Community health nursing a canadian perspective 3rd edition by stamler test bank

Name: Date: Course: Stamler/Yiu: Community Health certain air pollutant with the incidence in a population not exposed to that pollutant to determine relative risk.. It focuses on a grou

Community Health Nursing: A Canadian Perspective: 3rd Edition Test Bank – Stamler & Yiu

2 Describe three areas that Florence Nightingale addressed during the

Crimean War that advanced the science of

epidemiology Give an example for each area that illustrates the relationship

with current community health nursing

practice

3 Choose any infectious disease, such as tuberculosis, sexually

transmitted infection, influenza, leprosy, etc Apply

your chosen disease to the natural history of disease process and describe

two interventions that could be done by

CHNs in each of the five levels of preventive measures

4 Define three of Timmreck’s criteria of causation Give an example of where a CHN would apply each of the chosen

criteria

5 Calculate the odds ratio of developing colorectal cancer related to a low-fibre diet from the following example Write

a statement that would explain your results to a

client Study group = 300

Risk factor = low-fibre diet

Disease = colorectal cancer

a) persons with low-fibre diet and colorectal cancer = 100

b) persons with high-fibre diet and colorectal cancer = 20

Total persons with colorectal cancer = 120

c) person with low-fibre diet and no colorectal cancer = 20

d) persons with high-fibre diet and no colorectal cancer =

160 Total persons without colorectal cancer = 180

6 Identify four criteria that researchers and practitioners use to assess a causal relationship between a stimulus and

the occurrence of a disease

7 A public health nurse has been contacted because 12 students living in a

college dormitory are ill with bacterial

meningitis The cases have been confirmed to be caused by Neisseria meningitidis Using the Venn diagram,

describe the environmental characteristics in this scenario and the mode

of transmission of this organism

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8 What term refers to ―the study of the occurrence and distribution of

health-related states or events in specified

activity would promote the health of this population?

a Case finding children who may have been exposed to a teacher with hepatitis

A b Teaching handwashing and respiratory hygiene

c Providing antimicrobials for newly diagnosed contacts

d Advocating for testing of sexually transmitted infections (STIs) at a based clinic

school-10 A nurse is working with a student nurse and explains that 12% of deaths

were from colorectal cancer in 2010 What

word is used to describe this type of statistical information?

Name: Date: Course:

Stamler/Yiu: Community Health

certain air pollutant with the incidence in a population not exposed to that

pollutant to determine relative risk The

PHN asks the student to select the statistic, which supports that the risk for

asthma is greater in the exposed

population What is the correct answer?

(Refer to Case 1 above.) The PHN asks the nursing student to develop

some questions for a survey about smoking

behaviour Which question would be best at eliciting information on

period prevalence?

a ―Do you currently smoke?‖

b ―Have you smoked within the last six

months?‖ c ―Have you ever smoked?‖

d ―At what age did you start smoking?‖

Name: Date: Course: Stamler/Yiu:

(Refer to Case 1 above.) The nursing student wants to administer a survey

about smoking behaviours to students in

various grade levels within the school district to identify the best grade to

initiate health education A follow-up

survey will be administered to assess the effectiveness of the educational

program What type of research design

would be best at providing the epidemiological information needed in

What strategy presented by the student would be best at meeting this

ethical concern?

a Data will be used in a confidential manner

b The survey will be anonymous

c The participants will sign a consent form

d Ethics approval will be sought

Name: Date: Course: Stamler/Yiu:

16 A nurse in a large urban centre is working to provide prophylactic agents

to exposed vulnerable hosts What action

is the best example of this goal?

a Providing varicella-zoster immune globin (VZIG) to appropriate children after a classmate is diagnosed with

chickenpox

b Administering human papilloma virus (HPV) vaccine to girls in grade 6

c Routinely immunizing 1-year-old children for measles, mumps, and rubella

d Tuberculosis (TB) testing exposed students at a high school after a student

is diagnosed with TB

17 Chapter 9 – Case 2

The public health nurses (PHNs) are busy responding to seasonal influenza in a community of approximately 75

000 people An assisted living facility has an increased number of influenza

cases among the residents

(Refer to Case 2 above.) A nurse is doing an inservice with the housekeeping staff

at the facility about the

transmission of the influenza virus Which is an example of indirect

transmission via a fomite?

a Inhaling a droplet from a sneeze

b Shaking a contaminated hand

c Drinking tainted water

d Touching a contaminated doorknob

Name: Date: Course: Stamler/Yiu:

Community Health

a Increasing assessments of the ill to identify complications

early b Screening individuals for signs of influenza

c Instructing individuals to sneeze into one’s

arm d Administering Tamiflu to ill residents 19

(Refer to Case 2 above.) Family members of the residents have been

following FluWatch on the Public Health

Agency of Canada web page What type of reporting is FluWatch?

a Statistics Canada information

20 What statement best describes a cohort study?

a It focuses on a group of people exposed to a particular health problem

or potential stressor over time

b The researcher manipulates some of the variables in order to ascertain the effect

d Selected variables within a specific population are studied to look for

evidence of association and causality

21 What is an example of tertiary prevention of a communicable

disease? a Observing clients taking tuberculosis medication

b Demonstrating vaccine efficacy rates

c Encouraging frequent handwashing during flu season

d Immunizing students during a meningitis outbreak

22 What type of research design was used in the Framingham Heart

Study? a Case series

c Canadian Institutes of Health Information (CIHI)

d Public Health Agency of Canada (PHAC)

24 A nurse is concerned about a recent outbreak of measles in a group of migrant workers How would the nurse

explain the concept of incidence to a new staff member?

a The rate at which new cases occur in a population during a specified period

b A measurement of disease frequency

c Occurs frequently and with predicted regularity

d The proportion of a population that is affected by the disease at a specific

time Name: Date: Course: Stamler/Yiu:

Test: Chapter 09

8

25 What is the purpose of epidemiology?

a The study of the occurrence and distribution of health-related states in specified populations

b To provide statistics to direct health care funding to the appropriate cause

c To predict and control challenges to population health

d An area of medicine that deals with the study of the causes of disease in

27 Which epidemiological model best allows a nurse to visualize the

relationships between various determinants of

28 A nurse wants to know the current rate of human papilloma virus

(HPV) infection in women aged 25 years as

indicated by abnormal Pap smears Which type of research design would be best to answer this question?

a Manipulation methodology

b Cross-sectional

c Prospective cohort

d Randomized controlled

Name: Date: Course:

Stamler/Yiu: Community Health

1 – public health epidemiology CHN e.g., monitoring and tracking

sexually transmitted infections over time

– exposure-oriented epidemiology CHN e.g., studying the effects of a vegetarian diet on the health outcomes of

children

– disease-oriented epidemiology CHN e.g., studying the distribution of

cervical cancer in social districts within a

2 – increased the recording of death statistics CHN e.g., HHN provide

information for the completion of the death

certificates

– used the death statistics to explain and publicize the reality of the

horrid situation CHN e.g., CHNs have been very

vocal in publicizing the effects and causes of homelessness

– used polar diagrams to demonstrate that what was killing the soldiers

was contagious diseases CHN e.g., CHNs

can use Venn diagrams to illustrate the multiple host/agent/environmental

factors influencing heart disease

– implemented sanitation practices that proved to authorities that her ideas

were correct CHN e.g., CHNs educate

people about how HIV is transmitted and correct myths about how it is not

Canadian Edition

Test: Chapter 09

10

3 Sexually transmitted

infections Health promotion

– health education on human sexuality development

– social marketing campaign to promote healthy sexual choices, such as condom use, abstinence, and limited

sexual partners

– specific protection

– accessibility to free condoms and sexual health

counselling Early diagnosis and prompt treatment

– STI testing at easily accessible free clinics

– treatment of STIs and case follow-up to treat contacts

Disability limitation

– testing of cure after STI treatment for high-risk persons

– counselling for people with nontreatable STIs such as

4 See Table 9.1 for more details

– consistency CHN e.g., Everyone who drank the contaminated camp water got sick

– strength CHN e.g., People who drank the most water got the most sick

– specificity CHN e.g., Giardia parasites in the water made people sick with an enteric illness Influenza virus in the

water would not make people sick with an enteric illness

– time relationship CHN e.g., A person can’t get influenza until after exposure

to the virus

– congruence (coherence) CHN e.g., Since influenza can be transmitted through mucous membrane exposure, a

person whose hands are contaminated with influenza virus and who rubs her

eyes with her hands is more likely to

get sick than someone does not touch her face with her hands

– sensitivity CHN e.g., The greater the discrimination between those who got sick from eating raw meat and those

who got sick from eating cooked meat, the greater the sensitivity to the

disease being spread through raw meat

– biological/medical CHN e.g., A child who plays with a child with chickenpox

is more likely to get sick than one who

plays with a child who is not sick

– plausibility CHN e.g., Research has demonstrated that moderate exercise may be more helpful to prevent cardiac

disease

– experiments and research CHN e.g., Replicated studies over time add to the weight of evidence that smoking

causes lung cancer

– analogy factors (transfer of knowledge) CHN e.g., It is reasonable to develop

a vaccine for the serotypes of HPV

that cause cervical cancer, since other specific viruses have successfully

been prevented through vaccination

– strength of association-Exposure to a specific stressor or cause is most likely

to bring on the disease

– dose-response-Persons who are most exposed to the contaminated food (e.g., ate the most) are the most ill

– specificity-The cause is linked to a specific disease (e.g.,

Mycobacterium tuberculosis does not result in

chickenpox)

– consistency-Everyone who eats contaminated food gets the illness If other food

in another time and place is

contaminated with the same bacteria, the same illness occurs

– biologic plausibility-Consistent with the biologic/medical knowledge that

is known (new discoveries may precede

Physical—weather (e.g., meningitis typically occurs in late winter or early spring) Biological—microorganism (e.g., Neisseria meningitidis)

Social—housing (e.g., young people living in close quarters)

Mode of transmission: spread by droplet from mouth and nose usually through coughing, sneezing, or kissing

Incorrect: Susceptibility is described as vulnerability, which determines the

individual host response

Incorrect: Biologic plausibility is a causation criterion used to assess a causal relationship between a stimulus and

the occurrence of a disease

Incorrect: Nosology is a branch of medicine that deals with classification

of diseases

Correct: This is the definition of epidemiology

Hints:

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Stamler/Yiu: Community Health

Correct: This is an age-appropriate primary prevention strategy that would

promote health during the

prepathogenesis period in the natural history of disease

Incorrect: Providing antimicrobial medications is a secondary prevention activity Incorrect: Screening is a secondary prevention activity and STI testing would be

better suited for the adolescent

Incorrect: Crude mortality rate is determined by total deaths from any cause in

a given year in a population divided

by average total population for the same year

Incorrect: Prevalence is the number of people with a given disease in a

population at one point in time

Correct: Proportional mortality is the number of deaths from a specific cause in

a given population for a particular

time period and is compared with the total number of deaths in that

same population and time period

Incorrect: Another mortality statistic is PYLL, which has arisen from the

assumption that a person who dies early in

life has lost greater potential than has a person who dies much later in

life Hints:

Name: Date: Course:

Stamler/Yiu: Community Health

of people who have the disease, thus answering the proposed question

Incorrect: Incidence describes the identification of new cases of a disease in a

population over time

Incorrect: Relative risk answers the question, ―Are some populations more at risk

Incorrect: The relative risk is less than 1.0 (e.g., 0.05); therefore, the given

risk factor is probably not significant for

the resulting asthma

Incorrect: If the relative risk ratio is

Incorrect: If the resulting number is 1.0, it means that both groups have the

same risk of the health problem, and

most likely the risk factor in question makes little or no difference

Correct: If the resulting number is >1.0, it indicates that the risk in the exposed group is higher than the risk in the

unexposed group, and the risk factor in question is at least one of the significant risk factors for the problem or

disease

Hints:

Name: Date: Course:

Stamler/Yiu: Community Health

Incorrect: This question provides information on point prevalence

Correct: This is the best question to obtain information on period prevalence Incorrect: This is an example of getting information on cumulative or lifetime incidence

Incorrect: This question does not provide information on period prevalence Hints:

and implementing interventions or to measure change

Incorrect: In case-control studies, the individuals in the group with the disease are matched with individuals who are

similar in some characteristics (e.g., age, gender, time, geographic residence)

but who have not manifested the

disease in question

Incorrect: In cohort studies, the researcher examines the individual histories of

a group of people manifesting a

particular disease to find out what common factors they share and what differences can be discerned

Incorrect: In a randomized control design, individuals are assigned randomly

either to a group that receives the new

treatment or to a group that does not receive the new treatment The latter is known

as the control group After a

period of time, specific variables are measured in each group and

compared Hints:

Name: Date: Course:

Stamler/Yiu: Community Health

Incorrect: Consent ensures voluntary participation of the research subject but

does not guarantee privacy

Incorrect: Ethics approval must be sought for any study where data are

collected about or from humans, but this is

not a strategy for ensuring participant privacy

Incorrect: Data used in a confidential manner is important, but this is not the best