exam 2 Flashcards
(ON_SLIDES)
refers to the differences among people, especially those related to values, attitudes, beliefs, norms, behaviors, customs and ways of living, what is this called?
Cultural diversity
(ON-SLIDES)
a formal area of study and practice focused on a comparative analysis of different cultures and
subcultures in the world with respect to cultural care, health and illness beliefs, values, and practices with the goal of using this knowledge to provide culture-specific and culture-universal nursing care to people, coined by Leininger is what type of nursing?
a. culture-specific care
b. transcultural nursing
c. culture-universal care
d. cultural diversity
b. transcultural nursing
(ON SLIDES)
particularistic values, beliefs and patterning of behaviors, that tend to be special, local, or unique to a designated culture and which do not tend to be shared with members of other cultures is what type of care?
culture-specific care
(ON-SLIDES)
commonalities of values, norms of behaviors, and life patterns that are similarly held among cultures about human behavior and lifestyles and form the bases for formulating theories for developing cross-cultural laws of human behavior is what type of care?
Culture-universal care
(ON-SLIDES)
culture is?
a set of knowledge, beliefs, morals, law, art, customs and tradition
-refers to a complex whole
(ON-SLIDES)
A group of teens develops their own method of texting in a language that they feel is all their own. The change is subtle, but the meanings and the feelings associated with the text are known only to a select few. This behavior is an example of:
A)Culture
B)Cultural competence
C)Cultural safety
D)Ethnocentrism
A (Culture)
The nurse is caring for a client who refuses the food as served. He states that the food is foreign to him and will make him ill. All food must be blessed. The personal care attendant is upset by this behavior and states that the client should eat the food anyway. The client’s behavior is most likely a result of:
A)Psychosocial deficit
B)Cultural belief
C)Allergies
D)Hygiene
B (cultural belief)
rationale:
Culture is how people approach the world. Culture includes language, religion, occupation, economics, art, politics, and philosophy, along with diet. The fact that the client says that the food must be “blessed” indicates a religious belief that is part of his culture. There is no evidence of a psychosocial deficit in this client, or of allergies or hygiene concerns
The nurse is present when a mother begins cupping her child. She states that it will help to heal the child’s respiratory tract infection. The nurse understands that the cultural belief that cupping will aid in the healing process is a:
A)Shared instinct
B)Learned behavior
C)Private idiosyncrasy
D)Genetically programmed idea
B (learned behavior)
rationale:
Usually culture is first “learned” from parents and siblings and then from peers, teachers, neighbors, books, television, and other media. Thus, it is not innate instinct, a private idiosyncrasy, or a genetically programmed idea.
A Mexican-American client arrives at the emergency department. He reports abdominal pain and has been vomiting for 5 days. The nurse notes that he is exhibiting symptoms of dehydration, and his vital signs and labs confirm this. The nurse asks the client why he waited so long to seek medical care. He states that he is being treated by the Curandero and wishes to continue while in the hospital. The nurse recognizes the different cultural assumptions regarding care. This situation is an example of:
A)Cross-cultural nursing
B)Ethnocentrism
C)Cultural safety
D)Transcultural bias
A (cross-cultural nursing)
rationale:
Cross-cultural nursing is any nursing work in which the nurse and the client have different cultures. Ethnocentrism is the assumption that others believe and behave as the dominant culture does, or the belief that the dominant culture is superior to others. Cultural safety is the practice of providing culturally appropriate health services to disadvantaged groups while stressing dignity and avoiding institutional racism, assimilation (forcing people to adopt a dominant culture), and repressive practices. There is no evidence of bias in this scenario
The nurse conducts a well-child clinic in your community. The client population is culturally diverse, and, although the clinic is busy, it runs smoothly because it has an interpreter. In addition to the interpreter, it is important that the nurses treat each client that reflects his or her individual cultural needs. This is cultural:
A)Bias
B)Artwork
C)Competence
D)Beliefs
C (competence)
rationale:
In nursing, cultural competence means considering cultural aspects of health, illness, and treatment for each client or community, as well as doing so at each stage of the nursing process. The nurse should not display cultural bias or favoritism to any specific culture. The nurse does not need to display the beliefs of other cultures, just respect, and understanding of them. The nurse does not need to display cultural artwork.
A nurse, new to the community health agency, works in a culturally diverse area of the community. The nurse is responsible for providing holistic care to clients and to be culturally competent. The health agency requires the nurse to demonstrate which competency to exhibit cultural competence? (Select all that apply.)
A)Value diversity B)Adopt the client's cultural values C)Acquire cultural knowledge D)Adapt to diversity E)Speak the language of the client
A,C,D (value diversity, acquire cultural knowledge, adapt to diversity)
rationale:
For community and public health agencies to be culturally competent, they must do the following: have a defined set of values and principles and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally; have the capacity to (1) value diversity, (2) conduct self-assessment, (3) manage the dynamics of difference, (4) acquire and institutionalize cultural knowledge, and (5) adapt to diversity and the cultural contexts of the communities they serve; and incorporate this capacity in all aspects of policy making, administration, practice, and service delivery, as well as systematically involve consumers, key stakeholders, and communities.
The nurse is called to make an unscheduled visit to a new client in her home. The purpose of the visit is to admit the client and treat an abdominal wound. The nurse discovers that the client is from a culture unfamiliar to her. In this situation, the nurse should demonstrate cultural competence and awareness by: (Select all that apply.)
A)Being open to the client’s ideas and way of life
B)Obtaining objective data when caring for the client
C)Exhibiting respect and patience
D)Being aware of your own culture
E)Assuming that you have enough knowledge to get by
A,C,D ( being open to the client’s ideas and way of life, exhibiting respect and patience, being aware of your own culture)
rationale:
Although the nurse will not be fluent in all cultures at all times, certain principles will make him or her a more culturally competent nurse: openness to others’ ideas and ways of life, respect, curiosity, patience, and self-awareness of one’s own culture and culturally mediated ideas, as well as the humility to know that one can always learn more about a certain client’s culture and that person as an individual. Obtaining objective data about the client will not help the nurse demonstrate cultural competence and awareness. The nurse should not assume that he or she has enough knowledge but should be willing to learn more.
(LEARNED IN CLASS)
During a conference after rounds, a nurse states, “They are in the United States now; you would think that they would act like us.” This nurse is exhibiting:
A)Cultural humility
B)Ethnocentrism
C)Cultural competence
D)Cross-cultural nursing
B (ethnocentrism)
rationale:
Ethnocentrism refers to the tendency of people to view their way of doing things and their culture as superior to the cultures and ways of others. Cultural humility requires community health nurses to continually self-evaluate and critique their own cultural assumptions and advocate for their clients in a non paternalistic way. In nursing, cultural competence means considering cultural aspects of health, illness, and treatment for each client or community, as well as doing so at each stage of the nursing process. Cross-cultural nursing is any nursing work in which the nurse and client have different cultures.
During an ice storm, people in one neighborhood banded together and shared the home of a neighbor who still had power and heat. Other neighbors provided food, water, and bedding. In another neighborhood, the neighbors did not know one another and weathered the storm alone. Both neighborhoods are part of the same community. What characteristic did the people in the first neighborhood share that made them a subculture that those in the second neighborhood lacked?
A)Belief in the value of the cooperation
B)Religion
C)Socioeconomic status
D)Geography
A (belief in the value of the cooperation)
rationale:
A subculture may be large or small, clustered together or scattered, but its members share some cultural facets such as experience, belief, language (or lingo), practices, and values. The only common characteristic that the neighbors in the first neighborhood had with each other that the neighbors in the second neighborhood lacked was a belief in the value of cooperating with one another during the storm. There is no indication that they were of the same religion or socioeconomic status. People in both neighborhoods have geography as a common characteristic.
The nurse enters a client’s home to provide care to a wound and teach the client’s wife how to care for the wound. The nurse is comfortable with the client’s culture and the fact that it is matriarchal in nature. As teaching begins, the husband interrupts and states that the woman does not change bandages according to his culture. He asks if the nurse is familiar with his culture and then says that all members of his neighborhood follow its principles. The nurse should suspect that the client is a member of:
A)A cult
B)An orthodox religious group
C)A subculture
D)An occupation
C (subculture)
rationale:
Just as any group of people from a certain place may share a culture, any group of people who share a certain characteristic can share a smaller culture, or subculture. In this situation, although the nurse is familiar with the culture of the client and her husband, it is apparent that they also belong to a subculture that the nurse is unfamiliar with. There is no indication that the client and her husband are members of a cult, orthodox religious group, or certain occupations, all of which are types of subcultures.
To demonstrate true cultural sensitivity and awareness, the nurse must:
A)Travel to other countries on the occasion
B)Become bilingual
C)Be competent in his or her own cultural heritage
D)Know the practices of all major cultures in one’s region of the country
C ( being competent in his or her own cultural heritage)
rationale:
The first imperative of cultural competence is to be competent in one’s own cultural heritage. International travel, being bilingual and knowing practices of major cultures are all helpful, but not as important as being competent in one’s own cultural heritage.
A client, diagnosed with hypertension, is prescribed a no-added-salt, low-fat diet. He agrees and repeats the teaching principles. At the next visit, the nurse notices salted meat on the counter and the client shows the nurse his food diary. The diet in the past week does not reflect the physician’s orders. What cultural component may have contributed to the noncompliance with the diet order?
A)Diet may be too lean
B)The wife cooks according to the husband’s preferences
C)Diet may not meet the cultural criteria for food choices
D)Food tastes bland and unappetizing
C (diet may not meet the cultural criteria for food choices)
rationale: What and how people eat varies tremendously among cultures, the understanding of which is crucial to good nursing care. A nurse educating a client who is newly diagnosed with diabetes or hyperlipidemia about dietary restrictions will be much more effective if he or she chooses examples that resonate with that particular client. Although the diet could be too lean or bland and unappetizing or the wife might cook according to the husband’s preferences, these are not cultural components.
what are the universal features of all cultures, what they believe is called?
values
what are the rules by which human behavior is governed and result from the cultural values held by the group?
norms
Every culture that has what is shared by the majority?
dominant value
what are groups in a culture that share different values than the majority called?
sub-culture
what are the organizational elements (components) of culture?
- child-rearing practices
- family-basic social unit in a culture
- religious practices
- space
- communication
What does culture influence?
How a person perceives and evaluates the world, and behaves in that world
Culture is influenced by what?
Education, income, and other shared socioeconomic factors
(on-slide)
The ability of nurses to recognize their own cultural abilities and perspectives and how this influences your interaction with the client is for a nurse to have?
cultural competence
What are the foundations to competent care?
Self-awareness (any healthcare worker must have this)
Humility
Culturally competent nursing requires that the nurse understands…
- Their own cultural perspective (self-awareness)
- The culture of institutions that influence the health and well-being of communities
- Lifestyle, value systems, and health/illness behaviors of diverse people
What are the four principles to culturally competent care?
Care is:
- Specific to the client
- Unique to their norms/values
- Includes self-empowerment strategies to facilitate client decision making in health behaviors
- Provided with sensitivity
(ON-SLIDES)
What are the BARRIERS of developing cultural competence?
Stereotyping Prejudice Racism Ethnocentrism Cultural Blindness Cultural Imposition Cultural Conflict Cultural Shock
Leininger’s Theory of Cultural Care (Sunrise model)
Helps us think about cultures in a respectful way and shows us how to use knowledge to provide to provide culturally competent care
(ON SLIDES)
Race relates to a persons?
physical characteristics
(ON SLIDES)
race, religion, and national origin are part of?
ethnicity
(ON SLIDES))
the nurse can support the use of cultural practices in health care when the practice does not have a harmful effect is called what type of accommodation?
cultural accommodation
is a form of prejudice where individuals feel they have power over a group based on skin color or other physical characteristics?
racism
is an emotional reaction of beliefs about a group. An individual is pre-judged to have negative traits?
prejudice
Is assigning particular beliefs about an individual or group without recognizing individual differences called what?
stereotyping
Is a belief that ones own culture determines the standards by which everyone should be judged?
Ethnocentrism
what is it called when a person does not see differences between their culture and others?
Cultural blindness
a person imposes their cultural beliefs on a person of another culture is called?
Cultural imposition
(IMPORTANT)
What is the role of the nurse in a comprehensive cultural assessment of the culture include?
- Values, beliefs and attitudes regarding health, illness, birth, death and health care providers
- Nutritional assessment
- Socioeconomic assessment
- Developmental considerations-child-bearing and child-rearing practices, care of older adults
What are resources (FEDERAL) for minority health?
- US Department of Health and Human Services
- Office of Minority Health-coordinates federal efforts to improve the health status of racial and ethnic minorities - -Indian Health Services provides health services to Native Americans and Alaska Natives. Works with this population to establish goals. Tribes actively involved with health care services
What are the four characteristics of a culture?
- they are learned from birth
- shared by all members of the cultural group
- adapted to specific conditions related to the environment, technical factors and available resources
- Culture is dynamic
Who is considered the first epidemiologist?
A)Hippocrates of Cos
B)Aretaeus the Cappadocian
C)Claudius Galen
D)Susruta
A (hippocrates of Cos)
rationale:
Hippocrates of Cos was the first to record the relationship of the external environment to the health of individuals and is considered the first epidemiologist. Aretaeus the Cappadocian described pulmonary tuberculosis in detail. Claudius Galen described the four humors, introduced many drugs derived from plants, and was the first to describe smallpox. Susruta was a Brahmin physician who associated malaria with the mosquito.
Which occurs in the epidemiologic process that is similar to the diagnosis phase of the nursing process?
A)Data are gathered from reliable sources
B)Healthcare needs and assets are identified
C)Goals and objectives for care are established
D)A tentative hypothesis is formulated
D (a tentative hypothesis is formulated)
rationale:
During the diagnosis phase of the epidemiologic process, a tentative hypothesis is formulated. During the assessment phase of the epidemiologic process, data are gathered from reliable sources. During the diagnosis phase of the nursing process, healthcare needs and assets are identified and goals and objectives for care are established.
Which most accurately describes how disease patterns have changed from 1900 to the present?
A)Morbidity and mortality from infectious diseases have increased.
B)Morbidity and mortality from unintentional injuries have decreased.
C)Morbidity and mortality from chronic degenerative conditions have decreased.
D)Morbidity and mortality from noninfectious diseases have increased.
D (morbidity and mortality from noninfectious diseases have increased)
rationale:
Primarily as a result of improved public health practices in the early 20th century, life expectancy in the United States, the United Kingdom, and European countries, as well as in other developed countries, rose. With it, a change in the patterns of disease occurred. No longer are infectious diseases the leading causes of death; the morbidity and mortality from noninfectious diseases and chronic degenerative conditions have increased
The community health nurse knows that early attempts to understand illness and disease-focused on the study of the experiences of individual people. Using this knowledge, how would the nurse define epidemiology to a group of nursing students?
A)An outbreak that occurs when there is an increased incidence of a disease beyond that which is normally found in the population
B)Model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment
C)Study of the distribution and determinants of states of health and illness in human populations
D)Epidemiologic model that strongly emphasizes the concept of multiple causations while de-emphasizing the role of agents in explaining illness
C (Study of the distribution and determinants of states of health and illness in human populations)
rationale:
Epidemiology is the study of the distribution and determinants of states of health and illness in human populations. An epidemic is an outbreak that occurs when there is an increased incidence of a disease beyond that which is normally found in the population. The epidemiologic triad is a model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment. The web of causation is an epidemiologic model that strongly emphasizes the concept of multiple causations while de-emphasizing the role of agents in explaining illness.
Which most accurately defines “rate”?
A)Course of a disease or condition from the onset to resolution
B)Primary measurement used to describe either the occurrence or the existence of a specific state of health or illness
C)Probability or likelihood that a disease or illness will occur in a group of people who presently do not have the problem
D)Characteristic or event that has been shown to increase the probability that a specific disease or illness will develop
B (Primary measurement used to describe either the occurrence or the existence of a specific state of health or illness)
Rate is the primary measurement used to describe either the occurrence or the existence of a specific state of health or illness. Natural history is the course of a disease or condition from the onset to resolution. Risk is the probability or likelihood that a disease or illness will occur in a group of people who presently do not have the problem. A risk factor is a characteristic or event that has been shown to increase the probability that a specific disease or illness will develop.
In researching cases of West Nile virus in the community, the nurse explores how the interactions among people infected with this virus, mosquitoes, and the environment they share contribute to outbreaks of this disease. Which epidemiologic model is used in this case?
A)Epidemiologic triad
B)Wheel of causation
C)Web of causation
D)Natural history
A (Epidemiologic triad)
rationale:
The epidemiologic triad is the classic model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment, not by any single factor. The wheel of causation de-emphasizes the agent as the sole cause of disease while emphasizing the interplay of physical, biological, and social environments. The web of causation is an epidemiologic model that strongly emphasizes the concept of multiple causation while de-emphasizing the role of agents in explaining illness. Natural history is the course of a disease or condition from the onset to resolution.
The nurse explores all of the possible factors that contribute to coronary artery disease in the community as links in multiple interrelated chains. Which epidemiologic models is the nurse using?
A)Epidemiologic triad
B)Wheel of causation
C)Web of causation
D)Natural history
C (Web of causation)
rationale:
The web of causation is an epidemiologic model that strongly emphasizes the concept of multiple causation while de-emphasizing the role of agents in explaining illness. The epidemiologic triad is the classic model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment, not by any single factor. The wheel of causation de-emphasizes the agent as the sole cause of disease while emphasizing the interplay of physical, biological, and social environments. Natural history is the course of a disease or condition from the onset to resolution.
Which occurs in the epidemiologic process that is similar to the implementation phase of the nursing process?
A)Data are gathered from reliable sources
B)Actions are initiated to carry out the plan
C)Actions are evaluated and report prepared
D)Further research is conducted if necessary
B (Actions are initiated to carry out the plan)
rationale:
During the implementation phase of the epidemiologic process, actions are initiated to implement the plan. During the assessment phase of the epidemiologic process, data are gathered from reliable sources. During the evaluation phase of the epidemiologic process, actions are evaluated, a report is prepared, and further research is conducted if necessary.
Which best describes a risk factor?
A)Course of a disease or condition from the onset to resolution
B)Primary measurement used to describe either the occurrence or the existence of a specific state of health or illness
C)Probability or likelihood that a disease or illness will occur in a group of people who presently do not have the problem
D)Characteristic or event that has been shown to increase the probability that a specific disease or illness will develop
D (Characteristic or event that has been shown to increase the probability that a specific disease or illness will develop)
rationale:
A risk factor is a characteristic or event that has been shown to increase the probability that a specific disease or illness will develop. An outbreak is a course of a disease or condition from the onset to resolution. Rate is a primary measurement used to describe either the occurrence or the existence of a specific state of health or illness. Risk is the probability or likelihood that a disease or illness will occur in a group of people who presently do not have the problem.
In researching an outbreak of malaria in the developing nation where the nurse currently works, the nurse decides to not focus on the role of mosquitoes in transmitting the disease but on how the physical environment of the community, biological aspects of the community, and social customs interact to affect the prevalence of this disease. Which epidemiological model is the nurse using?
A)Epidemiologic triad
B)Wheel of causation
C)Web of causation
D)Natural history
B ( wheel of causation)
rationale:
The wheel of causation de-emphasizes the agent as the sole cause of disease while emphasizing the interplay of physical, biological, and social environments. The epidemiologic triad is the classic model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment, not by any single factor. The web of causation is an epidemiologic model that strongly emphasizes the concept of multiple causation while de-emphasizing the role of agents in explaining illness. Natural history is the course of a disease or condition from the onset to resolution.
epidemiology covers?
- Infectious and chronic disease
- Mental health
- Accidents and injuries
- Occupational and environmental exposures
The study of the distribution and determination of health and disease in human populations. The principle science of public health. Used to promote health and reduce risks?
Epidemiology
Person-Place-Time Model
- Person: “Who” factors such as demographic characteristics and health and disease statistics
- Place: “Where” factors such as geographic location, climate and environmental conditions, and political and social environment
- Time: “When” factors such as time of day, week, or month and secular trends over months and years
Epidemiological triad (triangle) consists of?
Host, environment, and agent
- not for chronic diseases
- alterations in any of these disrupts the communicable disease process
Host factors of the epidemiological triad are? Intrinsic Factors (Susceptibility, or Response to Agent)
Influence exposure, susceptibility, or response to agent
include: Genetics
- Age
- Gender- male or female
- Ethnic group- certain conditions are more prevalent in specific ethnic groups
- Physiological state- rest, exercise
- Prior immunological experience- have you been vaccinated and it relates to your immune system (active or passive)
- Preexisting disease- having other chronic diseases that put them at risk further
- Human behavior- drinking, drugs, unsafe sex, poor diet, poor exercise
Agent of Disease (Etiologic Factors)?
- Nutritive elements (excesses, deficiencies)
- Chemical agents (Poisons, allergens)
- Physical agents (Ionizing radiation, mechanical)
- Infectious agents (metazoa, protozoa, bacteria, fungi, rickettsia, viruses)
Environmental Factors (Influence Existence of the Agent, Exposure, or Susceptibility to Agent) in the triad? (Extrinsic factors)
influence existence of the agent, exposure, or susceptibility to agent. This includes…1. Physical environment-climate, noise, radiation
- Biological environment-population density, food, water, flora, fauna
- Socioeconomic environment-occupations, exposure to chemicals , economic environment, urbanization
Descriptive epidemiology
- Study of the amount and distribution of disease
- Used by public health professionals
- Identified patterns frequently indicate possible causes of disease
Analytic Epidemiology
- Examine complex relationships among the many determinants of disease
- Investigation of the causes of disease, or etiology
Wheel Model of Human-Environment Interaction
In the middle: Host (human); this is the genetic core
-Surrounding that in the wheel is Biological environment, social environment, and physical environment
Web of Causation
many different things lead up to the final outcome
- ex:illustrates the complexity of relationships among causal variables for heart disease
- these factors can be modified which will alter the final outcome
What are rates?
arithmetic expressions that help practitioners consider a count of an event relative to the size of the population from which it is extracted
-calculating rates–> measures the frequency
Epidemiologic Process
- Define a case-who, where and when
- Calculate rates-measures frequency
- Establish causality-why and how
- Screening-reliability of methods-must have referrals & follow-up. Yield of screening= number of true positive relative to all positive results.
- The surveillance-continuous process to identify trends in disease and risks
What are 2 types of Observational Methods-No interventions or treatment is used?
- Descriptive Epidemiology
Information is collected to characterize a health problem. Provides the foundation for the development of hypotheses testing. - Analytic Epidemiology
Investigates the causes of disease by determining why a disease rate is lower in one population group than in another. Comparisons between groups are made to determine the role of risk factors causing a disease or health problem. Examine causality.
What type of studies are these?
1. Cross-Sectional Studies-Prevalence Studies-collect data by questionnaire or interview of a cross section of the population with a disease or risk factor. Behavior Risk Factor Survey (just to collect the data)
2. Retrospective/Case Control Study-goes back in time. One group has disease, other group does not have the disease. Groups compared for risk factors. (medical records could be lost, subject recall may be a problem)
3. Prospective Studies-Longitudinal Studies-follows disease free people over long period-examines causality.
(cause and effect) -this is the best techniques going forward in time
Observational studies
What type of studies are these?
- True experiments have an experimental and control group.
- Subjects are randomly assigned to the experimental group or control group.
- The experimental group receives a treatment and the control group does not receive a treatment.
- Mainly used to test medications or other treatments.
Interventional-Experimental studies
The public health nurse is preparing to participate in a descriptive epidemiology study. Which statement best describes descriptive epidemiology?
a. The study seeks to answer questions about the cure for a disease
b. The study seeks to answer questions about the distribution of disease in a population
c. The study seeks to answer questions about the cause of a disease
b
The study seeks to answer questions about the distribution of disease in a population
What do incidence rates describe?
the occurrence of new cases of a disease or condition in a community over a period of time relative to the size of the population at risk for that disease or condition during that same time period.describe the occurrence of new cases of a disease or condition in a community over a period of time relative to the size of the population at risk for that disease or condition during that same period of time. Only new cases that occur in the designated time
are counted. Researcher needs to determine the time of onset.
What do attack rates document?
the number of new cases of a disease in those exposed to the disease (ex. food poisoning; denominator is the number of people exposed to a suspect food, and the numerator is the number of people who were exposed and became ill.
-Usually specific to an exposure, e.g. food poisoning or a communicable disease
Prevalence
the number of all cases of a specific disease or condition in a population at a given point in time. Cases include old and new cases that develops within the same time period. Prevalence rates are higher with chronic diseases because cases remain in populations for long
periods of time
* new or old cases the population ( all cases) regards to chronic disease, COPD, HTN, heart disease–> only time you come out of it is when you die
Mortality rate
-measure of death rates
Establishing Causality includes: (select all that apply)
a. Strength of association-rates of morbidity and mortality must be higher in the exposed group than in the non-exposed group.
b. Dose-response relationship-an increased exposure to the risk factor causes a concomitant increase in disease rate.
c. Temporally correct relationship-exposure to the causal factor must occur before the disease
d. Biological plausibility-data must explain the relationship e.g.cigarette smoking increases the risk of lung cancer
e. Consistency with other studies-various studies in other populations must show similar results.
a, b, c, d, e
Classification of infectious diseases include which of the following (select all that apply):
a. endemic-occurrence of an infectious disease at a consistent, expected level in a geographic area, e.g. influenza
b. outbreak-unexpected occurrence of an infectious disease in a limited geographic area, during a limited period of time
c. pandemic-a steady occurrence of disease over a large geographic area e.g. worldwide
d. epidemic-unexpected increase of an infectious disease in a geographic area over an extended period of time
a, b, c, d
unexpected increase of an infectious disease in a geographic area over an extended period of time is called?
epidemic
a steady occurrence of disease over a large geographic area e.g. worldwide is called?
pandemic
occurrence of an infectious disease at a consistent, expected level in a geographic area, e.g. influenza is called?
endemic
Those who survive a chronic disease without cure remain in the:
prevalence pot which is The relationship between incidence and prevalence
risk refers to the?
the probability of an adverse event
Primary prevention:
when interventions occur before disease development
-Includes health promotion and specific prevention
secondary prevention
occurs after pathogenesis; screening and physical examinations that are aimed at early diagnosis
tertiary prevention
focuses on limitation of disability and the rehabilitation of those with irreversible diseases such as diabetes and spinal cord injury
Why is it important to identify causality of disease?
to encourage the most effective prevention activities and develop treatment modalities
What are cross-sectional studies also called?
Prevalence or correlational studies
Why are observational studies used?
- Descriptive purposes
- Etiology of disease
- No manipulation by investigator
Why is it impossible for a cross-sectional study to make causal inferences?
because the study cannot establish the temporal sequence of events (i.e., the cause preceded the effect)
The nurse works with a female client who recently developed an infection of Staphylococcus aureus while in the hospital. In this case, S. aureus is which component in the chain of infection?
A)Host
B)Environmental reservoir
C)Agent
D)Portal
C (agent)
rationale:
The agent, or the microbe that causes the disease, is the “what” of the epidemiologic triangle. The host, or the organism that is harboring the infectious agent, is the “who” of the triangle. The environment, which includes those external factors that cause or allow disease transmission, is the “where” of the triangle. Other necessary elements include a portal of exit from the host, environmental reservoirs, transmission, and a portal of entry to a new host.
A student nurse asks if an infectious disease is the same thing as a communicable disease. The nurse explains that an infectious disease is not necessarily a communicable disease. Which must a communicable disease have that an infectious disease does not have to have? (Select all that apply.)
A)Pathogenic microorganism
B)Portal of exit from the infected person
C)Means of transmission
D)Portal of entry to a susceptible host
E)Organism that harbors the infectious agent
B,c,d
rationale:
An infectious disease in a human host is one caused by the growth of pathogenic microorganisms in the body. For a disease to be communicable, or contagious, there must be a portal of exit from the infected person (or animal), a means of transmission, and a portal of entry to a susceptible host. Thus, an infectious disease need not be contagious, or communicable.
Infectious agents are biological agents capable of producing an infection or infectious disease. Which are considered biological agents? (Select all that apply.)
A)Fungi B)Fomites C)Bacteria D)Viruses E)Helminths
A,C,D,E
rationale:
Infectious agents are biological agents capable of producing an infection or infectious disease and include bacteria, viruses, rickettsiae, fungi, protozoa, and helminths. Fomites are any substance that adheres to and transmits infectious materials. An infectious disease need not be contagious or communicable.
In infectious disease epidemiology, just the presence of an infectious agent is not sufficient to produce an infectious disease. Which host factors determine whether a person is at risk for an infection or an infectious disease? (Select all that apply.)
A)Age B)Sex C)Occupation D)Physical and emotional health E)Immune status
A,B,D,E
rationale:
There are several host factors that determine whether a person is at risk for an infection or an infectious disease. These include age, sex, race, physical and emotional health, and immune status. Occupation is not a host factor
When an infectious agent enters the host and begins to multiply, an infection occurs. The time between exposure to an infectious agent and the manifestation of symptoms in the host is known as:
A)Carrier time
B)Colonization
C)Incubation period
D)Latent period
C (incubation period)
rationale:
The time between exposure to an infectious agent and the manifestation of symptoms in the host is called the incubation period. Asymptomatic people are carriers of a virus and can transmit the virus to others through percutaneous inoculation, exposure to mucous membranes, and sexual contact. When an infectious agent is present and there are no clinical signs of disease, colonization with the infectious agent is said to have occurred, and the infected person is capable of transmitting the agent.
The latent period is the stage of a disease during which symptoms are?
hidden
A client with tuberculosis sneezes in the waiting room and infects several other clients who are sitting on the other side of the room. Which mechanism of transmission is involved in this case?
A)Airborne
B)Droplet
C)Direct contact
D)Indirect contact
A (airborne)
rationale:
Airborne transmission occurs when microorganisms are carried in the air in small particles, called droplet nuclei, at distances that exceed a few feet. Droplet transmission theoretically is a form of contact transmission; the mechanism of transfer of the pathogen to the host is quite distinct from either direct or indirect transmission. Therefore, droplet transmission is considered a separate route of transmission. Droplets
Direct contact occurs through?
direct body surface–to–body surface contact and physical transfer of microorganisms between a susceptible host and an infected or colonized person (or animal).
what type of contact involves contact of a susceptible host with a contaminated intermediate inanimate object, called a vehicle, such as a contaminated surgical instrument, needle, toy, soiled clothing, or bed linen?
indirect contact
are generated from the source person primarily during coughing, sneezing, or talking and are propelled a short distance (<3 feet) through the air and deposited on the conjunctivae, nasal mucosa, or mouth of another person. ?
droplets
The student-nurse discusses transmission that involves contact of a susceptible host with a vehicle. Based on the chain of infection links, which exemplifies a vehicle?
A)Animals
B)Insects
C)Reptiles
D)Water
D (water)
rationale:
Indirect contact involves contact of a susceptible host with a contaminated intermediate inanimate object, called a vehicle, such as a contaminated surgical instrument, needle, toy, soiled clothing, or bed linen. Vehicles also include food, water, and contaminated hands that are not washed. Indirect contact also includes vector transmission. Vectors are animal or insect carriers of infectious agents.
Chloroquine-resistant malaria occurs in most of Africa, the Middle East, and Asia and all of the South Pacific islands. This type of disease occurrence is known as:
A)Endemic
B)Epidemic
C)Pandemic
D)Outbreak
A (endemic) ( a normal occurence)
rationale:
An endemic disease, infection, or infectious agent occurs when it becomes prevalent within a population or geographic area. The use of “outbreak” in this text is synonymous with epidemic.
is an epidemic that generally spreads worldwide?
pandemic
refers to a significant increase in an infection or infectious disease beyond the expected (endemic) level in a certain population and/or geographic area?
epidemic or outbreak
Person, place, and time characterize the description of an epidemiologic problem. Using knowledge of outbreak investigations, which occurs with propagated outbreaks?
A)Same person or vehicle as the reservoir or means of transmission
B)Infection transmitted from person to person over a short period of time
C)Generating secondary infections with intervals between peaks that approximate the usual incubation period for the infection
D)Generating tertiary infections following exposure to a primary case
C (generating secondary infections)
rationale:
A propagated outbreak is one where the infection is transmitted from person to person over a longer period of time than with a common source outbreak, and it can generate secondary infections with intervals between peaks that approximate the usual incubation period for the infection. A common source outbreak is one that has the same origin. Secondary infections are those that occur within the accepted incubation period following exposure to a primary case.
Several levels of public health surveillance are necessary to protect the nation’s health. At what level are healthcare providers and health facilities required to report certain infectious diseases?
A)Local
B)State
C)Federal
D)International
B (state)
rationale:
Local reporting mechanisms are community specific. At the state level, healthcare providers and health facilities are required to report certain infectious diseases to state health departments. At the federal level, the Department of Health and Human Services (DHHS) is the US public health infrastructure that develops policies to protect the nation’s health. The Centers for Disease Control and Prevention (CDC) also is a partner with the World Health Organization (WHO) through the Global Outbreak Alert and Response Network and the WHO Surveillance and Response system, which provide international epidemic alerts and responses
Which agency has an electronic surveillance system for the early notification of community-based epidemics?
A)Department of Health and Human Services
B)Centers for Disease Control and Prevention
C)World Health Organization
D)Department of Defense
D (department of defense)
rationale: The Department of Defense (DoD) has an electronic surveillance system for the early notification of community-based epidemics (ESSENCE), which has been in operation since 2001 to detect infectious disease outbreaks. At the federal level, the Department of Health and Human Services (DHHS) is the U.S. public health infrastructure that develops policies to protect the nation’s health. The Centers for Disease Control and Prevention (CDC) is a major DHHS agency that protects the nation’s health by developing guidelines that promote health and quality of life by preventing and controlling disease, injury, and disability. The CDC is also a partner with the World Health Organization (WHO) through the Global Outbreak Alert and Response Network and the WHO Surveillance and Response system, which provide international epidemic alerts and responses.
refer to the pathophysiological responses of the host to the infectious agent, manifesting as an illness . Infection is the entry & multiplication of an agent in the host is?
infectious disease and comunicable disease
emphasizes that an infectious agent alone is not sufficient to cause disease—the agent must be transmitted in the environment to a susceptible host is called?
multicausation
What are the stages/periods of infection (LCIA)?
latent, communicable, incubation, active illness
