1|Page
HLTH 236 FINAL 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 studying an outbreak of
gastrointestinal illness in a small town. After interviewing affected
individuals, the researcher notes that all cases ate at the same
restaurant on the same day. This type of investigation is called:
A) Retrospective cohort study
B) Clinical trial
C) Outbreak investigation
D) Cross-sectional survey
Rationale: Outbreak investigation is a focused epidemiological
study to identify the source and control an acute cluster of
illness. A retrospective cohort study might be used within the
investigation, but the overall process is outbreak investigation.
2. Which of the following is the best definition of “incidence” in
epidemiology?
A) The total number of existing cases of a disease at a specific
time
B) The number of new cases of a disease occurring in a
population during a specified time period
C) The proportion of deaths from a specific cause in a population
D) The average number of years a person is expected to live
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Rationale: Incidence measures new events; prevalence measures
existing cases. Mortality and life expectancy are different
measures.
3. A community health nurse is planning a smoking cessation
program. Using the PRECEDE-PROCEED model, which action
occurs first?
A) Implement the intervention
B) Evaluate program outcomes
C) Conduct a social assessment to identify quality of life
concerns
D) Select educational strategies
Rationale: The PRECEDE-PROCEED model begins with social
diagnosis (identifying needs and quality of life), then
epidemiological, behavioral, and environmental diagnosis, then
education, implementation, and evaluation.
4. A county reports 50 new cases of hepatitis A in a month, with a
population of 500,000. The incidence rate per 100,000 population
is:
A) 1 per 100,000
B) 10 per 100,000
C) 50 per 100,000
D) 100 per 100,000
*Rationale: (,000) × 100,000 = 10 per 100,000. Formula:
(new cases / population) × multiplier.*
5. Which level of prevention is represented by a nurse teaching a
community class about healthy eating and exercise to prevent heart
disease?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
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Rationale: Primary prevention aims to prevent disease before it
occurs (health promotion and specific protection). Secondary
prevention is early detection; tertiary is rehabilitation.
6. A screening test for cervical cancer has a sensitivity of 90% and a
specificity of 95%. This means:
A) 90% of people without the disease will test negative
B) 90% of people with the disease will test positive
C) 95% of people with the disease will test positive
D) The test is equally accurate for positive and negative results
Rationale: Sensitivity = true positive rate (ability to correctly
identify those with disease). Specificity = true negative rate
(ability to correctly identify those without disease).
7. A researcher wants to determine if a new vaccine reduces the
incidence of influenza. The strongest study design for this purpose
is:
A) Case-control study
B) Randomized controlled trial
C) Ecological study
D) Cross-sectional study
Rationale: Randomized controlled trials (RCTs) provide the
highest level of evidence for causal inference regarding
interventions. Case-control studies are observational and less
definitive for intervention effects.
8. According to the Health Belief Model, which factor is most likely
to predict that an individual will get a flu shot?
A) High perceived susceptibility to influenza
B) Low perceived severity of influenza
C) High perceived barriers to getting the shot
D) High perceived susceptibility and high perceived benefits
Rationale: The Health Belief Model posits that perceived
susceptibility, perceived severity, perceived benefits, and low
, 4|Page
perceived barriers combine to influence behavior. Both
susceptibility and benefits are strong predictors.
9. A community has a high rate of lead poisoning among children.
Which of the following is an example of an environmental
intervention at the policy level?
A) Distributing educational brochures about lead paint
B) Enacting a law requiring lead inspection before home sale
C) Providing free lead testing at clinics
D) Offering nutritional counseling to reduce lead absorption
Rationale: Policy-level interventions change laws, regulations, or
systems. Education and testing are individual or programmatic;
policy is structural.
10. Which of the following is a core function of public health as
defined by the Institute of Medicine (IOM)?
A) Hospital administration
B) Assessment
C) Direct medical care
D) Pharmaceutical research
Rationale: The three core functions are assessment, policy
development, and assurance. Direct medical care is not a core
public health function, though assurance includes ensuring
access to care.
11. A health department reports that the mortality rate from heart
disease in a city is 200 per 100,000. This is an example of:
A) Morbidity rate
B) Crude mortality rate
C) Case fatality rate
D) Standardized mortality ratio
Rationale: Crude mortality rate is total deaths from all causes or
a specific cause per population, without age adjustment. Case
fatality is deaths among those with the disease.
HLTH 236 FINAL 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 studying an outbreak of
gastrointestinal illness in a small town. After interviewing affected
individuals, the researcher notes that all cases ate at the same
restaurant on the same day. This type of investigation is called:
A) Retrospective cohort study
B) Clinical trial
C) Outbreak investigation
D) Cross-sectional survey
Rationale: Outbreak investigation is a focused epidemiological
study to identify the source and control an acute cluster of
illness. A retrospective cohort study might be used within the
investigation, but the overall process is outbreak investigation.
2. Which of the following is the best definition of “incidence” in
epidemiology?
A) The total number of existing cases of a disease at a specific
time
B) The number of new cases of a disease occurring in a
population during a specified time period
C) The proportion of deaths from a specific cause in a population
D) The average number of years a person is expected to live
,2|Page
Rationale: Incidence measures new events; prevalence measures
existing cases. Mortality and life expectancy are different
measures.
3. A community health nurse is planning a smoking cessation
program. Using the PRECEDE-PROCEED model, which action
occurs first?
A) Implement the intervention
B) Evaluate program outcomes
C) Conduct a social assessment to identify quality of life
concerns
D) Select educational strategies
Rationale: The PRECEDE-PROCEED model begins with social
diagnosis (identifying needs and quality of life), then
epidemiological, behavioral, and environmental diagnosis, then
education, implementation, and evaluation.
4. A county reports 50 new cases of hepatitis A in a month, with a
population of 500,000. The incidence rate per 100,000 population
is:
A) 1 per 100,000
B) 10 per 100,000
C) 50 per 100,000
D) 100 per 100,000
*Rationale: (,000) × 100,000 = 10 per 100,000. Formula:
(new cases / population) × multiplier.*
5. Which level of prevention is represented by a nurse teaching a
community class about healthy eating and exercise to prevent heart
disease?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
,3|Page
Rationale: Primary prevention aims to prevent disease before it
occurs (health promotion and specific protection). Secondary
prevention is early detection; tertiary is rehabilitation.
6. A screening test for cervical cancer has a sensitivity of 90% and a
specificity of 95%. This means:
A) 90% of people without the disease will test negative
B) 90% of people with the disease will test positive
C) 95% of people with the disease will test positive
D) The test is equally accurate for positive and negative results
Rationale: Sensitivity = true positive rate (ability to correctly
identify those with disease). Specificity = true negative rate
(ability to correctly identify those without disease).
7. A researcher wants to determine if a new vaccine reduces the
incidence of influenza. The strongest study design for this purpose
is:
A) Case-control study
B) Randomized controlled trial
C) Ecological study
D) Cross-sectional study
Rationale: Randomized controlled trials (RCTs) provide the
highest level of evidence for causal inference regarding
interventions. Case-control studies are observational and less
definitive for intervention effects.
8. According to the Health Belief Model, which factor is most likely
to predict that an individual will get a flu shot?
A) High perceived susceptibility to influenza
B) Low perceived severity of influenza
C) High perceived barriers to getting the shot
D) High perceived susceptibility and high perceived benefits
Rationale: The Health Belief Model posits that perceived
susceptibility, perceived severity, perceived benefits, and low
, 4|Page
perceived barriers combine to influence behavior. Both
susceptibility and benefits are strong predictors.
9. A community has a high rate of lead poisoning among children.
Which of the following is an example of an environmental
intervention at the policy level?
A) Distributing educational brochures about lead paint
B) Enacting a law requiring lead inspection before home sale
C) Providing free lead testing at clinics
D) Offering nutritional counseling to reduce lead absorption
Rationale: Policy-level interventions change laws, regulations, or
systems. Education and testing are individual or programmatic;
policy is structural.
10. Which of the following is a core function of public health as
defined by the Institute of Medicine (IOM)?
A) Hospital administration
B) Assessment
C) Direct medical care
D) Pharmaceutical research
Rationale: The three core functions are assessment, policy
development, and assurance. Direct medical care is not a core
public health function, though assurance includes ensuring
access to care.
11. A health department reports that the mortality rate from heart
disease in a city is 200 per 100,000. This is an example of:
A) Morbidity rate
B) Crude mortality rate
C) Case fatality rate
D) Standardized mortality ratio
Rationale: Crude mortality rate is total deaths from all causes or
a specific cause per population, without age adjustment. Case
fatality is deaths among those with the disease.
