ANSWER KEY & FULL RATIONALES
CMS RN Community Health 2026
Proctored Assessment
Updated 2026 Edition — 70 NGN Questions and Answers
Exam Preparation | Review | Built for Level 3 Mastery
70 70 Every NCJMM
ANSWERS FULL RATIONALES OPTION EXPLAINED STEP LABELLED
This key gives the correct answer to every item in the Practice Exam Booklet, followed by a full rationale explaining the
nursing concept, an option-by-option analysis of why each choice is correct or incorrect, and a key takeaway with a
test-taking strategy. Each option is restated so the key can be studied on its own.
Use the Quick Answer Grid on the next pages to score yourself first, then study the full rationale for every item —
including the ones you answered correctly.
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 ANSWER KEY & RATIONALES
Quick Answer Grid
Score yourself here first. Full rationales for every item follow.
# Format Topic Answer
1 Multiple Choice Core functions of public health B
2 Multiple Choice Epidemiologic study designs C
3 Calculation Calculating an incidence rate C
4 Calculation Calculating point prevalence D
5 Calculation Screening test sensitivity B
6 Calculation Calculating the infant mortality rate C
7 Ordered Response Steps of an outbreak investigation B, D, F, A, C, E
8 Multiple Choice Community assessment methods A
9 Multiple Choice Writing measurable program objectives (SMART) B
10 Multiple Choice Health Belief Model B
11 Select All That Apply Health literacy and client teaching A, C, D, E
12 Select All That Apply Personal safety during home visits A, B, C, E, G
13 Ordered Response Bag technique during a home visit B, E, D, A, C
14 Select All That Apply Medicare home health eligibility A, B, C, E
15 Multiple Choice Medicare hospice benefit A
16 Multiple Choice Intimate partner violence — screening and response D
17 Multiple Choice Suspected child maltreatment — mandated reporting D
18 Select All That Apply School nursing — head lice (pediculosis capitis) A, B, C, D, G
19 Multiple Choice School nursing — anaphylaxis D
20 Ordered Response Occupational health — hierarchy of controls D, B, C, E, A
21 Multiple Choice Occupational exposure — needlestick injury A
22 Multiple Choice Vaccine storage — temperature excursion C
23 Select All That Apply Sexually transmitted infections — chlamydia teaching A, B, C, D, G
and partner treatment
24 Multiple Choice Disaster triage — START A
25 Multiple Choice Radiation emergency — potassium iodide and B
protective actions
26 Multiple Choice Chemical exposure — decontamination B
27 Multiple Choice Culturally and linguistically appropriate care — using C
interpreters
28 Select All That Apply Harm reduction — naloxone teaching for opioid A, B, C, E, G
overdose
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 ANSWER KEY & RATIONALES
# Format Topic Answer
29 Multiple Choice Family assessment tools — ecomap D
30 Multiple Choice Social determinants of health (Healthy People 2030) A
31 NGN · Matrix Multiple Levels of prevention Primary: 1, 4, 7 · Secondary: 2, 5, 8 ·
Choice Tertiary: 3, 6, 9
32 NGN · Bowtie Childhood lead poisoning Condition: Lead poisoning · Actions:
A1, A2 · Parameters: P1, P2
33 NGN · Matrix Multiple Bioterrorism agents — transmission-based precautions Standard: 1, 4, 5 · Droplet: 3 · Contact
Choice + Airborne: 2 · Contact + Droplet: 6
34 NGN · Drop-Down Cloze Epidemiologic triangle — Lyme disease 1: agent · 2: host · 3: environment · 4:
permethrin-treated light clothing,
DEET, daily tick checks
35 NGN · Highlight Windshield survey — identifying threats to community 1, 3, 4, 6, 7, 9
health
36 NGN · Matrix Multiple Immunizations — contraindications and precautions Administer: 1, 3, 5, 7, 8 · Do not
Choice administer: 2, 4, 6
37 NGN · Matrix Multiple Transtheoretical (Stages of Change) model Precontemplation: 1 · Contemplation:
Choice 2 · Preparation: 3, 6 · Action: 4 ·
Maintenance: 5
38 NGN · Trend (Multiple Surveillance data trend — syphilis and congenital A, B, C, D
Response) syphilis
39 NGN · Bowtie Occupational health — organophosphate pesticide Condition: Organophosphate
poisoning poisoning · Actions: A1, A2 ·
Parameters: P1, P2
40 NGN · Drop-Down Cloze Program evaluation — process, impact, outcome, 1: process · 2: impact · 3: outcome · 4:
summative summative
41 NGN · Matrix Multiple Phases of disaster management Mitigation: 1, 2 · Preparedness: 3, 4, 5
Choice · Response: 6, 7 · Recovery: 8, 9
42 NGN · Highlight Recognizing indicators of intimate partner violence 1, 2, 3, 4, 6, 9
during pregnancy
43 NGN · Matrix Multiple Viral hepatitis — transmission and prevention A: fecal–oral + vaccine · B:
Response blood/sexual/perinatal + vaccine · C:
blood/sexual/perinatal · D:
blood/sexual/perinatal + vaccine · E:
fecal–oral
44 NGN · Matrix Multiple Disaster mental health — expected reactions versus Expected: 1, 2, 4, 7 · Referral: 3, 5, 6
Choice need for referral
45 NGN · Drop-Down Ethics — allocation of scarce resources 1: LTCF residents · 2: highest risk of
Rationale severe complications and death · 3:
utilitarianism
46 NGN · Multiple Response Food safety teaching A, D, E, F, H
(Select All That Apply)
47 NGN · Multiple Response Case Study 1 — Recognizing cues in a foodborne A, B, C, D
(Select All That Apply) outbreak
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 ANSWER KEY & RATIONALES
# Format Topic Answer
48 NGN · Drop-Down Cloze Case Study 1 — Analyzing cues: identifying the likely 1: STEC O157:H7 · 2: bloody diarrhea,
pathogen and complication cramps, little fever, 3–4 days after
undercooked ground beef · 3:
hemolytic uremic syndrome
49 NGN · Multiple Choice Case Study 1 — Prioritizing among callers C
50 NGN · Calculation Case Study 1 — Calculating a food-specific attack rate C
51 NGN · Matrix Multiple Case Study 1 — Taking action to control the outbreak Indicated: 1, 4, 5, 6, 7 ·
Choice Contraindicated: 2, 3, 8
52 NGN · Matrix Multiple Case Study 1 — Evaluating outbreak control measures Effective: 1, 2, 5, 6 · Further action: 3,
Choice 4
53 NGN · Multiple Response Case Study 2 — Recognizing cues during a home health A, B, C, D, E, F
(Select All That Apply) visit
54 NGN · Drop-Down Cloze Case Study 2 — Analyzing cues: heart failure 1: fluid volume excess from
exacerbation and financial exploitation worsening HF · 2: skipped furosemide
and high-sodium diet · 3: possible
elder financial exploitation
55 NGN · Multiple Choice Case Study 2 — Prioritizing client problems A
56 NGN · Multiple Response Case Study 2 — Generating solutions for a complex A, B, C, D, G, H
(Select All That Apply) home health client
57 NGN · Matrix Multiple Case Study 2 — Taking action on home safety Indicated: 1, 2, 3, 6 · Contraindicated:
Choice 4, 5, 7
58 NGN · Matrix Multiple Case Study 2 — Evaluating outcomes after 2 weeks Improved: 1, 2, 4, 5 · Not improved:
Choice 3, 6
59 NGN · Multiple Response Case Study 3 — Recognizing cues in a disaster shelter A, B, C, D
(Select All That Apply)
60 NGN · Drop-Down Cloze Case Study 3 — Analyzing cues: carbon monoxide 1: CO poisoning · 2: falsely reassuring
poisoning and hyperkalemia · 3: oximeters can’t distinguish COHb
from O2Hb · 4: hyperkalemia
61 NGN · Multiple Choice Case Study 3 — Prioritizing shelter residents C
62 NGN · Multiple Response Case Study 3 — Generating solutions for a shelter A, B, C, D, G, H
(Select All That Apply) gastroenteritis outbreak
63 NGN · Matrix Multiple Case Study 3 — Taking action for CO poisoning, Indicated: 1, 4, 5, 7 · Contraindicated:
Choice hyperkalemia, and generator safety 2, 3, 6
64 NGN · Matrix Multiple Case Study 3 — Evaluating outcomes in the shelter on Effective: 1, 2, 4, 6 · Not effective: 3, 5
Choice Day 5
65 NGN · Multiple Response Case Study 4 — Recognizing cues of possible active A, B, C, F
(Select All That Apply) tuberculosis among contacts
66 NGN · Matrix Multiple Case Study 4 — Interpreting tuberculin skin test results Positive: 1, 2, 4, 6 · Negative: 3, 5
Choice
67 NGN · Multiple Choice Case Study 4 — Prioritizing contacts for evaluation and D
treatment
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 ANSWER KEY & RATIONALES
# Format Topic Answer
68 NGN · Multiple Response Case Study 4 — Generating solutions: treatment A, B, D, E, G
(Select All That Apply) adherence and transmission control
69 NGN · Matrix Multiple Case Study 4 — Teaching about latent TB infection Accurate: 1, 2, 3, 6, 7 · Needs further
Choice treatment with rifampin teaching: 4, 5
70 NGN · Matrix Multiple Case Study 4 — Evaluating outcomes of the contact Effective: 1, 4, 5 · Not effective: 2, 3, 6
Choice investigation
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 ANSWER KEY & RATIONALES
Full Rationales — Items 1–70
Correct answer · full rationale · option-by-option analysis · key takeaway
ITEM 1 Multiple Choice · Management of Care · Cognitive level: Analyze
Topic: Core functions of public health · NCJMM step: Analyze Cues
Question: Which activity should the nurse classify under the core function of assurance?
✔ CORRECT ANSWER: B — Arranging for and monitoring services in underserved zip codes
Full Rationale
The three core functions of public health organize the 10 Essential Public Health Services and describe what public
health agencies — and public health nurses — do for populations:
1. Assessment — systematically collecting, analyzing, and sharing data about the health of the community. Examples:
surveillance of diseases and risk factors, community health assessments, epidemiologic investigations, analyzing vital
statistics and screening data, and identifying health problems and their distribution across groups.
2. Policy development — using the evidence from assessment to develop policies, plans, laws, and priorities that
support individual and community health. Examples: advocating for or testifying in support of legislation, building
coalitions and community partnerships to set priorities, writing community health improvement plans, and informing
decision-makers.
3. Assurance — making sure that necessary services are available, accessible, and of acceptable quality for
everyone. Examples: providing services directly or linking people to services when they are not otherwise available,
enforcing laws and regulations, ensuring a competent workforce, and evaluating the effectiveness, accessibility, and
quality of services.
The nurse’s mobile-clinic activity is assurance because it ensures access to needed services in areas with a
documented gap (no pediatric primary care provider) and evaluates whether families are actually receiving those
services. A useful way to remember the three functions: assessment asks “What is the problem?”; policy development
asks “What should we do about it?”; and assurance asks “Are the needed services being delivered, and are they
working?”
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 ANSWER KEY & RATIONALES
Why Each Option Is Right or Wrong
A — Organizing a coalition to draft a Building a coalition and drafting a community action plan is policy
community action plan for healthy development, because it involves mobilizing partnerships and setting
food access priorities and plans based on assessment data.
✘ INCORRECT
B — Arranging for a mobile clinic to Arranging for services where none exist and monitoring whether families
provide services in zip codes without a receive them is assurance — ensuring access to necessary, quality services
pediatric provider and monitoring and evaluating their delivery.
whether families receive the services
✔ CORRECT
C — Testifying before the county Testifying in support of an ordinance is policy development — using
board of commissioners in support of evidence to influence laws and regulations that promote health.
the vending-machine ordinance
✘ INCORRECT
D — Analyzing body mass index data Collecting and analyzing population data to identify the extent and
from the school districts and distribution of a health problem is assessment, the first core function. This
comparing rates by zip code step identifies the problem but does not ensure that services are delivered.
✘ INCORRECT
KEY TAKEAWAY & TEST-TAKING STRATEGY
Assessment = gather and analyze data. Policy development = use data to create plans, laws, coalitions, and
advocacy. Assurance = make sure services are provided, accessible, enforced, and evaluated.
ITEM 2 Multiple Choice · Health Promotion and Maintenance · Cognitive level: Analyze
Topic: Epidemiologic study designs · NCJMM step: Analyze Cues
Question: Which type of epidemiologic study is the team conducting?
✔ CORRECT ANSWER: C — Case-control study
Full Rationale
Epidemiologic studies are classified by how participants are selected and in which direction the investigators look
(from exposure to outcome, or from outcome back to exposure).
Case-control study (retrospective): Investigators begin with the outcome — they select people who have the disease
(cases) and people who do not have it (controls) — and then look backward to compare their past exposures. The
measure of association is the odds ratio. Case-control studies are efficient for rare diseases and for diseases with long
latency periods, because the investigators do not have to wait years for cases to develop. Their main weakness is
recall bias (cases may remember past exposures differently from controls).
Cohort study (usually prospective): Investigators begin with exposure — they identify people who are exposed and
not exposed and who are free of the disease — and follow them forward in time to see who develops the outcome.
Cohort studies calculate incidence and relative risk, and they are well suited to common outcomes but are expensive
and slow for rare diseases. (Retrospective cohort studies use existing records but still move from exposure to
outcome.)
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 70 Every NCJMM
ANSWERS FULL RATIONALES OPTION EXPLAINED STEP LABELLED
This key gives the correct answer to every item in the Practice Exam Booklet, followed by a full rationale explaining the
nursing concept, an option-by-option analysis of why each choice is correct or incorrect, and a key takeaway with a
test-taking strategy. Each option is restated so the key can be studied on its own.
Use the Quick Answer Grid on the next pages to score yourself first, then study the full rationale for every item —
including the ones you answered correctly.
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 ANSWER KEY & RATIONALES
Quick Answer Grid
Score yourself here first. Full rationales for every item follow.
# Format Topic Answer
1 Multiple Choice Core functions of public health B
2 Multiple Choice Epidemiologic study designs C
3 Calculation Calculating an incidence rate C
4 Calculation Calculating point prevalence D
5 Calculation Screening test sensitivity B
6 Calculation Calculating the infant mortality rate C
7 Ordered Response Steps of an outbreak investigation B, D, F, A, C, E
8 Multiple Choice Community assessment methods A
9 Multiple Choice Writing measurable program objectives (SMART) B
10 Multiple Choice Health Belief Model B
11 Select All That Apply Health literacy and client teaching A, C, D, E
12 Select All That Apply Personal safety during home visits A, B, C, E, G
13 Ordered Response Bag technique during a home visit B, E, D, A, C
14 Select All That Apply Medicare home health eligibility A, B, C, E
15 Multiple Choice Medicare hospice benefit A
16 Multiple Choice Intimate partner violence — screening and response D
17 Multiple Choice Suspected child maltreatment — mandated reporting D
18 Select All That Apply School nursing — head lice (pediculosis capitis) A, B, C, D, G
19 Multiple Choice School nursing — anaphylaxis D
20 Ordered Response Occupational health — hierarchy of controls D, B, C, E, A
21 Multiple Choice Occupational exposure — needlestick injury A
22 Multiple Choice Vaccine storage — temperature excursion C
23 Select All That Apply Sexually transmitted infections — chlamydia teaching A, B, C, D, G
and partner treatment
24 Multiple Choice Disaster triage — START A
25 Multiple Choice Radiation emergency — potassium iodide and B
protective actions
26 Multiple Choice Chemical exposure — decontamination B
27 Multiple Choice Culturally and linguistically appropriate care — using C
interpreters
28 Select All That Apply Harm reduction — naloxone teaching for opioid A, B, C, E, G
overdose
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 ANSWER KEY & RATIONALES
# Format Topic Answer
29 Multiple Choice Family assessment tools — ecomap D
30 Multiple Choice Social determinants of health (Healthy People 2030) A
31 NGN · Matrix Multiple Levels of prevention Primary: 1, 4, 7 · Secondary: 2, 5, 8 ·
Choice Tertiary: 3, 6, 9
32 NGN · Bowtie Childhood lead poisoning Condition: Lead poisoning · Actions:
A1, A2 · Parameters: P1, P2
33 NGN · Matrix Multiple Bioterrorism agents — transmission-based precautions Standard: 1, 4, 5 · Droplet: 3 · Contact
Choice + Airborne: 2 · Contact + Droplet: 6
34 NGN · Drop-Down Cloze Epidemiologic triangle — Lyme disease 1: agent · 2: host · 3: environment · 4:
permethrin-treated light clothing,
DEET, daily tick checks
35 NGN · Highlight Windshield survey — identifying threats to community 1, 3, 4, 6, 7, 9
health
36 NGN · Matrix Multiple Immunizations — contraindications and precautions Administer: 1, 3, 5, 7, 8 · Do not
Choice administer: 2, 4, 6
37 NGN · Matrix Multiple Transtheoretical (Stages of Change) model Precontemplation: 1 · Contemplation:
Choice 2 · Preparation: 3, 6 · Action: 4 ·
Maintenance: 5
38 NGN · Trend (Multiple Surveillance data trend — syphilis and congenital A, B, C, D
Response) syphilis
39 NGN · Bowtie Occupational health — organophosphate pesticide Condition: Organophosphate
poisoning poisoning · Actions: A1, A2 ·
Parameters: P1, P2
40 NGN · Drop-Down Cloze Program evaluation — process, impact, outcome, 1: process · 2: impact · 3: outcome · 4:
summative summative
41 NGN · Matrix Multiple Phases of disaster management Mitigation: 1, 2 · Preparedness: 3, 4, 5
Choice · Response: 6, 7 · Recovery: 8, 9
42 NGN · Highlight Recognizing indicators of intimate partner violence 1, 2, 3, 4, 6, 9
during pregnancy
43 NGN · Matrix Multiple Viral hepatitis — transmission and prevention A: fecal–oral + vaccine · B:
Response blood/sexual/perinatal + vaccine · C:
blood/sexual/perinatal · D:
blood/sexual/perinatal + vaccine · E:
fecal–oral
44 NGN · Matrix Multiple Disaster mental health — expected reactions versus Expected: 1, 2, 4, 7 · Referral: 3, 5, 6
Choice need for referral
45 NGN · Drop-Down Ethics — allocation of scarce resources 1: LTCF residents · 2: highest risk of
Rationale severe complications and death · 3:
utilitarianism
46 NGN · Multiple Response Food safety teaching A, D, E, F, H
(Select All That Apply)
47 NGN · Multiple Response Case Study 1 — Recognizing cues in a foodborne A, B, C, D
(Select All That Apply) outbreak
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 ANSWER KEY & RATIONALES
# Format Topic Answer
48 NGN · Drop-Down Cloze Case Study 1 — Analyzing cues: identifying the likely 1: STEC O157:H7 · 2: bloody diarrhea,
pathogen and complication cramps, little fever, 3–4 days after
undercooked ground beef · 3:
hemolytic uremic syndrome
49 NGN · Multiple Choice Case Study 1 — Prioritizing among callers C
50 NGN · Calculation Case Study 1 — Calculating a food-specific attack rate C
51 NGN · Matrix Multiple Case Study 1 — Taking action to control the outbreak Indicated: 1, 4, 5, 6, 7 ·
Choice Contraindicated: 2, 3, 8
52 NGN · Matrix Multiple Case Study 1 — Evaluating outbreak control measures Effective: 1, 2, 5, 6 · Further action: 3,
Choice 4
53 NGN · Multiple Response Case Study 2 — Recognizing cues during a home health A, B, C, D, E, F
(Select All That Apply) visit
54 NGN · Drop-Down Cloze Case Study 2 — Analyzing cues: heart failure 1: fluid volume excess from
exacerbation and financial exploitation worsening HF · 2: skipped furosemide
and high-sodium diet · 3: possible
elder financial exploitation
55 NGN · Multiple Choice Case Study 2 — Prioritizing client problems A
56 NGN · Multiple Response Case Study 2 — Generating solutions for a complex A, B, C, D, G, H
(Select All That Apply) home health client
57 NGN · Matrix Multiple Case Study 2 — Taking action on home safety Indicated: 1, 2, 3, 6 · Contraindicated:
Choice 4, 5, 7
58 NGN · Matrix Multiple Case Study 2 — Evaluating outcomes after 2 weeks Improved: 1, 2, 4, 5 · Not improved:
Choice 3, 6
59 NGN · Multiple Response Case Study 3 — Recognizing cues in a disaster shelter A, B, C, D
(Select All That Apply)
60 NGN · Drop-Down Cloze Case Study 3 — Analyzing cues: carbon monoxide 1: CO poisoning · 2: falsely reassuring
poisoning and hyperkalemia · 3: oximeters can’t distinguish COHb
from O2Hb · 4: hyperkalemia
61 NGN · Multiple Choice Case Study 3 — Prioritizing shelter residents C
62 NGN · Multiple Response Case Study 3 — Generating solutions for a shelter A, B, C, D, G, H
(Select All That Apply) gastroenteritis outbreak
63 NGN · Matrix Multiple Case Study 3 — Taking action for CO poisoning, Indicated: 1, 4, 5, 7 · Contraindicated:
Choice hyperkalemia, and generator safety 2, 3, 6
64 NGN · Matrix Multiple Case Study 3 — Evaluating outcomes in the shelter on Effective: 1, 2, 4, 6 · Not effective: 3, 5
Choice Day 5
65 NGN · Multiple Response Case Study 4 — Recognizing cues of possible active A, B, C, F
(Select All That Apply) tuberculosis among contacts
66 NGN · Matrix Multiple Case Study 4 — Interpreting tuberculin skin test results Positive: 1, 2, 4, 6 · Negative: 3, 5
Choice
67 NGN · Multiple Choice Case Study 4 — Prioritizing contacts for evaluation and D
treatment
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 ANSWER KEY & RATIONALES
# Format Topic Answer
68 NGN · Multiple Response Case Study 4 — Generating solutions: treatment A, B, D, E, G
(Select All That Apply) adherence and transmission control
69 NGN · Matrix Multiple Case Study 4 — Teaching about latent TB infection Accurate: 1, 2, 3, 6, 7 · Needs further
Choice treatment with rifampin teaching: 4, 5
70 NGN · Matrix Multiple Case Study 4 — Evaluating outcomes of the contact Effective: 1, 4, 5 · Not effective: 2, 3, 6
Choice investigation
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 ANSWER KEY & RATIONALES
Full Rationales — Items 1–70
Correct answer · full rationale · option-by-option analysis · key takeaway
ITEM 1 Multiple Choice · Management of Care · Cognitive level: Analyze
Topic: Core functions of public health · NCJMM step: Analyze Cues
Question: Which activity should the nurse classify under the core function of assurance?
✔ CORRECT ANSWER: B — Arranging for and monitoring services in underserved zip codes
Full Rationale
The three core functions of public health organize the 10 Essential Public Health Services and describe what public
health agencies — and public health nurses — do for populations:
1. Assessment — systematically collecting, analyzing, and sharing data about the health of the community. Examples:
surveillance of diseases and risk factors, community health assessments, epidemiologic investigations, analyzing vital
statistics and screening data, and identifying health problems and their distribution across groups.
2. Policy development — using the evidence from assessment to develop policies, plans, laws, and priorities that
support individual and community health. Examples: advocating for or testifying in support of legislation, building
coalitions and community partnerships to set priorities, writing community health improvement plans, and informing
decision-makers.
3. Assurance — making sure that necessary services are available, accessible, and of acceptable quality for
everyone. Examples: providing services directly or linking people to services when they are not otherwise available,
enforcing laws and regulations, ensuring a competent workforce, and evaluating the effectiveness, accessibility, and
quality of services.
The nurse’s mobile-clinic activity is assurance because it ensures access to needed services in areas with a
documented gap (no pediatric primary care provider) and evaluates whether families are actually receiving those
services. A useful way to remember the three functions: assessment asks “What is the problem?”; policy development
asks “What should we do about it?”; and assurance asks “Are the needed services being delivered, and are they
working?”
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 ANSWER KEY & RATIONALES
Why Each Option Is Right or Wrong
A — Organizing a coalition to draft a Building a coalition and drafting a community action plan is policy
community action plan for healthy development, because it involves mobilizing partnerships and setting
food access priorities and plans based on assessment data.
✘ INCORRECT
B — Arranging for a mobile clinic to Arranging for services where none exist and monitoring whether families
provide services in zip codes without a receive them is assurance — ensuring access to necessary, quality services
pediatric provider and monitoring and evaluating their delivery.
whether families receive the services
✔ CORRECT
C — Testifying before the county Testifying in support of an ordinance is policy development — using
board of commissioners in support of evidence to influence laws and regulations that promote health.
the vending-machine ordinance
✘ INCORRECT
D — Analyzing body mass index data Collecting and analyzing population data to identify the extent and
from the school districts and distribution of a health problem is assessment, the first core function. This
comparing rates by zip code step identifies the problem but does not ensure that services are delivered.
✘ INCORRECT
KEY TAKEAWAY & TEST-TAKING STRATEGY
Assessment = gather and analyze data. Policy development = use data to create plans, laws, coalitions, and
advocacy. Assurance = make sure services are provided, accessible, enforced, and evaluated.
ITEM 2 Multiple Choice · Health Promotion and Maintenance · Cognitive level: Analyze
Topic: Epidemiologic study designs · NCJMM step: Analyze Cues
Question: Which type of epidemiologic study is the team conducting?
✔ CORRECT ANSWER: C — Case-control study
Full Rationale
Epidemiologic studies are classified by how participants are selected and in which direction the investigators look
(from exposure to outcome, or from outcome back to exposure).
Case-control study (retrospective): Investigators begin with the outcome — they select people who have the disease
(cases) and people who do not have it (controls) — and then look backward to compare their past exposures. The
measure of association is the odds ratio. Case-control studies are efficient for rare diseases and for diseases with long
latency periods, because the investigators do not have to wait years for cases to develop. Their main weakness is
recall bias (cases may remember past exposures differently from controls).
Cohort study (usually prospective): Investigators begin with exposure — they identify people who are exposed and
not exposed and who are free of the disease — and follow them forward in time to see who develops the outcome.
Cohort studies calculate incidence and relative risk, and they are well suited to common outcomes but are expensive
and slow for rare diseases. (Retrospective cohort studies use existing records but still move from exposure to
outcome.)
Original practice items written for study purposes. Not affiliated with or endorsed by ATI Nursing Education. 7
