Foundations of Nursing Study Set 1

Nursing

Quiz 9 :

Epidemiological Applications

Quiz 9 :

Epidemiological Applications

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Discuss the steps in the epidemiological process.
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Epidemiology can be defined as a study of determination of states of health, events in the population of humans, its distribution as well as the application of such studies in control as well as the prevention of any health related consequences.
Information on epidemiology plays a very essential role in completing the objectives of public health that is aimed for promoting mental, physical as well as well-being inside the population.
The steps in the epidemiological process are as follows:
1. Data sources- It is the first step in the epidemiological process to know how the data will be obtained. Birth and mortality statistics are calculated from vital records. It gives health related information, hence vital in many countries. Census data, birth certificates, death certificates, and surveillance data come under this category.
2. Rate adjustment- Rates are an essential factor for epidemiological studies. Age adjustment is done by direct or indirect methods. A standard population is considered as an external population that serves as a reference.
3. Comparison groups- The exposed group is compared with the unexposed group to decide, whether the disease rate is the result of suspected risk factors. This comparison is important for observational studies to control for confounding variables or factors.

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An infection preventionist (IP) at a local hospital contacted the nurse epidemiologist at the local health department to report that the hospital had received three laboratory reports of Acinetobacter baumannii infection from inmates at the local jail. The IP states that the jail typically sends all of their laboratory specimens to them for processing. The IP stated that the specimens were obtained from wounds and collected within a 2-month period. The nurse epidemiologist suspects an outbreak and launches an investigation because the situation is: A. An unusual problem B. There is a potential risk to the public C. There is a casual pathway D. All the above
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The disease progression is the complex process between causal agents, susceptible persons, and the environment. These three together are called the epidemiologic triangle. All these three elements are dependent on each other. Variation in any one of the factors may change the others too.
The agent is an animate or inanimate factor whose presence or absence is necessary for disease progression. The agents can be infectious, chemical or physical. The infectious agents are commonly microbes such as bacteria, viruses, fungi, and parasites. The chemical agents include heavy metals, toxic chemicals and pesticides. The physical agents are radiation, heat, cold and machinery.
The host is a living species that is being susceptible for the infection caused by the agent. There are several factors that make the host susceptible to be infected. These factors are genetic susceptibility, age, sex, and immune status and life style patterns.
The conditions that internally or externally influence the given host are known as environment. The factors that are the part of environment are climate, plant, animal life, human population distribution, socioeconomic factors, and working conditions.

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On August 26, an open house is held by the Dean of the School of Nursing to welcome new and returning nursing students. Approximately 50 nursing students and professors attend. Light appetizers and cider are served. On the morning of August 28, two nursing students report to the student health clinic with nausea and vomiting. Later that day, three other students report to the clinic with headache, nausea, and vomiting. Two of the five students report that their symptoms began the evening of August 27, and the other three report symptom onset the morning of August 28. Two nursing professors call in sick with nausea and diarrhea on August 28. Both attended the Dean's open house and a reception earlier in the week. The student health nurse notifies the nurse epidemiologist at the local health department that she has seen five nursing students with gastrointestinal symptoms. She reports their names, dates of birth, dates and times of onset of symptoms. The nurse epidemiologist notifies the student health nurse that all of the stool specimens were positive for norovirus. Based on the incubation period for norovirus (12-48 hours) and the dates of onset of symptoms, the nurse epidemiologist suspects the students were exposed to the virus at or around the same time. She hypothesizes that the nurses contracted norovirus from a contaminated item consumed at the open house event. She makes arrangements to meet with the Dean to discuss the situation and gather additional information. What information would be useful to the nurse epidemiologist
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The responsibility of the nurse epidemiologist is to find out the reason of infection, and take necessary interventions. Norovirus causes viral gastroenteritis in humans. The virus infects through contaminated, food, water, droplets, and from person to person contact. The symptoms of norovirus infections are nausea, vomiting and watery diarrhea.
It may be possible that the food served at the event was contaminated. The students ate that contaminated food and got infected. If the persons that served and prepared the food are infected then it is possible that the food got infected by the droplets or the aerosols.
The list of the people that attended the event may reflect that if anyone present is infected prior to the event or not. If anyone prior infected is present in the event, then it may be possible that the other got infected through person to person contact.
The faculty and the students that are not present at the event may also be the source of infection. It is possible that the infection came from the classroom. So, the people absent at the event may also be the infection source.
Hence, the correct answer is option
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On August 26, an open house is held by the Dean of the School of Nursing to welcome new and returning nursing students. Approximately 50 nursing students and professors attend. Light appetizers and cider are served. On the morning of August 28, two nursing students report to the student health clinic with nausea and vomiting. Later that day, three other students report to the clinic with headache, nausea, and vomiting. Two of the five students report that their symptoms began the evening of August 27, and the other three report symptom onset the morning of August 28. Two nursing professors call in sick with nausea and diarrhea on August 28. Both attended the Dean's open house and a reception earlier in the week. The student health nurse notifies the nurse epidemiologist at the local health department that she has seen five nursing students with gastrointestinal symptoms. She reports their names, dates of birth, dates and times of onset of symptoms. Based on the data analysis the nurse epidemiologist determined that the fresh vegetable tray is associated with illness. She also learned that two of the food handlers were not feeling well during the event. What measures should she take at this point to control the outbreak
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On August 26, an open house is held by the Dean of the School of Nursing to welcome new and returning nursing students. Approximately 50 nursing students and professors attend. Light appetizers and cider are served. On the morning of August 28, two nursing students report to the student health clinic with nausea and vomiting. Later that day, three other students report to the clinic with headache, nausea, and vomiting. Two of the five students report that their symptoms began the evening of August 27, and the other three report symptom onset the morning of August 28. Two nursing professors call in sick with nausea and diarrhea on August 28. Both attended the Dean's open house and a reception earlier in the week. The student health nurse notifies the nurse epidemiologist at the local health department that she has seen five nursing students with gastrointestinal symptoms. She reports their names, dates of birth, dates and times of onset of symptoms. The nurse epidemiologist decides to interview everyone (ill and well) who attended the open house. This type of study is called a:
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Explain the basic epidemiological concepts of population at risk, natural history of disease, levels of prevention, host-agent-environment relationships, and the web-of-causation model.
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Mary Miles is the nurse epidemiologist for the Warren County Health Department. A local church contacted Ms. Miles when several church members became sick after the annual church picnic. Of the 200 people who attended the picnic, 100 were ill with diarrhea, nausea, or vomiting. Ten people required emergency medical treatment or hospitalization. Incubation periods ranged from 1.5 to 30 hours, with a mean of 6 hours and a median of 3.5 hours. Duration of illness ranged from 1 to 80 hours, with a mean of 30 hours and a median of 15 hours. The annual church picnic is a potluck lunch buffet. The menu included macaroni casserole (brought by the Joneses), turkey with gravy and stuffing (brought by the Smiths), potato salad (brought by the Changs), green bean casserole (brought by the Champs), chili (brought by the Turners), homemade bread (brought by Granny Ivy), chocolate cake (brought by the Bushes), and cookies (brought by the Beckmans). Ms. Miles interviewed the church members who were ill and found that three food items were significantly associated with illness: turkey, gravy, and stuffing. Ms) Miles interviewed the Smiths, who brought the turkey, gravy, and stuffing to the picnic. Review of food-handling procedures indicated that the turkey had cooled for 4 hours at room temperature after cooking-a time and temperature sufficient for bacterial growth and toxin production. Furthermore, the same utensils were used for both the turkey and other foods before and after cooking. Ms) Miles talked with the Smiths about proper food-handling practices, emphasizing hand washing, proper cooling and preserving methods, and better equipment and utensil sanitation. Ms. Miles also offered a similar class to the church congregation. Which level of prevention is Ms. Miles exemplifying
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Differentiate between descriptive and analytic epidemiology.
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An infection preventionist (IP) at a local hospital contacted the nurse epidemiologist at the local health department to report that the hospital had received three laboratory reports of Acinetobacter baumannii infection from inmates at the local jail. The IP states that the jail typically sends all of their laboratory specimens to them for processing. The IP stated that the specimens were obtained from wounds and collected within a 2-month period. The nurse epidemiologist discovers that all of the infected inmates have their wound dressings changed on the same day of the week in the same treatment room. She notices there is no sink or evidence of hand sanitizer in the treatment room. She recommends the following strategies except:
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Mary Miles is the nurse epidemiologist for the Warren County Health Department. A local church contacted Ms. Miles when several church members became sick after the annual church picnic. Of the 200 people who attended the picnic, 100 were ill with diarrhea, nausea, or vomiting. Ten people required emergency medical treatment or hospitalization. Incubation periods ranged from 1.5 to 30 hours, with a mean of 6 hours and a median of 3.5 hours. Duration of illness ranged from 1 to 80 hours, with a mean of 30 hours and a median of 15 hours. The annual church picnic is a potluck lunch buffet. The menu included macaroni casserole (brought by the Joneses), turkey with gravy and stuffing (brought by the Smiths), potato salad (brought by the Changs), green bean casserole (brought by the Champs), chili (brought by the Turners), homemade bread (brought by Granny Ivy), chocolate cake (brought by the Bushes), and cookies (brought by the Beckmans). Ms. Miles interviewed the church members who were ill and found that three food items were significantly associated with illness: turkey, gravy, and stuffing. Ms) Miles interviewed the Smiths, who brought the turkey, gravy, and stuffing to the picnic. Review of food-handling procedures indicated that the turkey had cooled for 4 hours at room temperature after cooking-a time and temperature sufficient for bacterial growth and toxin production. Furthermore, the same utensils were used for both the turkey and other foods before and after cooking. Ms) Miles talked with the Smiths about proper food-handling practices, emphasizing hand washing, proper cooling and preserving methods, and better equipment and utensil sanitation. Ms. Miles also offered a similar class to the church congregation. For the nurse to evaluate why people at the picnic became sick, what questions should she ask the people who brought the food
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On August 26, an open house is held by the Dean of the School of Nursing to welcome new and returning nursing students. Approximately 50 nursing students and professors attend. Light appetizers and cider are served. On the morning of August 28, two nursing students report to the student health clinic with nausea and vomiting. Later that day, three other students report to the clinic with headache, nausea, and vomiting. Two of the five students report that their symptoms began the evening of August 27, and the other three report symptom onset the morning of August 28. Two nursing professors call in sick with nausea and diarrhea on August 28. Both attended the Dean's open house and a reception earlier in the week. The student health nurse notifies the nurse epidemiologist at the local health department that she has seen five nursing students with gastrointestinal symptoms. She reports their names, dates of birth, dates and times of onset of symptoms. The nurse epidemiologist notes that the infections are clustered in time, place, and person. She interviews all of the ill nursing students and learns that all of them attended the open house at the Dean's home. What should the nurse do next
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An infection preventionist (IP) at a local hospital contacted the nurse epidemiologist at the local health department to report that the hospital had received three laboratory reports of Acinetobacter baumannii infection from inmates at the local jail. The IP states that the jail typically sends all of their laboratory specimens to them for processing. The IP stated that the specimens were obtained from wounds and collected within a 2-month period. The nurse epidemiologist decided to visit the jail. Based on what she knows about the transmission of Acinetobacter baumannii, she should collect the following information.
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Explain how nurses use epidemiology in community health practice.
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Mary Miles is the nurse epidemiologist for the Warren County Health Department. A local church contacted Ms. Miles when several church members became sick after the annual church picnic. Of the 200 people who attended the picnic, 100 were ill with diarrhea, nausea, or vomiting. Ten people required emergency medical treatment or hospitalization. Incubation periods ranged from 1.5 to 30 hours, with a mean of 6 hours and a median of 3.5 hours. Duration of illness ranged from 1 to 80 hours, with a mean of 30 hours and a median of 15 hours. The annual church picnic is a potluck lunch buffet. The menu included macaroni casserole (brought by the Joneses), turkey with gravy and stuffing (brought by the Smiths), potato salad (brought by the Changs), green bean casserole (brought by the Champs), chili (brought by the Turners), homemade bread (brought by Granny Ivy), chocolate cake (brought by the Bushes), and cookies (brought by the Beckmans). Ms. Miles interviewed the church members who were ill and found that three food items were significantly associated with illness: turkey, gravy, and stuffing. Ms. Miles interviewed the Smiths, who brought the turkey, gravy, and stuffing to the picnic. Review of food-handling procedures indicated that the turkey had cooled for 4 hours at room temperature after cooking-a time and temperature sufficient for bacterial growth and toxin production. Furthermore, the same utensils were used for both the turkey and other foods before and after cooking. Ms. Miles talked with the Smiths about proper food-handling practices, emphasizing hand washing, proper cooling and preserving methods, and better equipment and utensil sanitation. Ms. Miles also offered a similar class to the church congregation. Is Ms. Miles performing descriptive epidemiology or analytic epidemiology
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An infection preventionist (IP) at a local hospital contacted the nurse epidemiologist at the local health department to report that the hospital had received three laboratory reports of Acinetobacter baumannii infection from inmates at the local jail. The IP states that the jail typically sends all of their laboratory specimens to them for processing. The IP stated that the specimens were obtained from wounds and collected within a 2-month period. She decides to educate all staff about the organism, including how it is transmitted and prevention strategies. This level of prevention is
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Mary Miles is the nurse epidemiologist for the Warren County Health Department. A local church contacted Ms. Miles when several church members became sick after the annual church picnic. Of the 200 people who attended the picnic, 100 were ill with diarrhea, nausea, or vomiting. Ten people required emergency medical treatment or hospitalization. Incubation periods ranged from 1.5 to 30 hours, with a mean of 6 hours and a median of 3.5 hours. Duration of illness ranged from 1 to 80 hours, with a mean of 30 hours and a median of 15 hours. The annual church picnic is a potluck lunch buffet. The menu included macaroni casserole (brought by the Joneses), turkey with gravy and stuffing (brought by the Smiths), potato salad (brought by the Changs), green bean casserole (brought by the Champs), chili (brought by the Turners), homemade bread (brought by Granny Ivy), chocolate cake (brought by the Bushes), and cookies (brought by the Beckmans). Ms. Miles interviewed the church members who were ill and found that three food items were significantly associated with illness: turkey, gravy, and stuffing. Ms) Miles interviewed the Smiths, who brought the turkey, gravy, and stuffing to the picnic. Review of food-handling procedures indicated that the turkey had cooled for 4 hours at room temperature after cooking-a time and temperature sufficient for bacterial growth and toxin production. Furthermore, the same utensils were used for both the turkey and other foods before and after cooking. Ms) Miles talked with the Smiths about proper food-handling practices, emphasizing hand washing, proper cooling and preserving methods, and better equipment and utensil sanitation. Ms. Miles also offered a similar class to the church congregation. Identify the agent, host, and environment in this case study.
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Describe the essential elements of epidemiology and an epidemiological approach.
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Define epidemiology and describe how it has developed over time.
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On August 26, an open house is held by the Dean of the School of Nursing to welcome new and returning nursing students. Approximately 50 nursing students and professors attend. Light appetizers and cider are served. On the morning of August 28, two nursing students report to the student health clinic with nausea and vomiting. Later that day, three other students report to the clinic with headache, nausea, and vomiting. Two of the five students report that their symptoms began the evening of August 27, and the other three report symptom onset the morning of August 28. Two nursing professors call in sick with nausea and diarrhea on August 28. Both attended the Dean's open house and a reception earlier in the week. The student health nurse notifies the nurse epidemiologist at the local health department that she has seen five nursing students with gastrointestinal symptoms. She reports their names, dates of birth, dates and times of onset of symptoms. The nurse epidemiologist at the health department develops a line list to organize the data. The line list includes the information reported by the student health nurse. What is the term used to describe the type of epidemiology associated with time, place, and person
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