Deck 19: Environmental Health

Question 1

The nursing instructor has completed a session exploring the various factors which can contribute to environmental health. Which is the most accurate definition of an exposure pathway for the students to provide at the completion of this session?

A) The total amount of a contaminant that comes in direct contact with the body
B) Factor that determines a person's level of exposure to a contaminant
C) Method by which people are exposed to an environmental contaminant
D) Process to determine whether exposure to an environmental contaminant has occurred

Answer 1

Method by which people are exposed to an environmental contaminant

Question 2

The nurse travels to Nigeria with a humanitarian aid organization to assess and treat members of a remote community. The children all have high levels of lead in their blood, as a result of exposure to lead dust created by gold mining. Many children are dying. The nurse has never witnessed such a phenomenon in the United States. Which are the most likely reasons for this discrepancy? (Select all that apply.)

A) Larger mining operations than in the United States
B) Lack of environmental regulations or of their enforcement
C) Lack of knowledge concerning environmental dangers
D) Weaker immune systems than in the United States
E) Need of the miners to earn a living and fewer work options

Answer 2

Lack of environmental regulations or of their enforcement
Lack of knowledge concerning environmental dangers
Need of the miners to earn a living and fewer work options

Question 3

The nurse visits the home of client in a low-income community and notices that paint is flaking off the walls and forming a dust in the corners of some rooms. The nurse asks the client when the house was built, and she responds that it was built in 1959. Which contaminant should the nurse expect to find in this home?

A) Lead
B) Radon
C) Asbestos
D) Pesticide

Answer 3

Lead

Question 4

The nurse has witnessed the passage of several important pieces of legislation which have helped highlight the importance of environmental health and environmental protection. Which is the best response from the nurse if explaining the Superfund?

A) National program to control the damaging effects of air pollution
B) Program that protects and enhances the quality of the nation's air by regulating stationary and mobile sources of air emissions
C) Environmental program established to address abandoned hazardous waste sites
D) Comprehensive framework of standards, technical tools, and financial assistance to address the many causes of pollution and poor water quality

Question 5

A team of nursing students are preparing a report that will evaluate a local health concern in the rural farming community. Which explanation best describes the risk assessment the students should perform?

A) Assessment of the adverse effects of chemical, physical, or biologic agents on people, animals, and the environment
B) Process to help determine whether an individual has been exposed to environmental contaminants
C) Assessment of factors that determine a person's level of exposure to an environmental contaminant
D) Determination of the likelihood of adverse effects in a group exposed to an environmental contaminant

Question 6

There are different methods for conducting risk assessment for environmental contaminants. Which formula should the nurse prioritize to determine the amount of risk?

A) Hazard = exposure × risk
B) Exposure = risk × hazard
C) Risk = contaminant presence × exposure
D) Risk = hazard × exposure

Question 7

The public health nurse has been alerted to a possible health concern involving an environmental exposure. Which should the nurse exemplify as environmental media and transport mechanisms within the exposure pathway? (Select all that apply.)

A) Mercury
B) Groundwater
C) Pond
D) Air
E) Subsurface soil

Question 8

The public health nurse is visiting a new client who is being evaluated for a possible radiologic contamination. Which contaminant would the nurse expect to find is most likely responsible?

A) Lead
B) Mercury
C) Ricin
D) Radon

Question 9

The nurse visits a community along a creek where residents have begun to report upper respiratory illnesses and asthma. After investigating, the nurse learns that several miles upstream is a hazardous material disposal site. In addition, chemicals have leached through the soil into the creek water and have been carried downstream to this community. Although children are not allowed into the creek, they do often play along the bank. Which represents the route of exposure in this situation?

A) Creek water
B) Chemicals
C) Bank of the creek
D) Inhalation

Question 10

The nurse notes an increasing number of individuals coming to the clinic reporting respiratory difficulties. The nurse notes that the families involved depend on wood-burning stoves for heat. The nurse determines that bioavailability of the contaminant is most likely resulting in which situation?

A) Absorbed into the body and becomes available at the site of physiologic activity
B) Initially escapes a container and becomes available for contact with living organisms
C) Is airborne and available for inhalation
D) Is waterborne and available for skin contact

Question 11

The nurse conducts biomonitoring of residents of a community exposed to mercury vapor from a manufacturing facility nearby. Which form of biomonitoring should the nurse prioritize to determine the exposure to this contaminant?

A) Measuring heart rate
B) Collecting blood or urine
C) Assessing respiratory rate
D) Obtaining body weight and composition measures

Question 12

The nurse asks a client, "Do you wear the clothes you wear at work at home?" Which subject on the exposure history is the nurse prioritizing with this questioning?

A) Present work
B) Past work
C) Home/residence
D) Concerns

Question 13

The nurse is assessing a client who has been exposed to an environmental contaminant. The nurse considers the question, "Has the exposure pathway been interrupted?" In which phase of the nursing process should the nurse prioritize this question?

A) Assessment
B) Planning
C) Intervention
D) Evaluation

Question 14

A nursing student is fascinated by environmental epidemiology and is considering advanced training in this field. Which response would be most accurate for the student to provide when explaining what this field involves?

A) Focuses on the amount of a contaminant that is absorbed into the body
B) Involves monitoring the results of medical tests to determine whether a person has been exposed to a contaminant
C) Focuses on the incidence and prevalence of disease or illness in a population from exposures in their environments
D) Involves monitoring the number of adverse effects of chemical, physical, or biologic agents on people, animals, and the environment

Question 15

The information gained from environmental epidemiologic studies can be very helpful in trying to identify whether an exposure or what particular exposures have made people ill. Which are major challenges to most environmental epidemiology studies which the team should be prepared to encounter? (Select all that apply).

A) Resource intensive in terms of personnel and money
B) Period between exposure and illness can be very short
C) Weak ability to identify outbreaks of infectious disease
D) Limited availability of data on many contaminants and their effect on people's health
E) Time consuming to perform

Question 16

Children may be more vulnerable to environmental exposures than adults. There are several factors that increase children's vulnerability. Which factors should the healthcare provider prioritize when children are involved? (Select all that apply.)

A) Their body systems are still rapidly developing
B) They eat less, drink less, and breathe more in proportion to their body size than do adults
C) Their bodies may be less able to break down and excrete contaminants
D) Their behaviors can expose them to more contaminants
E) Their breathing zone is further from the ground

Question 17

The public health nurse has determined that no one in the community receives adequate healthcare. Which belief is the nurse prioritizing to ensure environmental justice for everyone in the community?

A) Those who violate the environment should be required to pay significant fines or face extensive prison sentences
B) All the harms humans have committed against the environment will one day result in divine judgment
C) All people should have equal access to the environment
D) No group should suffer more from environmental health consequences than others

Question 18

Environmental justice is an important consideration when working with tribal communities. In which way is traditional tribal practices most often directly affected by contaminated land and water?

A) Spiritual practices
B) Dietary practices
C) Work opportunities
D) Exercise opportunities

Question 19

In the United States, most citizens have access to clean water and sanitation services and often take these services for granted. Worldwide, however, clean water and sanitation are not standard. How many people worldwide in 2015 lacked access to improved water sources?

A) 8 million
B) 88 million
C) 884 million
D) 8.8 billion

Question 20

Changes to water supplies and increased flooding, which are believed to result from climate change, may make some areas more vulnerable to diseases. Which diseases are expected to become more prevalent as a result of climate change? (Select all that apply.)

A) Asthma
B) Lung cancer
C) Diarrhea
D) Malaria
E) Dengue fever

Question 21

The public health team provides care to a community where several chemical manufacturers are located. Which concept should the nurses prioritize when working with these factories and their employees?

A) Use precautions to prevent contamination of the environment by new substances
B) Encourage the company to ensure substances are properly tested before manufacturing
C) Request copies of all testing reports to enable preparation for possible exposure incidents
D) Ensure all employees have an initial assessment on record to serve as a baseline of their health