Certified Occupational Health Nurse (COHN) Exam — Questions and Answers

Question 1: An employee involved in a motor vehicle accident during a business trip sustains a broken wrist. Under OSHA recordkeeping, this injury is:

Non-recordable because motor vehicles are excluded
Recordable only if the employee was driving a company vehicle
Recordable because it occurred while performing work duties (Correct answer)
Non-recordable because it occurred off-site

Correct answer: Recordable because it occurred while performing work duties

Injuries sustained while performing work-related tasks during travel are considered work-related and must be recorded if they meet recordability criteria.

Question 2: Which OSHA recordkeeping form is used to summarize work-related injuries and illnesses and must be posted annually?

OSHA 300
OSHA 300A (Correct answer)
OSHA 301
OSHA 101

Correct answer: OSHA 300A

OSHA Form 300A is the Summary of Work-Related Injuries and Illnesses, required to be posted from February 1 through April 30 each year.

Question 3: When calculating the OSHA incidence rate, the denominator of 200,000 represents:

100 full-time employees working 40 hours per week for 50 weeks (Correct answer)
The national average hours worked per industry
The annual hours worked per single employee
The number of employees in the company

Correct answer: 100 full-time employees working 40 hours per week for 50 weeks

200,000 represents the base of 100 full-time equivalent employees (100 × 40 hrs × 50 weeks), allowing injury rates to be compared across organizations of different sizes.

Question 4: Which route of entry is the most common pathway for occupational chemical exposures?

Ingestion
Inhalation (Correct answer)
Skin absorption
Injection

Correct answer: Inhalation

Inhalation is the primary route of entry for most workplace chemical exposures because airborne substances are readily drawn into the lungs.

Question 5: An employee files a workers' compensation claim claiming a back injury is work-related. The employer believes it is a pre-existing condition. Who typically makes the official determination?

The employer's HR department
The employee's personal physician
The occupational health nurse
The state workers' compensation board or commission (Correct answer)

Correct answer: The state workers' compensation board or commission

State workers' compensation boards or commissions adjudicate disputes about claim validity, including whether an injury is work-related.

Question 6: When a worker enters a grain storage bin, the main risk they encounter is:

Anaphylactic reaction
Suffocation (Correct answer)
Limb amputation
Heat stroke

Correct answer: Suffocation

The main risk of asphyxia makes entering a grain storage bin particularly perilous. Grain moving like quicksand can engulf and confine a worker in as little as four to five seconds. When silo gases displace oxygen inside the small silo, suffocation may result. The Occupational Safety and Health Administration requires employers to adhere to best practices and offer training (OSHA). The second most dangerous risk of working in a grain storage bin is amputations from machinery-related incidents. The particles from the rotting grain within the container could cause an allergic reaction in the workers. Acute reactions can include shock in the beginning.

Question 7: An employee with a shoulder injury is cleared for modified duty but refuses to return, citing fear of re-injury. What is the COHN's BEST initial response?

Report the employee's refusal to HR for disciplinary action
Contact the workers' compensation carrier to terminate benefits
Conduct a motivational interview to explore concerns and provide education about safe return to work (Correct answer)
Require the employee to undergo a psychiatric evaluation

Correct answer: Conduct a motivational interview to explore concerns and provide education about safe return to work

Motivational interviewing and education address fear-avoidance beliefs compassionately and are the most effective initial approaches to overcome psychological barriers to RTW.

Question 8: In social cognitive theory, 'self-efficacy' in the context of health promotion means:

A person's belief in their ability to successfully perform a specific behavior (Correct answer)
The social support a person receives from coworkers
An individual's understanding of health risk information
The incentives provided by an employer for healthy behaviors

Correct answer: A person's belief in their ability to successfully perform a specific behavior

Self-efficacy, per Bandura, is the individual's confidence in their capability to execute the behavior needed to achieve a goal.

Question 9: A key proactive method for identifying workplace hazards involves systematically breaking a job into its basic steps, identifying the hazards associated with each step, and then recommending control measures. This process is best known as:

Incident Investigation
Workplace Ergonomic Survey
Root Cause Analysis (RCA)
Job Hazard Analysis (JHA) (Correct answer)

Correct answer: Job Hazard Analysis (JHA)

A Job Hazard Analysis (JHA), also known as a Job Safety Analysis (JSA), is a fundamental safety management tool used to proactively identify hazards and implement controls *before* an incident occurs. It focuses on the relationship between the worker, the task, the tools, and the work environment. RCA and Incident Investigation are reactive processes performed after an adverse event.

Question 10: Under HIPAA, an occupational health nurse may share an employee's protected health information (PHI) with the employer without authorization when:

It is needed to comply with OSHA medical surveillance requirements (Correct answer)
The information is more than 7 years old
The employee's supervisor asks about the diagnosis
The employer specifically requests the full medical record

Correct answer: It is needed to comply with OSHA medical surveillance requirements

HIPAA permits disclosure of PHI to comply with legally mandated OSHA medical surveillance programs without individual employee authorization.

Question 11: Universal precautions require that blood and body fluids from ALL patients be treated as:

Infectious only if the patient tests positive for HIV or HBV
Non-infectious unless visible blood contamination is present
Infectious only in high-risk settings such as oncology or ICU units
Potentially infectious regardless of known diagnosis (Correct answer)

Correct answer: Potentially infectious regardless of known diagnosis

Universal precautions, established by CDC, require treating all blood and specified body fluids as potentially infectious for bloodborne pathogens regardless of patient diagnosis or perceived risk.

Question 12: Which of the following best describes the need for the Factory Nurses Conference that occupational health nurses (OHNs) felt?

All the other specialties in nursing had created their own conferences and groups
Funding was made available by large employers for the nurses to meet
Most OHNs practiced alone and wanted to be able to interact with peers (Correct answer)
Creating their own group would be less expensive to maintain membership than joining the American Nurses Association (ANA)

Correct answer: Most OHNs practiced alone and wanted to be able to interact with peers

The most appropriate answer would be: Most OHNs practiced alone and wanted to be able to interact with peers. Occupational health nurses (OHNs) often work independently in various workplace settings, which can be isolating. The creation of the Factory Nurses Conference, or any similar group or conference, would provide OHNs with an opportunity to connect, collaborate, and interact with peers who share similar roles, challenges, and experiences.

Question 13: Which of the following statements accurately describes the relationship between the Family and Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA)?

The ADA applies to employers with 50 or more employees, while FMLA applies to those with 15 or more.
An employee who qualifies for FMLA leave is automatically considered to have a disability under the ADA.
An employee can be entitled to protections under both laws simultaneously, and their rights are determined by the provisions of each separate law. (Correct answer)
Once an employee exhausts their 12 weeks of FMLA leave, an employer has no further obligation to provide additional leave.

Correct answer: An employee can be entitled to protections under both laws simultaneously, and their rights are determined by the provisions of each separate law.

FMLA and ADA are separate laws with different definitions and eligibility criteria. An employee's 'serious health condition' under FMLA may also qualify as a 'disability' under the ADA, making them eligible for protections under both. The ADA applies to employers with 15+ employees, while FMLA applies to those with 50+ employees. Importantly, additional leave beyond the FMLA's 12 weeks may be a reasonable accommodation required under the ADA.

Question 14: Within a comprehensive health and safety program, what is the primary goal of conducting a systematic worksite analysis?

To assign blame for past accidents and incidents.
To fulfill the minimum annual regulatory requirement for safety inspections.
To document employee compliance with safety rules for annual performance reviews.
To proactively identify, anticipate, and evaluate existing and potential workplace hazards. (Correct answer)

Correct answer: To proactively identify, anticipate, and evaluate existing and potential workplace hazards.

Worksite analysis, which includes processes like the Job Hazard Analysis (JHA), is a core element of a health and safety program designed to proactively find and assess hazards before they cause harm. Its purpose is to look at jobs, tasks, and the overall environment to find potential dangers so that they can be controlled or eliminated. It is a forward-looking, preventive process, not a reactive or punitive one.

Question 15: Which federal agency is responsible for setting and enforcing workplace exposure limits called Permissible Exposure Limits (PELs)?

EPA
NIOSH
OSHA (Correct answer)
ACGIH

Correct answer: OSHA

OSHA establishes and enforces PELs as legally binding exposure limits under 29 CFR 1910 (general industry) and 29 CFR 1926 (construction).

Question 16: What is the primary purpose of a Safety Data Sheet (SDS) in the workplace?

To record OSHA inspection findings for hazardous substances
To document workers' compensation claims for chemical injuries
To provide hazard communication and safe handling information for chemicals (Correct answer)
To calculate permissible exposure limits for chemical mixtures

Correct answer: To provide hazard communication and safe handling information for chemicals

An SDS provides comprehensive information on a chemical's hazards, composition, handling, storage, emergency procedures, and exposure limits to protect workers.

Question 17: Which legislation primarily governs the confidentiality of an injured worker's medical information shared in occupational case management?

Employee Retirement Income Security Act (ERISA)
OSHA Act of 1970
Fair Labor Standards Act (FLSA)
HIPAA Privacy Rule (Correct answer)

Correct answer: HIPAA Privacy Rule

HIPAA's Privacy Rule governs the confidentiality and appropriate disclosure of protected health information, including in occupational case management contexts.

Question 18: A chemical with a Threshold Limit Value-Ceiling (TLV-C) must NEVER be exceeded:

During any 15-minute period in the work shift
On more than 2 occasions per 8-hour shift
For more than 30 cumulative minutes per shift
At any time during the work shift (Correct answer)

Correct answer: At any time during the work shift

TLV-C is a ceiling concentration that should not be exceeded at any time, unlike TLV-TWA or TLV-STEL which allow time averaging.

Question 19: Which FMLA provision allows an employee to take leave in blocks as small as one hour for a chronic condition?

Reduced schedule leave
Continuous leave
Intermittent leave (Correct answer)
Parental leave

Correct answer: Intermittent leave

Intermittent FMLA leave permits employees to take leave in separate blocks of time for a single qualifying reason.

Question 20: OSHA's recordkeeping rule (29 CFR 1904) requires employers with 10 or more employees to maintain which form for work-related injuries?

OSHA 101
SF-600 Form
OSHA 201
OSHA 300 Log (Correct answer)

Correct answer: OSHA 300 Log

The OSHA 300 Log is used to record work-related injuries and illnesses and must be maintained for 5 years.

Question 21: Which lighting condition is classified as a physical hazard that a COHN should evaluate in an occupational health assessment?

Fluorescent lighting flickering at 60 Hz
Blue-enriched light promoting alertness
Natural daylighting in office environments
Insufficient task lighting causing eyestrain and accident risk (Correct answer)

Correct answer: Insufficient task lighting causing eyestrain and accident risk

Inadequate illumination is a recognized physical hazard that increases eyestrain, reduces accuracy, and raises the risk of accidents and injuries in the workplace.

Question 22: Early return-to-work programs have been shown to benefit employers primarily by:

Allowing employers to monitor injured workers for claim fraud
Shifting liability from the employer to the workers' compensation insurer
Reducing total disability costs, maintaining worker productivity, and preserving employee skills and morale (Correct answer)
Eliminating all future workers' compensation claims

Correct answer: Reducing total disability costs, maintaining worker productivity, and preserving employee skills and morale

Early RTW programs reduce total claim costs, maintain productivity, prevent deconditioning, and support employee morale and retention.

Question 23: Which of the following best illustrates the principle of 'least restrictive environment' in return-to-work planning?

Assigning the worker to a completely different department with no physical demands
Returning the worker to the closest possible approximation of their pre-injury job with minimal modification (Correct answer)
Keeping the worker off work until full recovery to prevent any risk
Requiring the worker to complete 12 weeks of work hardening before any job assignment

Correct answer: Returning the worker to the closest possible approximation of their pre-injury job with minimal modification

Returning the worker to the highest functional level with the least restriction possible promotes faster recovery and workforce integration.

Question 24: Which organs or tissues are most affected by ionizing radiation?

Liver
Bone marrow (Correct answer)
Calcium edta
Spleen

Correct answer: Bone marrow

Ionizing radiation can have various effects on different tissues and organs in the body, but one of the tissues that is particularly sensitive to radiation is the bone marrow. The bone marrow is responsible for the production of blood cells, including red blood cells, white blood cells, and platelets. These cells are vital for the proper functioning of the immune system, oxygen transport, and blood clotting.

Question 25: Which tool is most useful for assessing an injured worker's functional capacity prior to return to work?

SF-36 Health Survey
Mini-Mental State Examination
Pain Catastrophizing Scale
Functional Capacity Evaluation (FCE) (Correct answer)

Correct answer: Functional Capacity Evaluation (FCE)

A Functional Capacity Evaluation objectively measures a worker's physical abilities and limitations relevant to specific job demands.

Question 26: Which of the following is a PRIMARY responsibility of an occupational case manager during an onsite visit?

Administering prescription medications to injured workers
Negotiating labor contracts on behalf of the employer
Conducting disciplinary actions against supervisors
Performing ergonomic assessments and identifying workplace hazards (Correct answer)

Correct answer: Performing ergonomic assessments and identifying workplace hazards

During onsite visits, occupational case managers assess the work environment, identify hazards, and support ergonomic improvements to facilitate safe return to work.

Question 27: Biological monitoring in occupational health measures what?

The amount of a chemical or its metabolite in a worker's blood, urine, or breath (Correct answer)
The radiation dose received by workers in nuclear facilities
The number of bacteria present in the workplace environment
Air concentration of chemicals in the workplace

Correct answer: The amount of a chemical or its metabolite in a worker's blood, urine, or breath

Biological monitoring quantifies internal exposure by detecting a chemical or its metabolites in biological specimens, reflecting total exposure from all routes.

Question 28: Which level of prevention does a nurse practice when administering Hepatitis B vaccines to newborns?

Secondary prevention
Primordial prevention
Tertiary prevention
Primary prevention (Correct answer)

Correct answer: Primary prevention

Vaccination before disease occurs is primary prevention, aimed at reducing the incidence of disease.

Question 29: In workers' compensation case management, 'maximum medical improvement' (MMI) refers to:

The date on which indemnity benefits automatically terminate
Full recovery with no residual impairment
Employer certification that a worker is fit for full-duty return
The point at which a worker's medical condition has stabilized and is unlikely to improve further with treatment (Correct answer)

Correct answer: The point at which a worker's medical condition has stabilized and is unlikely to improve further with treatment

MMI is the point at which a worker's condition is medically stable and further significant improvement is not expected, regardless of whether full recovery has occurred.

Question 30: During a hazard walk-through, an ABOHN-certified nurse identifies that workers are exposed to silica dust above the permissible exposure limit. Her first priority action should be:

Conduct pulmonary function testing on all exposed workers
File a complaint with OSHA on behalf of workers
Order N95 respirators immediately for all affected workers
Document the finding and notify management with recommendations for engineering controls (Correct answer)

Correct answer: Document the finding and notify management with recommendations for engineering controls

Documenting findings and recommending engineering controls follows the hierarchy of controls and appropriate occupational health nursing advocacy channels before escalating to regulatory bodies.

Question 31: In toxicology, the term LC50 refers to which of the following?

The lethal dose of a chemical when ingested by 50% of a test population.
The legal concentration limit for a chemical in the workplace.
The lethal concentration of an airborne substance that kills 50% of a test population. (Correct answer)
The lowest concentration of a chemical that causes a chronic effect.

Correct answer: The lethal concentration of an airborne substance that kills 50% of a test population.

LC50 stands for Lethal Concentration, 50%. It is a standard measure of the toxicity of an airborne substance (like a gas, vapor, or dust) and represents the concentration that is lethal to half of the tested animal population during a specific exposure period.

Question 32: An employee is medically cleared to return to work without restrictions after an injury, but tells the occupational health nurse, "I'm terrified I'm going to hurt myself again just by doing my regular tasks." This statement indicates a significant barrier to a successful return to work. What is this type of barrier best described as?

A psychosocial factor influencing recovery. (Correct answer)
A failure of the medical provider to communicate clearance.
An administrative policy conflict.
A legal impediment related to liability.

Correct answer: A psychosocial factor influencing recovery.

The employee's fear of re-injury is a classic example of a psychosocial barrier. These factors, which include fear, anxiety, lack of confidence, and perceived lack of support, can significantly impede or delay a return to work even when an employee is physically capable. Addressing these psychological and social components is a critical part of holistic return-to-work case management.

Question 33: Which assessment tool is used in the START triage system to categorize a non-breathing adult victim who does not breathe after one head-tilt/chin-lift?

Red (immediate)
Black (expectant/deceased) (Correct answer)
Yellow (delayed)
Green (minor)

Correct answer: Black (expectant/deceased)

In START triage, a non-breathing adult who does not resume breathing after airway repositioning is categorized Black (expectant/deceased), as resources are focused on salvageable victims.

Question 34: An occupational health nurse performing a health and safety audit should PRIMARILY review which documents?

Marketing materials and customer complaints
Injury logs, inspection records, training documentation, and written programs (Correct answer)
Employee performance appraisals and payroll records
HIPAA notices and privacy policies

Correct answer: Injury logs, inspection records, training documentation, and written programs

Audits verify program compliance and effectiveness through injury logs, safety inspection records, written safety programs, and training records.

Question 35: Which OSHA standard requires fall protection for general industry workers at heights of 4 feet or more?

29 CFR 1910.23 (Correct answer)
29 CFR 1926.502
29 CFR 1910.132
29 CFR 1910.147

Correct answer: 29 CFR 1910.23

29 CFR 1910.23 (Walking-Working Surfaces) requires fall protection for general industry workers when exposed to fall hazards of 4 feet or more.

Question 36: Which statute prohibits employers from retaliating against employees who file workers' compensation claims?

The Employee Retirement Income Security Act (ERISA)
The Americans with Disabilities Act (ADA)
State anti-retaliation provisions in workers' compensation laws (Correct answer)
Title VII of the Civil Rights Act

Correct answer: State anti-retaliation provisions in workers' compensation laws

Most U.S. states have anti-retaliation provisions in their workers' compensation statutes that protect employees from being fired or discriminated against for filing claims.

Question 37: A case manager is reviewing a treatment plan for an injured worker that includes procedures with questionable evidence of effectiveness. The MOST appropriate response is to:

Contact the employer directly to deny the treatment
Approve all treatments to avoid conflict with the treating physician
Immediately refer the case for an Independent Medical Examination
Apply evidence-based guidelines to evaluate appropriateness and communicate concerns through proper channels (Correct answer)

Correct answer: Apply evidence-based guidelines to evaluate appropriateness and communicate concerns through proper channels

Occupational case managers apply evidence-based clinical guidelines to assess treatment appropriateness and raise concerns professionally and through appropriate channels.

Question 38: Under the ADA, when an employee requests a workplace accommodation for a chronic health condition, the COHN's role primarily includes:

Denying accommodation requests that may affect productivity
Providing clinical information to support the interactive accommodation process (Correct answer)
Making the final determination on accommodation approval
Filing the accommodation paperwork with EEOC directly

Correct answer: Providing clinical information to support the interactive accommodation process

The COHN contributes clinical expertise and functional capacity information to support the employer's interactive process but does not make the legal accommodation decision.

Question 39: A manufacturing company has just implemented a comprehensive new health and safety program. When evaluating the program's effectiveness after one year, which of the following is considered a lagging indicator of performance?

Number of safety committee meetings held during the year.
Number of proactive hazard reports submitted by employees.
Percentage of employees who completed mandatory safety training.
The company's OSHA recordable injury rate. (Correct answer)

Correct answer: The company's OSHA recordable injury rate.

Lagging indicators are reactive, measuring outcomes and events that have already occurred. The OSHA recordable injury rate is a classic lagging indicator because it quantifies past incidents. The other options—training completion, hazard reports, and meetings held—are leading indicators, which are proactive measures intended to prevent future incidents.

Question 40: When reviewing a candidate's application, ABOHN discovers falsified continuing education documentation. What is the most likely consequence?

ABOHN notifies the state board but takes no independent action
The candidate is placed on probation for one year
The candidate must retake only the CE portion of requirements
The certification is revoked and the candidate may be permanently barred (Correct answer)

Correct answer: The certification is revoked and the candidate may be permanently barred

Fraudulent documentation constitutes a serious ethical violation; ABOHN can revoke certification and may permanently bar the individual from future credentialing.

Question 41: Which of the following is an example of secondary prevention in occupational health case management?

Implementing pre-employment physicals to screen for pre-existing conditions
Early intervention programs after an injury to prevent long-term disability (Correct answer)
Installing ergonomic workstations before any injuries occur
Returning a permanently disabled worker to the workforce through vocational training

Correct answer: Early intervention programs after an injury to prevent long-term disability

Secondary prevention focuses on early intervention after an injury occurs to minimize severity and prevent long-term disability or complications.

Question 42: Which federal law prohibits discrimination based on genetic information in employment and health insurance?

GINA (Correct answer)
ERISA
ADA
HIPAA

Correct answer: GINA

The Genetic Information Nondiscrimination Act (GINA) prohibits employers and health insurers from discriminating based on genetic information.

Question 43: Workers' compensation is based on which legal principle that shields employers from employee lawsuits in exchange for no-fault benefits?

Vicarious liability
The exclusive remedy doctrine (Correct answer)
Respondeat superior
Contributory negligence

Correct answer: The exclusive remedy doctrine

The exclusive remedy doctrine limits workers to workers' compensation benefits as their sole legal remedy against employers for work-related injuries.

Question 44: What does the hierarchy of controls prioritize as the most effective method for controlling workplace hazards?

Administrative controls
Elimination of the hazard (Correct answer)
Personal protective equipment (PPE)
Engineering controls

Correct answer: Elimination of the hazard

Elimination removes the hazard entirely and is the most effective control at the top of the hierarchy, followed by substitution, engineering controls, administrative controls, and PPE.

Question 45: A community health nurse is conducting a windshield survey. Which observation is MOST characteristic of this assessment method?

Interviewing key community informants
Reviewing census demographic data
Driving through the community to observe environmental and social features (Correct answer)
Analyzing hospital admission records

Correct answer: Driving through the community to observe environmental and social features

A windshield survey involves systematically observing a community from a vehicle to assess physical, social, and environmental characteristics.

Question 46: Health literacy is BEST defined as:

The capacity to obtain, process, and understand basic health information to make informed decisions (Correct answer)
Fluency in both English and a second language
Completion of at least a high school education
The ability to read medical textbooks

Correct answer: The capacity to obtain, process, and understand basic health information to make informed decisions

Health literacy encompasses finding, understanding, and using health information — it is a cognitive and social skill, not simply reading ability.

Question 47: What type of ventilation system removes contaminants at their source before they can spread into the work area?

General dilution ventilation
Recirculation ventilation
Local exhaust ventilation (LEV) (Correct answer)
Positive pressure ventilation

Correct answer: Local exhaust ventilation (LEV)

Local exhaust ventilation captures and removes airborne contaminants at or near their point of generation, preventing worker exposure.

Question 48: An employee is returning to a physically demanding job with a temporary restriction of 'no lifting over 20 pounds.' Which of the following represents the MOST appropriate communication from the occupational health nurse to the employee's direct supervisor?

"Jane is returning tomorrow, but be aware she has a rotator cuff tear and is still in physical therapy."
"To maintain confidentiality, I cannot share any information about Jane's return. Please observe her and let me know if you see any issues."
"You will need to ensure Jane follows all her medical restrictions, and you should report any non-compliance to me immediately."
"Jane is returning to work tomorrow. For the next four weeks, she is restricted from lifting anything over 20 pounds. Let's discuss how we can accommodate this in her duties." (Correct answer)

Correct answer: "Jane is returning to work tomorrow. For the next four weeks, she is restricted from lifting anything over 20 pounds. Let's discuss how we can accommodate this in her duties."

The supervisor has a legitimate need to know the employee's functional limitations to provide a safe and appropriate work assignment. However, they do not have a need to know the medical diagnosis or details of treatment. This choice correctly shares only the necessary work-related restrictions, specifies the duration, and proactively opens a dialogue about accommodation, all while protecting the employee's private medical information.

Question 49: A worker is splashed with an unknown corrosive chemical in the eyes. The IMMEDIATE first aid action is to:

Apply a neutralizing solution specific to the pH of the chemical
Check the SDS before beginning any treatment to identify the chemical
Cover both eyes with sterile dressings and transport to emergency care
Irrigate both eyes continuously with water or saline for at least 15-20 minutes (Correct answer)

Correct answer: Irrigate both eyes continuously with water or saline for at least 15-20 minutes

Immediate copious irrigation for 15-20 minutes takes priority over chemical identification because seconds count in preventing corneal damage — the SDS can be checked during or after irrigation.

Question 50: An occupational health nurse is reviewing shelter-in-place procedures. Which scenario BEST indicates when shelter-in-place is preferred over evacuation?

A credible bomb threat received by security
An active fire in the building's east wing
A structural failure warning from engineering
An external airborne chemical release with rapidly changing wind direction (Correct answer)

Correct answer: An external airborne chemical release with rapidly changing wind direction

An external airborne chemical release with unpredictable wind direction makes evacuation dangerous; sheltering in-place protects employees by sealing them indoors away from contaminated air.

Question 51: Under the ADA, which of the following best defines 'reasonable accommodation' in the context of return-to-work?

Reassignment to a higher-paying position to compensate for limitations
Any modification that eliminates all physical demands of a job
Providing unlimited leave until the employee fully recovers
A modification or adjustment that enables a qualified individual with a disability to perform essential job functions (Correct answer)

Correct answer: A modification or adjustment that enables a qualified individual with a disability to perform essential job functions

Reasonable accommodation is a modification or adjustment that enables a qualified individual with a disability to perform essential job functions without causing undue hardship to the employer.

Question 52: An occupational health nurse reviewing OSHA 300 logs notices a cluster of hand lacerations in one production department over three months. This is an example of which hazard identification approach?

Biological exposure monitoring
Industrial hygiene sampling
Reactive injury trend analysis (Correct answer)
Prospective hazard surveillance

Correct answer: Reactive injury trend analysis

Analyzing OSHA 300 log injury patterns after they have occurred is a reactive approach that identifies hazard clusters through trend analysis of recorded incidents.

Question 53: What is the most critical reason for maintaining accurate OSHA 300 logs as part of occupational health nursing recordkeeping?

Calculating workers' compensation insurance premiums
Tracking injury and illness trends to identify hazards and drive prevention (Correct answer)
Satisfying mandatory disclosure requirements for employee unions only
Documenting individual employee medical histories

Correct answer: Tracking injury and illness trends to identify hazards and drive prevention

OSHA 300 logs enable systematic analysis of workplace injury and illness trends, helping occupational health nurses and safety teams identify hazards and target prevention efforts.

Question 54: What is the minimum number of hours of occupational health nursing experience required to sit for the COHN examination?

3,000 hours
1,000 hours (Correct answer)
5,000 hours
4,000 hours

Correct answer: 1,000 hours

ABOHN requires a minimum of 1,000 hours of occupational health nursing practice within the five years preceding application to sit for the COHN exam.

Question 55: A COHN is evaluating pinch-grip force requirements at an assembly line. Excessive pinch force is most associated with which condition?

Lateral epicondylitis
Carpal tunnel syndrome
Thoracic outlet syndrome
De Quervain's tenosynovitis (Correct answer)

Correct answer: De Quervain's tenosynovitis

De Quervain's tenosynovitis involves inflammation of the tendons controlled by the abductor pollicis longus and extensor pollicis brevis, aggravated by repetitive pinch-grip tasks.

Question 56: Which document is typically the first step in initiating a workers' compensation claim?

A first report of injury (FROI) filed by the employer (Correct answer)
A physician's disability certification
A lawsuit filed in state court
An OSHA 300 log entry

Correct answer: A first report of injury (FROI) filed by the employer

The FROI is the employer's official notification to the workers' compensation insurer that a workplace injury or illness has occurred.

Question 57: Which federal standard governs the medical removal protection (MRP) provisions that require removal of workers with elevated blood lead levels?

29 CFR 1910.1200
29 CFR 1910.1030
29 CFR 1910.1025 (Correct answer)
29 CFR 1910.1000

Correct answer: 29 CFR 1910.1025

29 CFR 1910.1025 (Lead Standard) includes MRP provisions requiring temporary removal of workers whose blood lead levels exceed specified limits, with wage and benefit protection during removal.

Question 58: What is the OSHA permissible exposure limit (PEL) for noise as an 8-hour time-weighted average (TWA)?

95 dBA
90 dBA (Correct answer)
85 dBA
100 dBA

Correct answer: 90 dBA

OSHA's PEL for occupational noise is 90 dBA as an 8-hour TWA, with engineering or administrative controls required when this limit is exceeded.

Question 59: When an employee's work restrictions conflict with the employer's production needs, the COHN's BEST approach is to:

Advise the employee to ignore the production pressure
Facilitate a multidisciplinary meeting to problem-solve modified duty options that honor restrictions while meeting operational needs (Correct answer)
Side with the employer's production needs to protect the company
Remove the employee from work entirely to avoid conflict

Correct answer: Facilitate a multidisciplinary meeting to problem-solve modified duty options that honor restrictions while meeting operational needs

The COHN facilitates collaborative problem-solving among all stakeholders to find solutions that respect medical restrictions while addressing operational realities.

Question 60: A case manager receives pressure from an employer client to document findings in a way that minimizes the worker's injury severity. The COHN should:

Refuse and document findings objectively in accordance with professional and ethical standards (Correct answer)
Consult the employer's legal team before completing documentation
Omit the injury details entirely to avoid conflict
Comply to maintain the client relationship

Correct answer: Refuse and document findings objectively in accordance with professional and ethical standards

COHNs are bound by professional ethics to document accurately and objectively; falsifying or minimizing records violates ethical and potentially legal standards.

Question 61: A COHN evaluates a production line and finds workers using pliers that require high grip force due to a spring return mechanism. The best ergonomic solution is to:

Have workers wear padded gloves
Teach workers to grip only with fingertips
Replace with self-opening (low return-force) pliers (Correct answer)
Reduce the shift length by 30 minutes

Correct answer: Replace with self-opening (low return-force) pliers

Self-opening pliers eliminate the need to actively open the tool against a spring, significantly reducing cumulative grip force and MSD risk.

Question 62: Which metric is MOST commonly used to evaluate the effectiveness of an occupational case management program?

Number of OSHA recordable incidents per year
Employer premium savings on general liability insurance
Return-to-work rates and duration of disability (Correct answer)
Employee satisfaction scores on annual surveys

Correct answer: Return-to-work rates and duration of disability

Return-to-work rates and duration of disability are the primary outcome metrics for measuring the success of occupational case management programs.

Question 63: An occupational health nurse is tasked with improving a health and safety program where employees seem disengaged and rarely report near misses. Which of the following strategies is most effective for fostering meaningful employee involvement?

Mandating that all employees watch a series of general safety videos annually.
Establishing a joint labor-management safety committee with clear roles and responsibilities. (Correct answer)
Increasing the number of generic safety posters and signs throughout the facility.
Implementing a top-down communication strategy where management dictates all safety rules.

Correct answer: Establishing a joint labor-management safety committee with clear roles and responsibilities.

Worker participation is a key pillar of a successful safety program. A joint labor-management safety committee provides a formal structure for workers to participate as equals in identifying hazards, developing solutions, and reviewing incidents. This active involvement and shared ownership is far more effective at building engagement than passive, one-way measures like posters or mandated videos.

Question 64: Under the ADA, an employer is required to provide a reasonable accommodation unless it causes:

Any additional cost
Undue hardship (Correct answer)
Minor inconvenience
A change in job duties

Correct answer: Undue hardship

The ADA requires reasonable accommodations unless they impose an undue hardship on the employer's operations or finances.

Question 65: A nurse reports tingling and numbness in the thumb, index, and middle fingers that worsens at night. The COHN suspects carpal tunnel syndrome. The most appropriate next action is:

Document the complaint and monitor without intervention
Issue wrist splints without further evaluation
Refer for medical evaluation and nerve conduction study (Correct answer)
Immediately reassign the nurse to a non-clinical role

Correct answer: Refer for medical evaluation and nerve conduction study

Referral for formal medical evaluation, including nerve conduction studies, is the appropriate step to confirm the diagnosis before initiating treatment or job modification.

Question 66: Which employee group should be prioritized when resources are limited for a worksite cardiovascular disease prevention program?

Managers and supervisors exclusively
Employees identified as high risk through biometric screenings (Correct answer)
All employees under age 40
Only employees with current cardiovascular diagnoses

Correct answer: Employees identified as high risk through biometric screenings

Targeting high-risk individuals identified through biometric screenings maximizes impact by directing limited resources where benefit is greatest.

Question 67: Which metric BEST measures the effectiveness of a return-to-work program?

The number of ergonomic evaluations completed
The number of workers' compensation claims filed per year
Employee satisfaction scores from annual surveys
Lost workday rate, total disability duration, and percentage of workers successfully returning to their original position (Correct answer)

Correct answer: Lost workday rate, total disability duration, and percentage of workers successfully returning to their original position

Program effectiveness is best measured by outcome metrics such as lost workday rates, total disability duration, and the rate of successful return to the original position.

Question 68: In a transitional duty program, a light-duty assignment should primarily be:

Limited to sedentary office tasks regardless of the worker's trade
Assigned without input from the treating physician
Temporary, goal-oriented, and designed to progress toward full duty (Correct answer)
Permanent to prevent re-injury

Correct answer: Temporary, goal-oriented, and designed to progress toward full duty

Transitional duty should be temporary and goal-oriented, with progressive increases in activity designed to return the worker to their original position.

Question 69: An occupational case manager notices a gap between the treating physician's restrictions and the employer's modified duty offer. The best first step is to:

Facilitate communication between the physician and the employer's HR team (Correct answer)
Request an independent medical examination immediately
Advise the worker to refuse the modified duty
File a complaint with the state workers' compensation board

Correct answer: Facilitate communication between the physician and the employer's HR team

Facilitating communication between stakeholders is a core case management function that helps resolve discrepancies and supports timely return to work.

Question 70: An employer wants to contest an OSHA citation. Within how many working days of receiving the citation must the employer file a Notice of Contest?

30 working days
15 working days (Correct answer)
5 working days
10 working days

Correct answer: 15 working days

Employers must file a Notice of Contest within 15 working days of receiving an OSHA citation or the citation becomes a final order.

Question 71: Which federal agency provides the National Response Framework (NRF) that guides emergency management coordination?

CDC
FEMA (Correct answer)
NIOSH
OSHA

Correct answer: FEMA

FEMA (Federal Emergency Management Agency) publishes the National Response Framework, which establishes a comprehensive approach to national incident response.

Question 72: An OHN implements a mandatory hearing conservation program for all employees exposed to noise levels at or above the OSHA action level. This program includes baseline and annual audiograms, training, and provision of hearing protection. This entire program is an example of which level of prevention?

Primary prevention
Administrative prevention
Secondary prevention (Correct answer)
Tertiary prevention

Correct answer: Secondary prevention

Secondary prevention focuses on the early detection and treatment of disease to slow its progression. A hearing conservation program with regular screening tests (audiograms) is designed to detect early signs of hearing loss, allowing for timely intervention to prevent further damage. While it has primary prevention elements (training, PPE), its core function of early detection through screening places it firmly in the secondary prevention category.

Question 73: An employee works in a boiler room where temperatures regularly exceed 95°F. Which early symptom of heat illness should prompt immediate removal from the environment?

Mild headache after the first hour
Confusion, slurred speech, or cessation of sweating (Correct answer)
Muscle cramps in the legs
Mild perspiration and thirst

Correct answer: Confusion, slurred speech, or cessation of sweating

Confusion, slurred speech, and anhidrosis (cessation of sweating) are signs of heat stroke — a life-threatening emergency requiring immediate removal and cooling.

Question 74: A workers' compensation case is classified as 'permanent partial disability' (PPD). What does this indicate?

The worker is permanently unable to perform any work
The worker has a permanent impairment but retains some work capacity (Correct answer)
The worker is fully recovered and returned to full duty
The worker's injury is still under investigation

Correct answer: The worker has a permanent impairment but retains some work capacity

PPD indicates the worker has reached MMI with a residual permanent impairment but can still perform some type of work.

Question 75: A construction worker is found unconscious in a confined space where fuel combustion equipment was used. The FIRST priority action is:

Put on supplied-air SCBA before entering to rescue (Correct answer)
Lower a rope and have the worker self-rescue
Ventilate the space for 10 minutes before entering without PPE
Immediately enter and drag the worker out

Correct answer: Put on supplied-air SCBA before entering to rescue

Confined space rescuers must use supplied-air SCBA because entering without respiratory protection leads to multiple fatalities — the majority of confined space deaths are untrained would-be rescuers.

Question 76: The purpose of a 'job demands analysis' (JDA) in occupational health is BEST described as:

Calculating overtime pay requirements for physically demanding jobs
Determining the minimum education required for a specific position
Evaluating employee performance for merit reviews
Systematically identifying the physical, cognitive, and environmental requirements of a job to match with worker capabilities (Correct answer)

Correct answer: Systematically identifying the physical, cognitive, and environmental requirements of a job to match with worker capabilities

A JDA identifies and quantifies the essential physical, cognitive, and environmental demands of a job to enable proper matching of worker capability to job requirements.

Question 77: Under OSHA's multi-employer worksite policy, which employer is responsible for creating and controlling the overall safety program on a construction site?

The controlling/general contractor (Correct answer)
The union safety steward
The subcontractor with the most workers
The host employer's insurance carrier

Correct answer: The controlling/general contractor

The controlling employer (typically the general contractor) bears responsibility for establishing and enforcing site-wide safety conditions under OSHA's multi-employer citation policy.

Question 78: A COHN notices that employees in the warehouse have a higher BMI on average than office workers. The MOST appropriate first action is to:

Report findings to management for disciplinary review
Analyze work tasks and lifestyle factors contributing to the disparity (Correct answer)
Refer all overweight warehouse employees to their physicians
Immediately start a weight-loss program for warehouse workers

Correct answer: Analyze work tasks and lifestyle factors contributing to the disparity

Analyzing contributing factors ensures interventions are targeted, culturally appropriate, and based on root causes rather than assumptions.

Question 79: When identifying psychosocial hazards in the workplace, which tool is MOST appropriate for the occupational health nurse to use?

OSHA 300 log review
Noise dosimeter measurements
Industrial hygiene air sampling
Validated workplace stress surveys (Correct answer)

Correct answer: Validated workplace stress surveys

Validated workplace stress surveys (such as the JCQ or NIOSH Generic Job Stress Questionnaire) are designed to systematically identify psychosocial stressors including workload, control, and social support.

Question 80: What does the term 'IDLH' stand for in occupational health and safety?

Inhalation Dose Limit for Health
Integrated Dust and Liquid Hazard
Industrial Dust Level Hazard
Immediately Dangerous to Life or Health (Correct answer)

Correct answer: Immediately Dangerous to Life or Health

IDLH represents the maximum airborne concentration of a substance from which a worker could escape within 30 minutes without irreversible health effects or impairment.

Question 81: Which of the following BEST describes 'disability duration guidelines' in occupational case management?

Evidence-based benchmarks for expected recovery and return-to-work timelines by diagnosis (Correct answer)
OSHA standards for maximum allowable lost workdays
Legal mandates dictating how long a worker must remain off work
Insurance policy limits on indemnity payment duration

Correct answer: Evidence-based benchmarks for expected recovery and return-to-work timelines by diagnosis

Disability duration guidelines (e.g., ODG, Reed Group) provide evidence-based benchmarks to guide appropriate return-to-work planning by diagnosis.

Question 82: A COHN-S performing a job hazard analysis (JHA) should begin by:

Interviewing injured workers
Reviewing OSHA 300 logs
Selecting the job to be analyzed (Correct answer)
Issuing PPE to all workers

Correct answer: Selecting the job to be analyzed

The first step of a JHA is selecting the job to be analyzed, typically prioritizing high-risk or frequently injurious tasks.

Question 83: Under the OSH Act, which entity has primary authority to enforce workplace safety regulations for private sector workers?

OSHA (Correct answer)
NIOSH
EPA
CDC

Correct answer: OSHA

OSHA (Occupational Safety and Health Administration) has authority to set and enforce workplace safety standards for private sector employees.

Question 84: The term 'maximum medical improvement' (MMI) in occupational health means:

The employee is cleared for unrestricted full-duty work
The employee has fully recovered and has no permanent impairment
The condition has stabilized and is unlikely to improve significantly with further treatment (Correct answer)
The employee's injury claim is closed and no further benefits are payable

Correct answer: The condition has stabilized and is unlikely to improve significantly with further treatment

MMI indicates that a condition has reached a plateau and is unlikely to improve significantly with further medical treatment, though some permanent impairment may remain.

Question 85: A manufacturing employee is diagnosed with carpal tunnel syndrome, a condition potentially aggravated by their job tasks. In managing this case, the occupational health nurse should prioritize which of the following interventions?

Placing the employee on indefinite medical leave.
Advising the employee to seek employment in a different industry.
Conducting an ergonomic assessment of the employee's workstation. (Correct answer)
Recommending immediate surgery to resolve the condition.

Correct answer: Conducting an ergonomic assessment of the employee's workstation.

A primary principle of occupational health is to identify and mitigate workplace hazards. An ergonomic assessment helps to identify risk factors in the employee's job tasks and environment that may be causing or exacerbating the condition. Addressing these factors is crucial for both recovery and prevention of future injury.

Question 86: When designing a comprehensive workplace wellness program, which component is crucial for identifying the specific health needs and risks of the employee population to ensure the program is targeted and effective?

Marketing the program heavily through internal communication channels.
Securing a significant budget from senior management.
Offering a wide variety of fitness classes and challenges.
Conducting aggregate health risk appraisals and biometric screenings. (Correct answer)

Correct answer: Conducting aggregate health risk appraisals and biometric screenings.

A successful wellness program begins with understanding the specific needs of the workforce. Conducting health risk appraisals (HRAs) and biometric screenings provides valuable aggregate data on health risks, such as high blood pressure, cholesterol, and stress levels, allowing the OHN to tailor interventions and prioritize resources effectively.

Question 87: Which class of fire extinguisher is appropriate for a fire involving energized electrical equipment?

Class B
Class D
Class C (Correct answer)
Class A

Correct answer: Class C

Class C extinguishers use non-conductive extinguishing agents (CO₂ or dry chemical) safe for energized electrical equipment, where water-based Class A agents would create electrocution risk.

Question 88: An outbreak of gastrointestinal illness occurs at a community picnic. The epidemiological tool MOST useful for identifying the food source is:

Cohort study with attack rates by food item (Correct answer)
Case-control study comparing hospital records
Cross-sectional survey of area restaurants
Ecological study of neighborhood income

Correct answer: Cohort study with attack rates by food item

A retrospective cohort study calculating food-specific attack rates among picnic attendees is the standard method for foodborne outbreak investigation.

Question 89: Which early indicator would MOST alert the occupational health nurse to a potential musculoskeletal hazard in a warehouse operation?

Elevated workers' compensation insurance premiums
A single acute back injury reported in the OSHA 300 log
Workers self-reporting discomfort during end-of-shift symptom surveys (Correct answer)
Increased absenteeism on Mondays only

Correct answer: Workers self-reporting discomfort during end-of-shift symptom surveys

End-of-shift symptom surveys capture early musculoskeletal discomfort before injuries occur, providing the earliest and most actionable signal of ergonomic hazards.

Question 90: The occupational health nurse is analyzing injury trends and notices an increase in soft-tissue injuries during the afternoon shift. Which surveillance method best identifies causative workplace factors?

Exit interview data collection
Passive surveillance using only workers' comp claims
Review of OSHA 300 log entries only
Active surveillance through systematic worksite walk-throughs (Correct answer)

Correct answer: Active surveillance through systematic worksite walk-throughs

Active surveillance through walk-throughs allows direct observation of tasks, postures, and conditions contributing to injuries.

Question 91: A nurse is calculating the cost-benefit of a new ergonomics program. Direct costs of workplace injuries include:

OSHA fines and legal fees
Medical treatment and workers' compensation indemnity payments (Correct answer)
Lost productivity and training replacement workers
Decreased employee morale and administrative time

Correct answer: Medical treatment and workers' compensation indemnity payments

Direct costs are those directly attributable to the injury, including medical expenses and indemnity (wage replacement) payments.

Question 92: Treatment for exposure to lead

Tremors, impaired psychomotor dev in children who are exposed in utero
Pleural effusion, asbestosis and mesothelioma
"The dose makes the poison"
Remove from exposure and chelation (Correct answer)

Correct answer: Remove from exposure and chelation

The treatment for lead exposure typically involves two main approaches: removing the individual from further exposure to lead and implementing chelation therapy.

Question 93: Which OSHA standard requires employers to provide hearing protection when noise levels exceed 85 dBA as an 8-hour time-weighted average?

29 CFR 1910.120
29 CFR 1910.134
29 CFR 1910.147
29 CFR 1910.95 (Correct answer)

Correct answer: 29 CFR 1910.95

29 CFR 1910.95 (Occupational Noise Exposure) mandates a hearing conservation program when noise reaches the 85 dBA action level as an 8-hr TWA.

Question 94: Which framework is BEST used to analyze the social determinants of health affecting a community?

Maslow's Hierarchy of Needs
Kübler-Ross grief model
The biomedical model
Healthy People 2030 social determinants framework (Correct answer)

Correct answer: Healthy People 2030 social determinants framework

Healthy People 2030 organizes social determinants into five domains: economic stability, education, health care access, neighborhood, and social context.

Question 95: When conducting a telephonic case management call with an injured worker, which action is MOST important at the start of the call?

Request a recorded statement for the insurer's file
Inquire about the worker's attorney contact information
Identify yourself, your role, and explain the purpose and voluntary nature of case management services (Correct answer)
Immediately ask about fraud indicators

Correct answer: Identify yourself, your role, and explain the purpose and voluntary nature of case management services

Ethical case management requires transparency: identifying yourself and explaining your role and the voluntary nature of services protects worker rights and builds trust.

Question 96: Which hierarchy of controls level provides the GREATEST protection against workplace injury?

Engineering controls
Elimination of the hazard (Correct answer)
Personal protective equipment
Administrative controls

Correct answer: Elimination of the hazard

Elimination removes the hazard entirely and is the most effective level at the top of the hierarchy of controls.

Question 97: An occupational health nurse notices a statistically significant increase in musculoskeletal disorders in the assembly line department. The BEST tool to identify contributing risk factors is:

An ergonomic job analysis (Correct answer)
A pre-placement physical exam review
A severity rate calculation
A OSHA 300 log audit

Correct answer: An ergonomic job analysis

An ergonomic job analysis systematically evaluates tasks for physical stressors such as force, repetition, and awkward posture that contribute to musculoskeletal disorders.

Question 98: Which data source would BEST help a COHN identify leading health risks in a workforce for program planning?

OSHA injury and illness logs alone
Employee self-reported sick day reasons
A combination of workers' compensation data, health risk appraisals, and biometric screenings (Correct answer)
National health statistics from the CDC only

Correct answer: A combination of workers' compensation data, health risk appraisals, and biometric screenings

Combining multiple data sources provides a comprehensive picture of workforce health risks, capturing occupational, lifestyle, and clinical factors.

Question 99: In occupational health, the hierarchy of controls lists which measure as MOST effective for hazard reduction?

Engineering controls
Elimination (Correct answer)
Administrative controls
Personal protective equipment

Correct answer: Elimination

Elimination of the hazard entirely is the most effective control measure at the top of the hierarchy.

Question 100: In the context of disability management, a well-documented analysis of a job's essential functions is MOST critical for which reason?

It guarantees an employee the right to return to their exact pre-injury position regardless of medical restrictions.
It is the primary document used to file for workers' compensation benefits.
It provides the objective basis for engaging in the interactive process and determining if a reasonable accommodation is possible. (Correct answer)
It allows a supervisor to re-assign any tasks the returning employee feels uncomfortable performing.

Correct answer: It provides the objective basis for engaging in the interactive process and determining if a reasonable accommodation is possible.

Under the ADA, an individual must be able to perform the essential (or fundamental) duties of the job, with or without a reasonable accommodation. A clear definition of these essential functions is the foundation for the entire accommodation process. It allows the occupational health nurse and employer to analyze an employee's restrictions and determine if an accommodation can be made to enable them to perform these core duties, or if doing so would pose an undue hardship.

Question 101: Under workers' compensation, 'temporary total disability' (TTD) benefits are typically paid when:

The employer has no light-duty positions available
The worker has a permanent impairment rating above 50%
The worker chooses not to return to modified duty
The worker is completely unable to work while recovering from a work-related injury (Correct answer)

Correct answer: The worker is completely unable to work while recovering from a work-related injury

TTD benefits are paid when an injured worker is temporarily unable to perform any work while healing from a work-related injury or illness.

Question 102: An occupational health nurse practitioner with a master's degree applies for COHN-S. What experience prerequisite must she satisfy?

500 hours of occupational health nursing in the past 3 years
No experience required if a master's degree is held
1,500 hours of occupational health nursing in the past 5 years (Correct answer)
3,000 hours of occupational health nursing over any period

Correct answer: 1,500 hours of occupational health nursing in the past 5 years

The COHN-S requires a minimum of 1,500 hours of occupational health nursing practice within the five years preceding application.

Question 103: A school nurse notices increased absenteeism among students from one neighborhood after heavy rain. The nurse's BEST action reflecting environmental health practice is to:

Send absence letters to parents
Request a mental health counselor for students
Increase on-site vaccination coverage
Investigate potential environmental causes such as flooding or mold exposure (Correct answer)

Correct answer: Investigate potential environmental causes such as flooding or mold exposure

Linking absenteeism patterns to environmental events like flooding requires investigation into physical hazards such as mold or contaminated water.

Question 104: What is the primary goal of occupational case management from the employer's perspective?

To ensure the employee receives the most advanced medical treatment available.
To strictly enforce company attendance policies.
To minimize the employee's time away from work and control associated costs. (Correct answer)
To gather information for potential disciplinary action.

Correct answer: To minimize the employee's time away from work and control associated costs.

Occupational case management aims to facilitate a safe and timely return to work for an injured or ill employee. This benefits the employer by controlling costs associated with workers' compensation, disability, and lost productivity, while also supporting the employee's recovery.

Question 105: A COHN wants to reduce musculoskeletal disorders among assembly line workers. Which primary prevention strategy is MOST appropriate?

Redesigning workstations to fit the range of workers (Correct answer)
Providing ergonomic training after injury occurs
Screening workers for pre-existing musculoskeletal conditions
Offering physical therapy referrals to symptomatic employees

Correct answer: Redesigning workstations to fit the range of workers

Workstation redesign is primary prevention because it eliminates the hazard before injury occurs, rather than responding to symptoms.

Question 106: Which of the following situations would require the COHN to override a supervisor's decision to return an injured worker to full duty?

The supervisor believes the worker is exaggerating symptoms
The treating physician has issued a written restriction that precludes full-duty work (Correct answer)
The worker has been on modified duty for more than two weeks
The worker complains about minor job dissatisfaction

Correct answer: The treating physician has issued a written restriction that precludes full-duty work

Medical restrictions issued by the treating physician are binding; no supervisor has the authority to override written medical work restrictions.

Question 107: A construction worker is injured on a multi-employer worksite. Who bears OSHA citation liability?

Only the general contractor
Only the property owner
Only the subcontractor whose employee was injured
Potentially any employer whose acts or omissions contributed to the hazard (Correct answer)

Correct answer: Potentially any employer whose acts or omissions contributed to the hazard

OSHA's multi-employer citation policy holds any employer (creating, exposing, correcting, or controlling) potentially liable if they contributed to or failed to address a hazard.

Question 108: Which document serves as the primary written guide outlining an organization's overall approach to occupational health and safety?

Incident investigation report
Safety data sheet
Job hazard analysis
Health and safety policy statement (Correct answer)

Correct answer: Health and safety policy statement

The health and safety policy statement communicates management's commitment and the organization's overall approach to workplace safety.

Question 109: The OSHA Hazard Communication Standard requires chemical manufacturers to provide Safety Data Sheets (SDS) with how many sections?

14
12
16 (Correct answer)
18

Correct answer: 16

The GHS-aligned OSHA HazCom standard requires SDS to follow a standardized 16-section format.

Question 110: IDLH: What is it?

Immediate dangerous to life or health (Correct answer)
Irreversible tissue death
Protect the public
Ability to dissolve oils

Correct answer: Immediate dangerous to life or health

IDLH stands for "Immediate Danger to Life or Health." It is a term used to describe the highest level of airborne concentration of a substance from which an individual could escape within 30 minutes without suffering irreversible health effects or acute symptoms that could impair their ability to escape.

Question 111: When a public health nurse identifies a cluster of tuberculosis cases in a shelter, the FIRST action is to:

Report the cluster to the local health department (Correct answer)
Conduct a mass chest X-ray campaign
Administer BCG vaccine to all residents
Place all residents on isoniazid prophylaxis

Correct answer: Report the cluster to the local health department

Mandatory reporting to the local health department initiates the official public health response and contact investigation.

Question 112: Which of the following presents the occupational health nurse (OHN) with the most challenges?

Collaborating with other worksite professionals and retaining leadership in the arena of employee health
Managing competence through attending conferences and maintaining services when the nurse (sole provider) is absent
Allocating time between direct service to employees and management tasks
Managing ethical conflicts between responsibilities to management and responsibilities to employees (Correct answer)

Correct answer: Managing ethical conflicts between responsibilities to management and responsibilities to employees

The OHN is charged with upholding professional norms and codes as an advocate for workers. The OHN is likewise answerable to management, typically receives compensation from management, and is required to operate under a set of rules and regulations established by the business. The nurse faces moral problems because she is devoted to the staff and the management.

Question 113: As part of the OSHA Hazard Communication Standard (29 CFR 1910.1200), employers must provide employees with effective training on hazardous chemicals in their work area. Which of the following is a required element of this training?

Methods and observations employees can use to detect the presence or release of a hazardous chemical. (Correct answer)
A demonstration of the chemical manufacturing process for each substance.
The company's purchasing procedures and vendor list for all hazardous chemicals.
The chemical formula and molecular weight of every substance used in the facility.

Correct answer: Methods and observations employees can use to detect the presence or release of a hazardous chemical.

OSHA's Hazard Communication Standard, 29 CFR 1910.1200(h), explicitly requires that employee training includes the methods and observations that may be used to detect the presence or release of a hazardous chemical in the work area (e.g., monitoring conducted by the employer, continuous monitoring devices, visual appearance or odor of hazardous chemicals when being released, etc.). The other options are not required components of employee training under this standard.

Question 114: What is the primary purpose of a return-to-work (RTW) program?

To terminate injured employees who cannot perform full duty
To facilitate the safe and timely return of injured workers to productive employment (Correct answer)
To eliminate the employer's workers' compensation liability
To reduce the employer's OSHA recordable injury rate

Correct answer: To facilitate the safe and timely return of injured workers to productive employment

RTW programs focus on getting injured workers back to safe, appropriate work as soon as medically possible, benefiting both the worker and the employer.

Question 115: Which element should be included in every occupational health nurse's personal emergency preparedness role to ensure legal and professional accountability?

A personal social media policy
A signed waiver from all employees receiving emergency care
Pre-authorization from the employer to administer all medications independently
Documentation of all emergency interventions in real time or as soon as possible after the event (Correct answer)

Correct answer: Documentation of all emergency interventions in real time or as soon as possible after the event

Timely and accurate documentation of emergency interventions protects the nurse legally, supports continuity of care, and fulfills professional and regulatory standards.

Question 116: Which document serves as the foundation for workplace emergency preparedness planning under OSHA standards?

Safety Data Sheet
Hazard Communication Standard
Job Safety Analysis
Emergency Action Plan (EAP) (Correct answer)

Correct answer: Emergency Action Plan (EAP)

OSHA 29 CFR 1910.38 requires employers to develop an Emergency Action Plan (EAP) that outlines procedures for employee safety during emergencies.

Question 117: Which statement best describes the relationship between ABOHN and AAOHN?

ABOHN is a subsidiary division of AAOHN
AAOHN administers all ABOHN examinations
ABOHN is an autonomous credentialing body whose exam content is informed by AAOHN practice standards (Correct answer)
They are the same organization operating under two names

Correct answer: ABOHN is an autonomous credentialing body whose exam content is informed by AAOHN practice standards

ABOHN is a separate, autonomous credentialing organization that develops its certification examinations based on AAOHN's published practice standards and competencies.

Question 118: Which ABOHN competency domain encompasses conducting pre-placement physical examinations and fitness-for-duty evaluations?

Environmental health management
Worker and workplace health assessment and surveillance (Correct answer)
Business and financial management
Health promotion and education

Correct answer: Worker and workplace health assessment and surveillance

Pre-placement physicals and fitness-for-duty evaluations are assessment activities that fall within the worker and workplace health assessment and surveillance competency domain.

Question 119: An employer must report the in-patient hospitalization of an employee as a result of a work-related incident to OSHA within what time frame?

48 hours
24 hours (Correct answer)
7 calendar days
8 hours

Correct answer: 24 hours

OSHA's regulation 29 CFR 1904.39(a)(2) requires employers to report any work-related in-patient hospitalization, amputation, or loss of an eye to OSHA within 24 hours of learning about the event. The 8-hour reporting requirement is specifically for a work-related fatality.

Question 120: A worker sustained a repetitive strain injury and is reluctant to return to a modified duty role. Which approach is MOST effective in motivating return to work?

Using motivational interviewing to explore the worker's concerns and goals (Correct answer)
Contacting the worker's family to persuade them
Requiring a psychiatric evaluation before any further communication
Threatening to stop workers' compensation benefits

Correct answer: Using motivational interviewing to explore the worker's concerns and goals

Motivational interviewing is an evidence-based, collaborative communication technique effective in addressing ambivalence and facilitating behavior change.

Question 121: A functional capacity evaluation (FCE) is primarily used in return-to-work programs to:

Objectively measure a worker's physical abilities and compare them to job demands (Correct answer)
Establish the employee's psychological readiness to return to work
Calculate the cost of workplace modifications needed
Determine an employee's eligibility for workers' compensation benefits

Correct answer: Objectively measure a worker's physical abilities and compare them to job demands

An FCE objectively measures a worker's physical abilities, endurance, and tolerances, then compares these to the specific demands of their job.

Question 122: Which concept describes the ability of a health and safety program to be systematically replicated and maintained over time within an organization?

Root cause analysis
Return on investment
Incidence rate calculation
Sustainability (Correct answer)

Correct answer: Sustainability

Sustainability in health and safety programming refers to building systems, culture, and resources that allow programs to continue long-term without constant re-initiation.

Question 123: A nurse who suspects a supervisor is pressuring an injured worker to return to work before medically appropriate should FIRST:

Advise the worker to retain an attorney
File a complaint with OSHA on the worker's behalf
Ignore the situation as supervisor-employee relations are outside the nurse's scope
Document the concern and discuss it with the occupational health medical director or appropriate supervisor (Correct answer)

Correct answer: Document the concern and discuss it with the occupational health medical director or appropriate supervisor

The COHN should document concerns and escalate through appropriate channels, such as consulting with the occupational health medical director or raising the issue with HR or management.

Question 124: An injured worker is cleared for return to work but refuses due to fear of re-injury. Which intervention is MOST appropriate?

Terminate case management services immediately
Advise the employer to discipline the worker for non-compliance
File a report with OSHA about the worker's non-compliance
Coordinate a graded exposure or work-hardening program and address fear-avoidance with behavioral support (Correct answer)

Correct answer: Coordinate a graded exposure or work-hardening program and address fear-avoidance with behavioral support

Work hardening and graded exposure address kinesiophobia and fear-avoidance behaviors that impede return to work following occupational injury.

Question 125: Which action by an occupational health nurse BEST demonstrates primary prevention of workplace injury?

Developing a safety training program on hazard recognition (Correct answer)
Conducting a post-offer physical examination
Managing return-to-work after an injury
Providing early treatment for a reported strain

Correct answer: Developing a safety training program on hazard recognition

Primary prevention stops injury before it occurs; hazard recognition training prevents exposures that lead to injury.

Question 126: A worker sprains an ankle and is placed on restricted duty for three days. How should the occupational health nurse classify this on the OSHA 300 log?

Days away from work case
Non-recordable first aid case
Other recordable case
Restricted work or job transfer case (Correct answer)

Correct answer: Restricted work or job transfer case

Restricted or transferred work cases are recorded in the 'Job transfer or restriction' column of the OSHA 300 log.

Question 127: When reviewing a physician's return-to-work restrictions, a COHN notices the restrictions are vague (e.g., 'light duty'). What is the BEST action?

Send the employee back out on full disability leave until clearer restrictions are provided
Interpret the restrictions based on the nurse's clinical judgment alone
Return the employee to full duty since 'light duty' is too vague to enforce
Contact the treating physician to clarify specific functional limitations in measurable terms (Correct answer)

Correct answer: Contact the treating physician to clarify specific functional limitations in measurable terms

The COHN should contact the treating physician to obtain specific, measurable restrictions (e.g., maximum pounds lifted, hours standing) to properly match the worker to available duties.

Question 128: A packing plant employee reports experiencing soreness at the base of their right thumb. Over the tendons towards the distal radius, he has swelling and pain. He has probably developed the following:

De Quervain disease (Correct answer)
Epicondylitis
Trigger finger
Dupuytren disease

Correct answer: De Quervain disease

A variant of tenosynovitis called De Quervain disease causes the tendon sheaths on the radial (thumb) side of the wrist to enlarge. Tenosynovitis is an infection of the tendon sheath lining. As seen in a packing plant, the tendon sheath's capacity to produce adequate lubricant might be damaged by repetitive action or constant, intense gripping. Repetitive friction then disrupts the tendons' effortless slide in the sheath, resulting in pain at the base of the thumb. Sewing, packing, and butchering workers are also at risk for developing this illness, as are middle-aged women. An abnormality of the finger flexor tendon called the trigger finger allows a bent finger to become trapped and then burst out or pop when extended. Farmers, industrial workers, and musicians are susceptible to this illness since repetitive hand movements bring it on. A genetic condition called Dupuytren disease causes the palmar fascia to thicken gradually, squeezing the fingers into the palm—a tendon tear results in epicondylitis, which causes pain on the outside of the elbow. Tennis elbow is the name given to this ailment because it frequently affects tennis players; golfer's elbow is the name given to another type of epicondylitis.

Question 129: Which OSHA standard governs confined space entry in general industry, requiring a permit for spaces with serious safety or health hazards?

29 CFR 1910.134
29 CFR 1910.146 (Correct answer)
29 CFR 1910.138
29 CFR 1910.147

Correct answer: 29 CFR 1910.146

29 CFR 1910.146 (Permit-Required Confined Spaces) requires employers to evaluate confined spaces and implement a permit system for those with serious recognized hazards.

Question 130: According to NIOSH, the recommended weight limit (RWL) for a lift is calculated. If the RWL is 20 lbs and the actual load is 40 lbs, the Lifting Index (LI) is:

2.0 (Correct answer)
0.5
4.0
1.0

Correct answer: 2.0

LI = Actual Load ÷ RWL = 40 ÷ 20 = 2.0; an LI > 1.0 indicates the task exceeds safe lifting capacity.

Question 131: A worker recently suffered a heart attack and was released from the hospital. What would be the best course of action for the nurse to follow?

Develop a program on exercise and nutrition for all employees
Advocate for improvements in the food being offered by the vending machines in the employee's lounge
Determine appropriate temporary, perhaps part-time, responsibilities to ease the employee's reentry to the workplace (Correct answer)
Plan a party for when the client is able to return to the workplace

Correct answer: Determine appropriate temporary, perhaps part-time, responsibilities to ease the employee's reentry to the workplace

The appropriate action for the nurse to take in this scenario would be: Determine appropriate temporary, perhaps part-time, responsibilities to ease the employee's reentry to the workplace. Following a heart attack, it is crucial to prioritize the employee's health and support their safe return to work. Determining suitable temporary or part-time responsibilities can help ease the transition back to the workplace while considering the individual's health condition, limitations, and the need for a gradual reintegration process.

Question 132: Which industrial hygiene sampling strategy determines the worst-case exposure for a worker during a particular task?

Biological monitoring
Worst-case or task-based sampling (Correct answer)
Full-shift time-weighted average sampling
Grab sampling

Correct answer: Worst-case or task-based sampling

Worst-case or task-based sampling focuses on the highest-exposure tasks to identify peak exposures that may exceed ceiling or short-term exposure limits (STELs).

Question 133: A community health nurse advocates for fluoridation of the municipal water supply. This is an example of which public health role?

Case manager
Policy advocate (Correct answer)
Educator
Direct care provider

Correct answer: Policy advocate

Advocating for evidence-based policy changes such as water fluoridation reflects the policy advocate role in community/public health nursing.

Question 134: A COHN is evaluating outcomes of a worksite smoking cessation program. Which outcome is a PROCESS measure rather than an outcome measure?

Percentage of employees who quit smoking at 6 months
Change in employees' carbon monoxide breath test readings
Number of employees who attended cessation classes (Correct answer)
Reduction in smoking-related healthcare claims

Correct answer: Number of employees who attended cessation classes

Process measures evaluate program delivery activities (e.g., attendance), while outcome measures assess health results.

Question 135: Which federal law requires employers with 50 or more employees to provide up to 12 weeks of unpaid, job-protected leave for certain family and medical reasons?

Family and Medical Leave Act (FMLA) (Correct answer)
Employee Retirement Income Security Act (ERISA)
Occupational Safety and Health Act (OSH Act)
Americans with Disabilities Act (ADA)

Correct answer: Family and Medical Leave Act (FMLA)

The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons.

Question 136: Return-to-work programs after occupational injury are BEST described as which level of prevention?

Primary prevention
Primordial prevention
Secondary prevention
Tertiary prevention (Correct answer)

Correct answer: Tertiary prevention

Tertiary prevention aims to reduce the impact of an established disease or injury through rehabilitation, including return-to-work programs.

Question 137: Which factor is MOST predictive of a prolonged disability and delayed return to work?

Severity of the initial physical injury alone
Psychosocial factors such as fear-avoidance beliefs, job dissatisfaction, and depression (Correct answer)
The employee's age at time of injury
The type of workers' compensation insurance carrier

Correct answer: Psychosocial factors such as fear-avoidance beliefs, job dissatisfaction, and depression

Research consistently shows that psychosocial factors — including fear of re-injury, depression, job dissatisfaction, and poor social support — are the strongest predictors of prolonged disability.

Question 138: An office worker is diagnosed with carpal tunnel syndrome. The occupational health nurse is developing a plan to mitigate ergonomic risk factors for this employee. Which of the following would be the MOST effective initial intervention?

Recommending surgery to release the carpal tunnel.
Providing the employee with a wrist splint to wear at all times.
Placing the employee on permanent work restrictions.
Conducting an ergonomic assessment of the employee's workstation. (Correct answer)

Correct answer: Conducting an ergonomic assessment of the employee's workstation.

The most effective initial intervention is to identify and address the root cause of the problem. An ergonomic assessment of the workstation will help identify specific risk factors, such as improper chair height, monitor position, or keyboard/mouse setup, that may be contributing to the carpal tunnel syndrome. Correcting these environmental factors is a primary prevention strategy. The other options are treatment or secondary/tertiary interventions that may be considered later but do not address the initial cause.

Question 139: A worker presents with skin burns and eye irritation after a chemical splash. The occupational health nurse should begin decontamination by:

Applying a neutralizing chemical agent to the affected area
Administering oral antihistamines for the allergic reaction
Covering the burns with a sterile dressing immediately
Flushing the area with copious amounts of water for at least 15–20 minutes (Correct answer)

Correct answer: Flushing the area with copious amounts of water for at least 15–20 minutes

Immediate and prolonged water irrigation (15–20 minutes minimum) dilutes and removes the chemical, reducing tissue damage before any specific antidote is considered.

Question 140: An occupational health nurse discovers a serious safety violation during a workplace walk-through. What is the nurse's priority action?

Immediately report it to management and recommend corrective action (Correct answer)
Wait until the next safety committee meeting to raise the concern
Document the finding and report it in the monthly safety newsletter
File an anonymous OSHA complaint without notifying management

Correct answer: Immediately report it to management and recommend corrective action

Immediate reporting to management with recommended corrective action is the priority to protect workers from imminent harm and fulfill the nurse's professional and legal duty.

Question 141: Which body has statutory authority to approve ABOHN as a certification organization recognized for occupational health nursing practice standards?

NCQA (National Committee for Quality Assurance)
ANCC (American Nurses Credentialing Center)
No external statutory body; ABOHN is self-regulating (Correct answer)
OSHA

Correct answer: No external statutory body; ABOHN is self-regulating

ABOHN is an independent, self-regulating credentialing body; no external statutory authority is required to approve its occupational health nursing certifications.

Question 142: Which type of epidemiological study is BEST suited for investigating a rare occupational disease with a long latency period?

Randomized controlled trial
Prospective cohort study
Cross-sectional study
Case-control study (Correct answer)

Correct answer: Case-control study

Case-control studies are efficient for rare diseases because they start with cases (disease present) and match them with controls, allowing retrospective exposure assessment.

Question 143: Which of the following best describes 'light duty' work in occupational health?

Work performed by part-time employees only
Modified job tasks assigned to an employee within their medical restrictions (Correct answer)
Work that does not qualify for workers' compensation
Administrative paperwork tasks given to all injured workers

Correct answer: Modified job tasks assigned to an employee within their medical restrictions

Light duty assignments accommodate the injured worker's medical restrictions while keeping them productive and facilitating their recovery.

Question 144: Under OSHA's bloodborne pathogen standard, hepatitis B vaccination must be offered to at-risk employees:

At the annual occupational health exam
After the first needlestick exposure
Within 10 working days of initial assignment (Correct answer)
Only if the employee requests it in writing

Correct answer: Within 10 working days of initial assignment

OSHA 29 CFR 1910.1030 requires employers to offer hepatitis B vaccination to at-risk workers within 10 working days of initial assignment at no cost.

Question 145: Which of the following is the PRIMARY purpose of a post-incident investigation following a workplace injury?

Assign blame to the responsible employee
Identify root causes to prevent recurrence (Correct answer)
Calculate workers' compensation costs
Document information for legal defense

Correct answer: Identify root causes to prevent recurrence

Post-incident investigations are primarily designed to identify root causes and implement corrective actions to prevent future injuries.

Question 146: What is the role of an independent medical examination (IME) in workers' compensation?

To provide treatment recommendations by the employee's personal doctor
To determine the employer's liability in a court of law
To authorize emergency surgery for workplace injuries
To obtain an objective medical opinion on diagnosis, causation, or work capacity (Correct answer)

Correct answer: To obtain an objective medical opinion on diagnosis, causation, or work capacity

An IME is performed by a neutral physician to provide an unbiased assessment of the worker's condition, causation, or ability to return to work.

Question 147: Under OSHA's multi-employer worksite policy, which employer type has the PRIMARY duty to correct hazards at a construction site?

Exposing employer
Correcting employer
Creating employer (Correct answer)
Controlling employer

Correct answer: Creating employer

The creating employer—the one who caused the hazardous condition—has the primary duty to correct it under OSHA's multi-employer citation policy.

Question 148: An occupational health nurse is part of a team evaluating hazards in a sterile processing department of a hospital. Which type of hazard should be considered a primary focus due to the nature of the items being handled?

Physical hazards from autoclave noise
Ergonomic hazards from repetitive motions
Psychosocial hazards from high-pressure deadlines
Biological hazards from contaminated surgical instruments (Correct answer)

Correct answer: Biological hazards from contaminated surgical instruments

While ergonomic, psychosocial, and physical hazards may be present, the primary and most unique hazard in a sterile processing department is the risk of exposure to biological agents like bacteria and viruses from contaminated instruments. This is a critical focus for preventing occupational infections.

Question 149: Which term describes a hazard that results from the combined effects of two workplace stressors that is greater than the sum of their individual effects?

Synergistic effect (Correct answer)
Antagonistic effect
Potentiation effect
Additive effect

Correct answer: Synergistic effect

A synergistic effect occurs when two hazards together produce a health impact greater than the sum of their individual effects, such as combined silica and cigarette smoke increasing lung cancer risk.

Question 150: According to the COHN scope of practice, occupational health nurses collaborate with which team member to identify workplace chemical hazards?

Physical therapist
Social worker
Industrial hygienist (Correct answer)
Ergonomist

Correct answer: Industrial hygienist

Industrial hygienists specialize in recognizing, evaluating, and controlling occupational chemical, physical, and biological hazards.

Question 151: An employee enrolled in a worksite wellness program asks the COHN how their health data will be used. The COHN's BEST response is to:

Tell the employee their data will remain completely private without exception
Redirect the employee to HR for all privacy questions
Assure the employee that only management has access to individual results
Explain data confidentiality policies and how aggregate data protects individual privacy (Correct answer)

Correct answer: Explain data confidentiality policies and how aggregate data protects individual privacy

Explaining how confidentiality is maintained and how aggregate (not individual) data is used builds trust and supports informed consent.

Question 152: What is 'vocational rehabilitation' in workers' compensation?

Legal representation during claim disputes
Physical therapy to restore full range of motion
Services to help an injured worker return to suitable employment (Correct answer)
Psychological counseling for work-related stress

Correct answer: Services to help an injured worker return to suitable employment

Vocational rehabilitation includes job retraining, education, and job placement services for workers who cannot return to their previous occupation due to a work-related injury.

Question 153: A nurse who lets her COHN credential lapse and applies to reinstate it must meet which condition?

Complete 10 additional CE hours beyond normal requirements
Apply for a new CAOHN credential instead
Retake the full certification exam (Correct answer)
Pay a late fee within 90 days with no exam required

Correct answer: Retake the full certification exam

If a COHN credential lapses beyond the allowed reinstatement window, the nurse must retake and pass the full certification examination to regain certification.

Question 154: In workers' compensation, what does 'maximum medical improvement' (MMI) mean?

The employee's medical costs have reached the policy maximum
The employee requires surgery to improve their condition
The employee's condition has stabilized and further recovery is not expected (Correct answer)
The employee has fully recovered and can return to full duty

Correct answer: The employee's condition has stabilized and further recovery is not expected

MMI is the point at which a work-related injury or illness has stabilized and no further improvement is expected with continued treatment.

Question 155: Under the Family and Medical Leave Act (FMLA), how many weeks of unpaid leave are eligible employees entitled to per year for qualifying reasons?

24 weeks
16 weeks
12 weeks (Correct answer)
6 weeks

Correct answer: 12 weeks

FMLA entitles eligible employees of covered employers to up to 12 weeks of unpaid, job-protected leave per year for qualifying family or medical reasons.

Question 156: What does a noise dosimeter measure in an occupational setting?

A worker's cumulative noise exposure over a work shift (Correct answer)
Background noise levels in office environments
Sound frequency ranges in industrial machinery
Peak noise levels only during machinery startups

Correct answer: A worker's cumulative noise exposure over a work shift

A noise dosimeter worn by a worker records the time-weighted average noise exposure over the entire shift to compare against OSHA's PEL of 90 dBA and action level of 85 dBA.

Question 157: In legal terms, what is 'causation' in a workers' compensation claim?

The severity of the worker's injury
The proof that the injury or illness arose out of and in the course of employment (Correct answer)
The employer's negligence in preventing the injury
The total medical costs associated with the injury

Correct answer: The proof that the injury or illness arose out of and in the course of employment

Causation establishes that the injury or illness is work-related—it must arise out of (AOE) and in the course of employment (COE) to be compensable.

Question 158: A worker is found unconscious after exposure to hydrogen sulfide gas. After ensuring scene safety, the nurse's NEXT priority is:

Document the incident for OSHA reporting
Apply a chemical antidote kit
Begin CPR and administer 100% oxygen (Correct answer)
Obtain a detailed occupational history

Correct answer: Begin CPR and administer 100% oxygen

Hydrogen sulfide causes rapid asphyxiation; after scene safety, the immediate priority is to restore oxygenation through CPR and 100% supplemental oxygen.

Question 159: An employee with a documented anxiety disorder requests a quiet workspace as an ADA accommodation. The employer should:

Immediately provide any workspace the employee requests without discussion
Deny the request because mental health conditions are not covered under the ADA
Engage in the interactive process to determine if the accommodation is reasonable (Correct answer)
Require the employee to provide monthly psychiatric evaluations

Correct answer: Engage in the interactive process to determine if the accommodation is reasonable

The ADA covers mental health conditions, and employers must engage in a good-faith interactive process to determine whether a requested accommodation is reasonable.

Question 160: A worker in a beryllium machining facility develops progressive dyspnea and is found to have non-caseating granulomas on lung biopsy. The MOST likely diagnosis is:

Extrinsic allergic alveolitis (hypersensitivity pneumonitis)
Chronic beryllium disease (berylliosis) (Correct answer)
Silicosis
Sarcoidosis unrelated to occupational exposure

Correct answer: Chronic beryllium disease (berylliosis)

Chronic beryllium disease (CBD) is a granulomatous lung disease caused by beryllium sensitization; it is clinically and pathologically indistinguishable from sarcoidosis but requires beryllium lymphocyte proliferation test (BeLPT) for diagnosis.

Certified Occupational Health Nurse (COHN) Exam

The COHN examination, administered by the American Board for Occupational Health Nurses (ABOHN), certifies nurses who demonstrate competency in occupational health nursing practice across clinical care, case management, coordination, and advisory roles.

160

Questions

180 min

Time Limit

55%

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