chemicals C. Fleas D. Roaches E. Mosquitoes

C, D, E

A community health nurse would recommend pneumococcal vaccine for which group? A. Healthy adults in their 50s B. 1-year-old children C. 30-year-old adults who have simple respiratory tract infections D. Adults over age 65 who have COPD

Organize the following steps in the epidemiologic study from the first step to the last. 1. Collect the data. 2. Identify the problem. 3. Analyze the findings. 4. Disseminate the findings. 5. Review the literature. 6. Develop conclusions and applications. 7. Design the study. A. 2, 7, 1, 5, 6, 3, 4 B. 5, 2, 7, 1, 6, 3, 4 C. 5, 2, 7, 1, 3, 6, 4 D. 2, 5, 7, 1, 3, 6, 4

A student nurse is having difficulty understanding the differences between public health care agencies and private health care agencies. What is the best response from the instructor? A. Private sector health agencies usually are constrained in developing innovations in health care. B. Private sector health care agencies usually meet the needs of special groups of people. C. Public health sector agencies generally satisfy the health care needs of an individual. D. Private sector health services are complementary and supplementary to government health agencies.

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: A. portal of entry. B. mode of transmission. C. host. D. reservoir.

A public health nurse is asked by a group of students why they should chose public health nursing as a career focus. What is the best response by the public health nurse? A. Public health nursing focuses only on health care, not illness. B. Public health agencies provide the main source of employment. C. Public health nurses can lead the effort in making health care more accessible to all citizens. D. Financial resources for patients are more readily available in public health nursing, enabling more to be help.

The community health nurse is investigating how many cases of STDs have occurred in the local high school during the past month. Which approach is the nurse applying in the investigative process? A. Descriptive epidemiology B. Experimental epidemiology C. Prevalence epidemiology D. Analytical epidemiology

Implementing any of the three main approaches to the tertiary prevention of communicable disease includes: A. education, immunization, and screening. B. screening, immunization, and isolation and quarantine. C. case and contact investigation, notification, and treatment. D. care and treatment, isolation and quarantine, and safe handling and control of infectious wastes.

When reviewing the trends in communicable diseases for a county, the community health nurse notes that there was an increased incidence of Lyme disease. The nurse develops a plan for prevention and control integrating the understanding that this disease is most likely transmitted by which mode? A. Direct B. Vehicle-borne C. Vector D. Airborne

During a lively class discussion on health care rationing, several students indicate that they find this upsetting. What is the best response from the instructor? A. The main focus for rationing is to expand medical care to all. B. Advances in knowledge and technological capabilities will eliminate the need for rationing in the future. C. Rationing is the end result of today's market. D. Fair rationing focuses on the needs of the population.

Which statement about assessment (one of the core public health functions) and how it can be applied to environmental health is most accurate? A. Assessment is least valuable when related to where the person attends school. B. It is not necessary for nurses to have a background in the environmental health sciences. C. Assessment should be limited to the general population and should not include the increased vulnerability of certain groups. D. Assessment includes the investigation of health hazards, surveillance of health issues, examining causes, and assessing needs.

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? A. Proper wound cleansing and bandaging techniques B. Establishment of the need for a clean environment C. A sophisticated coding system for medical conditions D. Separation of infected individuals from those injured

When applying the epidemiologic triad model to a community's plan of care, which would the community health nurse address? A. Health, illness, and injury B. Immunity, causation, and risk C. Incidence, prevalence, and case fatality D. Host, agent, and environment

Care of Communities: Community Health Nursing EXAM Answers

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