What are the odds of a newborn being born with a neural tube defect after reviewing the contingency table below outlining use of folic acid vitamin supplementation during pregnancy?

Disease No Disease
Exposure

Folate Supplementation 24 563
No Folate Supplementation
631

727
Question 1 options:
1) 20.3%
2) 4.9%
3) 8.9%
4) 5.2%
Question 2
Clinicians began to report cases of an unusual form of femoral fracture among women taking bisphosphonates for osteoporosis prevention. When comparing women with femoral fracture to those women without, the following odds ratio was calculated: OR = 33.4, p = 0.03, 95% CI : 31.2 - 34.3. What do these values mean?
Question 2 options:

1. 1) More evaluation is needed before any conclusions can be drawn.
2. 2) Bisphosphonates cause femoral fracture among women at risk for osteoporosis at an incidence rate of 31.2-34.3.
3. 3) Women taking bisphosphonates have a higher risk for femoral fracture than those women with osteoporosis.
4. Women taking bisphosphonates are 33 times more likely to have a femoral fracture than those who do not take this drug.
   Question 3
   When an odds ratio is calculated from a two by two table (contingency table) then the:
   Question 3 options:
   1) Ratio may take any positive value up to 2.0.
   2) Odds ratio will be changed if you change the reciprocal order of the columns.
   3) Odds ratio is a measure of the strength of the relationship between the row and column variables.
   4) Proportions of observations in the first row can be combined together.
   Question 4 (1 point)
   Epidemiologists use risk ratios and proportions to describe the characteristics of populations. Which one of the following activities might risk ratios and proportions be used for?
   Question 4 options:
5. 1) To calculate reasons for risk factors.
6. 2) To quantify a problem.
7. To calculate the groups.
   4) To quantify morbidity.
   Question 5 (1 point)
   The prevalence of binge drinking among adolescents' ages 15- 19 years of age is approximately 20%. After calculating the Odds Ratio, it was found that the odds of binge drinking was 4 times higher among adolescents struggling in school. This suggests which of the following?
   1) Adolescents need to do better in school.
   2) Binge drinking is a risk factor for adolescents and they should be offered a treatment
   program.
   3)The odds of binge drinking increase over time as students struggle in school.
   4) Schoo3ls should identify adolescent students with lower marks because they are at increased risk.
   Question 6 (1 point)
   A study compares breast cancer patients with women who do not have breast cancer. The researcher found that 75/100 breast cancer cases did not use calcium supplements as compared with 25/100 non-cases. What is the odds ratio?
   Question 6 options:
   1) 9.0
   2) 27.0
   3) 1.0
   4) 3.0
   Save
   Question 7 (1 point)
   The relative risk of tetanus infection after taking the tetanus vaccine was 0.20. This suggests which of the following?
   Question 7 options:
   1) The tetanus vaccine is protective against tetanus infection.
8. Those who took the vaccine were 20 x more likely to get tetanus.
9. The relative risk of tetanus is not high
   4) None of the options.

Question 8
At times the odds ratio and the risk ratio can be used interchangeably, for example, when the disease is relatively rare. When the odds ratio is used in place of relative risk, what is one consideration?
Question 8 options:

1. How well the odds ratio approximates relative risk.
2. How the disease is monitored in the population.
3. That the control group is consistent with the population.
4. How frequently the disease occurs in the broader population.
   Question 9
   In a study about the association of smoking and lung cancer, the odds ratio was found to be 14.04. Would you argue that smoking causes lung cancer based on this result?
   Question 9 options:
   1) No, but there is a strong association
   2) No
   3) Yes, but there is a weak association
   4) Yes
   Question 10
   When comparing odds and probability, the important thing to remember about the concept of "odds" is that all outcomes possible are considered.
   Question 10 options:
   1) True
   2) False

Question 11
A study examines measles cases vs. controls (those without measles). The researcher found that 33/100 measles cases did not get the vaccine as compared with 7/100 control group got the vaccine but did not get measles. If you created a contingency table (2x2) table, what would be in cell b?
Question 11 options:
1) 95
2) 7
3) 67
4) 33
Question 12 (1 point)
True or False? "The Odds Ratio can assess the strength of association between exposure and the disease variables."
Question 12 options:
1) True
2) False
Question 13
A group of people have worked in an asbestos mine for the past 30 years. Approximately 21/30 people have developed lung cancer before the age of 65 years. An epidemiologist investigating the problem identified the relative risk to be 4.0 for exposure to asbestos. This suggests which of the following:
Question 13 options:

1. Asbestos is not a risk factor for lung cancer among these miners.
2. Asbestos is a causal factor for lung cancer among these miners.
3. Asbestos is likely a risk factor for lung cancer among these miners.
4. Asbestos is a protective factor for lung cancer among these miners.
   Question 14
   True or false. A British study reported in the Globe and
   Mail newspaper stated that among smokers who got lung cancer, "women were 1.7 times more vulnerable than men to get small-cell lung cancer." The number 1.7 is a sample odds ratio.
   Question 14 options:
   1) True
   2) False
   Question 15
   Relative risk:
   Question 15 options:
5. Cannot be greater than 1.0.
6. Is the ratio of sick patients, diagnosed as positive for the disease and the total number of sick patients.
7. Shows the relationship between a factor assumed to influence the occurrence of disease and the disease.
8. Is very small when exposed to the risk factor.
   Question 16
   Your brother had a wedding and 79 people attended. 50 people ate the cake and got sick. Here is the contingency table:

Got sick Did not get sick Total
Ate cake

50 3 53
Did not eat cake 4 22 26
total 54 25 79

Which of the following numbers would be best represent the calculation for the odds ratio?
Question 16 options:

1. (50x54) / (3x25)
2. (4x3) / (50x22)
3. (50x22) / (4x3)
4. (4x3) / (22x54)
   Question 17
   The risk ratio and the odds ratio can be used interchangeably when the health outcome is rare.
   Question 17 options:
   1) True
   2) False
   Question 18
   Which of the following calculations should be performed for this case?
   "Incidental appendectomies were performed for 131 clients.
   After two days, seven of these clients developed post-operative would infections. The cumulative incidence was first calculated for those clients who had an appendectomy and then developed a wound infection and also for the group who did not develop a wound infection."
   Question 18 options:
5. Odds ratio
6. Relative risk
7. Incidence rate
8. Prevalence rate
   Question 19
   Relative risk and prevalence are considered which of the following types of calculations?
   Question 19 options:
   1 Probability
   2 Predictive
   3 Odds ratio
   4 Relativity
   Question 20
   The odds ratio is a measure of choice for studies that enroll a group of "case-patients" and a comparable group without the disease (Controls). The number of persons in the control group can be decided by the investigator.
   Question 20 options:
   1) True
   2) False
   Question 21
   Migraine headaches were identified in 5/1000 men and in 10/1000 women 40-55 years of age. What inferences can we make about this statement in relation to incidence and prevalence?
   Question 21 options:
   1) That women are two times more likely to develop migraine headaches than men in the 40-55 year age group.
   2) The incidence of migraines among men is lower than for women in the 40-55 year age category.
9. Men have a shorter life expectancy than women and therefore have fewer migraines.
10. Limited inferences as we have no information about incidence and prevalence for these groups.
    Question 22
    In a province that did not require varicella vaccine (chicken pox), an elementary school experienced a long outbreak of varicella among its students from September to December. To calculate the "risk" of disease you would want to consider which of the following?
    Question 22 options:
11. All the students at the beginning divided by all the students at the end
12. All the students who had and did not have varicella divided by all the students
13. All new cases of varicella divided by all susceptible cases of varicella
14. All the students with varicella from September to December divided by those who died
    Question 23
    A researcher is interested in recording the number of patients in Ontario, Canada who have the common cold during the month of February 2017. Which of the following measures of morbidity would be the most appropriate to consider for this question?
    Question 23 options:
    1) Point prevalence
    2) Incidence density
    3 Period prevalence
    4 Cumulative incidence
    Question 24
    Which of the following are frequency measures? Question 24 options:
    1) Diagnosis of illness
    2) Birth rate, death rate
15. Determinants of health
16. Spot map of illness
    Question 25
    The nurse epidemiologist was asked to examine the rate of homicide deaths in the community comparing males to females. She computed the data and found 11.1 men were victims of homicide and 3.3 women were victims. Which of the following would be the homicide ratio for men to women?
    Question 25 options:
17. 1) 3/11
18. 2) 3.3 : 11.1
19. 11.1 : 3.3
20. 11.3/3.1
    Question 26
    The nurse epidemiologist was asked to examine the rate of homicide deaths in the community comparing males to females. He computed the data and found that the mortality rate among men was much higher than for women. Which recommendation would the nurse give the policymaker based on this data?
    Question 26 options:
    1 Because the homicide rate is higher among males, prevention education programs should differentiate risk factors for men vs. women
21. Men should be targeted for their risk for homicide before women because they are more likely to be victims
22. Homicide prevention programs should focus on women because they are more vulnerable and more likely to be victimized
23. Women should not be offered intervention programs because fewer are victims
    Question 27
    What type of rate/proportion relates to this fraction?

men who died from lung cancer in 2004 / All men who died from cancer in 2004

Question 27 options:
1Prevalence rate
2Frequency rate
3Incidence proportion
4Mortality rate
Question 28
200 people live in a Long-term care facility. In a five day period, 52 people symptoms of Legionnaire's disease. It was later determined that the bacteria was inhaled from an infected cooling duct in the facility. Which of the following rates represents the risk of attack from Legionnaire's disease in this facility?
Question 28 options:
1) 30.3%
2) 3.8%
3) 26%
4) 35.1%
Question 29
All proportions are ratios, but not all ratios are proportions Question 29 options:
1)true
2) False

Question 30
If you were to investigate the prevalence of disease "at the time of the study", this is an example of what type of prevalence?
Question 30 options:
1) Immediate prevalence
2) Point prevalence
3) Duration of prevalence
4) Period prevalence
Question 31
You are reading a study of the prevalence of sickle cell anemia and want to decide if the study is scientifically sound. Which of the following is not an important consideration?
Question 31 options:

1. Sickle cell anemia is clearly defined population.
2. The study is done on a sample from a defined population.
3. The follow up period is long enough to see changes in infection outcomes.
4. The study is done on a representative sample of the population.
   Question 32
   A study was published in 2010 that indicated an increase in ophthalmic complications post glaucoma filtering surgery. One of these complications is endophtalmitis. The incidence of endophthalmitis in this study was found to be 12% in 25 patients given a new drug and 20% for 20% for 20 patients given the standard drug mitomycin. The difference in efficacy between the two drugs was not statistically significant. What can we say about the effectiveness of the new drug?
   Question 32 options:
5. The new drug should be used for a more accurate calculation of incidence.
6. The new drug is more effective than the standard drug for treating endophthalmitis.
7. Neither drug has been found to be better at reducing endophthalmitis.
8. More evidence is needed to calculate prevalence rates.
   Question 33
   What type of rate/proportion relates to this fraction?
   All new cases of influenza virus in Ontario between November 2016 and April 2017 / All susceptible people who could get influenza in Ontario
   Question 33 options:
   1) Mortality rate
   2) Prevalence rate
   3) Incidence proportion
   4) Frequency rate
   Question 34
   You have been asked to determine the point prevalence rate for all CCU patients who have cardiogenic shock across Ontario. Which of the following is a consideration for measuring point prevalence?
   Question 34 options:
9. You are assessing all patients who are at risk for cardiogenic shock.
10. You can identify all new cases of cardiogenic shock in Ontario.
11. You are measuring prevalence for all patients during a specific period of time.
12. The prevalence is measured at the same time point for all individuals
    Question 35
    Case fatality rate is best described as: Question 35 options:
    1) The number of people who die from a disease
    2) The number of people who die from the disease divided by the people who are susceptible to the disease
    3) The number of people who die from a disease divided by the number of people with the disease
    4) 4) The number of people with the disease
    Question 36
    You are a nurse working in a medicine unit. You are asked to recommend prevention strategies for heart disease. You recommend that your patients increase the amount of antioxidants in their diet, take Omega-3 Fatty Acid supplements and begin a walking program. These are examples of what type of prevention?
    Question 36 options:
13. Primary
14. Tertiary
15. Secondary
16. Healthy living
    Question 37
    The cholesterol component most responsible for atherosclerotic plaque formation is:
    Question 37 options:
17. Total cholesterol.
18. HDL.
19. Phospholipids.
20. LDL.
    Question 38
    Sarah is postmenopausal and has asthma and hypertension. She smokes cigarettes and has a LDL level of 170 mg/dL and a HDL of 40 mg/dL. To reduce Sarah's risk of a cardiovascular event, what should be done?
    Question 38 options:
    1) All of the options.
    2) Lower the LDL level.
    3) Recommend that Sarah seek treatment for her hypertension and asthma.
    4) Lower the HDL level.
    Question 39
    Women who had high serum cholesterol levels were found to be 14 times more likely to have a cerebral vascular accident (CVA). These results indicate which one of the following?
    Question 39 options:
21. That high serum cholesterol can cause CVA.
22. That the subjects were representative of the population.
23. There is a strong association between high cholesterol and CVA.
24. There is a high relative risk for CVA.
    Question 40
    The nurse practitioner is evaluating a client for potential coronary artery disease. He prescribes an exercise stress test. The exercise stress test assesses which of the following?
    Question 40 options:
25. To identify possible atrial defibrillation.
26. To help determine whether or not a CABG is required.
27. To assess the severity of CAD and the prognosis.
28. To identify clients actively having a MI.
    Question 41
    CVD is higher in Eastern Europe because of epidemiological transition which suggests that:
    Question 41 options:
    1) Disease trends are connected to issues such as socioeconomic status and broader political issues.
    2) People moved from Western Europe to Eastern Europe and transitioned disease into the region.
    3) Survival rates in Eastern Europe have increased making it more likely that people have disease.
    4) Higher GDP results in higher rates of CVD as seen in some Middle Eastern count
    Question 42
    Which of the following would be recommended as a tertiary disease prevention strategy for coronary heart disease?
    Question 42 options:
29. A healthy 20 year old man who exercises 4 times a week.
30. A 30 year old woman receiving annual physical examination.
31. A person recovering post-MI who eats low fat, low sodium diet.
32. A 40 year old person receiving cholesterol screening.
    Question 43
    You are a Public Health Nurse representing Toronto on a national public health committee that aims to reduce cardiovascular disease in the Canadian school system. What recommendations might you make to the committee to help reduce risk in Canadian schools?
    Question 43 options:
33. Recommend 'junk food' in vending machines since children like these foods.
34. Provide education about reduction of "trans fats" in the Canadian diet.
35. Allow schools to make their own decisions about heart disease.
36. Mandate that schools offer healthy food choices in the cafeteria.
    Question 44
    Over 80% of deaths due to cardiovascular disease occur in developing countries (poorer regions of the world). What is a potential factor for this rate to be so high?
    Question 44 options:
37. Limited data until recently that tracks trends in cardiovascular disease deaths.
38. Policymakers have not been interested in tracking heart disease or deaths.
39. High rates of unemployment causing higher rates of lipid level.
40. Higher income levels, higher physical activity and more access to cigarettes.
    Question 45
    Which of the following diet related risk factors for cardiovascular disease do Canadians have one of the highest consumption rates in the world?
    Question 45 options:
    1 low level HDLs
41. Trans fatty acids
42. omega-3 fatty acids
43. Vegetables
    Question 46
    Rick is modifying his diet to try and lose weight. However, despite Rick telling you that he followed his diet plan, he has not lost any weight after 3 months. The follow up lab results indicate the following: Total cholesterol = 238 mg/dL, Triglycerides = 100 mg/dL, HDL - 28 mg/dL, LDL = 190 mg/dL. What would you recommend that Rick do?
    Question 46 options:
44. Stop his current diet plan and try another type of diet.
45. Continue with the diet plan for one more month.
46. Recommend that Rick see the family physician for drug therapy to control his cholesterol.
47. Start up an exercise program with a goal of uninterrupted exercise for 30 minutes at least 2 days per week.
    Question 47
    Since the 1900's the ten leading causes of mortality have changed over time. Present day disease that are the leading causes of death globally include which of the following?
    Question 47 options:
    1) Heart disease, Cancer and Stroke.
    2) Pneumonia, Influenza and Tuberculosis.
    3) Diabetes, Heart disease, and Suicide.
    4) Alzheimer's disease, Diabetes and Kidney disease.
    Question 48
    Mr. Ahmad, 72 years old, recently had a heart attack and wants to prevent a future occurrence. He knows he can work on his lifestyle, but wants to know what risk factors are not modifiable. As his registered nurse, what risk factors would you suggest are not modifiable?
    Question 48 options:
48. Healthy waist to hip circumference
49. Physical activity
50. Advancing age
51. Fruit and vegetable intake
    Question 49
    Mrs. Nguyen is at risk for heart disease in that she is not very physically active. Her job requires her to sit for eight hours as a call centre operator. She has gained over 20 lbs in the last two years and her BMI is in the 'overweight' category. As her nurse, what education about lifestyle changes could you start with to help Mrs. Nguyen to reduce her risk for heart disease?
    Question 49 options:
52. Explore easy dietary changes and physical activity that Mrs. Nguyen can start immediately.
53. Discuss alternative types of employment to deal with stress.
54. Recommend Mrs. Nguyen speak with her doctor and start statins to lower cholesterol.
55. Help Mrs. Nguyen to quit smoking by enrolling her in a smoking cessation program.
    Question 50
    For clients with known coronary artery disease, it is recommended that the LDL cholesterol be:
    Question 50 options:
    1) 100 mg/dL or less.
    2) 101-130 mg/dL.
    3) 131-200 mg/dL.
    4) 200 mg/dL or less.

Sample Solution