NR 436 EPIDEMIOLOGY PRACTICE QUESTIONS |
VERIFIED QUESTIONS & ANSWERS | LATEST
UPDATE 2026/2027 | ACTUAL EXAM | EXAM REVIEW |
100% CORRECT ANSWERS | VERIFIED SOLUTIONS
This focused practice examination has been meticulously developed for
Chamberlain University BSN students enrolled in NR 436: Community Health
Nursing, with specific emphasis on the epidemiology and biostatistics
competencies assessed throughout the course. This 100-question assessment
comprehensively covers epidemiological principles, study designs, disease
surveillance methods, outbreak investigation procedures, measures of morbidity
and mortality, screening test characteristics, causal inference frameworks, and the
application of epidemiological data to community health practice. Each question
has been crafted by epidemiology and public health education specialists to reflect
the Chamberlain curriculum design, emphasizing quantitative reasoning, critical
analysis of population health data, application of epidemiological methods to
disease prevention and control, and the synthesis of epidemiological evidence to
inform evidence-based community health nursing practice. This resource is
designed to prepare students for the epidemiology components of the NR 436
midterm and final examinations.
Table of Contents:
1.0 Epidemiological Foundations and Historical Context
2.0 Measures of Disease Frequency: Incidence, Prevalence, and Rates
3.0 Measures of Association: Risk, Relative Risk, and Odds Ratios
4.0 Study Designs: Experimental, Cohort, Case-Control, and Cross-Sectional
5.0 Screening Tests: Sensitivity, Specificity, and Predictive Values
6.0 Outbreak Investigation and Disease Surveillance
7.0 Causal Inference and Bias in Epidemiological Research
8.0 Epidemiology Applied to Community Health Nursing Practice
,Question 1: A community health nurse is analyzing the occurrence of type 2
diabetes in a community. The nurse identifies that there are currently 840
individuals diagnosed with diabetes among the 28,000 residents of the community.
What epidemiological measure does this number represent?
A) The incidence rate of diabetes in the community
B) The prevalence of diabetes—the total number of existing cases (both new and
pre-existing) in a defined population at a specified point in time
C) The cumulative incidence of diabetes over the past year
D) The mortality rate due to diabetes complications
Correct Answer: B
Prevalence measures the total number of existing cases of a disease in a defined
population at a specified point in time or during a specified period. It is a
"snapshot" of the disease burden. The nurse has identified 840 existing cases
(point prevalence). Incidence (A) measures only NEW cases occurring during a
defined time period. Cumulative incidence (C) would measure the proportion of
the population that develops diabetes over a specified follow-up period among
those at risk at the start. Mortality rate (D) measures deaths from diabetes.
Question 2: A public health nurse is investigating an outbreak of pertussis in an
elementary school with 450 students. Over the past 6 weeks, 36 new cases of
pertussis have been diagnosed among students. There were no cases at the
beginning of the school year. What is the cumulative incidence (attack rate) of
pertussis among students during this 6-week outbreak period?
A) 36 per 450 students
B) 8.0% or 80 per 1,000 students
C) 12.5% or 125 per 1,000 students
D) 92.0% or 920 per 1,000 students
Correct Answer: B
Cumulative incidence (attack rate) = (Number of new cases during the period /
Population at risk at the beginning of the period) × multiplier = () × 100
= 8.0% or 80 per 1,000 students. The attack rate is a specific form of cumulative
incidence used during outbreaks to measure the proportion of an at-risk
population that develops disease over a defined period. All students are considered
at risk at the start of the outbreak since there were no pre-existing cases.
Question 3: A community health nurse is reviewing vital statistics data for a
county. In the past year, the county had 1,500 live births and 12 infant deaths
,(deaths of infants under 1 year of age). What is the infant mortality rate per 1,000
live births?
A) 0.8 per 1,000 live births
B) 8.0 per 1,000 live births
C) 12.5 per 1,000 live births
D) 125 per 1,000 live births
Correct Answer: B
Infant mortality rate = (Number of infant deaths / Number of live births) × 1,000 =
(,500) × 1,000 = 0.008 × 1,000 = 8.0 per 1,000 live births. This rate is
higher than the U.S. national average of approximately 5.6 per 1,000 and exceeds
the Healthy People 2030 target of 5.0 per 1,000. Infant mortality rate is a sensitive
indicator of population health, reflecting maternal health, access to quality
prenatal and perinatal care, socioeconomic conditions, and racial and ethnic
disparities.
Question 4: A public health nurse is analyzing mortality data. In a community of
120,000 people, there were 960 deaths from all causes during the past year. There
were 240 deaths from cardiovascular disease. What is the proportionate mortality
ratio (PMR) for cardiovascular disease?
A) 20%
B) 25%
C) 40%
D) 0.2%
Correct Answer: B
Proportionate mortality ratio = (Number of deaths from a specific cause / Total
deaths from all causes) × 100 = () × 100 = 25%. PMR indicates the
proportion of all deaths attributable to a specific cause. It does NOT measure the
risk of dying from that cause (which would require a mortality rate using the total
population as the denominator). PMR is useful for identifying leading causes of
death and setting public health priorities, but it can be misleading if the total
mortality rate differs between populations.
Question 5: A community health nurse is calculating the incidence rate of Lyme
disease in a county. Over the past year, 45 new cases were diagnosed in a county
with a midyear population of 75,000. What is the incidence rate per 100,000
population per year?
A) 6.0 per 100,000
, B) 33.3 per 100,000
C) 60.0 per 100,000
D) 166.7 per 100,000
Correct Answer: C
Incidence rate = (Number of new cases / Total person-time at risk) × multiplier. In
this simplified calculation assuming a stable population: (,000) × 100,000
= 0.0006 × 100,000 = 60.0 per 100,000 population per year. The incidence rate
measures the rapidity with which new cases are occurring in the population. This
rate can be compared to state and national rates to determine if the county has an
elevated disease burden.
Question 6: A nurse epidemiologist is comparing two communities. Community A
has a crude mortality rate of 8.5 per 1,000, while Community B has a crude
mortality rate of 11.2 per 1,000. However, after age-adjustment using the standard
U.S. population, Community A's adjusted rate is 10.8 per 1,000 and Community
B's adjusted rate is 9.4 per 1,000. What explains this reversal?
A) The age-adjustment calculation is mathematically incorrect
B) Community B has an older population age distribution than Community A; the
higher crude rate in Community B is largely due to its older population, and when
age is controlled through standardization, Community B actually has lower age-
specific mortality rates than Community A
C) Community A has better healthcare facilities, which is reflected in the adjusted
rate
D) Crude rates are always more accurate than adjusted rates
Correct Answer: B
This phenomenon is an example of confounding by age. Community B's crude
mortality rate appears higher because it has a larger proportion of older adults,
who have inherently higher mortality rates. Age-adjustment removes the effect of
different age distributions, allowing a fair comparison. After adjustment,
Community B has lower mortality, indicating that within each age group, death
rates are actually lower in Community B. This illustrates why crude rates can be
misleading when comparing populations with different age structures.
Question 7: A community health nurse is conducting a foodborne illness outbreak
investigation following a church supper. Of 100 attendees, 60 became ill with
gastrointestinal symptoms. Forty-five of the ill individuals ate the turkey dinner,
and 15 of the ill individuals did not eat the turkey. Among the 40 attendees who
VERIFIED QUESTIONS & ANSWERS | LATEST
UPDATE 2026/2027 | ACTUAL EXAM | EXAM REVIEW |
100% CORRECT ANSWERS | VERIFIED SOLUTIONS
This focused practice examination has been meticulously developed for
Chamberlain University BSN students enrolled in NR 436: Community Health
Nursing, with specific emphasis on the epidemiology and biostatistics
competencies assessed throughout the course. This 100-question assessment
comprehensively covers epidemiological principles, study designs, disease
surveillance methods, outbreak investigation procedures, measures of morbidity
and mortality, screening test characteristics, causal inference frameworks, and the
application of epidemiological data to community health practice. Each question
has been crafted by epidemiology and public health education specialists to reflect
the Chamberlain curriculum design, emphasizing quantitative reasoning, critical
analysis of population health data, application of epidemiological methods to
disease prevention and control, and the synthesis of epidemiological evidence to
inform evidence-based community health nursing practice. This resource is
designed to prepare students for the epidemiology components of the NR 436
midterm and final examinations.
Table of Contents:
1.0 Epidemiological Foundations and Historical Context
2.0 Measures of Disease Frequency: Incidence, Prevalence, and Rates
3.0 Measures of Association: Risk, Relative Risk, and Odds Ratios
4.0 Study Designs: Experimental, Cohort, Case-Control, and Cross-Sectional
5.0 Screening Tests: Sensitivity, Specificity, and Predictive Values
6.0 Outbreak Investigation and Disease Surveillance
7.0 Causal Inference and Bias in Epidemiological Research
8.0 Epidemiology Applied to Community Health Nursing Practice
,Question 1: A community health nurse is analyzing the occurrence of type 2
diabetes in a community. The nurse identifies that there are currently 840
individuals diagnosed with diabetes among the 28,000 residents of the community.
What epidemiological measure does this number represent?
A) The incidence rate of diabetes in the community
B) The prevalence of diabetes—the total number of existing cases (both new and
pre-existing) in a defined population at a specified point in time
C) The cumulative incidence of diabetes over the past year
D) The mortality rate due to diabetes complications
Correct Answer: B
Prevalence measures the total number of existing cases of a disease in a defined
population at a specified point in time or during a specified period. It is a
"snapshot" of the disease burden. The nurse has identified 840 existing cases
(point prevalence). Incidence (A) measures only NEW cases occurring during a
defined time period. Cumulative incidence (C) would measure the proportion of
the population that develops diabetes over a specified follow-up period among
those at risk at the start. Mortality rate (D) measures deaths from diabetes.
Question 2: A public health nurse is investigating an outbreak of pertussis in an
elementary school with 450 students. Over the past 6 weeks, 36 new cases of
pertussis have been diagnosed among students. There were no cases at the
beginning of the school year. What is the cumulative incidence (attack rate) of
pertussis among students during this 6-week outbreak period?
A) 36 per 450 students
B) 8.0% or 80 per 1,000 students
C) 12.5% or 125 per 1,000 students
D) 92.0% or 920 per 1,000 students
Correct Answer: B
Cumulative incidence (attack rate) = (Number of new cases during the period /
Population at risk at the beginning of the period) × multiplier = () × 100
= 8.0% or 80 per 1,000 students. The attack rate is a specific form of cumulative
incidence used during outbreaks to measure the proportion of an at-risk
population that develops disease over a defined period. All students are considered
at risk at the start of the outbreak since there were no pre-existing cases.
Question 3: A community health nurse is reviewing vital statistics data for a
county. In the past year, the county had 1,500 live births and 12 infant deaths
,(deaths of infants under 1 year of age). What is the infant mortality rate per 1,000
live births?
A) 0.8 per 1,000 live births
B) 8.0 per 1,000 live births
C) 12.5 per 1,000 live births
D) 125 per 1,000 live births
Correct Answer: B
Infant mortality rate = (Number of infant deaths / Number of live births) × 1,000 =
(,500) × 1,000 = 0.008 × 1,000 = 8.0 per 1,000 live births. This rate is
higher than the U.S. national average of approximately 5.6 per 1,000 and exceeds
the Healthy People 2030 target of 5.0 per 1,000. Infant mortality rate is a sensitive
indicator of population health, reflecting maternal health, access to quality
prenatal and perinatal care, socioeconomic conditions, and racial and ethnic
disparities.
Question 4: A public health nurse is analyzing mortality data. In a community of
120,000 people, there were 960 deaths from all causes during the past year. There
were 240 deaths from cardiovascular disease. What is the proportionate mortality
ratio (PMR) for cardiovascular disease?
A) 20%
B) 25%
C) 40%
D) 0.2%
Correct Answer: B
Proportionate mortality ratio = (Number of deaths from a specific cause / Total
deaths from all causes) × 100 = () × 100 = 25%. PMR indicates the
proportion of all deaths attributable to a specific cause. It does NOT measure the
risk of dying from that cause (which would require a mortality rate using the total
population as the denominator). PMR is useful for identifying leading causes of
death and setting public health priorities, but it can be misleading if the total
mortality rate differs between populations.
Question 5: A community health nurse is calculating the incidence rate of Lyme
disease in a county. Over the past year, 45 new cases were diagnosed in a county
with a midyear population of 75,000. What is the incidence rate per 100,000
population per year?
A) 6.0 per 100,000
, B) 33.3 per 100,000
C) 60.0 per 100,000
D) 166.7 per 100,000
Correct Answer: C
Incidence rate = (Number of new cases / Total person-time at risk) × multiplier. In
this simplified calculation assuming a stable population: (,000) × 100,000
= 0.0006 × 100,000 = 60.0 per 100,000 population per year. The incidence rate
measures the rapidity with which new cases are occurring in the population. This
rate can be compared to state and national rates to determine if the county has an
elevated disease burden.
Question 6: A nurse epidemiologist is comparing two communities. Community A
has a crude mortality rate of 8.5 per 1,000, while Community B has a crude
mortality rate of 11.2 per 1,000. However, after age-adjustment using the standard
U.S. population, Community A's adjusted rate is 10.8 per 1,000 and Community
B's adjusted rate is 9.4 per 1,000. What explains this reversal?
A) The age-adjustment calculation is mathematically incorrect
B) Community B has an older population age distribution than Community A; the
higher crude rate in Community B is largely due to its older population, and when
age is controlled through standardization, Community B actually has lower age-
specific mortality rates than Community A
C) Community A has better healthcare facilities, which is reflected in the adjusted
rate
D) Crude rates are always more accurate than adjusted rates
Correct Answer: B
This phenomenon is an example of confounding by age. Community B's crude
mortality rate appears higher because it has a larger proportion of older adults,
who have inherently higher mortality rates. Age-adjustment removes the effect of
different age distributions, allowing a fair comparison. After adjustment,
Community B has lower mortality, indicating that within each age group, death
rates are actually lower in Community B. This illustrates why crude rates can be
misleading when comparing populations with different age structures.
Question 7: A community health nurse is conducting a foodborne illness outbreak
investigation following a church supper. Of 100 attendees, 60 became ill with
gastrointestinal symptoms. Forty-five of the ill individuals ate the turkey dinner,
and 15 of the ill individuals did not eat the turkey. Among the 40 attendees who
