PRACTICE EXAM BOOKLET
CMS RN Community Health 2026
Proctored Assessment
Updated 2026 Edition — 70 NGN Questions and Answers
Exam Preparation | Review | Built for Level 3 Mastery
70 30 16 4
NGN-ERA ITEMS CLINICAL-JUDGMENT ITEMS STAND-ALONE NGN UNFOLDING CASE STUDIES
This booklet contains 70 original, high-difficulty practice items covering the content of the RN Community Health
proctored assessment: public health foundations, epidemiology and biostatistics, community assessment and
program planning, health promotion and teaching, communicable disease control, environmental and occupational
health, vulnerable populations, home health and hospice, and emergency preparedness. Every item is tagged to a step
of the NCSBN Clinical Judgment Measurement Model. Part I has 30 clinical-judgment items (multiple choice, select-all,
ordered response, and calculations); Part II has 16 stand-alone NGN items (matrix, bowtie, highlight, drop-down, and
trend); and Part III has four six-item unfolding NGN case studies.
Suggested timing: 70 minutes (about 1 minute per item). Record your answers on the answer sheet at the back,
then check them against the separate Answer Key.
Important: All items, scenarios, and rationales in this guide are original and were written for practice. They are not reproductions
of actual ATI assessment items, and this guide is not affiliated with, sponsored by, or endorsed by ATI Nursing Education. Clinical
content reflects widely taught nursing standards; always follow your program’s textbooks, current evidence, and facility policy.
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
How to Use This Practice Exam
Read every stem completely before looking at the options. Community health items are written at the application and
analysis levels and often shift the focus from one client to a population: which group is at greatest risk, which
intervention reaches the most people, which level of prevention applies, or what the nurse should do first in an
outbreak or disaster. Every item in this booklet is labeled with the clinical judgment (NCJMM) step it targets in the
answer key.
Item type How to answer
Multiple choice Select the ONE best answer. Several options may be true; choose the one that best answers the
question asked (priority, first, best, most appropriate).
Select all that apply (SATA) Select EVERY option that is correct. There may be anywhere from one to all options correct.
Evaluate each option independently as true or false.
Ordered response Arrange all of the options in sequence from first to last and write the letters in order.
Calculation Work the calculation yourself first, then select the matching answer. Each wrong option
represents a specific, common calculation error.
NGN — Matrix For each row, mark the column(s) that apply. “Multiple choice” matrices allow one mark per
row; “multiple response” matrices allow more than one.
NGN — Bowtie Choose the one condition the client is most likely experiencing (center), two actions to take
(left), and two parameters to monitor (right).
NGN — Drop-down cloze / Choose one option from each numbered drop-down list to complete the sentence(s) correctly.
rationale
NGN — Highlight Circle the numbers of the underlined findings in the passage that answer the question.
NGN — Trend Compare data across time points, then answer the question that follows.
Unfolding case study Six items that move through the Clinical Judgment Measurement Model: recognize cues →
analyze cues → prioritize hypotheses → generate solutions → take action → evaluate
outcomes. New information may appear in later items.
Content Coverage
NCLEX-RN Client Needs category Items Item format Items
Safety and Infection Control 24 Multiple choice (incl. calculation) 26
Health Promotion and Maintenance 18 Select all that apply / multiple response 15
Management of Care 12 Ordered response 3
Psychosocial Integrity 7 NGN matrix (choice and response) 16
Physiological Adaptation 5 NGN drop-down cloze / rationale 6
Reduction of Risk Potential 3 NGN bowtie 2
Pharmacological and Parenteral Therapies 1 NGN highlight 2
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 2
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
Test-Taking Strategies for Community Health
• Think population first: the best answer often protects the most people or the most vulnerable group (children,
older adults, pregnant people, immunocompromised people, people experiencing homelessness).
• Levels of prevention: ask “Does the disease already exist?” Not yet → primary; present but undiagnosed →
secondary (screening); diagnosed with damage → tertiary (rehabilitation, complication prevention).
• Safety and life threats still come first: ABCs and Maslow apply in homes, shelters, and outbreaks — an actual
physiological emergency outranks a potential public health risk.
• Outbreaks: verify, define, count, describe (time, place, person), test hypotheses (attack rates), control,
communicate. Exclude ill food handlers and child-care workers.
• Disasters: START triage (30–2–can do); rescue before alarm; use utilitarianism (greatest good for the greatest
number) when resources are scarce.
• Mandated reporting: suspected child or elder abuse is reported on reasonable suspicion — no proof required.
Never confront a suspected abuser.
• Respect autonomy: competent adults make their own decisions; use the least restrictive option and qualified
interpreters.
Part I — Clinical Judgment Items (1–30)
Multiple choice · Select all that apply · Ordered response · Epidemiologic calculations
ITEM 1 of 70 Multiple Choice · Management of Care
A public health nurse employed by a county health department has spent the past 6 months working on several
projects related to childhood obesity, which affects 22% of the county’s school-age children. The nurse reviews the
following activities that the nurse completed during that period:
• Analyzed body mass index data from the school districts and compared rates by zip code.
• Testified before the county board of commissioners in support of an ordinance requiring that vending machines in
county buildings offer healthy options.
• Organized a coalition of parents, pediatricians, and grocers to draft a community action plan for healthy food
access.
• Arranged for a mobile clinic to provide nutrition counseling and well-child examinations in two zip codes that have
no pediatric primary care provider, and monitored whether families in those zip codes were actually receiving the
services.
The nurse is preparing an annual report organized around the three core functions of public health.
Which activity should the nurse classify under the core function of assurance?
○ A. Organizing a coalition to draft a community action plan for healthy food access
○ B. Arranging for a mobile clinic to provide services in zip codes without a pediatric provider and monitoring
whether families receive the services
○ C. Testifying before the county board of commissioners in support of the vending-machine ordinance
○ D. Analyzing body mass index data from the school districts and comparing rates by zip code
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 3
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
ITEM 2 of 70 Multiple Choice · Health Promotion and Maintenance
A community health nurse is participating in an investigation of a rare type of liver cancer that has been diagnosed in
18 residents of a small town over the past 4 years. Residents have expressed concern about a former industrial site
near the river. Because the disease is rare and the exposures of interest may have occurred decades ago, the research
team identifies the 18 residents who have the cancer and selects 72 residents of similar age and sex who do not have
the cancer. Trained interviewers then ask both groups detailed questions about their past residential history,
occupational history, and use of private well water. The team plans to calculate an odds ratio to estimate the strength
of the association between past well-water use and the cancer.
Which type of epidemiologic study is the team conducting?
○ A. Randomized controlled trial
○ B. Cross-sectional study
○ C. Case-control study
○ D. Prospective cohort study
ITEM 3 of 70 Calculation · Health Promotion and Maintenance
A public health nurse in a county with a midyear population of 248,000 is preparing the annual communicable disease
report for 2025. Surveillance data for hepatitis A show the following:
• 60 new cases of hepatitis A were reported with symptom onset between January 1 and December 31, 2025.
• 15 additional residents were still recovering on January 1, 2025, from cases that began in late 2024.
• 4 of the new cases in 2025 were in residents who died of complications.
The state health department asks counties to report incidence rates per 100,000 population so that counties of
different sizes can be compared.
What is the 2025 incidence rate of hepatitis A in this county? (Round to the nearest tenth.)
○ A. 0.2 per 100,000
○ B. 2.4 per 100,000
○ C. 24.2 per 100,000
○ D. 30.2 per 100,000
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 4
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
ITEM 4 of 70 Calculation · Health Promotion and Maintenance
A nurse working for a rural health network is preparing a community health assessment for a town with 12,500 adult
residents. As part of the assessment, the nurse reviews data from the regional health information exchange and a
household survey. On July 1, 2025, a total of 1,150 adult residents were living with diagnosed type 2 diabetes
mellitus. Of these, 140 had been newly diagnosed during the preceding 6 months (January 1 through June 30, 2025).
The board of the health network wants the result expressed per 1,000 adults so it can compare the town with the
state.
What is the point prevalence of diagnosed type 2 diabetes among adults in the town on July 1, 2025?
○ A. 9.2 per 1,000 adults
○ B. 11.2 per 1,000 adults
○ C. 80.8 per 1,000 adults
○ D. 92 per 1,000 adults
ITEM 5 of 70 Calculation · Reduction of Risk Potential
A county health department is evaluating a new rapid point-of-care screening test for hepatitis C antibodies that it is
considering for use in its mobile outreach van. To evaluate the test, 1,000 adults were tested with both the rapid test
and the laboratory reference (“gold standard”) test. The results are shown in the table below.
■ RAPID TEST RESULTS COMPARED WITH THE REFERENCE STANDARD
Disease present (reference Disease absent (reference test Total
test positive) negative)
Rapid test positive 180 40 220
Rapid test negative 20 760 780
Total 200 800 1,000
What is the sensitivity of the rapid screening test?
○ A. 81.8%
○ B. 90%
○ C. 95%
○ D. 97.4%
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 5
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
ITEM 6 of 70 Calculation · Health Promotion and Maintenance
A maternal-child health nurse at a state health department is reviewing 2025 vital statistics for a county as part of a
request for grant funding for a home-visiting program. The county’s data for 2025 are:
• 4,820 live births
• 31 deaths of infants younger than 1 year of age, of which 21 occurred during the first 27 days of life
• 18 fetal deaths (stillbirths at 20 weeks of gestation or later)
• 6 maternal deaths related to pregnancy
The grant application asks for the infant mortality rate expressed in the standard units used in the United States.
What is the county’s 2025 infant mortality rate?
○ A. 0.6 per 1,000 live births
○ B. 4.4 per 1,000 live births
○ C. 6.4 per 1,000 live births
○ D. 10.2 per 1,000 live births
ITEM 7 of 70 Ordered Response · Safety and Infection Control
On a Monday morning, a public health nurse at a county health department receives reports from two urgent care
centers and a hospital emergency department of 23 people with vomiting and diarrhea over the weekend — far more
than the 2 to 4 cases usually reported in a week. Several of the ill people attended the same wedding reception on
Saturday evening. The nurse is part of the health department’s outbreak response team and helps plan the
investigation, following the systematic approach recommended by the Centers for Disease Control and Prevention
(CDC). The team knows that control measures should be started as soon as a likely source is suspected, but it is
organizing the investigation in its standard sequence.
In what order should the team carry out the following steps of the outbreak investigation? Arrange the steps
from first to last.
☐ A. Describe the cases by time (including an epidemic curve), place, and person.
☐ B. Verify the diagnosis with laboratory testing and confirm that the number of cases exceeds what is
expected.
☐ C. Develop hypotheses about the source and test them with an analytic study comparing ill and well
attendees.
☐ D. Construct a working case definition.
☐ E. Implement control and prevention measures and communicate the findings.
☐ F. Systematically search for additional cases and record their information in a line list.
Sequence: 1. ______ 2. ______ 3. ______ 4. ______ 5. ______
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 6
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
ITEM 8 of 70 Multiple Choice · Health Promotion and Maintenance
A nurse has just been hired as the first public health nurse for an unincorporated area on the edge of a mid-sized city.
The area has about 9,000 residents. Before meeting with community leaders next week, the nurse wants to get a
quick, firsthand overview of the physical environment of the area — including the condition of housing, the types of
businesses and food outlets, the availability of public transportation, the presence of parks and sidewalks, signs of
environmental hazards, and how and where people gather during the day. The nurse has a limited budget and needs
to complete this initial step within 1 week.
Which community assessment method should the nurse use?
○ A. A windshield survey, driving and walking through the neighborhoods at different times of day
○ B. A mailed household survey of a random sample of residents about health behaviors
○ C. A focus group of 8 to 10 residents to discuss their health concerns
○ D. Key informant interviews with the mayor’s office, school principals, and faith leaders
ITEM 9 of 70 Multiple Choice · Management of Care
A community health nurse is developing a smoking-cessation program for pregnant clients at a federally qualified
health center. The center’s data show that 18% of clients who began prenatal care in 2025 reported smoking
cigarettes during pregnancy. The nurse is writing the program’s objectives for a grant proposal and wants each
objective to meet SMART criteria — specific, measurable, achievable, relevant, and time-bound. A colleague drafted
several possible objectives for the nurse to review.
Which objective best meets the SMART criteria?
○ A. Pregnant clients will understand the dangers of smoking during pregnancy.
○ B. By December 31, 2027, the percentage of pregnant clients at the center who report smoking at the
36-week prenatal visit will decrease from 18% to 10%.
○ C. The program will reduce smoking among pregnant clients as much as possible.
○ D. The nurse will provide smoking-cessation education to pregnant clients at every visit.
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 7
CMS RN Community Health 2026
Proctored Assessment
Updated 2026 Edition — 70 NGN Questions and Answers
Exam Preparation | Review | Built for Level 3 Mastery
70 30 16 4
NGN-ERA ITEMS CLINICAL-JUDGMENT ITEMS STAND-ALONE NGN UNFOLDING CASE STUDIES
This booklet contains 70 original, high-difficulty practice items covering the content of the RN Community Health
proctored assessment: public health foundations, epidemiology and biostatistics, community assessment and
program planning, health promotion and teaching, communicable disease control, environmental and occupational
health, vulnerable populations, home health and hospice, and emergency preparedness. Every item is tagged to a step
of the NCSBN Clinical Judgment Measurement Model. Part I has 30 clinical-judgment items (multiple choice, select-all,
ordered response, and calculations); Part II has 16 stand-alone NGN items (matrix, bowtie, highlight, drop-down, and
trend); and Part III has four six-item unfolding NGN case studies.
Suggested timing: 70 minutes (about 1 minute per item). Record your answers on the answer sheet at the back,
then check them against the separate Answer Key.
Important: All items, scenarios, and rationales in this guide are original and were written for practice. They are not reproductions
of actual ATI assessment items, and this guide is not affiliated with, sponsored by, or endorsed by ATI Nursing Education. Clinical
content reflects widely taught nursing standards; always follow your program’s textbooks, current evidence, and facility policy.
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
How to Use This Practice Exam
Read every stem completely before looking at the options. Community health items are written at the application and
analysis levels and often shift the focus from one client to a population: which group is at greatest risk, which
intervention reaches the most people, which level of prevention applies, or what the nurse should do first in an
outbreak or disaster. Every item in this booklet is labeled with the clinical judgment (NCJMM) step it targets in the
answer key.
Item type How to answer
Multiple choice Select the ONE best answer. Several options may be true; choose the one that best answers the
question asked (priority, first, best, most appropriate).
Select all that apply (SATA) Select EVERY option that is correct. There may be anywhere from one to all options correct.
Evaluate each option independently as true or false.
Ordered response Arrange all of the options in sequence from first to last and write the letters in order.
Calculation Work the calculation yourself first, then select the matching answer. Each wrong option
represents a specific, common calculation error.
NGN — Matrix For each row, mark the column(s) that apply. “Multiple choice” matrices allow one mark per
row; “multiple response” matrices allow more than one.
NGN — Bowtie Choose the one condition the client is most likely experiencing (center), two actions to take
(left), and two parameters to monitor (right).
NGN — Drop-down cloze / Choose one option from each numbered drop-down list to complete the sentence(s) correctly.
rationale
NGN — Highlight Circle the numbers of the underlined findings in the passage that answer the question.
NGN — Trend Compare data across time points, then answer the question that follows.
Unfolding case study Six items that move through the Clinical Judgment Measurement Model: recognize cues →
analyze cues → prioritize hypotheses → generate solutions → take action → evaluate
outcomes. New information may appear in later items.
Content Coverage
NCLEX-RN Client Needs category Items Item format Items
Safety and Infection Control 24 Multiple choice (incl. calculation) 26
Health Promotion and Maintenance 18 Select all that apply / multiple response 15
Management of Care 12 Ordered response 3
Psychosocial Integrity 7 NGN matrix (choice and response) 16
Physiological Adaptation 5 NGN drop-down cloze / rationale 6
Reduction of Risk Potential 3 NGN bowtie 2
Pharmacological and Parenteral Therapies 1 NGN highlight 2
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 2
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
Test-Taking Strategies for Community Health
• Think population first: the best answer often protects the most people or the most vulnerable group (children,
older adults, pregnant people, immunocompromised people, people experiencing homelessness).
• Levels of prevention: ask “Does the disease already exist?” Not yet → primary; present but undiagnosed →
secondary (screening); diagnosed with damage → tertiary (rehabilitation, complication prevention).
• Safety and life threats still come first: ABCs and Maslow apply in homes, shelters, and outbreaks — an actual
physiological emergency outranks a potential public health risk.
• Outbreaks: verify, define, count, describe (time, place, person), test hypotheses (attack rates), control,
communicate. Exclude ill food handlers and child-care workers.
• Disasters: START triage (30–2–can do); rescue before alarm; use utilitarianism (greatest good for the greatest
number) when resources are scarce.
• Mandated reporting: suspected child or elder abuse is reported on reasonable suspicion — no proof required.
Never confront a suspected abuser.
• Respect autonomy: competent adults make their own decisions; use the least restrictive option and qualified
interpreters.
Part I — Clinical Judgment Items (1–30)
Multiple choice · Select all that apply · Ordered response · Epidemiologic calculations
ITEM 1 of 70 Multiple Choice · Management of Care
A public health nurse employed by a county health department has spent the past 6 months working on several
projects related to childhood obesity, which affects 22% of the county’s school-age children. The nurse reviews the
following activities that the nurse completed during that period:
• Analyzed body mass index data from the school districts and compared rates by zip code.
• Testified before the county board of commissioners in support of an ordinance requiring that vending machines in
county buildings offer healthy options.
• Organized a coalition of parents, pediatricians, and grocers to draft a community action plan for healthy food
access.
• Arranged for a mobile clinic to provide nutrition counseling and well-child examinations in two zip codes that have
no pediatric primary care provider, and monitored whether families in those zip codes were actually receiving the
services.
The nurse is preparing an annual report organized around the three core functions of public health.
Which activity should the nurse classify under the core function of assurance?
○ A. Organizing a coalition to draft a community action plan for healthy food access
○ B. Arranging for a mobile clinic to provide services in zip codes without a pediatric provider and monitoring
whether families receive the services
○ C. Testifying before the county board of commissioners in support of the vending-machine ordinance
○ D. Analyzing body mass index data from the school districts and comparing rates by zip code
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 3
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
ITEM 2 of 70 Multiple Choice · Health Promotion and Maintenance
A community health nurse is participating in an investigation of a rare type of liver cancer that has been diagnosed in
18 residents of a small town over the past 4 years. Residents have expressed concern about a former industrial site
near the river. Because the disease is rare and the exposures of interest may have occurred decades ago, the research
team identifies the 18 residents who have the cancer and selects 72 residents of similar age and sex who do not have
the cancer. Trained interviewers then ask both groups detailed questions about their past residential history,
occupational history, and use of private well water. The team plans to calculate an odds ratio to estimate the strength
of the association between past well-water use and the cancer.
Which type of epidemiologic study is the team conducting?
○ A. Randomized controlled trial
○ B. Cross-sectional study
○ C. Case-control study
○ D. Prospective cohort study
ITEM 3 of 70 Calculation · Health Promotion and Maintenance
A public health nurse in a county with a midyear population of 248,000 is preparing the annual communicable disease
report for 2025. Surveillance data for hepatitis A show the following:
• 60 new cases of hepatitis A were reported with symptom onset between January 1 and December 31, 2025.
• 15 additional residents were still recovering on January 1, 2025, from cases that began in late 2024.
• 4 of the new cases in 2025 were in residents who died of complications.
The state health department asks counties to report incidence rates per 100,000 population so that counties of
different sizes can be compared.
What is the 2025 incidence rate of hepatitis A in this county? (Round to the nearest tenth.)
○ A. 0.2 per 100,000
○ B. 2.4 per 100,000
○ C. 24.2 per 100,000
○ D. 30.2 per 100,000
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 4
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
ITEM 4 of 70 Calculation · Health Promotion and Maintenance
A nurse working for a rural health network is preparing a community health assessment for a town with 12,500 adult
residents. As part of the assessment, the nurse reviews data from the regional health information exchange and a
household survey. On July 1, 2025, a total of 1,150 adult residents were living with diagnosed type 2 diabetes
mellitus. Of these, 140 had been newly diagnosed during the preceding 6 months (January 1 through June 30, 2025).
The board of the health network wants the result expressed per 1,000 adults so it can compare the town with the
state.
What is the point prevalence of diagnosed type 2 diabetes among adults in the town on July 1, 2025?
○ A. 9.2 per 1,000 adults
○ B. 11.2 per 1,000 adults
○ C. 80.8 per 1,000 adults
○ D. 92 per 1,000 adults
ITEM 5 of 70 Calculation · Reduction of Risk Potential
A county health department is evaluating a new rapid point-of-care screening test for hepatitis C antibodies that it is
considering for use in its mobile outreach van. To evaluate the test, 1,000 adults were tested with both the rapid test
and the laboratory reference (“gold standard”) test. The results are shown in the table below.
■ RAPID TEST RESULTS COMPARED WITH THE REFERENCE STANDARD
Disease present (reference Disease absent (reference test Total
test positive) negative)
Rapid test positive 180 40 220
Rapid test negative 20 760 780
Total 200 800 1,000
What is the sensitivity of the rapid screening test?
○ A. 81.8%
○ B. 90%
○ C. 95%
○ D. 97.4%
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 5
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
ITEM 6 of 70 Calculation · Health Promotion and Maintenance
A maternal-child health nurse at a state health department is reviewing 2025 vital statistics for a county as part of a
request for grant funding for a home-visiting program. The county’s data for 2025 are:
• 4,820 live births
• 31 deaths of infants younger than 1 year of age, of which 21 occurred during the first 27 days of life
• 18 fetal deaths (stillbirths at 20 weeks of gestation or later)
• 6 maternal deaths related to pregnancy
The grant application asks for the infant mortality rate expressed in the standard units used in the United States.
What is the county’s 2025 infant mortality rate?
○ A. 0.6 per 1,000 live births
○ B. 4.4 per 1,000 live births
○ C. 6.4 per 1,000 live births
○ D. 10.2 per 1,000 live births
ITEM 7 of 70 Ordered Response · Safety and Infection Control
On a Monday morning, a public health nurse at a county health department receives reports from two urgent care
centers and a hospital emergency department of 23 people with vomiting and diarrhea over the weekend — far more
than the 2 to 4 cases usually reported in a week. Several of the ill people attended the same wedding reception on
Saturday evening. The nurse is part of the health department’s outbreak response team and helps plan the
investigation, following the systematic approach recommended by the Centers for Disease Control and Prevention
(CDC). The team knows that control measures should be started as soon as a likely source is suspected, but it is
organizing the investigation in its standard sequence.
In what order should the team carry out the following steps of the outbreak investigation? Arrange the steps
from first to last.
☐ A. Describe the cases by time (including an epidemic curve), place, and person.
☐ B. Verify the diagnosis with laboratory testing and confirm that the number of cases exceeds what is
expected.
☐ C. Develop hypotheses about the source and test them with an analytic study comparing ill and well
attendees.
☐ D. Construct a working case definition.
☐ E. Implement control and prevention measures and communicate the findings.
☐ F. Systematically search for additional cases and record their information in a line list.
Sequence: 1. ______ 2. ______ 3. ______ 4. ______ 5. ______
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 6
,CMS RN COMMUNITY HEALTH 2026 PROCTORED ASSESSMENT · NGN PRACTICE EDITION EXAM BOOKLET
ITEM 8 of 70 Multiple Choice · Health Promotion and Maintenance
A nurse has just been hired as the first public health nurse for an unincorporated area on the edge of a mid-sized city.
The area has about 9,000 residents. Before meeting with community leaders next week, the nurse wants to get a
quick, firsthand overview of the physical environment of the area — including the condition of housing, the types of
businesses and food outlets, the availability of public transportation, the presence of parks and sidewalks, signs of
environmental hazards, and how and where people gather during the day. The nurse has a limited budget and needs
to complete this initial step within 1 week.
Which community assessment method should the nurse use?
○ A. A windshield survey, driving and walking through the neighborhoods at different times of day
○ B. A mailed household survey of a random sample of residents about health behaviors
○ C. A focus group of 8 to 10 residents to discuss their health concerns
○ D. Key informant interviews with the mayor’s office, school principals, and faith leaders
ITEM 9 of 70 Multiple Choice · Management of Care
A community health nurse is developing a smoking-cessation program for pregnant clients at a federally qualified
health center. The center’s data show that 18% of clients who began prenatal care in 2025 reported smoking
cigarettes during pregnancy. The nurse is writing the program’s objectives for a grant proposal and wants each
objective to meet SMART criteria — specific, measurable, achievable, relevant, and time-bound. A colleague drafted
several possible objectives for the nurse to review.
Which objective best meets the SMART criteria?
○ A. Pregnant clients will understand the dangers of smoking during pregnancy.
○ B. By December 31, 2027, the percentage of pregnant clients at the center who report smoking at the
36-week prenatal visit will decrease from 18% to 10%.
○ C. The program will reduce smoking among pregnant clients as much as possible.
○ D. The nurse will provide smoking-cessation education to pregnant clients at every visit.
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 7
