Community health test 2 Flashcards
A public health nurse (PHN) is asked by the hospital administration to find out why there are so many pediatric asthma patients coming to the emergency room (ER) for treatment and to develop a plan to reduce admissions by 10%. The nurse needs to untangle the multiple risk factors involved in order to determine what type of intervention should be developed. Which framework should the PHN use to best understand the multiple factors contributing to asthma in this population?
the web of causation
epidemiological triangle
Classic model used in epidemiology to explain the occurrence of disease - has a host, agent, and environment that explains the occurrence of disease
epidemiological constants
person, place, and time
web of causation
helps to understand the multiple factors that contribute to the development of disease
ecological model
Used to design health promotion efforts and understand health behavior
health promotion
includes interventions that can be done to help maintain health
health behaviors
include behaviors that contribute either positively or negatively to overall health
determinants
Any factor that brings about change in a health condition or other defined characteristic
population
Complete collection of individuals having a quality or characteristic in common
distribution
Involves the analysis of disease patterns according to the characteristics of person, place and time
environment
All of the external factors that can influence the host’s vulnerability to a disease
Biologicial, chemical, physical or nutritional; responsible for the disease
agent
Susceptible human or animal
host
You are working as a public health nurse and assisting with a recent outbreak investigation in your community. The local Catholic church recently held a potluck dinner with 75 attendees. Unfortunately, 15 of the attendees became ill with vomiting and diarrhea within two days of the potluck dinner. You have been asked to calculate the attack rate among attendees. The attack rate is:
ill/ill+well x 100
answer: 20%
John Snow, considered the founder of epidemiology, realized the source of the London’s cholera epidemic through:
Developing a frequency distribution of the number of human deaths by placing hash marks on a city map
The public health nursing student is studying outbreak investigations and disease trends. The student learns that there are three precipitating factors also known as the epidemiological constants essential to an outbreak investigation and include which of the following?
person, place, and time
Epidemiology is defined as “the study of the ____________ and ____________ of health-related states or events in specified ___________ and the application of this study to the control of health problems.”
distribution, determinants, populations
air quality manager
Building permits, burn codes, dust control, monitor air quality
epidemiology and public health preparedness
Communicable disease control and surveillance, emergency medical services oversight, emergency preparedness, vital statistics (birth and death records)
Business office, grants management, human resources
administrative health services
Chronic disease prevention, immunizations, sexual health, TB, maternal child adolescent health, WIC
community and clinical health services
Food safety/protection, land development, inspections (child care, hotels, motels, public pools, tattoo/body piercing establishments, waste management, vector control)
environmental health services
The neonatal nurse is providing anticipatory guidance to the mother of a newborn infant. When discussing immunization schedules, the nurse explains that the first dose of inactivated poliovirus vaccine (IPV) is given at what age?
2 months
In the United States, the oral polio vaccine is…
no longer given because vaccine virus may spread from the recipient to contacts
Before going to college, students, especially those that will be living in a dorm, should consider getting …
Meningococcal vaccine
According to the State of Nevada, which of the following is not accepted as an exemption from immunizations?
Personal belief exemption. religious exemption and medical exemption are both reasons
At what age can children begin getting yearly flu shots?
6 months
true or false: It is recommended that pregnant women receive one dose of Tdap with each pregnancy, preferably between 27 and 36 weeks gestation.
true
Which of the following is the first anti-cancer vaccine?
hepatitis B vaccine
Which vaccine is given soon after birth?
hepatitis B
Pediarix combines which of the following vaccines:
DTap - Hep B - IPV
Which vaccine is given subcutaneously?
varicella
true or false: If the first dose of hepatitis B vaccine was given more than one year ago, and no subsequent doses were given, you should repeat the first dose.
false
A parent brings her 4-month-old infant to a well-baby clinic for immunizations. The child is up to date with the immunization schedule. The nurse should prepare to administer which immunizations at this 4-month visit?
DTaP, Hib, IPV, PCV, RV
Which of the following vaccines usually aren’t given until a child’s first birthday (12 months of age).
MMR
DTaP stands for:
Diphtheria - Tetanus - acellular Pertussis
Which of the following vaccines helps to prevent bacterial meningitis in children aged 2 months to 2 years?
Hib
If a child has an adverse effect after receiving immunizations, the parent and/or the health care provider can report it to…
VAERS (the Vaccine Adverse Event Reporting System)
Human Papillomavirus or HPV is:
caused by a virus, spread skin to skin, infects 80% of women by 50 years of age, and is the 2nd leading cause of cancer deaths in women worldwide
Which of the following infectious diseases is NOT considered a vaccine-preventable disease at this time?
hepatitis C
The shingles vaccine is available for:
people aged 50 years of age and older
True or False: All vaccinations have the potential to cause a severe allergic reaction in certain patients.
true
Older adults have higher body burdens of chemicals that have been absorbed over their lifetimes, and these chemicals collect in the adipose tissue or bone, and can later result in poor health outcomes, such as cancer or organ damage. The public health nurse recognizes that this substance collection is called:
bioaccumulation
Fair distribution of environmental burdens; fair application of environmental laws, policies and regulations regardless of race, color, national origin, or income.
environmental justice
The science and practice of preventing human injury and illness and promoting well being by identifying and evaluating environmental sources and hazardous agents and limiting exposures to hazardous agents in air, water, soil, food or other environmental setting that may adversely affect human health.
environmental health
The human-made surroundings created for the daily activities of humans, reflects the range of physical and social elements that make up a community.
built-environment
A nurse is using the I-PREPARE mnemonic to assess a client’s potential environmental exposures. Which of the following questions should the nurse ask when assessing for “A” in the mnemonic?
what do you like to do for fun?
I PREPARE mnemonic
one method of determining current and past environmental exposures I: investigate P:present work R: Residence E: Environmental concerns P: past work A: activities R: referrals and resources E: educate
The public health nurse understands that the toxicity of chemicals in children is more severe than that in older populations because of which of the following reasons?
Children play in outdoor soil, which can be contaminated,
Children may ingest improperly stored chemicals, for example in old food containers or in easily accessible locations such as under the sink, Children have faster rates of absorption of toxic substances, In urban settings, children may not have adequate places to play and in rural settings, children are at risk of injuries from farm equipment and vehicles, Children have less developed immune systems
A public health nurse is evaluating a community’s access to grocery stores, accessible transportation, outside activities, and the maintenance of its neighborhood buildings. The nurse is evaluating the:
Built environment
What was the incidence rate of reported Chlamydia cases in Washoe County in 2018? (reported cases per 100,000 population)
594
Which of the following agencies is the main resource for HIV care In Washoe County?
HOPES
Considering the acronym “CHART” for the key STD motivators, “A” stands for which of the following?
Asymptomatic Infection
metronidazole 500 mg PO BID x 7 days is recommended for
bacterial vaginosis
ceftriaxone 250 mg IM AND azythromycin 1 G PO OR doxycycline 100 mg PO BID x 7 days is recommended for
gonorrhea
benzathine penicillin G (2.4 million units IM in a single dose) is recommended for
syphilis
azithromycin 1 g PO OR doxycycline 100 mg PO BID x 7 days is recommended for
chlamydia
Which of the following groups is not included in the list of persons who should get tested for sexually transmitted diseases (STDs)?
Persons < 25 years of age who are not sexually active
acronym “CHART” for the key STD motivators
C: complications of untreated disease H: HIV connection A: Asymptomatic infection R: Re-infection T: Transmission
Recognizing the differences between cultures; no one culture is superior to another
ethnorelativism
Includes self-awareness of one’s own cultural background, biases, and differences
cultural awareness
A skill the nurse develops in learning to respect individual dignity and preferences, as well as acknowledging cultural differences
cultural competence
Refers to a group of people who have shared patterns of communication, shared sense of beliefs, common patterns of clothing, predictable socialization patterns, and similar dietary preferences and food preparation
culture
Believing one’s own culture is best; judging another culture by the values and standards of one’s own culture
ethnocentrism
Which of the following are examples of ways to convey cultural sensitivity?
Use culturally sensitive language, Show respect for a client’s support systems, Provide health teaching materials in the client’s primary language and at the recommended readability level
Examples of groups typically viewed as vulnerable:
People living in poverty People of color The uninsured Those experiencing homelessness Older adults Those with disabilities Those with increased frailty Those suffering from noncommunicable diseases Those who do not speak English Immigrants Refugees People marginalized by sexual preference Those who are incarcerate
Vulnerability
The increased susceptibility to poor health of an individual or group stemming from exposure to multiple risk factors
The differential and negative treatment of an individual based on his or her race, ethnicity, gender, socioeconomic status, or other group membership
discrimination
A characteristic of a person or a group of persons that is contrary to those characteristics of the larger group
stigma
The increased susceptibility to poor health of an individual or group stemming from exposure to multiple risk factors
vulnerability
A social process through which a person or group is on the periphery of society based on identity, associations, experiences, or environment
marginalization
Populations at substantially greater risk for poor physical, mental, and social health; may be associated with socioeconomic status, where they live, gender, age, disability status, or sexual orientation
vulnerable populations
An exagerated, usually negative belief or image applied to an entire category of people
stereotype
bilateral organization
Represent a single government that gives aid to developing countries
nongovernmental organizations
Voluntary groups organized at the local, national, or international level to provide service and humanitarian relief, advocacy, development, and sustainable programs, and to monitor policies and provide information
multilateral organizations
Collaborative work and funding come from multiple governments, nongovernmental sources, and is distributed to many different countries
Millennium Development Goals (MDGs)
Created by the United Nations
Called for more developed nations to contribute resources to improve conditions in lesser-developed countries, making global health a responsibility of nations around the world
primary care
Refers to personal health care services
primary health care
Refers to the essential care needed to have healthy individuals and a healthy community; concept originated at the 1978 WHO conference
global health
Global health refers to health issues that transcend national boundaries and governments and call for actions on the global forces that determine the health of people
Involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration
Global health is a new approach to the concept of international health
epidemic
Occurrence of a disease clearly in excess of normal expectancy
endemic
The habitual presence of a disease within a given geography
pandemic
An epidemic affecting or attacking the population of an extensive region, country, or continent
When an epidemic occurs in multiple countries or continents
Communicable Disease Surveillance
Descriptive epidemiology used to investigate disease patterns to identify who was affected, where the issue is located, how it occurs, why or what the cause is, and when the condition started
Monitoring disease patterns can help identify an unusual disease outbreak or newly emerging disease
Useful in developing public health policies regarding disease management
Evaluate the efficiency of communicable disease programs
disease transmission can be
direct (person to person) or indirect (Occurs through a common vehicle such as a contaminated air or water supply, or by a vector such as the mosquito)
modes of transmission
airborne, food borne, waterborne, vector borne, direct contact
disease defenses
Herd Immunity
- Protection due to the immunity of most community members making exposure unlikely
Natural immunity
- Natural defense mechanisms of the body to resist specific antigens or toxins
Acquired immunity
- Develops through actual exposure to the infectious agent
nursing in environmental health
Identify environmental health risk, participate in research, and use advocacy to improve environmental quality
Contribute to environmental health by engaging in environmentally friendly practices and use of material, as well as providing information to the public about environmental health
Use toxicological information to understand the specific effects that environmental hazards have on populations at risk or following exposure
CDC reference level of blood lead levels
5 uq/dL is elevated
routes fo exposure to lead
Occurs primarily through ingestion; inhalation is the second major pathway of exposure
prevention of lead exposure
Wash your hands before you eat
Take off your shoes at the door
Eat a healthy diet that includes iron and calcium
Regularly check your home for chipping, peeling, or deteriorating paint
Test your home’s drinking water (schools and childcares should also be tested
Healthy People 2020 Environmental Health Objectives (6 themes)
Outdoor air quality Surface and ground water quality Toxic substances and hazardous wastes Homes and communities Infrastructure and surveillance Global environmental health
