CPH - COMPREHENSIVE PRACTICE EXAM SET 2
VERIFIED QUESTIONS & ANSWERS 2026-2027
Overview
This comprehensive practice exam contains verified-style CPH questions covering all
core domains: Biostatistics, Epidemiology, Environmental Health, Health Policy &
Management, Social & Behavioral Sciences, and Program Planning/Evaluation. Each
question includes a detailed rationale to reinforce understanding of key concepts tested
on the 2026 CPH blueprint. Use this to systematically assess your knowledge, identify
weak areas, and build exam confidence.
Question 1
A researcher is analyzing data from a longitudinal study and finds that the correlation
between physical activity and BMI is –0.65. This indicates:
A) A weak positive association
B) A strong positive association
C) A strong negative association
D) No association
Rationale: Correlation coefficients range from –1 to +1. A value of –0.65 indicates a
moderately strong negative (inverse) relationship – as physical activity increases, BMI
tends to decrease. Values near 0 indicate no association, and positive values indicate direct
relationships.
Question 2
In a community health assessment, which type of data would be considered "primary
data"?
A) Birth certificates from the state vital records office
B) A survey administered by the health department to local residents
C) National cancer registry statistics
D) Hospital discharge data from the state health department
Rationale: Primary data are collected firsthand by the researcher for the specific study
purpose. A survey designed and administered by the health department is primary data.
,Vital records, cancer registries, and hospital discharge data are secondary data collected
by others.
Question 3
A public health program aims to increase vaccination rates among preschoolers. Which
evaluation design would best establish causality?
A) Pre-post design without a control group
B) Randomized controlled trial
C) Time-series design
D) Cross-sectional survey
Rationale: The randomized controlled trial (RCT) is the gold standard for establishing
causality because randomization balances confounders and ensures the intervention
precedes the outcome. Pre-post and time-series lack a concurrent control group, and
cross-sectional designs cannot establish temporality.
Question 4
Which of the following is a common measure of disease frequency that accounts for the
time each person is at risk?
A) Prevalence
B) Cumulative incidence
C) Incidence rate (incidence density)
D) Attack rate
Rationale: Incidence rate (incidence density) includes person-time in the denominator,
accounting for varying follow-up times. Prevalence is a proportion at a point in time,
cumulative incidence assumes complete follow-up, and attack rate is a type of cumulative
incidence for outbreaks.
,Question 5
A screening test has a sensitivity of 85% and a specificity of 90%. If the disease
prevalence is 2%, what is the positive predictive value (PPV)?
A) Approximately 85%
B) Approximately 90%
C) Approximately 15%
D) Approximately 50%
Rationale: PPV = (sensitivity × prevalence) / [(sensitivity × prevalence) + (1 – specificity) ×
(1 – prevalence)]. With low prevalence, PPV is low despite high sensitivity/specificity. PPV
≈ (0.85×0.02)/[(0.85×0.02)+(0.10×0.98)] = 0.017/0.115 ≈ 14.8%. This illustrates why
screening rare diseases yields many false positives.
Question 6
The "social determinants of health" framework emphasizes that health is most
influenced by:
A) Genetic predisposition
B) The conditions in which people are born, grow, live, work, and age
C) Access to medical care alone
D) Individual lifestyle choices only
Rationale: The WHO defines SDOH as the conditions in which people are born, grow, live,
work, and age – shaped by the distribution of money, power, and resources. While
genetics, healthcare, and lifestyle matter, SDOH are the upstream drivers of health
inequities.
Question 7
Which statistical test would be appropriate to compare the median age between two
independent groups when the data are not normally distributed?
A) T-test
B) ANOVA
C) Mann-Whitney U test
D) Pearson correlation
, Rationale: The Mann-Whitney U test (Wilcoxon rank-sum) is a non-parametric test for
comparing medians between two independent groups when normality is violated. The t-
test assumes normality, ANOVA is for ≥3 groups, and correlation measures association,
not group differences.
Question 8
A case-control study is conducted to investigate the association between processed
meat consumption and colorectal cancer. Which measure of association is most
appropriate?
A) Relative risk
B) Odds ratio
C) Incidence rate ratio
D) Risk difference
Rationale: Case-control studies cannot directly calculate risk or incidence because the
denominator (at-risk population) is not known. The odds ratio is the appropriate measure,
approximating the relative risk when the disease is rare. Relative risk and incidence rate
ratio require cohort data.
Question 9
The "precautionary principle" would support which of the following actions?
A) Waiting for definitive scientific proof before regulating a suspected carcinogen
B) Implementing restrictions on a chemical with suspected health effects despite
incomplete evidence
C) Requiring cost-benefit analysis before any environmental action
D) Allowing industries to self-regulate until harm is proven
Rationale: The precautionary principle states that lack of full scientific certainty should not
postpone measures to prevent serious or irreversible harm. It shifts the burden of proof to
the proponent of the potentially harmful activity and supports early action even with
incomplete evidence.
VERIFIED QUESTIONS & ANSWERS 2026-2027
Overview
This comprehensive practice exam contains verified-style CPH questions covering all
core domains: Biostatistics, Epidemiology, Environmental Health, Health Policy &
Management, Social & Behavioral Sciences, and Program Planning/Evaluation. Each
question includes a detailed rationale to reinforce understanding of key concepts tested
on the 2026 CPH blueprint. Use this to systematically assess your knowledge, identify
weak areas, and build exam confidence.
Question 1
A researcher is analyzing data from a longitudinal study and finds that the correlation
between physical activity and BMI is –0.65. This indicates:
A) A weak positive association
B) A strong positive association
C) A strong negative association
D) No association
Rationale: Correlation coefficients range from –1 to +1. A value of –0.65 indicates a
moderately strong negative (inverse) relationship – as physical activity increases, BMI
tends to decrease. Values near 0 indicate no association, and positive values indicate direct
relationships.
Question 2
In a community health assessment, which type of data would be considered "primary
data"?
A) Birth certificates from the state vital records office
B) A survey administered by the health department to local residents
C) National cancer registry statistics
D) Hospital discharge data from the state health department
Rationale: Primary data are collected firsthand by the researcher for the specific study
purpose. A survey designed and administered by the health department is primary data.
,Vital records, cancer registries, and hospital discharge data are secondary data collected
by others.
Question 3
A public health program aims to increase vaccination rates among preschoolers. Which
evaluation design would best establish causality?
A) Pre-post design without a control group
B) Randomized controlled trial
C) Time-series design
D) Cross-sectional survey
Rationale: The randomized controlled trial (RCT) is the gold standard for establishing
causality because randomization balances confounders and ensures the intervention
precedes the outcome. Pre-post and time-series lack a concurrent control group, and
cross-sectional designs cannot establish temporality.
Question 4
Which of the following is a common measure of disease frequency that accounts for the
time each person is at risk?
A) Prevalence
B) Cumulative incidence
C) Incidence rate (incidence density)
D) Attack rate
Rationale: Incidence rate (incidence density) includes person-time in the denominator,
accounting for varying follow-up times. Prevalence is a proportion at a point in time,
cumulative incidence assumes complete follow-up, and attack rate is a type of cumulative
incidence for outbreaks.
,Question 5
A screening test has a sensitivity of 85% and a specificity of 90%. If the disease
prevalence is 2%, what is the positive predictive value (PPV)?
A) Approximately 85%
B) Approximately 90%
C) Approximately 15%
D) Approximately 50%
Rationale: PPV = (sensitivity × prevalence) / [(sensitivity × prevalence) + (1 – specificity) ×
(1 – prevalence)]. With low prevalence, PPV is low despite high sensitivity/specificity. PPV
≈ (0.85×0.02)/[(0.85×0.02)+(0.10×0.98)] = 0.017/0.115 ≈ 14.8%. This illustrates why
screening rare diseases yields many false positives.
Question 6
The "social determinants of health" framework emphasizes that health is most
influenced by:
A) Genetic predisposition
B) The conditions in which people are born, grow, live, work, and age
C) Access to medical care alone
D) Individual lifestyle choices only
Rationale: The WHO defines SDOH as the conditions in which people are born, grow, live,
work, and age – shaped by the distribution of money, power, and resources. While
genetics, healthcare, and lifestyle matter, SDOH are the upstream drivers of health
inequities.
Question 7
Which statistical test would be appropriate to compare the median age between two
independent groups when the data are not normally distributed?
A) T-test
B) ANOVA
C) Mann-Whitney U test
D) Pearson correlation
, Rationale: The Mann-Whitney U test (Wilcoxon rank-sum) is a non-parametric test for
comparing medians between two independent groups when normality is violated. The t-
test assumes normality, ANOVA is for ≥3 groups, and correlation measures association,
not group differences.
Question 8
A case-control study is conducted to investigate the association between processed
meat consumption and colorectal cancer. Which measure of association is most
appropriate?
A) Relative risk
B) Odds ratio
C) Incidence rate ratio
D) Risk difference
Rationale: Case-control studies cannot directly calculate risk or incidence because the
denominator (at-risk population) is not known. The odds ratio is the appropriate measure,
approximating the relative risk when the disease is rare. Relative risk and incidence rate
ratio require cohort data.
Question 9
The "precautionary principle" would support which of the following actions?
A) Waiting for definitive scientific proof before regulating a suspected carcinogen
B) Implementing restrictions on a chemical with suspected health effects despite
incomplete evidence
C) Requiring cost-benefit analysis before any environmental action
D) Allowing industries to self-regulate until harm is proven
Rationale: The precautionary principle states that lack of full scientific certainty should not
postpone measures to prevent serious or irreversible harm. It shifts the burden of proof to
the proponent of the potentially harmful activity and supports early action even with
incomplete evidence.
