Homework Lance
1. A nurse wants to have a better understanding of the physiological effects of selected chemicals. Which of the following individuals would provide the most useful information to the nurse?
a.
Chemist
b.
Epidemiologist
c.
Pharmacologist
d.
Toxicologist
ANS: D
Toxicology is the basic science that studies the health effects associated with chemical exposures. The other specialists would probably be able to provide some information, but the toxicologist would most likely provide information related to physiological processes.
DIF: Cognitive Level: Apply (Application) REF: p. 92
2. A nurse wants to find information about environmental threats that are present in the community. Which of the following would be the best source of data for the nurse?
a.
CINAHL
b.
National Library of Medicine
c.
State health department
d.
Closest local library
ANS: B
Technology helps us understand environmental threats. The National Library of Medicine (NLM) databases are user-friendly and accessible on the Internet. The NLM website provides access to medical databases such as PubMed and GratefulMed, which can be searched for possible environmental linkages to illnesses using key terms.
DIF: Cognitive Level: Remember (Knowledge) REF: p. 93
3. A nurse is assessing potential environmental health risks in the community. Which of the following would be the first step that the nurse should take?
a.
Conduct health risk assessments of randomly selected individuals
b.
Perform a windshield survey
c.
Review facility permits and consumer confidence reports
d.
Survey community members
ANS: B
Conducting a windshield survey is a useful first step to understanding potential environmental health risks. This provides first-hand information about the community and areas of concern that must be investigated.
DIF: Cognitive Level: Apply (Application) REF: p. 94
4. A community citizen reports to the public health nurse that the city water in one neighborhood has had an unusual taste for the past few months. Which of the following actions should the nurse take first?
a.
Check the most recent consumer confidence report.
b.
Consult the Centers for Disease Control and Prevention.
c.
Notify the Environmental Protection Agency (EPA).
d.
Place a call to the poison control center.
ANS: A
The consumer confidence report (also known as the right-to-know report) reports the condition of drinking water. Because this is only one citizen, whose sense of taste may be affected by many conditions, it would not be appropriate to overreact by calling in governmental agencies first. Even so, in case one needed to contact an authority, it would be appropriate to start with local governmental agencies such as the city water department rather than federal agencies.
DIF: Cognitive Level: Apply (Application) REF: p. 97
5. A nurse who works at the local hospital asks a public health nurse what might be causing her hands to become very sore and sensitive. Which of the following statements would be the most appropriate response by the public health nurse?
a.
“Ask the staff in employee health if there have been any other complaints.”
b.
“Call the local health department about any recent problems at the hospital.”
c.
“Check the material safety data sheet on any chemicals you have used recently.”
d.
“See the nurse’s health care provider for a complete work-up.”
ANS: C
Employees have the right to know about hazardous chemicals with which they work. Employers must maintain a list of all hazardous chemicals used on the premises, along with a material safety data sheet that addresses health risks related to these chemicals, as well as information about safe use and handling.
DIF: Cognitive Level: Analyze (Analysis) REF: pp. 97-98
6. Which of the following statements about children and environmental hazards is correct?
a.
The prevalence of autism is directly related to the increase in environmental toxins.
b.
Children are more susceptible to environmental toxins because of their smaller size.
c.
The prevalence of asthma among children has been decreasing.
d.
Children are more susceptible to cancer if they have a family history of the disease.
ANS: B
Because of the smaller size of children, they are exposed to higher doses of pesticide residues in the foods they eat and drink. Autism has increased 1000% since the mid-1980s. However, there is not a direct link to environmental toxins discussed in the text. The prevalence of asthma is at an all time high. Only about 5% of all cancers are strongly associated with heredity.
DIF: Cognitive Level: Understand (Comprehension) REF: pp. 99-100
7. Which of the following actions represents the use of secondary prevention to reduce environmental health risks?
a.
Collecting blood specimens from preschool children to check for lead levels
b.
Meeting with local government officials to request that the city clean up a hazardous vacant lot
c.
Referring a child with toxic lead levels to a neurologist
d.
Teaching parents of a 2-year-old about the dangers of lead-based paint in older homes
ANS: A
Secondary prevention refers to actions such as surveillance and screening, which are undertaken so that problems may be detected at early stages.
DIF: Cognitive Level: Apply (Application) REF: p. 100
8. An occupational health nurse at a local factory is using primary prevention strategies to reduce the environmental health risks among the employees. Which of the following activities would the nurse most likely implement?
a.
Checking radiation detectors to monitor for unsafe levels of radiation exposure
b.
Irrigating the eyes of an employee who has had a chemical splash to the face
c.
Teaching new employees who will work outdoors about the signs and symptoms of heat-related illness
d.
Using spirometry to rule out obstructive or restrictive lung disease for workers who will be wearing mask respirators
ANS: C
Education is a primary preventive strategy. When examining the sources of environmental health risks in communities and planning intervention strategies, it is important to apply the basic principles of disease prevention.
DIF: Cognitive Level: Apply (Application) REF: p. 100
9. A nurse wants to help keep the community environment safe. Which of the following is the most appropriate action for the nurse to take?
a.
Conserve water by bathing less often.
b.
Downsize to a smaller living space.
c.
Reduce, reuse, and recycle.
d.
Replace all his appliances with new energy-efficient ones.
ANS: C
All citizens can engage in minimizing their impact on the environment by reducing, reusing, and recycling. Although it would be nice to replace all appliances for energy-efficient newer models, most people can’t afford that—furthermore, it is an environmental issue to discard the used models. Similarly, downsizing to a smaller living space could help the environment, because the nurse would use less energy, but again, not everyone can afford all the expenses involved in moving. On the other hand, all persons can reduce, reuse, and recycle the individual products they currently consume.
DIF: Cognitive Level: Apply (Application) REF: pp. 100-101
10. Which of the following best describes the purpose of local health departments making unannounced inspections of local restaurants?
a.
To enforce local laws and regulations
b.
To ensure compliance
c.
To provide exposure to oversight
d.
To monitor employee safety
ANS: B
Ensuring compliance refers to the process of making certain that permitting requirements are met. Although this activity may be seen as a type of monitoring, the question asks for the purpose, which is to ensure compliance. Enforcement involves penalties such as fines or facility closure.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 104
11. A city has announced its plans to build a city dump near a community of poor and predominantly African-American citizens. Which of the following principles would the nurse be using when vocalizing opposition for this plan?
a.
Environmental justice
b.
Equal rights
c.
Primary prevention
d.
Risk protection
ANS: A
Environmental justice is the goal of campaigns seeking to improve the unequal burden of environmental risks borne by impoverished and minority communities. The Environmental Justice Act would be used in support of the nurse’s position.
DIF: Cognitive Level: Apply (Application) REF: p. 104
12. A nurse is completing a basic health assessment. Which of the following questions should be asked by an environmentally aware nurse?
a.
“Is anyone else in your family having these symptoms?”
b.
“Can you tell me about your house or apartment?”
c.
“What jobs have you held longest?”
d.
“Where do you live?”
ANS: C
An exposure history should identify current and past exposures, have a preliminary goal of reducing or eliminating current exposures, and have a long-term goal of reducing adverse health effects. The “I PREPARE” mnemonic consigns the important questions to categories that can be easily remembered. Asking about previous employment helps to answer the “P” of past work.
DIF: Cognitive Level: Apply (Application) REF: p. 95
13. A high school student considering a job in the restaurant industry after graduation asks a nurse about workplace safety issues. Which of the following acts would the nurse most likely discuss with the student?
a.
Chemical Safety Information, Site Security, and Fuels Regulatory Act
b.
Comprehensive Environmental Response, Compensation, and Liability Act
c.
Food Quality Protection Act
d.
Occupational Safety and Health Act
ANS: D
The Occupational Safety and Health Act (OSHA) was passed to ensure worker and workplace safety in all employment settings, including restaurants. Others may contribute to safety but do not have the full oversight of OSHA.
DIF: Cognitive Level: Apply (Application) REF: p. 103
14. The nurse is examining blood lead levels in school-age children 1 year after a community-wide education intervention. Which of the following phases of the nursing process is being implemented?
a.
Assessment
b.
Diagnosis
c.
Intervention
d.
Evaluation
ANS: D
In this instance, the nurse is evaluating the results of the intervention to determine whether goals were reached. If you chose assessment, understand that this would have been done earlier in the process because assessment was needed to determine that a problem existed and that interventions were needed.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 94
15. A nurse practitioner has established a mobile clinic to vaccinate noninstitutionalized adults against influenza. Which of the following phases of the nursing process is being implemented?
a.
Assessment
b.
Planning
c.
Intervention
d.
Evaluation
ANS: C
Giving immunizations is an intervention that will increase the number of people who will be vaccinated. Intervention includes coordinating medical, nursing, and public health actions to meet the client’s needs.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 94
MULTIPLE RESPONSE
1. A public health nurse is assisting the community in dealing with the effects of lead paint poisoning. Which of the following activities would the nurse most likely complete? (Select all that apply.)
a.
Administering medications to those with signs of lead poisoning
b.
Assessing community members for any health problems
c.
Setting up a blood screening program with the local health department
d.
Encouraging local landlords to improve the condition of their housing
ANS: C, D
The nurse’s role is to understand the roles of each respective agency and organization, know the public health laws, and work with the community to coordinate services to address the community’s needs. Other needed interventions include organizing a blood-lead screening program through the local health department, educating local health providers to encourage them to systematically test children for lead poisoning, and working with local landlords to improve the condition of their housing stock.
DIF: Cognitive Level: Apply (Application) REF: pp. 93-94
2. Which of the following are the major sources of air pollution in the United States? (Select all that apply.)
a.
Burning of fossil fuels
b.
Waste incineration
c.
Industrial plants
d.
Motor vehicles
ANS: A, B, D
Motor vehicles are the greatest single source of air pollution in the United States. The burning of fossil fuels (diesel, industrial boilers, and power plants) and waste incineration are two other major contributors.
DIF: Cognitive Level: Remember (Knowledge) REF: pp. 94-95
3. A nurse wants to use the principles of risk and outrage to improve an environmental hazard in the community. To accomplish this, which of the following actions would be taken by the nurse? (Select all that apply.)
a.
Advertise in the media throughout the entire surrounding area.
b.
Communicate the correct information in a timely fashion.
c.
Share all the data found on the community assessment.
d.
Talk to those affected or those worried about the situation.
ANS: B, D
Sharing all the data would be overwhelming, and much of the data might not be relevant. Using epidemiological statistics would not be meaningful to those without the education or experience to be able to draw an appropriate conclusion. Instead, the correct information must be given in a language the audience—namely, those at risk or worried about the risk—can understand. Use the communication channels the neighborhood residents use and meet at a common meeting place for the community. It is wasteful of resources to advertise in media throughout a wider region or to meet at a central regional facility when only community residents will be interested or involved.
DIF: Cognitive Level: Apply (Application) REF: pp. 101-102
4. Which of the following strategies would a nurse expect to be implemented by a typical state environmental agency? (Select all that apply.)
a.
Acting, through unannounced inspections, to ensure compliance
b.
Writing permits that help limit toxic hazards
c.
Monitoring hazardous substances to uphold established standards
d.
Obtaining and analyzing samples to confirm compliance
ANS: A, C, D
The organization and approach to environmental protection vary somewhat among states, but the common essential strategies of prevention and control via the permitting process, establishment of environmental standards, and monitoring, as well as compliance and enforcement, are found in every state.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 102
5. Which of the following actions would a nurse take when serving as an advocate for the community? (Select all that apply.)
a.
Asking questions related to health implications at policy meetings
b.
Calling the local health department to report problems at the hospital
c.
Serving as a source of information at public meetings
d.
Volunteering to serve on health-related committees
ANS: A, C, D
Advocacy roles of the community-oriented nurse include attending policy meetings to obtain health-related information, holding public meetings (or serving on panels at meetings) to provide health-related information, serving on health-related committees, and informing local media about environmental hazards in the community.
DIF: Cognitive Level: Apply (Application) REF: p. 104
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