**Community Health Crusade: Epidemiology,
Disaster, & Vulnerable Populations**
---
1. Community health nurse identifies obesity, hypertension, and diabetes clusters. First step in
community assessment?
A) Windshield survey
B) Implement exercise program
C) Refer all residents to clinic
D) Apply for grant funding
💫RATIONALE✔️✔️: Windshield survey provides visual data on community resources, environment, and
social determinants. Foundation for further assessment.
💫ANSWER✔️✔️: A) Windshield survey
---
2. Community health planning model (CHANGE) purpose?
A) Assess community capacity and readiness for intervention
B) Change individual behavior
C) Fund clinics
D) Hire staff
💫RATIONALE✔️✔️: CHANGE (Community Health Assessment and Group Evaluation) identifies strengths,
gaps, and readiness for policy/environmental change.
💫ANSWER✔️✔️: A) Assess community capacity and readiness for intervention
---
3. Leading Health Indicators (HP2030) include which priority?
A) Access to health services, clinical preventive services, environmental quality
B) Only disease treatment
C) Hospital funding
,D) Medical research
💫RATIONALE✔️✔️: HP2030 Leading Health Indicators: access, preventive services, mental health,
substance abuse, environmental quality, injury, nutrition, physical activity.
💫ANSWER✔️✔️: A) Access to health services, clinical preventive services, environmental quality
---
4. Epidemiologic triad: host, agent, environment. Example of environmental factor for Lyme disease?
A) Wooded area, deer population, climate
B) Tick
C) Human immune status
D) Borrelia burgdorferi
💫RATIONALE✔️✔️: Environment = external factors allowing disease transmission (habitat, climate,
vectors). Agent = tick, bacteria. Host = human.
💫ANSWER✔️✔️: A) Wooded area, deer population, climate
---
5. Incidence vs prevalence. Which calculation requires new cases over time?
A) Incidence rate
B) Prevalence rate
C) Attack rate
D) Case fatality rate
💫RATIONALE✔️✔️: Incidence = new cases/population at risk over specified time. Prevalence = existing
cases (new + old)/population.
💫ANSWER✔️✔️: A) Incidence rate
---
6. Community outbreak of gastroenteritis from restaurant. Which study design to identify source?
A) Retrospective cohort or case-control
B) Randomized controlled trial
C) Prospective cohort over 5 years
D) Cross-sectional survey
💫RATIONALE✔️✔️: Outbreak investigation: case-control (compare exposures) or retrospective cohort (if
defined group). Fast, efficient.
,💫ANSWER✔️✔️: A) Retrospective cohort or case-control
---
7. Herd immunity threshold for measles (R0 ~12-18). Required vaccination coverage?
A) 92-95%
B) 50%
C) 70%
D) 80%
💫RATIONALE✔️✔️: Herd immunity threshold = 1 - (1/R0). For R0=15, threshold = 93%. Measles requires
>95% for elimination.
💫ANSWER✔️✔️: A) 92-95%
---
8. Nurse investigating tuberculosis cluster in homeless shelter. Contact tracing priority?
A) Close contacts (same sleeping area, >8 hours exposure)
B) All shelter residents regardless of exposure
C) Staff only
D) No tracing needed
💫RATIONALE✔️✔️: Close contacts with prolonged indoor exposure highest risk. TST/IGRA, CXR if
positive.
💫ANSWER✔️✔️: A) Close contacts (same sleeping area, >8 hours exposure)
---
9. Patient with active pulmonary TB, homeless, non-adherent. Public health action?
A) Directly observed therapy (DOT) by health department, possible court-ordered isolation
B) Ignore
C) Discharge to street
D) Incarceration
💫RATIONALE✔️✔️: DOT ensures adherence. Legal isolation if refusal and risk to public. Balance civil
liberties and public safety.
💫ANSWER✔️✔️: A) Directly observed therapy (DOT) by health department, possible court-ordered
isolation
---
, 10. Reportable communicable diseases: which must be reported to local health department?
A) Measles, TB, hepatitis A, syphilis, gonorrhea, pertussis
B) Common cold
C) Athlete's foot
D) Seasonal allergies
💫RATIONALE✔️✔️: Nationally notifiable diseases vary by state. Includes vaccine-preventable (measles),
STIs, TB, hepatitis, foodborne outbreaks.
💫ANSWER✔️✔️: A) Measles, TB, hepatitis A, syphilis, gonorrhea, pertussis
---
11. HIV reporting: name-based reporting required in all US states?
A) Yes, name-based reporting to health department (confidential)
B) Only anonymous
C) No reporting needed
D) Only CD4 count
💫RATIONALE✔️✔️: All states require name-based HIV reporting (confidential, not public). Partner
notification services available.
💫ANSWER✔️✔️: A) Yes, name-based reporting to health department (confidential)
---
12. Partner notification for STI (syphilis). Nurse's role?
A) Offer to notify partners (patient can do anonymously via health department)
B) Notify partners without consent
C) Ignore
D) Post on social media
💫RATIONALE✔️✔️: Disease Intervention Specialists (DIS) offer partner services. Patient referral or
provider referral with anonymity.
💫ANSWER✔️✔️: A) Offer to notify partners (patient can do anonymously via health department)
---
13. Zika virus prevention counseling for pregnant women?
A) Avoid travel to endemic areas, prevent mosquito bites, use condoms if partner exposed
Disaster, & Vulnerable Populations**
---
1. Community health nurse identifies obesity, hypertension, and diabetes clusters. First step in
community assessment?
A) Windshield survey
B) Implement exercise program
C) Refer all residents to clinic
D) Apply for grant funding
💫RATIONALE✔️✔️: Windshield survey provides visual data on community resources, environment, and
social determinants. Foundation for further assessment.
💫ANSWER✔️✔️: A) Windshield survey
---
2. Community health planning model (CHANGE) purpose?
A) Assess community capacity and readiness for intervention
B) Change individual behavior
C) Fund clinics
D) Hire staff
💫RATIONALE✔️✔️: CHANGE (Community Health Assessment and Group Evaluation) identifies strengths,
gaps, and readiness for policy/environmental change.
💫ANSWER✔️✔️: A) Assess community capacity and readiness for intervention
---
3. Leading Health Indicators (HP2030) include which priority?
A) Access to health services, clinical preventive services, environmental quality
B) Only disease treatment
C) Hospital funding
,D) Medical research
💫RATIONALE✔️✔️: HP2030 Leading Health Indicators: access, preventive services, mental health,
substance abuse, environmental quality, injury, nutrition, physical activity.
💫ANSWER✔️✔️: A) Access to health services, clinical preventive services, environmental quality
---
4. Epidemiologic triad: host, agent, environment. Example of environmental factor for Lyme disease?
A) Wooded area, deer population, climate
B) Tick
C) Human immune status
D) Borrelia burgdorferi
💫RATIONALE✔️✔️: Environment = external factors allowing disease transmission (habitat, climate,
vectors). Agent = tick, bacteria. Host = human.
💫ANSWER✔️✔️: A) Wooded area, deer population, climate
---
5. Incidence vs prevalence. Which calculation requires new cases over time?
A) Incidence rate
B) Prevalence rate
C) Attack rate
D) Case fatality rate
💫RATIONALE✔️✔️: Incidence = new cases/population at risk over specified time. Prevalence = existing
cases (new + old)/population.
💫ANSWER✔️✔️: A) Incidence rate
---
6. Community outbreak of gastroenteritis from restaurant. Which study design to identify source?
A) Retrospective cohort or case-control
B) Randomized controlled trial
C) Prospective cohort over 5 years
D) Cross-sectional survey
💫RATIONALE✔️✔️: Outbreak investigation: case-control (compare exposures) or retrospective cohort (if
defined group). Fast, efficient.
,💫ANSWER✔️✔️: A) Retrospective cohort or case-control
---
7. Herd immunity threshold for measles (R0 ~12-18). Required vaccination coverage?
A) 92-95%
B) 50%
C) 70%
D) 80%
💫RATIONALE✔️✔️: Herd immunity threshold = 1 - (1/R0). For R0=15, threshold = 93%. Measles requires
>95% for elimination.
💫ANSWER✔️✔️: A) 92-95%
---
8. Nurse investigating tuberculosis cluster in homeless shelter. Contact tracing priority?
A) Close contacts (same sleeping area, >8 hours exposure)
B) All shelter residents regardless of exposure
C) Staff only
D) No tracing needed
💫RATIONALE✔️✔️: Close contacts with prolonged indoor exposure highest risk. TST/IGRA, CXR if
positive.
💫ANSWER✔️✔️: A) Close contacts (same sleeping area, >8 hours exposure)
---
9. Patient with active pulmonary TB, homeless, non-adherent. Public health action?
A) Directly observed therapy (DOT) by health department, possible court-ordered isolation
B) Ignore
C) Discharge to street
D) Incarceration
💫RATIONALE✔️✔️: DOT ensures adherence. Legal isolation if refusal and risk to public. Balance civil
liberties and public safety.
💫ANSWER✔️✔️: A) Directly observed therapy (DOT) by health department, possible court-ordered
isolation
---
, 10. Reportable communicable diseases: which must be reported to local health department?
A) Measles, TB, hepatitis A, syphilis, gonorrhea, pertussis
B) Common cold
C) Athlete's foot
D) Seasonal allergies
💫RATIONALE✔️✔️: Nationally notifiable diseases vary by state. Includes vaccine-preventable (measles),
STIs, TB, hepatitis, foodborne outbreaks.
💫ANSWER✔️✔️: A) Measles, TB, hepatitis A, syphilis, gonorrhea, pertussis
---
11. HIV reporting: name-based reporting required in all US states?
A) Yes, name-based reporting to health department (confidential)
B) Only anonymous
C) No reporting needed
D) Only CD4 count
💫RATIONALE✔️✔️: All states require name-based HIV reporting (confidential, not public). Partner
notification services available.
💫ANSWER✔️✔️: A) Yes, name-based reporting to health department (confidential)
---
12. Partner notification for STI (syphilis). Nurse's role?
A) Offer to notify partners (patient can do anonymously via health department)
B) Notify partners without consent
C) Ignore
D) Post on social media
💫RATIONALE✔️✔️: Disease Intervention Specialists (DIS) offer partner services. Patient referral or
provider referral with anonymity.
💫ANSWER✔️✔️: A) Offer to notify partners (patient can do anonymously via health department)
---
13. Zika virus prevention counseling for pregnant women?
A) Avoid travel to endemic areas, prevent mosquito bites, use condoms if partner exposed
