Population and Community Health Nursing Clark 6E Test bank

Population and Community Health Nursing Clark  6E  Test bank
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Population and Community Health Nursing, 6e (Clark)
Chapter 3 Epidemiology and Population Health Nursing

1) After being diagnosed with cancer the patient tells the population health nurse that the disease is punishment from God. Which theory of disease causation is this patient using to explain the illness?
1. Environment.
2. Physical forces.
3. Specific organism.
4. Divine intervention.
Answer: 4
Explanation: 4. Theories about the cause of disease and ill health have evolved over time. The first recognized attempt to attribute a cause to illness occurred during the religious era. During this period, disease was thought to be caused directly or indirectly by divine intervention, possibly as punishment for sins or as a trial of faith. During Hippocrates time, the primary belief of disease was from harmful substances in the environment. Before the religious era, disease was often attributed to physical forces such as miasmas or mists. The belief that disease was caused by a specific organism was introduced in the late 1870s with the bacteriologic era.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Physiological Integrity
Cognitive Level: Analysis
Learning Outcome: 3-1

2) A patient diagnosed with a terminal illness asks why the disease developed when others who have less healthy lifestyle habits enjoy good health. Which theory of disease causation should the nurse use when responding to this patients enquiry?
1. Environment.
2. Divine intervention.
3. Single cause theory.
4. Multiple cause theory.
Answer: 4
Explanation: 4. The discovery of specific agents responsible for particular diseases did not explain why some people exposed to an agent developed the disease, while others did not. The result of this explanatory failure was the movement into the current era of multiple causation or the ecosocial perspective. The era of multiple causation is characterized by the recognition that multiple factors interact in the development of health or illness in a given person or population and that there is seldom one single cause. During Hippocrates time, the primary belief of disease was from harmful substances in the environment. During the religious era disease was thought to be caused directly or indirectly by divine intervention, possibly as punishment for sins or as a trial of faith. During the bacteriologic era specific organisms were identified as causative agents for specific diseases.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 3-1

3) The population health nurse is visiting the home of a family whose youngest child developed chickenpox after being exposed to a classmate with the same disease. Of which criterion for establishing a causal relationship is this situation an example?
1. Frequency.
2. Consistency.
3. Absolute risk.
4. Susceptibility.
Answer: 2
Explanation: 2. Consistency is the first criterion for establishing a causal relationship. This consistency must be between the supposed causal factor and its presumed effect. The condition in question must occur when the factor is present, not when it is absent. Frequency is not a criterion for establishing a causal relationship. Absolute risk is the probability that anyone in a given population will develop a particular condition. Susceptibility is the ability to be affected by factors contributing to a particular health condition.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Physiological Integrity
Cognitive Level: Analysis
Learning Outcome: 3-2

4) The population health nurse is trying to identify the causative relationship for a group of school students who developed viral meningitis. Which criterion must the nurse identify to prove causation for the development of the disease in these students?
1. Coherence.
2. Specificity.
3. Consistency.
4. Temporal relationship.
Answer: 4
Explanation: 4. Only the criterion of a correct temporal relationship is absolutely required for attributing causation. Temporal relationship is the time between the factor and the result condition. The factor thought to be causative should occur before the condition occurs. Coherence is the idea that one condition that causes another must be logical and should be congruent with other known facts. Specificity is present when the factor in question results in one specific condition. Consistency is when the condition in question occurs when the factor is present and not when it is absent.
Nursing/Int.Conc: Nursing Process: Diagnosis
Client Need: Physiological Integrity
Cognitive Level: Application
Learning Outcome: 3-2

5) The population health nurse notes that the number of cases of diabetes in a community remained stable during the last year. However in January, ten new diagnoses of diabetes were confirmed. What type of data is the nurse analyzing?
1. Incidence.
2. Morbidity.
3. Prevalence.
4. Case fatality rate.
Answer: 1
Explanation: 1. Incidence reflects the number of new cases of a particular condition identified during a specified period of time. Morbidity is the ratio of the number of cases of a disease or condition to the number of people in the population. Prevalence is the total number of people affected by a particular condition at a specified point in time. Case fatality rate is the percentage of persons who develop a health problem and who die as a result of it.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 3-4

6) The population health nurse is compiling childhood illness statistics and finds that the morbidity for chickenpox is higher for one neighborhood in comparison to the local county. What does this information mean to the nurse?
1. There are new cases of chickenpox in the neighborhood.
2. There are a larger percentage of children with chickenpox in the neighborhood.
3. A large group of children have been affected by chickenpox in the neighborhood.
4. There has been a rise in the number of children with chickenpox during a specified period of time in the neighborhood.
Answer: 4
Explanation: 4. Morbidity is the ratio of the number of cases of a disease or condition to the number of people in the population. The morbidity for chickenpox indicates the total number and new cases identified during and at a specified period of time. Incidence is the number of new cases alone. The percentage with chickenpox represents case rate. Prevalence is the group affected by chickenpox.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis
Learning Outcome: 3-4

7) The population health nurse is compiling statistics about lung cancer in one neighborhood that has experienced an average of 15 years from diagnosis to death. Which concept of epidemiology is the nurse analyzing?
1. Mortality rate.
2. Survival time.
3. Morbidity rate.
4. Survival rate.
Answer: 2
Explanation: 2. The average length of time from diagnosis to death is survival time. Mortality rate is the ratio of the numbers of deaths from a specific condition. Morbidity rate reflects the incidence and prevalence of a specific condition. Survival rate is the proportion of people with a given condition who remain alive after a specific period.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis
Learning Outcome: 3-4

8) The population health nurse is explaining the epidemiologic triad to a group of nursing students. What should the nurse use as an example of this triad?
1. Sun, beach, and sunburn.
2. Rural Mississippi, deer, and Lyme disease.
3. Potato salad, outdoor picnic, and food poisoning.
4. Standing water, mosquitoes, and warm weather.
Answer: 3
Explanation: 3. The epidemiologic triad consists of agent, host, and environment. Potato salad is the agent, the host is food poisoning, and the environment is the outdoor picnic. Sun, beach, and sunburn does not exemplify the epidemiologic triad. Rural Mississippi, deer, and Lyme disease does not exemplify the epidemiologic triad. Standing water, mosquitoes, and warm weather does not exemplify the epidemiologic triad.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 3-6

9) The population health nurse is planning to use a web of causation to explain the development of a health problem in a group of patients. What should the nurse use as an example of the web of causation?
1. Oil refinery, flare emissions, and asthma.
2. Mosquitoes, West Nile virus, and decreased mosquito spraying.
3. Adolescent pregnancy rate, lower socioeconomic status and education, and close friends with infants.
4. Access to alcohol, decreased enforcement of minors, and attractive media portrayal of alcohol that contributes to adolescent alcohol usage.
Answer: 4
Explanation: 4. Web of causation explores the influence of multiple factors on a specific health condition. The factors of access to alcohol, decreased enforcement of age checking, and the attractive portrayal of alcohol in the media contributes to adolescent alcohol usage. The other examples are of the epidemiologic triad.
Nursing/Int.Conc: Nursing Process: Planning
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 3-6

10) The population health nurse is identifying determinants of health to address the development of cancer in a small rural neighborhood. Which determinants should the nurse identify? (Select all that apply.)
1. Availability of health facilities.
2. Mean age of the male population.
3. Prevailing diet high in unprocessed foods and low fat.
4. High percentage of tobacco use among the male population.
5. Proximity of the community to chemical plants that have a poor history of regulating emissions.
Answer: 3, 4, 5
Explanation: 3. Determinants of health are broad categories of factors that influence health and illness. Determinants of health to address the development of cancer in a community would be the proximity to chemical plants with emissions, tobacco usage, and diet. Availability of health facilities has no bearing on the development of cancer. Mean age of a population has no bearing on cancer development.
4. Determinants of health are broad categories of factors that influence health and illness. Determinants of health to address the development of cancer in a community would be the proximity to chemical plants with emissions, tobacco usage, and diet. Availability of health facilities has no bearing on the development of cancer. Mean age of a population has no bearing on cancer development.
5. Determinants of health are broad categories of factors that influence health and illness. Determinants of health to address the development of cancer in a community would be the proximity to chemical plants with emissions, tobacco usage, and diet. Availability of health facilities has no bearing on the development of cancer. Mean age of a population has no bearing on cancer development.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 3-6
11) The population health nurse is concerned that a group of lifeguards who refuse to use sunscreen might develop skin cancer. On what is the nurse focusing this concern?
1. Risk.
2. Cases.
3. Mortality.
4. Morbidity.
Answer: 1
Explanation: 1. Risk is the probability that a given individual will develop a specific condition. Cases are the number of a particular event. Mortality is the ratio of the number of deaths in various categories to the number of people in a given population. Morbidity is the ratio of the number of cases of a disease or condition to the number of people in the population.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis
Learning Outcome: 3-3

12) After reviewing data collected during a community health fair the population health nurse is concerned that 500 people have an absolute risk of developing peripheral vascular disease. How should the nurse explain this risk to the community leaders?
1. Probability that any of the 500 people will develop peripheral vascular disease.
2. Probability that one of the 500 people will develop peripheral vascular disease when compared to the rest of the population.
3. The ability that the 500 people will be affected by factors that contribute to the development of peripheral vascular disease.
4. The likelihood that the 500 people will be exposed to factors that contribute to the development of peripheral vascular disease.
Answer: 1
Explanation: 1. Absolute risk is the probability that anyone in a given population will develop a particular condition. Relative risk is the probability that someone in a group of people with a particular characteristic will develop the condition when compared to people without that characteristic. Susceptibility is the ability to be affected by factors contributing to a particular health condition. Exposure potential is the likelihood of encountering or being exposed to factors that contribute to a condition.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 3-3
13) The population health nurse is reviewing data collected on a group of patients to determine which patients are experiencing the same health problem. In which step of the epidemiologic process is the nurse functioning?
1. Defining the condition.
2. Developing control strategies.
3. Identifying strategic points of control.
4. Determining the natural history of the condition.
Answer: 1
Explanation: 1. The nurse is working within the first step of the process or defining the condition. The nurse is working to clearly define what is, and what is not, an instance of the problem. Developing control strategies is the fourth step of the process and occurs after the condition is defined, the natural history of the condition is determined, and strategic points of control have been identified. When identifying strategic points of control the nurse identifies strategic points at which the development or course of the condition might be controlled. Determining the natural history of the condition is a description of the events that precede its development and occur during its course, as well as its typical outcomes. This step occurs after the condition is defined.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 3-5

14) After collecting information from patients about a health problem the population health nurse is analyzing the information to determine the natural history of the condition. What elements of the natural history should the nurse identify? (Select all that apply.)
1. Signs and symptoms of the health problem.
2. The effects that the health problem has on the body.
3. Length of time the health problem will affect the body.
4. Factors that contribute to the development of the health problem.
5. Outcomes and factors that affect the outcomes of the health problem.
Answer: 1, 2, 4, 5
Explanation: 1. Determining a conditions natural history involves identifying factors that contribute to its development, typical signs and symptoms of the condition, its effects on the human system, and its typical outcomes and factors that may affect those outcomes. The length of time the health problem will affect the body is not a factor when determining a conditions natural history.
2. Determining a conditions natural history involves identifying factors that contribute to its development, typical signs and symptoms of the condition, its effects on the human system, and its typical outcomes and factors that may affect those outcomes. The length of time the health problem will affect the body is not a factor when determining a conditions natural history.
4. Determining a conditions natural history involves identifying factors that contribute to its development, typical signs and symptoms of the condition, its effects on the human system, and its typical outcomes and factors that may affect those outcomes. The length of time the health problem will affect the body is not a factor when determining a conditions natural history.
5. Determining a conditions natural history involves identifying factors that contribute to its development, typical signs and symptoms of the condition, its effects on the human system, and its typical outcomes and factors that may affect those outcomes. The length of time the health problem will affect the body is not a factor when determining a conditions natural history.
Nursing/Int.Conc: Nursing Process: Diagnosis
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis
Learning Outcome: 3-5

15) A patient comes into the clinic with manifestations of an acute respiratory infection. When analyzing the natural history of the condition, the population health nurse identifies that this patient is in which stage?
1. Clinical.
2. Preclinical.
3. Resolution.
4. Susceptibility.
Answer: 1
Explanation: 1. The natural history of a condition is often divided into four stages: susceptibility, preclinical, clinical, and resolution. In the susceptibility stage, factors contributing to development of the condition are present and the person is at-risk for its development. When exposure to causative factors has occurred, but no symptoms have appeared, the condition is in the preclinical stage. The clinical stage begins with the onset of signs and symptoms characteristic of the disease or condition. In the resolution stage, the condition culminates in a return to health, death, or continuation in a chronic state.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Physiological Integrity
Cognitive Level: Analysis
Learning Outcome: 3-5

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