Population-Centered Health Care in the Community,
Latest Edition 2025/2026 questions and verified answers
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MULTIPLE CHOICE
1. Why is it important for nurses to understand the premises of environmental health?
a. Nurses should be able to assess risks and advocate for policies that support healthy
environments.
b. Toxicologists often consult nurses about environmental pollutants.
c. Pollutant exposures such as lead are reported by nurses to the Environmental Protection
Agency (EPA).
d. Many Americans live in areas that do not meet current national air quality standards.
ANS: A
Potential risks to health are concerns for professional nurses. It is the responsibility of the
nurse to understand as much as possible about these risks: how to assess them, how to
eliminate/reduce them, how to communicate and educate about them, and how to advocate
for policies that support healthy environments. Toxicologists do not often consult nurses
about environmental pollutants. Pollutant exposures are not routinely reported by nurses.
Although there may be problems with air quality standards in the United States, this would
not be the primary reason why nurses should understand environmental health.
2. Why is it important for a nurse to have knowledge of environmental health and the effects of
chemical, biological, and radiological materials? a. They are a major cause of global warming.
b. They are often found in the air, water, and products we use.
c. They are frequently linked to the development of chronic illnesses.
d. They are products that nurses work with daily.
ANS: B
Chemical, biological, and radiological pollutants are often found in the air we breathe, the
water we drink, and the products we use. These are not a major cause of global warming.
They are not frequently linked to the development of chronic illnesses. These are not
products that nurses work with daily.
3. A nurse fulfills the environmental health competency of “assessment and referral.” Which of the
following actions has the nurse most likely completed? a. Advocating for public policy changes
b. Understanding policy framework and major pieces of legislation
c. Completing an environmental health history
d. Describing the scientific principles about environmental health
, ANS: C
Assessment and referral states that all nurses should be able to successfully complete an
environmental health history, recognize the potential environmental hazards and sentinel
illnesses, and make appropriate referrals for conditions with probable environmental causes.
Advocating for public policy changes is part of advocacy. Understanding policy framework
and legislation is part of legislation and regulation. Describing the scientific principles of
environmental health is part of basic knowledge and concepts.
4. How have nurses historically learned to identify a possible relationship between environmental
chemical exposures and their potential harm? a. Extrapolation by toxicologists
b. Biomonitoring
c. Completing chemistry courses
d. Observing signs and symptoms in clients
ANS: D
Nurses have historically made discoveries related to chemical exposure when people
presented with signs and symptoms related to known chemical toxicity. Extrapolation by
toxicologists and biomonitoring are modern methods. Completing a chemistry course does
not show how to identify these possible relationships.
5. What term is used to refer to the basic science applied to understanding the health effects
associated with chemical exposures? a. Toxicology
b. Pharmacology
c. Chemistry
d. Environmental epidemiology
ANS: A
Toxicology is the study of the health effects associated with chemical exposures.
Pharmacology is the branch of medicine concerned with the multiple aspects of drugs.
Chemistry is the branch of science with deals with the way that matter is composed.
Environmental epidemiology is concerned with the discovery of environmental exposures
that cause or protect against illness or disease.
6. What statement accurately describes the characteristics of epidemiology?
a. It is a science that studies the poisonous effects of chemicals.
b. It explains the association between learning disabilities and exposure to lead-based paint
at the cellular level.
c. It helps nurses understand the strength of the association between exposure and
health effects.
d. It is a method for tracking the prevalence of health outcomes.
ANS: C
Epidemiology studies the incidence and prevalence of disease, helping nurses understand
the strength of the association between exposure and health effects. Toxicology is the
science that studies the poisonous effects of chemicals. Environmental surveillance provides
data with which to track and analyze the incidence and prevalence of health outcomes.
Epidemiology does not examine causes at the cellular level.
,7. When researching pesticides, the nurse looks at the “family” of the chemical. What similarities
are found among chemicals that have been placed in the same family? a. Route of entry into the
body
b. Actions and associated risks
c. Effects that they have on the body
d. Potency and toxicity
ANS: B
Chemicals are grouped so it’s possible to understand the actions and risks associated with
each group. Although some common health risks exist within these families of chemicals,
the possible health risks for each chemical should be evaluated individually when a potential
human exposure exists.
8. Which example contains the components necessary to form an epidemiologic triangle? a.
Pesticides, water, food
b. Lead, mercury, soil
c. Trichloroethylene, water, infants
d. Children under 12, elderly, temperature
ANS: C
The epidemiologic triangle consists of an agent (chemical), host (community consisting of
several variants), and environment (air, water, soil, etc.). The other examples do not contain
an agent, host, and environment.
9. When would it be appropriate for a nurse to use a Geographic Information System (GIS)?
a. Recording client data collected at a foot clinic
b. Identifying areas with an increased incidence of lead poisoning
c. Evaluating effectiveness of a farm safety program
d. Scheduling health promotion programs in the community
ANS: B
The use of a GIS allows the PHN to apply the principles of epidemiology into practice. GIS
allows nurses to code data so that it is related spatially to a place on earth and is helpful in
determining concentrated areas for incidence of disease and illness. An electronic health
record (EHR) would be the most appropriate place to record client data from a foot clinic.
Evaluation of effectiveness of a farm safety program would need to be done through some
type of assessment or evaluation method—GIS would not be useful to collect this data. GIS
is not a scheduling system and would not be helpful when scheduling health promotion
programs in the community.
10. A public health nurse (PHN) is organizing a multidisciplinary team to address the issue of water
pollution in the community. Which group of professionals would be invited to address this
issue?
a. Physicians, water sanitation workers, and occupational therapists
b. Pharmacologists, radiologists, and epidemiologists
, c. Nurse practitioners, pharmacologists, and environmentalists
d. Geologists, meteorologists, and chemists
ANS: D
Scientists who study how pollutants travel in air, water, and soil are geologists,
meteorologists, and chemists. The other professionals are not experts in the area of water
pollution in the community.
11. A nurse would identify which as a point source of air pollution?
a. A smoke stack
b. The number of cars and trucks
c. The amount of fossil fuel consumed in a community
d. Ground ozone levels
ANS: A
Point sources of pollution are identifiable sources of air pollution, such as a smoke stack.
Nonpoint sources come from more diffuse exposures, such as from cars and trucks. The
amount of fossil fuel that is consumed and ground ozone levels do not identify sources of air
pollution.
12. A nurse is completing an exposure history using the mnemonic I PREPARE. What data would a
nurse collect when asking questions about the first “P”?
a. Present work
b. Potential exposures
c. Personal protective equipment use
d. Past work
ANS: A
Present work is the first “P.” Potential exposures are part of the “I”—investigate potential
exposures. Personal protective equipment use is not part of the mnemonic. Past work is the
second “P.”
13. What is the greatest single source of air pollution in the United States?
a. Waste incineration
b. Power plants
c. Motor vehicles
d. Molds
ANS: C
Mobile sources such as cars and trucks are the greatest single source of air pollution in the
United States. Waste incineration and power plants are major contributors after motor
vehicles. Molds contribute to poor indoor air quality.
14. A nurse wants to find more information about indoor air quality. Which of the following
websites would be most helpful?
a. The National Institutes of Health (NIH)
b. The American Lung Association