The CHN can enhance the sensitivity and specificity of a test by using its predictive value. Which one of the following best defines positive predictive value?

Correct Answer: D

Rationale: Positive predictive value (PPV) is the proportion of individuals with a positive test result who actually have the disease. This is crucial in determining the likelihood that a positive test accurately identifies a true positive case. By calculating PPV, we can assess the test's ability to predict the presence of the disease. In this context, the CHN (clinical history and physical examination) can help improve the accuracy of test results by enhancing the predictive value. Choice A is incorrect because it describes the negative predictive value, which is the proportion of individuals with a negative test result who are actually disease-free. Choice B is incorrect as it refers to the variability of the trait being measured, not predictive value. Choice C is incorrect as it discusses inconsistencies in the testing instrument, which are unrelated to predictive value.

Correct Answer: B

Rationale: The correct answer is B: Informant interviews with local community members. This method is best because it directly involves the individuals within the community who have firsthand knowledge and experience regarding immigrant access to regional health care. They can provide valuable insights and perspectives that may not be captured through other methods. A: Interviews with employees of the local health board may provide some insights, but they may not have the same level of direct experience and perspective as community members. C: Interview with a legislator or local politician may offer a broader policy perspective, but may not capture the specific experiences of community members. D: Interview with a public health official may provide valuable information, but may not offer the same depth of insights as direct interactions with community members.

Correct Answer: B

Rationale: The correct answer is B because it directly assesses the impact of the program on reducing teen injury and death related to drunk driving. By comparing statistics before and after the program, we can determine its effectiveness. A: This question focuses on participant satisfaction, not the program's impact on reducing teen injury and death related to drunk driving. C: This question focuses on the amount of alcohol intake by teens, not the program's impact on reducing teen injury and death related to drunk driving. D: This question focuses on program implementation issues, not the program's impact on reducing teen injury and death related to drunk driving.

Correct Answer: C

Rationale: The correct answer is C: Measuring the goal effect. In this scenario, the CHN is comparing the number of new teen clients seeking contraceptive counseling before and after the education intervention program. This step involves evaluating the impact or effect of the program on the intended goal, which is to decrease teen pregnancy rates. By comparing the data before and after the intervention, the CHN can assess whether the program has been effective in achieving its goal. Incorrect choices: A: Determining outcome goal measurement - This step involves establishing specific, measurable outcomes before implementing the program. It is done prior to the intervention. B: Goal setting - This step involves setting specific, achievable goals at the beginning of the program. It is not the same as measuring the impact of the program. D: Evaluating the program - While evaluating the program is part of the overall evaluation process, in this scenario, the focus is specifically on measuring the effect of the program on the goal of decreasing teen pregnancy rates.

Correct Answer: C

Rationale: The correct answer is C because secondary prevention involves early detection and intervention to prevent further progression of a disease. In this case, modifying diet and medications can help manage obesity-related health issues. Choice A focuses on primary prevention, Choice B is more specific to hypertension, and Choice D is more indicative of screening for diabetes, making them incorrect for the context of secondary prevention in obese women.