CPH Exam Practice Questions
Which of the following estimates of an odds ratio most strongly suggests a computational error? - 7.8 - 1.2 - -0.9 - 20.9
-0.9
Out of a population of 500,000 people, 500 were observed for two years. Five developed disease. What is the incidence density rate?
2.5/1000
U.S. mandates Creutzfeld-Jacob disease, a prion disease to be nationally notifiable from all the states. What kind of infectious agent is a prion?
A protein
National Physical Activity Guidelines for Americans suggest adults need to participate in at least 150 minutes per week in moderate intensity physical activity for substantial health benefits. A study was designed to test whether there is the difference in mean time (in minutes) spent in moderate intensity physical activity in adults with no, mild, moderate and severe depression. Time spent in moderate intensity physical activity is a continuous measure which can be assessed using an accelerometer. Which among the following is the most appropriate statistical technique to test the difference in time spent in moderate intensity physical activity between adults with no, mild, moderate and severe depression? - Spearman correlation - ANOVA - t-test - chi-quared test
ANOVA
In low resource countries during an outbreak, what simple, low-tech sanitation measure can dramatically reduce the spread of enteric bacteria and viruses?
Add chlorine to water storage containers
New to your leadership position, you realize that two of the programs you manage have similar functions, and work with the same population in the same area. Data trends over the past 5 years suggest that the health condition has improved significantly. You decide that only one program is needed to provide the necessary services to the community. This is an example of:
An analysis to justify and allocate resources
A public health professional is asked to conduct a needs assessment for a community. A needs assessment:
Assists to identify and prioritize health problems
Facilitation takes work and in a meeting of multiple stakeholders it becomes important for the facilitator to prioritize his or her role. Above all the facilitator should:
Be neutral
Which of the following methods is the most accurate exposure assessment in workers? - Determination of the chemical in the air - Biomonitoring of chemicals or metabolites of the chemicals in blood and urine - Determination of the chemical on the skin - Estimation of the exposure by taking an occupational history
Biomonitoring of chemicals or metabolites of the chemicals in blood and urine
By what programmatic mechanism does the U.S. Environmental Protection Agency (EPA) work with states to implement national environmental standards such as NAAQS?
By using a State Implementation Plan (SIP) approved by the EPA
Which of the following best describes a study where exposure histories is collected from a group of persons with a specific disease and from a comparison group to determine the relative frequency of an exposure? - Clinical Trial - Randomized control trial - Case-control - Cohort
Case-control
Which of the following disinfection methods is most commonly used in US drinking water supply systems? - Ozonation - Bromination - Chlorination - Ultraviolet irradiation
Chlorination
Which of these has been defined as a core function of public health? - Maintaining the census to define populations - Consulting stakeholders to decide what best serves public interest - Conducting research to solve all population health problems - Acting in an ethical manner
Consulting stakeholders to decide what best serves public interest
When making decisions, public health leaders face the ethical challenge of:
Creating maximum benefit for all while minimizing individual harm
To evaluate public health performance, we consider capacity, process, and outcomes. Which of the following represents an example of an "outcome?" - An increase in the types of vaccines offered to protect against common childhood diseases - Decrease in number of children age 0-2 with vaccine preventable diseases - Routine health care - Increase in number of patients seen in the mobile immunization van
Decrease in number of children age 0-2 with vaccine preventable diseases
When beginning work with a coalition of community groups to improve health outcomes in the community, a key first step would be to:
Develop a shared vision
Which of the following is the best example of a process evaluation for a program designed to decrease mortality from drinking and driving among high school youth? - Document change in mortality associated with drinking and driving - Document change in numbers of youth riding with impaired drivers - Document risks of riding with impaired drivers - Document number of students who attend a drinking and driving education program
Document number of students who attend a drinking and driving education program
Which term is used to characterize the movement addressing the social condition of unequal distribution of environmental hazards experienced by minority populations or groups with low income?
Environmental justice
Determining whether to continue or modify but not terminate a program is a reasonable objective of a:
Formative evaluation
For the governance of an organization, which of the following should be measurable? - Vision and values - Mission and vision - Goals and objectives - Mission and goals
Goals and objectives
Activists criticized America's public health policy response during initial years of its AIDS epidemic on the grounds that: - Absence of universal health care insurance prevented victims from accessing expensive treatment - Government indifference and political infighting resulted in apathy toward a suffering gay community. - Too much money was being spent on treatment, not enough on prevention to stop the epidemic. - Too much resource was being spent on urging people to change risk behaviors, not enough on medication.
Government indifference and political infighting resulted in apathy toward a suffering gay community.
The local health jurisdiction is seeking governmental funding to address breast cancer which has a lower incidence rate in group X than in group Y, though group X has a higher mortality rate. This is an example of:
Health disparity
An individual's capacity to obtain, process, and understand basic health information and services needed to make basic health decisions is called:
Health literacy
That individuals are motivated to satisfy or pursue food, drink, or shelter before focusing on esteem or self-actualization is an example of which model?
Hierarchy of needs (Maslow)
The epidemiologic triangle (triad) describes the occurrence of disease as an interaction between what three factors?
Host, agent and environment
HACCP is a food safety system employed to:
Identify and control problems that may cause foodborne illness before they happen
To report on a program to local officials about the degree to which the program meets its ultimate goal and provides evidence for use in policy and funding decisions, what is needed?
Impact evaluation
The most important reason for reduced mortality during the initial stage of a demographic/epidemiologic transition in a population is:
Improved sanitation
Historically, which of the following had the greatest impact on average life expectancy? - Vaccinations for infectious diseases - Improvements in sanitation and hygiene - Advances in medical care technology - Increased application of health education
Improvements in sanitation and hygiene
Which of the following practices enhances equity across populations when making health policy decisions in a community? - Requiring randomized control evidence of effectiveness - Allocating resources based on population size - Collecting health-related data about the individuals in the community - Including diverse constituencies in the decision-making groups
Including diverse constituencies in the decision-making groups
Which of the following pairs of values are most likely to conflict during a response to a public health emergency? - Truth-telling versus community welfare - Beneficence versus justice - Individual autonomy versus community welfare - Community welfare versus justice
Individual autonomy versus community welfare
Societies have fostered discrimination against certain communities in various ways. Policy makers must address this to move toward health equity. One theory, which explains the reinforcing feedback loop of poor housing quality, lesser paying jobs, poor education and poor health outcomes, may be summarized as:
Institutional racism
Which statement best describes the role of public health professionals in government employ with respect to authoring manuscripts about their work for publication in peer-review journals? - Since, as government employees, they cannot sign copyright releases to publishers they cannot submit manuscripts as authors. - The role of government health departments does not include research nor writing for journals. - Conflict of interest and ethics rules allow public health department employees to write for government publications but not for-profit journals. - It is challenging to find the time and gain necessary internal clearances, but sharing lessons learned through such publication is an important aspect of professionalism.
It is challenging to find the time and gain necessary internal clearances, but sharing lessons learned through such publication is an important aspect of professionalism.
The primary disadvantage of incremental program budgeting is:
It may not reflect the current programmatic priorities of the organization
Which of the following are the three ethical principles outlined in the Belmont Report? - Beneficence, liberty, and risk reduction - Justice, beneficence, and respect for people - Quality, respect for people, and ethical treatment - Justice, respect for people, and integrity
Justice, beneficence, and respect for people
A district health department is trying to decide whether to invest in interpretation services and translated materials to address local language barriers, address needs of limited English proficient (LEP) clients and meet Federal requirements. The Four Factor Analysis-to guide LHDs in meeting these mandates and to provide recommendations for providing translated materials and interpretation services- is part of a: - National Standards for Culturally and Linguistically Appropriate Services (CLAS) Assessment - Language Needs Assessment - Health Resource Access Assessment - Community Literacy Assessment
Language Needs Assessment
Which of the following terms means that a tumor has spread to other locations within the body? - Malignany - Metastatic - Benign - Hyperplastic
Metastatic
In the PRECEDE-PROCEED model, the step in program planning where planners use data to identify and rank health problems is called:
Needs assessment
An anti-vaccine group is pressuring government to stop requiring vaccination of children because the disease incidence rate has become very low. The health department is defending the vaccination stance and looking for a way to explain this to legislators. In terms of systems theory, the relationship over time between required vaccination and decrease in incidence rate is a:
Negative feedback loop
High level of nitrates in groundwater are of particular concern in rural communities that rely on well water because:
Nitrates can cause "Blue-Baby Syndrome" in infants
Which of the following statements best characterizes research findings about trait-based approaches to leadership theory? - Intelligence, high energy, and initiative are necessary - Personality traits are irrelevant - No one set of traits has been established as necessary - Leaders are born, not made
No one set of traits has been established as necessary
Before implementing a research study that involves human subjects, which of the following is an ethical consideration: - Securing enough funding for the project - Reporting only data to support the hypothesis and highlights strengths - Ensuring that all participants receive an incentive upon completion of data collection - Obtaining an approval or a waiver from an Institutional Review Board prior to the start of the study
Obtaining an approval or a waiver from an Institutional Review Board prior to the start of the study
The sensitivity of a particular screening test for a disease is 95%, and the specificity is 90%. Which of the following statements is correct? - Of 100 people sampled from a population with the disease, the test will correctly detect 95 individuals as positive for the disease - Of 100 people sampled from a population with the disease, the test will correctly detect 90 individuals as positive for the disease - If a person tests positive, the probability of having the disease is 0.95 - If a person tests positive, the probability of having the disease is 0.90
Of 100 people sampled from a population with the disease, the test will correctly detect 95 individuals as positive for the disease
A case-control study comparing ovarian cancer cases with community controls found an odds ratio of 2.0 in relation to exposure to radiation. Which is the correct interpretation of the measure of association? - Women exposed to radiation had 2.0 times the risk of ovarian cancer when compared to women not exposed to radiation - Women exposed to radiation had 2.0 times the risk of ovarian cancer when compared to women without ovarian cancer - Ovarian cancer cases had 2.0 times the odds of exposure to radiation when compared to controls - Ovarian cancer cases had 2.0 times the odds of exposure to radiation when compared to controls with other cancers
Ovarian cancer cases had 2.0 times the odds of exposure to radiation when compared to controls
The Theory of Planned Behavior was built on the Theory of Reasoned Action. Which component was added? - Perceived behavioral control -Subjective norm - Behavioral Intentions - Attitude
Perceived behavioral control
Generally, the largest single component in most public health budgets, and therefore the one with which managers must be most familiar is:
Personnel
The Dartmouth Atlas of Healthcare demonstrates that small area variations in Medicare expenditures across geographic areas are primarily attributable to differences in: - Physician practice styles - Consumer preferences for high-cost services - Age of the population served - Health status of the population served
Physician practice styles
The U.S. Supreme Court interpreted the 10th amendment to the U.S. Constitution to give the states 'police powers' to pursue public health initiatives that protect general welfare, however differences in such initiatives persist across the states because:
Police powers permit each state the right to define and delegate authority and responsibility for public health services
A supervisor asks three staff members to work together on developing and implementing a community health needs assessment. The supervisor has requested the final needs assessment to be completed in three weeks and after two and a half weeks, only two of the staff members have completed their sections. What would be the best way for the supervisor to give constructive feedback to the staff member who has not completed their assignment?
Prepare by developing a "feedback sandwich" approach with two reinforcing statements surrounding a corrective statement.
In the planning process, the group being served is referred to as the:
Priority Population
The first step in the policy process typically is:
Problem definition
Social marketing is the use of marketing principles to influence human behavior in order to improve health. Which one below is NOT one of the 4 P's of social marketing? - Price - Promotion - Place - Process
Process
Waiting until a program or intervention is complete to begin evaluation activities misses important and valuable opportunities for what type of evaluation?
Process evaluation
The four P's of public health marketing services include:
Product, price, place, and promotion
Which measure of mortality would you calculate to determine the proportion of all deaths that is caused by heart disease?
Proportionate mortality ratio
An understaffed city health department submits an annual budget to it's city leadership; including a request for an additional 6.0 FTE positions. This budget includes the funding request but no accompanying narrative and was submitted despite the City Manager's request for each department to avoid any funding increases in their requests. When asked about this, the department responds by: - Submitting another budget with no new positions. - Asking another department to decrease their budget by 6.0 FTE positions. - Provide information to justify the increased number of positions. - Reaching out to the media to gain citizen support for the new positions.
Provide information to justify the increased number of positions.
The best example of community engagement and empowerment refers to which of the following? - Teaching community members how to best communicate with providers - Conducting health needs and assets assessment with communities and sharing the information - Teaching self-determination to community members - Reciprocal transfer of knowledge and skills among all collaborators and community partners
Reciprocal transfer of knowledge and skills among all collaborators and community partners
An incremental approach to program planning in public health:
Results in plans that may be immediately necessary but may overlap or leave gaps
Which of the following components of a strategic planning process in a public health agency has logical priority over the others? - Preparing an action plan for eradicating giardiasis in the municipal water system - Developing the operating budget and staffing plan for the agency - Reviewing (and revising) the vision and mission statements for the agency - Setting strategic goals for a three-year cycle
Reviewing (and revising) the vision and mission statements for the agency
Characteristics, attributes or exposures such as hypertension, unsafe sex, alcohol consumption, unsafe water that can increase the likelihood of developing disease or injury are known as
Risk factors
As a first step in public health emergency preparedness, jurisdictions should:
Self-assess their ability to address resource elements for each preparedness capability and then assess their ability to demonstrate the functions associated with each capability.
The nutrient-rich solids produced as a byproduct of municipal sewage treatment and often proposed for use as a soil amender in agriculture is termed:
Sludge
Income, interpersonal stress, and education level are all examples of ____________, which determine the overall health, and quality of life of our communities.
Social determinants
Public health actions frequently involve a balancing of individual rights vs. the good of the community. Where that balance is struck is based on:
Societal values
When setting goals and objectives, it is important that they are considered "SMART". The S in SMART stands for: - Scientific - Socially Significant - Statistically Significant - Specific
Specific
The objective of the National Environmental Policy Act of 1969 and its equivalent at the State level is to:
Subject a proposed major project or action to a comprehensive environmental review study
An appropriately tailored intervention message most importantly should:
Take into account characteristics of the target population
After reviewing evidence demonstrating increased survival of narcotic self-overdose after immediate naloxone administration, the State Commissioner of Health issues the following standing order: "This order authorizes pharmacists who maintain a current active license practicing in a pharmacy located in Virginia that maintains a current active pharmacy permit to dispense one of the following naloxone formulations (notes intranasal or autoinject kits options), in accordance the current Board of Pharmacy-approved protocol." "The State Good Samaritan Act states in part that any person who, in good faith prescribes, dispenses, or administers naloxone or other opioid antagonist used for overdose reversal in an emergency to an individual who is believed to be experiencing or about to experience a life-threatening opiate overdose shall not be liable for any civil damages for ordinary negligence in acts or omissions resulting from the rendering of such treatment if acting in accordance with the Good Samaritan Act or in his role as a member of an emergency medical services agency." This order demonstrates:
Tertiary Prevention and Harm Reduction Strategy
To learn more about the "natural course" of syphilis, from 1932-1972, the US Public Health Service left infected study participants (comprised of poor black men) untreated. This resulted in pain, blindness, infertility, and death, as well as transmission of the disease to partners and children. The Tuskegee Syphilis Study, is a sentinel public health event because of these ethical violations and resulted in:
The Belmont Report
Which of the following can be considered a concern with live, attenuated vaccines? - They are very expensive to produce - They produce a weak response and require booster shots - They can cause disease in an immunocompromised individual - People can develop allergic reactions to them
They can cause disease in an immunocompromised individual
For the first time scientists in the United States conducted a longitudinal study that followed children with Zika for one year. They found that even children who appeared with no deformities at birth developed specific developmental delays. Which communication criteria do Zika scientists meet when they share their research findings with their communities and global constituencies?
They provide strategic leadership in leading local and international solutions
The recent HIV/AIDS campaign to encourage testing and 'knowing your status' has resulted in an increase in testing in group A but has not had the intended impact in group B. In thinking about the campaign and to increase its impact on group B, the most important consideration in redesigning the print and social media content should be:
To conduct focus groups to learn more about the groups' beliefs and values
Public health agencies should be aware of how to communicate the role of public health with external stakeholders. What is the role of public health agencies when communicating with external stakeholders?
To promote the agency and engage in advocacy
In an effort to improve a research center's public image, the director commits to securing additional funding for faculty whose research has significant measurable community impact. This leadership style can be described as:
Transactional
Which term below refers to the concept of confirming conclusions from qualitative data through multiple data sources, multiple methods, multiple theories, or multiple data collectors.
Triangulation
Can federal environmental laws allow States to make parallel environmental laws?
Yes, if no less stringent than federal standards
A public health department government employee manages that department's non-infectious conditions epidemiology program. The program's recent report on traffic accident deaths has attracted attention. Mothers Against Drunk Drivers, a non-profit incorporation, has asked that person to simultaneously take a leadership role in MADD's program to oversee fund-raising activities and promote compliance with laws about drinking and driving. Would it be ethical for this person to accept MADD's offer of simultaneous employment?
Yes, provided the outside activity is not operated within the government agency, and the employee does not incur conflicts of interest, divulge confidential information nor receive special privileges or benefits.
Ethical standards apply to government officers and employees. For such individuals, these standards apply:
at all times, whether they are on or off duty.
Succession planning involves a defined plan to:
cultivate a new group of leaders
Succession planning involves a defined plan to: - cultivate a new group of leaders - outline new ideas for research studies - amend the mission and operations of an organization - update current programs and services to incorporate policy and regulatory changes
cultivate a new group of leaders
The primary purpose of strategic planning is to:
determine the direction an organization will pursue
The best use of clinical practice guidelines is as an:
indication of the best diagnostic and treatment practices based on the best available evidence.
In the design and implementation of public health data systems, installing security features should be:
inherent in privacy by design at all stages.
The biggest change in competencies for public health career professionals circa 2019 is
more emphasis on 'soft' skills for leading teams and on integration across technical skills
In the funding applications that state public health departments typically submit every year, program and organizational budget requests: - are not included, only research project funding is described. - are justified by reasonable numbers on accounting spreadsheets. - need explanation in a budget narrative. - tend to always be funded.
need explanation in a budget narrative.
An outbreak of pneumonia has occurred at a resort and it is determined that Legionella is the organism that is responsible. To find the source of the bacteria, one of the highest priorities would be to check:
resort water supply and storage
After identifying and appointing expert members to inter-professional teams for implementing health initiatives, the administration:
should plan to confirm the team norms and dynamics are productive.
