Chapter 12: Epidemiology Nursing School Test Banks

Stanhope: Public Health Nursing, 8th Edition

Chapter 12: Epidemiology

Test Bank

MULTIPLE CHOICE

1. The factors, exposures, characteristics, and behaviors that determine patterns of disease are described using:
a. Descriptive epidemiology
b. Analytic epidemiology
c. Distribution
d. Determinants
ANS: D
Determinants may be individual, relational, social, communal, or environmental.

DIF: COG: Remembering REF: 255-256 OBJ: 1

2. To understand the causes of health and disease, epidemiology studies:
a. Individuals
b. Families
c. Groups
d. Populations
ANS: D
Epidemiology monitors health of populations, understands determinants of health and disease in communities, and investigates and evaluates interventions to prevent disease and maintain health.

DIF: COG: Understanding REF: 255 OBJ: 1

3. When a nurse examines birth and death certificates during an epidemiologic investigation, what data category is being used?
a. Routinely collected data
b. Data collected for other purposes but useful for epidemiologic research
c. Original data collected for specific epidemiologic studies
d. Surveillance data
ANS: A
These are examples of data collected routinely.

DIF: COG: Applying REF: 271 OBJ: 1

4. An epidemiologist wanting to know what caused severe diarrhea and vomiting in several people at a local banquet would be using:
a. Descriptive epidemiology
b. Analytic epidemiology
c. Distribution
d. Determinants
ANS: B
Analytic epidemiology is directed toward understanding the etiology of the disease.

DIF: COG: Applying REF: 256 OBJ: 1

5. Which is an example of an epidemic?
a. Bird flu in China
b. Adult obesity in the United States
c. An isolated case of smallpox in Africa
d. The nursing shortage in the United States
ANS: B
It is estimated that 30% of the adults in the United States are obese. According to the CDC, this is an epidemic.

DIF: COG: Applying REF: 256 OBJ: 1

6. John Snow is called the father of epidemiology because of his work with:
a. Cholera
b. Malaria
c. Polio
d. Germ theory
ANS: A
John Snow investigated the spread of cholera in the mid-nineteenth century.

DIF: COG: Remembering REF: 257 OBJ: 2

7. The interaction between an agent, a host, and the environment is called:
a. Natural history of disease
b. Risk
c. Web of causality
d. The epidemiologic triangle
ANS: D
The epidemiologic triangle consists of the interaction between an agent, a host, and the environment.

DIF: COG: Remembering REF: 264 OBJ: 3

8. Public health professionals refer to three levels of prevention as tied to specific stages in the:
a. Epidemiologic triangle
b. Web of causation
c. Natural history of disease
d. Surveillance process
ANS: C
The natural history of disease is the course of the disease process from onset to resolution. The three levels of prevention provide a framework commonly used in public health practice to depict this process.

DIF: COG: Understanding REF: 265 OBJ: 3

9. Which is an example of an agent in the epidemiologic triangle?
a. Human population distribution
b. Salmonella
c. Genetic susceptibility
d. Climate
ANS: B
An agent includes infectious organisms.

DIF: COG: Applying REF: 265 OBJ: 3

10. When studying chronic disease, the multifactorial etiology of illness is considered. What does this imply?
a. Genetics and molecular structure of disease is paramount.
b. Single organisms that cause a disease, such as cholera, must be studied in more detail.
c. Focus should be on the factors or combinations and levels of factors contributing to disease.
d. The recent rise in infectious disease is the main focus.
ANS: C
Multifactorial etiology implies a focus on combinations and levels of factors.

DIF: COG: Applying REF: 257 OBJ: 3

11. Immunization for measles is an example of:
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Health promotion
ANS: A
Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

DIF: COG: Applying REF: 266 OBJ: 4

12. Screening for hearing defects is an example of:
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Health promotion
ANS: B
Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

DIF: COG: Applying REF: 267 OBJ: 4

13. Vocational rehabilitation of a person with a neuromuscular disease is an example of:
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Health promotion
ANS: C
Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

DIF: COG: Applying REF: 267 OBJ: 4

14. An example of primary prevention is:
a. Pap smear
b. Blood pressure screening
c. Diet and exercise
d. Physical therapy
ANS: C
Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

DIF: COG: Analyzing REF: 265-266 OBJ: 4

15. An example of secondary prevention is:
a. Rehabilitation
b. Avoidance of high-risk behaviors
c. Immunization
d. Mammogram
ANS: D
Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

DIF: COG: Analyzing REF: 267 OBJ: 4

16. An example of tertiary prevention is:
a. Rehabilitative job training
b. Parenting education
c. Testicular self-examination
d. Family counseling
ANS: A
Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

DIF: COG: Analyzing REF: 267 OBJ: 4

17. The probability an event will occur within a specified period of time is called:
a. Rate
b. Risk
c. Epidemiology
d. Epidemic
ANS: B
Risk is the probability an event will occur within a specified period of time.

DIF: COG: Remembering REF: 259 OBJ: 5

18. Which statement is true about mortality rates? Mortality rates:
a. Are informative only for fatal diseases
b. Provide information about existing disease in the population
c. Are calculated using a population estimate at year-end
d. Reveal the risk of getting a particular disease
ANS: A
Mortality rates are informative only for fatal diseases and do not provide direct information about the level of existing disease or the risk of getting a particular disease.

DIF: COG: Understanding REF: 262 OBJ: 5

19. A screening for diabetes revealed 20 previously diagnosed diabetics and 10 probable new cases, which were later confirmed, for a total of 30 cases. This is called:
a. Prevalence
b. Incidence
c. Attack
d. Morbidity
ANS: A
Prevalence is the measure of existing disease in a population at a particular time.

DIF: COG: Applying REF: 261-262 OBJ: 5

20. An example of an attack rate is the:
a. Number of cases of cancer recorded at a medical center
b. Number of people who died of cholera in India in a given year
c. Number of beef cattle inoculated against mad-cow disease on a farm
d. Proportion of people becoming ill after eating at a fast-food restaurant
ANS: D
Attack rates are often specific to exposures, such as food-specific attack rates.

DIF: COG: Analyzing REF: 262 OBJ: 5

21. Which would be considered a serious epidemic of influenza?
a. 50 cases
b. 100 cases
c. 500 cases
d. Unable to determine
ANS: D
One cannot tell the degree of seriousness without a denominator, which represents the total population.

DIF: COG: Evaluating REF: 257 OBJ: 5

22. The most important predictor of overall mortality is:
a. Race
b. Age
c. Gender
d. Income
ANS: B
The mortality curve by age drops sharply during and after the first year of life to a low point in childhood, then begins to increase through adolescence and young adulthood and then increases sharply through middle and older ages.

DIF: COG: Understanding REF: 273 OBJ: 6

23. An outbreak of a gastrointestinal illness from a food-borne pathogen is an example of a(n):
a. Attack rate
b. Point epidemic
c. Secular trend
d. Event-related cluster
ANS: B
One temporal and spatial pattern of disease distribution is the point epidemic. A point epidemic is most clearly seen when the frequency of cases is plotted against time. The sharp peak characteristic of such graphs indicates a concentration of cases in some short interval of time.

DIF: COG: Applying REF: 274 OBJ: 6

24. A study that uses information on current health status, personal characteristics, and potential risk factors or exposures all at once is called:
a. Cross-sectional
b. Ecological
c. Case-control
d. Cohort
ANS: A
A cross-sectional study collects information on current health status, personal characteristics, and potential risk factors or exposures all at once.

DIF: COG: Remembering REF: 277 OBJ: 7

25. The type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome is a(n):
a. Case control study
b. Cross-sectional study
c. Cohort study
d. Experimental study
ANS: C
A cohort study is the type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome.

DIF: COG: Remembering REF: 275-276 OBJ: 7

26. Voters have recently decided to have fluoride added to the city water system. Epidemiologists wanting to study the effect of fluoride on dental caries would be conducting a(n):
a. Ecological study
b. Double-blind study
c. Community trial
d. Screening
ANS: C
This is similar to clinical trials, but the issue is often health promotion and disease prevention rather than treatment of existing disease.

DIF: COG: Applying REF: 279 OBJ: 7

27. The proportion of persons with positive test results who actually have a disease, interpreted as the probability that an individual with a positive test result has the disease, is the:
a. Sensitivity
b. Specificity
c. Positive predictive value
d. Negative predictive value
ANS: C
Positive predictive value refers to the proportion of persons with positive test results who actually have the disease, interpreted as the probability that an individual with a positive test result has the disease.

DIF: COG: Understanding REF: 270 OBJ: 8

28. A nurse is told that a screening test has high specificity. This means that the test:
a. Provides precise and consistent readings
b. Accurately identifies those with the condition or trait
c. Accurately identifies those without the trait
d. Has a high level of false positives
ANS: C
Specificity refers to the test accurately identifying those without the trait.

DIF: COG: Applying REF: 269 OBJ: 8

29. In which situation does the nurse need to be aware of the potential for selection bias?
a. Determining the population to be studied
b. Considering how the participants will enter the study
c. Studying cause and effect relationships
d. Documenting results of the study
ANS: B
Selection bias is attributable to the way subjects enter a study. It has to do with selection procedures and the population from which subjects are drawn.

DIF: COG: Applying REF: 279 OBJ: 9

30. As a result of an outbreak of influenza in a community, a nurse encourages members of the community to receive the influenza vaccine. Which level of prevention is being used?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Multifactorial prevention
ANS: A
Nurses are involved in epidemiologic surveillance by monitoring the potential for disease outbreaks. Primary prevention refers to interventions aimed at preventing the occurrence of disease, injury, or disability.

DIF: COG: Applying REF: 266-267|280 OBJ: 11

MULTIPLE RESPONSE

1. Epidemiologic studies of diseases conducted by nurses during the twentieth century were influenced by the (select all that apply):
a. Increasing rate of poverty
b. Declining child mortality rates
c. Overcrowding in major cities
d. Development of new vaccinations
ANS: B, D
Factors contributing to the development and application of epidemiologic methods in the twentieth century were: improved nutrition, new vaccines, better sanitation, the advent of antibiotics and chemotherapies, and declining infant and child mortality and birth rates. A rise in the standard of living occurred for many following the Great Depression and World War II.

DIF: COG: Applying REF: 257 OBJ: 2

2. Nurses incorporate epidemiology into their practice and function in epidemiologic roles through (select all that apply):
a. Policy making and enforcement
b. Collection, reporting, analysis, and interpretation of data
c. Environmental risk communication
d. Documentation on patient charts and records
ANS: B, C, D
The 2nd, 3rd, and 4th options are examples of the use of epidemiology in practice. The first option does not apply to epidemiology.

DIF: COG: Applying REF: 280 OBJ: 10

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