NUR412 Epidemiology Midterm

Which study design is least able to establish causality?

Cross-sectional

Which study design is preferred when assessing a rare exposure?

Cohort

Among hypertensive men who consumed alcohol the Relative Risk of stroke was 1.86. What is the Relative Risk?

86% increased risk of stroke among HTN men who drink

True or False. A new drug that shortens the duration of patient illness impacts both incidence and prevalence.

False

25 new cases of ovarian cancer were reported in South Florida in the last year. Incidence or Prevalence?

Incidence

Which study design is preferred when assessing a rare disease?

Case control

Randomization is used in what type of study designs?

Experimental

Which design assesses exposure status and then follows participants to identify disease?

Cohort

Which study design does NOT assess participants at multiple time points?

Cross-sectional

Women with premature infants & dysfunctional coping skills have a Relative Risk of PTSD of 2.5. What is the Relative Risk?

2.5 times increased risk for PTSD

Currently, there are 100 people with ovarian cancer in South Florida. Incidence or Prevalence?

Prevalence

Children who have 30 minutes of recreation daily have a Relative Risk of obesity of 0.25. What is the Relative Risk?

75% decreased risk of obesity

Last year there were 25 existing & 20 new cases of HIV. What were the incidence and prevalence?

Incidence = 20; Prevalence = 45

Women who attend daily Zumba classes have a RR of being a professional salsa dancer of 1.0. What is the Relative Risk?

No association between Zumba and pro salsa dancing

"Never events" are discouraged under what reimbursement system?

Pay-for-Performance

One of the biggest concerns influencing the economic health status of the United States is?

Aging of citizens

Medicare beneficiaries include

elderly woman
disabled man

Medicaid funding comes from?

Federal and State funds

Which reimbursement systems (2) could cause HCPs to refuse to care for a chronically ill patient?

Prospective and Pay-for-Performance

All of the following are associated with rising health care costs EXCEPT:

Poverty

Uncompensated care

The aging population

More specialty care & services

Poverty

The "donut hole" applies to which part of Medicare?

Part D

Which of the following is the largest source of health care funding?

Private insurance

What are Determinants of Health?

The causes of the immediate causes of disease

Social Determinants of Health

conditions in which people are born, grow up, live, learn, work, play worship, and age + systems put in place to deal with illnesses that affect health & quality of life

What forces shape Social Determinants of Health?

economics, social policies, politics

What is an example of secondary prevention?

A. planning an educational program on healthy lifestyles
B. Discussing healthy menu planning with diabetic clients
C. Providing skin testing for tuberculosis to the homeless
D. Transporting clients to Alcoholics Anonymous meetings

C. Providing skin testing for TB to the homeless

Secondary prevention involves efforts to detect & treat existing health problems at the earliest possible stage, when disease or impairment is already present or among high-risk populations

Which activity would reflect a community health nurse working at the primary prevention level?

A. Teaching safe sex practices to teenagers
B. Performing adult hypertension screening
C. Encouraging women to do breast self-examination
D. Helping with a post-mastectomy exercise program

A. Teaching safe sex practices to teenagers

Which of the following best characterizes retrospective payment for health services?

A. External authority sets the rates
B. Rates of reimbursement vary
C. Wellness is encouraged
D. Fee is set up in advance

D. Fee is set up in advance

The fee is established in advance & reimbursement occurs after the service is provided. It also encouraged sickness rather than illness.

Smoke-free policies are which type of policy?

Allocative
Redistributive
Regulatory
Authorization

Regulatory

Medicaid and Medicare are examples of which type of policy?

Allocative
Redistributive
Regulatory
Authorization

Allocative

Taxpayer-funded food stamps are an example of which type of policy?

Allocative
Redistributive
Regulatory
Authorization

Redistributive

The EPA's Clean Water Act is which type of policy?

Private
Redistributive
Regulatory
Public

Public

A bill calling for the formation of a new chronic disease surveillance system.

Appropriation
Redistributive
Allocative
Authorization

Authorization

A PHN can provide input at a public hearing for what avenue of policy development?

Legislation
Regulation
Administrative decisions
Judicial decisions

Regulation

A PHN can provide testimony for what avenue of policy development?

Legislation
Regulation
Administrative decisions

Legislation

The ACA's individual mandate was modified under what avenue of policy development?

Legislation
Regulation
Administrative decisions
Judicial decisions

Judicial decisions

A PHN can do which of the following to get a issue on a policy agenda? (Select all that apply)

- Use credible evidence to inform policy makers
- Develop clear policy alternatives
- Make the policy as comprehensive as possible
- Build a united coalition of groups that support the policy

- Use credible evidence to inform policy makers
- Develop clear policy alternatives
- Build a united coalition of groups that support the policy

The Affordable Care Act did which of the following to reduce health care costs? (Select all that apply)

- Mandated health insurance coverage
- Expanded Medicaid
- Eliminated discriminatory insurance practices
- Emphasized secondary prevention

- Mandated health insurance coverage
- Expanded Medicaid
- Eliminated discriminatory insurance practices

What is the level of prevention?
Removal of asbestos from an older home (to avoid associated health problems)

Primary
Secondary
Tertiary

Primary

What is the level of prevention?
Advocating for regulations setting safety standards for the disposal of chemical waste.

Primary
Secondary
Tertiary

Primary

What is the level of prevention?
Stocking the new clinic with anti-venom serum

Primary
Secondary
Tertiary

Secondary

What is the level of prevention?
In order to prevent further illness, funding is provided to clean up a contaminated area.

Primary
Secondary
Tertiary

Tertiary

What is the level of prevention?
Educate community members about first aid practices

Primary
Secondary
Tertiary

Secondary

What is the level of prevention?
Providing a pain management referral to deal with long-lasting side effects of Lyme disease.

Primary
Secondary
Tertiary

Tertiary

Which determinant?
Funding for clinical diagnostic services have been exhausted.

Biological
Health system
Behavioral
Environmental

Health system

Which determinant?
A pregnant woman bitten by a Zika-infected mosquito gives birth to a fetus with encephalitis.

Biological
Sociocultural
Behavioral
Psychological

Biological

Which determinant?
An Olympic swimmer fell ill after swimming in contaminated water in Rio.

Biological
Sociocultural
Behavioral
Psychological

Behavioral

Which determinant?
To make ends meet, Sam works at a dry cleaning store where he handles the washing chemicals.

Biological
Sociocultural
Psychological
Behavioral

Sociocultural

Which of the following health issues contributes the greatest global mortality burden?

Child mortality
Noncommunicable disease
Communicable disease
Maternal mortality

Noncommunicable disease

Which primary health care core activities are secondary prevention? (select all that apply)

control of endemic diseases
immunization
basic sanitation
provision of essential medications

- control of endemic diseases
- provision of essential medications

Millennium development goals that directly impact health are: (select all that apply)

- Reducing child mortality
- Combating communicable diseases
- Promoting maternal health
- Ensure environmental stability

- Reducing child mortality
- Combating communicable diseases
- Promoting maternal health

Which type of power is least common in global governance?

Discursive power
Decision-making power
Legal power
Resource-based power

Legal power