1. Disease surveillance, a critical role function for the public health nurse (PHN), can best be defined as the ongoing, systematic collection, analysis, interpretation, and dissemination of specific health data relevant to public health. The nurse's know
ANS: C
Surveillance is a critical role for the nurses practicing in the community. A comprehensive understanding and knowledge of surveillance systems and how they work will help nurses improve the quality and the usefulness of the data collected for the
2. A PHN uses the state health department's reportable disease system to complete a community assessment of a rural county with issues of access to primary care services. This can best be described as what type of surveillance system?
a. Active
b. Passive
ANS: B
In a passive system of surveillance, health care providers, agencies, or laboratories send case reports to local health departments. The case reports are summarized and forwarded to the state health department, national governmental agency, or orga
3. The nurse epidemiologist in a local health district receives a report from a local pediatrician that a case of chickenpox has been diagnosed in a second grader at one of the local elementary schools. The nurse proceeds to contact the school to determin
ANS: A
In an active system of surveillance, the PHN, as an employee of the health department, may begin a search for cases through contacts with the local health providers and health care agencies. The nurse names the disease or event and gathers data abo
4. The first step in initiating a surveillance strategy is to confirm the:
a. existence of the event.
b. magnitude of the problem.
c. source of the outbreak.
d. tentative hypothesis.
ANS: A
The first step in conducting an investigation is to confirm that an occurrence/outbreak actually exists and that a supposed event is not a false alarm. The investigator must find out the nature, location, and severity of the problem. Only the inves
5. During an investigation, once the problem has been identified and the initial magnitude delineated in a case definition, the next step is to:
a. check the state reportable disease list and request help.
b. initiate control measures appropriate to the e
ANS: B
Once an event/outbreak has been identified, confirmed, and initially defined, early and continuously changing control measures should be initiated to contain the event and minimize further impact on the public. Then, the investigation can proceed a
6. One of the unique advantages of using data reporting such as a spatial map to analyze and present data is that such a tool provides a graphical way of determining:
a. characteristics of the population.
b. potential hypothesis.
c. priority prevention ta
ANS: C
A spatial map is a data-reporting tool that graphically presents the distribution of an event/outbreak in such a way that priority prevention target areas can easily be identified, because it shows graphically what is happening and where it is happ
7. The most common sources of surveillance data are databases maintained by the federal agencies, state health departments, and other organizations with an interest in understanding a specific disease or event. The National Program of Cancer Registries co
ANS: C
A good example of a process in place to collect morbidity data is the National Program of Cancer Registries. This program provides for monitoring the types of cancer found in a state and the locations of the cancer risks and health problems in the
8. Collaboration among local, state, and federal agencies; health care providers, agencies, and organizations; and other community-based services that address issues of safety and welfare in a community is critical to the success of a quality surveillance
ANS: C
The Core Competencies for public health are divided into eight practice domains: analytical assessment skills, policy/program development, communication, cultural competency, community dimensions of practice, basic public health sciences, financial
9. Disease and event surveillance systems exist to help improve the health of the public through the systematic and ongoing collection, distribution, and use of health-related data. A PHN utilizes the data in available surveillance systems to make a prese
ANS: D
A nurse can contribute to surveillance systems and can best use the data collected through such systems to help manage endemic health problems and those that are emerging, such as evolving infectious diseases and bioterrorist (human-created) health
1. Morbidity data can most easily be located in which of the following sources? (Select all that apply.)
a. Environmental surveys
b. Hospital discharge reports
c. Medical examiners' reports
d. Specialized disease registries
e. Vital statistics sources
ANS: A, B, D
Mortality data can be found in data sources containing vital statistics, which typically include death certificates and coroner/medical examiner reports, and birth certificates. Morbidity data are typically found in reports of notifiable dise
1. Public health nurses (PHNs) are challenged to respond to public health-related trends of the twenty-first century, which include:
a. racial, ethnic, and economic health disparities; rise of drug-resistant pathogens; unequal access to health care; and v
ANS: A
Twenty-first-century challenges include increasing rates of drug resistance in community-acquired pathogens and societal issues such as welfare reform, economic disparities, racial/ethnic disparities, behavioral influences on health, and unequal ac
2. Rapid changes in public health are providing a challenge to PHNs because there is neither time nor staff to provide nurses with the on-the-job training needed to acquire the core public health competencies required of the PHN. This resulted in revision
ANS: C
Historically, many of the core public health competencies were provided by PHNs who had learned these skills in the workplace while gaining knowledge through years of practice. Because of rapid changes in public health and limited resources, this a
3. A PHN in the local health department assists the community in identifying the health need priorities and the services that can best meet these needs in a cost-effective manner. This is an example of the tertiary prevention public health nursing functio
ANS: B
Case management is a major tertiary prevention function for PHNs at the community level of practice. Case managers assist clients in identifying the services they need the most at the least cost. They also assist communities and populations in iden
4. State public health agency responsibilities include:
a. conducting community health assessments.
b. enforcing public health codes.
c. monitoring health status.
d. providing expertise that facilitates evidence-based practice.
ANS: C
Federal public health agencies develop regulations that implement policies formulated by Congress, provide funding to state and territorial health agencies for public health activities, survey the nation's health status and health needs, set practi
5. The PHN serves as a bridge between at-risk populations and the community's health care resources. This role is based on the nurse's responsibility to:
a. collect and analyze data on public health programs.
b. ensure that all populations have access to
ANS: B
Public health's shift from being the primary care provider of last resort to the developing partnerships to meet the health promotion and disease prevention needs of populations has raised concerns about available health care for the uninsured and
6. If the two major goals of Healthy People 2020 are to be achieved, collaboration is essential for public health nursing practice, and collaboration with existing groups at the local level is encouraged for which of the following reasons?
a. The federal
ANS: C
Partnerships and collaboration among groups are much more powerful in making change than the individual client and PHN working alone. Because public health departments do not have the resources to accomplish the Healthy People 2020 goals independen
7. The PHN ensures that a local community coalition for improving school lunches takes the time to listen to each stakeholder's view, develops a common validated language for discussing the initiative, and shares the credit for the success of the initiati
ANS: B
Changes can be accomplished more easily and effectively by partnerships and collaboration among groups than by the individual client and PHN working alone. The Community Campus Partnerships for Health involved its members and partners in developing
8. The federal-state-local partnership teams with other organizations to develop and implement responses to identified public health concerns because:
a. community health is a shared responsibility.
b. health objectives are defined nationally.
c. populati
ANS: A
PHNs partner with multidisciplinary teams of people within public health areas, in other human services and public safety agencies, and in community-based organizations. The health of communities is a shared responsibility that requires a variety o
9. The PHN applies knowledge in working with a local school board coalition to develop a helmet safety campaign in the middle and high schools. This best exemplifies which aspect of public health?
a. Core Competency
b. Core function
c. Nursing role
d. Sta
ANS: A
The core public health competencies are divided into eight domains: analytical assessment skills, basic public health science skills, cultural competency skills, communication skills, community dimensions of practice skills, financial planning and
1. The Quad Council of Public Health Nursing identified eight principles that distinguish the public health nursing specialty from other nursing specialties, including which of the following? (Select all that apply.)
a. Collaboration with other profession
ANS: A, B, C, E
The tenets (principles) of public health nursing were developed by the Quad Council of Public Health Nursing and integrated into the Scope and Standards of Public Health Nursing Practice of the American Nurses Association (ANA, 2005). Thes
1. A nurse is assigned to provide community outreach to a small town that was partially destroyed by a tornado 3 years earlier and has been rebuilt. The first client is a family who lost their home and their best friend in the tornado. The best interventi
ANS: D
The approach of relief activities needs to shift from short-term aid to long-term support. Promoting individual, family, and community preparedness increases safety in the event of disaster and can help children and adults feel empowered. This buil
2. The highest priority for a nurse who is among the first responders to a disaster is:
a. arranging for shelter for disaster providers.
b. beginning community assessment as soon as possible to ensure a rapid recovery.
c. beginning surveillance and planni
ANS: D
The first priority when responding to a disaster is to immediately plan for, coordinate, and carry out effective triage. Disaster response includes community assessment, surveillance, health education, and coordination of shelter arrangements. Howe
3. The emergency support functions of the National Response Framework (NRF) and the National Incident Management System (NIMS) provide:
a. authority to step in and take control of state, local, and voluntary organizations during disasters.
b. command and
ANS: D
The first level of disaster response is carried out by the locality (office of emergency management). Through mutual aid agreements, localities can arrange for additional support from surrounding communities (emergency operations center). When the
4. A nurse is working with a disaster medical assistance team as it responds to a disaster. A new team member excitedly insists that its personnel can exceed their 12-hour shifts and do not need breaks. The best intervention on the part of the nurse is to
ANS: C
The nurse needs to be aware that rescue workers are repeatedly exposed to stress and, despite their training in managing such situations, have a higher than normal risk of developing post-traumatic stress syndromes. The nurse can assist the new tea
5. The major factor that has led to sharply increased insurance payouts following disasters in the United States in recent decades has been:
a. El Ni�o.
b. geography.
c. technology.
d. human development.
ANS: D
The cost in more developed countries is higher because of the extent of material possessions and complex infrastructures, including technology. In the United States, increases in population and development in areas vulnerable to natural disasters,
6. A nurse takes the time to read and understand the community's disaster plans and participates in mock disaster drills as a leader of the triage team. The nurse obtained disaster management training through the local Red Cross chapter and registered wit
ANS: B
Preparedness takes place at three levels: personal, professional, and community. The nurse who is professionally prepared is aware of and understands the disaster plans at the workplace and in the community. Preparedness also involves the developme
7. After a mock disaster drill, the nurse participates in a "hot wash" of the exercise in which participants from all units speak about successes, problem solving, failures, and unanticipated challenges or obstacles faced during the mock disaster drill. T
ANS: D
Federal agencies and professional organizations have outlined competencies for public health professionals at all points of the disaster management cycle. One competency speaks to the ability to evaluate drills, exercises, or actual events. As valu
8. An extensive train derailment occurs in the suburbs of a large metropolitan area. First responders determine that although no fatalities occurred, the derailed cars contain a noxious gas that diffuses readily into the air. The event easily overwhelms t
ANS: B
The first level of disaster response occurs at the locality, with mobilization of entities such as the fire department, law enforcement, public health agencies, and voluntary organizations like the Red Cross. If the disaster warrants significant lo
9. A nurse wishes to become actively involved in disaster management and is extremely interested in providing first aid and delivering aggregate health promotion, disease prevention, and emotional support. It would be ideal for the nurse to train and volu
ANS: D
Creation and operation of shelters are generally the responsibility of the local Red Cross chapter, although the military may be charged with setting up "tent cities" or mobile home parks for large groups of people needing temporary shelter. Becaus
1. Disaster-related nursing is an evolving specialty. Nurses have unique skills that can be applied in which of the following aspects of disaster management? (Select all that apply.)
a. Completion of the American Red Cross disaster management course and r
ANS: A, B, D, E
Nurses have skills in assessment, planning, implementation, evaluation, education, priority setting, collaboration, and provision of health care services to address both preventive and acute care needs. These skills sets are important in t