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NR 503 Week 4 Midterm Review Guide (Chapter 1 – 20) | (GRADED A) Questions and Answers solution | 100% Guaranteed pass
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Chapter 1-4 Question: Which of the following is a condition which may occur during the incubation period? Question: Chicken pox is a highly communicable disease. It may … transmitted by direct c ontact with a person infected with the varicella-zoster virus (VZV). The typical incubation time is be...

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  • February 2, 2022
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NR 503 Week 4 Midterm Review Guide (Chapter 1 – 20)
Midterm Review Guide



Chapter 1-4

1. Which of the following is a condition which may occur during the incubation period?

-Transmission of infection.

2. Chicken pox is a highly communicable disease. It may be transmitted by direct contact with a
person infected with the varicella-zoster virus (VZV). The typical incubation time is between 10-
20 days. A boy started school 2 weeks after showing symptoms of chicken pox including mild
fever, skin rash, and fluid-filled blisters. One month after the boy returned to school, non of his
classmates had been infected by VZV. The main reason was:

-Contact was after infectious period.

3. The ability of a single person to remain free of clinical illness following exposure to infectious
agent is known as:

-immunity

4. Which of the following is characteristic of single-exposure, common-vehicle outbreak?

-The epidemic curve has a normal distribution when plotted against the logarithm of time.
Involve a sudden, rapid increase in cases of disease that are limited to persons who share a
common exposure.

5. What is the diarrhea attack rate in persons who ate both ice cream and pizza?

-39/52 (The attack rate is defined as the number of people who develop diarrhea divided by the
total number of people at risk.

6. What is the OVERALL attack rate in persons who did not eat ice cream?

-33% (The attack rate is the # of persons with diarrhea (14+9) divided by the total # of persons
who did not eat ice cream (40+30)

7. Which of the food items (or combination of items) is most likely to the infective item(s)?

-ice cream only (only 70% developed diarrhea regardless of their pizza consumption (39/52 and
11/15). Among both groups of persons who did not eat ice cream, each attack rate was equal to
or less than 35% (14/40 and 9/30).

8. Which of the following reasons can explain why a person who did not consume the infective
food item got sick?

,-All of the above (They were directly exposed to persons who did eat the infective food item,
diarrhea is general symptom consistent with a number of illnesses, there may have been an
inaccurate recall of which foods were eaten)

9. An outbreak of gastroenteritis occurred at a boarding school with a student enrollment of 846.
57 students reported symptoms including vomiting, diarrhea, nausea, and low-grade fever
between 10 p.m. on 9/24 and 8 p.m. on 9/25. The ill students lived in dormitories that housed
723 of the students. The table below provides information of the # of students per type of
residence and the # reporting illnesses consistent with the described symptoms and onset time.
Calculate the attack rate among all students at the boarding school.

-6.7% (divide the total number of cases (57) by the total number of students (846).

10. Same question above + Calculate the attack rates for boys and girls separately.

43 boys/426 total boys =

14 girls/420=

11.Same question + What is the proportion of total cases occurring in boys?

-43/57 = 75.4%

12. Same question + What is the proportion of total cases occurring in students who live in
dormitories?

-52/57 = 91.2%

13. Same question + Which proportion is more informative for the purpose of the outbreak
investigation?

-Both proportions are useful. Dormitory residents account for over 90% of the cases indicating
an outbreak of an infectious agent that was transmitted at the school. Furthermore, over 75% o
the cases were boys indicating that the responsible agent was more likely to have been
transmitted in the boys dormitory.

14. A group of researchers are interested in conducting a clinical trial to determine whether a new
cholesterol-lowering agent was useful in preventing coronary heart disease (CHD). They
identified 12,327 potential participants for the trial. At the initial clinical exam, 309 were
discovered to have CHD. The remaining subjects entered the trial and were divided equally into
the treatment and placebo groups. Of those in the treatment group, 505 developed CHD after 5
years of follow-up while 477 developed CHD during the same period in the placebo group. What
was the prevalence of CHD at the initial exam?

-The prevalence of CHD at the initial exam was 309 cases of CHD divided by 12, 327
participants. This equals a prevalence of 25.1 cases of CHD per 1,000 persons.

,15. Same question + What was the incidence of CHD during the 5-year study?

-The incidence rate reflects the # of new cases developing in the population at risk. Since
prevalent CHD cases were excluded from the study, the population at risk was 12,018 (12,327
persons less 309 cases CHD). During the 5-year study period, 982 incident cases of CHD
developed. This equals an incidence rate of 81.7 cases of CHD per 1,000 persons.

16. Which of the following are examples of population prevalence rate?

-The # of persons with hypertension per 100,000 population. (The # of affected persons in a
specified population size at a given time.

17. What would be the effect on age-specific incidence rates of uterine cancer if women with
hysterectomies were excluded from the denominator of incidence calculation assuming that most
women who have hysterectomies are older than 50 years of age?

-Rates would increase in women older than 50 years of age but may decrease in younger women
as they get older.

18.A survey was conducted among 1,000 randomly sampled adult males in the United States in
2005. The results from this survey are shown below. The researchers stated that there was a
doubling of risk of hypertension in each age group younger than 60 years of age. You conclude
that the researcher’s interpretation:

-Is incorrect because prevalence rates are estimated. Since no duration-incidence can not be
calculated.

19. The incidence and prevalence rates of a chronic childhood illness for a specific community
are given below.

-The duration of disease is becoming shorter.

20.A prevalence survey conducted from January 1 through December 21, 2003 identified 580
new cases of TB in a city of 2 million persons. The incidence rate of TB in this population has
historically been 1 per 4,000 persons each year. What is the incident rate of TB per 100,000
persons in 2003?

-29 new cases of TB per 100,000 persons. This is found by dividing the new cases of TB by the
total population at risk (580/2,000,000) and multiplying this rate by 100,000 to standardize the
rate.

21. Same info as above, Has the risk of TB increased or decreased during 2003?

-The risk of TB increased over the historic incident rate. The comparison can be made by
standardizing the historic rate to a rate per 100,000 persons. To do this, multiply the numerator
and denominator by 25.

, 22.Which of the following is an advantage of active surveillance?

-Entails a concerted effort to collect information about disease occurrence. Involves dedicated
staff members who have been specifically directed to contact physicians and hospitals in order to
collect reports of disease cases.

23. The population of a city on February 15, 2005, was 36,000. The city has a passive
surveillance system that collects hospital and private physician reports of influenza cases every
month. During the period between 1/1 and 4/1, 2005, 2,200 new cases of influenza occurred in
the city. Of these cases, 775 persons were ill with influenza according to surveillance reports on
4/1. The monthly incidence rate of active cases o influenza for the 3-month period was:

-20 per 1,000 population

(monthly incidence rate is calculated based on the # of new cases of a disease developing during
the 3-month period.

24. Same info + The prevalence rate of active influenzas as of 4/ 1/ 05.

-20 per 1,000

25. Same info –What can be inferred about influenza cases occurring in the city?

-The average duration of influenza is approximately 1 month

26.A study found that adults older than age 50 had a higher prevalence of pneumonia than those
who were younger than age 50. Which of the following is consistent with this finding?

-Incidence rates do not vary by age, but older adults have pneumonia for a longer duration
compared to younger adults.

27. Which of the following statements are true? More than one answer may be correct.

-Prevalence rates are useful for public health planning

-Incidence rates can be used to estimate prevalence when the mean duration of the disease is
known.

28. A disease has an incidence of 10 per 1,000 persons per year, and 80% of those affected will
die within 1 year. Prior to the year 2000, only 50% of cases of the dease were detected by
physician diagnosis prior to death. In the year 2000, a lab test was developed that identified 90%
of cases an average of 6 months prior to symptom onset; however, the prognosis did not improve
after diagnosis. Comparing the epidemiology of the disease prior to 2000 with the epidemiology
of the disease after the development of the lab test, which statement is true concerning the
disease in 2000?

-Incidence is higher and prevalence is higher than in 1999.

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