"One of the nation's hardest-hit cities" refers to the immediately preceding noun--Cleveland. This is actually the same in all 5 answer choices. Noun modifiers generally do modify the closest noun, and in this case we have no choice.

The problem with E is that the phrase "a national hard-hit city" doesn't really mean anything. It doesn't compare Cleveland to any other cities, and also describes the city as "national," which doesn't make sense. What does it mean for a city to be national? The meaning in A-C (D is a bit off) is that of all the cities in the nation, Cleveland is among those that have been hit the hardest. It is "one of the nation's hardest-hit cities."
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Hi DmitryFarber ,

I have chosen C since the sentence is in present tense and are must be used , and the Subject is the" increasingly economic fallout "and verb is "maintain" can you please let me know that , what i have said is correct or wrong .
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