NR 503: Population Health, Epidemiology &
Statistical Principles Actual WEEK 4 MIDTERM
EXAM | Verified Solutions
SECTION 1: FOUNDATIONS OF EPIDEMIOLOGY & POPULATION HEALTH (Q1-10)
Q1 (Multiple Choice): A public health nurse investigating a sharp rise in gastroenteritis
cases over 72 hours among attendees of a single county fair is observing which pattern
of disease occurrence?
A. Pandemic
B. Endemic
C. Epidemic
D. Secular trend
Correct Answer: C
Verified Solution: An epidemic is defined as the occurrence of cases of disease clearly
in excess of normal expectancy in a given community or region within a short period of
time. The key differentiators are: temparal (sudden, 72-hour rise), geographic (single
county fair—localized), and magnitude (sharp rise above baseline). A pandemic (A)
requires global or multi-continental spread. Endemic (B) refers to the expected, baseline
level of disease in a population. A secular trend (D) describes long-term patterns over
years or decades, not acute events.
,Q2 (Multiple Choice): Which epidemiologic concept best describes the proportion of
total deaths attributed to cardiovascular disease in a given year?
A. Case fatality rate
B. Cause-specific mortality rate
C. Proportionate mortality ratio
D. Years of potential life lost
Correct Answer: C
Verified Solution: The Proportionate Mortality Ratio (PMR) is defined as deaths from a
specific cause / total deaths from all causes, typically expressed as a percentage. This
measures the relative importance of a cause of death among all deaths, not the risk of
dying from that cause in the population. The case fatality rate (A) is deaths/cases of a
disease. The cause-specific mortality rate (B) is deaths from a cause/population at risk.
YPLL (D) measures premature mortality weighted by age at death.
Q3 (Select All That Apply): Which of the following represent social determinants of
health as defined by the WHO Commission on Social Determinants of Health? (Select all
that apply.)
1. Genetic predisposition to type 2 diabetes
2. Access to quality primary care services
3. Neighborhood socioeconomic deprivation
4. Early childhood education opportunities
5. Availability of healthy food options in community
Correct Answers: 2, 3, 4, 5
, Verified Solution: Social determinants of health are the conditions in which people are
born, grow, live, work, and age—the structural drivers of health inequities. These include:
healthcare access (2), neighborhood conditions (3), education (4), and built
environment/food access (5). Genetic predisposition (1) is a biological determinant, not
a social determinant. The distinction is critical: social determinants are modifiable
through policy and social intervention, while genetic factors are not.
Q4 (Multiple Choice): A statewide tobacco cessation program targeting adolescents
before they initiate smoking represents which level of prevention?
A. Primordial prevention
B. Primary prevention
C. Secondary prevention
D. Tertiary prevention
Correct Answer: B
Verified Solution: Primary prevention aims to prevent disease onset by addressing risk
factors or enhancing resistance in healthy individuals. Targeting adolescents before
smoking initiation fits this definition precisely. Primordial prevention (A) addresses
underlying social/environmental conditions that create risk (e.g., banning tobacco
advertising). Secondary prevention (C) involves early detection of existing disease
(screening). Tertiary prevention (D) reduces complications of established disease
(smoking cessation in existing smokers would be tertiary).
Q5 (Multiple Choice): Which historical epidemiologic contribution is correctly matched
with its figure and significance?
Statistical Principles Actual WEEK 4 MIDTERM
EXAM | Verified Solutions
SECTION 1: FOUNDATIONS OF EPIDEMIOLOGY & POPULATION HEALTH (Q1-10)
Q1 (Multiple Choice): A public health nurse investigating a sharp rise in gastroenteritis
cases over 72 hours among attendees of a single county fair is observing which pattern
of disease occurrence?
A. Pandemic
B. Endemic
C. Epidemic
D. Secular trend
Correct Answer: C
Verified Solution: An epidemic is defined as the occurrence of cases of disease clearly
in excess of normal expectancy in a given community or region within a short period of
time. The key differentiators are: temparal (sudden, 72-hour rise), geographic (single
county fair—localized), and magnitude (sharp rise above baseline). A pandemic (A)
requires global or multi-continental spread. Endemic (B) refers to the expected, baseline
level of disease in a population. A secular trend (D) describes long-term patterns over
years or decades, not acute events.
,Q2 (Multiple Choice): Which epidemiologic concept best describes the proportion of
total deaths attributed to cardiovascular disease in a given year?
A. Case fatality rate
B. Cause-specific mortality rate
C. Proportionate mortality ratio
D. Years of potential life lost
Correct Answer: C
Verified Solution: The Proportionate Mortality Ratio (PMR) is defined as deaths from a
specific cause / total deaths from all causes, typically expressed as a percentage. This
measures the relative importance of a cause of death among all deaths, not the risk of
dying from that cause in the population. The case fatality rate (A) is deaths/cases of a
disease. The cause-specific mortality rate (B) is deaths from a cause/population at risk.
YPLL (D) measures premature mortality weighted by age at death.
Q3 (Select All That Apply): Which of the following represent social determinants of
health as defined by the WHO Commission on Social Determinants of Health? (Select all
that apply.)
1. Genetic predisposition to type 2 diabetes
2. Access to quality primary care services
3. Neighborhood socioeconomic deprivation
4. Early childhood education opportunities
5. Availability of healthy food options in community
Correct Answers: 2, 3, 4, 5
, Verified Solution: Social determinants of health are the conditions in which people are
born, grow, live, work, and age—the structural drivers of health inequities. These include:
healthcare access (2), neighborhood conditions (3), education (4), and built
environment/food access (5). Genetic predisposition (1) is a biological determinant, not
a social determinant. The distinction is critical: social determinants are modifiable
through policy and social intervention, while genetic factors are not.
Q4 (Multiple Choice): A statewide tobacco cessation program targeting adolescents
before they initiate smoking represents which level of prevention?
A. Primordial prevention
B. Primary prevention
C. Secondary prevention
D. Tertiary prevention
Correct Answer: B
Verified Solution: Primary prevention aims to prevent disease onset by addressing risk
factors or enhancing resistance in healthy individuals. Targeting adolescents before
smoking initiation fits this definition precisely. Primordial prevention (A) addresses
underlying social/environmental conditions that create risk (e.g., banning tobacco
advertising). Secondary prevention (C) involves early detection of existing disease
(screening). Tertiary prevention (D) reduces complications of established disease
(smoking cessation in existing smokers would be tertiary).
Q5 (Multiple Choice): Which historical epidemiologic contribution is correctly matched
with its figure and significance?
