ch. 3
John Snow, considered the founder of epidemiology, realized the source of the London’s cholera epidemic through:
Developing a frequency distribution of deaths.
When comparing the body mass index (BMI) of obese women in two cities, John found that the average BMI of City A was higher than that of City B. However, when he concluded that a woman in City A will have a higher BMI than a woman in City B, his conclusion was an example of __________
An ecological fallacy.
John has just taken a job as a PHN at the local public health department in a high-income county adjacent to a large metropolitan area. He has been asked to work with the team that does outbreak investigations and conducts surveillance. John has also assumed responsibility for surveillance of sexually transmitted infections (STIs). The primary purpose of surveillance of STIs at the local public health department is to be able to:
Identify a possible rise in cases above the endemic level and take action.
The state public health department has been tracking syphilis, as mandated by the Centers for Disease Control and Prevention, with little change in the incidence rate over time. Recently, however, incidence rates indicate they may have an outbreak. They deploy health-care professionals, including nurses, to further investigate beginning with a review of medical records. The first type of surveillance conducted is an example of _______________ surveillance and the second type of surveillance conducted is an example of______________ surveillance.
Passive and active
When a PHN collects data on a group using existing records and can immediately analyze the data this is a?
retrospective cohort study
The history and development of epidemiology has gone through several developmental phases. The nursing student learns that these phases came about in history in what order?
Sanitary phase, infectious disease phase, and risk factor phase
To better understand the risk factors for the high prevalence of asthma in her school, the school nurse gets approval to send out an anonymous survey to the parents. She is seeking preliminary data on how many of the students who may have asthma are exposed to secondary smoke. Questions for the parents include information about their children’s history of asthma and whether anyone living in the home smokes. Which study design best describes her study?
Cross-sectional study
John has just taken a job as a PHN at the local public health department in a high-income county adjacent to a large metropolitan area. He has been asked to work with the team that does outbreak investigations and conducts surveillance. There has been an outbreak of measles in the county that his public health department serves. John was asked to put together an alert to parents related to the outbreak. What is one aspect of this type of outbreak that presents substantial challenges to persons working in a local public health department like John’s?
Person-to-person transmission
A local health department reports that there are 1,375 smokers in a town of 5,000. Of these smokers, 536 have reported that they have influenza. What percent of smokers have influenza? Round your answer to the nearest whole percent. ____________________
39%
A case-control study helps determine the odds ratio of a disease occuring based on a risk factor * TRUE OR FALSE
TRUE
A public health nurse (PHN) is asked by the hospital administration to find out why there are so many pediatric asthma patients coming to the emergency department (ED) for treatment and to develop a plan to reduce admissions by 10%. The PHN knows the first step, prior to developing an intervention, is to understand the multiple risk factors involved. Which framework would best help the PHN understand the multiple risk factors contributing to asthma in this population?
The web of causation
A control or “no disease” group is needed for study on risk factors associated with oral cancer. The nurses conducting the study decide to use a group of patients with skin cancer as their controls because these patients are at the same facility. Having another type of cancer could itself be a risk factor and is a potential limitation in the study. This variable, having another type of cancer, would be called a(n):
Confounder
A young couple with a family history of cystic fibrosis meets with a nurse to ask about preconception testing using genetic markers for early identification of the disease to help them make childbearing decisions. The area of study that has helped health-care providers and families answer these questions is called:
Genomics
A PHN is studying the rate of H1N1 in the community. If there are five cases of H1N1 in the community of 1,000 people, what is the prevalence rate? ____________________
5 per 1,000
The study that follows a specific population, subset of population, or group over a specific period of time is a?
cohort study
Jane works for the public health department with the primary job of conducting outbreak investigations. There has been a recent outbreak of hepatitis A. She has collected data on the number of new cases among the contacts of initial (primary) cases, divided it by the number of people in the population at risk, and then multiplied it by a given multiplier. She is calculating the:
Secondary attack rate
An epidemiologist uses the epidemiological triangle to explain the occurrence of disease by looking at the three main components of the model: the host, the environment, and the agent. The PHN understands that the agent could be one of many types except:
Ecological.
In a large urban public health department (PHD), Sam, the PHD’s epidemiologist, is concerned about upward trends related to type 2 diabetes over the past 5 years. To help identify the key risk factors, Sam begins to examine three categories of risk central to epidemiology. These categories include all of the following except:
Prevalence
Renee, a nurse working in a primary care clinic, is conducting a physical assessment of Adam, age 42, who reports multiple medical issues. Renee is concerned and wonders what might explain his poor health. During this visit, she asks Adam about his work history and discovers that he is working in a chemical plant. This information is not sufficient to a direct causal link between possible workplace exposure to toxins and his current medical issues because: (Select all that apply.)
- The patient has medical problems that could be caused by lifestyle decisions rather than by working in the plant.
- Even if Adam has been exposed to toxic substances, the threshold required to have adverse or fatal consequences might not have been reached.
John Snow, "founder of epidemiology", realized the source of the London's cholera epidemic through?
Developing a frequency distribution of deaths
A public health nurse is comparing the prevalence of type 2 diabetes in two counties in Ohio. From an epidemiological perspective these are:
Independent rates.
John has just taken a job as a PHN at the local public health department in a high-income county adjacent to a large metropolitan area. He has been asked to work with the team that does outbreak investigations and conducts surveillance. As part of John’s work in outbreak investigations, which three precipitating factors, also known as the epidemiological constants, should he consider to help guide these investigations?
Person, place, and time
Yin is a nurse in a rural primary care clinic. One of the issues that has arisen is how to address patients who come in asking about testing for BRCA1 and BRCA2, the tumor suppressing genes that, if mutated, may indicate hereditary breast and ovarian cancer. Yin reads up on the issue and tells her colleagues that there are arguments against genetic testing for BRCA1 and BRCA2 that include all of the following except:
The test is difficult to perform.
A PHN recognizes that which of the following are types of cohort studies? (Select all that apply.)
Prospective
Retrospective
Historical
Longitudinal
The development of epidemiology has gone through several phases. In what order did these phases develop?
Sanitary phase, infectious dieseas phase, risk factor phase