Free CPHN Practice Test: 20 Questions With Rationales
Twenty one-best-answer questions with three options each, the same format as the real exam, 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 weighting in the NBPHE's published content outline, 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. Sections are ordered by exam weight, largest first, and labeled with the NBPHE's official domain numbers. For how the domains break down, see the CPHN content outline.
Answered 0 of 20
Assessment and Analysis (Domain 4, 20%)
Approximately 20% of the exam. Four questions here.
A public health nurse reviewing 2025 surveillance data for a county of 200,000 residents finds 40 newly diagnosed tuberculosis cases and reports a rate of 20 per 100,000. Which measure has the nurse reported?
Show answer and rationale
Answer: A. Annual incidence rate
Incidence counts new cases arising in a defined population over a set period, and 40 new cases among 200,000 residents in one year equals 20 per 100,000. Period prevalence would count everyone living with tuberculosis during the year, not only new diagnoses. An attack rate describes a narrowly defined exposed group during a short outbreak window, not a whole county over a year.
A public health nurse new to a neighborhood wants a quick, direct look at housing conditions, open space, and visible services before planning a community assessment. Which method should the nurse use first?
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Answer: B. Conduct a windshield survey of the area
A windshield survey lets the nurse directly observe the physical and social environment by driving or walking through it, which matches the need for a quick firsthand look at conditions. A focus group gathers residents' perceptions in a facilitated discussion, which is valuable later but does not provide direct observation. Key informant interviews capture the views of selected individuals rather than the nurse's own observation of the setting.
A public health nurse mapping census tract data finds 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 by these data?
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Answer: C. Income and canopy are associated with the admissions
Area-level cross-sectional data can show that social and environmental determinants occur together with an outcome, so an association is the strongest supported conclusion. Claiming that low income is causing the admissions overstates what this design can show, since it cannot establish cause or rule out other factors. Saying the data cannot link conditions to asthma at all ignores the association the data clearly display.
A public health nurse comparing screening tests for a community diabetes program reads that one test correctly identifies 95 of every 100 people who truly have the condition. Which property of the test does this figure describe?
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Answer: A. Sensitivity of the test
Sensitivity is the proportion of people who truly have the condition whom the test correctly flags as positive, which is exactly what 95 of 100 describes. Specificity is the proportion of people without the condition whom the test correctly calls negative. Positive predictive value is the probability that a person with a positive result truly has the condition, and it shifts with prevalence.
Communication and Cultural Competence (Domain 2, 19%)
Approximately 19% of the exam. Four questions here.
During a home visit, a public health nurse teaches a client to self-administer insulin and wants to confirm the client understood the teaching. What should the nurse do next?
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Answer: B. Have the client explain each step in their own words
Having the client restate each step in their own words is the teach-back method, which lets the nurse confirm understanding and reteach any gaps on the spot. Asking whether any steps are unclear invites a simple yes or no, and clients often say they understand when they do not. A written summary is a helpful reinforcement but does not show whether the client understood the teaching.
A public health nurse makes a home visit to a client who speaks limited English, and the client's adult son offers to interpret. What should the nurse do first?
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Answer: C. Arrange a qualified medical interpreter
A qualified medical interpreter is the standard because trained interpreters convey clinical information accurately and protect the client's confidentiality. Family members may omit, filter, or misstate information and can inhibit the client from sharing sensitive concerns. Translated written materials alone allow no two-way dialogue and cannot confirm what the client understood.
A public health nurse is writing a flyer to promote a free flu vaccine clinic to the general public. At what reading level should the nurse aim to write the flyer?
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Answer: A. Sixth to eighth grade
Plain language guidance from sources such as the CDC and NIH recommends writing materials for the general public at or below about an eighth grade reading level, often aiming for sixth grade, so they remain usable by adults with limited health literacy. A ninth to tenth grade level exceeds the reading ability of many adults and reduces comprehension. An eleventh to twelfth grade level excludes an even larger share of the intended audience.
A public health nurse routinely reflects on personal assumptions and invites each client to describe what matters most in their care. Which concept does this practice best reflect?
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Answer: B. Cultural humility
Cultural humility is an ongoing practice of self-reflection that treats the client as the expert on their own culture and values, which matches both behaviors described. Cultural competence emphasizes acquiring knowledge and skills about cultural groups, rather than continual self-examination and client-led understanding. Cultural blindness ignores cultural differences, which is the opposite of inviting clients to share what matters to them.
Systems and Foundational Knowledge (Domain 1, 19%)
Approximately 19% of the exam. Four questions here.
A public health nurse orienting new staff explains the framework under which the essential public health services are organized. Which three core functions should the nurse name?
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Answer: C. Assessment, policy development, and assurance
The three core functions of public health are assessment, policy development, and assurance, and the essential public health services are organized beneath them. Prevention, health promotion, and protection are important public health goals but are not the core functions framework. Surveillance, investigation, and emergency response are specific activities that fall within the core functions rather than defining them.
A public health nurse organizes a fall prevention class for independent older adults who have never fallen. Which level of prevention does this class represent?
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Answer: A. Primary prevention
Primary prevention acts before injury or disease occurs, which is what teaching fall prevention to adults who have never fallen accomplishes. Secondary prevention detects existing problems early, such as screening for gait or balance problems. Tertiary prevention limits disability after a condition or injury is already established, such as rehabilitation after a fall.
A public health nurse explains to parents why high measles vaccination coverage in a school also helps protect infants who are too young to be vaccinated. Which concept is the nurse describing?
Show answer and rationale
Answer: B. Herd immunity
Herd immunity occurs when enough of a population is immune to interrupt transmission, which indirectly protects people who cannot be vaccinated, such as young infants. Passive immunity is protection from antibodies received from another source, such as maternal antibodies, not from the immunity of others around the infant. Active immunity is protection a person develops in their own body after infection or vaccination, which these infants do not yet have.
During an outbreak investigation, a public health 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?
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Answer: C. Vehicle of transmission
A vehicle is an inanimate medium, such as water, food, or a contaminated object, that carries an agent from its source to a host. The reservoir is where the agent normally lives and multiplies, and the stem places that source elsewhere. The portal of entry is the route by which the agent enters the host's body, such as the mouth, not the medium that carries it.
Planning and Implementation (Domain 3, 12%)
Approximately 12% of the exam. Two questions here.
A public health nurse works with a city council to pass an ordinance restricting tobacco sales near schools. At which level of practice is this intervention aimed?
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Answer: A. Systems level
Systems level practice changes the laws, policies, and structures that shape health for everyone, which is what a citywide ordinance does. Community level practice works to shift the norms, attitudes, and behaviors of a population, such as through a public awareness campaign, without changing the governing structures. Individual level practice changes the knowledge or behavior of specific people.
A public health nurse on a health department planning team must help choose among several identified community problems with limited funding. Which criterion should guide the choice first?
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Answer: B. Magnitude and feasibility of each issue
Priority setting weighs how large and serious a problem is against whether the department can realistically affect it with available resources. News attention reflects public visibility rather than population need and can steer resources away from serious problems. Choosing by lowest cost alone favors easy, inexpensive problems while larger ones go unaddressed.
Leadership and Management (Domain 7, 11%)
Approximately 11% of the exam. Two questions here.
Two team members disagree about clinic scheduling, and the public health nurse leader guides them to a solution that fully satisfies both. Which conflict management approach is the nurse leader using?
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Answer: C. Collaborating approach
Collaborating works through a conflict until both parties' concerns are fully met, producing a solution both sides accept. Competing imposes one party's position over the other, so only one side is satisfied. Accommodating has one party yield to the other, which preserves the relationship but leaves one side's needs unmet.
Before delegating a task to unlicensed assistive personnel at a community clinic, what should the public health nurse confirm first?
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Answer: A. The task fits the person's scope and skills
Delegation requires that the task fall within the delegatee's legal scope and demonstrated competence, because the delegating nurse remains accountable for the outcome. Past delegation by other nurses does not show that this person is trained or permitted to perform the task. Time savings are a benefit of delegation but do not establish that the task can be performed safely and lawfully.
Policy, Advocacy, and Partnerships (Domain 6, 10%)
Approximately 10% of the exam. Two questions here.
A public health nurse brings together schools, faith groups, and a food bank, each keeping its own mission, to pool resources and work jointly on child hunger over the long term. Which partnership structure has the nurse formed?
Show answer and rationale
Answer: B. Community coalition
A coalition is an ongoing alliance of independent organizations that pool resources and influence toward a shared goal while keeping their own identities. An advisory board counsels a single organization rather than taking joint action across organizations. A task force is usually temporary and formed to complete a specific charge, which does not fit a long-term joint effort.
A public health nurse presents local data on youth vaping to state legislators so they will consider the issue during the next legislative session. Which stage of the policy process is the nurse influencing?
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Answer: C. Agenda setting
Agenda setting is the stage at which a problem gains enough attention among decision makers to be considered for action, which is the nurse's goal. Policy adoption is the formal enactment of a specific policy, which comes after an issue is already under consideration. Policy evaluation judges the effects of a policy after it has been put in place.
Quality and Evaluation (Domain 5, 9%)
Approximately 9% of the exam. Two questions here.
A public health nurse managing a new home visiting program reports the number of home visits completed in the first quarter. Which type of evaluation measure is the nurse reporting?
Show answer and rationale
Answer: A. Process measure
A process measure tracks whether program activities were delivered as planned, such as a count of visits completed. An outcome measure describes change in the health status or behavior of the people served, which a visit count does not show. A balancing measure watches for unintended consequences elsewhere in the system caused by the program.
A public health nurse leading a quality improvement project wants to test a new reminder call process with a few clinic clients before spreading it countywide. Which model should the nurse use?
Show answer and rationale
Answer: B. Plan Do Study Act improvement cycle
The Plan Do Study Act cycle tests a change on a small scale, studies the results, and then adapts, adopts, or abandons it before wider spread. Root cause analysis looks back to find why an adverse event or failure occurred rather than testing a new change. Failure mode and effects analysis anticipates how a process could fail, but it does not itself involve a small-scale test of the change.
Your result
0 of 20 correct
This is a twenty question sample, not a readiness prediction. The CPHN passing score is a scaled 500 on a 200 to 800 scale, but the number of correct answers that equals 500 is only set after the first group of candidates tests, 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, numbers, and weights are taken from the NBPHE's published CPHN Exam Content Outline. Always confirm current details with the NBPHE.