CHW (Community Health Worker) Final Exam –
2026 Edition
150 original multiple-choice items | Difficulty mix: 30 % easy, 50 % moderate, 20 %
advanced
QUESTION 1
A CHW is visiting a Spanish-speaking household. The 8-year-old child offers to interpret for the
grandmother. The most appropriate action is to:
A. Accept the help to save agency interpreter costs
B. Politely refuse and reschedule with a qualified interpreter
C. Ask the child to interpret only medical terms
D. Proceed slowly so the child can keep up
Correct Answer: B
Rationale: Minor children are not qualified interpreters; relying on them violates confidentiality
and risks misinterpretation. Rescheduling with a trained interpreter respects ethical and legal
standards.
QUESTION 2
Which outreach method is most effective for engaging a hard-to-reach refugee community?
A. Mass-email blast in English
B. Door-to-door visits with bilingual flyers
C. Posters inside the agency office
D. Facebook ads targeting zip codes
Correct Answer: B
Rationale: Refugee communities often have language and technology barriers; face-to-face
contact with culturally appropriate materials builds trust. Mass e-mail (A) assumes literacy and
internet access; office posters (C) reach only those already inside; social media (D) may miss
elders.
QUESTION 3
During motivational interviewing, a client says, “I know I should quit smoking, but it relaxes
me.” The CHW’s best response is:
,A. “You really must stop—smoking kills.”
B. “What do you like most about relaxing without cigarettes?”
C. “Have you tried nicotine patches?”
D. “Lots of people quit, so can you.”
Correct Answer: B
Rationale: Option B evokes change talk by exploring benefits of change; A and D create
resistance; C jumps to solutions before readiness.
QUESTION 4
Which document must a CHW secure written permission to share with an outside specialty
clinic?
A. Demographic intake sheet
B. Insurance verification form
C. Recent hospital discharge summary
D. Appointment reminder card
Correct Answer: C
Rationale: Discharge summaries contain protected health information (PHI); sharing requires
HIPAA authorization. Demographics (A) and insurance (B) are often shared under TPO
exceptions; reminder cards (D) contain minimal PHI.
QUESTION 5
A neighborhood has no sidewalks and limited public transport. This is best categorized as which
social determinant?
A. Economic stability
B. Neighborhood & built environment
C. Social & community context
D. Health & health care
Correct Answer: B
Rationale: Sidewalks and transport are physical features of the built environment. Economic
stability (A) relates to income; social context (C) to support networks; health care (D) to service
access.
,QUESTION 6
A client’s BP is 158/96 mmHg on two visits. The CHW should:
A. Begin teaching the DASH diet at once
B. Advise starting antihypertensive medication
C. Refer to a clinician for evaluation
D. Reassure that anxiety can raise readings
Correct Answer: C
Rationale: CHWs do not diagnose or prescribe; Stage 2 hypertension requires clinician
evaluation. Teaching (A) is premature without diagnosis; advising meds (B) is outside scope;
reassurance (D) delays care.
QUESTION 7
When documenting a home visit, the CHW notices an open bag of insulin vials on a warm
windowsill. The most accurate objective note is:
A. “Client stores insulin incorrectly.”
B. “Insulin vials observed on windowsill, temperature warm to touch.”
C. “Client needs education on insulin storage.”
D. “Vials probably spoiled—advise discard.”
Correct Answer: B
Rationale: Objective documentation describes what is seen/felt without judgment or diagnosis.
Options A, C, and D add inference or advice.
QUESTION 8
Which principle underlies trauma-informed outreach?
A. Persuade clients to disclose past abuse early
B. Maintain strict appointment deadlines
C. Provide choice and foster control
D. Focus on problems first, strengths later
Correct Answer: C
, Rationale: Trauma-informed practice emphasizes safety, trust, choice, collaboration, and
empowerment. Pushing disclosure (A) can retraumatize; rigid deadlines (B) ignore coping needs;
strengths focus (D) should be concurrent.
QUESTION 9
A CHW is asked to testify at the city council about park safety. Which role is fulfilled?
A. Direct service provider
B. Advocate
C. Case manager
D. Data collector
Correct Answer: B
Rationale: Testifying for systemic change exemplifies community-level advocacy. Direct service
(A) and case management (C) are individual-level; data collection (D) is preparatory.
QUESTION 10
During a community fair, an older adult suddenly becomes confused and diaphoretic. BP is
180/110, HR 110 irregular. First action is to:
A. Offer fruit juice
B. Have them lie on the ground
C. Activate EMS immediately
D. Check blood sugar with glucometer
Correct Answer: C
Rationale: Hypertensive emergency with arrhythmia requires paramedic evaluation; juice (A)
could harm if stroke; lying down (B) is secondary; glucometer (D) delays definitive care.
QUESTION 11
The primary goal of motivational interviewing is to:
A. Convince clients to adopt healthier behaviors
B. Elicit the client’s own motivations for change
C. Provide detailed education on risks
D. Set strict behavioral goals
Correct Answer: B
2026 Edition
150 original multiple-choice items | Difficulty mix: 30 % easy, 50 % moderate, 20 %
advanced
QUESTION 1
A CHW is visiting a Spanish-speaking household. The 8-year-old child offers to interpret for the
grandmother. The most appropriate action is to:
A. Accept the help to save agency interpreter costs
B. Politely refuse and reschedule with a qualified interpreter
C. Ask the child to interpret only medical terms
D. Proceed slowly so the child can keep up
Correct Answer: B
Rationale: Minor children are not qualified interpreters; relying on them violates confidentiality
and risks misinterpretation. Rescheduling with a trained interpreter respects ethical and legal
standards.
QUESTION 2
Which outreach method is most effective for engaging a hard-to-reach refugee community?
A. Mass-email blast in English
B. Door-to-door visits with bilingual flyers
C. Posters inside the agency office
D. Facebook ads targeting zip codes
Correct Answer: B
Rationale: Refugee communities often have language and technology barriers; face-to-face
contact with culturally appropriate materials builds trust. Mass e-mail (A) assumes literacy and
internet access; office posters (C) reach only those already inside; social media (D) may miss
elders.
QUESTION 3
During motivational interviewing, a client says, “I know I should quit smoking, but it relaxes
me.” The CHW’s best response is:
,A. “You really must stop—smoking kills.”
B. “What do you like most about relaxing without cigarettes?”
C. “Have you tried nicotine patches?”
D. “Lots of people quit, so can you.”
Correct Answer: B
Rationale: Option B evokes change talk by exploring benefits of change; A and D create
resistance; C jumps to solutions before readiness.
QUESTION 4
Which document must a CHW secure written permission to share with an outside specialty
clinic?
A. Demographic intake sheet
B. Insurance verification form
C. Recent hospital discharge summary
D. Appointment reminder card
Correct Answer: C
Rationale: Discharge summaries contain protected health information (PHI); sharing requires
HIPAA authorization. Demographics (A) and insurance (B) are often shared under TPO
exceptions; reminder cards (D) contain minimal PHI.
QUESTION 5
A neighborhood has no sidewalks and limited public transport. This is best categorized as which
social determinant?
A. Economic stability
B. Neighborhood & built environment
C. Social & community context
D. Health & health care
Correct Answer: B
Rationale: Sidewalks and transport are physical features of the built environment. Economic
stability (A) relates to income; social context (C) to support networks; health care (D) to service
access.
,QUESTION 6
A client’s BP is 158/96 mmHg on two visits. The CHW should:
A. Begin teaching the DASH diet at once
B. Advise starting antihypertensive medication
C. Refer to a clinician for evaluation
D. Reassure that anxiety can raise readings
Correct Answer: C
Rationale: CHWs do not diagnose or prescribe; Stage 2 hypertension requires clinician
evaluation. Teaching (A) is premature without diagnosis; advising meds (B) is outside scope;
reassurance (D) delays care.
QUESTION 7
When documenting a home visit, the CHW notices an open bag of insulin vials on a warm
windowsill. The most accurate objective note is:
A. “Client stores insulin incorrectly.”
B. “Insulin vials observed on windowsill, temperature warm to touch.”
C. “Client needs education on insulin storage.”
D. “Vials probably spoiled—advise discard.”
Correct Answer: B
Rationale: Objective documentation describes what is seen/felt without judgment or diagnosis.
Options A, C, and D add inference or advice.
QUESTION 8
Which principle underlies trauma-informed outreach?
A. Persuade clients to disclose past abuse early
B. Maintain strict appointment deadlines
C. Provide choice and foster control
D. Focus on problems first, strengths later
Correct Answer: C
, Rationale: Trauma-informed practice emphasizes safety, trust, choice, collaboration, and
empowerment. Pushing disclosure (A) can retraumatize; rigid deadlines (B) ignore coping needs;
strengths focus (D) should be concurrent.
QUESTION 9
A CHW is asked to testify at the city council about park safety. Which role is fulfilled?
A. Direct service provider
B. Advocate
C. Case manager
D. Data collector
Correct Answer: B
Rationale: Testifying for systemic change exemplifies community-level advocacy. Direct service
(A) and case management (C) are individual-level; data collection (D) is preparatory.
QUESTION 10
During a community fair, an older adult suddenly becomes confused and diaphoretic. BP is
180/110, HR 110 irregular. First action is to:
A. Offer fruit juice
B. Have them lie on the ground
C. Activate EMS immediately
D. Check blood sugar with glucometer
Correct Answer: C
Rationale: Hypertensive emergency with arrhythmia requires paramedic evaluation; juice (A)
could harm if stroke; lying down (B) is secondary; glucometer (D) delays definitive care.
QUESTION 11
The primary goal of motivational interviewing is to:
A. Convince clients to adopt healthier behaviors
B. Elicit the client’s own motivations for change
C. Provide detailed education on risks
D. Set strict behavioral goals
Correct Answer: B
