Free CPHN Practice Test: 20 Questions With Rationales
Twenty multiple choice questions covering all seven domains of the Certified in Public Health Nursing exam. Every answer comes with a full rationale. No signup, no email required.
The number of questions from each domain below roughly follows the exam's expected weighting, so the balance of this test reflects the balance of the real thing. Work through a question before opening the answer. Reading the rationale for the options you ruled out matters as much as reading the one for the option you chose, because that is where the reasoning behind the distractors becomes visible.
These are original practice items written by CPHNPrep. They are not retired or leaked exam questions, and no such questions exist publicly, since the CPHN exam has not yet been administered. For how the domains break down, see the CPHN content outline.
Answered 0 of 20
Domain 1: Assessment and Analysis
Approximately 20% of the exam. Four questions here.
A health department reports 40 new cases of tuberculosis in a county of 200,000 residents during 2025. Which measure does this figure represent?
Show answer and rationale
Answer: B. Incidence rate
Incidence measures new cases arising in a population during a defined period, which is what 40 new cases in one year describes. Prevalence counts all existing cases at a point or over a period, attack rate applies to a narrow exposed group over a short window, and case fatality rate is deaths among those who have the disease.
A public health nurse drives systematically through a neighborhood recording housing conditions, open space, and visible services. Which assessment method is this?
Show answer and rationale
Answer: A. Windshield survey
A windshield survey is a direct observational assessment of a community's physical and social environment made while driving or walking through it. Key informant interviews gather views from selected individuals, focus groups gather them in a facilitated group, and secondary data review analyzes existing datasets.
Census tract data show that the neighborhood with the county's highest asthma admission rate also has the lowest median income and the least tree canopy. Which conclusion is best supported?
Show answer and rationale
Answer: B. Determinants of health are associated with the pattern
Area-level cross-sectional data can show that social and environmental determinants travel together with an outcome, but cannot establish that any single factor produced it. Options A and D assert causation the design cannot support, and option C contradicts the observed pattern.
A screening test correctly identifies 95 of every 100 people who truly have the condition. Which property does 95% describe?
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Answer: C. Sensitivity
Sensitivity is the proportion of people who have the disease whom the test correctly flags as positive. Specificity is the proportion without the disease correctly called negative, and the predictive values describe the probability of disease given a test result, which shifts with prevalence.
Domain 2: Communication and Cultural Competence
Approximately 19% of the exam. Four questions here.
After teaching a client to self-administer insulin, the nurse asks the client to explain the steps back in their own words. Which technique is this?
Show answer and rationale
Answer: B. Teach-back
Teach-back asks the learner to restate information in their own words so the educator can confirm understanding and reteach where needed. Motivational interviewing builds readiness to change, active listening reflects what the speaker says, and health coaching supports goal setting over time.
A client speaks limited English and their adult son offers to interpret during a home visit. What should the nurse do first?
Show answer and rationale
Answer: C. Arrange a qualified medical interpreter
A qualified medical interpreter is the standard because family members and untrained bystanders may omit, filter, or misstate clinical information, and their use raises confidentiality concerns. Options A and B rely on untrained interpreters, and written materials alone allow no dialogue and confirm nothing.
At what reading level should written health education materials for the general public generally be written?
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Answer: A. Fifth to sixth grade
Plain language guidance places general public materials at roughly a fifth to sixth grade reading level so they remain usable by adults with limited health literacy. The higher levels exceed the reading ability of a large share of adults and reduce both comprehension and adherence.
A nurse routinely examines their own assumptions and invites each client to describe what matters in their care. Which concept does this reflect?
Show answer and rationale
Answer: D. Cultural humility
Cultural humility is an ongoing practice of self-reflection that treats the client as the expert on their own culture, rather than a body of knowledge one finishes acquiring. Cultural competence emphasizes acquired skill, cultural blindness ignores difference, and cultural imposition forces one's own values onto others.
Domain 3: Systems and Foundational Knowledge
Approximately 19% of the exam. Four questions here.
Which set names the three core functions of public health?
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Answer: A. Assessment, policy development, assurance
The three core functions of public health are assessment, policy development, and assurance, and the essential public health services are organized beneath them. The other sets name genuine public health activities but are not the core functions framework.
A nurse organizes a fall prevention class for independent older adults who have no history of falls. Which level of prevention is this?
Show answer and rationale
Answer: B. Primary
Primary prevention acts before injury or disease occurs, which is what teaching fall prevention to adults who have not fallen accomplishes. Secondary prevention detects existing problems early, tertiary prevention limits disability after a condition is established, and primordial prevention targets the underlying societal conditions rather than an at-risk group.
Population level protection that occurs when enough people are immune to interrupt transmission is called:
Show answer and rationale
Answer: C. Herd immunity
Herd immunity arises when the immune share of a population is high enough to break chains of transmission, indirectly protecting people who are not immune. Passive and active immunity describe how an individual acquires protection, and cross immunity refers to protection against a related pathogen.
During an outbreak investigation, a nurse identifies contaminated well water as the medium carrying the pathogen from its source to people. Which link in the chain of infection does the water represent?
Show answer and rationale
Answer: D. Vehicle
A vehicle is an inanimate medium such as water, food, or a contaminated object that carries an agent to a host. The agent is the pathogen itself, the reservoir is where the agent normally lives and multiplies, and the portal of entry is the route by which it enters the host.
Domain 4: Planning and Implementation
Approximately 12% of the exam. Two questions here.
A nurse works with a city council to pass an ordinance restricting tobacco sales near schools. At which level of practice is this intervention aimed?
Show answer and rationale
Answer: D. Systems
Systems level practice changes the laws, policies, and organizational structures that shape health for everyone, which is what a citywide ordinance does. Individual and family level work changes the knowledge or behavior of specific people, and community level work shifts norms and attitudes without altering the governing structures.
A health department must choose among several identified community problems with limited funding. Which criterion should guide the choice first?
Show answer and rationale
Answer: C. Magnitude and feasibility of the issue
Priority setting weighs how large and serious a problem is against whether the department can realistically affect it with the resources available. Staff familiarity and news attention reflect convenience and visibility rather than population need, and cost alone steers a program toward trivial problems while serious ones go unaddressed.
Domain 5: Leadership and Management
Approximately 11% of the exam. Two questions here.
Two team members disagree about clinic scheduling, and the nurse leader guides them to a solution that satisfies both. Which conflict management approach is this?
Show answer and rationale
Answer: D. Collaborating
Collaborating works a conflict through until both parties' concerns are met, producing a solution both sides accept. Avoiding sidesteps the issue, accommodating yields to the other party, and competing imposes one party's position, so none of them satisfies both sides.
Before delegating a task to unlicensed assistive personnel, the nurse must first confirm that the task:
Show answer and rationale
Answer: A. Falls within the person's scope and training
Delegation requires that the task sit within the delegatee's legal scope and demonstrated competence, because the delegating nurse remains accountable for the outcome. Preference, precedent, and time savings do not establish that the person may safely and lawfully perform it.
Domain 6: Policy, Advocacy, and Partnerships
Approximately 10% of the exam. Two questions here.
A nurse convenes schools, faith groups, and a food bank to jointly address child hunger. This partnership structure is best described as a:
Show answer and rationale
Answer: A. Coalition
A coalition is an alliance of independent organizations that pool resources and influence toward a shared goal while keeping their own identities. A task force is temporary and formed to complete a specific charge, an advisory board counsels an organization without joint action, and a focus group gathers opinions rather than mounting an intervention.
Bringing evidence of a health problem to legislators so it will be taken up for consideration occurs during which stage of the policy process?
Show answer and rationale
Answer: D. Agenda setting
Agenda setting is the stage at which a problem gains enough attention among decision makers to be considered for action. Adoption is the formal enactment of a chosen policy, implementation puts an enacted policy into practice, and evaluation judges its effects afterward.
Domain 7: Quality and Evaluation
Approximately 9% of the exam. Two questions here.
A program reports the number of home visits completed during its first quarter. Which type of evaluation measure is this?
Show answer and rationale
Answer: B. Process measure
A process measure tracks whether program activities were delivered as planned, such as a count of visits completed. Outcome and impact measures describe change in health status or longer term population effects, and a balancing measure watches for unintended consequences elsewhere in the system.
In a quality improvement project, testing a change on a small scale before spreading it is the core of which model?
Show answer and rationale
Answer: C. Plan Do Study Act
The Plan Do Study Act cycle tests a change on a small scale, studies the result, and then adapts, adopts, or abandons it before wider spread. Root cause analysis investigates why an adverse event occurred, failure mode and effects analysis anticipates how a process could fail, and SWOT analysis is a strategic planning tool.
Your result
0 of 20 correct
This is a twenty question sample, not a readiness prediction. The NBPHE has not published a passing score for the CPHN exam, so no result here can tell you whether you would pass.
How did you score?
Twenty questions is enough to expose a weak domain but not enough to measure readiness. Treat the result as a direction finder rather than a prediction. If you missed more than one question in any single domain, start your study there and use the domain weights to decide how much time each one deserves. The step-by-step study plan walks through how to build that schedule.
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Start free practiceCPHNPrep is an independent study resource and is not affiliated with, endorsed by, or sponsored by the National Board of Public Health Examiners (NBPHE). The questions on this page are original practice items written by CPHNPrep and are not actual exam questions. Domain names and weights are based on publicly available information about the content outline and may be refined by the NBPHE before the exam launches. Always confirm current details with the NBPHE.