Community Health & Epidemiology: 2026 Basics
1. A community health nurse is designing a cardiovascular wellness program for a local community
center. According to the levels of prevention framework, which of the following activities should the
nurse implement as a primary prevention strategy?
A. Setting up a weekly blood pressure screening clinic.
B. Conducting nutrition and exercise education classes for healthy adults.
C. Facilitating a support group for individuals recovering from myocardial infarction.
D. Referring adults with borderline hypertension to a cardiologist.
Correct Answer: B. Conducting nutrition and exercise education classes for healthy adults.
Rationale: Primary prevention focuses on health promotion and disease prevention to halt the occurrence of
disease before it starts. Nutrition and exercise education for healthy adults aims to prevent the development of
cardiovascular disease. Blood pressure screenings (A) and referrals (D) are secondary prevention (early detection
and intervention). A support group for post-MI patients (C) is tertiary prevention (rehabilitation and preventing
further disability).
2. The public health department plans to distribute educational pamphlets about the importance of the
measles, mumps, and rubella (MMR) vaccine to parents at a local daycare. Under which category of
prevention does this intervention fall?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention
Correct Answer: A. Primary prevention
Rationale: Immunization promotion and administration are classic examples of primary prevention because they
protect susceptible individuals from contracting an infectious disease, thereby preventing the disease from
occurring.
3. A nurse is conducting a windshield survey in a low-income neighborhood and notices a high density
of fast-food restaurants and a lack of fresh produce markets. The nurse decides to lobby the city
council for a community garden. This intervention targets which level of prevention?
A. Tertiary prevention
B. Secondary prevention
C. Primary prevention
D. Primordial prevention
Correct Answer: C. Primary prevention
,Rationale: Modifying environmental factors to promote healthy eating habits and prevent the onset of chronic
lifestyle-related diseases (like obesity or diabetes) is a primary prevention initiative. (Note: While some
frameworks discuss "primordial prevention" for changing social/environmental conditions, standard nursing
curricula categorize such community-level health promotion under primary prevention).
4. An occupational health nurse is conducting routine audiometric screening for workers in a noisy
manufacturing facility. How should the nurse classify this type of screening?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Health promotion
Correct Answer: B. Secondary prevention
Rationale: Screening programs are secondary prevention because they aim to detect disease or health deficits at an
early, asymptomatic stage, allowing for prompt intervention to prevent further deterioration or permanent damage.
5. A school nurse is teaching a class of middle school students about the importance of wearing helmets
while riding bicycles or skateboards. This teaching is an example of:
A. Primary prevention.
B. Secondary prevention.
C. Tertiary prevention.
D. Health screening.
Correct Answer: A. Primary prevention.
Rationale: Promoting safety behaviors like wearing helmets prevents injuries from occurring in the first place,
placing it squarely in the primary prevention category.
6. A nurse is organizing a community mobile health van to perform screening mammograms for
women over the age of 40 in rural areas. What is the primary goal of this secondary prevention
program?
A. To prevent the development of breast cancer.
B. To detect breast cancer early when treatment is most effective.
C. To rehabilitate breast cancer survivors.
D. To educate the public on risk factors for breast cancer.
Correct Answer: B. To detect breast cancer early when treatment is most effective.
Rationale: Mammography screening is a secondary prevention tool designed to detect breast cancer at an early,
localized stage, which reduces mortality rates by enabling early clinical intervention. It does not prevent breast
cancer from developing (which would be primary prevention).
,7. A home health nurse visits a client with type 2 diabetes who recently underwent a below-the-knee
amputation. The nurse teaches the client how to perform daily skin inspections on the remaining foot
to prevent neuropathic ulcers. Under which level of prevention does this nurse's action fall?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Palliative prevention
Correct Answer: C. Tertiary prevention
Rationale: Tertiary prevention aims to manage established disease, minimize its complications, and restore the
client to the highest possible level of functioning. Since the client already has advanced diabetes complications
(amputation), teaching foot care to prevent further ulcers is tertiary prevention.
8. A community nurse is conducting a tuberculosis (TB) skin testing (Mantoux test) clinic for
employees at a local homeless shelter. Which level of prevention is this?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Environmental control
Correct Answer: B. Secondary prevention
Rationale: Tuberculosis skin screening is secondary prevention because its objective is to identify infected
individuals early (including latent TB cases) to initiate prophylactic treatment and prevent transmission.
9. The municipal water district decided to add fluoride to the public drinking water supply to prevent
dental cavities in the general population. This public health measures represents:
A. Primary prevention.
B. Secondary prevention.
C. Tertiary prevention.
D. Community screening.
Correct Answer: A. Primary prevention.
Rationale: Water fluoridation is an upstream primary prevention measure that protects the teeth of the entire
community, preventing dental caries before they occur.
10. A nurse works at a community mental health clinic. Which of the following activities performed by
the nurse is an example of tertiary prevention?
A. Teaching stress management techniques to college students during finals week.
, B. Screening postpartum mothers for depression using the Edinburgh Postnatal Depression Scale.
C. Facilitating a weekly medication compliance and social skills group for clients diagnosed with
schizophrenia.
D. Providing crisis intervention counseling following a community disaster.
Correct Answer: C. Facilitating a weekly medication compliance and social skills group for clients
diagnosed with schizophrenia.
Rationale: A support and skills group for clients with an established chronic mental illness (schizophrenia) is
tertiary prevention, as it helps prevent relapses, rehospitalization, and assists in rehabilitation. Stress management
teaching (A) is primary prevention. Depression screening (B) is secondary prevention. Crisis intervention (D) is
secondary prevention aimed at immediate stabilization.
11. A nurse is reviewing recommendations from the U.S. Preventive Services Task Force (USPSTF)
regarding low-dose aspirin use for the primary prevention of cardiovascular disease. Which client
would be receiving primary prevention with aspirin?
A. A client who takes daily aspirin to prevent a second myocardial infarction.
B. A client who takes daily aspirin to prevent a stroke after being diagnosed with transient ischemic attacks
(TIAs).
C. A client with high risk factors for heart disease who takes aspirin to prevent a first myocardial infarction.
D. A client taking aspirin post-coronary artery bypass graft surgery to maintain graft patency.
Correct Answer: C. A client with high risk factors for heart disease who takes aspirin to prevent a first
myocardial infarction.
Rationale: Since the client in option C has never had a cardiovascular event, using aspirin is intended to prevent
the initial occurrence of disease (primary prevention). In options A, B, and D, the client has already suffered from
cardiovascular disease, meaning the intervention is aimed at preventing recurrence or managing complications
(tertiary prevention).
12. A clinic nurse is educating a pregnant client about the importance of taking prenatal folic acid
supplements. What is the primary clinical objective of this primary prevention strategy?
A. To prevent gestational diabetes in the mother.
B. To prevent neural tube defects in the fetus.
C. To screen the fetus for chromosomal abnormalities.
D. To treat pregnancy-induced hypertension.
Correct Answer: B. To prevent neural tube defects in the fetus.
Rationale: Folic acid supplementation prior to and during early pregnancy is a primary prevention measure that
prevents the development of neural tube defects, such as spina bifida, in the developing fetus.
1. A community health nurse is designing a cardiovascular wellness program for a local community
center. According to the levels of prevention framework, which of the following activities should the
nurse implement as a primary prevention strategy?
A. Setting up a weekly blood pressure screening clinic.
B. Conducting nutrition and exercise education classes for healthy adults.
C. Facilitating a support group for individuals recovering from myocardial infarction.
D. Referring adults with borderline hypertension to a cardiologist.
Correct Answer: B. Conducting nutrition and exercise education classes for healthy adults.
Rationale: Primary prevention focuses on health promotion and disease prevention to halt the occurrence of
disease before it starts. Nutrition and exercise education for healthy adults aims to prevent the development of
cardiovascular disease. Blood pressure screenings (A) and referrals (D) are secondary prevention (early detection
and intervention). A support group for post-MI patients (C) is tertiary prevention (rehabilitation and preventing
further disability).
2. The public health department plans to distribute educational pamphlets about the importance of the
measles, mumps, and rubella (MMR) vaccine to parents at a local daycare. Under which category of
prevention does this intervention fall?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention
Correct Answer: A. Primary prevention
Rationale: Immunization promotion and administration are classic examples of primary prevention because they
protect susceptible individuals from contracting an infectious disease, thereby preventing the disease from
occurring.
3. A nurse is conducting a windshield survey in a low-income neighborhood and notices a high density
of fast-food restaurants and a lack of fresh produce markets. The nurse decides to lobby the city
council for a community garden. This intervention targets which level of prevention?
A. Tertiary prevention
B. Secondary prevention
C. Primary prevention
D. Primordial prevention
Correct Answer: C. Primary prevention
,Rationale: Modifying environmental factors to promote healthy eating habits and prevent the onset of chronic
lifestyle-related diseases (like obesity or diabetes) is a primary prevention initiative. (Note: While some
frameworks discuss "primordial prevention" for changing social/environmental conditions, standard nursing
curricula categorize such community-level health promotion under primary prevention).
4. An occupational health nurse is conducting routine audiometric screening for workers in a noisy
manufacturing facility. How should the nurse classify this type of screening?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Health promotion
Correct Answer: B. Secondary prevention
Rationale: Screening programs are secondary prevention because they aim to detect disease or health deficits at an
early, asymptomatic stage, allowing for prompt intervention to prevent further deterioration or permanent damage.
5. A school nurse is teaching a class of middle school students about the importance of wearing helmets
while riding bicycles or skateboards. This teaching is an example of:
A. Primary prevention.
B. Secondary prevention.
C. Tertiary prevention.
D. Health screening.
Correct Answer: A. Primary prevention.
Rationale: Promoting safety behaviors like wearing helmets prevents injuries from occurring in the first place,
placing it squarely in the primary prevention category.
6. A nurse is organizing a community mobile health van to perform screening mammograms for
women over the age of 40 in rural areas. What is the primary goal of this secondary prevention
program?
A. To prevent the development of breast cancer.
B. To detect breast cancer early when treatment is most effective.
C. To rehabilitate breast cancer survivors.
D. To educate the public on risk factors for breast cancer.
Correct Answer: B. To detect breast cancer early when treatment is most effective.
Rationale: Mammography screening is a secondary prevention tool designed to detect breast cancer at an early,
localized stage, which reduces mortality rates by enabling early clinical intervention. It does not prevent breast
cancer from developing (which would be primary prevention).
,7. A home health nurse visits a client with type 2 diabetes who recently underwent a below-the-knee
amputation. The nurse teaches the client how to perform daily skin inspections on the remaining foot
to prevent neuropathic ulcers. Under which level of prevention does this nurse's action fall?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Palliative prevention
Correct Answer: C. Tertiary prevention
Rationale: Tertiary prevention aims to manage established disease, minimize its complications, and restore the
client to the highest possible level of functioning. Since the client already has advanced diabetes complications
(amputation), teaching foot care to prevent further ulcers is tertiary prevention.
8. A community nurse is conducting a tuberculosis (TB) skin testing (Mantoux test) clinic for
employees at a local homeless shelter. Which level of prevention is this?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Environmental control
Correct Answer: B. Secondary prevention
Rationale: Tuberculosis skin screening is secondary prevention because its objective is to identify infected
individuals early (including latent TB cases) to initiate prophylactic treatment and prevent transmission.
9. The municipal water district decided to add fluoride to the public drinking water supply to prevent
dental cavities in the general population. This public health measures represents:
A. Primary prevention.
B. Secondary prevention.
C. Tertiary prevention.
D. Community screening.
Correct Answer: A. Primary prevention.
Rationale: Water fluoridation is an upstream primary prevention measure that protects the teeth of the entire
community, preventing dental caries before they occur.
10. A nurse works at a community mental health clinic. Which of the following activities performed by
the nurse is an example of tertiary prevention?
A. Teaching stress management techniques to college students during finals week.
, B. Screening postpartum mothers for depression using the Edinburgh Postnatal Depression Scale.
C. Facilitating a weekly medication compliance and social skills group for clients diagnosed with
schizophrenia.
D. Providing crisis intervention counseling following a community disaster.
Correct Answer: C. Facilitating a weekly medication compliance and social skills group for clients
diagnosed with schizophrenia.
Rationale: A support and skills group for clients with an established chronic mental illness (schizophrenia) is
tertiary prevention, as it helps prevent relapses, rehospitalization, and assists in rehabilitation. Stress management
teaching (A) is primary prevention. Depression screening (B) is secondary prevention. Crisis intervention (D) is
secondary prevention aimed at immediate stabilization.
11. A nurse is reviewing recommendations from the U.S. Preventive Services Task Force (USPSTF)
regarding low-dose aspirin use for the primary prevention of cardiovascular disease. Which client
would be receiving primary prevention with aspirin?
A. A client who takes daily aspirin to prevent a second myocardial infarction.
B. A client who takes daily aspirin to prevent a stroke after being diagnosed with transient ischemic attacks
(TIAs).
C. A client with high risk factors for heart disease who takes aspirin to prevent a first myocardial infarction.
D. A client taking aspirin post-coronary artery bypass graft surgery to maintain graft patency.
Correct Answer: C. A client with high risk factors for heart disease who takes aspirin to prevent a first
myocardial infarction.
Rationale: Since the client in option C has never had a cardiovascular event, using aspirin is intended to prevent
the initial occurrence of disease (primary prevention). In options A, B, and D, the client has already suffered from
cardiovascular disease, meaning the intervention is aimed at preventing recurrence or managing complications
(tertiary prevention).
12. A clinic nurse is educating a pregnant client about the importance of taking prenatal folic acid
supplements. What is the primary clinical objective of this primary prevention strategy?
A. To prevent gestational diabetes in the mother.
B. To prevent neural tube defects in the fetus.
C. To screen the fetus for chromosomal abnormalities.
D. To treat pregnancy-induced hypertension.
Correct Answer: B. To prevent neural tube defects in the fetus.
Rationale: Folic acid supplementation prior to and during early pregnancy is a primary prevention measure that
prevents the development of neural tube defects, such as spina bifida, in the developing fetus.
