Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 10th Edition
Chapter 06: Environmental Health
1. A public health nurse has been recruited to lead a community environmental lead exposure reduction program. What
action by this nurse is best?
a. Advocate for funding at the state and federal levels.
b. Create a multidisciplinary team to work on different aspects of the problem.
c. Determine how other cities and counties have managed this problem.
d. Research the number of houses likely to contain lead-based paint.
All actions could lead to the success of this program; however, environmental health-risk identification and risk-reduction
intervention require a multidisciplinary team. The nurse would put together a multidisciplinary team to address the problem
from many different perspectives.
Cognitive Level: Apply
Associated Chapter Objective: 2
2. An occupational health nurse is conducting employee toxic exposure histories at a dog food manufacturing plant. Using the
I PREPARE model, what question does the nurse ask?
a. Do you eat your lunch inside or outside the building?
b. Does your job include soldering any metals?
c. Have you ever served in the military?
d. What is the intensity of your exposure to chemicals?
I PREPARE stands for Investigate potential exposures, present work, residence, environmental concerns, past work,
activities, referrals and resources, and educate. The best question to ask to gain information about exposures at the dog food
plant would be to ask about soldering metal. A history of military service is another area for assessment but is not related to
the person’s current place of employment.
Cognitive Level: Apply
Associated Chapter Objective: 3
3. A college health nurse is working to improve environmental air quality on campus. Using the precautionary principal,
what action does the nurse take?
a. Develop a bike-rental program for students, staff, and faculty.
b. Install “smart thermostats” and motion-generated lights in buildings.
c. Make the entire campus a smoke-free zone.
d. Raise the parking fees to discourage people from driving to campus.
The precautionary principle calls for action to reduce potentially toxic exposure to humans in light of data or other indicators,
rather than delaying until more “conclusive” studies are performed. The burning of fossil fuels to power automobiles and
buses and to generate electricity is the single greatest source of air pollution in the United States, so using this principle to
connect air pollution and health, the nurse would establish a bike-rental program.
Cognitive Level: Create
Associated Chapter Objective: 1
4. Campaigns to decrease the inequitable burden of environmental risks on the poor and people of color in the United States
strive to apply which ethical principle?
a. Societal justice
b. Nonmaleficence
c. Beneficence
d. Environmental justice
,Environmental health risks notably have disproportionately affected poor people and people of color in the United States.
Low-income citizens and people of color are more likely to live near a hazardous waste site, and increased incidence of
childhood lead poisoning and increased rates of childhood asthma are seen in these groups. Environmental justice is the
principle of assuring that no group is more at risk of harmful exposure than another.
Cognitive Level: Understand
Associated Chapter Objective: 3
5. A community health nurse manager has integrated exposure history elements into the assessment practices of the health
department that are relevant to the urban industrial community served. This strategy indicates that the nurse manager is
aware of the relationship between:
a. community strengths and weaknesses.
b. environment and human health/disease.
c. toxicology studies and the environment.
d. federal and state environmental regulations.
Understanding the relationship between the environment and human health and disease has become more important over the
years. The environment is now known to play a role as a determinant of health status, an explanation of disease, an influence
on health risk, and a cause of human toxicity and the ever-increasing burden of potentially toxic synthetic chemicals that our
bodies carry.
Cognitive Level: Understand
Associated Chapter Objective: 1
6. A family with a small child lives in a home on a Brownfield site. What action does the public health nurse take
when conducting a home visit?
a. Assess the child for meeting developmental milestones.
b. Have the parent complete a 3-day food diary.
c. Request the child’s immunization records.
d. Watch the child during therapeutic play.
Brownfield sites are lands that have been previously used and are now being developed for another purpose, such as housing.
Due to their history, they may contain soil contaminated with various toxins. The nurse would assess the child for meeting
developmental milestones as many toxins affect growth and development in children.
Cognitive Level: Apply
Associated Chapter Objective: 3
7. Monitoring and public reporting of air quality in a local community to assist individuals with asthma or other respiratory
conditions best illustrates the application of:
a. compliance and enforcement.
b. environmental epidemiology.
c. secondary prevention.
d. toxicology.
Epidemiologic studies enable us to understand the strength of the association between exposures and health effects, such as
the relation between air pollution and asthma exacerbation.
Cognitive Level: Understand
Associated Chapter Objective: 2
8. When applying the nursing process to environmental health, which action would the nurse take?
a. Conduct an assessment focused on a client’s presenting problem.
b. Coordinate interventions with the primary care provider of record.
c. Examine criteria that are limited to the client’s immediate responses.
d. Include outcome measures to mitigate and eliminate the contributing factors.
,If the nurse suspects that the client’s health problem is being influenced by environmental factors, the nurse should follow
the nursing process and note the environmental aspects of the problem in every step of the nursing process. For instance, in
goal setting, the nurse should include outcome measures that relate to mitigation and elimination of the environmental
factors.
Cognitive Level: Application
Associated Chapter Objective: 3
1. The role of the nurse who wants to become more active in environmental health could include which of the following?
(Select all that apply.)
a. Assessing farmworkers for pesticide exposure and providing pesticide risk education
b. Conducting epidemiologic investigations as a public health nurse (PHN)
c. Developing corporate policy to protect workers from unsafe levels of toxic agents
d. Organizing the local community to encourage landlords to remove lead-based paint
e. Working as a skilled risk communicator for a local chemical manufacturer
Nurses can have a vital role in reducing environmental risk, educating workers and/or the community, and helping to
eliminate risks in the local community. As nurses learn more about the environment, opportunities for integration of
such
work into their practices, educational programs, research, advocacy, and policy work will become evident and will evolve.
Cognitive Level: Apply
Associated Chapter Objective: 5 & 6
2. A new nurse asks the mentor what an MSDS is for. What responses by the mentor are most accurate? (Select all
that apply.)
a. Contains information on chemical products.
b. Describes any special precautions using chemicals requires.
c. Details the health risks associated with the products.
d. Explains the manufacturing precautions taken.
e. Must be written by the product manufacturer.
An MSDS (Material Safety Data Sheet) contains information about any chemicals found in the workplace, written by the
product manufacturer, The information includes special precautions needed when using the product, any health risks
associated with using the product, and any requirements for handling the chemical such as protective gloves.
Cognitive Level: Understand
Associated Chapter Objective: 6
Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 10th Edition
Chapter 15: Communicable and Infectious Disease Risks
1. A school nurse is teaching students about the relationship between the risk of sexually transmitted disease (STD) and
risk- taking behaviors. Which key point will the nurse include?
a. All STDs are easily preventable with consistent condom use.
b. Once a young woman is pregnant, she is no longer at risk for most STDs.
c. STDs are most likely to be transmitted during a student’s initial sexual
encounter. d. Use of alcohol and drugs makes a student more likely to make risky
decisions.
Drug use is linked to STD transmission because drugs such as alcohol lower inhibitions and impair judgment about engaging
in risky behaviors. Addictions to drugs may cause individuals to acquire the drug or money to purchase the drug by
performing sexual favors. This increases both the frequency of sexual contacts and the chances of contracting STDs.
Adolescents are particularly at risk.
Cognitive Level: Understand
Associated Chapter Objective: 4
, 2. A client newly diagnosed with herpes simplex virus 2 (HSV-2) infection and syphilis asks, “Okay, so how do I get rid of
all this stuff?” In developing a plan of care, the nurse recognizes that which topic is essential to address?
a. Correct use of condoms to prevent transmission of all STDs.
b. Cures for each of the STDs identified.
c. Risk of skin-to-skin contact in transmitting the identified STDs.
d. Safety of sexual contact in the absence of lesions.
Among other things, clients need to understand how STDs are transmitted, including by body fluids and through skin-to-skin
contact. HSV2 can be transmitted in the absence of skin lesions.
Cognitive Level: Synthesis
Associated Chapter Objective: 5
3. A nurse is assigned to teach clients STD prevention information. What information will the nurse include in
the presentation?
a. Always use spermicides with condoms to reduce the risk of contracting chlamydia or gonorrhea.
b. Condoms can be effective in preventing infections transmitted by fluids from mucosal surfaces but are not always effective
in preventing infections transmitted by skin-to-skin contact.
c. Condoms should not be used during oral sex, because they are not effective in preventing transmission of infection.
d. When genital ulcers are present, condoms should be used to prevent the spread of infection.
The lesions of HSV-2 and HPV infection as well as other lesions capable of transmitting STDs can occur on all parts of the
male and female genitalia and rectum. Condoms are effective in reducing transmission via body fluids from the penis and
vagina. However, lesions not covered by a male or female condom can still transmit infection even with proper condom
use.
Cognitive Level: Understand
Associated Chapter Objective: 5
4. Community health nurses conducting health education among populations vulnerable to HIV infection explain the natural
history of the infection, including the fact that HIV infection may go undetected during the primary infection stage because of
which issue?
a. Antibody test results are typically negative.
b. Antibody production by the immune system increases.
c. Incubation period is prolonged.
d. Symptoms include myalgias, sore throats, and rash.
Individuals may experience flu-like symptoms such as lymphadenopathy, myalgias, sore throat, lethargy, rash, and fever
during the primary stage of HIV infection. Results of an antibody test during this phase are usually negative, so the illness
often is not recognized as HIV infection. After a variable period of time, commonly 6 weeks to 3 months, HIV antibodies
appear in the blood and can be used to confirm the presence of HIV infection.
Cognitive Level: Understand
Associated Chapter Objective: 1
5. A client comes to the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and abdominal
discomfort. During the course of the assessment, the nurse inquires as to the client’s employment and job duties.
Which response would the nurse view as most important?
a. Identifies as bi-sexual.
b. Is a strict pesco-vegetarian.
c. Occasionally uses intravenous drugs.
d. Works in a daycare center and changes diapers.
This patient has symptoms of hepatitis A. Hepatitis A virus is most often transmitted through the fecal-oral route. It remains
the most frequently reported vaccine-preventable disease. Outbreaks are common in daycare centers where staff must change
diapers, among household and sexual contacts of infected individuals, and among travelers to countries were hepatitis A is
endemic.
Chapter 06: Environmental Health
1. A public health nurse has been recruited to lead a community environmental lead exposure reduction program. What
action by this nurse is best?
a. Advocate for funding at the state and federal levels.
b. Create a multidisciplinary team to work on different aspects of the problem.
c. Determine how other cities and counties have managed this problem.
d. Research the number of houses likely to contain lead-based paint.
All actions could lead to the success of this program; however, environmental health-risk identification and risk-reduction
intervention require a multidisciplinary team. The nurse would put together a multidisciplinary team to address the problem
from many different perspectives.
Cognitive Level: Apply
Associated Chapter Objective: 2
2. An occupational health nurse is conducting employee toxic exposure histories at a dog food manufacturing plant. Using the
I PREPARE model, what question does the nurse ask?
a. Do you eat your lunch inside or outside the building?
b. Does your job include soldering any metals?
c. Have you ever served in the military?
d. What is the intensity of your exposure to chemicals?
I PREPARE stands for Investigate potential exposures, present work, residence, environmental concerns, past work,
activities, referrals and resources, and educate. The best question to ask to gain information about exposures at the dog food
plant would be to ask about soldering metal. A history of military service is another area for assessment but is not related to
the person’s current place of employment.
Cognitive Level: Apply
Associated Chapter Objective: 3
3. A college health nurse is working to improve environmental air quality on campus. Using the precautionary principal,
what action does the nurse take?
a. Develop a bike-rental program for students, staff, and faculty.
b. Install “smart thermostats” and motion-generated lights in buildings.
c. Make the entire campus a smoke-free zone.
d. Raise the parking fees to discourage people from driving to campus.
The precautionary principle calls for action to reduce potentially toxic exposure to humans in light of data or other indicators,
rather than delaying until more “conclusive” studies are performed. The burning of fossil fuels to power automobiles and
buses and to generate electricity is the single greatest source of air pollution in the United States, so using this principle to
connect air pollution and health, the nurse would establish a bike-rental program.
Cognitive Level: Create
Associated Chapter Objective: 1
4. Campaigns to decrease the inequitable burden of environmental risks on the poor and people of color in the United States
strive to apply which ethical principle?
a. Societal justice
b. Nonmaleficence
c. Beneficence
d. Environmental justice
,Environmental health risks notably have disproportionately affected poor people and people of color in the United States.
Low-income citizens and people of color are more likely to live near a hazardous waste site, and increased incidence of
childhood lead poisoning and increased rates of childhood asthma are seen in these groups. Environmental justice is the
principle of assuring that no group is more at risk of harmful exposure than another.
Cognitive Level: Understand
Associated Chapter Objective: 3
5. A community health nurse manager has integrated exposure history elements into the assessment practices of the health
department that are relevant to the urban industrial community served. This strategy indicates that the nurse manager is
aware of the relationship between:
a. community strengths and weaknesses.
b. environment and human health/disease.
c. toxicology studies and the environment.
d. federal and state environmental regulations.
Understanding the relationship between the environment and human health and disease has become more important over the
years. The environment is now known to play a role as a determinant of health status, an explanation of disease, an influence
on health risk, and a cause of human toxicity and the ever-increasing burden of potentially toxic synthetic chemicals that our
bodies carry.
Cognitive Level: Understand
Associated Chapter Objective: 1
6. A family with a small child lives in a home on a Brownfield site. What action does the public health nurse take
when conducting a home visit?
a. Assess the child for meeting developmental milestones.
b. Have the parent complete a 3-day food diary.
c. Request the child’s immunization records.
d. Watch the child during therapeutic play.
Brownfield sites are lands that have been previously used and are now being developed for another purpose, such as housing.
Due to their history, they may contain soil contaminated with various toxins. The nurse would assess the child for meeting
developmental milestones as many toxins affect growth and development in children.
Cognitive Level: Apply
Associated Chapter Objective: 3
7. Monitoring and public reporting of air quality in a local community to assist individuals with asthma or other respiratory
conditions best illustrates the application of:
a. compliance and enforcement.
b. environmental epidemiology.
c. secondary prevention.
d. toxicology.
Epidemiologic studies enable us to understand the strength of the association between exposures and health effects, such as
the relation between air pollution and asthma exacerbation.
Cognitive Level: Understand
Associated Chapter Objective: 2
8. When applying the nursing process to environmental health, which action would the nurse take?
a. Conduct an assessment focused on a client’s presenting problem.
b. Coordinate interventions with the primary care provider of record.
c. Examine criteria that are limited to the client’s immediate responses.
d. Include outcome measures to mitigate and eliminate the contributing factors.
,If the nurse suspects that the client’s health problem is being influenced by environmental factors, the nurse should follow
the nursing process and note the environmental aspects of the problem in every step of the nursing process. For instance, in
goal setting, the nurse should include outcome measures that relate to mitigation and elimination of the environmental
factors.
Cognitive Level: Application
Associated Chapter Objective: 3
1. The role of the nurse who wants to become more active in environmental health could include which of the following?
(Select all that apply.)
a. Assessing farmworkers for pesticide exposure and providing pesticide risk education
b. Conducting epidemiologic investigations as a public health nurse (PHN)
c. Developing corporate policy to protect workers from unsafe levels of toxic agents
d. Organizing the local community to encourage landlords to remove lead-based paint
e. Working as a skilled risk communicator for a local chemical manufacturer
Nurses can have a vital role in reducing environmental risk, educating workers and/or the community, and helping to
eliminate risks in the local community. As nurses learn more about the environment, opportunities for integration of
such
work into their practices, educational programs, research, advocacy, and policy work will become evident and will evolve.
Cognitive Level: Apply
Associated Chapter Objective: 5 & 6
2. A new nurse asks the mentor what an MSDS is for. What responses by the mentor are most accurate? (Select all
that apply.)
a. Contains information on chemical products.
b. Describes any special precautions using chemicals requires.
c. Details the health risks associated with the products.
d. Explains the manufacturing precautions taken.
e. Must be written by the product manufacturer.
An MSDS (Material Safety Data Sheet) contains information about any chemicals found in the workplace, written by the
product manufacturer, The information includes special precautions needed when using the product, any health risks
associated with using the product, and any requirements for handling the chemical such as protective gloves.
Cognitive Level: Understand
Associated Chapter Objective: 6
Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 10th Edition
Chapter 15: Communicable and Infectious Disease Risks
1. A school nurse is teaching students about the relationship between the risk of sexually transmitted disease (STD) and
risk- taking behaviors. Which key point will the nurse include?
a. All STDs are easily preventable with consistent condom use.
b. Once a young woman is pregnant, she is no longer at risk for most STDs.
c. STDs are most likely to be transmitted during a student’s initial sexual
encounter. d. Use of alcohol and drugs makes a student more likely to make risky
decisions.
Drug use is linked to STD transmission because drugs such as alcohol lower inhibitions and impair judgment about engaging
in risky behaviors. Addictions to drugs may cause individuals to acquire the drug or money to purchase the drug by
performing sexual favors. This increases both the frequency of sexual contacts and the chances of contracting STDs.
Adolescents are particularly at risk.
Cognitive Level: Understand
Associated Chapter Objective: 4
, 2. A client newly diagnosed with herpes simplex virus 2 (HSV-2) infection and syphilis asks, “Okay, so how do I get rid of
all this stuff?” In developing a plan of care, the nurse recognizes that which topic is essential to address?
a. Correct use of condoms to prevent transmission of all STDs.
b. Cures for each of the STDs identified.
c. Risk of skin-to-skin contact in transmitting the identified STDs.
d. Safety of sexual contact in the absence of lesions.
Among other things, clients need to understand how STDs are transmitted, including by body fluids and through skin-to-skin
contact. HSV2 can be transmitted in the absence of skin lesions.
Cognitive Level: Synthesis
Associated Chapter Objective: 5
3. A nurse is assigned to teach clients STD prevention information. What information will the nurse include in
the presentation?
a. Always use spermicides with condoms to reduce the risk of contracting chlamydia or gonorrhea.
b. Condoms can be effective in preventing infections transmitted by fluids from mucosal surfaces but are not always effective
in preventing infections transmitted by skin-to-skin contact.
c. Condoms should not be used during oral sex, because they are not effective in preventing transmission of infection.
d. When genital ulcers are present, condoms should be used to prevent the spread of infection.
The lesions of HSV-2 and HPV infection as well as other lesions capable of transmitting STDs can occur on all parts of the
male and female genitalia and rectum. Condoms are effective in reducing transmission via body fluids from the penis and
vagina. However, lesions not covered by a male or female condom can still transmit infection even with proper condom
use.
Cognitive Level: Understand
Associated Chapter Objective: 5
4. Community health nurses conducting health education among populations vulnerable to HIV infection explain the natural
history of the infection, including the fact that HIV infection may go undetected during the primary infection stage because of
which issue?
a. Antibody test results are typically negative.
b. Antibody production by the immune system increases.
c. Incubation period is prolonged.
d. Symptoms include myalgias, sore throats, and rash.
Individuals may experience flu-like symptoms such as lymphadenopathy, myalgias, sore throat, lethargy, rash, and fever
during the primary stage of HIV infection. Results of an antibody test during this phase are usually negative, so the illness
often is not recognized as HIV infection. After a variable period of time, commonly 6 weeks to 3 months, HIV antibodies
appear in the blood and can be used to confirm the presence of HIV infection.
Cognitive Level: Understand
Associated Chapter Objective: 1
5. A client comes to the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and abdominal
discomfort. During the course of the assessment, the nurse inquires as to the client’s employment and job duties.
Which response would the nurse view as most important?
a. Identifies as bi-sexual.
b. Is a strict pesco-vegetarian.
c. Occasionally uses intravenous drugs.
d. Works in a daycare center and changes diapers.
This patient has symptoms of hepatitis A. Hepatitis A virus is most often transmitted through the fecal-oral route. It remains
the most frequently reported vaccine-preventable disease. Outbreaks are common in daycare centers where staff must change
diapers, among household and sexual contacts of infected individuals, and among travelers to countries were hepatitis A is
endemic.
