NR 503 Epidemiology – Solved Exam Questions and Answers for Advanced Nursing Practice

NR 503 Epidemiology – Solved Exam Questions and Answers for Advanced Nursing Practice Internal validity - answerswhether the study measures what it was supposed to measure. external validity - answersthe generalizability of the results to other populations probability - answersthe study of the lows of chance specificity - answersthe test ability to yield a negative results when the person does not have the conditions gold standard - answerstest with 100% sensitivity and specificity Positive Predictive Value (PPV) - answersthe probability of the person actually having the disease when the screening test or diagnostic test is negative clinical significance - answersreferring to the results that have clinical significance natural history of the disease - answersnatural of the disease and how it progress primary prevention - answersrefers to the process of altering susceptibility or reducing exposure to susceptible individuals and includes general health promotion and specific measures designed to prevent disease prior to a person getting the disease interventions aimed at preventing the condition, disorder, and disease educating to prevent disease secondary prevention - answersintervention aim at detecting the disease early in its source, ex screening for hypertension screening to identify the disease at the earliest stage tertiary prevention - answersstrategies are implemented during the middle or late stages of clinical disease and refer to measures taken to alleviate disability and restore effective functioning. limiting the effects of the disease once is established ex rehabilitations programs. True Positive (TP) - answersoccurs when the test correctly reports disease presence when disease is in fact present. false positive test - answersoccurs when the test incorrectly reports disease presence when disease is in fact absent false negative - answersoccurs when the test incorrectly reports the absence of disease when disease is in fact present Likehood ratio test (LD) - answerscombines sensitivity and specificity data to help the clinician quantify how much the odds of disease changed based on a positive or negative test results. early and middle childhood - answersperson to person interventions aim to modify adolescents risk/ protective behaviours and health outcomes by improving their caregiver's parenting skills. adolescent health - answersthe us preventive service task force (USPSTF) strongly recommends that all adolescents and adults are at increase risk for HIV infection to be screen. blood disorder and blood safety - answersthe us preventive service task force (USPSTF) recommends screening of sickle cell in newborns genomics guidelines - answersthe us preventive service task force (USPSTF) recommends that woman whose family hx us associated with an increase risk of deleterious mutations in BRCA1 or BRCA2 genes to be referred for genetic counseling and evaluation for BRCA testing. social determinant of health - answersassess the cleanliness of clients water, food and air. Epidemiology - answersthe science of public health. study and analysis of the distributions, patterns and determinants of health and disease conditions in defined populations population health - answersfocuses on risk, data, demographics and outcomes for large groups outcome - answersthe end results follows and interventions aggregate - answersdefined population data - answerscompiled information prevalence rates - answersmeasures the number of cases of disease during a specific period of time snd is measure of burden incidence rates - answersdescribe the occurrence of new events in a population over a period of time relative to the size of the population at risk. surveillance - answerscollection, analysis, dissemination of data high risk - answersincrease change of poor health outcome morbidity - answerspresence of illness population mortality rates - answersalso known as death rates can be useful when evaluating and comparing populations vital statistics - answersquantitative data concerning the population such as # of births, marriages and deaths morbidity - answersrefers to having a disease or a symptoms of disease or to amount of disease within a population mortality cases - answersmeasures of the frequency of occurrence of death in a defined population during an specific interval. social justice - answersthe view that everyone deserves equal economic, political and social rights and opportunities this includes the right to good health population - answersfocuses on risk data demographics and outcomes campaing of action - answersto implement solutions to the challenges facing the nursing profession and to build upon nurse based approaches to improving quality and transforming health outcomes. population health - answersfocuses on risk data, demographics and outcomes Racism - answersBelief that one race is superior to another, prejudice, discrimination cultural broker - answersserves as a mediator between diverse populations cultural congruence - answersthe application of evidence based nursing that is in agreement with the preferred cultural values, belief and practices of the health care consumer and other stakeholders CLAS standards - answersaim to improve healthcare quality by establishing framework for organizations HP 2020 - answersFederal prevention agenda for a building a healthier nation determinants of health - answersthe range of personal, social, economics and environmental factors that affect the health of individuals or populations surveillance system - answersongoing systematic collection, analysis and interpretation of health data screening tools - answersA screening instrument is one that distinguishes individuals who do not have a disorder from those who might have one. IHI (Institute for Healthcare Improvement) - answershas used improvement science to advance and sustain better outcomes in health and health across the world triple aim - answersimproving the patient experience of care (including quality and satisfaction ), improving the health of populations and reducing the per capita cost of healthcare epidemiological triad - answerstraditional model for infectious disease, consists of external agent a susceptible host and environment that brings the host and agents together. descriptive epidemilogy - answersaims to describe the distribution of diseases and determinats 5 W's - answersWHAT (DX) WhO (PERSON) WHERE(PLACE) WHEN(TIME) WHY, HOW (CAUSES RISK FACTORS) validity - answersthe ability of the test to correctly identify those who don't have the disease Positive predictive value - answersis the probability that subjects with a positive screening test truly have the disease negative predictive value - answersprobability that a result is true negative health policy - answersdecision, plans and actions that are undertaken to achieve specific healthcare goals. global health - answersthe health of the population in the global content who - answersWorld Health Organization responsible for international public health SDGs - answersSustainable Development Goals is to ensure healthy lives and promote well being for all ages genetic conseling - answersmedical test that identify changes in chromosomes, genes or proteins advocacy - answerspublic support for or recommendation of a particular cause or policy Case-control study - answersA type of observational study in which two existing groups differing in outcome are identified and compares on the basis of some supposed casual attribute research pyramid hierarchy - answerssystematic reviews randomized controlled studies cohort case control cases series, case reports editorials, expert opinions RTC (randomized control study) - answersa randomized control trial is a type of scientific experiment that aims to reduce sustain sources of bias when testing the effectiveness of new treatment. randomly assign participants into a experimental groups or control group. implicit bias - answersis an unconscious association, belief or attitude toward any social group, due to implicit biases people tend to attribute certain qualities or characteristic to all member of particular group or phenomenon known as stereotyping. prejudice - answerspreconceived opinion that is not based on reason or actual experience microaggressions - answersbrief and commonplace daily verbal, behavioral, and environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults to the target person or group LGBTQ - answersindividuals whose sexual orientation is lesbian, gay, bisexual, or transgendered, or who are currently questioning their sexual orientation access to healthcare - answersability to obtain health services when needed aggregate populations - answersa group of persons who share one or more traits or characteristic without necessarily having had any direct social connection ex: female doctors aged adjusted death - answersis a death rate that controls for the effect of differences in population age distributions. they represent the proportion of the us 2000 population in each age group and sum to 1.0 population age groups - answers3 groups under 15 years working groups (15-64) elderly population(65 and older) confidence interval - answersa range of values so defined that there is a specified probability that the value of a parameter lies within it. ethinicity - answersthe fact or state of belonging to a social group that has a common national or cultural interrelationship between gender, ethnicity and class gender - answersmale or female social preference - answershow much others like you cohort study - answersa study design where are or more samples (called cohort) are followed prospectively and subsequent status evaluations with respect to a disease or outcome are conducted to determine which initial participants exposure characteristic (risk factor) are associated with it. cross-sectional study - answersto learn about the characteristic of a population at one point in time like a snapshot. no comparison group all members of a small defined group or a sample form a large group. produces estimated of the prevalence of the population characteristics ex: is measuring the magnitude and pattern of violence among pregnant women. cross sectional study estimates - answersprevalence of health conditions or prevalence of a behavior , risk factor or potential for disease to learn about characteristic such as knowledge, attitudes and practices of individuals in a population to monitor trends over time with serial cross sectional studies NIH - answersabbreviation for National Institutes of Health; the federal agency that funds and conducts biomedical research risk factors - answerscharacteristics or behaviors that increase the likelihood of developing a medical disorder or disease Distribution Patterns - answershow individuals in a population are spread out Frequency - answersHow many wave peaks pass a certain point per given time Bureau of Labor Statistics (BLS) - answersthe primary purpose is to research assemble and publish a range of statistical data on labor market, prices and productability Health and Human Services (HHS) - answersThe United States Department of Health and Human Services (HHS) is a cabinet level executive branch department of the us government with goals of protecting the health of all american s and providing human services OSHA - answersOccupational Safety and Health Administration national center of health statistics - answersto provide statistics and data that can guide public policies and actions aim to improve health cdc data and health statistics - answerstrack data that has change so that action can be taken using changed data morbidity and mortality weekly report - answersReported cases of specified notifiable diseases are reported weekly in the Morbidity and Mortality Weekly Report. It lists morbidity and mortality data by state and region of the country. Prepared by the CDC. office of minority health - answersdedicated to improve the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparites NIH/ NINH - answersenvisions a world where people experience fulfillment in all stages of life world health statistic division - answersThe GHE provide a comprehensive and comparable assessment of mortality and loss of health due to diseases, injuries and risk factors. ANA - answersAmerican Nurses Association model of care - answersway of health services are delivered AANP - answersAmerican Academy of Nurse Practitioners minorties - answersthe smaller number or part especially a number that is less than half the whole # race - answersIdentity with a group of people descended from a common ancestor. social justice - answersjustice in terms of the distribution of wealth opportunities and privileges within a society infectious agent - answersorganism that are capable of producing infection or infectious disease host - answersa person who receives or entertains other people as guest agent - answersinfectious microorganism or pathogens chronic illness - answersirreversible illness that causes permanent physical impairment and requires long-term health care risk reduction - answersa proactive process in which individuals participate in behaviors that enable them to react to actual or potential threats to their health health literacy - answersability to obtain read understand and use healthcare information in order to make appropriate health decisions and follow instructions for treatment ESOL - answersA program that accommodates students from different language backgrounds in the same class linguistic appropiate - answersinstructional system which had the language development behavioral health equity - answersenables recovery for people with mental health and substance abuse SAMHSA - answersSubstance Abuse and Mental Health Administration; coordinates and funds sustainable substance abuse and mental health programs in communities or community health agencies office of behavioral health society SAMHSA - answersincrease the availability of culturally and linguistically competent mental and behavioral health services accessible to racial and ethnic minorities rural health - answersPoverty and poor health status are common, shortage of health care providers and services, long distances and limited availability of personal transportation urban health - answersConsiders those characteristics of the environment as they relate to the health of the population living in large cities -Factors: physical and social environment, and access to health and social services agency for healthcare research and quality (ahrq) - answersis to produce evidence to make healthcare safer, higher quality more accessible equitable and affordable disparities reports (AHRQ) - answersstrategies to reduce health disparities priority populations - answersdemographic factors such as age, gender race /ethnicity income level or education level disabilities - answersphysical or mental impairments or deficiencies that interfere with a person's normal functioning evidence-based practice - answersclinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences Quality Improvement (QI) - answersan approach to the continuous study and improvement of the processes of providing health care services to meet the needs of patients and others and inform health care policy hp 2020 goals - answersattain high-quality, longer lives free of preventable disease, disability, injury, and premature death; achieve health equity, eliminate disparities, and improve the health of all groups; create social and physical environments that promote good health for all; and promote quality of life, healthy development, and healthy behaviors across all life stages. risk analysis - answersthe characterization of potential adverse effects of human exposures to environmental hazards causation - answersis an increase in a casual factor or exposure causes an increase in the outcome of interest (disease) surveillance - answersis the ongoing systematic collection, analysis and interpretations of health data essential to the planning, implementation and evaluation of public health practice closely integrated with timely dissemination of these data to those who need to know. RTC - answersGOLD STANDARD FOR A CLINICAL TRIAL Case-control study - answersobservational individuals with and without the disease compared compares proportions of those who have the exposure and the disease and those who have the exposure and who do not have the disease in case control studies temporal relationship may be had to establish can measure odds ratio and sometime attributable risk if additional information is available cohort - answersindividuals exposed and nor expose compared compares incidence of the disease in exposed and not exposed individuals in prospective cohort studies temporal relationship between disease and exposure is ealy establish can measure absolute and relative risk, odds ration and attributable risk epidemiological triangle - answersis a model that has historically been used to explained causation. the causative agent susceptible host the environment the web of causation - answersthe disease develops as results of many antecedent factors and not as a result of a single isolated cause. the use of the web is helpful for visualizing how difficult is to untangle the many events that can precede the onset of a chronic illness. methods of analysis - answersdepends on the ability to recognized the difference between the collection and use of data from individuals and populations and the ability to assess needs and evaluate outcomes at the population rates - answersmethods for measuring overtime such as disease and injury in any population identify trends and evaluated outcomes and can allow for comparisons within and between groups rate - answersnumerator (# f events)/denominator (average population) X constant multiplier crude rates - answersapply to an entire population without any reference to any characteristic of the individuals in it specific rates - answerscan also be calculated for a population that has been categorized into groups. descriptive studies types - answerscase reports case series cross-sectional studies correlation or ecologic studies descriptive epidemilogy - answersis used to describe the distribution of disease and other health-related states and events in terms of personal characteristics, geographical distribution, and time in prospective cohort design - answersthe investigator begins with a defined population and then follows a group of individuals who were exposed or non exposed to a factor of interest and then follows both groups to compare the incidence of an outcome or disease. retrospective cohort design - answersexposure is ascertained from past records and outcomes is ascertained at he time the study begins. if there is an association exits between the exposure and the outcome then the incidence rate in the exposed group will be greater than the incidence rate in the non exposed group. the purpose of a well designed study is to - answersproperly identify the impact of the variable (or variables) under study and to avoid bias and/or design flaws caused by another, unmeasurable variable. errors of inference - answerswhen a researcher draws the wrong conclusion because of a problem with the research methodology the result is a type I or type II error. type I error - answersoccurs when a null hypothesis is rejected when in fact is true type II errors - answersoccurs when one fails to reject a null hypothesis when in fact is false random errors - answersreduce the statistical power of a study and can occur because of unpredictable changes in an instrument used for collecting data or because of changes in the environment. selection bias - answersoccurs when the selected subject in a sample are not representative of the population of interest. the systematic error that occurs when "selecting a study group or groups within the study" withdrawal bias - answerscan occur when people of certain characteristic drop out of a group at a different rate. information bias - answersdeals on how information or data are collected for a study confounding - answersoccurs when it appears that a true association exits between an exposure and an outcome but in reality this association is confounded by another variable or exposure. synergism - answersoccurs when the combined effect of two or more factors is greater than the sum of the individuals effects of each factor. RTC Strengths - answerslower likelihood of confounding variables minimized bias in treatment assignment able to control intervention or treatment RTC Weakness - answerslabor intensive costly lengthy sometimes impractical or unethical to conduct Cohort designs strengths - answersable to identify confounding and address in the study able to control exposure able to calculate relative risk and incidence rates can study multiple outcomes Cohort designs weakness - answerslabor intensive costly lengthy case control strengths - answersinexpensive shorter time to completion able to study variables with long latency or impact periods provides a means to compare groups able to calculate offs ratios able to study rare or fatal diseases can study multiple exposures case control weakness - answersrisk of bias and confounding variables sometimes unable to measure or determine exposure selection bias measurement error recall bias cannot assess risk cross sectional strengths - answersable to calculate prevalence of population studied assesses exposures and outcomes at one time provides a snapshot of study population inexpensive cross sectional weakness - answersrisk of confounding variables selection bias cannot control for or identify the significance of potentially important variables cannot assess risk what - answersis the title of the program is the focus of the program the goals of the program are the objectives of the program outcomes will be measured is the budget for the program is the timeline for program development, implementation, and evaluation where - answerswill the program take place is the program base location will the staff be housed will supplies or resources for the program be stored who - answersare the stakeholders is in charge of the program are the staff members involved in program development, implementation and or evaluation is the program attempting to reach will fund this program when - answerswill the program be implemented will the program succeed or fail how - answerswill data be collected often will data be collected ofter will outcomes be examined will the program be developed? implemented? evaluated will the program sustain its funding or obtain future funding will the program success be determined risk factor - answersa condition that may adversely affect an individual health absolute risk - answersthe incidence of disease in a population relative risk - answersthe ratio of the risk of disease in exposed individuals to the risk of disease in non exposed individuals odds ratio - answersthe ration of the odds of development of disease in non exposed person attributable risk - answershow much of the risk(incidence) of the disease we hope to prevent if able to eliminate exposure to the agent in question incidence rate - answersthe number of new cases of a disease that occurs during a specified period of time in a population at risk for developing the disease prevalence rate - answersthe number of affected person present in the population at a specific time devided by the number of person in the population at that same time pandemic - answersDisease that occurs over a wide geographic area and affects a very high proportion of the population. outbreak - answersthe occurrence of disease within persons in excess of what would normally be expected in a clearly defined community, location, time of the year. quarantine - answersthe separation and restriction of the movement of people who were or are expose to a contagious disease for a set period of time, to see whether they become ill isolation - answersthe separation of sick people with contagious disease from those who are not ill disaster epidemiology - answersThe use of epidemiology to assess the short- and long-term adverse health effects of disasters and to predict consequences of future disasters. GEDDI - answersGenetics early disease detection intervention developed a model strategy for using clinical, genetic, and family history information to reduce the risk of disease, death and disability in affected individuals, family members and populations. genetics - answersthe study of individuals genes and their impact on relatively rare single gene disorders genomics - answersstudy of whole genomes, including genes and their functions genetic epidemiology - answersthe link of epidemiology and genetics accommodation - answersto create an environment that accommodates health practice and ritual from other cultures within a plan of care Acculturation - answersdegree to which an individual from one culture has given up the traits of that culture and adopted the traits of the dominant cultural in which they now reside assimilation - answersthe social, economic and political integration of a cultural group into a mainstream society to which it may have emigrated cultural competence - answersrespect for and understanding of diverse ethnic and cultural groups, their histories, traditions, beliefs and value systems cultural awareness - answersself examination of one's own culture prejudices and biases toward other cultures. an in depth exploration of one's own cultural/ethnic background cultural humility - answersa lifelong commitment to self evaluation and self evaluation and self critiques, redressing the power of imbalances in the patient physician dynamic, developing mutually. beneficial relationship cultural knowledge - answersobtaining a sound educational foundation concerning the various worldwide of differences cultures. obtaining knowledge regarding biological variations, disease and health conditions and variation in drug metabolism. cultural skill - answersability to collect culturally relevant data regarding the clients health hx and presenting problems. ability to conduct culturally based physical assessments. conducting theses assessments in a culturally sensitive manner cultural desire - answersmotivation of the healthcare provider to "want" to engage in the process of cultural competence, characteristics of compassion, authenticity, humility, openness, availability and flexibility commitment and passion to caring, regardless of conflict.