4150 Epidemiology Concepts in Nursing & Global Healthcare - Final Exam Review (Qns & Ans), Exams of Nursing

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41 50 Epidemiology Concepts in

Nursing & Global Healthcare

Final Exam Review

(Questions & Solutions)

1. Multiple Choice Question: A 82‑year‑old male with a history of congestive heart failure, chronic kidney disease, and diabetes presents to the ED with acute dyspnea and confusion. Which initial assessment parameter is most critical for determining his immediate risk of deterioration?

• A. Temperature
• B. Oxygen saturation
• C. Blood glucose
• D. Jugular venous distension Correct ANS : B. Oxygen saturation Rationale: Oxygen saturation provides an immediate measure of tissue oxygenation. In a high‑risk, multi‑comorbid older adult, hypoxemia can quickly lead to organ dysfunction; hence, it is a priority during initial assessment.

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2. Fill-in-the-Blank Question: The systematic framework consisting of assessment, diagnosis, planning, implementation, and evaluation is known as the __________. Correct ANS : nursing process Rationale: The nursing process provides a structured, cyclical approach that customizes care for both acute crises and chronic management based on

and social data to facilitate individualized planning. The patient’s astrological sign (E) is not clinically relevant.

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5. Multiple Choice Question: A 70‑year‑old female with COPD and heart failure is admitted with severe pneumonia. Which ventilatory strategy is most appropriate to protect her lungs while ensuring adequate oxygenation?

• A. High tidal volume ventilation
• B. Lung‑protective ventilation with low tidal volumes and optimal PEEP
• C. Pressure‑controlled ventilation with minimal PEEP
• D. Immediate trial of non‑invasive ventilation Correct ANS : B. Lung‑protective ventilation with low tidal volumes and optimal PEEP Rationale: Lung‑protective strategies (e.g., tidal volumes around 6 mL/kg ideal body weight and proper PEEP) minimize risks such as barotrauma and volutrauma, especially important in patients with compromised pulmonary reserves.

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6. Fill-in-the-Blank Question: When adjusting medication dosages in patients with renal impairment, nurses estimate renal function by calculating __________ clearance. Correct ANS : creatinine Rationale:

Estimating creatinine clearance (using formulas like Cockcroft–Gault) determines renal excretory capacity, which guides safe dosing of renally eliminated drugs and prevents toxicity.

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7. True/False Question: True or False: In septic patients, early goal‑directed therapy—including the administration of broad‑spectrum antibiotics within the first hour—is critical in reducing mortality and preventing multi‑organ failure. Correct ANS : True Rationale: Early intervention in sepsis is evidence‑based; prompt antibiotics along with early hemodynamic optimization help prevent progression to shock and irreversible organ dysfunction.

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8. Multiple Response Question: Which strategies are essential to safely manage polypharmacy in older adults with multiple comorbidities? (Select all that apply)

• A. Regular medication reconciliation
• B. Reviewing each medication's indication, dose, and interactions
• C. Relying solely on long‑term prescriptions without periodic review
• D. Collaborating with pharmacists and interdisciplinary team members
• E. Providing individualized patient education on medications Correct ANS s: A, B, D, E

Rationale: Patient- and family-centered care fosters collaboration and individualized planning, improving treatment adherence and satisfaction.

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11. True/False Question: True or False: Frequent medication reviews and reconciliation are essential in older adults due to the increased risk of drug interactions stemming from polypharmacy. Correct ANS : True Rationale: Older adults are particularly vulnerable to adverse drug events from polypharmacy. Regular reviews ensure safe prescribing practices and minimize harmful interactions.

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12. Multiple Response Question: What are key elements of effective discharge planning for acutely ill adults transitioning from the hospital? (Select all that apply)

• A. Detailed medication management instructions
• B. Scheduled follow‑up appointments and lab tests
• C. Coordination with home health and rehabilitation services
• D. Clear education on warning signs and when to seek help
• E. A generic discharge summary Correct ANS s: A, B, C, D

Rationale: Individualized discharge plans that include specific instructions, follow-up care, and family education are essential. Generic summaries (E) fail to address the patient’s unique needs.

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13. Multiple Choice Question: In a patient with chronic heart failure experiencing an acute exacerbation, which non‑pharmacologic intervention is especially beneficial?

• A. Prolonged bed rest
• B. Early mobilization as tolerated
• C. Strict fluid restriction without monitoring
• D. Isolation from social support Correct ANS : B. Early mobilization as tolerated Rationale: Early mobilization helps reduce complications such as deconditioning and thromboembolism, and it is evidence‑based for improving overall recovery in patients with cardiac conditions.

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14. Fill-in-the-Blank Question: For pain assessment in critically ill or cognitively impaired patients, the use of __________ pain scales—which leverage both self-report (when possible) and behavioral cues—is advisable. Correct ANS : behavioral

• D. Sole decision-making by the attending physician
• E. Incorporating family feedback into care planning Correct ANS s: A, B, C, E Rationale: Effective interdisciplinary collaboration involves multiple professionals and family participation to ensure comprehensive and coordinated care. Reliance solely on one discipline (D) limits this holistic approach.

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17. Multiple Choice Question: 

A 75‑year‑old patient with chronic renal failure develops hyperkalemia and is at risk for life‑threatening arrhythmias. Which immediate pharmacologic intervention is most appropriate?

• A. High‑volume IV fluid administration
• B. Intravenous calcium gluconate
• C. Oral potassium‑binding resin
• D. Initiation of beta‑agonist therapy Correct ANS : B. Intravenous calcium gluconate Rationale: IV calcium gluconate immediately stabilizes the cardiac membrane in hyperkalemia, reducing arrhythmia risk while further treatments to lower serum potassium are initiated.

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18. Fill-in-the-Blank Question: 

Before implementing advanced interventions, a thorough __________ assessment must be conducted to establish a baseline for evaluation and subsequent care modifications. Correct ANS : comprehensive Rationale: A comprehensive assessment includes physical, cognitive, psychosocial, and functional dimensions, forming the basis for individualized, dynamic care adjustments in critically ill patients.

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19. True/False Question: True or False: Beta‑blockers are contraindicated in patients with acute myocardial infarction who also present with cardiogenic shock due to their potential to worsen cardiac output. Correct ANS : True Rationale: Beta‑blockers reduce myocardial contractility; in the context of cardiogenic shock, they can exacerbate reduced cardiac output, making them contraindicated until the patient is stabilized.

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20. Multiple Response Question: When making pharmacologic adjustments in critically ill older adults, which patient-specific factors should be considered? (Select all that apply)

22. Fill-in-the-Blank Question: Clinical practice guidelines provide a structured, __________ approach to decision‑making by integrating the best available evidence with clinical expertise. Correct ANS : evidence‑based Rationale: Evidence‑based clinical practice guidelines ensure that treatment protocols are grounded in current research, standardizing care and enhancing patient outcomes through scientifically validated interventions.

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23. True/False Question: True or False: Continuous monitoring of vital signs and physiologic parameters is essential in the critical care setting to promptly detect any deterioration in patient status. Correct ANS : True Rationale: Continuous monitoring is central to the care of critically ill patients, allowing for rapid detection of changes and timely intervention, thus reducing adverse events.

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24. Multiple Response Question: Which environmental or system‑based factors in the hospital can significantly influence the recovery of critically ill patients? (Select all that apply)

• A. Noise levels and quality of sleep
• B. Adequate lighting and orientation aids
• C. Family presence and open communication
• D. Hospital policies and resource allocation
• E. The patient’s preferred daytime playlist on repeat Correct ANS s: A, B, C, D Rationale: The physical environment (noise, light), family support, and systemic policies all play roles in patient recovery. While music preferences can enhance comfort, they are not as universally pivotal as the other factors.

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25. Multiple Choice Question: In a septic patient, after obtaining cultures, what is the most critical nursing intervention to implement immediately?

• A. Initiate broad‑spectrum antibiotics
• B. Begin high‑volume IV fluid resuscitation
• C. Delay treatment until full labs result
• D. Start vasopressor therapy immediately Correct ANS : A. Initiate broad‑spectrum antibiotics Rationale: Timely administration of appropriate antimicrobial therapy is central in

28. Multiple Response Question: Which non‑pharmacologic interventions can support recovery in acutely ill patients with complex health problems? (Select all that apply)

• A. Nutritional support and individualized dietary recommendations
• B. Physical therapy and early mobilization protocols
• C. Psychological counseling and stress management strategies
• D. Strict, prolonged bed rest without repositioning
• E. Family education and involvement in care planning Correct ANS s: A, B, C, E Rationale: Non‑pharmacologic interventions such as nutrition, mobility, psychological support, and family engagement aid recovery and help reduce complications. Prolonged bed rest without repositioning (D) can lead to additional risks and is not recommended.

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29. Multiple Choice Question: An older adult with acute respiratory distress in the ICU is being ventilated. Which evidence‑based ventilatory strategy is recommended to minimize ventilator‑induced lung injury?

• A. High tidal volume ventilation
• B. Lung‑protective ventilation using low tidal volumes with appropriate PEEP
• C. Aggressive alveolar recruitment maneuvers without monitoring
• D. Relying solely on non‑invasive ventilation regardless of clinical status Correct ANS : B. Lung‑protective ventilation using low tidal volumes with appropriate

PEEP

Rationale: Lung‑protective ventilation strategies minimize barotrauma and volutrauma by using low tidal volumes combined with proper positive end‑expiratory pressure, which is especially beneficial in the care of vulnerable, older adults.

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30. Fill-in-the-Blank Question: Prior to initiating any advanced, critical interventions, a thorough __________ assessment is performed to establish baseline parameters for ongoing evaluation and care modifications. Correct ANS : comprehensive Rationale: A comprehensive assessment—including physical, cognitive, psychosocial, and functional domains—is essential to formulating individualized care plans and monitoring progress in patients with acute and critical health alterations. Which of the following is the best definition of epidemiology? A) The study of how diseases spread and can be controlled. B) The study of individual patient care. C) The study of healthcare policies. D) The study of genetic diseases. Correct ANS : A Rationale: Epidemiology focuses on the distribution and determinants of health-related states in specific populations.

B) It compares participants with a disease to those without. C) It randomly assigns participants to treatment groups. D) It assesses the prevalence of disease at a single point in time. Correct ANS : B Rationale: A case-control study starts with the outcome (disease status) and looks back to identify exposures. Fill-in-the-Blank Questions The __ model explains how various factors contribute to disease development and transmission. Correct ANS : epidemiological Rationale: The epidemiological model outlines the interplay between host, agent, and environment in disease processes. In epidemiology, the __ rate refers to the number of new cases of a disease in a specified population during a defined time period. Correct ANS : incidence Rationale: The incidence rate quantifies the frequency of new cases, crucial for understanding disease dynamics. The __ effect refers to the phenomenon where an intervention is more effective in certain populations than in others. Correct ANS : heterogeneity Rationale: Heterogeneity in treatment effects highlights the variability in responses among different population groups. A __ is a graphical representation that shows the relationship between two variables. Correct ANS : scatter plot Rationale: Scatter plots are useful for visualizing correlations between variables in epidemiological data. The __ is the time between exposure to a risk factor and the onset of disease.

Correct ANS : latency period Rationale: The latency period is critical in understanding chronic diseases and their progression. True/False Questions True or False: Prevalence is the total number of existing cases of a disease within a population at a given time. Correct ANS : True Rationale: Prevalence measures the burden of disease in a population at a specific time. True or False: Randomized controlled trials (RCTs) are considered the gold standard in epidemiological research. Correct ANS : True Rationale: RCTs minimize bias and provide robust evidence for causal relationships. True or False: The epidemiological triangle consists of host, agent, and vector only. Correct ANS : False Rationale: The epidemiological triangle includes host, agent, and environment. True or False: A high prevalence rate indicates that a disease is highly contagious. Correct ANS : False Rationale: Prevalence indicates the number of existing cases and does not necessarily reflect contagiousness. True or False: Public health interventions can reduce the incidence of communicable diseases. Correct ANS : True Rationale: Effective public health measures can significantly lower the incidence of diseases through prevention and control strategies.