100+ Free CPH Practice Questions

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A public health researcher calculates an odds ratio of 3.2 (95% CI: 1.8–5.7) for the association between smoking and lung cancer in a case-control study. What does this result indicate?

Smokers are 3.2 times less likely to develop lung cancer than non-smokers

The odds of lung cancer are 3.2 times higher among smokers compared to non-smokers, and the association is statistically significant

Smoking causes lung cancer with 95% certainty

32% of lung cancer cases are caused by smoking

to track

2026 Statistics

Key Facts: CPH Exam

200

Exam Questions

175 scored + 25 pretest

4 hrs

Time Limit

Multiple-choice format

Content Domains

8-12% each

$385

Exam Fee

Standard fee

Year-round

Testing Availability

CBT or online proctor

2 yrs

Recertification Cycle

30 credits required

The CPH exam has 200 multiple-choice questions (175 scored, 25 unscored pretest items) with a 4-hour time limit. It uses a criterion-referenced passing standard based on a scaled score — there is no fixed percentage cutoff. The exam covers 10 equally weighted domains (8–12% each). It is offered year-round at computer-based testing centers and via live-online proctoring. The standard fee is $385, and recertification requires 30 credits every 2 years ($95 fee).

Sample CPH Practice Questions

Try these sample questions to test your CPH exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A public health researcher calculates an odds ratio of 3.2 (95% CI: 1.8–5.7) for the association between smoking and lung cancer in a case-control study. What does this result indicate?

A.Smokers are 3.2 times less likely to develop lung cancer than non-smokers

B.The odds of lung cancer are 3.2 times higher among smokers compared to non-smokers, and the association is statistically significant

C.Smoking causes lung cancer with 95% certainty

D.32% of lung cancer cases are caused by smoking

Explanation: An odds ratio (OR) of 3.2 means the odds of lung cancer are 3.2 times higher in smokers compared to non-smokers. The 95% confidence interval (1.8–5.7) does not include 1.0, indicating the association is statistically significant. The OR does not prove causation, does not indicate a percentage of cases caused by the exposure, and a value greater than 1 indicates increased (not decreased) risk. Exam Tip: When interpreting odds ratios, always check whether the confidence interval includes 1.0 — if it does, the result is not statistically significant.

2Which measure of disease frequency describes the number of NEW cases of a disease occurring in a population during a specified time period?

A.Prevalence

B.Incidence rate

C.Case fatality rate

D.Mortality rate

Explanation: Incidence rate (or incidence) measures the number of new cases of a disease occurring in a population during a specified time period. Prevalence measures all existing cases (both new and old) at a given point in time. Case fatality rate is the proportion of people who die from a disease among those diagnosed. Mortality rate measures deaths in a population. Exam Tip: Remember the distinction — incidence = new cases, prevalence = existing cases.

3A researcher wants to determine whether a new vaccine reduces the incidence of influenza. She randomly assigns 500 participants to receive the vaccine and 500 to receive a placebo, then follows both groups for one flu season. What type of study design is this?

A.Case-control study

B.Cross-sectional study

C.Randomized controlled trial

D.Cohort study

Explanation: This is a randomized controlled trial (RCT) because participants are randomly assigned to an intervention (vaccine) or control (placebo) group, and outcomes are compared between the groups. A cohort study follows groups with different exposures but does not randomly assign them. A case-control study starts with cases and controls and looks backward at exposures. A cross-sectional study measures exposure and outcome at the same point in time. Exam Tip: Random assignment is the hallmark of an RCT and distinguishes it from observational study designs.

4In biostatistics, a Type I error occurs when:

A.The null hypothesis is incorrectly rejected when it is actually true

B.The null hypothesis is incorrectly accepted when it is actually false

C.The sample size is too small to detect a difference

D.The confidence interval is too wide

Explanation: A Type I error (alpha error) occurs when the null hypothesis is rejected even though it is true — essentially a false positive. A Type II error (beta error) occurs when the null hypothesis is not rejected even though it is false — a false negative. Small sample sizes increase the risk of Type II errors by reducing statistical power. Wide confidence intervals suggest imprecision but are not themselves an error type. Exam Tip: Type I = false positive (rejecting a true null); Type II = false negative (failing to reject a false null).

5A health department tracks emergency department visits for heat-related illness during summer months using electronic health records. This is an example of:

A.Active surveillance

B.Passive surveillance

C.Syndromic surveillance

D.Sentinel surveillance

Explanation: Syndromic surveillance uses pre-diagnostic data sources such as emergency department chief complaints, electronic health records, and over-the-counter medication sales to detect health events in near real-time. Active surveillance involves health authorities actively seeking cases through outreach. Passive surveillance relies on healthcare providers reporting cases to the health department. Sentinel surveillance uses a selected group of reporting sources (e.g., select physicians or hospitals) to monitor trends. Exam Tip: Syndromic surveillance is distinguished by its use of pre-diagnostic, electronic data for early detection.

6A study reports a p-value of 0.03. Using a significance level (alpha) of 0.05, what is the correct interpretation?

A.There is a 3% chance the results are correct

B.The result is statistically significant, and the null hypothesis is rejected

C.The result is not statistically significant because 0.03 is too small

D.There is a 97% probability the alternative hypothesis is true

Explanation: A p-value of 0.03 is less than the predetermined significance level of 0.05, which means the result is statistically significant and the null hypothesis is rejected. The p-value represents the probability of observing results as extreme or more extreme than those obtained, assuming the null hypothesis is true — it does not represent the probability of the results being correct or the alternative hypothesis being true. Exam Tip: p-value < alpha = statistically significant = reject the null hypothesis.

7Which sampling method divides the population into subgroups (such as age groups or geographic regions) and then randomly selects participants from each subgroup?

A.Simple random sampling

B.Stratified random sampling

C.Cluster sampling

D.Convenience sampling

Explanation: Stratified random sampling divides the population into distinct subgroups (strata) based on a characteristic and then randomly selects from each stratum. This ensures representation from key subgroups. Simple random sampling gives every individual an equal chance of selection without stratification. Cluster sampling randomly selects entire groups (clusters) and includes all members of selected clusters. Convenience sampling selects easily accessible participants and is not random. Exam Tip: Stratified = divide into subgroups first, then randomly sample within each.

8A health department investigates a cluster of gastrointestinal illness at a community picnic. Of 200 attendees, 45 became ill. Among 120 who ate potato salad, 40 became ill; among 80 who did not eat potato salad, 5 became ill. What is the attack rate among those who ate potato salad?

A.22.5%

B.33.3%

C.6.3%

D.88.9%

Explanation: The attack rate among those who ate potato salad is calculated as: (number ill who ate potato salad / total who ate potato salad) x 100 = (40/120) x 100 = 33.3%. The overall attack rate is 45/200 = 22.5%. The attack rate among those who did NOT eat potato salad is 5/80 = 6.3%. The difference between these food-specific attack rates suggests potato salad as a likely source. Exam Tip: Attack rate = (ill in exposed group / total in exposed group) x 100.

9Which statistical test is MOST appropriate for comparing the means of two independent groups when the data are normally distributed?

A.Chi-square test

B.Independent samples t-test

C.Pearson correlation

D.Mann-Whitney U test

Explanation: The independent samples t-test compares the means of two independent groups when the data are continuous and normally distributed. The chi-square test is used for categorical data to compare observed and expected frequencies. Pearson correlation measures the strength of a linear relationship between two continuous variables. The Mann-Whitney U test is the non-parametric alternative to the t-test, used when data are not normally distributed. Exam Tip: For comparing two means with normal data, use the t-test; for non-normal data, use the Mann-Whitney U.

10In multiple linear regression analysis, the R-squared value represents:

A.The correlation coefficient between two variables

B.The proportion of variance in the dependent variable explained by the independent variables

C.The probability that the model is statistically significant

D.The number of predictors in the model

Explanation: R-squared (coefficient of determination) represents the proportion of variance in the dependent variable that is explained by the independent variables in the model. An R-squared of 0.65, for example, means 65% of the variation in the outcome is accounted for by the predictor variables. It is not the same as the correlation coefficient (r), though r-squared in simple regression equals the square of r. It does not represent statistical significance or the number of predictors. Exam Tip: R-squared tells you how much of the outcome the model explains — higher is generally better, but always consider the context.

About the CPH Exam

The CPH credential is the national certification for public health professionals, administered by the National Board of Public Health Examiners (NBPHE). The exam covers 10 domains of public health practice including data analytics and informatics, communication, leadership, law and ethics, disease prevention, collaboration, program planning and evaluation, program management, policy, and health equity and social justice.

Questions

200 scored questions

Time Limit

4 hours

Passing Score

Criterion-referenced scaled score

Exam Fee

$385 (National Board of Public Health Examiners (NBPHE))

CPH Exam Content Outline

12%

Data, Analytics, and Informatics

Biostatistics, epidemiological methods, data collection and analysis, surveillance systems, and health informatics

12%

Communication

Health communication strategies, risk communication, health literacy, media advocacy, and audience-appropriate messaging

11%

Disease Prevention and Injury Reduction

Epidemiology of infectious and chronic diseases, outbreak investigation, screening programs, injury prevention, and environmental health hazards

11%

Program Planning and Evaluation

Needs assessment, logic models, evidence-based interventions, process and outcome evaluation, and quality improvement

10%

Collaboration and Partnership

Community engagement, coalition building, stakeholder analysis, inter-organizational relationships, and participatory approaches

10%

Health Equity and Social Justice

Social determinants of health, health disparities, cultural competence, environmental justice, and structural racism in health

Leadership

Organizational leadership, systems thinking, change management, workforce development, and governance

Program and Resource Management

Budgeting, grant management, human resources, organizational behavior, and performance management

Law and Ethics

Public health law, ethical principles, privacy and confidentiality (HIPAA), IRB processes, and regulatory frameworks

Policy in Public Health

Health policy analysis, policy-making process, advocacy, health economics, healthcare systems (ACA, Medicare, Medicaid), and regulatory policy

How to Pass the CPH Exam

What You Need to Know

Passing score: Criterion-referenced scaled score
Exam length: 200 questions
Time limit: 4 hours
Exam fee: $385

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CPH Study Tips from Top Performers

1Start with the NBPHE self-assessment to identify which of the 10 domains need the most focus

2Use the official CPH Content Outline as your primary study map — it defines exactly what is testable

3Focus on applied knowledge rather than memorization — questions test how to apply public health principles in real scenarios

4Study epidemiology and biostatistics concepts thoroughly — Data, Analytics, and Informatics is the highest-weighted domain at 12%

5Review health communication and risk communication frameworks — Communication is also weighted at 12%

6Practice identifying study designs, measures of association, and interpreting statistical outputs for the data-heavy questions

7Understand key public health laws including HIPAA, ACA, and quarantine authority for the Law and Ethics domain

8Learn the major health behavior models (Health Belief Model, Social Ecological Model, Transtheoretical Model) for behavioral science questions

9Take the NBPHE practice exams to familiarize yourself with the single-best-answer format and question style

Frequently Asked Questions

What is the CPH certification?

The CPH (Certified in Public Health) is a national voluntary credential administered by the National Board of Public Health Examiners (NBPHE). It demonstrates competence across 10 core domains of public health practice. Since 2008, public health professionals from over 95 countries have earned the CPH credential. It is recognized by employers, academic institutions, and public health organizations as the standard for public health competence.

What is the CPH exam format?

The CPH exam consists of 200 multiple-choice questions in a single-best-answer format. Of these, 175 are scored and 25 are unscored pretest items being validated for future exams. The time limit is 4 hours. The exam is offered year-round at computer-based testing centers and through live-online proctoring. No calculator is needed — questions avoid complex mathematical calculations.

Who is eligible to take the CPH exam?

There are several eligibility pathways: (1) Students of CEPH-accredited schools or programs of public health identified by their institution, (2) Alumni/graduates of CEPH-accredited programs, (3) Faculty with a graduate degree and 3+ years teaching/working in public health, (4) Standard eligibility: bachelor's degree + 5 years public health experience, or graduate degree + 3 years public health experience, or graduate certificate from a CEPH-accredited program + 3 years experience.

How much does the CPH exam cost?

The standard CPH exam fee is $385. NBPHE offers discounts through partnerships with over 50 organizations, schools, and public health programs. A 'Take Two' bundle includes the exam fee plus one free retake. Recertification costs $95 every 2 years and requires 30 continuing education credits.

What is the CPH passing score?

The CPH uses a criterion-referenced passing standard based on a scaled score rather than a fixed percentage cutoff. Passing is based on overall performance across all domains, not individual domain scores. There is no penalty for guessing, so candidates should answer every question even if unsure.

What topics are covered on the CPH exam?

The CPH exam covers 10 domains: Data, Analytics, and Informatics (12%); Communication (12%); Disease Prevention and Injury Reduction (11%); Program Planning and Evaluation (11%); Collaboration and Partnership (10%); Health Equity and Social Justice (10%); Leadership (9%); Program and Resource Management (9%); Law and Ethics (8%); and Policy in Public Health (8%). Each domain tests applied knowledge of public health principles.

How long should I study for the CPH exam?

Most candidates study for 2-4 months, dedicating 8-12 hours per week. Focus areas depend on your background — those with MPH degrees may need less review of foundational topics. NBPHE recommends starting with a self-assessment to identify weak domains, then using the CPH Content Outline, practice exams, sample questions, and review webinars to prepare.

How do I recertify my CPH?

CPH recertification is required every 2 years and involves reporting at least 30 recertification credits and paying a $95 fee. Credits can be earned through continuing education, teaching, research, professional service, AJPH article reviews, and other qualifying activities. Extensions are available in 3-month increments at no cost.

Can I take the CPH exam online?

Yes, the CPH exam can be taken via live-online proctoring from home or office, or at a computer-based testing center. The exam is offered year-round with scheduling available as soon as 72 hours after eligibility approval. Online testing requires a stable internet connection, webcam, and a quiet testing environment.