Chapter 06: Environmental Health Stanhope: Foundations for Population Health in Community/Public Health Nursing, 5th Edition,100% CORRECT

Document Content and Description Below

Chapter 06: Environmental Health Stanhope: Foundations for Population Health in Community/Public Health Nursing, 5th Edition MULTIPLE CHOICE 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. Pharmacist d. Toxicologist ANS: D Toxicology is the basic science that studies the health effects associated with chemical exposures. A chemist, epidemiologist, or pharmacist would probably be able to provide some information, but the toxicologist would most likely provide information related to physiological processes. 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. Cumulative Index of Nursing and Allied Health (CINAHL) database b. National Library of Medicine c. State health department d. Closest local library ANS: B NURSINGTB.COM 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. The CINAHL database provides access to literature related to nursing and allied health journals and would not be as comprehensive as the National Library of Medicine. It would be difficult to access information easily through the heatlh department. The information that is available at the local library would be dependent on the community in which one lived. 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 firsthand information about the community and areas of concern that must be investigated. Conducting health risk assessments of randomly seleced individuals or surveying community members does not give the nurse a good assessment of potential environmental health risks of the entire community. Reviewing facility permits and consumer confidence reports would not provide enough information to assess the environment of a community. 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. 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 byNtheRpuIblicGheaBlth.nCursMe? 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. After checking the material safety data sheets, the next steps would be to connect with a health care provider which could include staff in employee health, a local health department, or one’s own health care care provider. The first step should be to determine what exposure occurred. 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 incidence 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. Infants and young children drink more fluids per body weight than adults, and this increases the dose of contaminants in their drinking water, milk (hormones and antibiotics), and juices (particularly pesticides). Only a smal percentage of childhood cancers are associated with heredity. However, exposure to ionizing radiation increases the risk of childhood leukemia and posiibly other cancers. All of the causes of autism spectrum disorder are not currently known. Environmental factors are thought to be a possible cause, as are biologic and genetic factors. Asthma is common among children and the strongest risk factors are genetic factors and inhaled substances and particles that provoke an allergic reaction or irritate the airways. Indoor air quality is a growing concern because of the alarming rise in the incidence of asthma in the United States, particularly among children. 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. Meeting with local government officials to request that the city clean up a hazardous vacant lot and referring child with toxic lead levels to a neurologist are examples of tertiary prevention as the problem already exists. Education to avoid exposureNis pRart oIf pGrimaBry.pCrevMention which relates to teaching parents about the dangers of lead-based pain in older homes. 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. Checking radiation detectors and using spirometry are both examples of screening for potential exposure which is part of secondary prevention. Irrigating the eyes of an employee who had a chemical splash to the face addresses tertiary prevention as a problem has already occurred. 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 persons can engage in minimizing their impact on the environment by reducing, reusing, and recycling the individual products they currently consume. 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. 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 oversight to potential exposure 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. 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 oppNoUsiRtioSnIfNorGthTisBp.laCnO? M a. Environmental justice b. Environmental epidemiology c. Tertiary prevention d. Risk communication 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. Environmental epidemiology is concerned with the discovery of environmental exposures that contribute or protect against disease or illness which is not accomplished by the nurse vocalizing opposition to the plan. Vocalizing opposition to the plan would not be a tertiary prevention strategy as the nurse is addressing a problem that does not yet exist. Risk communication includes general principles of good communication (right information, to the right people, at the right time). In this scenario the nurse is vocalizing opposition, not communicating risks. 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. “How many people live in your home?” c. “What jobs have you held longest?” d. “Where did you live 10 years ago?” 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. The other questions do not address the topics identified in the “I PREPARE” mnemonic (investigate potential exposures, present work, residence, environmental concerns, past work, activities, referrals and resources, and educate). 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. The Chemical Safety Information, Site Security, and Fuels Regulatory Act, Comprehensive Environmental Response, Compensation, and Liability Act, and Food Quality Protection Act may contribute to safety but do not have the full oversight of OSHA. 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 implementedN? R I G B.C M a. Assessment b. Diagnosis c. Intervention d. Evaluation ANS: D U S N T O In this instance, the nurse is evaluating the results of the intervention to determine whether goals were reached. Assessment would have been done earlier in the process because this was needed to determine that a problem existed and that interventions were needed. Diagnosis occurs when the disease and environmental factors are related to the diagnosis. When intervention is used, the nurse coordinates medical, nursing, and public health actions to meet the client’s needs. 15. A nurse practitioner has established a mobile clinic to vaccinate 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. Assessment would have been done earlier in the process because this was needed to determine that a problem existed and that interventions were needed. Planning occurs when the nurse looks at communicy policy and laws as methods to faciliate the care needs for the client. When critiera that includes the immediate and long-term responoses of the client as well as the recidivism of the problem for the client is examined this is part of the evaluation phase. 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. Administering medications to those with signs of lead poisioning is not a typNicUaRl rSolIe NofGtTheBn.urCseOwMhen dealing with lead posioning. Assessing community members for any health problems is to broad of an intervention and does not address the specific need of the nurse working with lead poisoning in the community. 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. Wood burning fireplaces 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. Wood burning fireplaces are not one of the major sources of air pollution that has been identified. 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 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. 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. 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. Completing a community assessment 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. Completing a community assessment is not a strategy that is typically implemented by a state environmental agency, rather that typically occurs at the local level. 5. Which of the following actions would a nurse take when serving as an advocate for the community? (Select all that aNpUplRy.S) INGTB.COM 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. Calling the local health department to report problems at the hospital does not demonstrate the nurse advocating for the community as the hospital does not represent the entire community. [Show More]

Last updated: 1 year ago

Preview 1 out of 13 pages