NR-503 WEEK 8 FINAL EXAM 2026/2027 | Epidemiology
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SECTION 1: EPIDEMIOLOGICAL FOUNDATIONS & STUDY
DESIGNS (Questions 1-18)
Question 1
Which definition best describes epidemiology as applied in graduate nursing and
public health practice?
A. The study of individual patient diagnoses and treatment plans in clinical settings B.
The study of the distribution and determinants of health-related states or events in
specified populations and the application of this study to the control of health
problems C. The statistical analysis of hospital financial data to improve revenue
cycles D. The laboratory investigation of pathogen morphology and antimicrobial
susceptibility
Correct Answer: B. The study of the distribution and determinants of health-
related states or events in specified populations and the application of this study
to the control of health problems [CORRECT]
Rationale: Epidemiology is fundamentally the study of population-level patterns of
health and disease, including distribution (who, where, when) and determinants
(causes, risk factors), with the explicit goal of applying findings to control health
problems. This is the classic definition from John Last and the CDC. Students often
confuse epidemiology with clinical medicine (individual patient care) or microbiology
(laboratory pathogen study).
Question 2
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A community health nurse tracks new cases of Type 2 diabetes in a county of 100,000
adults over one year. There were 400 new cases diagnosed. What is the incidence
rate of Type 2 diabetes in this population?
A. 4 per 1,000 person-years B. 400 per 100,000 person-years C. 4 per 100 person-
years D. 0.4 per 1,000 person-years
Correct Answer: A. 4 per 1,000 person-years [CORRECT]
Rationale: Incidence rate = new cases / population at risk / time = ,
year = 0.004 per person-year = 4 per 1,000 person-years. Students often forget to
express the rate using a standard multiplier (per 1,000 or per 100,000) or confuse
incidence rate with cumulative incidence. The correct standardization is essential for
comparing rates across populations.
Question 3
On March 1, 2026, a nurse epidemiologist surveys a town of 50,000 residents and
identifies 750 people currently living with asthma. What is the point prevalence of
asthma on that date?
A. 1.5 per 1,000 population B. 15 per 1,000 population C. 150 per 1,000 population D.
0.15 per 1,000 population
Correct Answer: B. 15 per 1,000 population [CORRECT]
Rationale: Point prevalence = all existing cases at a point in time / total population
= ,000 = 0.015 = 15 per 1,000 population. Students frequently confuse point
prevalence with incidence (new cases only) or miscalculate the decimal placement
when converting to per 1,000. Prevalence includes both new and pre-existing cases
at the specified time point.
Question 4
During an outbreak of meningococcal disease on a college campus, 45 students
develop the illness and 3 die. What is the case fatality rate?
,3
A. 6.7% B. 3.0% C. 15.0% D. 0.067%
Correct Answer: A. 6.7% [CORRECT]
Rationale: Case fatality rate (CFR) = deaths from disease / total cases of disease ×
100 = × 100 = 6.7%. CFR measures the severity of a disease among those
diagnosed. Students often incorrectly use the total campus population as the
denominator (which would calculate mortality rate, not CFR) or confuse CFR with
proportionate mortality.
Question 5
A 35-year-old dies in a motor vehicle accident. Using a standard life expectancy of 75
years, how many years of potential life lost (YPLL) are attributed to this death?
A. 35 years B. 40 years C. 75 years D. 110 years
Correct Answer: B. 40 years [CORRECT]
Rationale: YPLL = standard life expectancy - age at death = 75 - 35 = 40 years. YPLL
is a measure of premature mortality that gives greater weight to deaths occurring at
younger ages, highlighting the social and economic impact of preventable deaths.
Students sometimes incorrectly add the values or use the age at death as the YPLL
rather than the difference.
Question 6
A public health nurse is comparing two summary measures of population health
burden. One measure combines years of life lost due to premature death and years
lived with disability. The other measures health outcomes that account for both
quality and quantity of life. Which pair correctly identifies these measures?
A. DALY and QALY B. QALY and YPLL C. YPLL and DALY D. QALY and case fatality rate
Correct Answer: A. DALY and QALY [CORRECT]
, 4
Rationale: Disability-Adjusted Life Year (DALY) = Years of Life Lost (YLL) + Years
Lived with Disability (YLD), measuring overall disease burden. Quality-Adjusted Life
Year (QALY) measures health outcomes by combining life years gained with quality-
of-life weights (0-1 scale), commonly used in cost-effectiveness analyses. Students
often confuse these acronyms or incorrectly associate QALY with mortality-only
measures.
Question 7
A researcher identifies a group of 5,000 factory workers exposed to a chemical
solvent and follows them forward for 15 years to track lung cancer incidence,
comparing them to 5,000 unexposed workers. Which study design is being used?
A. Retrospective case-control study B. Prospective cohort study C. Cross-sectional
prevalence study D. Ecological correlation study
Correct Answer: B. Prospective cohort study [CORRECT]
Rationale: This is a prospective cohort study because exposed and unexposed
groups are identified at baseline and followed forward in time to observe disease
incidence. Cohort studies measure incidence and can calculate relative risk.
Retrospective cohort studies look backward using existing records. Case-control
studies start with diseased and non-diseased groups and look backward for
exposure. Students often confuse the temporal direction of cohort versus case-
control designs.
Question 8
In a prospective cohort study of 2,000 smokers and 2,000 non-smokers followed for
10 years, 120 smokers developed lung cancer compared to 20 non-smokers. What is
the relative risk (RR) of lung cancer among smokers?
A. 6.0 B. 0.06 C. 100 D. 0.167
Correct Answer: A. 6.0 [CORRECT]