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[Section 1: Epidemiology & Disease Surveillance (Q1-12)]
Q1. Which three components form the epidemiologic triangle used to analyze disease
occurrence in populations?
A. Time, place, and person
B. Agent, host, and environment
C. Incidence, prevalence, and mortality
D. Sensitivity, specificity, and predictive value
Correct Answer: B. Agent, host, and environment [CORRECT]
Rationale: The epidemiologic triangle consists of agent, host, and environment as the
three interactive factors determining disease patterns. Option A describes the
epidemiologic variables used in outbreak investigation, C describes rates, and D
describes screening test characteristics.
Q2. A community health nurse investigates a foodborne illness at a senior center. Over a
2-week period, 45 new cases of salmonellosis are identified among 1,500 residents.
What is the incidence rate per 1,000 population?
A. 15 per 1,000
B. 30 per 1,000
C. 45 per 1,000
D. 60 per 1,000
Correct Answer: B. 30 per 1,000 [CORRECT]
Rationale: Incidence rate = (New cases / Population at risk) × multiplier = (,500) ×
1,000 = 30 per 1,000. Option A incorrectly uses the wrong numerator or denominator, C
reports the raw case count, and D doubles the correct rate.
,Q3. During a community health fair, a nurse screens 800 adults for type 2 diabetes and
finds that 120 have been previously diagnosed and 30 are newly diagnosed. What is the
point prevalence of diabetes in this population?
A. 3.75%
B. 15.0%
C. 18.75%
D. 22.5%
Correct Answer: C. 18.75% [CORRECT]
Rationale: Point prevalence = (Total existing cases at a point in time / Total population)
× 100 = (120 + 30) / 800 × 100 = 18.75%. Option A calculates only new incidence, B uses
only previously diagnosed cases, and D incorrectly adds an extra numerator value.
Q4. A new screening test for hepatitis C is administered to 200 high-risk individuals.
Among 80 who truly have the disease, 72 test positive. What is the sensitivity of this
screening test?
A. 80%
B. 85%
C. 90%
D. 95%
Correct Answer: C. 90% [CORRECT]
Rationale: Sensitivity = (True positives / All diseased) × 100 = × 100 = 90%.
Option A uses the total sample as the denominator, B is a distractor using incorrect
numerator/denominator pairing, and D overestimates the true positive rate.
Q5. The same hepatitis C screening test is given to 200 individuals. Among 120 who do
not have the disease, 108 test negative. What is the specificity of this test?
A. 85%
B. 88%
C. 90%
D. 95%
Correct Answer: C. 90% [CORRECT]
, Rationale: Specificity = (True negatives / All non-diseased) × 100 = × 100 =
90%. Option A uses the total sample as denominator, B uses an incorrect numerator,
and D overestimates the calculation.
Q6. A community clinic uses a rapid strep test with 95% sensitivity and 90% specificity
in a population where strep throat prevalence is 10%. If 1,000 children are tested, what
is the approximate positive predictive value (PPV)?
A. 45%
B. 51%
C. 68%
D. 95%
Correct Answer: B. 51% [CORRECT]
Rationale: Using a 2×2 table: True positives = 95 (95% of 100 diseased), False positives
= 90 (10% of 900 non-diseased). PPV = 95 / (95 + 90) = ≈ 51.4%. Option A
underestimates by using wrong values, C overestimates, and D confuses sensitivity with
PPV.
Q7. During an outbreak investigation, a community health nurse confirms the diagnosis
and defines a case. The next step in the standard outbreak investigation process is to:
A. Develop and test a hypothesis immediately
B. Count cases and classify them by time, place, and person characteristics
C. Implement control measures before collecting any additional data
D. Publish findings in a peer-reviewed journal
Correct Answer: B. Count cases and classify them by time, place, and person
characteristics [CORRECT]
Rationale: The standard outbreak investigation steps follow a sequence: verify
diagnosis, confirm outbreak, define case, count cases and orient data by
time/place/person, then develop hypotheses. Option A skips the descriptive
epidemiology phase, C violates the principle of data-driven response, and D occurs after
the investigation concludes.