CPH Practice Exam 3-4|145 Questions with Verified Answers,100% CORRECT

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CPH Practice Exam 3-4|145 Questions with Verified Answers The first step in the policy process typically is: 1. Undertake Consultation 2. Problem definition 3. Policy analysis 4. develop ... options and proposals - CORRECT ANSWER 2. Problem definition explanation: Problem definition is typically the first step in the policy process. The second step is agenda setting. The next step is policy making. The fourth step is budgeting. The fifth step is implementation and the final step of the policy process is evaluation. Activists criticized America's public health policy response during initial years of its AIDS epidemic on the grounds that: 1. Absence of universal health care insurance prevented victims from accessing expensive treatment 2. Government indifference and political infighting resulted in apathy toward a suffering gay community. 3. Too much money was being spent on treatment, not enough on prevention to stop the epidemic. 4. Too much resource was being spent on urging people to change risk behaviors, not enough on medication. - CORRECT ANSWER 2. Government indifference and political infighting resulted in apathy toward a suffering gay community. A researcher has implemented an intervention. The program activities included STD counseling for the members of a community-based organization. One outcome measure would be best addressed by which of the following questions? 1. Did STD counseling result in changes in knowledge among the target population? 2. When did the program activities take place? 3. What are the barriers to implementation of program activities? 4. What is the number of people who received counselling? - CORRECT ANSWER 1. Did STD counseling result in changes in knowledge among the target population? The "Greenhouse Gas" of primary concern in global warming is: 1. Chlorofluorocarbons 2. Carbon monoxide 3. Sulfur dioxide 4. Carbon dioxide - CORRECT ANSWER 4. Carbon dioxide Which of the following is the least acceptable method for making drinking water available in an emergency situation? 1. Using a tank truck to deliver water from a potable source 2. Using a community tap connected to a potable source 3. Pumping water from an uncontaminated aquifer 4. Pumping water directly from a river - CORRECT ANSWER 4. Pumping water directly from a river 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? 1. Point out all the issues they have had with this staff member's performance to-date. 2. Prepare by developing a "feedback sandwich" approach with two reinforcing statements surrounding a corrective statement. 3. Give feedback to the staff member as the supervisor catches them on their way into the office. 4. Hold the entire team accountable in group meeting. - CORRECT ANSWER 2. Prepare by developing a "feedback sandwich" approach with two reinforcing statements surrounding a corrective statement. The logic model that has been the dominant paradigm representing types of information that may be collected to draw inferences about quality of care provided by a healthcare system has been: 1. Donabedian's model 2. Shewart's PDCA 3. Theory of Change 4. Web of Causation - CORRECT ANSWER 1. Donabedian's model The ability to reject the null hypothesis when the null is in fact false is called? 1. Type I error 2. Type II error 3. Power 4. Level of significance - CORRECT ANSWER 3. power 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? Select the BEST answer. 1. They practice transparency in advancing Zika research 2. They demonstrate beneficence, a core public health ethical principle 3. They provide strategic leadership in leading local and international solutions 4. They demonstrate their competence in Zika research - CORRECT ANSWER 3. They provide strategic leadership in leading local and international solutions Historically, which of the following had the greatest impact on average life expectancy? 1. Vaccinations for infectious diseases 2. Improvements in sanitation and hygiene 3. Advances in medical care technology 4. Increased application of health education - CORRECT ANSWER 2. Improvements in sanitation and hygiene Based upon experience of the most successful and visionary organizations, for a new program what is the most important step in building an effective staff? 1. Hire people who fit the culture of the program. 2. Consistent disciplinary action to shape team performance. 3. Regularly scheduled extra-curricular team-building retreats. 4. Very detailed policy and procedure manuals. - CORRECT ANSWER 1. Hire people who fit the culture of the program. All written intervention messages (whether printed, computer-delivered, or Internet-based) must: 1. Start with the most important information first 2. Include graphics, pictures, and the like to attract people's attention 3. Be at a reading level suitable to the target population 4. Be no longer than four sentences long - CORRECT ANSWER 3. Be at a reading level suitable to the target population Generally, the largest single component in most public health budgets, and therefore the one with which managers must be most familiar is: 1. computer software and hardware 2. pharmaceuticals 3. personnel 4. shortfalls - CORRECT ANSWER 3. personnel Which of the following strategic planning tools is in the form of a 2x2 table? 1. Gantt chart 2. Network diagram 3. Precede Proceed model 4. SWOT chart - CORRECT ANSWER 4. SWOT chart The objective of the National Environmental Policy Act of 1969 and its equivalent at the State level is to: 1. Subject a proposed major project or action to a comprehensive environmental review study 2. Ensure that an important industrial project or action is constructed 3. Ensure that the environment is protected at all cost 4. Achieve sustainable development while relieving communities concerns - CORRECT ANSWER 1. Subject a proposed major project or action to a comprehensive environmental review study Safe Harbor provisions are intended to protect patient privacy by defining: 1. the covered entities with which patient data may be shared. 2. which data elements to remove to create de-identified data sets. 3. encryption protocols and Internet routes for transmitting data. 4. data use agreement provisions for sharing confidential data sets. - CORRECT ANSWER 2. which data elements to remove to create de-identified data sets. Informed consent should avoid inclusion of: 1. risks and benefits 2. technical jargon 3. contact information 4. purpose - CORRECT ANSWER 2. technical jargon 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: 1. Submitting another budget with no new positions. 2. Asking another department to decrease their budget by 6.0 FTE positions. 3. Provide information to justify the increased number of positions. 4. Reaching out to the media to gain citizen support for the new positions. - CORRECT ANSWER 3. Provide information to justify the increased number of positions. To compare educational attainment, measured with the categories, "some high school," and "High school degree, GED, or more," which of the following tests would be appropriate? 1. Chi-square goodness of fit test 2. Chi-square test of independence 3. Two independent samples t test 4. Analysis of variance - CORRECT ANSWER 2. Chi-square test of independence explanation: A chi-square test of independence is the appropriate test to compare the proportions of participants in each category of educational attainment, which is expressed as an ordinal variable. Double-blinded (masked) studies are an important way to: 1. Achieve comparability of cases and controls 2. Avoid observer and interviewee bias 3. Increase the efficiency of the study design 4. Reduce the effects of sampling variation - CORRECT ANSWER 2. Avoid observer and interviewee bias Policy analysis when designing public health programs is: 1. involves a straightforward statistical analysis of health and public polling data. 2. a subjective political task accomplished by legislative debate and trade-offs. 3. complex, involving data collection and clarification of objectives. 4. impossible to define because different policy areas require different approaches. - CORRECT ANSWER 3. complex, involving data collection and clarification of objectives. May a state officer or employee of a regulatory agency concurrently conduct an outside (private) business or accept outside employment? 1. Yes, provided the outside business activity is unrelated to the area that he or she regulates. 2. No, any outside business engagement gives the appearance of unacceptable conflict of interest. 3. Perhaps, but only if the outside business engagement is approved by the agency's head. 4. There is no clear ethical standard - this is more a question of ability to manage both schedules. - CORRECT ANSWER 1. Yes, provided the outside business activity is unrelated to the area that he or she regulates. To work effectively, a public health specialist should be able to meet the social, cultural and linguistic needs of individuals within the community. This is termed cultural: 1. awareness 2. competence 3. feasibility 4. measures - CORRECT ANSWER 2. competence 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: 1. To present additional statistics to highlight the magnitude of the problem 2. To request a larger budget -- print and post more posters; more radio, and TV ads 3. To hire a consultant to determine if the literacy level is appropriate 4. To conduct focus groups to learn more about the groups' beliefs and values - CORRECT ANSWER 4. To conduct focus groups to learn more about the groups' beliefs and values In the funding applications that state public health departments typically submit every year, program and organizational budget requests: 1. are not included, only research project funding is described. 2. are justified by reasonable numbers on accounting spreadsheets. 3. need explanation in a budget narrative. 4. tend to always be funded. - CORRECT ANSWER 3. need explanation in a budget narrative. State public health departments typically conduct needs assessments and program evaluations, but do not perform academic research projects and their financial accounting systems are not set up to hold research funds in anticipation of future project expenses. Dollar figure request items shown need to be explained in a section typically called the budget narrative. Since funding success depends upon political will and is competitive against applicants from other programs, it is important to defend a budget request in clear and meaningful language. Which of the following survey items best assesses an individual's socioeconomic status in terms of increasing validity and response rate? 1. Income in the past month 2. Highest level of education attained 3. Eligibility for public assistance 4. Perception of economic insecurity - CORRECT ANSWER 4. Perception of economic insecurity explanation: Of all the options, perception of economic insecurity (e.g., concern about food insecurity) best assesses an individual's current economic status while reducing non-response due to concern about stigma. Respondents are least likely to respond to income and public assistance questions, while educational attainment does not accurately reflect one's economic situation. Which of the following measures of variability is calculated by subtracting the 25th percentile of data from the 75th percentile of data? 1. Variance 2. Interquartile range 3. Median absolute deviation 4. Coefficient of variation - CORRECT ANSWER 2. Interquartile range A distinctive foundation of the Comprehensive Unit-based Safety Program (CUSP) developed at Johns Hopkins and promoted by the Agency for Healthcare Research and Quality creates a culture of safety by focusing on: 1. detecting and reporting sentinel events 2. open attitudes and mutual respect 3. using standardized checklists 4. assuring professional expertise - CORRECT ANSWER 2. open attitudes and mutual respect Can a state public health agency authorize its employees to use or donate frequent flyer miles for personal travel that were acquired during state business travel? 1. Yes, there is no ethical violation in allowing a government employee to keep frequent flyer miles for personal use or to specify their preferred airline for business travel. 2. Yes, there is no ethical violation in allowing a government employee to keep frequent flyer miles for personal use, but they cannot specify their own preferred airline for business travel. 3. No, this would violate the "de minimis" use of government resources so any frequent flyer miles acquired during business travel must be retained by the government agency. 4. No, this would violate several ethical constructs, so any participation in frequent flyer programs during government service must be prohibited. - CORRECT ANSWER 2. Yes, there is no ethical violation in allowing a government employee to keep frequent flyer miles for personal use, but they cannot specify their own preferred airline for business travel. The best use of clinical practice guidelines is as an: 1. indication of the best diagnostic and treatment practices based on the best available evidence. 2. enforceable standard of care against which deviations should be detected and corrected. 3. ideal therapy plan that should be supported in public health regulation and patient education. 4. information pamphlet for distribution in public health patient education programs. - CORRECT ANSWER 1. indication of the best diagnostic and treatment practices based on the best available evidence. 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? 1. Hierarchy of needs (Maslow) 2. Expectancy theory (Vroom) 3. Two-factor theory (Herzberg) 4. Theory X/Theory Y (McGregor) - CORRECT ANSWER 1. Hierarchy of needs (Maslow) What is the "reservoir host" for West Nile Virus? 1. Birds 2. Mosquitoes 3. Humans 4. Cattle - CORRECT ANSWER 1. Birds Before implementing a research study that involves human subjects, which of the following is an ethical consideration: 1. Securing enough funding for the project 2. Reporting only data to support the hypothesis and highlights strengths 3. Ensuring that all participants receive an incentive upon completion of data collection 4. Obtaining an approval or a waiver from an Institutional Review Board prior to the start of the study - CORRECT ANSWER 4. Obtaining an approval or a waiver from an Institutional Review Board prior to the start of the study 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: 1. Police powers prohibit states from defining standards of care and required the federal government to do so 2. Standards of care are implied by police powers but implementation is left to the states 3. Police powers permit each state the right to define and delegate authority and responsibility for public health services 4. States use police powers to fund public health services only through property taxes, and these vary from state to state - CORRECT ANSWER 3. Police powers permit each state the right to define and delegate authority and responsibility for public health services The primary disadvantage of incremental program budgeting is: 1. It makes comparison from one year to the next difficult 2. It requires the justification of all dollars allocated 3. It requires far more time and effort than zero-based budgeting (ZBB) 4. It may not reflect the current programmatic priorities of the organization - CORRECT ANSWER 4. It may not reflect the current programmatic priorities of the organization As a first step in public health emergency preparedness, jurisdictions should: 1. Ask a local government leader what will be expected of them. 2. Outsource public health emergency preparedness responsibilities. 3. 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. 4. Design and conduct at least one table-top exercise. - CORRECT ANSWER 3. 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. 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 1. Risk factors 2. Environmental factors 3. Causal factors 4. Community factors - CORRECT ANSWER 1. Risk factors The best example of community engagement and empowerment refers to which of the following? 1. Teaching community members how to best communicate with providers 2. Conducting health needs and assets assessment with communities and sharing the information 3. Teaching self-determination to community members 4. Reciprocal transfer of knowledge and skills among all collaborators and community partners - CORRECT ANSWER 4. Reciprocal transfer of knowledge and skills among all collaborators and community partners The Dartmouth Atlas of Healthcare demonstrates that small area variations in Medicare expenditures across geographic areas are primarily attributable to differences in: 1. Physician practice styles 2. Consumer preferences for high-cost services 3. Age of the population served 4. Health status of the population served - CORRECT ANSWER 1. Physician practice styles The small area variations in Medicare expenditure that are observed in the Dartmouth Atlas of Healthcare are attributable to differences in how physicians practice medicine. The Dartmouth Atlas of Healthcare found wide variations in the frequency that various medical care treatments occurred in different areas of the United States. Additional research has shown that these variations are likely not associated with differences in health status, patient age, or consumer preferences, but rather with the practice styles noted and with the supply of physicians in different areas. Research on small area variations has supported the development of clinical practice guidelines. The leadership in a public health organization has decided to conduct a training needs assessment of its staff, identify training needs, and to invest in training and other resources to ensure that the organization is able to carry out its essential functions and its mission, now and into the future. This is an example of (a/an): 1. Capacity building 2. Efficiency Study 3. Continuous Quality Improvement 4. Feasibility Study - CORRECT ANSWER 1. Capacity building explanation: Capacity building in an organization are categorized by efforts of the organization to enhance its ability to competently achieve its (operational, programmatic, financial) goals now and into the future When planning print materials for a public health education program, you should always: 1. Develop materials at least a 12th grade reading level 2. Work with an experienced graphic designer 3. Test them with members of the intended audience 4. Use the largest print possible - CORRECT ANSWER 3. Test them with members of the intended audience Which of the following approaches recognize that health of people is interconnected with health of animals and environment; and collaborate with physicians, veterinarians, ecologists, epidemiologists, and other related healthcare providers to monitor and control public health threats and to learn about how diseases spread among people, animals, and the environment? 1. Veterinary Public Health 2. Environmental Health 3. One Health 4. Population Health - CORRECT ANSWER 3. One Health Which of the following can be considered a concern with live, attenuated vaccines? 1. They are very expensive to produce 2. They produce a weak response and require booster shots 3. They can cause disease in an immunocompromised individual 4. People can develop allergic reactions to them - CORRECT ANSWER 3. They can cause disease in an immunocompromised individual 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: 1. Transactional 2. Transformational 3. Passive-avoidant 4. Autocratic - CORRECT ANSWER 1. Transactional If a food contaminated with a virus, such as hepatitis A, is left out for 4 hours in a kitchen at a temperature of 85 degrees Fahrenheit, the virus count in the food: 1. increases exponentially 2. increases slowly 3. depends on acidity of the food 4. does not change - CORRECT ANSWER 4. does not change Many people do not attempt to decrease unhealthy behaviors such as overeating or smoking because they lack the confidence that they can successfully change. This is an example of: 1. perceived susceptibility 2. perceived severity 3. self-efficacy 4. cues to action - CORRECT ANSWER 3. self-efficacy For the governance of an organization, which of the following should be measurable? 1. Vision and values 2. Mission and vision 3. Goals and objectives 4. Mission and goals - CORRECT ANSWER 3. Goals and objectives What is an evaluation designed to present conclusions about whether a program should be sustained, changed, or eliminated? 1. Formative evaluation 2. Implementation evaluation 3. Process evaluation 4. Summative evaluation - CORRECT ANSWER 4. Summative evaluation explanation: Evaluation falls into one of two broad categories: formative and summative. Summative evaluations should be completed once your programs are well established and will tell you to what extent the program is achieving its goals. Which leadership theory advances the notion that one's task-relationship orientation can only be modified within certain limits and that structural and power factors will dictate whether you have a good leadership "fit?" 1. Contingency 2. Path-Goal 3. Transactional 4. Transformational - CORRECT ANSWER 1. Contingency explanation: Contingency Theory views effective leadership as contingent on matching a leader's style to the right setting. After the nature of a situation is determined, the fit between leader's style and the situation can be evaluated. Situational factors include leader member relations, task structure (degree to which tasks are clearly defined) and position power within the organization. A collaborative approach to research that equitably involves all partners in the research process and recognizes the strengths that each brings. For example, these partners could include community members, organizational representatives, and researchers. Please identify which of the following options best describes this type of research. 1. Ecological Study 2. Community Based Participatory Research 3. Theory of Reasoned Action 4. Randomized Community Trial - CORRECT ANSWER 2. Community Based Participatory Research To determine whether to expand a component of a current intervention, which type of evaluation is needed? 1. Formative evaluation 2. Process evaluation 3. Outcome evaluation 4. Impact evaluation - CORRECT ANSWER 1. Formative evaluation As per CDC, a Formative evaluation ensures that a program or program activity is feasible, appropriate, and acceptable before it is fully implemented. It is usually conducted when a new program or activity is being developed or when an existing one is being adapted or modified. 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 1. National Standards for Culturally and Linguistically Appropriate Services (CLAS) Assessment 2. Language Needs Assessment 3. Health Resource Access Assessment 4. Community Literacy Assessment - CORRECT ANSWER 2. Language Needs Assessment explanation: Language Needs Assessment includes a review of four factors-the Four Factor Analysis-to guide LHDs (recipients) in meeting these mandates and to provide recommendations for providing translated materials and interpretation services. The four factors are: 1. The number or proportion of LEP residents within each district, 2. The frequency with which LEP individuals come into contact with VDH programs, 3.The nature and importance of the program, activity or service provided by the recipient to its beneficiaries, and, 4. The resources available to the grantee/recipient and the costs of interpretation/ translation services (http://www.vdh.virginia.gov/omhhe/CLAS/language-needs-assessment/)." The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (The National CLAS Standards) "aim to improve health care quality and advance health equity by establishing a framework for organizations to serve the nation's increasingly diverse communities (https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53)." To "conduct ongoing assessments of the organization's CLAS-related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities" is just 1 of 28 National CLAS Standards Which of the following principles of medical and public health ethics requires doing no harm while promoting the welfare of others? 1. Autonomy 2. Beneficence 3. Privacy 4. Justice - CORRECT ANSWER 2. Beneficence explanation: Beneficence is defined as promoting the welfare of others while avoiding behavior that results in harm. A public health professional is asked to conduct a needs assessment for a community. A needs assessment: 1. Introduces resources to fill community gaps 2. Ensures a competent public and personal health care workforce 3. Assists to identify and prioritize health problems 4. Provides health resources for medically underserved populations - CORRECT ANSWER 3. Assists to identify and prioritize health problems 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? 1. Feasibility study 2. Cost analysis study 3. Process evaluation 4. Impact evaluation - CORRECT ANSWER 4. Impact evaluation explanation: Impact evaluations often serve an accountability purpose to determine if and how well a program worked. Impact Evaluations can also help answer program design questions to determine which, among several alternatives, is the most effective approach. vs. Cost-effectiveness analysis is a way to examine both the costs and health outcomes of one or more interventions. It compares an intervention to another intervention (or the status quo) by estimating how much it costs to gain a unit of a health outcome, like a life year gained or a death prevented. Under which circumstance would there be no ethical violation for an officer or employee of a governmental regulatory agency to accept food or beverage paid for by others? 1. Any meal, at any time, can be accepted from anyone except when an actual regulatory transaction is taking place. 2. Breakfast or dinner alone at his or her hotel provided in lieu of an honorarium for speaking at an industry-sponsored event. 3. Lunch provided on-site by an organization to everyone involved during day-long inspections of their operational facilities. 4. Meals or social events provided to all registrants at a regional conference attended as a registrant at an agency approved event - CORRECT ANSWER 4. Meals or social events provided to all registrants at a regional conference attended as a registrant at an agency approved event The principal difference between other industrialized countries and the United States in terms of providing universal health care coverage is that: 1. This is recognized as a basic human right in the other countries' founding document but not in the United States Constitution 2. All hospitals are owned by and all physicians are employees of the other governments while the United States takes a free market approach 3. The other countries spend more per capita on healthcare while achieving similar or better health outcomes for a larger proportion of their population. 4. The other countries spend less per capita on healthcare while achieving similar or better health outcomes for a larger proportion of their population - CORRECT ANSWER 4. The other countries spend less per capita on healthcare while achieving similar or better health outcomes for a larger proportion of their population To conduct an individual interview with an unemancipated adolescent aged 14 - 15 for a study on diabetes in high school students, from whom must the researcher gain consent, assent, and/or permission according to the ethical practices outlined by the Office of Human Research Protections ? 1. A parent/guardian 2. Teenager 3. Teenager and school official 4. Teenager and parent/guardian - CORRECT ANSWER 4. Teenager and parent/guardian Administrative law judges, who adjudicate conflicts involving the decision-making of units of government agencies: 1. have at the federal and state level full judicial power, like all trial judges. 2. are elected as non-partisan candidates within congressional districts. 3. ensure compliance with constitutional requirements of due process. 4. are in all respects the same as "hearing officers" within government agencies. - CORRECT ANSWER 3. ensure compliance with constitutional requirements of due process. A common bacterial contaminant of poultry products is: 1. Bacillus cereus 2. Clostridium perfringens 3. E. coli 4. Salmonella - CORRECT ANSWER 4. Salmonella Over the history of the HIV infection pandemic, in its initial phase, transmission in populations started with a sharp rise through homosexual male-male intercourse and in its late phase the steepest rise tended to be through: 1. Homosexual male-male intercourse 2. Homosexual female-female intercourse 3. Heterosexual male-female intercourse 4. Transfusion of contaminated blood - CORRECT ANSWER 3. Heterosexual male-female intercourse Mutations in the _______________ gene lead to an increased risk for developing breast or ovarian cancer. 1. BRCA2 2. PPARG 3. APC 4. hMSH1 - CORRECT ANSWER 1. BRCA2 BRCA2 is a Tumor-Suppressor gene. Mutations in this gene, and the related gene BRCA1, account for 5-10% of breast and ovarian cancer cases. When conducting a research study, which of the following is an unique requirement when the study involves human subjects? 1. Securing enough funding for the project 2. Reporting only the data that strengthens support of the hypothesis 3. Ensuring that all participants receive an incentive upon completion of data collection 4. Obtaining a waiver or an approval from an Institutional Review Board prior to the start of the study - CORRECT ANSWER 4. Obtaining a waiver or an approval from an Institutional Review Board prior to the start of the study Which of the following components of a strategic planning process in a public health agency has logical priority over the others? 1. Preparing an action plan for eradicating giardiasis in the municipal water system 2. Developing the operating budget and staffing plan for the agency 3. Reviewing (and revising) the vision and mission statements for the agency 4. Setting strategic goals for a three-year cycle - CORRECT ANSWER 3. Reviewing (and revising) the vision and mission statements for the agency explanation: The initial activity in the prevailing strategic planning paradigm is the review and (as needed) revision of the organization's mission and vision statements and its core values. This provides a philosophical foundation for subsequent steps in the strategic planning process. 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: 1. Submitting another budget with no new positions. 2. Asking another department to decrease their budget by 6.0 FTE positions. 3. Provide information to justify the increased number of positions. 4. Reaching out to the media to gain citizen support for the new positions. - CORRECT ANSWER 3. Provide information to justify the increased number of positions. Which of the following is an expected benefit of consolidating independent hospitals and provider groups into an integrated health care system? 1. Economies of scale in production 2. Lower costs of integration 3. Ease of accommodating diverse organizational cultures 4. Immediate gains in administrative efficiency - CORRECT ANSWER 1. Economies of scale in production explanation: Growth through mergers and acquisitions are typically justified on the basis of economic efficiencies achieved through enhanced economies of scale, an increase share of the relevant market by the integrated system, and greater revenues. However, the demands of implementation and maintaining a larger integrated system increase the administrative burden (and associated overhead costs). Accommodating different organizational cultures is a challenge faced by management in most corporate mergers and often is recognized as a root cause of failed mergers and acquisitions. Exposures to negative situations such as a parent who smokes, sedentary lifestyle, high levels of alcohol consumption, and unprotected sex can increase the likelihood of developing disease or injury and poor health outcomes. Such exposures are often referred to as: 1. Risk factors 2. Environmental factors 3. Socioeconomic factors 4. Community factors - CORRECT ANSWER 1. Risk factors In the planning process, the group being served is referred to as the: 1. Pilot population 2. Key informants 3. General population 4. Priority population - CORRECT ANSWER 4. Priority population explanation: The priority population is the people for whom the program is intended. In the past, this has also been called the target population. 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: 1. Be neutral 2. Focus on the content 3. Take notes 4. Listen to the active speakers - CORRECT ANSWER 1. Be neutral By what programmatic mechanism does the U.S. Environmental Protection Agency (EPA) work with states to implement national environmental standards such as NAAQS? 1. By creating a memorandum of understanding focusing on cost-sharing of environmental burdens 2. By establishing air quality monitoring stations 3. By using a State Implementation Plan (SIP) approved by the EPA 4. By funding risk assessment studies that provide a basis for the NAAQS for any criterion pollutant - CORRECT ANSWER 3. By using a State Implementation Plan (SIP) approved by the EPA explanation: The Constitutional division of powers between the Federal and State governments means that both levels of government must operate with mutual respect, recognizing that cooperation rather than conflict better serves the public interest. The natural continuum of the environment cuts across geopolitical boundaries and rightly elicits the concerns of both Federal and State governments. To avoid or minimize contradictory measures and standards among States, the Federal government provides the umbrella (uniform) guidance and standards for ambient air quality and requires States to participate in the implementation by developing a plan that meets Federal requirements. That plan is known as the SIP and contains a number of air quality control measures. Every Monday, the District Health Department calls a list of medical offices selected to represent each county in the District to obtain a report of number of patients with a laboratory-confirmed diagnosis of influenza. This is an example of what type of surveillance? 1. Passive and Syndromic 2. Passive and Sentinel 3. Active and Syndromic 4. Active and Sentinel - CORRECT ANSWER 4. Active and Sentinel explanation: A health agency contacted these providers for a report (Active). These health events were reported by health professionals who are selected to represent a geographic area or a specific reporting group (Sentinel). 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. 1. Triangulation 2. Systematic Review 3. Data Cleaning 4. Meta-analysis - CORRECT ANSWER 1. Triangulation explanation: Data triangulation is when a finding or piece of data is verified with several different data sources or research methods. Measuring inputs, throughputs, outputs and outcomes of health systems is, to an increasing extent, relying on "big data" which is distinct from other data in terms of its: 1. Volume, velocity, variety, variability and veracity 2. Terabyte file size, proprietary ownership, encryption and cost 3. Storage in data warehouses isolated from internet access 4. Importance, validation, curation and credibility - CORRECT ANSWER 1. Volume, velocity, variety, variability and veracity explanation: Volume, velocity, variety, variability and veracity distinguish "Big Data" from other data. Suppose a researcher calculates a confidence interval for a population mean based on a sample size of 9. Which of the following assumptions have been made? 1. The p value is not significant 2. The sampled population is approximately normal 3. The population standard deviation is known 4. No assumptions have been made - CORRECT ANSWER 2. The sampled population is approximately normal Succession planning involves a defined plan to: 1. cultivate a new group of leaders 2. outline new ideas for research studies 3. amend the mission and operations of an organization 4. update current programs and services to incorporate policy and regulatory changes - CORRECT ANSWER 1. cultivate a new group of leaders explanation: Succession planning is a "deliberate and systematic effort by an organization to ensure leadership continuity in key positions, retain and develop intellectual and knowledge capital for the future, and encourage individual advancement" An individual's capacity to obtain, process, and understand basic health information and services needed to make basic health decisions is called: 1. Medical informatics 2. Health literacy 3. Health education 4. Numeracy - CORRECT ANSWER 2. Health literacy If the chances of a second event occurring are the same as the chances of the first event occurring, regardless of the first event's outcome, then the two events are: 1. Equally likely 2. Independent 3. Indeterminate 4. Dependent - CORRECT ANSWER 2. Independent As identified in the seminal 1988 Institute of Medicine report on the future of public health, which of the following is not one of the three core functions of the roles and responsibilities of public health agencies? 1. Assessment 2. Financial performance management 3. Policy development 4. Assurance - CORRECT ANSWER 2. Financial performance management Which of the following characteristics is true for a prospective (or concurrent) cohort study, but not true for a retrospective (or historical) cohort study? 1. They are good for rare exposures 2. Exposed and unexposed groups are followed over time 3. The disease outcome has not yet occurred when the study begins 4. Incidence rates can be calculated for exposure groups - CORRECT ANSWER 3. The disease outcome has not yet occurred when the study begins An incremental approach to program planning in public health: 1. Uses multiple sources and methods to collect similar information 2. Provides an intensive, detailed description and analysis of a single project 3. Produces a plan where the specification of every step depends upon the results of previous steps 4. Results in plans that may be immediately necessary but may overlap or leave gaps - CORRECT ANSWER 4. Results in plans that may be immediately necessary but may overlap or leave gaps explanation: Issel writes that though the incremental approach to program planning may address an immediate need (i.e.: closing bathhouses in the early days of HIV/AIDS epidemic) it may also leave gaps (i.e.: did not identify the virus). The incremental approach to program planning will address only part of the problem, may be the result of disjointed efforts and leave many factors unaccounted for. A researcher is working with local barber shops to plan a health promotion intervention. The intervention activities will include health education training workshops and educational print materials for the customers. The intervention activities are hypothesized to lead to changes in customers' fruit/vegetable intake, physical activity, and screening adherence. Which of the following statements describes how the researcher might start a formative evaluation plan? 1. Document which participating barbers attended each of the training workshops 2. Document the barbers' change in fruit/vegetable intake 3. Document the customers' change in physical activity 4. Convene focus groups in two barber shops to discuss print materials - CORRECT ANSWER 4. Convene focus groups in two barber shops to discuss print materials The "danger zone," in which bacteria multiply in food fast enough to become a hazard, is: 1. 32° - 100° F 2. 32° - 212° F 3. 40° - 140° F 4. 40° - 212° F - CORRECT ANSWER 3. 40° - 140° F 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: 1. Health disparity 2. Harm reduction 3. Modifiable risk factors 4. Life expectancy - CORRECT ANSWER 1. Health disparity A supervisor of a small community health clinic serving a largely multi-national immigrant community assigns their project manager the responsibility of developing a new process to ensure complaints and conflicts are addressed promptly and respectfully for each patient. This is prompted by a recent complaint that a staff member was rudely addressing a limited English-speaking patient and her family when trying to communicate a diagnosis. In order to create a new process that takes into account the cultural and communication needs of the patients, the program manager must: 1. Create a new conflict process based solely on examples from other clinics. 2. Select a group of patients to provide input on how complaints should be resolved. 3. Wait until a new complaint occurs to observe the existing process. 4. Ask their coworkers how they personally deal with complaints and conflicts in the office. - CORRECT ANSWER 2. Select a group of patients to provide input on how complaints should be resolved. Which of the following factors is the least essential requirement for effective public health emergency preparedness? 1. Identifying surge capacity in the public health infrastructure 2. Developing channels for real-time interagency communication 3. Training key decision-makers and first responders for coordinated action 4. Developing and testing emergency preparedness plans on a monthly basis - CORRECT ANSWER 4. Developing and testing emergency preparedness plans on a monthly basis surge capacity definition: The ability to obtain adequate staff, supplies and equipment, structures and systems to provide sufficient care to meet immediate needs of an influx of patients following a large-scale incident or disaster The use of sun protection like sun screen and/or wearing a hat are examples of which type of prevention strategy? 1. Primary Prevention 2. Secondary Prevention 3. Tertiary Prevention 4. Quaternary Prevention - CORRECT ANSWER 1. Primary Prevention primary prevention definition: Primary Prevention measures include health promotion and disease prevention activities, before there is any evidence of disease. difference between secondary vs tertiary prevention: While secondary prevention seeks to prevent the onset of illness, tertiary prevention aims to reduce the effects of the disease once established in an individual. Forms of tertiary prevention are commonly rehabilitation efforts. Income, interpersonal stress, and education level are all examples of ____________, which determine the overall health, and quality of life of our communities. 1. Physical determinants 2. Spatial determinants 3. Environmental determinants 4. Social determinants - CORRECT ANSWER 4. Social determinants A short narrative or statement that describes the general focus and purpose of a program is called: 1. A mission statement 2. A long-term goal 3. A long-range plan 4. An objective - CORRECT ANSWER 1. A mission statement Out of a population of 500,000 people, 500 were observed for two years. Five developed disease. What is the incidence density rate? 1. 5/500 2. 5/1000 3. 5/500,000 4. 500/500,000 - CORRECT ANSWER 2. 5/1000 SMART objectives are: 1. small, manageable, active, ready, and timely 2. scientific, management-oriented, affirmative, rational and testable 3. sizable, market-based, action-oriented, reliable and trendy 4. specific, measurable, achievable, realistic and time bound - CORRECT ANSWER 4. specific, measurable, achievable, realistic and time bound A key characteristic of action research or community based participatory research (CBPR) include: 1. Securing local community IRB approvals for the project and informed consent 2. Embracing the community as a full and equal research partner 3. Presenting a well thought out research and analysis plan to the community 4. Partnering with law makers to ensure health improvements in the community - CORRECT ANSWER 2. Embracing the community as a full and equal research partner 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: 1. An analysis to justify and allocate resources 2. Applying a health equity and social justice lens 3. Strategic planning 4. Community Health Needs Assessment - CORRECT ANSWER 1. An analysis to justify and allocate resources It can be helpful to make sure you are setting goals and objectives that are SMART. The R in SMART stands for: 1. Reliable 2. Resistant 3. Realistic 4. Rapid - CORRECT ANSWER 3. Realistic 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: 1. The Nuremberg Code 2. The Belmont Report 3. Rose-Welch Report 4. The Legal Epidemiology Competency Model - CORRECT ANSWER 2. The Belmont Report When beginning work with a coalition of community groups to improve health outcomes in the community, a key first step would be to: 1. Develop a shared vision 2. Develop an evaluation plan 3. Develop a data collection plan 4. Develop a logic model - CORRECT ANSWER 1. Develop a shared vision Developing a shared vision is important in make sure the coalition of community groups is on the same page. A shared vision allows the different coalition groups to come to a consensus on the definition of the health need or issue they are working on. Ethical standards apply to government officers and employees. For such individuals, these standards apply: 1. only during their normal working hours. 2. just when performing official duties regardless of time. 3. when they identify themselves with their official title. 4. at all times, whether they are on or off duty. - CORRECT ANSWER 4. at all times, whether they are on or off duty. Ethical standards require employees to place loyalty to the Constitution, the laws, and ethical principles above private gain at all times. 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: 1. Positive feedback loop 2. Outflow effect 3. Negative feedback loop 4. Inflow effect - CORRECT ANSWER 3. Negative feedback loop River water pollution due to storm water runoff from chemically fertilized farm fields is an example of: 1. Non-point source pollution 2. Point source pollution 3. Accidental and unforeseeable pollution 4. Unpreventable and inconsequential pollution - CORRECT ANSWER 1. Non-point source pollution A non-point water pollution source such as a fertilized or freshly plowed farm field, an animal feed lot, or an agricultural waste storage area (e.g. for manure from poultry feeding operation) requires a different control approach compared to point sources such as factory smokestacks or waste discharge pipes. Area sources are sometimes quite difficult to manage due to their size. In order to effectively evaluate organizational performance, performance indicators must be: 1. approved by all organizational staff 2. publicly reported 3. benchmarked against previously agreed upon standards 4. clear in the organizational mission statement - CORRECT ANSWER 3. benchmarked against previously agreed upon standards HACCP is a food safety system employed to: 1. Detect bacterial contamination in food after it happens 2. Identify and control problems that may cause foodborne illness before they happen 3. Isolate and identify bacterial pathogens from a foodborne illness outbreak 4. Set temperature limits for food containing eggs - CORRECT ANSWER 2. Identify and control problems that may cause foodborne illness before they happen Hazard Analysis and Critical Control Points (HACCP) is a systematic, science-based approach to identify and control problems that may cause foodborne illness before they happen. The first step is to conduct a hazard analysis to identify all biological, physical, and chemical hazards associated with a food product. Next is to identify critical control points in food production where a measure can be applied to prevent, reduce, or eliminate a food safety hazard. Each measure applied at a critical control point must be grounded in an empirical parameter (such as setting limits on acceptable moisture level). Finally, there must be robust monitoring to assess whether the measures taken at each critical control point are effective and if corrective actions are necessary. Total coliform and E. coli counts are performed in routine monitoring of drinking water reservoirs because: 1. These bacteria commonly cause gastrointestinal infection in humans. 2. They are a more easily grown indicator of Legionella spp. contamination. 3. Outdated laws require heterotrophic plate count monitoring of water. 4. Their numbers give general indication of a water supply's sanitary condition. - CORRECT ANSWER 4. Their numbers give general indication of a water supply's sanitary condition Coliform bacteria are a group of bacteria present in the environment, and in the feces of humans as well as all warm-blooded animals. Few cause disease in humans. Some strains of E. coli are common only in wild or domestic animals, others in humans. They all are heterotrophic (meaning that they require nutrients in growth media) and are monitored by plate counts as an indicator of sanitary quality of food or water. When their heterotrophic plate count numbers are high, this is an indication of contamination from sources that also might introduce disease-causing organisms (pathogens, including bacteria, viruses or protozoa). High counts trigger public health responses like boil water advisories, product recalls, additional investigation of water treatment or food production practices, etc. Exposure assessment attempts to answer all of the following questions except: 1. Toxicity of the exposure 2. Frequency and duration of exposure 3. Population exposed 4. Route of exposure - CORRECT ANSWER 1. Toxicity of the exposure Exposure assessment is not concerned with the toxicity of the exposure. It is concerned with a population's contact with a contaminant and aims to quantify their exposure by assessing the magnitude, frequency, and duration of an exposure; the route of exposure (e.g. inhalation, ingestion, or dermal); and which segments of the population may have been exposed. 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: 1. Submitting another budget with no new positions. 2. Asking another department to decrease their budget by 6.0 FTE positions. 3. Provide information to justify the increased number of positions. 4. Reaching out to the media to gain citizen support for the new positions. - CORRECT ANSWER 3. Provide information to justify the increased number of positions. The biggest change in competencies for public health career professionals circa 2019 is 1. an increased emphasis in epidemiology and biostatistics course hours for entry to practice 2. more emphasis on 'soft' skills for leading teams and on integration across technical skills 3. separate lists of competency items for public health analysts versus program managers 4. a stronger focus on management and fiscal oversight - CORRECT ANSWER 2. more emphasis on 'soft' skills for leading teams and on integration across technical skills In a state with a state-directed public health organization, the State Commissioner of Health has notified health districts to close health department dental programs in response to a state legislature vote to defund and discontinue health department dental services. The district health department has identified dental services as a leading community health need. To help assure continued access to services, the best first step is to: 1. develop a list of possible service venues and proposals to secure financial support, and present them to the Commissioner's office. 2. develop agreements with local providers or organizations for the provision of dental services. 3. Continue the dental program in-house at the local health department, since it was already financially sustainable and heavily utilized. 4. ensure implementation of contracts and other agreements with community partners to provide community dental services. - CORRECT ANSWER 1. develop a list of possible service venues and proposals to secure financial support, and present them to the Commissioner's office. Since the upper chain of state health command has ordered dental service closure, consultation with the Commissioner's office will be needed to assure compliance with legislative directives and fidelity to state health department policy. The likelihood of support from the state-level is greater if it is well-defined and sustainable options are presented. Public Health law fundamentally attempts to balance the greater good of the community with... 1. the cost of implementation of the law 2. the acceptability of interventions 3. the autonomy of the individual 4. the ease of enforcement - CORRECT ANSWER 3. the autonomy of the individual Biological, environmental, behavioral, organizational, political, and social factors that contribute to the health status of individuals, groups, and communities are commonly referred to as: 1. Health behavior factors 2. Risk markers 3. Needs assessment 4. Determinants of health - CORRECT ANSWER 4. Determinants of health Which of the following practices enhances equity across populations when making health policy decisions in a community? 1. Requiring randomized control evidence of effectiveness 2. Allocating resources based on population size 3. Collecting health-related data about the individuals in the community 4. Including diverse constituencies in the decision-making groups - CORRECT ANSWER 4. Including diverse constituencies in the decision-making groups Public health departments can use health profession students (eg. medicine, nursing, other allied health specialties) in projects to assess community health needs: 1. if those students are formally employed by that health department under a national fellowship program that puts selected applicants into mentorship placements. 2. provided the students interview but do not take clinical measurements or samples from individuals. 3. when supervised by their clinical instructors in actions within the scope of that profession's practice. 4. but this is not often done because the health department would be responsible for all supervision and liability. - CORRECT ANSWER 3. when supervised by their clinical instructors in actions within the scope of that profession's practice. From a political perspective, which type of analysis provides the weakest identification of social and economic impact? 1. Cost-benefit analysis 2. Cost-effectiveness analysis 3. cost-minimization analysis 4. cost-utility analysis - CORRECT ANSWER 3. cost-minimization analysis Which of the following terms is expressed as a ratio? 1. Male Births / Male + Female Births 2. Female Births / Male + Female Births 3. Male Births / Female Births 4. Stillbirths / Male + Female Births - CORRECT ANSWER 3. Male Births / Female Births Which of the following statements best characterizes research findings about trait-based approaches to leadership theory? 1. Intelligence, high energy, and initiative are necessary 2. Personality traits are irrelevant 3. No one set of traits has been established as necessary 4. Leaders are born, not made - CORRECT ANSWER 3. No one set of traits has been established as necessary Which of the following statements is not associated with the current paradigm of quality management? 1. Sanctioning individuals for mistakes is the most appropriate method for ensuring effective quality of care 2. The appropriate locus for ensuring quality is at the system level 3. Process improvement is essential to ensuring quality of care 4. Employee satisfaction and patient satisfaction are closely linked - CORRECT ANSWER 1. Sanctioning individuals for mistakes is the most appropriate method for ensuring effective quality of care 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? 1. Price 2. Promotion 3. Place 4. Process - CORRECT ANSWER 4. Process 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 1. National Standards for Culturally and Linguistically Appropriate Services (CLAS) Assessment 2. Language Needs Assessment 3. Health Resource Access Assessment 4. Community Literacy Assessment - CORRECT ANSWER 2. Language Needs Assessment Language Needs Assessment includes a review of four factors-the Four Factor Analysis-to guide LHDs (recipients) in meeting these mandates and to provide recommendations for providing translated materials and interpretation services. The four factors are: 1. The number or proportion of LEP residents within each district, 2. The frequency with which LEP individuals come into contact with VDH programs, 3.The nature and importance of the program, activity or service provided by the recipient to its beneficiaries, and, 4. The resources available to the grantee/recipient and the costs of interpretation/ translation services A primary technique for preventing food-borne disease in cafeteria-type food service establishments is: 1. Encouraging customers to wash their hands before eating 2. Maintaining warm foods at a sufficiently high holding temperature 3. Weekly application of pesticides to control cockroaches 4. Annual physical examinations of food service workers - CORRECT ANSWER 2. Maintaining warm foods at a sufficiently high holding temperature What level of government typically provides the oversight and guidance to prioritize public health needs and resources that focuses program planning and evaluation? 1. Public Health Department Program Management 2. Public Health Department chief executive officer 3. Board of Health 4. Legislature - CORRECT ANSWER 3. Board of Health Local or state boards of health play a key role with responsibilities and authorities defined by statute. This includes oversight, guidance and in some cases actual policy- and rule-making. A public health department's top administration is accountable to its respective board of health. Given popularity of the phrase "evidence-based decisions", a member of a program advisory committee wants the next meeting's agenda to include a recent evaluation study published by an independent academic researcher. That study concludes that a government-guaranteed minimum annual income is the best solution to homelessness. The committee advises a program whose mandate is to oversee the operation of a health insurance program for children in families with income level lower than the federal poverty line. Should the study be added to the agenda? 1. Add the item - government programs are obliged to follow the lead of their advisory committee. 2. Add the item - decisions must follow the evidence if evidence points to a different allocation of resources. 3. Refrain from adding the item - one member is not a quorum. 4. Refrain from adding the item - it is not germane to program decision needs. - CORRECT ANSWER 4. Refrain from adding the item - it is not germane to program decision needs. Advisory committees are, by definition advisory rather than supervisory. Their meetings benefit from an agency clearly defining the questions on which it needs advice. Unless evidence being presented to inform policy discussion addresses those questions and its limits to interpretation are made clear, then it is a distraction rather than an asset. 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? 1. Environmental equity 2. Environmental justice 3. Environmental pollution 4. Environmental democracy - CORRECT ANSWER 2. Environmental justice Administrative law judges, who adjudicate conflicts involving the decision-making of units of government agencies: 1. have at the federal and state level full judicial power, like all trial judges. 2. are elected as non-partisan candidates within congressional districts. 3. ensure compliance with constitutional requirements of due process. 4. are in all respects the same as "hearing officers" within government agencies. - CORRECT ANSWER 3. ensure compliance with constitutional requirements of due process. Which of the following is an example of a utilization rate used to monitor health system performance? 1. Congenital syphilis rate 2. Late stage breast cancer incidence rate 3. Infant mortality rate 4. Readmission rate for depression - CORRECT ANSWER 4. Readmission rate for depression This is the only response that represents a direct measure of the use of health care services. A research study with a statistical power of 60% and alpha is set at 0.05 reports finding no statistically significant difference (p=0.11). To interpret the findings of this study, if a true difference really exists then there is: 1. An 89% probability that it would be detected. 2. A 60% probability that it would be detected. 3. A 40% probability that it would be detected. 4. An 11% probability that it would be detected. - CORRECT ANSWER 2. A 60% probability that it would be detected. 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: 1. Secondary Prevention and Harm Prevention Strategy 2. Secondary Prevention and Harm Reduction Strategy 3. Tertiary Prevention and Harm Reduction Strategy 4. Tertiary Prevention and Harm Prevention Strategy - CORRECT ANSWER 3. Tertiary Prevention and Harm Reduction Strategy A local public health department (LHD) must make significant budget cuts. Area managers are directed to review and compare current services, service utilization and cost to areas of need identified a recent community health needs assessment completed by the LHD. This approach, as a prelude to decision-making, is based on: 1. internal assessment and strategic goals 2. External assessment and department policy review 3. Internal assessment and external assessment 4. Strategic planning and maximizing program efficiency. - CORRECT ANSWER 3. Internal assessment and external assessment "In the context of public health assessment is the beginning of the continuum of problem identification, priority setting, strategic planning, intervention and evaluation. Assessment can be either internal, addressing processes within an organization, or external, addressing processes within the community. To help lay, professional and policy audiences understand the rationale for a program proposal, it is best to: 1. provide everyone with the same report, written in plain language aimed for a Grade 10 reading level. 2. recognize that policy or professional audiences prefer to see benefit or risk projections as ratios, lay audiences prefer them expressed as number-needed-to-treat or harm. 3. present a comprehensive literature review, summarize all the numbers in one table and let the facts speak for themselves. 4. tailor expression of need or gap, logic model of intervention, and expression of magnitude of anticipated benefit or harm to each audience. - CORRECT ANSWER 4. tailor expression of need or gap, logic model of intervention, and expression of magnitude of anticipated benefit or harm to each audience. The incidence of bacteria that are resistant to antibiotics is: 1. Increasing 2. Decreasing 3. Staying the same 4. Difficult to measure - CORRECT ANSWER 1. Increasing If two copies of a mutant allele are necessary to cause symptoms of a disease to appear in the phenotype, what type of genetic disease is this? 1. Recessive 2. Sex-linked 3. Autosomal 4. Dominant - CORRECT ANSWER 1. Recessive Which of the following do social cognitive theory and the social ecological model have in common? 1. Both consider factors that are within the individual and factors that operate outside the individual. 2. Both focus primarily on policy level environmental determinants of behavior. 3. Both come out of the value expectancy paradigm that associates behaviors with valued outcomes. 4. Both originally were developed exclusively to explain unhealthy versus healthy behaviors. - CORRECT ANSWER 1. Both consider factors that are within the individual and factors that operate outside the individual. The infant mortality rate (IMR) is calculated as the number of infant deaths under 1 yr of age divided by the: 1. total number of live births x 1,000 2. total population x 1,000 3. total number of deaths x 1,000 4. total number of live births plus the total number of stillbirths x 1,000 - CORRECT ANSWER 1. total number of live births x 1,000 Which of these has been defined as a core function of public health? 1. Maintaining the census to define populations 2. Consulting stakeholders to decide what best serves public interest 3. Conducting research to solve all population health problems 4. Acting in an ethical manner - CORRECT ANSWER 2. Consulting stakeholders to decide what best serves public interest 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: 1. Social Epidemiology 2. Institutional racism 3. Structural racism 4. Causative factors - CORRECT ANSWER 2. Institutional racism The best multi-platform software product to support public health field investigators who want a program on their portable device capable of generating survey questionnaires and analyzing survey data is: 1. Excel 2. Epi-Info 3. R 4. SPSS - CORRECT ANSWER 2. Epi-Info Epi-Info is a public domain product widely used by public health agency field staff. Unlike the other statistical analysis software listed, it is unique in supporting creation of questionnaires and transferring data from those questionnaires directly into the data tables for analysis. Measuring inputs, throughputs, outputs and outcomes of health systems is, to an increasing extent, relying on "big data" which is distinct from other data in terms of its: 1. Volume, velocity, variety, variability and veracity 2. Terabyte file size, proprietary ownership, encryption and cost 3. Storage in data warehouses isolated from internet access 4. Importance, validation, curation and credibility - CORRECT ANSWER 1. Volume, velocity, variety, variability and veracity The single best predictor of poor health is: 1. Poor sanitary conditions 2. Lack of medical care 3. Genetics 4. Poverty - CORRECT ANSWER 4. Poverty Researchers have identified socioeconomic status (SES) as a fundamental cause of the observed social inequalities in health and in particular of racial differences in health. In many instances the cause of health disparities will have little to do with genetics. Racial and ethnic health disparities are associated with socioeconomic differences and disappear significantly when SES factors are controlled. 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: 1. To present additional statistics to highlight the magnitude of the problem 2. To request a larger budget -- print and post more posters; more radio, and TV ads 3. To hire a consultant to determine if the literacy level is appropriate 4. To conduct focus groups to learn more about the groups' beliefs and values - CORRECT ANSWER 4. To conduct focus groups to learn more about the groups' beliefs and values When setting goals and objectives, it is important that they are considered "SMART". The S in SMART stands for: 1. Scientific 2. Socially Significant 3. Statistically Significant 4. Specific - CORRECT ANSWER 4. Specific Waiting until a program or intervention is complete to begin evaluation activities misses important and valuable opportunities for what type of evaluation? 1. Outcome and impact evaluation 2. Summative evaluation 3. Process evaluation 4. Participant evaluation - CORRECT ANSWER 3. Process evaluation Waiting until a program or intervention has completed to begin evaluation misses opportunities to conduct activities related to a process evaluation. Process evaluation is concerned with how the program is delivered. It deals with issues such as when program activities occur, where they occur, and who delivers them. In other words, process evaluation asks whether the program is being delivered as intended. An effective program may not yield desired results if it is not delivered properly. Outcome and impact evaluations typically occur after a program or intervention concludes and assess its impact on participants and the broader community, respectively. Summative evaluations assess the extent to which a program has achieved its goals. An appropriately tailored intervention message most importantly should: 1. Take into account characteristics of the target population 2. Be designed through community organizational strategies 3. Meet the criteria established by the funding agency 4. Be designed and tested by colleagues and experts in the field - CORRECT ANSWER 1. Take into account characteristics of the target population targeted communication is intended to reach a segment of the population that shares specific characteristics, while tailored communication is intended to reach a specific individual. Both strategies increase the effectiveness of interventions and are premised on acquiring in-depth familiarity with the audience before the message is created, tested, and disseminated. Otherwise, the message will be meaningless to the target population. Waterborne diseases can result from fecal contamination. Which of the following would be classified as a waterborne disease? 1. Cryptosporidium parvum 2. Flavivirus 3. Plasmodium spp. 4. Borrelia burgdorferi - CORRECT ANSWER 1. Cryptosporidium parvum Cryptosporidium parvum, colloquially referred to as crypto, is a waterborne disease that is a major cause of gastroenteritis worldwide. It is a protozoan parasite that is resistant to chlorination, making its control difficult. Flavivirus is a genus of viruses that includes mosquito-transmitted diseases such as Yellow Fever that are classified as water-related because part of disease's vector's lifestyle occurs in water. Plasmodium spp. is a family of parasites that causes malaria, which, like flavivirus, is water-related. Borrelia burgdorferi is a bacterial species that causes Lyme disease, the vector for which is the deer tick. Public health actions frequently involve a balancing of individual rights vs. the good of the community. Where that balance is struck is based on: 1. Explicit direction found in the Nation's Constitution 2. Societal values 3. Science 4. Deontological principles - CORRECT ANSWER 2. Societal values Which of the following makes community-based participatory research (CBPR) unique compared to other research methods? 1. Approval from the institutional review board (IRB) is needed 2. The methods are heavily survey based 3. The participants (target population) becomes a part of the research process 4. It is only used with specific populations - CORRECT ANSWER 3. The participants (target population) becomes a part of the research process CBPR is different from other research methods because the community is part of the process from planning to implementation and is seen as a researcher instead of a subjects. Determining whether to continue or modify but not terminate a program is a reasonable objective of a: 1. formative evaluation 2. summative evaluation. 3. qualitative evaluation. 4. quantitative evaluation - CORRECT ANSWER 1. formative evaluation What is the MOST important statistical attribute a confirmatory test must have to limit false positives effectively? 1. High sensitivity 2. High specificity 3. Low sensitivity 4. Low specificity - CORRECT ANSWER 2. High specificity High specificity effectively limits False Positives. High specificity indicates that if the test is positive, you can effectively rule IN the condition with very few false positives. A Type I error is defined as the probability of rejecting the: 1. Null hypothesis when the null hypothesis is true 2. Alternative hypothesis when the null hypothesis is true 3. Null hypothesis when the alternative hypothesis is true 4. Alternative hypothesis when the alternative hypothesis is true - CORRECT ANSWER 1. Null hypothesis when the null hypothesis is true After identifying and appointing expert members to inter-professional teams for implementing health initiatives, the administration: 1. has shifted all responsibility to the team. 2. role should only consist of receiving periodic progress reports. 3. should plan to confirm the team norms and dynamics are productive. 4. can announce that the initiative was successfully launched. - CORRECT ANSWER 3. should plan to confirm the team norms and dynamics are productive [Show More]

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