K310
Public Health
Proctored Final Exam Review
(With Solutions)
2026
1
,1. Case: A regional health department detects a sudden rise in acute
gastroenteritis cases after heavy rains. Which surveillance approach
will most rapidly identify the likely contaminated water source?
- A. Passive surveillance of hospital discharge data
- B. Syndromic surveillance combined with rapid environmental
sampling and case‑control study
- C. Annual prevalence survey
- D. Sentinel surveillance in remote clinics only
Answer: B. Syndromic surveillance combined with rapid
environmental sampling and case‑control study
Rationale: Syndromic signals provide early detection; environmental
testing plus a case‑control design quickly links exposure to illness.
2. Case: A national immunization program considers switching from a
2‑dose to a 3‑dose schedule for a new vaccine. Which evaluation
metric best assesses incremental population benefit?
- A. Vaccine cold‑chain capacity only
- B. Incremental cost‑effectiveness ratio (cost per DALY averted)
comparing 2‑dose vs 3‑dose strategies
- C. Number of syringes used
- D. Provider preference survey
Answer: B. Incremental cost‑effectiveness ratio (cost per DALY
averted) comparing 2‑dose vs 3‑dose strategies
Rationale: ICER quantifies additional health benefit per additional
cost, informing resource allocation at population level.
3. Case: During an influenza pandemic, a hospital must prioritize
limited antiviral stock. Which ethical principle and operational
criterion should guide allocation?
- A. Random allocation only
- B. Prioritize healthcare workers essential to response and patients
with highest likelihood of benefit (utility and reciprocity)
- C. First‑come, first‑served regardless of role
2
, - D. Allocate to wealthiest patients
Answer: B. Prioritize healthcare workers essential to response and
patients with highest likelihood of benefit (utility and reciprocity)
Rationale: Combining utility (maximize lives saved) and reciprocity
(protect responders) is ethically defensible in emergencies.
4. Case: A community health program aims to reduce type 2 diabetes
incidence. Which upstream intervention is most likely to produce
sustained population impact?
- A. Individual counseling only
- B. Zoning policies to increase access to healthy food and safe
active‑transport infrastructure
- C. One‑time health fair screening
- D. Short social media campaign without policy change
Answer: B. Zoning policies to increase access to healthy food and
safe active‑transport infrastructure
Rationale: Structural interventions alter environmental
determinants and sustain behavior change at population scale.
5. Case: A surveillance system reports a disease with low prevalence
but high case fatality. Which performance attribute is most critical for
the system?
- A. High specificity only
- B. High sensitivity and timeliness to detect rare but severe cases
early
- C. Low cost only
- D. High user satisfaction only
Answer: B. High sensitivity and timeliness to detect rare but severe
cases early
Rationale: Early detection of rare, high‑impact events requires
sensitive, timely surveillance to enable rapid response.
6. Case: A public health team models an outbreak using an SEIR
model. Which parameter change would most reduce the basic
3
Public Health
Proctored Final Exam Review
(With Solutions)
2026
1
,1. Case: A regional health department detects a sudden rise in acute
gastroenteritis cases after heavy rains. Which surveillance approach
will most rapidly identify the likely contaminated water source?
- A. Passive surveillance of hospital discharge data
- B. Syndromic surveillance combined with rapid environmental
sampling and case‑control study
- C. Annual prevalence survey
- D. Sentinel surveillance in remote clinics only
Answer: B. Syndromic surveillance combined with rapid
environmental sampling and case‑control study
Rationale: Syndromic signals provide early detection; environmental
testing plus a case‑control design quickly links exposure to illness.
2. Case: A national immunization program considers switching from a
2‑dose to a 3‑dose schedule for a new vaccine. Which evaluation
metric best assesses incremental population benefit?
- A. Vaccine cold‑chain capacity only
- B. Incremental cost‑effectiveness ratio (cost per DALY averted)
comparing 2‑dose vs 3‑dose strategies
- C. Number of syringes used
- D. Provider preference survey
Answer: B. Incremental cost‑effectiveness ratio (cost per DALY
averted) comparing 2‑dose vs 3‑dose strategies
Rationale: ICER quantifies additional health benefit per additional
cost, informing resource allocation at population level.
3. Case: During an influenza pandemic, a hospital must prioritize
limited antiviral stock. Which ethical principle and operational
criterion should guide allocation?
- A. Random allocation only
- B. Prioritize healthcare workers essential to response and patients
with highest likelihood of benefit (utility and reciprocity)
- C. First‑come, first‑served regardless of role
2
, - D. Allocate to wealthiest patients
Answer: B. Prioritize healthcare workers essential to response and
patients with highest likelihood of benefit (utility and reciprocity)
Rationale: Combining utility (maximize lives saved) and reciprocity
(protect responders) is ethically defensible in emergencies.
4. Case: A community health program aims to reduce type 2 diabetes
incidence. Which upstream intervention is most likely to produce
sustained population impact?
- A. Individual counseling only
- B. Zoning policies to increase access to healthy food and safe
active‑transport infrastructure
- C. One‑time health fair screening
- D. Short social media campaign without policy change
Answer: B. Zoning policies to increase access to healthy food and
safe active‑transport infrastructure
Rationale: Structural interventions alter environmental
determinants and sustain behavior change at population scale.
5. Case: A surveillance system reports a disease with low prevalence
but high case fatality. Which performance attribute is most critical for
the system?
- A. High specificity only
- B. High sensitivity and timeliness to detect rare but severe cases
early
- C. Low cost only
- D. High user satisfaction only
Answer: B. High sensitivity and timeliness to detect rare but severe
cases early
Rationale: Early detection of rare, high‑impact events requires
sensitive, timely surveillance to enable rapid response.
6. Case: A public health team models an outbreak using an SEIR
model. Which parameter change would most reduce the basic
3
