Chapter 10: Environmental Health Nursing School Test Banks

Stanhope: Public Health Nursing, 8th Edition

Chapter 10: Environmental Health

Test Bank

MULTIPLE CHOICE

1. Why is it important for nurses to understand the premises of environmental health?
a. Nurses should be able to assess risks and advocate for policies that support healthy environments.
b. Toxicologists often consult nurses about environmental pollutants.
c. Pollutant exposures such as lead are reported by nurses to the Environmental Protection Agency.
d. Many Americans live in areas that do not meet current national air quality standards.
ANS: A
Potential risks to health are concerns for professional nurses. It is the responsibility of the nurse to understand as much as possible about these risks: how to assess them, how to eliminate/reduce them, how to communicate and educate about them, and how to advocate for policies that support healthy environments.

DIF: COG: Understanding REF: 217 OBJ: 1

2. Environmental health is important to nurses because chemical, biological, and radiological materials are:
a. A major cause of global warming
b. Often found in the air, water, and products we use
c. Frequently linked to the development of chronic illnesses
d. Products that nurses work with on a daily basis
ANS: B
Chemical, biological, and radiological pollutants are often found in the air we breathe, the water we drink, and the products we use.

DIF: COG: Understanding REF: 219 OBJ: 1

3. How have nurses historically learned to identify a possible relationship between environmental chemical exposures and their potential harm?
a. Extrapolation by toxicologists
b. Biomonitoring
c. Completing chemistry courses
d. Observing signs and symptoms in clients
ANS: D
Nurses have historically made discoveries related to chemical exposure when people presented with signs and symptoms related to known chemical toxicity. The first two options are modern methods.

DIF: COG: Understanding REF: 221 OBJ: 1

4. The basic science applied to understanding the health effects associated with chemical exposures is:
a. Toxicology
b. Pharmacology
c. Chemistry
d. Environmental epidemiology
ANS: A
Toxicology is the study of the health effects associated with chemical exposures.

DIF: COG: Remembering REF: 221 OBJ: 2

5. Epidemiology:
a. Is a science that studies the poisonous effects of chemicals
b. Explains the association between learning disabilities and exposure to lead-based paint at the cellular level
c. Helps nurses understand the strength of the association between exposure and health effects
d. Is a method for tracking the prevalence of a disease
ANS: C
Epidemiology studies the incidence and prevalence of disease, helping nurses understand the strength of the association between exposure and health effects.

DIF: COG: Understanding REF: 222 OBJ: 2

6. A public health nurse is working with a migrant farm worker who has experienced an exposure to a pesticide. When researching pesticides, the nurse looks at the family of the chemical. What similarities are found among chemicals that have been placed in the same family?
a. Route of entry into the body
b. Actions and associated risks
c. Effects that they have on the body
d. Potency and toxicity
ANS: B
Chemicals are grouped so its possible to understand the actions and risks associated with each group.

DIF: COG: Applying REF: 222 OBJ: 2

7. A public health nurse is organizing a multidisciplinary team to address the issue of water pollution in the community. The most likely members that would be invited to address this issue would be:
a. Physicians, water sanitation workers, and occupational therapists
b. Pharmacologists, radiologists, and epidemiologists
c. Nurse practitioners, pharmacologists, and environmentalists
d. Geologists, meteorologists, and chemists
ANS: D
Scientists who study how pollutants travel in air, water, and soil are geologists, meteorologists, and chemists.

DIF: COG: Analyzing REF: 223 OBJ: 2

8. Which example contains the components necessary to form an epidemiologic triangle?
a. Pesticides, water, food
b. Lead, mercury, soil
c. Trichloroethylene, water, infants
d. Children under 12, elderly, temperature
ANS: C
The epidemiologic triangle consists of an agent (chemical), host (community consisting of several variants), and environment (air, water, soil, etc.).

DIF: COG: Evaluating REF: 222 OBJ: 2

9. An example of a point source of air pollution is:
a. A smoke stack
b. The number of cars and trucks
c. How much fossil fuel is consumed in a community
d. Ground ozone levels
ANS: A
Point sources of pollution are identifiable sources of air pollution, such as a smoke stack.

DIF: COG: Applying REF: 225 OBJ: 3

10. Which is considered a nonpoint source of pollution?
a. Hazardous waste site
b. Animal waste from wildlife
c. Chlorine poured down a well
d. Stagnant water
ANS: B
Point source means a single place from which the pollutant is released into the environment, whereas nonpoint source implies a more diffuse source of pollution.

DIF: COG: Applying REF: 228 OBJ: 3

11. If a nurse wanted more information on indoor air quality, which website would be most helpful?
a. The National Institutes of Health (NIH)
b. The American Lung Association
c. Right to Know
d. The Occupational Safety and Health Administration (OSHA)
ANS: B
Sources of information about air quality include the Environmental Protection Agency (EPA) and the American Lung Association.

DIF: COG: Applying REF: 226 OBJ: 3

12. 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. Present work
b. Potential exposures
c. Personal protective equipment use
d. Problems with health
ANS: A
Present work is the first P.

DIF: COG: Applying REF: 225 OBJ: 3

13. A nurse fulfills the environmental health competency of assessment and referral when:
a. Advocating for public policy changes
b. Understanding policy framework and major pieces of legislation
c. Completing an environmental health history
d. Describing the scientific principles about environmental health
ANS: C
Assessment is always an important element of the nursing process. The third option is an example of the assessment phase of the nursing process.

DIF: COG: Analyzing REF: 220 OBJ: 3

14. The greatest single source of air pollution in the United States is from:
a. Waste incineration
b. Power plants
c. Motor vehicles
d. Molds
ANS: C
Waste incineration and power plants are major contributors after motor vehicles. Molds contribute to poor indoor air quality.

DIF: COG: Remembering REF: 225 OBJ: 4

15. Which environmental law sets basic structure for regulating pollutants to United States waters?
a. Safe Drinking Water Act
b. Toxic Substance Control Act
c. Clean Water Act
d. Pollution Prevention Act
ANS: C
The Clean Water Act sets basic structure for regulating pollutants to United States waters.

DIF: COG: Remembering REF: 235 OBJ: 4

16. Employees working with hazardous chemicals have the right to know about the chemicals they are working with through the creation of the:
a. Material Safety Data Sheet
b. Consumer Confidence Report
c. Hazard Communication Standard
d. Environmental Protection Agency
ANS: C
This standard requires employers to maintain a list of all hazardous chemicals that are used on site.

DIF: COG: Understanding REF: 227 OBJ: 4

17. A nurse is addressing the problem of air pollution in the community. The first step in the process of controlling the pollution would be:
a. Setting standards
b. Monitoring
c. Permitting
d. Compliance
ANS: C
Permitting is a process by which the government places limits on the amount of pollution emitted into the air or water.

DIF: COG: Applying REF: 234 OBJ: 4

18. An acceptable level of emissions or a maximum contaminant level allowed is an example of which environmental protection strategy?
a. Controlling pollution
b. Waste minimization
c. Land use planning
d. Environmental standard
ANS: D
An example of an environmental standard is an acceptable level of emissions or a maximum contaminant level allowed.

DIF: COG: Applying REF: 234 OBJ: 4

19. An inspection of a facility after a permit is obtained for the purpose of observing whether the plans submitted in the permit application are being implemented as approved is an example of which environmental protection strategy?
a. Controlling pollution
b. Waste minimization
c. Land use planning
d. Environmental monitoring
ANS: D
Environmental monitoring would be an inspection of a facility after a permit is obtained to observe whether the plans submitted in the permit application are being implemented as approved.

DIF: COG: Applying REF: 234 OBJ: 4

20. Which question would a nurse ask during the first phase of a risk assessment?
a. Has the chemical been released into the environment?
b. How much and by which route of entry can the chemical enter the body?
c. Is the chemical known to be associated with a negative health effect?
d. What is the prediction for potential harm?
ANS: C
The first phase is determining if a chemical is known to be associated with negative health effects (in animals or humans).

DIF: COG: Evaluating REF: 228 OBJ: 5

21. What action can a nurse take on an individual level to reduce pollution in the environment?
a. Provide a tax incentive to factories that do not pollute.
b. Make laws related to allowed levels of pollution in the area.
c. Choose a less-polluting car.
d. Move to an area with less pollution.
ANS: C
Citizens can reduce air pollution by doing their part, which can include choosing less-polluting cars.

DIF: COG: Applying REF: 232 OBJ: 6

22. When would it be appropriate for a nurse to use a Geographic Information System (GIS)?
a. Recording client data collected at a foot clinic
b. Determining neighborhoods that have an increased incidence of lead poisoning
c. Evaluating effectiveness of a farm safety program
d. Scheduling health promotion programs in the community
ANS: B
The use of a Geographic Information System (GIS) allows the public health nurse to apply the principles of epidemiology into practice. GIS allows nurses to code data so that it is related spatially to a place on earth and is helpful in determining concentrated areas for incidence of disease and illness.

DIF: COG: Analyzing REF: 222 OBJ: 6

MULTIPLE RESPONSE

1. Which approach(s) can a nurse use when assessing environmental health risks? Select all that apply.
a. Ask legislators to provide a list of environmental pollutants in the area.
b. Develop a list of exposures associated with urban, rural, or suburban settings.
c. Assess the risk by medium such as air, water, soil, or food.
d. Divide the environment into functional locations: home, school, workplace, and community.
ANS: B, C, D
The 2nd, 3rd, and 4th options are ways a nurse can assess the environment.

DIF: COG: Applying REF: 223 OBJ: 3

2. A public health nurse working with a family living in poverty recognizes that they are more likely to be exposed to environmental hazards because they have (select all that apply):
a. Limited funds to pay for health care
b. Poor nutrition
c. Homes located closer to hazardous waste sites
d. Less education
ANS: A, B, C
Families living in poverty are more likely to experience environmental justice issues such as disproportionate environmental exposures. Sub-standard housing, living closer to hazardous waste sites, working in more hazardous jobs, poorer nutrition, and less access to quality health care all contribute to this issue. Although limited education is related to poverty, it is not discussed as causing an increase in environmental exposure.

DIF: COG: Applying REF: 220 OBJ: 6

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