1|Page
HLTH 236 MIDTERM ACTUAL
COMPREHENSIVE EXAM PREP 2025 ALL
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK|NEW
AND REVISED
1. A public health researcher is differentiating between health
disparities and health care disparities. Which scenario best
describes a health care disparity?
A) A higher incidence of diabetes in a low-income community
B) A patient being denied a kidney transplant due to their
insurance type despite being a suitable candidate
C) A higher prevalence of asthma in a community located near a
highway
D) A community with higher rates of heart disease due to limited
access to grocery stores with fresh produce
Rationale: Health care disparities refer to differences in access to or
quality of health care services, such as denial of a transplant due to
insurance. Health disparities refer to differences in the incidence,
prevalence, mortality, or burden of disease.
2. According to the five domains of health (IOM framework), which
domain is the strongest predictor of health disparities?
A) Genetics
B) Socioeconomic Status
C) Environmental Exposures
D) Medical Care
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Rationale: Socioeconomic status (SES) is consistently identified as the
most important predictor of health disparities, influencing access to
resources, stress levels, and health behaviors.
3. A nurse notices that a patient from a specific cultural background
refuses pain medication, believing that suffering is a natural part of
life. This patient is operating from which theory of illness?
A) Personalistic Theory
B) Naturalistic Theory
C) Biomedical Theory
D) Magicoreligious Theory
Rationale: Naturalistic theory explains illness as a result of
imbalances in natural forces (e.g., yin/yang, hot/cold). It contrasts with
personalistic theory, which attributes illness to supernatural agents.
4. A community health worker is developing a diabetes prevention
program. They notice that the target population has a high level of
perceived susceptibility to the disease but low perceived benefits
of changing their diet. Which health behavior theory is the worker
using?
A) Transtheoretical Model (Stages of Change)
B) Health Belief Model (HBM)
C) Social Cognitive Theory
D) Theory of Planned Behavior
Rationale: The Health Belief Model uses constructs including
perceived susceptibility, severity, benefits, and barriers to predict
health behaviors. Perceived susceptibility and perceived benefits are
core to the model.
5. What was the primary ethical violation of the Tuskegee Syphilis
Study (1932–1972)?
A) Lack of informed consent and failure to treat participants after
penicillin became available
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B) Lack of informed consent and failure to treat participants
with penicillin
C) Using placebo controls without a treatment arm
D) Publishing false data about syphilis progression
Rationale: The Tuskegee study violated beneficence and justice by
withholding treatment (penicillin) from African American men
without their informed consent. Participants were misled about
receiving "free healthcare" when they were actually untreated.
6. A researcher is studying health outcomes among immigrants.
According to the healthy immigrant effect, what would they
expect to find?
A) Immigrants have worse health outcomes than native-born
populations
B) Immigrants typically arrive with better health than native-
born populations, which may decline over time
C) Health outcomes improve with each generation
D) Immigrants have no measurable difference in health status
Rationale: The healthy immigrant effect describes the phenomenon
where recent immigrants often have better health outcomes than the
native-born population due to pre-screening and health requirements
for immigration. This advantage tends to diminish with longer
residence.
7. A hospital administrator is working to implement the CLAS
standards (Culturally and Linguistically Appropriate Services).
Which action would best demonstrate cultural competence at the
organizational level?
A) Hiring a single bilingual staff member
B) Providing interpreter services, training all staff in cultural
awareness, and adapting health materials to the literacy levels
of the served population
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C) Decorating the waiting room with ethnic art
D) Asking patients to bring their own family interpreters
Rationale: The CLAS standards require comprehensive organizational
strategies including language assistance, workforce diversity, and
continuous quality improvement. Simply hiring one bilingual staff
member or using family interpreters does not meet CLAS requirements
for professional interpretation.
8. A student is studying the difference
between inequality and inequity in health. Which statement
accurately defines health inequity?
A) Differences in health outcomes between countries
B) Avoidable, unfair, or remediable differences in health
among population groups
C) Natural variations in health status due to genetics
D) Differences in health outcomes that cannot be changed
Rationale: Health inequity refers to differences that are systematic,
avoidable, and unjust. Inequality refers to any difference in health
outcomes, while inequity specifies that the difference is unfair and
preventable.
9. A community faces high rates of obesity. According to the social
ecological model, which intervention would address
the community level?
A) A weight loss app for individuals
B) Creating safe walking trails and increasing access to
farmers' markets in the neighborhood
C) A family-based meal planning program
D) A workplace wellness challenge
Rationale: The social ecological model has multiple levels: individual,
interpersonal, organizational, community, and policy. The community
level involves the physical and social environment of the neighborhood
HLTH 236 MIDTERM ACTUAL
COMPREHENSIVE EXAM PREP 2025 ALL
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK|NEW
AND REVISED
1. A public health researcher is differentiating between health
disparities and health care disparities. Which scenario best
describes a health care disparity?
A) A higher incidence of diabetes in a low-income community
B) A patient being denied a kidney transplant due to their
insurance type despite being a suitable candidate
C) A higher prevalence of asthma in a community located near a
highway
D) A community with higher rates of heart disease due to limited
access to grocery stores with fresh produce
Rationale: Health care disparities refer to differences in access to or
quality of health care services, such as denial of a transplant due to
insurance. Health disparities refer to differences in the incidence,
prevalence, mortality, or burden of disease.
2. According to the five domains of health (IOM framework), which
domain is the strongest predictor of health disparities?
A) Genetics
B) Socioeconomic Status
C) Environmental Exposures
D) Medical Care
,2|Page
Rationale: Socioeconomic status (SES) is consistently identified as the
most important predictor of health disparities, influencing access to
resources, stress levels, and health behaviors.
3. A nurse notices that a patient from a specific cultural background
refuses pain medication, believing that suffering is a natural part of
life. This patient is operating from which theory of illness?
A) Personalistic Theory
B) Naturalistic Theory
C) Biomedical Theory
D) Magicoreligious Theory
Rationale: Naturalistic theory explains illness as a result of
imbalances in natural forces (e.g., yin/yang, hot/cold). It contrasts with
personalistic theory, which attributes illness to supernatural agents.
4. A community health worker is developing a diabetes prevention
program. They notice that the target population has a high level of
perceived susceptibility to the disease but low perceived benefits
of changing their diet. Which health behavior theory is the worker
using?
A) Transtheoretical Model (Stages of Change)
B) Health Belief Model (HBM)
C) Social Cognitive Theory
D) Theory of Planned Behavior
Rationale: The Health Belief Model uses constructs including
perceived susceptibility, severity, benefits, and barriers to predict
health behaviors. Perceived susceptibility and perceived benefits are
core to the model.
5. What was the primary ethical violation of the Tuskegee Syphilis
Study (1932–1972)?
A) Lack of informed consent and failure to treat participants after
penicillin became available
,3|Page
B) Lack of informed consent and failure to treat participants
with penicillin
C) Using placebo controls without a treatment arm
D) Publishing false data about syphilis progression
Rationale: The Tuskegee study violated beneficence and justice by
withholding treatment (penicillin) from African American men
without their informed consent. Participants were misled about
receiving "free healthcare" when they were actually untreated.
6. A researcher is studying health outcomes among immigrants.
According to the healthy immigrant effect, what would they
expect to find?
A) Immigrants have worse health outcomes than native-born
populations
B) Immigrants typically arrive with better health than native-
born populations, which may decline over time
C) Health outcomes improve with each generation
D) Immigrants have no measurable difference in health status
Rationale: The healthy immigrant effect describes the phenomenon
where recent immigrants often have better health outcomes than the
native-born population due to pre-screening and health requirements
for immigration. This advantage tends to diminish with longer
residence.
7. A hospital administrator is working to implement the CLAS
standards (Culturally and Linguistically Appropriate Services).
Which action would best demonstrate cultural competence at the
organizational level?
A) Hiring a single bilingual staff member
B) Providing interpreter services, training all staff in cultural
awareness, and adapting health materials to the literacy levels
of the served population
, 4|Page
C) Decorating the waiting room with ethnic art
D) Asking patients to bring their own family interpreters
Rationale: The CLAS standards require comprehensive organizational
strategies including language assistance, workforce diversity, and
continuous quality improvement. Simply hiring one bilingual staff
member or using family interpreters does not meet CLAS requirements
for professional interpretation.
8. A student is studying the difference
between inequality and inequity in health. Which statement
accurately defines health inequity?
A) Differences in health outcomes between countries
B) Avoidable, unfair, or remediable differences in health
among population groups
C) Natural variations in health status due to genetics
D) Differences in health outcomes that cannot be changed
Rationale: Health inequity refers to differences that are systematic,
avoidable, and unjust. Inequality refers to any difference in health
outcomes, while inequity specifies that the difference is unfair and
preventable.
9. A community faces high rates of obesity. According to the social
ecological model, which intervention would address
the community level?
A) A weight loss app for individuals
B) Creating safe walking trails and increasing access to
farmers' markets in the neighborhood
C) A family-based meal planning program
D) A workplace wellness challenge
Rationale: The social ecological model has multiple levels: individual,
interpersonal, organizational, community, and policy. The community
level involves the physical and social environment of the neighborhood
