NR503 EPIDEMIOLOGY MIDTERM EXAM
QUESTIONS AND ANSWERS
Secondary Prevention - Answer-The early detection and prompt treatment of a disease
at the earliest possible stage are referred to as secondary prevention. The goals of
secondary prevention are to either identify and cure a disease at a very early stage or
slow its progression to prevent complications and limit disability. Secondary prevention
measures are carried out during the preclinical or presymptomatic stage of disease.
Screening programs are designed to detect specific diseases in their early stages while
they are curable and to prevent or reduce morbidity and mortality related to a later
diagnosis of disease. Examples of secondary prevention include the Pap smear,
mentioned earlier, as well as annual testing of cholesterol levels, mammography, and
rapid HIV testing of asymptomatic individuals.
Tertiary Prevention - Answer-Tertiary prevention strategies are implemented during the
middle or late stages of clinical disease and refer to measures taken to alleviate
disability and restore effective functioning. Attempts are made to slow the progression
or to cure the disease. In cases in which permanent changes have taken place,
interventions are planned and designed to help people lead a productive and satisfying
life by maximizing the use of remaining capabilities (rehabilitation). Cardiac
rehabilitation programs that provide physical and occupational therapies to
postoperative cardiac patients are an example of tertiary prevention.
Is screening a tertiary intervention? If yes, why, if not, what is it? - Answer-No,
screening is a secondary intervention. Screening helps APNs detect a disease once it is
present and assist and facilitate the patient or population to get care for the disease that
has been detected
How does social justice and health inequities influence population health care
provision? Why is this critical information for the provision of evidence-based care? -
Answer-More and more studies are being conducted to look at the relationship of
sustained exposure to toxic stress to a variety of poor health outcomes and high-risk
behaviours. These behaviours include such things as cutting, hypervigilance,
promiscuity, eating disorders, poor school performance, depression, violence, suicidal
ideation/attempts, and justice system involvement. These are just a few of the many
behaviours found to be associated with sustained exposure to toxic stress. Studies such
as these illustrate the importance of understanding the social determinants of poor
health and the potential for doing good and preventing harm to aggregates and
populations by targeting exposures to such things as child abuse and neglect for
prevention, early recognition, and intervention.,
Vital Statistics - Answer-Vital statistics provide important outcome measures that
APRNs can monitor and compare over time and analyze by demographic variables to
detect such things as health disparities. In the United States, the National Center for
, Health Statistics (NCHS) collects the official records of births, deaths, marriages,
divorces, fetal deaths, and induced terminations of pregnancies from state and local
health departments (Aschengrau & Seage, 2013). Personnel from local health
departments review the data from death certificates, including demographic data,
looking at the immediate cause of death and any contributing factors of death, and
recording multiple causes of death. Local data are sent to a state office for collation and
then sent to the NCHS, which provides this information to the public on its website
(http://www.cdc.gov/nchs) and in an annual publication, Vital Statistics of the United
States (Friis & Sellers, 2009). APRNs can access national and global health statistics
from multiple agency sources, including government agencies, to identify health trends
and patterns (Partners, 2014). However, due to the lack of agencies and/or resources in
certain populations or regions, health information might not be available or might be
limited in scope
Morbidity - Answer-Refers to ill health in an individual and the levels of ill health in a
population or group.
Mortality - Answer-Mortality rates, also known as death rates, can be useful when
evaluating and comparing populations. As stated earlier, there are many factors that
can affect the natural history of disease, and measuring mortality allows investigators to
compare death rates among and within populations
Cases - Answer-Refers to individuals who acquire a certain disease or condition.
Social Justice - Answer-the defense of human dignity by ensuring that essential human
needs are met and that essential human rights are protected for all people
Epidemiology - Answer-the study of disease distribution within populations and the risk
factors that affect increases or decreases in distribution.
Incidence - Answer-Incidence rates describe the occurrence of new events in a
population over a period of time relative to the size of the population at risk,Incidence
provides information about the rate at which new cases occur and is a measure of risk.
Incidence rates provide us with a direct measure of how often new cases occur within a
particular population and provide some basis on which to assess risk.
Prevalence - Answer-Prevalence rates describe the number of all cases of a specific
disease or attribute in a population at a given point in time relative to the size of the
population at risk. Period prevalence measures the number of cases of disease during a
specific period of time and is a measure of burden
Outcomes - Answer-The possible results of an experiment
Inter-professional collaboration - Answer-Multiple health care workers from a variety of
professions working together to deliver evidence-informed, patient centered health care
QUESTIONS AND ANSWERS
Secondary Prevention - Answer-The early detection and prompt treatment of a disease
at the earliest possible stage are referred to as secondary prevention. The goals of
secondary prevention are to either identify and cure a disease at a very early stage or
slow its progression to prevent complications and limit disability. Secondary prevention
measures are carried out during the preclinical or presymptomatic stage of disease.
Screening programs are designed to detect specific diseases in their early stages while
they are curable and to prevent or reduce morbidity and mortality related to a later
diagnosis of disease. Examples of secondary prevention include the Pap smear,
mentioned earlier, as well as annual testing of cholesterol levels, mammography, and
rapid HIV testing of asymptomatic individuals.
Tertiary Prevention - Answer-Tertiary prevention strategies are implemented during the
middle or late stages of clinical disease and refer to measures taken to alleviate
disability and restore effective functioning. Attempts are made to slow the progression
or to cure the disease. In cases in which permanent changes have taken place,
interventions are planned and designed to help people lead a productive and satisfying
life by maximizing the use of remaining capabilities (rehabilitation). Cardiac
rehabilitation programs that provide physical and occupational therapies to
postoperative cardiac patients are an example of tertiary prevention.
Is screening a tertiary intervention? If yes, why, if not, what is it? - Answer-No,
screening is a secondary intervention. Screening helps APNs detect a disease once it is
present and assist and facilitate the patient or population to get care for the disease that
has been detected
How does social justice and health inequities influence population health care
provision? Why is this critical information for the provision of evidence-based care? -
Answer-More and more studies are being conducted to look at the relationship of
sustained exposure to toxic stress to a variety of poor health outcomes and high-risk
behaviours. These behaviours include such things as cutting, hypervigilance,
promiscuity, eating disorders, poor school performance, depression, violence, suicidal
ideation/attempts, and justice system involvement. These are just a few of the many
behaviours found to be associated with sustained exposure to toxic stress. Studies such
as these illustrate the importance of understanding the social determinants of poor
health and the potential for doing good and preventing harm to aggregates and
populations by targeting exposures to such things as child abuse and neglect for
prevention, early recognition, and intervention.,
Vital Statistics - Answer-Vital statistics provide important outcome measures that
APRNs can monitor and compare over time and analyze by demographic variables to
detect such things as health disparities. In the United States, the National Center for
, Health Statistics (NCHS) collects the official records of births, deaths, marriages,
divorces, fetal deaths, and induced terminations of pregnancies from state and local
health departments (Aschengrau & Seage, 2013). Personnel from local health
departments review the data from death certificates, including demographic data,
looking at the immediate cause of death and any contributing factors of death, and
recording multiple causes of death. Local data are sent to a state office for collation and
then sent to the NCHS, which provides this information to the public on its website
(http://www.cdc.gov/nchs) and in an annual publication, Vital Statistics of the United
States (Friis & Sellers, 2009). APRNs can access national and global health statistics
from multiple agency sources, including government agencies, to identify health trends
and patterns (Partners, 2014). However, due to the lack of agencies and/or resources in
certain populations or regions, health information might not be available or might be
limited in scope
Morbidity - Answer-Refers to ill health in an individual and the levels of ill health in a
population or group.
Mortality - Answer-Mortality rates, also known as death rates, can be useful when
evaluating and comparing populations. As stated earlier, there are many factors that
can affect the natural history of disease, and measuring mortality allows investigators to
compare death rates among and within populations
Cases - Answer-Refers to individuals who acquire a certain disease or condition.
Social Justice - Answer-the defense of human dignity by ensuring that essential human
needs are met and that essential human rights are protected for all people
Epidemiology - Answer-the study of disease distribution within populations and the risk
factors that affect increases or decreases in distribution.
Incidence - Answer-Incidence rates describe the occurrence of new events in a
population over a period of time relative to the size of the population at risk,Incidence
provides information about the rate at which new cases occur and is a measure of risk.
Incidence rates provide us with a direct measure of how often new cases occur within a
particular population and provide some basis on which to assess risk.
Prevalence - Answer-Prevalence rates describe the number of all cases of a specific
disease or attribute in a population at a given point in time relative to the size of the
population at risk. Period prevalence measures the number of cases of disease during a
specific period of time and is a measure of burden
Outcomes - Answer-The possible results of an experiment
Inter-professional collaboration - Answer-Multiple health care workers from a variety of
professions working together to deliver evidence-informed, patient centered health care
