Chap 15
A community health nurse is teaching nursing students about emerging and reemerging infectious diseases. Which situation best represents a reemerging infectious disease?
A. A newly identified infectious disease appears in a population.
B. A previously declining infectious disease begins increasing in a community.
C. An infectious disease remains at a stable rate over several years.
D. A noninfectious chronic illness becomes more common.
Correct Answer: B. A previously declining infectious disease begins increasing in a community.
Rationale: A reemerging infectious disease is a known infectious disease that has previously declined but is now increasing in incidence within a particular geographic area or population. Examples discussed in Chapter 15 include tuberculosis and measles.
A community health nurse visits a family living in an older home with peeling paint. The parents are concerned that their 2-year-old may have been exposed to lead. Which action should the nurse take first?
A. Recommend that the family immediately move to another home.
B. Assess the child's potential exposure by obtaining a detailed environmental exposure history.
C. Instruct the parents to remove all peeling paint themselves.
D. Reassure the parents that lead exposure is unlikely unless symptoms are present.
Correct Answer: B. Assess the child's potential exposure by obtaining a detailed environmental exposure history.
Rationale: The nurse's first action is to assess the child's potential environmental exposure. Chapter 19 emphasizes obtaining an exposure history that includes the home environment, possible contaminants, and exposure concerns. Young children are particularly vulnerable because their body systems are developing and their behaviors can increase contact with contaminants.
An occupational health nurse is developing a workplace injury prevention program at a manufacturing facility. Which action should the nurse take first?
A. Implement a mandatory employee exercise program.
B. Conduct an assessment of both the workers and the workplace environment.
C. Distribute educational materials about workplace injuries.
D. Evaluate employee satisfaction with existing wellness programs.
Correct Answer: B. Conduct an assessment of both the workers and the workplace environment.
Rationale: The occupational health nursing process begins with a comprehensive assessment of both the worker and the workplace. This assessment helps the nurse identify occupational hazards, worker characteristics, and potential health risks before developing interventions.
Select all that apply
A public health nurse is investigating an increase in emerging infectious diseases. Which factors may contribute to this increase? Select all that apply.
A. Increased international travel
B. Microbial adaptation and change
C. Changes in climate and ecosystems
D. Breakdown of public health infrastructure
E. Improved access to routine vaccinations
Correct Answers: A, B, C, D
Select all that apply
A public health nurse is evaluating possible chemical contamination near a residential neighborhood. Which components are necessary when assessing an environmental exposure pathway? Select all that apply.
A. Source of contamination
B. Environmental media and transport mechanisms
C. Point and route of exposure
D. Receptor population
E. Confirmation that every exposed person has developed an illness
Correct Answers: A, B, C, D (Select All That Apply)
Rationale: Chapter 19 identifies five components of an environmental exposure pathway: source of contamination, environmental media and transport mechanisms, point of exposure, route of exposure, and receptor population. All must be considered when determining whether an exposure pathway is complete.
Select all that apply
An occupational health nurse is assessing potential workplace hazards. Which findings represent occupational health hazards? Select all that apply.
A. Exposure to infectious microorganisms
B. Contact with hazardous chemicals
C. Excessive workplace noise
D. Chronic job-related stress
E. Participation in a voluntary employee wellness program
Correct Answers: A, B, C, D
Rationale: Chapter 25 identifies biologic, chemical, physical, and psychosocial hazards as important occupational health concerns. Occupational health nurses assess these hazards to identify risks and develop prevention strategies.
A nurse working in a community clinic notices an increase in measles cases among unvaccinated children. Which intervention should the nurse prioritize to reduce future outbreaks?
A. Encourage routine vaccination according to recommended schedules.
B. Recommend antibiotics to all children exposed to measles.
C. Advise families to avoid all outdoor activities.
D. Wait until additional cases occur before educating families.
Correct Answer: A. Encourage routine vaccination according to recommended schedules.
Rationale: Measles is a highly contagious, vaccine-preventable infectious disease. Routine immunization is one of the most effective strategies for preventing outbreaks. Nurses play an essential role in educating families, addressing vaccine concerns, and promoting immunization.
A nurse is developing an intervention for a community with suspected contaminated drinking water. Which intervention best demonstrates the primary goal of environmental health nursing?
A. Provide educational brochures without assessing the contamination.
B. Implement measures to interrupt the exposure pathway between the contaminant and community residents.
C. Wait until residents develop symptoms before intervening.
D. Focus only on treating individuals who become ill.
Correct Answer: B. Implement measures to interrupt the exposure pathway between the contaminant and community residents.
Rationale: Chapter 19 emphasizes that environmental health interventions are most often designed to interrupt or break an exposure pathway. By preventing or reducing contact with a contaminant, nurses can help protect community members from potentially harmful exposures.
A nurse employed at an industrial facility identifies repeated employee exposure to hazardous chemicals. The employer requests information about federal agencies involved in occupational safety. Which statement by the nurse is correct?
A. NIOSH is responsible for enforcing workplace safety regulations.
B. OSHA conducts all occupational health research and does not enforce standards.
C. OSHA establishes and enforces workplace safety standards, while NIOSH conducts occupational safety and health research.
D. OSHA and NIOSH have identical responsibilities.
Correct Answer: C. OSHA establishes and enforces workplace safety standards, while NIOSH conducts occupational safety and health research.
Rationale: Chapter 25 distinguishes the responsibilities of these two federal agencies. OSHA is responsible for workplace safety and health standards and enforcement. NIOSH conducts scientific research, gathers occupational health information, and provides education and training to improve worker safety.
A hospitalized patient has an infection caused by carbapenem-resistant Enterobacteriaceae (CRE). Which nursing action is most appropriate to help prevent transmission?
A. Administer antibiotics to every patient on the unit.
B. Use appropriate infection prevention precautions, including hand hygiene.
C. Discontinue infection prevention precautions when the patient is afebrile.
D. Encourage visitors to share personal care items with the patient.
Correct Answer: B. Use appropriate infection prevention precautions, including hand hygiene.
Rationale: Carbapenem-resistant Enterobacteriaceae (CRE) are antibiotic-resistant bacteria identified in the PowerPoint as an urgent public health threat.
Nursing interventions to prevent transmission include appropriate hand hygiene, use of indicated personal protective equipment, adherence to contact precautions when required, and proper cleaning and disinfection of equipment.
A nurse is assessing a community where low-income families live near several potential environmental hazards. Which nursing action best demonstrates the principle of environmental justice?
A. Provide environmental health services only to residents with diagnosed illnesses.
B. Recommend that families relocate without considering financial resources.
C. Advocate for equitable environmental protections and access to health resources for all residents.
D. Prioritize neighborhoods with greater financial resources.
Correct Answer: C. Advocate for equitable environmental protections and access to health resources for all residents.
Rationale: Environmental justice means that no population should bear a disproportionate share of negative environmental health consequences because of race, culture, or income. Nurses promote environmental justice by advocating for equitable protections, access to resources, and opportunities for community participation.
An occupational health nurse is functioning in the researcher role and wants to determine whether a new workplace safety program has reduced occupational injuries. Which research approach would provide the most useful evidence?
A. Compare the number of new occupational injuries before and after implementation of the safety program, accounting for the number of workers at risk and the observation period.
B. Ask the employer whether the program appears successful.
C. Review only the total number of employees currently experiencing chronic health conditions.
D. Determine how many employees attended the safety education sessions without examining injury outcomes.
Correct Answer: A. Compare the number of new occupational injuries before and after implementation of the safety program, accounting for the number of workers at risk and the observation period.
Rationale: Chapter 25 identifies research as one of the roles of the occupational health nurse and emphasizes epidemiologic surveillance as a method of studying occupational injuries and illnesses.
Following an outbreak of a novel respiratory infection, a community hospital experiences a sudden increase in patients requiring care. Which action should the nurse leader prioritize?
A. Suspend communication with public health officials.
B. Focus exclusively on the hospital's financial losses.
C. Assess staffing, supplies, and capacity to respond to increased patient needs.
D. Delay infection prevention education until the outbreak ends.
Correct Answer: C. Assess staffing, supplies, and capacity to respond to increased patient needs.
Rationale: Epidemics and pandemics can place sudden and intense demands on healthcare systems. Nurse leaders must assess available resources, including staffing, personal protective equipment, supplies, and patient care capacity.
Select all that apply
A community health nurse has implemented an intervention to reduce exposure to an environmental contaminant. Which findings indicate that the intervention has been effective? Select all that apply.
A. The exposure pathway has been interrupted.
B. Community members report satisfaction with the intervention.
C. Health outcomes have improved.
D. The intervention can be sustained over time.
E. The intervention was implemented without evaluating its results.
Correct Answers: A, B, C, D (Select All That Apply)
Rationale: Chapter 19 identifies several important measures for evaluating environmental health interventions, including whether the exposure pathway has been interrupted, community satisfaction, improvements in health, the number of people affected, potential cost savings, and sustainability.
An occupational health nurse is evaluating a workplace health promotion program designed to reduce musculoskeletal injuries. Which finding best demonstrates that the program has achieved its intended outcome?
A. All employees received educational materials about injury prevention.
B. The employer approved additional funding for the program.
C. The number of newly reported musculoskeletal injuries per 100 workers decreased over the evaluation period.
D. Employees expressed interest in future wellness activities.
Correct Answer: C. The number of newly reported musculoskeletal injuries per 100 workers decreased over the evaluation period.
Rationale: Evaluation determines whether a workplace health promotion program achieved its intended outcomes. Because the goal of this program is to reduce musculoskeletal injuries, a reduction in new injuries provides a measurable indicator of effectiveness.
Using the number of new injuries per 100 workers allows the occupational health nurse to compare injury occurrence across evaluation periods, assuming comparable definitions and observation periods.