Arizona State University
Course Number: NUR 440
Course Title: Community and Public Health Nursing
Exam: Midterm Exam
Date:2026
A public health nurse is conducting a windshield survey in a low income neighborhood. They note
that the only available food sources are convenience stores and fast food outlets. This observation
identifies a social determinant of health known as a food desert. Which domain of Healthy People
2030 does this primarily fall under?
A) Health Care Access and Quality
B) Neighborhood and Built Environment
C) Economic Stability
D) Social and Community Context
Correct Answer: B
Rationale: Neighborhood and Built Environment focuses on the physical surroundings, including
access to healthy foods, safe housing, and environmental conditions that influence health outcomes
in a community.
A nurse is investigating an outbreak of Pertussis in a middle school. The nurse calculates the attack
rate among vaccinated and unvaccinated students. This calculation is a specific form of which
epidemiological measure?
A) Prevalence rate
B) Period prevalence
C) Incidence rate
D) Mortality rate
Correct Answer: C
1
,Rationale: The attack rate is a specialized form of incidence rate used in infectious disease
outbreaks to quantify the proportion of persons who are exposed to an agent and develop the
disease during a specific, limited time frame.
True or False: According to the Precautionary Principle, a community health nurse should wait for
definitive scientific proof of harm before taking action to reduce a population's exposure to a
suspected environmental toxin.
Correct Answer: False
Rationale: The Precautionary Principle mandates that when an activity poses a threat to human
health or the environment, precautionary measures should be taken even if some cause and effect
relationships are not fully established scientifically.
A nurse is developing a program to reduce the incidence of obesity in school aged children. Using
the Logic Model, the nurse lists "hiring three nutritional counselors" and "securing use of the
school gymnasium." These specific items are categorized as:
A) Outputs
B) Impacts
C) Outcomes
D) Inputs
Correct Answer: D
Rationale: In a Logic Model, inputs include the resources, staff, and funding required to implement
a program. Outputs are the activities performed, while outcomes are the changes that occur as a
result.
The nurse provides education to a high school student about the proper use of condoms to prevent
the transmission of HIV. This intervention represents which level of prevention?
A) Primary Prevention
B) Secondary Prevention
C) Tertiary Prevention
D) Quaternary Prevention
Correct Answer: A
Rationale: Primary prevention aims to prevent the onset of disease through health promotion and
specific protections. Since the student does not have the disease, the education is meant to prevent
initial infection.
2
,True or False: To achieve herd immunity for a highly contagious disease like measles in the United
States, usually 80 percent of the population must be fully vaccinated.
Correct Answer: False
Rationale: For highly contagious diseases like measles, the threshold for herd immunity is much
higher, typically estimated at 93 to 95 percent of the population.
When a community health nurse utilizes "Key Informants" during a community assessment, they
are seeking qualitative data. Which of the following is an example of a key informant?
A) The local census report from 2020
B) A database of hospital discharge summaries
C) A long term resident who owns a local grocery store
D) A table showing state level infant mortality rates
Correct Answer: C
Rationale: Key informants are individuals with specialized knowledge or a unique perspective on a
community's needs, values, and strengths. They provide depth that statistical data cannot capture.
A nurse is managing a "Lead Abatement" program in an older urban area. The nurse focuses on
ensuring that children with blood lead levels above 3.5 mcg/dL receive developmental assessments
and environmental inspections of their homes. This is an example of:
A) Primary Prevention
B) Secondary Prevention
C) Tertiary Prevention
D) Primordial Prevention
Correct Answer: B
Rationale: Secondary prevention involves screening and early detection followed by intervention to
prevent the progression of a condition that has already begun.
In the United States, the federal agency primarily responsible for the distribution of funds for
community health centers that serve the uninsured and underinsured is known as the ________.
Correct Answer: HRSA (Health Resources and Services Administration)
Rationale: HRSA is an agency of the U.S. Department of Health and Human Services and is the
primary federal agency for improving access to health care services for people who are uninsured,
isolated, or medically vulnerable.
3
, True or False: The Patient Protection and Affordable Care Act (ACA) prohibits insurance
companies from denying coverage to individuals based on pre-existing conditions.
Correct Answer: True
Rationale: This is a core consumer protection of the ACA, ensuring that individuals with chronic
illnesses can access and maintain health insurance without being penalized for their health history.
A nurse is analyzing the infant mortality rate (IMR) of a specific zip code. The IMR is technically
defined as the number of deaths of infants under age 1 per ________ live births in a given year.
Correct Answer: 1,000
Rationale: The IMR is a standard international indicator used to compare the health and well being
of different populations, calculated per 1,000 live births.
Which ethical principle is the nurse prioritizing when they advocate for a needle exchange program
to reduce the spread of Hepatitis C, even though some community members believe it encourages
drug use?
A) Autonomy
B) Distributive Justice
C) Non-maleficence
D) Beneficence
Correct Answer: B
Rationale: Distributive justice refers to the fair and equitable distribution of benefits and burdens in
a population. By providing a service that protects the health of a marginalized group, the nurse is
addressing health equity.
True or False: In the United States, health departments are legally permitted to breach a patient's
confidentiality if the patient has a confirmed case of a reportable mandatorily reportable disease
such as Syphilis.
Correct Answer: True
Rationale: Public health laws in the U.S. mandate that certain infectious diseases be reported to
local and state authorities to allow for contact tracing and the protection of the greater public
health.
A nurse plans to conduct an "Asset Map" for a community. What will this map specifically
identify?
A) The prevalence of chronic diseases in the elderly
B) Local parks, non profits, and community leaders that can support health
4
Course Number: NUR 440
Course Title: Community and Public Health Nursing
Exam: Midterm Exam
Date:2026
A public health nurse is conducting a windshield survey in a low income neighborhood. They note
that the only available food sources are convenience stores and fast food outlets. This observation
identifies a social determinant of health known as a food desert. Which domain of Healthy People
2030 does this primarily fall under?
A) Health Care Access and Quality
B) Neighborhood and Built Environment
C) Economic Stability
D) Social and Community Context
Correct Answer: B
Rationale: Neighborhood and Built Environment focuses on the physical surroundings, including
access to healthy foods, safe housing, and environmental conditions that influence health outcomes
in a community.
A nurse is investigating an outbreak of Pertussis in a middle school. The nurse calculates the attack
rate among vaccinated and unvaccinated students. This calculation is a specific form of which
epidemiological measure?
A) Prevalence rate
B) Period prevalence
C) Incidence rate
D) Mortality rate
Correct Answer: C
1
,Rationale: The attack rate is a specialized form of incidence rate used in infectious disease
outbreaks to quantify the proportion of persons who are exposed to an agent and develop the
disease during a specific, limited time frame.
True or False: According to the Precautionary Principle, a community health nurse should wait for
definitive scientific proof of harm before taking action to reduce a population's exposure to a
suspected environmental toxin.
Correct Answer: False
Rationale: The Precautionary Principle mandates that when an activity poses a threat to human
health or the environment, precautionary measures should be taken even if some cause and effect
relationships are not fully established scientifically.
A nurse is developing a program to reduce the incidence of obesity in school aged children. Using
the Logic Model, the nurse lists "hiring three nutritional counselors" and "securing use of the
school gymnasium." These specific items are categorized as:
A) Outputs
B) Impacts
C) Outcomes
D) Inputs
Correct Answer: D
Rationale: In a Logic Model, inputs include the resources, staff, and funding required to implement
a program. Outputs are the activities performed, while outcomes are the changes that occur as a
result.
The nurse provides education to a high school student about the proper use of condoms to prevent
the transmission of HIV. This intervention represents which level of prevention?
A) Primary Prevention
B) Secondary Prevention
C) Tertiary Prevention
D) Quaternary Prevention
Correct Answer: A
Rationale: Primary prevention aims to prevent the onset of disease through health promotion and
specific protections. Since the student does not have the disease, the education is meant to prevent
initial infection.
2
,True or False: To achieve herd immunity for a highly contagious disease like measles in the United
States, usually 80 percent of the population must be fully vaccinated.
Correct Answer: False
Rationale: For highly contagious diseases like measles, the threshold for herd immunity is much
higher, typically estimated at 93 to 95 percent of the population.
When a community health nurse utilizes "Key Informants" during a community assessment, they
are seeking qualitative data. Which of the following is an example of a key informant?
A) The local census report from 2020
B) A database of hospital discharge summaries
C) A long term resident who owns a local grocery store
D) A table showing state level infant mortality rates
Correct Answer: C
Rationale: Key informants are individuals with specialized knowledge or a unique perspective on a
community's needs, values, and strengths. They provide depth that statistical data cannot capture.
A nurse is managing a "Lead Abatement" program in an older urban area. The nurse focuses on
ensuring that children with blood lead levels above 3.5 mcg/dL receive developmental assessments
and environmental inspections of their homes. This is an example of:
A) Primary Prevention
B) Secondary Prevention
C) Tertiary Prevention
D) Primordial Prevention
Correct Answer: B
Rationale: Secondary prevention involves screening and early detection followed by intervention to
prevent the progression of a condition that has already begun.
In the United States, the federal agency primarily responsible for the distribution of funds for
community health centers that serve the uninsured and underinsured is known as the ________.
Correct Answer: HRSA (Health Resources and Services Administration)
Rationale: HRSA is an agency of the U.S. Department of Health and Human Services and is the
primary federal agency for improving access to health care services for people who are uninsured,
isolated, or medically vulnerable.
3
, True or False: The Patient Protection and Affordable Care Act (ACA) prohibits insurance
companies from denying coverage to individuals based on pre-existing conditions.
Correct Answer: True
Rationale: This is a core consumer protection of the ACA, ensuring that individuals with chronic
illnesses can access and maintain health insurance without being penalized for their health history.
A nurse is analyzing the infant mortality rate (IMR) of a specific zip code. The IMR is technically
defined as the number of deaths of infants under age 1 per ________ live births in a given year.
Correct Answer: 1,000
Rationale: The IMR is a standard international indicator used to compare the health and well being
of different populations, calculated per 1,000 live births.
Which ethical principle is the nurse prioritizing when they advocate for a needle exchange program
to reduce the spread of Hepatitis C, even though some community members believe it encourages
drug use?
A) Autonomy
B) Distributive Justice
C) Non-maleficence
D) Beneficence
Correct Answer: B
Rationale: Distributive justice refers to the fair and equitable distribution of benefits and burdens in
a population. By providing a service that protects the health of a marginalized group, the nurse is
addressing health equity.
True or False: In the United States, health departments are legally permitted to breach a patient's
confidentiality if the patient has a confirmed case of a reportable mandatorily reportable disease
such as Syphilis.
Correct Answer: True
Rationale: Public health laws in the U.S. mandate that certain infectious diseases be reported to
local and state authorities to allow for contact tracing and the protection of the greater public
health.
A nurse plans to conduct an "Asset Map" for a community. What will this map specifically
identify?
A) The prevalence of chronic diseases in the elderly
B) Local parks, non profits, and community leaders that can support health
4
