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Chapter 26
Question 1
What is the systematic application of information and computer science and technology to
public health practice, research, and learning?
1. Public health nursing
2. Public health practice
3. Public health informatics
4. Public health research
Correct Answer: 3
Rationale 1:
Public health informatics (PHI) is defined in several ways but one of the most widely
accepted definitions of PHI is “the systematic application of information and computer
science and technology to public health practice, research and learning” (Yasnoff, O’Carroll,
Koo, Linkins, & Kilbourne, 2000, p. 67). Public health has always been about disease
surveillance and management and it is apparent that identification of major disease outbreaks,
particularly epidemics, influences recognition of disease causation, distribution of disease,
and frequency of disease occurrence or transmission (Macha & McDonough, 2012).
Rationale 2:
Public health has always been about disease surveillance and management and it is apparent
that identification of major disease outbreaks, particularly epidemics, influences recognition
of disease causation, distribution of disease, and frequency of disease occurrence or
transmission (Macha & McDonough, 2012).
Rationale 3:
The systematic application of information and computer science and technology to public
health practice, research and learning” (Yasnoff, O’Carroll, Koo, Linkins, & Kilbourne, 2000,
p. 67). Public health has always been about disease surveillance and management and it is
apparent that identification of major disease outbreaks, particularly epidemics, influences
recognition of disease causation, distribution of disease, and frequency of disease occurrence
or transmission (Macha & McDonough, 2012).

Rationale 4:
Health has always been about disease surveillance and management and it is apparent that
identification of major disease outbreaks, particularly epidemics, influences recognition of
disease causation, distribution of disease, and frequency of disease occurrence or
transmission (Macha & McDonough, 2012).
Question 2
Which of the following is considered a major challenge with public health informatics (PHI)?
1. Need to have additional terminals in neutral locations
2. Need to have stronger linkages and interface between and among providers and systems
3. Need to convince health care providers of PHI benefits
4. Need for additional research on PHI effectiveness
Correct Answer: 2
Rationale 1:
The need for additional terminals in neutral locations is not a major challenge specific to
public health informatics (PHI). While access to technology and infrastructure may be a
consideration in certain contexts, it is not a defining challenge of PHI.
Rationale 2:
The need for stronger linkages and interfaces between and among providers and systems is a
significant challenge in public health informatics. Interoperability issues, fragmented data
systems, and lack of standardized data exchange protocols hinder the seamless sharing and
integration of health information across public health agencies, healthcare providers, and
other stakeholders. Strengthening linkages and interfaces is essential for enhancing data
interoperability, facilitating information exchange, and improving the effectiveness of public
health surveillance, response, and intervention efforts.
Rationale 3:
While convincing healthcare providers of the benefits of public health informatics (PHI) may
be a challenge in some contexts, it is not considered a major challenge specific to PHI.
Provider engagement and buy-in are important factors in the successful adoption and

implementation of PHI initiatives, but they are not the primary challenge associated with
PHI.
Rationale 4:
The need for additional research on the effectiveness of public health informatics (PHI) may
be important for advancing knowledge and evidence-based practices in the field, but it is not
considered a major challenge specific to PHI. While research gaps and knowledge translation
issues may exist, they are not the primary barrier to the advancement and implementation of
PHI initiatives.
Question 3
Public Health Informatics (PHI) is distinguished from other information systems and
technology by its emphasis on ____________________ in populations
Correct Answer: prevention
Rationale:
PHI is distinguished from other information systems and technology by its emphasis on
prevention in populations (Yasnoff, O’Carroll, Koo, Linkins, & Kilbourne, 2000, p. 67). The
focus on population health is linked to prevention as opposed to diagnosis and treatment.
Public health has a governmental context as public health nearly always involves linkages to
government agencies at the local, regional, national, or global levels.
Question 4
There are four major principles of public health informatics that are distinguishable from
other types of informatics. Which of the following responses is not considered a principle?
1. Promote the health of populations as opposed to health of individuals.
2. Prevent disease and injury by altering the conditions or the environment putting
populations at risk.
3. Should not reflect the governmental context in which public health is practiced.
4. Should explore the potential for prevention of all vulnerable points.
Correct Answer: 3
Rationale 1:

This statement aligns with a principle of public health informatics, as public health
informatics focuses on promoting the health of populations rather than individuals.
Population-based approaches to health promotion, disease prevention, and intervention are
central to the field of public health informatics.
Rationale 2:
This statement also aligns with a principle of public health informatics, emphasizing the
importance of preventing disease and injury by addressing the underlying conditions or
environmental factors that contribute to population health risks. Public health informatics
seeks to identify and mitigate risk factors at the population level to prevent adverse health
outcomes.
Rationale 3:
This statement contradicts the principles of public health informatics. The governmental
context is integral to public health practice, as public health agencies and governmental
organizations play key roles in disease surveillance, response, policy development, and
population health management. Public health informatics is inherently linked to the
governmental context in which public health activities are conducted, and it is essential to
consider governmental structures, policies, regulations, and partnerships in public health
informatics initiatives.
Rationale 4:
This statement aligns with a principle of public health informatics, emphasizing the
exploration of prevention strategies targeting all vulnerable points within a population. Public
health informatics aims to identify and address vulnerabilities and risk factors across various
domains, including environmental, social, behavioral, and biological factors, to prevent
disease, injury, and adverse health outcomes at the population level.
Question 5
Which national organization has begun to link public health electronic health records (EHRs)
with an immunization tracking system?
1. NIH
2. CDC

3. ANA
4. AACN
Correct Answer: 2
Rationale 1:
The Center for Disease Control is a national organization that has begun national initiatives to
link public health electronic health records (EHRs) with an immunization tracking system.
Rationale 2:
Disease Control is a national organization that has begun national initiatives to link public
health electronic health records (EHRs) with an immunization tracking system.
Rationale 3:
Control is a national organization that has begun national initiatives to link public health
electronic health records (EHRs) with an immunization tracking system.
Rationale 4:
Not correct. The Center for Disease Control is a national organization that has begun national
initiatives to link public health electronic health records (EHRs) with an immunization
tracking system.
Question 6
The _______________ website has a wealth of information for nurses through fact sheets as
well as a series of scenario-based workshops that are free of charge and can be completed
online on topics related to nursing care and management during a crisis.
Correct Answer: United States Homeland Security
Rationale:
Nuclear attack: http://www.dhs.gov/xlibrary/assets/prep_nuclear_fact_sheet.pdf
Question 7
The Centers for Disease Control (CDC) have begun national initiatives to link public health
electronic health records (EHRs) with an immunization tracking system (CDC, 2011). This
tracking system is focused on allowing EHRs of state and local health departments to share

data with immunization information systems and integrate these records with the CDC’s
vaccine tracking system. The initiative focuses on communication and which of the
following?
1. The ability to provide reminders, extend resources, and track records
2. The ability to combine data with global initiatives
3. The ability to work in tandem with governmental databases
4. The ability to design public health resources in case of an pandemic
Correct Answer: 1
Rationale 1:
With respect to public health communication and tracking of immunizations, the Centers for
Disease Control (CDC) have begun national initiatives to link public health electronic health
records (EHRs) with an immunization tracking system (CDC, 2011). This tracking system is
focused on allowing EHRs of state and local health departments to share data with
immunization information systems and integrate these records with the CDC’s vaccine
tracking system (CDC, 2011). A major focus of this initiative is to foster communication that
facilitates the ability to track, provide reminders, and extend the human and financial
resources needed to track immunization records.
Rationale 2:
Disease Control (CDC) have begun national initiatives to link public health electronic health
records (EHRs) with an immunization tracking system (CDC, 2011). This tracking system is
focused on allowing EHRs of state and local health departments to share data with
immunization information systems and integrate these records with the CDC’s vaccine
tracking system (CDC, 2011). A major focus of this initiative is to foster communication that
facilitates the ability to track, provide reminders, and extend the human and financial
resources needed to track immunization records.
Rationale 3:
A major focus of this initiative is to foster communication that facilitates the ability to track,
provide reminders, and extend the human and financial resources needed to track
immunization records.

Rationale 4:
Focus of this initiative is to foster communication that facilitates the ability to track, provide
reminders, and extend the human and financial resources needed to track immunization
records.
Question 8
The Homeland Security website has fact sheets and a series of scenario-based workshops that
are free and can be completed online. Which of the following types of terrorist attacks have
concomitant fact sheets on this website?
1. Chemical
2. Biological
3. Radiological
4. Nuclear
5. Improvised Explosive Attack
Correct Answer: 1,2,3,4,5
Rationale 1:
The National Academies has prepared, in cooperation with the Department, fact sheets on
five types of terrorist attacks including fact sheets on Chemical, Biological, Radiological,
Nuclear, and IED attacks (Homeland Security, 2011). These fact sheets offer clear, objective
information on these specific types of attacks as well as their impact and dangers helping
nurses focus on specific needs and communication in particular.
Rationale 2:
These fact sheets offer clear, objective information on these specific types of attacks as well
as their impact and dangers helping nurses focus on specific needs and communication in
particular.
Rationale 3:
These fact sheets offer clear, objective information on these specific types of attacks as well
as their impact and dangers helping nurses focus on specific needs and communication in
particular. The National Academies has prepared, in cooperation with the Department, fact

sheets on five types of terrorist attacks including fact sheets on Chemical, Biological,
Radiological, Nuclear, and IED attacks (Homeland Security, 2011).
Rationale 4:
Academies has prepared, in cooperation with the Department, fact sheets on five types of
terrorist attacks including fact sheets on Chemical, Biological, Radiological, Nuclear, and
IED attacks (Homeland Security, 2011). These fact sheets offer clear, objective information
on these specific types of attacks as well as their impact and dangers helping nurses focus on
specific needs and communication in particular.
Rationale 5:
Terrorist attacks including fact sheets on Chemical, Biological, Radiological, Nuclear, and
IED attacks (Homeland Security, 2011). These fact sheets offer clear, objective information
on these specific types of attacks as well as their impact and dangers helping nurses focus on
specific needs and communication in particular.
Question 9
Public health care is responsible for the protecting the health care needs of the public through
a variety of ways. With the increase in technology, which of the following statements is true
about information technology and public health protection?
1. Information technology provides the ability to access Center for Disease Control (CDC)
updates on outbreaks of communicable disease.
2. Information technology diminishes the ability to make rapid decisions during crisis
management.
3. Information technology controls communication during a crisis.
4. Information technology is unnecessary during a crisis.
Correct Answer: 1
Rationale 1:
Information technology provides opportunities to solidify critical linkages between major
stakeholders to enhance and facilitate timely and relevant communications between and
among all levels of healthcare providers. Furthermore, the ability to access Center for Disease
Control (CDC) updates on outbreaks of H1N1 or to track and trend the epidemiology of the

outbreak is critical in management and treatment as well as containment and in some cases
eradicating the disease before it rises to epidemic proportions.
Rationale 2:
Furthermore, the ability to access Center for Disease Control (CDC) updates on outbreaks of
H1N1 or to track and trend the epidemiology of the outbreak is critical in management and
treatment as well as containment and in some cases eradicating the disease before it rises to
epidemic proportions.
Rationale 3:
H1N1 or to track and trend the epidemiology of the outbreak is critical in management and
treatment as well as containment and in some cases eradicating the disease before it rises to
epidemic proportions.
Rationale 4:
Information technology provides opportunities to solidify critical linkages between major
stakeholders to enhance and facilitate timely and relevant communications between and
among all levels of healthcare providers.
Question 10
The use of the Internet for health information has grown exponentially in the past few years.
There are a multitude of reasons for individuals to check online before contacting their health
care provider. Which of the following statements is a major reason why people turn to the
Internet and websites for health related information?
1. Fewer people have health care insurance.
2. The long lines and waiting time in healthcare providers’ offices prevent individuals from
making appointments.
3. People refuse to pay the co-pay when they can find out about their illness for free.
4. People are reluctant to bother their primary healthcare provider.
Correct Answer: 4
Rationale 1:

This statement is not a major reason why people turn to the Internet for health-related
information. While lack of health insurance may be a barrier to accessing healthcare services,
it does not necessarily drive individuals to seek health information online as an alternative.
Rationale 2:
While long wait times in healthcare providers' offices may be frustrating for individuals, it is
not a major reason why people turn to the Internet for health-related information. Seeking
information online is often driven by a desire for convenience, accessibility, and
empowerment rather than solely by dissatisfaction with waiting times.
Rationale 3:
The reluctance to pay a co-pay may influence individuals' healthcare decisions, but it is not a
major reason why people turn to the Internet for health-related information. The availability
of free information online may be a factor, but it is not the primary driver behind individuals'
decisions to seek health information online.
Rationale 4:
This statement aligns with a major reason why people turn to the Internet for health-related
information. Many individuals may feel reluctant to bother their primary healthcare provider
with minor concerns or questions, especially if they perceive them as non-urgent or easily
addressable. Seeking information online allows individuals to research symptoms, conditions,
and treatments independently, without imposing on their healthcare provider's time or
resources. Additionally, some individuals may feel more comfortable exploring health-related
topics privately before discussing them with a healthcare provider.
Question 11
There is a global concern that not all populations or subpopulations have the resources and
capabilities to utilize or benefit from communication using technology and Internet. This
phenomenon is called _____________.
Correct Answer: digital divide
Rationale:
The concern is that not all populations or subpopulations have the resources and capabilities
to utilize or benefit from communication using technology and Internet. Goodall, Ward, and

Newman, (2010) refer to this concern as the “digital divide” and express concern and their
research examines the use of technology indicating that older people in Australia use
information and communication technology (ICT) less than other age group. There is a
compelling concern regarding governments or healthcare agencies to move exclusively to
ICT communication may create a chasm of the worst kind excluding select populations from
having access to this important health information.
Question 12
The ability to improve health outcomes and make data-driven decisions within a new or
existing health information infrastructure is critical. This can be accomplished through which
of the following?
1. Reliable databases
2. A cogent plan of action
3. Systems implementation
4. Public health informatics
Correct Answer: 1
Rationale 1:
The ability to improve health outcomes and make data-driven decisions within a new or
existing health information infrastructure is critical. For example, there is a clear need for
valid and reliable databases.
Rationale 2:
Health outcomes and make data-driven decisions within a new or existing health information
infrastructure is critical. For example, there is a clear need for valid and reliable databases.
Rationale 3:
Driven decisions within a new or existing health information infrastructure is critical. For
example, there is a clear need for valid and reliable databases.
Rationale 4:

There is a clear need for valid and reliable databases. The ability to improve health outcomes
and make data-driven decisions within a new or existing health information infrastructure is
critical.
Question 13
Research has suggested that there is a positive correlation between an individual's health
literacy and which of the following?
1. Knowledge of illness
2. Managed care
3. Computer skills
4. Health outcomes
Correct Answer: 4
Rationale 1:
While individuals with higher health literacy may indeed have greater knowledge of illness,
this statement does not capture the essence of the positive correlation between health literacy
and health outcomes. Health literacy encompasses more than just knowledge of illness; it also
involves the ability to understand, evaluate, and use health information to make informed
decisions and take appropriate actions regarding one's health.
Rationale 2:
Managed care refers to a system of healthcare delivery and financing, and while it may be
influenced by factors such as health literacy, it is not directly correlated with an individual's
health literacy level. Managed care arrangements can impact access to healthcare services,
utilization patterns, and care coordination but are not inherently linked to health literacy.
Rationale 3:
While computer skills may facilitate access to health information and resources online, they
are not directly correlated with an individual's health literacy level. Health literacy
encompasses broader skills related to understanding, evaluating, and applying health
information in various contexts, including but not limited to digital literacy.
Rationale 4:

This statement correctly identifies the positive correlation between an individual's health
literacy and health outcomes. Research has consistently shown that individuals with higher
levels of health literacy are more likely to experience better health outcomes, including
improved disease management, lower rates of hospitalization, better adherence to medical
recommendations, and overall better health status. Health literacy enables individuals to
navigate the healthcare system effectively, understand health-related information, make
informed decisions, and engage in behaviors that promote health and well-being.
Question 14
The relationship between information technology and the collection and analysis of data is
part of the development of evidence-based practice and improved patient outcomes. Which of
the following are essential elements that need to be considered to have a comprehensive,
robust health information system to promote public health informatics?
1. Data definitions
2. Coding classification systems
3. Data transmission capability
4. Health information exchange (HIE)
5. Data storage
Correct Answer: 1, 2, 3, 4
Rationale 1:
Data definitions establish clear and consistent meanings for the information collected,
ensuring uniformity and accuracy in data interpretation and analysis within the health
information system.
Rationale 2:
Systems provide standardized codes for diseases, procedures, and other medical concepts,
enabling efficient data entry, retrieval, and analysis while facilitating interoperability among
different health information systems.
Rationale 3:
Allowing for timely access to information for decision-making and public health surveillance.

Data transmission capability is crucial for securely and efficiently transferring health data
between different systems and stakeholders.
Rationale 4:
Health information exchange (HIE) facilitates the sharing of electronic health information
among healthcare organizations, public health agencies, and other relevant entities, promoting
coordinated care, disease monitoring, and health outcomes assessment.
Rationale 5:
While data storage is important for maintaining health information, it is not specifically
mentioned as a key element for promoting public health informatics in the context of
comprehensive health information systems. However, efficient and secure data storage is
implied within the other elements listed, as they all involve the management and utilization of
health data.

Test Bank for Handbook of Informatics for Nurses and Healthcare Professionals
Toni Lee Hebda, Patricia Czar, Theresa Calderone
9780132574952, 9780132959544, 9780134711010, 9780131512627, 9780130311023, 9780805373264, 9780135205433, 9780135043943

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