NR 436 EPIDEMIOLOGY PRACTICE QUESTIONS
STUDY GUIDE | LATEST UPDATE 2026/2027 | ACTUAL
EXAM | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS
This comprehensive practice resource is designed for nursing students enrolled in
NR 436: Community, Public, and Population Health Nursing, specifically targeting
the epidemiology component of the course. It delivers a rigorous assessment of
epidemiological principles, including measures of disease frequency, study designs,
bias and confounding, screening and diagnostic tests, outbreak investigation, and
data interpretation. The 100 multiple-choice questions blend foundational
knowledge with clinical reasoning and quantitative analysis, mirroring the
complexity of proctored examinations. Each item is accompanied by a detailed,
multi-sentence rationale explaining the correct answer and why the alternatives
are incorrect, reinforcing the critical thinking skills essential for applying
epidemiological concepts to population-based nursing practice. Updated for the
2026–2027 academic cycle, this resource provides verified solutions to help you
master epidemiology and excel on your course assessments.
Table of Contents
I. Measures of Disease Frequency (Incidence, Prevalence, Mortality)
II. Study Designs (Cohort, Case-Control, Cross-Sectional, Ecological)
III. Bias, Confounding, and Causality
IV. Screening and Diagnostic Tests (Sensitivity, Specificity, PPV, NPV)
V. Outbreak Investigation and Disease Surveillance
VI. Data Interpretation and Risk Assessment
VII. Epidemiology in Public Health Practice
, 1. A public health nurse is tracking the number of new cases of Lyme disease
in a county during the past year. This is an example of:
A) Prevalence
B) Incidence
C) Mortality rate
D) Attack rate
Correct Answer: B
Incidence refers to the number of new cases of a disease in a defined population
during a specific time period. Prevalence (A) includes all existing cases at a point in
time. Mortality rate (C) measures deaths. Attack rate (D) is a specific type of
incidence used during outbreaks. Thus, tracking new cases over a year is
measuring incidence.
2. A community health nurse is investigating an outbreak of foodborne illness
at a wedding reception. Of 100 guests who attended, 40 became ill within
48 hours. What is the attack rate?
A) 0.4%
B) 4%
C) 40%
D) 60%
Correct Answer: C
Attack rate = (number of new cases / total population at risk) × 100 = () ×
100 = 40%. Options A, B, and D are miscalculations. Thus, the attack rate is 40%.
3. A nurse is comparing the mortality rates of two communities. Community A
has a crude death rate of 12 per 1,000, while Community B has a crude
death rate of 8 per 1,000. After age adjustment, Community A's rate is 9 per
1,000 and Community B's rate is 10 per 1,000. Which conclusion is correct?
A) Community A has higher mortality after adjustment
B) Community B has higher mortality after adjustment
C) The crude rates are more accurate for comparison
D) Both communities have identical mortality
,Correct Answer: B
Age adjustment removes the confounding effect of different age distributions.
After adjustment, Community B's rate (10) is higher than Community A's (9),
indicating that Community B's older population masked its higher mortality in the
crude rate. Options A, C, and D are incorrect. Thus, B is correct.
4. A public health nurse is studying the relationship between smoking and
lung cancer. The nurse follows a group of smokers and non-smokers over 20
years and compares the incidence of lung cancer. This is an example of
which study design?
A) Case-control study
B) Cross-sectional study
C) Cohort study
D) Ecological study
Correct Answer: C
A cohort study follows a group of individuals over time, comparing disease
incidence between exposed and unexposed groups. A case-control study (A) starts
with disease status and looks backward; a cross-sectional study (B) measures
exposure and disease at one point in time; an ecological study (D) uses
population-level data. Thus, C is correct.
5. A nurse is conducting a case-control study to identify risk factors for a rare
cancer. Which of the following is the first step?
A) Select a control group without the disease
B) Identify and enroll individuals with the disease (cases)
C) Follow participants over time to see who develops the disease
D) Randomize participants to exposure groups
Correct Answer: B
In a case-control study, the researcher starts by identifying cases (those with the
disease) and then selects controls to compare past exposures. Option A is the
second step; C describes a cohort study; D describes a randomized controlled trial.
Thus, the first step is to define and enroll cases.
, 6. A community health nurse is analyzing the results of a mammography
screening program. The test has a sensitivity of 90% and a specificity of
95%. If a woman has a positive mammogram, which measure indicates the
likelihood that she truly has breast cancer?
A) Sensitivity
B) Specificity
C) Positive predictive value (PPV)
D) Negative predictive value (NPV)
Correct Answer: C
Positive predictive value (PPV) is the probability that individuals with a positive
screening test truly have the disease. Sensitivity (A) is the ability to identify those
with disease; specificity (B) is the ability to identify those without disease; NPV (D)
is the probability that those with a negative test are disease-free. Thus, C is
correct.
7. A public health nurse is investigating a point source outbreak of
gastroenteritis at a picnic. The epidemic curve shows a rapid rise in cases
followed by a gradual decline. This curve is most consistent with:
A) A continuous common source outbreak
B) A point source outbreak
C) A propagated outbreak
D) An intermittent exposure outbreak
Correct Answer: B
A point source outbreak (single exposure) produces a rapid spike in cases and a
more gradual decline. A continuous common source (A) would show a sustained
plateau; a propagated outbreak (C) would show successive peaks; intermittent
exposure (D) would show irregular spikes. Thus, the described curve is a point
source outbreak.
8. A nurse is calculating the infant mortality rate for a city. The city recorded
15,000 live births and 120 infant deaths in one year. What is the infant
mortality rate per 1,000 live births?
A) 0.8
STUDY GUIDE | LATEST UPDATE 2026/2027 | ACTUAL
EXAM | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS
This comprehensive practice resource is designed for nursing students enrolled in
NR 436: Community, Public, and Population Health Nursing, specifically targeting
the epidemiology component of the course. It delivers a rigorous assessment of
epidemiological principles, including measures of disease frequency, study designs,
bias and confounding, screening and diagnostic tests, outbreak investigation, and
data interpretation. The 100 multiple-choice questions blend foundational
knowledge with clinical reasoning and quantitative analysis, mirroring the
complexity of proctored examinations. Each item is accompanied by a detailed,
multi-sentence rationale explaining the correct answer and why the alternatives
are incorrect, reinforcing the critical thinking skills essential for applying
epidemiological concepts to population-based nursing practice. Updated for the
2026–2027 academic cycle, this resource provides verified solutions to help you
master epidemiology and excel on your course assessments.
Table of Contents
I. Measures of Disease Frequency (Incidence, Prevalence, Mortality)
II. Study Designs (Cohort, Case-Control, Cross-Sectional, Ecological)
III. Bias, Confounding, and Causality
IV. Screening and Diagnostic Tests (Sensitivity, Specificity, PPV, NPV)
V. Outbreak Investigation and Disease Surveillance
VI. Data Interpretation and Risk Assessment
VII. Epidemiology in Public Health Practice
, 1. A public health nurse is tracking the number of new cases of Lyme disease
in a county during the past year. This is an example of:
A) Prevalence
B) Incidence
C) Mortality rate
D) Attack rate
Correct Answer: B
Incidence refers to the number of new cases of a disease in a defined population
during a specific time period. Prevalence (A) includes all existing cases at a point in
time. Mortality rate (C) measures deaths. Attack rate (D) is a specific type of
incidence used during outbreaks. Thus, tracking new cases over a year is
measuring incidence.
2. A community health nurse is investigating an outbreak of foodborne illness
at a wedding reception. Of 100 guests who attended, 40 became ill within
48 hours. What is the attack rate?
A) 0.4%
B) 4%
C) 40%
D) 60%
Correct Answer: C
Attack rate = (number of new cases / total population at risk) × 100 = () ×
100 = 40%. Options A, B, and D are miscalculations. Thus, the attack rate is 40%.
3. A nurse is comparing the mortality rates of two communities. Community A
has a crude death rate of 12 per 1,000, while Community B has a crude
death rate of 8 per 1,000. After age adjustment, Community A's rate is 9 per
1,000 and Community B's rate is 10 per 1,000. Which conclusion is correct?
A) Community A has higher mortality after adjustment
B) Community B has higher mortality after adjustment
C) The crude rates are more accurate for comparison
D) Both communities have identical mortality
,Correct Answer: B
Age adjustment removes the confounding effect of different age distributions.
After adjustment, Community B's rate (10) is higher than Community A's (9),
indicating that Community B's older population masked its higher mortality in the
crude rate. Options A, C, and D are incorrect. Thus, B is correct.
4. A public health nurse is studying the relationship between smoking and
lung cancer. The nurse follows a group of smokers and non-smokers over 20
years and compares the incidence of lung cancer. This is an example of
which study design?
A) Case-control study
B) Cross-sectional study
C) Cohort study
D) Ecological study
Correct Answer: C
A cohort study follows a group of individuals over time, comparing disease
incidence between exposed and unexposed groups. A case-control study (A) starts
with disease status and looks backward; a cross-sectional study (B) measures
exposure and disease at one point in time; an ecological study (D) uses
population-level data. Thus, C is correct.
5. A nurse is conducting a case-control study to identify risk factors for a rare
cancer. Which of the following is the first step?
A) Select a control group without the disease
B) Identify and enroll individuals with the disease (cases)
C) Follow participants over time to see who develops the disease
D) Randomize participants to exposure groups
Correct Answer: B
In a case-control study, the researcher starts by identifying cases (those with the
disease) and then selects controls to compare past exposures. Option A is the
second step; C describes a cohort study; D describes a randomized controlled trial.
Thus, the first step is to define and enroll cases.
, 6. A community health nurse is analyzing the results of a mammography
screening program. The test has a sensitivity of 90% and a specificity of
95%. If a woman has a positive mammogram, which measure indicates the
likelihood that she truly has breast cancer?
A) Sensitivity
B) Specificity
C) Positive predictive value (PPV)
D) Negative predictive value (NPV)
Correct Answer: C
Positive predictive value (PPV) is the probability that individuals with a positive
screening test truly have the disease. Sensitivity (A) is the ability to identify those
with disease; specificity (B) is the ability to identify those without disease; NPV (D)
is the probability that those with a negative test are disease-free. Thus, C is
correct.
7. A public health nurse is investigating a point source outbreak of
gastroenteritis at a picnic. The epidemic curve shows a rapid rise in cases
followed by a gradual decline. This curve is most consistent with:
A) A continuous common source outbreak
B) A point source outbreak
C) A propagated outbreak
D) An intermittent exposure outbreak
Correct Answer: B
A point source outbreak (single exposure) produces a rapid spike in cases and a
more gradual decline. A continuous common source (A) would show a sustained
plateau; a propagated outbreak (C) would show successive peaks; intermittent
exposure (D) would show irregular spikes. Thus, the described curve is a point
source outbreak.
8. A nurse is calculating the infant mortality rate for a city. The city recorded
15,000 live births and 120 infant deaths in one year. What is the infant
mortality rate per 1,000 live births?
A) 0.8
