Test bank for community health nursing a canadian perspective 3rd edition by stamler

Give an example of where a CHN would apply each of the chosen Risk factor = low-fibre diet Disease = colorectal cancer... The proportion of a population that is affected by the disease a

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

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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

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

Name: Date: Course: Stamler/Yiu:

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?

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:

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:

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

(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

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?

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

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?

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

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

– 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 herpes

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

– 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

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

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

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

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

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

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

not a strategy for ensuring participant privacy

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

option for ensuring participant

exposure to the pathogen

Correct: This secondary prevention initiative is used to prevent the disease from occurring in vulnerable populations

by developing passive immunity

Incorrect: TB testing is a screening activity (secondary prevention) to identify students who have TB, but this activity

will not provide protection against the disease

Incorrect: This is a primary prevention activity completed prior to the girls being exposed to HPV

Incorrect: This is an example of direct transmission

Incorrect: This is an example of indirect transmission by droplet

Incorrect: Although water-borne is a type of indirect transmission, the influenza virus is not transmitted in this

Incorrect: Screening is a secondary prevention activity

Incorrect: Tamiflu is a treatment used to reduce the severity of the symptoms and

to speed up recovery time This

initiative, according to Figure 9.4, is secondary prevention

Correct: Attention to personal hygiene is an example of a primary prevention initiative

Incorrect: Completing assessments to identify complications from the flu is a screening activity, which is secondary

in the population, such as cancer,

heart disease, and liver failure

Incorrect: Health Reports is a peer-reviewed journal containing a variety of related articles

health-Incorrect: Statistics Canada produces data that help Canadians better understand

their country-its population,

resources, economy, society, and culture

Correct: This describes a prospective cohort study

Incorrect: This is the intent of a case series research methodology

Incorrect: Case-control studies are designed to compare two groups: one group has the disease and the other

group does not

Incorrect: This statement explains an experimental study design

Incorrect: This is a primary prevention activity

Incorrect: This initiative is an example of primary prevention

Incorrect: Health education is primary prevention

Correct: Tertiary prevention includes the treatment of disease as in the directly observed treatment (DOTs) program

Correct: The Framingham Heart Study was the first cohort study conducted in

1949

Incorrect: The Framingham Heart Study was not a case-control design

Incorrect: A case-series research methodology was not used in the Framingham Heart Study

Incorrect: This statement describes the term prevalence

Incorrect: A disease that occurs frequently and with predicted regularity within a population is endemic

Correct: This is a definition of incidence

Hints:

Name: Date: Course: Stamler/Yiu:

Community Health