1. A nurse felt it would be much easier to just copy the previous month's surveillance
report, changing only the date, since the number of events per month had not
significantly differed. Which of the following best explains why the nurse should
continue to invest time in collecting and reporting data that are always almost identical?
a. Because such data are legally required
b. Because it is still part of the nurse's responsibilities, even if it is a waste of time
c. To determine a local baseline rate and immediately notice any change
d. To determine differences among communities in need for state assistance - ANSWER
ANS: C To determine a local baseline rate and immediately notice any change
Disease surveillance allows for the establishment of base-line endemic rates of disease
occurrence and dissemination patterns. Surveillance allows for the mounting of a rapid
response to an outbreak of a disease or event that has the potential to produce a health
problem.
2. A nurse attends a conference to learn more about public health surveillance. Why is
this so important for the nurse to know?
a. Because nurses are working in public health agencies
b. Since nurses usually are the first to recognize and respond to the issue
c. Because nurses are designated to take responsibility to see that action is taken, when
necessary
d. Since nurses are typically those that interact with the general public and media -
ANSWER ANS: B Since nurses usually are the first to recognize and respond to the issue
Whether working in a small rural agency or a large urban agency; within the health
department, school, or urgent care center; or on the telephone performing triage
services during a disaster, nurses are often in the forefront of responses to be made in
the surveillance process. It is the nurse who sees the event first.
DIF: Cognitive Level: Apply (Application) REF: p. 268
,3. A rural public health nurse is spending time reviewing death certificates. Which of the
following best explains the purpose of this activity?
a. To make sure that causes of death in the local area are comparable to causes of
death nationally
b. To verify that none of the local health problems are emerging
c. To assess effectiveness of health promotion programs
d. To get mortality data for the local area - ANSWER ANS: D To get mortality data for the
local area
Mortality data are often the only source of health-related data available for small
geographic areas. The vital statistics reports, including death certificates, are
reviewed. Useful information also arises from the administrative data like discharge
reports and billing records.
DIF: Cognitive Level: Apply (Application) REF: p. 268
4. Which of the following types of surveillance is being used when case reports are
routinely sent to local health departments by health care providers and laboratories,
where the data are then summarized and forwarded to those responsible for monitoring
such reports?
a. Active surveillance
b. Passive surveillance
c. Sentinel surveillance
d. Special surveillance - ANSWER ANS: B Passive surveillance
It is passive surveillance in that case reports from health care providers or laboratories
are sent to local health departments. The summary of case reports is then forwarded to
the state health department, national government, or organizations responsible for
monitoring the problem, such as the CDC. In active surveillance, the health department
nurse may begin an active search for cases through contacts to determine the
magnitude of the problem. Sentinel surveillance looks for trends. Special surveillance is
developed when a particular type of information is desired.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 269
,5. In which of the following scenarios would the nurse be most likely to utilize active
surveillance?
a. A newspaper requests information regarding the incidence of asthma in the
community.
b. A real-time ongoing communication channel is established to monitor a specific
symptom.
c. Several children become ill with GI upset at one local school.
d. The nurse is asked to report the incidence of a specific nonreportable common
problem in the community. - ANSWER ANS: C Several children become ill with GI upset
at one local school.
In active surveillance, the nurse initiates a search for cases to identify the extent of the
problem-at what magnitude it exists. An example would be if several school children
became ill after eating lunch in the cafeteria or at the local hot dog stand, in which case,
active surveillance would be implemented to investigate food poisoning.
DIF: Cognitive Level: Apply (Application) REF: p. 269
6. Several of the children received treatment in the hospital due to excessive vomiting
and diarrhea. Which of the following would be the best explanation as to why the nurse
continues to investigate the cause of illness after the children have gone home from the
hospital?
a. So that the families of the children would know public health department cared about
them
b. So that action could be initiated to prevent any such future episodes
c. Because the children's parents need to know whom to sue for their medical expenses
d. To confirm that the symptoms were due to an infectious disease - ANSWER ANS: B So
that action could be taken to avoid any such future episodes
The purposes of an investigation include the control and prevention of disease or death
through the identification of factors contributing to the occurrence, and the
implementation of measures to prevent occurrences. In this case, the nurse wanted to
make sure children did not become ill again when it could be avoided.
, 7. A child came to school coughing almost constantly. The next day, six other children in
the same school room were coughing. Which of the following types of outbreak would
the nurse suspect?
a. Common source
b. Mixed
c. Propagated
d. Intermittent - ANSWER ANS: A Common source
A common source outbreak is a group that is exposed to a common noxious influence. In
this case, the group is the class of school children and the common noxious influence is
the sick child who was attending school. It is obvious what the cause of the illness
spread is.
DIF: Cognitive Level: Apply (Application) REF: p. 272
8. A nurse counted that of 18 children in a day care center room, 5 became ill. Which of
the following best describes a host factor that may be associated with this illness and
who became ill?
a. Some of the children were from very low socioeconomic families.
b. Some of the children slept during rest time while others only rested.
c. The bacterial cause of the illness was easily removed by hand washing.
d. The day care center room was much warmer on three sides in comparison to the side
with the floor to ceiling windows. - ANSWER ANS: A Some of the children were from very
low socioeconomic families.
The factors that must be considered as causes of outbreak are categorized as agents,
hosts, and environmental factors. Host factors may be age, sex, race, socioeconomic
status, genetics and lifestyle choices. The cause of the illness is an agent factor, and the
difference in temperature in the room is an environmental factor.
DIF: Cognitive Level: Apply (Application) REF: p. 272
9. A nurse overhears colleagues discussing that the number of depressed patients
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