# NBDHE practice questions: Community health and research principles Ten original NBDHE practice questions on community health and research principles, each answered on this page with a rationale and a source. Last updated: 2026-09-08. ## Question 1 Few families return permission forms for a school program. The team wants to understand where participation breaks down. Which evaluation question best addresses that need? - A. How much disease would occur without the program? - B. How were forms delivered and what barriers did families report? - C. How many instrument sets were originally purchased? - D. Did disease prevalence decline after five years? **Answer B:** How were forms delivered and what barriers did families report? This examines the delivery process and obstacles to participation. Why the other choices do not fit: A: That counterfactual concerns impact, not the immediate implementation issue. C: This input count alone does not explain form delivery or family barriers. D: That asks about a later outcome rather than the current delivery problem. **Common trap:** Choosing an outcome measure before understanding implementation. Source: [CDC Evaluation Framework 2024](https://www.cdc.gov/mmwr/volumes/73/rr/rr7306a1.htm) ## Question 2 A school team issued 60 referrals and confirmed that 24 participating children completed the designated follow-up visit. Which report correctly distinguishes the measures? - A. 84 completed visits across both stages - B. 60 referrals issued; 24 follow-up visits confirmed - C. 60 completed follow-up visits; 24 children referred - D. 40% of all children in the school completed follow-up **Answer B:** 60 referrals issued; 24 follow-up visits confirmed Issuing a referral and confirming a completed follow-up are distinct events. Why the other choices do not fit: A: Adding referral events to completed visits double counts different stages. C: This reverses the stipulated events. D: 24 of 60 describes the referred group; the total school denominator is not given. **Common trap:** Combining different stages under one completion label. Source: [CDC School Sealant Programs](https://www.cdc.gov/oral-health/php/school-dental-sealant-programs/index.html) ## Question 3 After explaining a referral, an educator wants to use teach-back. Which request best fits? - A. Please tell me in your own words how you will arrange the visit. - B. Can you promise that you will remember this next month? - C. Please read the referral sheet aloud exactly as printed. - D. Do you understand everything on the referral sheet? **Answer A:** Please tell me in your own words how you will arrange the visit. An own-words explanation makes understanding observable and allows clarification. Why the other choices do not fit: B: A promise about memory is not an explanation of the current plan. C: Verbatim reading need not demonstrate understanding. D: A yes/no answer provides little evidence of understanding. **Common trap:** Replacing understanding with yes/no agreement. Source: [AHRQ Teach-Back Method](https://www.ahrq.gov/health-literacy/improve/precautions/tool5.html) ## Question 4 During teach-back, a caregiver describes the wrong next step. What should the educator do next? - A. Record failure and end the explanation - B. Repeat the same wording faster to save time - C. Explain the step differently, then check understanding again - D. Ask for a signature as evidence of understanding **Answer C:** Explain the step differently, then check understanding again Teach-back checks the clarity of the explanation and supports another attempt. Why the other choices do not fit: A: The method is an opportunity to clarify, not a pass/fail memory test. B: Faster repetition does not address the observed misunderstanding. D: A signature does not demonstrate comprehension of the step. **Common trap:** Treating teach-back as a test of the listener. Source: [AHRQ Teach-Back Method](https://www.ahrq.gov/health-literacy/improve/precautions/tool5.html) ## Question 5 A team is choosing among school sites for a sealant program. Which information most directly helps align site selection with the program population CDC describes? - A. Caries-related need and barriers to obtaining private care - B. Which school can supply the largest publicity photograph - C. Which school already has the most private dental appointments - D. Which school offers the shortest commute for staff **Answer A:** Caries-related need and barriers to obtaining private care CDC describes the programs as reaching children at higher risk who may lack access to private care. Why the other choices do not fit: B: Publicity is not evidence of oral-health need or access barriers. C: High existing access alone does not identify the access barriers described. D: Convenience does not establish the intended population need. **Common trap:** Choosing delivery convenience as a proxy for community need. Source: [CDC School Sealant Programs](https://www.cdc.gov/oral-health/php/school-dental-sealant-programs/index.html) ## Question 6 A program has reliable counts of missed appointments but little understanding of why families miss them. Which addition would best address that unanswered question? - A. Assume all absences reflect a rejection of prevention - B. Ask affected families about their experiences and barriers - C. Rename missed appointments as completed referrals - D. Recalculate the same counts to more decimal places **Answer B:** Ask affected families about their experiences and barriers Qualitative information can address reasons that event counts alone do not explain. Why the other choices do not fit: A: That assigns a cause without gathering supporting evidence. C: Changing the label would misrepresent the event. D: Extra precision does not add information about the reasons. **Common trap:** Expecting numeric event counts to explain every cause. Source: [CDC Evaluation Framework 2024](https://www.cdc.gov/mmwr/volumes/73/rr/rr7306a1.htm) ## Question 7 Two sites report referral completion, but one counts appointments scheduled and the other counts visits attended. What should happen before combining their percentages? - A. Use whichever percentage is higher for the combined report - B. Average the percentages without examining their definitions - C. Multiply the two percentages to adjust for different events - D. Agree on the event definition and denominator, then reconcile the data **Answer D:** Agree on the event definition and denominator, then reconcile the data Unlike measures cannot be combined as if they represented the same event. Why the other choices do not fit: A: Selecting the higher number introduces a misleading summary. B: A common label does not make different events comparable. C: Multiplication does not reconcile incompatible definitions. **Common trap:** Assuming identical labels imply identical measures. Source: [CDC Evaluation Framework 2024](https://www.cdc.gov/mmwr/volumes/73/rr/rr7306a1.htm) ## Question 8 An evaluation finds that families cannot act on a referral because instructions omit the scheduling contact. Which next step best uses the finding? - A. Archive the report without changing delivery - B. Treat the logic model as proof that the barrier is resolved - C. Claim the program has already improved health outcomes - D. Revise the instructions and reassess the selected follow-up measure **Answer D:** Revise the instructions and reassess the selected follow-up measure Acting on findings links the evaluation to an improvement and another assessment. Why the other choices do not fit: A: That does not use the actionable finding. B: The model describes an expected relationship, not a completed correction. C: Finding a communication defect does not measure a health improvement. **Common trap:** Ending evaluation at the report rather than using its findings. Source: [CDC Evaluation Framework](https://www.cdc.gov/evaluation/php/evaluation-framework/index.html) ## Question 9 At one survey visit, 40 of 200 examined participants have a defined condition. Onset dates are unknown. Which measure can be calculated from these data? - A. Incidence rate of 20 per 100 person-years - B. Risk ratio of 0.20 - C. Annual incidence proportion of 20% - D. Point prevalence of 20% **Answer D:** Point prevalence of 20% 40 existing cases divided by 200 examined at that point equals 20%. Why the other choices do not fit: A: No person-time denominator is provided. B: There is no second group risk for a ratio. C: There is no new-case count or annual follow-up. **Common trap:** Calling existing cases new cases. Source: [CDC Morbidity Frequency Measures](https://archive.cdc.gov/www_cdc_gov/csels/dsepd/ss1978/lesson3/section2.html) ## Question 10 A cohort begins with 180 people free of a defined condition. All are followed for one year; 18 develop the condition. What is the one-year incidence proportion? - A. 18% - B. 10% - C. 9.1% - D. 90% **Answer B:** 10% The 18 new cases are divided by the 180 initially unaffected people at risk. Why the other choices do not fit: A: The case count is not a percentage without the correct denominator. C: 18 divided by 198 incorrectly adds new cases to the original denominator. D: 162 divided by 180 describes those who did not become cases. **Common trap:** Changing the initially at-risk denominator after events occur. Source: [CDC Morbidity Frequency Measures](https://archive.cdc.gov/www_cdc_gov/csels/dsepd/ss1978/lesson3/section2.html) ## Next step [Take the free 15-question NBDHE practice set](https://dentovio.com/nbdhe/free-practice-test) Official reference: [JCNDE — National Board Dental Hygiene Examination](https://jcnde.ada.org/nbdhe). Original exam-style questions written for study, never recalled exam content. Independent educational preparation, not clinical advice, and not affiliated with or endorsed by the Joint Commission on National Dental Examinations.