ACHA Certification Exam 2026/2027 –
Questions and Answers Comprehensive
Exam Guide.
SECTION DISTRIBUTION (ACHA College Health Professional Certification
Blueprint)
Section # Questions
Clinical Health Services in College Health 30
(primary care, reproductive health,
immunization, travel medicine)
Mental Health & Behavioral Health 25
(depression, anxiety, suicide prevention,
substance use, eating disorders)
Public Health & Population Health (outbreak 20
management, contact tracing, health
promotion, wellness)
Administration & Leadership (budget, 15
staffing, strategic planning, quality
improvement, risk management)
Health Equity, Diversity, Inclusion & Access 15
(marginalized populations, LGBTQ+ health,
first-generation students)
Legal, Ethical & Regulatory Issues (FERPA, 15
HIPAA, Title IX, Clery Act, mandatory
reporting, duty of care)
Emergency Preparedness & Response 15
(pandemic planning, campus crises, disaster
management, mental health emergencies)
TOTAL 150
SECTION 1: CLINICAL HEALTH SERVICES IN COLLEGE HEALTH (PRIMARY CARE,
REPRODUCTIVE HEALTH, IMMUNIZATION, TRAVEL MEDICINE) — 30 Questions
Q1: An 18-year-old college freshman presents to student health with fever, stiff neck,
photophobia, and a petechial rash. Vital signs: temperature 39.5°C, HR 120, BP 100/70. What
is the priority action?
• A. Administer ceftriaxone immediately and arrange transport to emergency department
• B. Obtain blood cultures and start oral doxycycline
• C. Perform lumbar puncture before antibiotics
,• D. Observe in student health for 4 hours
Correct Answer: A
Rationale: Correct because suspected bacterial meningitis (meningococcemia) is a medical
emergency; antibiotics should not be delayed for diagnostics or transport.
Q2: A student presents for travel medicine consult for a semester abroad in rural Ghana.
Which vaccines should be considered regardless of travel itinerary?
• A. Routine vaccines (MMR, Tdap, polio, varicella, influenza) plus COVID-19
• B. Yellow fever only
• C. Japanese encephalitis and rabies
• D. Cholera and typhoid only
Correct Answer: A
Rationale: Correct because all travelers should be up to date on routine vaccines; destination-
specific vaccines (yellow fever, typhoid, meningitis, etc.) are added based on itinerary and risk.
Q3: An international student from a tuberculosis-endemic country has a positive IGRA
(interferon-gamma release assay) with normal chest X-ray and no symptoms. The college
health provider should:
• A. Recommend treatment for latent tuberculosis infection (LTBI)
• B. Isolate the student in a negative pressure room
• C. Repeat IGRA in 6 months
• D. No treatment unless symptoms develop
Correct Answer: A
Rationale: Correct because LTBI treatment (isoniazid, rifampin, or rifapentine) is recommended
to prevent progression to active TB, especially in college congregate settings.
Q4: A student requests pre-exposure prophylaxis (PrEP) for HIV prevention. The student has
no known contraindications and normal renal function. The provider should:
• A. Decline because PrEP is not within college health scope
• B. Prescribe tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) after baseline HIV test
• C. Refer to off-campus infectious disease specialist
• D. Counsel on abstinence instead
Correct Answer: B
,Rationale: Correct because PrEP is within college health scope; CDC and ACHA recommend
TDF/FTC or TAF/FTC for at-risk individuals with baseline HIV test, renal function, and follow-up
q3 months.
Q5: A 19-year-old female student presents with dysuria, frequency, and urgency. Urinalysis
shows pyuria and positive nitrites. She is not pregnant and has no drug allergies. First-line
treatment is:
• A. Ciprofloxacin 500 mg BID for 3 days
• B. Nitrofurantoin 100 mg BID for 5 days
• C. Amoxicillin 500 mg TID for 10 days
• D. Azithromycin 1 g single dose
Correct Answer: B
Rationale: Correct because nitrofurantoin is first-line for uncomplicated cystitis in non-pregnant
women; fluoroquinolones are avoided as first-line due to resistance and adverse effects.
Q6: A student athlete presents with sore throat, fever, fatigue, and posterior cervical
lymphadenopathy. Monospot test is positive. Return-to-play clearance should occur:
• A. Immediately after symptom resolution
• B. After resolution of symptoms plus minimum 4 weeks or until splenomegaly resolves
• C. Only after 6 months
• D. When the student feels ready
Correct Answer: B
Rationale: Correct because infectious mononucleosis carries splenic rupture risk; return to
contact sports requires symptom resolution, minimum 3-4 weeks, and documented resolution of
splenomegaly.
Q7: A student presents requesting emergency contraception 60 hours after unprotected
intercourse. The most effective option is:
• A. Levonorgestrel 1.5 mg single dose (Plan B)
• B. Ulipristal acetate 30 mg single dose (Ella)
• C. Combined oral contraceptive Yuzpe regimen
• D. Copper IUD insertion within 5 days
Correct Answer: B
Rationale: Correct because ulipristal acetate is effective up to 120 hours and maintains efficacy
at higher BMI compared to levonorgestrel; copper IUD is most effective but requires clinic
availability.
, Q8: A student presents with acute ankle sprain sustained during intramural basketball.
Ottawa Ankle Rules indicate radiography is needed if:
• A. The patient cannot bear weight for 4 steps immediately after injury and in the clinic
• B. There is any swelling present
• C. The patient is an athlete
• D. Pain is present at the lateral malleolus only
Correct Answer: A
Rationale: Correct because Ottawa Ankle Rules recommend radiography if the patient cannot
bear weight for 4 steps both immediately and at evaluation, or if there is bony tenderness at
posterior edge/tip of malleoli, navicular, or base of 5th metatarsal.
Q9: A student with documented egg allergy (anaphylaxis to egg) requires influenza
vaccination. The appropriate vaccine is:
• A. No influenza vaccine due to contraindication
• B. Any age-appropriate inactivated influenza vaccine with standard 15-minute observation
• C. Live attenuated intranasal vaccine only
• D. Egg-free recombinant vaccine only
Correct Answer: B
Rationale: Correct because ACIP states that egg allergy, even anaphylaxis, is not a
contraindication to any influenza vaccine; any age-appropriate inactivated vaccine may be given
with standard 15-minute observation.
Q10: A student presents with symptoms of allergic rhinitis and requests immunotherapy
referral. College health should first:
• A. Refer immediately to allergy specialist
• B. Initiate intranasal corticosteroid and second-generation antihistamine trial
• C. Prescribe oral corticosteroids
• D. Recommend only saline nasal rinses
Correct Answer: B
Rationale: Correct because pharmacologic management with intranasal corticosteroids and
antihistamines is first-line for allergic rhinitis; immunotherapy is reserved for refractory cases or
patient preference.
Q11: A 20-year-old student presents with a new genital ulcer and tender inguinal
lymphadenopathy. Dark-field microscopy is unavailable. The most appropriate initial test is:
• A. HSV PCR only
Questions and Answers Comprehensive
Exam Guide.
SECTION DISTRIBUTION (ACHA College Health Professional Certification
Blueprint)
Section # Questions
Clinical Health Services in College Health 30
(primary care, reproductive health,
immunization, travel medicine)
Mental Health & Behavioral Health 25
(depression, anxiety, suicide prevention,
substance use, eating disorders)
Public Health & Population Health (outbreak 20
management, contact tracing, health
promotion, wellness)
Administration & Leadership (budget, 15
staffing, strategic planning, quality
improvement, risk management)
Health Equity, Diversity, Inclusion & Access 15
(marginalized populations, LGBTQ+ health,
first-generation students)
Legal, Ethical & Regulatory Issues (FERPA, 15
HIPAA, Title IX, Clery Act, mandatory
reporting, duty of care)
Emergency Preparedness & Response 15
(pandemic planning, campus crises, disaster
management, mental health emergencies)
TOTAL 150
SECTION 1: CLINICAL HEALTH SERVICES IN COLLEGE HEALTH (PRIMARY CARE,
REPRODUCTIVE HEALTH, IMMUNIZATION, TRAVEL MEDICINE) — 30 Questions
Q1: An 18-year-old college freshman presents to student health with fever, stiff neck,
photophobia, and a petechial rash. Vital signs: temperature 39.5°C, HR 120, BP 100/70. What
is the priority action?
• A. Administer ceftriaxone immediately and arrange transport to emergency department
• B. Obtain blood cultures and start oral doxycycline
• C. Perform lumbar puncture before antibiotics
,• D. Observe in student health for 4 hours
Correct Answer: A
Rationale: Correct because suspected bacterial meningitis (meningococcemia) is a medical
emergency; antibiotics should not be delayed for diagnostics or transport.
Q2: A student presents for travel medicine consult for a semester abroad in rural Ghana.
Which vaccines should be considered regardless of travel itinerary?
• A. Routine vaccines (MMR, Tdap, polio, varicella, influenza) plus COVID-19
• B. Yellow fever only
• C. Japanese encephalitis and rabies
• D. Cholera and typhoid only
Correct Answer: A
Rationale: Correct because all travelers should be up to date on routine vaccines; destination-
specific vaccines (yellow fever, typhoid, meningitis, etc.) are added based on itinerary and risk.
Q3: An international student from a tuberculosis-endemic country has a positive IGRA
(interferon-gamma release assay) with normal chest X-ray and no symptoms. The college
health provider should:
• A. Recommend treatment for latent tuberculosis infection (LTBI)
• B. Isolate the student in a negative pressure room
• C. Repeat IGRA in 6 months
• D. No treatment unless symptoms develop
Correct Answer: A
Rationale: Correct because LTBI treatment (isoniazid, rifampin, or rifapentine) is recommended
to prevent progression to active TB, especially in college congregate settings.
Q4: A student requests pre-exposure prophylaxis (PrEP) for HIV prevention. The student has
no known contraindications and normal renal function. The provider should:
• A. Decline because PrEP is not within college health scope
• B. Prescribe tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) after baseline HIV test
• C. Refer to off-campus infectious disease specialist
• D. Counsel on abstinence instead
Correct Answer: B
,Rationale: Correct because PrEP is within college health scope; CDC and ACHA recommend
TDF/FTC or TAF/FTC for at-risk individuals with baseline HIV test, renal function, and follow-up
q3 months.
Q5: A 19-year-old female student presents with dysuria, frequency, and urgency. Urinalysis
shows pyuria and positive nitrites. She is not pregnant and has no drug allergies. First-line
treatment is:
• A. Ciprofloxacin 500 mg BID for 3 days
• B. Nitrofurantoin 100 mg BID for 5 days
• C. Amoxicillin 500 mg TID for 10 days
• D. Azithromycin 1 g single dose
Correct Answer: B
Rationale: Correct because nitrofurantoin is first-line for uncomplicated cystitis in non-pregnant
women; fluoroquinolones are avoided as first-line due to resistance and adverse effects.
Q6: A student athlete presents with sore throat, fever, fatigue, and posterior cervical
lymphadenopathy. Monospot test is positive. Return-to-play clearance should occur:
• A. Immediately after symptom resolution
• B. After resolution of symptoms plus minimum 4 weeks or until splenomegaly resolves
• C. Only after 6 months
• D. When the student feels ready
Correct Answer: B
Rationale: Correct because infectious mononucleosis carries splenic rupture risk; return to
contact sports requires symptom resolution, minimum 3-4 weeks, and documented resolution of
splenomegaly.
Q7: A student presents requesting emergency contraception 60 hours after unprotected
intercourse. The most effective option is:
• A. Levonorgestrel 1.5 mg single dose (Plan B)
• B. Ulipristal acetate 30 mg single dose (Ella)
• C. Combined oral contraceptive Yuzpe regimen
• D. Copper IUD insertion within 5 days
Correct Answer: B
Rationale: Correct because ulipristal acetate is effective up to 120 hours and maintains efficacy
at higher BMI compared to levonorgestrel; copper IUD is most effective but requires clinic
availability.
, Q8: A student presents with acute ankle sprain sustained during intramural basketball.
Ottawa Ankle Rules indicate radiography is needed if:
• A. The patient cannot bear weight for 4 steps immediately after injury and in the clinic
• B. There is any swelling present
• C. The patient is an athlete
• D. Pain is present at the lateral malleolus only
Correct Answer: A
Rationale: Correct because Ottawa Ankle Rules recommend radiography if the patient cannot
bear weight for 4 steps both immediately and at evaluation, or if there is bony tenderness at
posterior edge/tip of malleoli, navicular, or base of 5th metatarsal.
Q9: A student with documented egg allergy (anaphylaxis to egg) requires influenza
vaccination. The appropriate vaccine is:
• A. No influenza vaccine due to contraindication
• B. Any age-appropriate inactivated influenza vaccine with standard 15-minute observation
• C. Live attenuated intranasal vaccine only
• D. Egg-free recombinant vaccine only
Correct Answer: B
Rationale: Correct because ACIP states that egg allergy, even anaphylaxis, is not a
contraindication to any influenza vaccine; any age-appropriate inactivated vaccine may be given
with standard 15-minute observation.
Q10: A student presents with symptoms of allergic rhinitis and requests immunotherapy
referral. College health should first:
• A. Refer immediately to allergy specialist
• B. Initiate intranasal corticosteroid and second-generation antihistamine trial
• C. Prescribe oral corticosteroids
• D. Recommend only saline nasal rinses
Correct Answer: B
Rationale: Correct because pharmacologic management with intranasal corticosteroids and
antihistamines is first-line for allergic rhinitis; immunotherapy is reserved for refractory cases or
patient preference.
Q11: A 20-year-old student presents with a new genital ulcer and tender inguinal
lymphadenopathy. Dark-field microscopy is unavailable. The most appropriate initial test is:
• A. HSV PCR only
