NR442 COMMUNITY HEALTH NURSING:
COMPREHENSIVE EXAM QUESTIONS &
ANSWERS (200 QUESTIONS WITH
RATIONALES 100% CORRECT
Epidemiology & Disease Investigation
1. A community health nurse is analyzing data for influenza in a metropolitan
area. In 2024, there were 450 new cases of influenza in a population of 500,000.
What is the annual incidence rate per 100,000 population?
• A. 45 per 100,000
• B. 90 per 100,000
• C. 450 per 100,000
• D. 0.09 per 100,000
Correct answer: B. 90 per 100,000
Rationale: Incidence rate is calculated as (Number of new cases / Population at risk)
x 100,000. The calculation is (,000) x 100,000 = 90 per 100,000.
2. A county health department reports that 8,500 residents currently have
diagnosed Type 2 diabetes in a population of 200,000. This measure represents:
• A. Incidence rate
• B. Prevalence
• C. Attack rate
• D. Crude mortality rate
Correct answer: B. Prevalence
Rationale: Prevalence measures all existing cases (both new and pre-existing) of a
disease in a population at a specific point in time. Incidence only counts new cases.
3. During a foodborne illness outbreak investigation, the nurse identifies 45
people who ate at a specific restaurant and 12 who became ill. The attack rate is
calculated as:
• A. () x 100 = 26.7%
• B. 12 / total population x 100,000
, • C. () x 100 = 375%
• D. (45 - 12) / 45 x 100 = 73.3%
Correct answer: A. () x 100 = 26.7%
Rationale: Attack rate is a type of incidence rate used in outbreak investigations,
calculated as (Number of people exposed who became ill / Total number of people
exposed) x 100.
4. A community health nurse is investigating a cluster of Legionnaires' disease
cases. Mapping case residences reveals all live within 2 miles of a cooling tower.
This describes which epidemiological concept?
• A. Common source outbreak
• B. Propagated outbreak
• C. Sporadic occurrence
• D. Endemic pattern
Correct answer: A. Common source outbreak
Rationale: A common source outbreak occurs when a group of people are exposed
to the same source of infection (like a contaminated cooling tower) over a short
period.
5. A community health nurse suspects an outbreak of scabies in the local area.
Which of the following actions should the nurse take first?
• A. Determine the incidence rate
• B. Institute prophylactic treatment
• C. Educate the community about disease transmission
• D. Discuss treatment plans with clients' families
Correct answer: A. Determine the incidence rate
Rationale: The first step in the nursing process (Assessment) when managing a
potential outbreak is to gather data to confirm the outbreak and determine its
magnitude. Calculating the incidence rate helps establish the baseline and the extent
of the problem.
Levels of Prevention
6. A community health nurse is designing an intervention to reduce childhood
obesity. Which strategy represents primary prevention?
, • A. Establishing school-based nutrition education and physical activity
programs for all elementary students
• B. Screening overweight children for prediabetes
• C. Providing insulin management education to children with diagnosed
diabetes
• D. Offering bariatric surgery referral for morbidly obese adolescents
Correct answer: A. Establishing school-based nutrition education and physical
activity programs for all elementary students
Rationale: Primary prevention aims to prevent a disease or injury before it occurs
by reducing risk factors. Health education and promotion programs for the general
population are classic examples.
7. A patient is admitted to the emergency department with chest discomfort
and shortness of breath. She is placed on oxygen, has labs drawn, and given an
EKG. What level of preventive care is this patient receiving?
• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Health promotion
Correct answer: B. Secondary prevention
Rationale: Secondary prevention focuses on early detection and prompt
intervention during the early stages of a health problem. The goal is to diagnose and
treat a condition early to prevent complications.
8. Which of the following is an example of tertiary prevention?
• A. Childhood immunizations
• B. Mammography screening
• C. Stroke rehabilitation
• D. HIV testing
Correct answer: C. Stroke rehabilitation
Rationale: Tertiary prevention aims to reduce the impact of an ongoing illness or
injury that has lasting effects. This involves rehabilitation, preventing complications,
and improving quality of life for those with chronic conditions.
Core Public Health Functions
, 9. Which activities represent the core public health functions as defined by the
Institute of Medicine? (Select all that apply.)
• A. Assessment
• B. Policy Development
• C. Diagnosis of individual illness
• D. Assurance
• E. Treatment planning for hospitalized patients
Correct answers: A, B, D
Rationale: The three core functions of public health are Assessment (systematic
data collection), Policy Development (using scientific knowledge to develop health
policies), and Assurance (ensuring essential health services are available and
accessible).
10. A community health nurse identifying a cluster of tuberculosis cases in a
homeless shelter is performing the public health core function of:
• A. Assurance
• B. Assessment
• C. Policy development
• D. Research
Correct answer: B. Assessment
Rationale: Identifying health problems and analyzing data to understand the health
status of the community is the core function of Assessment.
Ethical Principles & Social Determinants
11. Which ethical principle is demonstrated when a nurse reports a
communicable disease to the public health department?
• A. Autonomy
• B. Justice
• C. Beneficence and nonmaleficence
• D. Veracity
Correct answer: C. Beneficence and nonmaleficence
Rationale: Reporting communicable diseases is an act of Beneficence (doing good
by protecting the public's health) and Nonmaleficence (preventing harm to others
by controlling the spread of disease).
COMPREHENSIVE EXAM QUESTIONS &
ANSWERS (200 QUESTIONS WITH
RATIONALES 100% CORRECT
Epidemiology & Disease Investigation
1. A community health nurse is analyzing data for influenza in a metropolitan
area. In 2024, there were 450 new cases of influenza in a population of 500,000.
What is the annual incidence rate per 100,000 population?
• A. 45 per 100,000
• B. 90 per 100,000
• C. 450 per 100,000
• D. 0.09 per 100,000
Correct answer: B. 90 per 100,000
Rationale: Incidence rate is calculated as (Number of new cases / Population at risk)
x 100,000. The calculation is (,000) x 100,000 = 90 per 100,000.
2. A county health department reports that 8,500 residents currently have
diagnosed Type 2 diabetes in a population of 200,000. This measure represents:
• A. Incidence rate
• B. Prevalence
• C. Attack rate
• D. Crude mortality rate
Correct answer: B. Prevalence
Rationale: Prevalence measures all existing cases (both new and pre-existing) of a
disease in a population at a specific point in time. Incidence only counts new cases.
3. During a foodborne illness outbreak investigation, the nurse identifies 45
people who ate at a specific restaurant and 12 who became ill. The attack rate is
calculated as:
• A. () x 100 = 26.7%
• B. 12 / total population x 100,000
, • C. () x 100 = 375%
• D. (45 - 12) / 45 x 100 = 73.3%
Correct answer: A. () x 100 = 26.7%
Rationale: Attack rate is a type of incidence rate used in outbreak investigations,
calculated as (Number of people exposed who became ill / Total number of people
exposed) x 100.
4. A community health nurse is investigating a cluster of Legionnaires' disease
cases. Mapping case residences reveals all live within 2 miles of a cooling tower.
This describes which epidemiological concept?
• A. Common source outbreak
• B. Propagated outbreak
• C. Sporadic occurrence
• D. Endemic pattern
Correct answer: A. Common source outbreak
Rationale: A common source outbreak occurs when a group of people are exposed
to the same source of infection (like a contaminated cooling tower) over a short
period.
5. A community health nurse suspects an outbreak of scabies in the local area.
Which of the following actions should the nurse take first?
• A. Determine the incidence rate
• B. Institute prophylactic treatment
• C. Educate the community about disease transmission
• D. Discuss treatment plans with clients' families
Correct answer: A. Determine the incidence rate
Rationale: The first step in the nursing process (Assessment) when managing a
potential outbreak is to gather data to confirm the outbreak and determine its
magnitude. Calculating the incidence rate helps establish the baseline and the extent
of the problem.
Levels of Prevention
6. A community health nurse is designing an intervention to reduce childhood
obesity. Which strategy represents primary prevention?
, • A. Establishing school-based nutrition education and physical activity
programs for all elementary students
• B. Screening overweight children for prediabetes
• C. Providing insulin management education to children with diagnosed
diabetes
• D. Offering bariatric surgery referral for morbidly obese adolescents
Correct answer: A. Establishing school-based nutrition education and physical
activity programs for all elementary students
Rationale: Primary prevention aims to prevent a disease or injury before it occurs
by reducing risk factors. Health education and promotion programs for the general
population are classic examples.
7. A patient is admitted to the emergency department with chest discomfort
and shortness of breath. She is placed on oxygen, has labs drawn, and given an
EKG. What level of preventive care is this patient receiving?
• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Health promotion
Correct answer: B. Secondary prevention
Rationale: Secondary prevention focuses on early detection and prompt
intervention during the early stages of a health problem. The goal is to diagnose and
treat a condition early to prevent complications.
8. Which of the following is an example of tertiary prevention?
• A. Childhood immunizations
• B. Mammography screening
• C. Stroke rehabilitation
• D. HIV testing
Correct answer: C. Stroke rehabilitation
Rationale: Tertiary prevention aims to reduce the impact of an ongoing illness or
injury that has lasting effects. This involves rehabilitation, preventing complications,
and improving quality of life for those with chronic conditions.
Core Public Health Functions
, 9. Which activities represent the core public health functions as defined by the
Institute of Medicine? (Select all that apply.)
• A. Assessment
• B. Policy Development
• C. Diagnosis of individual illness
• D. Assurance
• E. Treatment planning for hospitalized patients
Correct answers: A, B, D
Rationale: The three core functions of public health are Assessment (systematic
data collection), Policy Development (using scientific knowledge to develop health
policies), and Assurance (ensuring essential health services are available and
accessible).
10. A community health nurse identifying a cluster of tuberculosis cases in a
homeless shelter is performing the public health core function of:
• A. Assurance
• B. Assessment
• C. Policy development
• D. Research
Correct answer: B. Assessment
Rationale: Identifying health problems and analyzing data to understand the health
status of the community is the core function of Assessment.
Ethical Principles & Social Determinants
11. Which ethical principle is demonstrated when a nurse reports a
communicable disease to the public health department?
• A. Autonomy
• B. Justice
• C. Beneficence and nonmaleficence
• D. Veracity
Correct answer: C. Beneficence and nonmaleficence
Rationale: Reporting communicable diseases is an act of Beneficence (doing good
by protecting the public's health) and Nonmaleficence (preventing harm to others
by controlling the spread of disease).
