CPH - COMPREHENSIVE PRACTICE EXAM SET 2
VERIFIED QUESTIONS & ANSWERS 2026
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 wants to compare the mean blood lead levels between two independent
groups (exposed vs. unexposed) with unequal variances. Which statistical test is most
appropriate?
A) Paired t-test
B) Wilcoxon rank-sum test
C) Two-sample t-test assuming equal variances
D) Welch’s t-test
Rationale: Welch’s t-test is specifically designed for two independent samples with unequal
variances and does not assume homogeneity of variance. The paired t-test is for
dependent data, and the Wilcoxon test is non-parametric (less powerful when normality
holds). The equal-variance t-test would violate assumptions, inflating Type I error.
Question 2
In a cohort study, the incidence rate of lung cancer among smokers is 200 per 100,000
person-years, and among non-smokers it is 20 per 100,000 person-years. What is the
rate ratio?
,A) 0.1
B) 10
C) *10.0*
D) 180
Rationale: Rate ratio = incidence rate in exposed / incidence rate in unexposed = 200/20
= 10.0. This indicates smokers have 10 times the rate of lung cancer compared to
non-smokers. Options A, B (without decimal), and D are incorrect calculations.
Question 3
Which study design is best for establishing temporality between an exposure and a rare
disease outcome?
A) Case-control study
B) Cohort study
C) Cross-sectional study
D) Ecological study
Rationale: Cohort studies follow participants over time, establishing that exposure
precedes outcome, which is essential for temporality. Case-control studies are efficient for
rare diseases but rely on retrospective exposure recall. Cross-sectional and ecological
studies measure exposure and outcome simultaneously, limiting causal inference.
Question 4
A p-value of 0.04 in a hypothesis test indicates:
A) There is a 4% chance the null hypothesis is true
B) There is a 4% probability of observing the data (or more extreme) if the null is
true
C) The alternative hypothesis is 96% likely to be true
D) The result is not statistically significant
Rationale: The p-value is the probability of obtaining results as extreme as observed,
assuming the null hypothesis is true. It does not directly state the probability that the null
or alternative is true. A p-value of 0.04 is statistically significant at the 0.05 level.
,Question 5
Which ethical principle is primarily violated when a researcher fails to disclose potential
risks to participants?
A) Justice
B) Beneficence
C) Respect for persons (autonomy)
D) Non-maleficence
Rationale: Respect for persons requires informed consent, which includes full disclosure of
risks so participants can make autonomous decisions. Beneficence involves maximizing
benefits, non-maleficence means avoiding harm, and justice refers to fair distribution of
burdens and benefits.
Question 6
In the PRECEDE-PROCEED model, which phase involves identifying factors that reinforce
health behaviors?
A) Phase 1 – Social assessment
B) Phase 2 – Epidemiological assessment
C) Phase 3 – Behavioral and environmental assessment
D) Phase 4 – Educational and ecological assessment
Rationale: Phase 4 (Educational and Ecological Assessment) identifies predisposing,
enabling, and reinforcing factors that influence behavior. Reinforcing factors include
rewards and feedback that encourage behavior maintenance. Phases 1-3 focus on needs,
health problems, and behavioral/environmental determinants.
Question 7
What is the median of the following data set: 4, 8, 6, 5, 9, 12, 7?
A) 6
B) *7*
, C) 7.5
D) 8
Rationale: First arrange in order: 4, 5, 6, 7, 8, 9, 12. The median is the middle value (4th
observation) = 7. The mean would be 7.29, and 7.5 is not a valid value in this dataset.
Question 8
A screening test has 90% sensitivity and 80% specificity. What does sensitivity measure?
A) The proportion of healthy people correctly identified as negative
B) The proportion of diseased people correctly identified as positive
C) The overall accuracy of the test
D) The positive predictive value
Rationale: Sensitivity = true positives / (true positives + false negatives). It measures the
test's ability to correctly identify those with the disease. Specificity measures healthy
identification, and PPV depends on disease prevalence.
Question 9
Which of the following is a Social Determinant of Health (SDOH)?
A) Blood pressure
B) Cholesterol level
C) Neighborhood safety
D) Genetic mutation
Rationale: SDOH are conditions in environments where people are born, live, learn, work,
play, and age – including neighborhood safety, housing, and food access. Blood pressure,
cholesterol, and genetics are biological/individual factors, not social determinants.
Question 10
A community health program aims to reduce childhood obesity. Which evaluation type
measures whether activities were implemented as planned?
VERIFIED QUESTIONS & ANSWERS 2026
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 wants to compare the mean blood lead levels between two independent
groups (exposed vs. unexposed) with unequal variances. Which statistical test is most
appropriate?
A) Paired t-test
B) Wilcoxon rank-sum test
C) Two-sample t-test assuming equal variances
D) Welch’s t-test
Rationale: Welch’s t-test is specifically designed for two independent samples with unequal
variances and does not assume homogeneity of variance. The paired t-test is for
dependent data, and the Wilcoxon test is non-parametric (less powerful when normality
holds). The equal-variance t-test would violate assumptions, inflating Type I error.
Question 2
In a cohort study, the incidence rate of lung cancer among smokers is 200 per 100,000
person-years, and among non-smokers it is 20 per 100,000 person-years. What is the
rate ratio?
,A) 0.1
B) 10
C) *10.0*
D) 180
Rationale: Rate ratio = incidence rate in exposed / incidence rate in unexposed = 200/20
= 10.0. This indicates smokers have 10 times the rate of lung cancer compared to
non-smokers. Options A, B (without decimal), and D are incorrect calculations.
Question 3
Which study design is best for establishing temporality between an exposure and a rare
disease outcome?
A) Case-control study
B) Cohort study
C) Cross-sectional study
D) Ecological study
Rationale: Cohort studies follow participants over time, establishing that exposure
precedes outcome, which is essential for temporality. Case-control studies are efficient for
rare diseases but rely on retrospective exposure recall. Cross-sectional and ecological
studies measure exposure and outcome simultaneously, limiting causal inference.
Question 4
A p-value of 0.04 in a hypothesis test indicates:
A) There is a 4% chance the null hypothesis is true
B) There is a 4% probability of observing the data (or more extreme) if the null is
true
C) The alternative hypothesis is 96% likely to be true
D) The result is not statistically significant
Rationale: The p-value is the probability of obtaining results as extreme as observed,
assuming the null hypothesis is true. It does not directly state the probability that the null
or alternative is true. A p-value of 0.04 is statistically significant at the 0.05 level.
,Question 5
Which ethical principle is primarily violated when a researcher fails to disclose potential
risks to participants?
A) Justice
B) Beneficence
C) Respect for persons (autonomy)
D) Non-maleficence
Rationale: Respect for persons requires informed consent, which includes full disclosure of
risks so participants can make autonomous decisions. Beneficence involves maximizing
benefits, non-maleficence means avoiding harm, and justice refers to fair distribution of
burdens and benefits.
Question 6
In the PRECEDE-PROCEED model, which phase involves identifying factors that reinforce
health behaviors?
A) Phase 1 – Social assessment
B) Phase 2 – Epidemiological assessment
C) Phase 3 – Behavioral and environmental assessment
D) Phase 4 – Educational and ecological assessment
Rationale: Phase 4 (Educational and Ecological Assessment) identifies predisposing,
enabling, and reinforcing factors that influence behavior. Reinforcing factors include
rewards and feedback that encourage behavior maintenance. Phases 1-3 focus on needs,
health problems, and behavioral/environmental determinants.
Question 7
What is the median of the following data set: 4, 8, 6, 5, 9, 12, 7?
A) 6
B) *7*
, C) 7.5
D) 8
Rationale: First arrange in order: 4, 5, 6, 7, 8, 9, 12. The median is the middle value (4th
observation) = 7. The mean would be 7.29, and 7.5 is not a valid value in this dataset.
Question 8
A screening test has 90% sensitivity and 80% specificity. What does sensitivity measure?
A) The proportion of healthy people correctly identified as negative
B) The proportion of diseased people correctly identified as positive
C) The overall accuracy of the test
D) The positive predictive value
Rationale: Sensitivity = true positives / (true positives + false negatives). It measures the
test's ability to correctly identify those with the disease. Specificity measures healthy
identification, and PPV depends on disease prevalence.
Question 9
Which of the following is a Social Determinant of Health (SDOH)?
A) Blood pressure
B) Cholesterol level
C) Neighborhood safety
D) Genetic mutation
Rationale: SDOH are conditions in environments where people are born, live, learn, work,
play, and age – including neighborhood safety, housing, and food access. Blood pressure,
cholesterol, and genetics are biological/individual factors, not social determinants.
Question 10
A community health program aims to reduce childhood obesity. Which evaluation type
measures whether activities were implemented as planned?
