24

1. What occurs during biological terrorism?a.

The intentional release of hazardous chemicals into the environment

b.

Environmental and occupational exposure to biological toxins

c.

Immunity to toxins related to repeated exposures

d.

An intentional release of viruses, bacteria, or their toxins

An intentional release of viruses, bacteria, or their toxins would be described as biological terrorism.

2. Which problem does a health department usually have the legal authority to investigate?a.

Pandemics

b.

Unusual clusters of illness

c.

World trends of disease

d.

Cases of the common cold and pneumonia

Powers of local government include surveillance of unusual clusters of illness.

3. Which is a feature of public health surveillance?a.

Sharing of the results with others

b.

Defining public health policy

c.

Evaluating interventions

d.

Planning national programs

The other three options are the purposes of surveillance, not features.

4. Why does a nurse conduct surveillance?a.

To eradicate a disease before it starts

b.

To establish a baseline rate of disease occurrence and patterns of spread

c.

To target populations for triage

d.

To reduce the incidence of heart disease in a community

Disease surveillance helps establish baseline rates of disease occurrence and patterns of spread to make it possible to initiate a rapid response to an outbreak.

5. Why would a hospital use surveillance?a.

To protect the public against isolated patients

b.

To eliminate pathogens from the environment

c.

To improve quality of care and outcomes

d.

To decrease the incidence of ventilator-acquired pneumonia

Hospital surveillance is used to improve quality of care and outcomes. An example is an infection that occurs in patients who had procedures at that facility. Reduction of the incidence of ventilator-acquired pneumonia is one reason why a hospital uses surveillance, but it does not address the entire issue.

6. A community coalition monitors the increasing obesity rate of children in their schools. Based on this data, they consider a variety of programming options which may possibly help decrease this trend. What was the purpose of conducting this surveillance?a.

Protect the children from diseases that affect obese children.

b.

Teach parents that obesity will not be tolerated in this community.

c.

Educate children on surveillance techniques.

d.

Demonstrate that new clinical and effective protocols need to be developed.

Ongoing surveillance in a community can lead to new clinical and effective protocols to address an issue.

7. A nurse is using surveillance to collect outcome data. What information would most likely be collected?a.

Number of clinic services which use evidence-based protocols

b.

Proportion of the population vaccinated against influenza

2

c.

Incidence of breast cancer in the population

d.

Probability of a bioterrorism attach occurring in the community

Outcome data focus on change in health status; incidence rates are one example of this type of information.

8. A nurse practitioner reports a case of gonorrhea to the local health department. Which type of surveillance system is being used?a.

Active

b.

Passive

c.

Sentinel

d.

Special

In the passive system, case reports are sent to local health departments by health care providers.

9. A public health nurse is investigating an outbreak of salmonellosis in a community. Which type of surveillance system is being used?a.

Active

b.

Passive

c.

Sentinel

d.

Special

In the active system, a public health nurse begins to search for cases through contacts in the community. The nurse names the disease and gathers data about existing cases to try to determine the magnitude of the problem.

10. What information is shared among agencies when they collaborate to implement a quality surveillance system?a.

How to use algorithms to identify which events should be investigated

b.

Who is to blame for a disease outbreak

c.

What shelters will be used and by whom

d.

How political action will be necessary to ensure public health

Collaboration promotes the development of plans and a directory of emergency responses. How to use algorithms is a key type of information that is shared.

11. What does each state do with the information that it receives about notifiable diseases?a.

Keeps its own records for surveillance purposes

b.

Reports the information to the local branch of the World Health Organization

c.

Transmits the data electronically, weekly, to the CDC

d.

Does nothing with the information

Data is transmitted weekly to the CDC through the National Electronic Telecommunications System for Surveillance.

12. When applying the Minnesota Model of Public Health Interventions: Applications for Public Health Nursing Practice steps of surveillance, what initial action would the nurse take?a.

Analyze data.

b.

Consider whether surveillance as an intervention is appropriate to the situation.

c.

Evaluate the impact of the surveillance.

d.

Collect data.

The first step in this model considers whether the surveillance was appropriate.

13. A large amount of data related to hypertension rates is collected in a community. The data is analyzed. What is the next step in the surveillance process?a.

Collecting data from multiple valid sources

b.

Evaluating the impact on the surveillance system

c.

Interpreting the data and disseminating it to decision makers

d.

Asking political officials to finance a hypertension clinic

After data is collected and analyzed, the findings must be disseminated.

4

14. What information is included in a case definition?a.

The precise point of contact

b.

Laboratory confirmation

c.

Source of contamination

d.

Clinical symptoms

Each case has a unique set of criteria based on what is known about the particular disease. It may include clinical symptoms, laboratory values, and epidemiologic criteria.

15. What was the purpose of the CDC creating the first list of standard case definitions for notifiable diseases?a.

Some diseases were under-reported and others were over-reported.

b.

There was no central office to collect data.

c.

Some people refused to notify officials when diseases were seen.

d.

No one knew where to report the information that was collected.

The initial work was done by the CDC because diseases were over-reported or under-reported.

16. A nurse is completing a disease investigation. Based on the clinical symptoms presented, it is assumed that the individual has measles. However, there has been no laboratory evidence documenting that this individual has the disease. What type of case is the nurse investigating?a.

A suspected case

b.

A confirmed case

c.

A prolonged case

d.

An identified case

A suspected case is a clinically compatible case of illness without isolation.17. The SARS (severe acute respiratory syndrome) outbreak was an epidemic that

spread over several countries. By definition, this is considered a:

a.

Hyperendemic

b.

Pandemic

c.

Mixed outbreak

d.

Holoendemic

A pandemic refers to the epidemic spread of the problem over several countries or continents.

18. If a person returns from overseas and it is determined that he has cholera, what must occur?a.

This is not a disease that is on the notifiable list: nothing need be reported.

b.

The case must be reported to the state and local health departments.

c.

The patient must be isolated immediately.

d.

The patient will probably die, so it is not reportable.

Cholera is on the notifiable list and must be reported to the state and local health departments.

19. Which source would a nurse use to collect morbidity data?a.

Vital statistics reports

b.

Birth records

c.

Death certificates

d.

Specialized disease registries

There are many sources of morbidity data (rate of disease incidence). The other three options do not provide morbidity data.

20. A college student goes to the Student Health Center with an extremely swollen neck. The advanced practice nurse determines that he has mumps. His roommate also is experiencing malaise and a sore throat. These two students by definition are considered a:a.

Mixed outbreak

b Common source

6

.c.

Point source

d.

Propagated outbreak

A point source outbreak involves all persons exposed becoming ill at the same time, during one incubation period.

21. A nurse is investigating a potential bioterrorism attack. What evidence would a nurse most likely find if a bioterrorism attack occurred?a.

A large number of cases of influenza

b.

A case of cholera in a local politician following a trip to India

c.

Dengue fever in a group of students who just returned from a mission trip

d.

An unusual illness in a population

Unusual illness in a population should trigger an investigation.

MULTIPLE RESPONSE

1. In which situation would a nurse use public surveillance? Select all that apply.a.

When estimating the magnitude of an influenza outbreak

b.

When determining the geographical distribution of gonorrhea cases

c.

When detecting an epidemic of whooping cough

d.

When reducing the prevalence of obesity

Estimating the magnitude of the problem, determining geographic distribution of an illness, and detecting epidemics are all uses of public surveillance.

2. A staff nurse has demonstrated the ability to be competent as a participant in surveillance and investigation activities. What skills would you expect that nurse to possess? Select all that apply.a.

The ability to identify appropriate data sources

b.

The ability to communicate effectively using written reports

c.

The ability to collaborate with community agencies

d.

The ability to create a budget

The staff nurse must have analytic assessment skills, communication skills, and community dimensions of practice to be a participant in surveillance and investigation.

3. Which are the objectives of a disease investigation? Select all that apply.a.

To enhance the knowledge of the nurse working in public health

b.

To control and prevent disease and death

c.

To identify factors that contribute to the disease outbreak/even occurrence

d.

To implement measures to prevent occurrences

8