Communities Exam 2 Nies
Community/Public Health
1. The nurse working in the community is aware that there are different models for studying the
epidemiology of a health condition in a population. One model of investigation of the interrelationships
and characteristics of disease is the epide...
Communities Exam 2 Nies
Community/Public Health
1. The nurse working in the community is aware that there are different models for studying the
epidemiology of a health condition in a population. One model of investigation of the interrelationships
and characteristics of disease is the epidemiological triangle. This model analyzes what three elements?
Ans- B. Agent, host, and environment
The epidemiological triangle considers the extent of the host's exposure to the agent, the virulence of
the agent, and the host's genetic or immunological susceptibility to the agent. Environmental conditions
at the time of exposure are also considered. Examination of these three elements allows assessment of
the problem, determination of protective factors, and evaluation of the vulnerability of the host to
disease. The person-place-time model organized epidemiologists' investigations of the disease pattern in
the community. Answer options A and D do not represent an epidemiologic model.
2. When chronic disease became a more important cause of death in developed countries, different
epidemiologic models were developed to study the many factors involved in the development of these
health conditions. Which is an example of such a model? Ans- C. Web of causation
Chronic disease is marked by a complexity of relationships among causal factors. The web of causation
model illustrates the interrelationships. The person-place-time model organized epidemiologists'
investigations of the disease pattern in the community. The epidemiological triangle considers the
extent of the host's exposure to the agent, the virulence of the agent, and the host's genetic or
immunological susceptibility to the agent. The wheel model is an example of a model that stresses the
multiplicity of host and environmental interactions.
3. In the 1850s, a researcher studied a cholera epidemic among people living in different sections of
London. The researcher who used epidemiologic methods to study the epidemic and used rates as an
epidemiologic tool was Ans- C. John Snow
John Snow is recognized as the researcher who applied epidemiologic methods in the investigation of a
cholera epidemic in London in the 1850s. Joseph Lister is considered the pioneer of antiseptic surgery.
William Farr was a 19th century British epidemiologist who is regarded as a founder of medical statistics.
Edward Jenner developed the smallpox vaccine.
,4. A community health nurse participating in planning programs for the coming year considers incidence
rates to better understand the needs of the community. Which statement below is the most accurate
explanation of incidence rates? Ans- A. New cases of a disease or condition in a community over a
period of time are included in incidence rates.
ncidence rates describe the occurrence of new cases of a disease or condition in a community during a
period of time relative to the size of the population at risk for that disease or condition during that same
time period. In calculating this rate, the numerator is the number of new cases during the specific period
of time, and the denominator consists only of those who are at risk for developing the disease or
condition during the specific period of time. A prevalence rate is the number of all cases of a specific
disease or condition in a population at a given point in time relative to the population at the same point
in time. Attack rates document the number of new cases of a disease in those exposed to the disease.
The percentage of deaths in a specific period of time from a specific cause refers to the mortality rate.
5. An epidemic is occurring in a public health nurse's community, and the nurse is working with the
epidemiologist and other health professionals seeking to identify the causative agent. What phrase best
describes such efforts? Ans- D. Analytic epidemiology
Analytic epidemiology investigates the causes of disease by determining why a disease rate is lower in
one population group than in another. This method tests hypotheses generated from descriptive data
and either accepts or rejects them on the basis of analytic research. Cohort studies obtain information
about the cause of disease by establishing a relationship between the presumed causal factors and the
effect. The study of the amount and distribution of disease constitutes descriptive epidemiology. When
prevalence rates describe the number of people with the disease at a specific point in time, they are
sometimes called point prevalences.
6. A community nurse is reviewing health statistics to gain a better understanding of a population's
health needs. Crude rates are available for several health occurrences. What statement accurately
describes crude rates? Ans- B. In calculating a crude rate, the average population size may be used as
denominator.
Crude rates are calculated by using the number of events as the numerator. The denominator used may
be the average population size or the population size at midyear and not the population at risk. Crude
rates are subject to certain biases in interpretation.
7. The percentage of deaths resulting from a specific cause provides the nurse with information about
areas in which public health programs might make significant contributions in reducing deaths. Select
the statistic often used for this purpose. Ans- A. Proportionate mortality rate
, Proportionate mortality rate is calculated using the number of deaths resulting from a specific cause in a
specific time period as the numerator and the total number of deaths in the same time period as the
denominator. In crude death rates, the numerator is the number of deaths and the denominator is the
average population size or the population size at midyear multiplied by a constant. Age adjustment or
standardization reduces bias when there is a difference between the age distributions of two
populations.
8. The health literature accessed by the community health nurse often addresses the probability of an
adverse event. What term refers to the likelihood that healthy people exposed to a specific factor will
experience a specific health condition? Ans- C. Risk
The term risk refers to the probability of an adverse event. Prevalence is the number of all cases of a
specific disease or condition in a population. Rates are arithmetic expressions that help practitioners
consider a count of an event relative to the size of the population from which it is extracted. Incidence
describes the occurrence of new cases of a disease or condition in a community over a period of time.
9. Through epidemiologic investigations, effective prevention measures are often identified. When the
nurse is engaged in providing prevention for the community before disease has developed, the
prevention activities meet the definition for what level of prevention? Ans- A. Primary
Primary prevention occurs when intervention activities take place before disease development.
Immunization is an example of primary prevention that provides specific protection. Secondary
prevention occurs after pathogenesis, namely screening and physical examinations that are aimed at
early diagnosis. Tertiary prevention focuses on rehabilitation and limitation of disability. Pathogenic
does not describe a type of prevention.
10. The public health nurse is working with a specific population and is preparing to participate in a
descriptive epidemiology study. Which of the statements apply to descriptive epidemiology? (Select all
that apply.) Ans- A. Descriptive epidemiology seeks to answer questions about the amount of disease in
a given population.
D. Descriptive epidemiology seeks to answer questions about the distribution of disease in a given
population.
The study of the amount and distribution of disease constitutes descriptive epidemiology. Patterns
identified through descriptive epidemiology may indicate possible causes. When these possible causes
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