Question 1: What is the primary purpose of quality improvement (QI) in IHSA practice?

• To satisfy accreditation requirements only
• To reduce staff workloads
• To systematically improve patient outcomes and healthcare processes through data-driven analysis (Correct answer)
• To increase billing revenue

Correct answer: To systematically improve patient outcomes and healthcare processes through data-driven analysis

Quality improvement uses systematic, data-driven approaches to analyze healthcare processes and outcomes, identifying areas for improvement and implementing changes that enhance patient care and safety.

Question 2: A coach is helping an injured athlete in an outdoor setting and has no gloves available. The BEST immediate alternative to protect against bloodborne pathogens is to:

• Wrap the hand in athletic tape before touching the wound
• Apply petroleum jelly to the hands before contact
• Avoid touching the wound until gloves are retrieved
• Use a plastic bag or multiple layers of gauze as a barrier (Correct answer)

Correct answer: Use a plastic bag or multiple layers of gauze as a barrier

When gloves are unavailable, impermeable barriers such as plastic bags or thick layers of gauze reduce direct skin contact with blood.

Question 3: The incubation period for herpes gladiatorum (HSV-1) after initial exposure in wrestlers is typically:

• 6–8 weeks
• 1–2 days
• 2–14 days (Correct answer)
• 3–4 weeks

Correct answer: 2–14 days

HSV-1 has an incubation period of approximately 2–14 days from exposure to the appearance of primary lesions.

Question 4: Which component of a personal fall arrest system absorbs the energy of a fall and must be replaced after any fall event?

• Shock-absorbing lanyard or deceleration device (Correct answer)
• Anchorage connector
• D-ring on the full-body harness
• Self-retracting lifeline (SRL) only

Correct answer: Shock-absorbing lanyard or deceleration device

The shock-absorbing (energy-absorbing) lanyard or deceleration device is designed to deploy and dissipate fall energy; once activated it is permanently deformed and must be replaced before further use.

Question 5: A patient who was assessed as Alert (A on AVPU) 10 minutes ago now responds only to Voice. This change represents:

• Improvement in the patient's condition
• A documentation error to be corrected
• Normal fluctuation that requires no intervention
• A one-level deterioration in neurological status requiring urgent reassessment (Correct answer)

Correct answer: A one-level deterioration in neurological status requiring urgent reassessment

Any decline in AVPU level indicates neurological deterioration and must trigger immediate reassessment and expedited transport.

Question 6: FMEA (Failure Mode and Effects Analysis) is distinguished from FTA because FMEA:

• Works top-down from a system failure to find root causes
• Focuses exclusively on human error as the cause of failure
• Is used only for chemical process hazard analysis
• Works bottom-up from individual component failures to assess system-level effects (Correct answer)

Correct answer: Works bottom-up from individual component failures to assess system-level effects

FMEA takes a bottom-up approach, analyzing how individual component failures propagate to affect the overall system.

Question 7: A student-athlete discloses a pre-existing cardiac condition on the health history form. The coach's appropriate next step is:

• Refer the disclosure to the school athletic trainer or team physician for medical clearance (Correct answer)
• Keep the information confidential and monitor the athlete independently
• Clear the athlete to participate as long as they feel well
• Require the athlete to obtain a second opinion before informing medical staff

Correct answer: Refer the disclosure to the school athletic trainer or team physician for medical clearance

Pre-existing cardiac conditions require evaluation by qualified medical personnel who can determine safe participation guidelines.

Question 8: The IHSA coaching model emphasizes that safety culture change is most sustainable when driven by:

• Strict enforcement of penalties for non-compliance
• Workers taking personal ownership of their own and colleagues' safety (Correct answer)
• Increased frequency of unannounced safety inspections
• Adding more safety signage and written reminders throughout the worksite

Correct answer: Workers taking personal ownership of their own and colleagues' safety

Sustainable safety culture requires internal motivation and peer accountability rather than reliance on external enforcement alone.

Question 9: When documenting a concussion evaluation using a standardized tool such as the SCAT, what is the recommended timeframe for completing documentation?

• Only after the athlete has been cleared by a physician
• Within 72 hours of the initial evaluation
• As soon as possible following the evaluation, ideally immediately after (Correct answer)
• At the end of the season in the annual report

Correct answer: As soon as possible following the evaluation, ideally immediately after

Concussion evaluation documentation should be completed as soon as possible after the assessment to ensure accuracy and timeliness for medical decision-making.

Question 10: In IHSA practice, what is evidence-based practice?

• Integrating best research evidence with clinical expertise and patient values (Correct answer)
• Following only the most recent research studies
• Relying solely on personal clinical experience
• Using only manufacturer recommendations

Correct answer: Integrating best research evidence with clinical expertise and patient values

Evidence-based practice combines the best available research evidence with the clinician's professional expertise and the individual patient's preferences and values to guide clinical decision-making.

Question 11: A facility's whirlpool used for therapeutic treatment should be disinfected between athlete uses with an EPA-registered disinfectant primarily to prevent transmission of:

• Hepatitis B virus through water contact
• Pseudomonas aeruginosa and other waterborne bacteria (Correct answer)
• Airborne respiratory pathogens
• Tinea pedis only

Correct answer: Pseudomonas aeruginosa and other waterborne bacteria

Whirlpools support Pseudomonas aeruginosa biofilm formation, making proper disinfection critical to prevent folliculitis and wound infections.

Question 12: Under IHSA concussion protocol, when may an athlete return to full-contact practice after being diagnosed with a concussion?

• When symptoms are gone for 24 hours
• When the athlete feels ready to play
• After 7 days regardless of symptoms
• Only after completing a stepwise return-to-play protocol and receiving medical clearance (Correct answer)

Correct answer: Only after completing a stepwise return-to-play protocol and receiving medical clearance

IHSA requires completion of a graduated return-to-play protocol and written clearance from a licensed physician or ATC before full-contact return.

Question 13: A safety coach is working with a crew whose safety performance has plateaued despite consistent training efforts. The most productive next step is to:

• Introduce more stringent disciplinary consequences for safety violations
• Increase training frequency by adding mandatory monthly refresher sessions
• Replace the current trainer with someone who has more field experience
• Conduct a root cause analysis to identify environmental, systemic, or cultural barriers to performance (Correct answer)

Correct answer: Conduct a root cause analysis to identify environmental, systemic, or cultural barriers to performance

Performance plateaus often reflect systemic or cultural barriers that additional training alone cannot resolve; root cause analysis identifies the real obstacles.

Question 14: Which action would constitute a breach of professional boundaries for an IHSA Certified Coach?

• Maintaining records of all coaching interactions
• Providing constructive feedback on a worker's safety performance
• Referring a participant to a specialist outside your scope of practice
• Entering into a personal financial arrangement with a coaching participant (Correct answer)

Correct answer: Entering into a personal financial arrangement with a coaching participant

Entering personal financial arrangements with coaching participants violates professional boundaries and creates a conflict of interest that compromises the coaching relationship.

Question 15: A near-miss incident is most valuable to safety management because it:

• Triggers mandatory OSHA recordkeeping requirements
• Reduces workers' compensation premiums immediately
• Eliminates the need for formal risk assessments
• Reveals hazards and system weaknesses before they cause injury (Correct answer)

Correct answer: Reveals hazards and system weaknesses before they cause injury

Near-misses expose latent hazards and control failures, providing a free opportunity to prevent future incidents.

Question 16: An IHSA Certified Coach is working with a team that includes workers from diverse cultural backgrounds. Ethical practice requires the coach to:

• Adapt communication and coaching approaches to be culturally sensitive and inclusive (Correct answer)
• Separate workers by cultural background for efficiency
• Focus training only on workers who are fluent in English
• Apply identical methods to all workers regardless of background

Correct answer: Adapt communication and coaching approaches to be culturally sensitive and inclusive

Ethical coaching requires cultural competency and adapting methods to ensure all workers receive equitable, effective safety education.

Question 17: Which technique uses structured 'What-If' questioning to systematically identify potential failure scenarios?

• What-If Analysis (Correct answer)
• Fault Tree Analysis (FTA)
• Bow-Tie Analysis
• HAZOP study

Correct answer: What-If Analysis

What-If Analysis uses structured brainstorming questions to explore deviations and failure scenarios.

Question 18: Which hand hygiene method is LEAST effective against Clostridioides difficile (C. diff) spores?

• Using alcohol-based hand sanitizer (Correct answer)
• Scrubbing hands under running water for 30 seconds
• Washing with an antimicrobial soap
• Washing with soap and water for 20 seconds

Correct answer: Using alcohol-based hand sanitizer

Alcohol-based hand sanitizers do not destroy C. diff spores; soap and water physically remove spores from the skin surface.

Question 19: In the context of IHSA coaching, 'safety climate' most directly influences hazard identification by affecting:

• Equipment inspection frequencies required by regulation
• The technical accuracy of risk matrix ratings
• The legal standards that define what constitutes a hazard
• Workers' willingness to report hazards without fear of reprisal (Correct answer)

Correct answer: Workers' willingness to report hazards without fear of reprisal

A positive safety climate where reporting is encouraged and blame-free leads to more hazards being identified and corrected before incidents occur.

Question 20: When selecting a disinfectant to use on wrestling mats, which EPA registration category should the product carry to ensure efficacy against fungi, bacteria, and viruses?

• Sterilant approved for heat-sensitive surfaces
• General-purpose cleaner with deodorizing properties
• Sanitizer (bactericidal only)
• Disinfectant with broad-spectrum claims on the EPA-registered label (Correct answer)

Correct answer: Disinfectant with broad-spectrum claims on the EPA-registered label

Only EPA-registered disinfectants with broad-spectrum label claims (bactericidal, fungicidal, and virucidal) are validated to address the full range of pathogens on wrestling mats.

Question 21: When developing a treatment plan for a construction worker with a repetitive strain injury, which element should be prioritized FIRST?

• Prescription of anti-inflammatory medication
• Referral to a specialist
• Immediate return-to-work scheduling
• Comprehensive functional assessment (Correct answer)

Correct answer: Comprehensive functional assessment

A comprehensive functional assessment establishes baseline deficits and guides all subsequent treatment decisions.

Question 22: Which of the following is a key characteristic that distinguishes an incident report from a clinical treatment note?

• An incident report is only required when legal action is anticipated
• An incident report documents the circumstances of an event for administrative and risk management purposes, not clinical care (Correct answer)
• Incident reports are only written by team physicians, not coaches
• An incident report replaces the need for any clinical documentation

Correct answer: An incident report documents the circumstances of an event for administrative and risk management purposes, not clinical care

Incident reports serve risk management and administrative functions by documenting event circumstances, separate from clinical notes which document healthcare delivery.

Question 23: An athlete collapses and is unresponsive with no normal breathing. The first action a coach should take is:

• Call 911 and begin CPR immediately (Correct answer)
• Place the athlete in the recovery position and observe
• Administer water to prevent dehydration-related unconsciousness
• Wait for a trainer to arrive before touching the athlete

Correct answer: Call 911 and begin CPR immediately

An unresponsive athlete with no normal breathing requires immediate 911 activation and CPR, as every minute without intervention reduces survival rates by 7-10%.

Question 24: An IHSA-certified coach uses an electronic health record (EHR) system. Which practice best protects record integrity?

• Logging out after each session and never sharing credentials (Correct answer)
• Sharing login credentials with trusted staff for efficiency
• Disabling automatic timeout features to avoid re-authentication delays
• Using a single generic account to reduce password complexity

Correct answer: Logging out after each session and never sharing credentials

Logging out after each session and maintaining unique individual credentials protects EHR integrity by ensuring accountability and preventing unauthorized access.

Question 25: The OSHA Voluntary Protection Programs (VPP) recognize worksites with exemplary safety management systems. Which VPP tier represents the highest level of recognition?

• Demonstration
• Star (Correct answer)
• Merit
• Recognition

Correct answer: Star

The Star program is OSHA's highest VPP designation, awarded to sites with comprehensive, successful safety and health programs.

Question 26: When disinfecting shared athletic equipment after a practice, the coach should ensure the disinfectant remains on the surface for the manufacturer's recommended contact time because:

• Longer contact time reduces chemical residue
• Premature wiping leaves active pathogens viable (Correct answer)
• It prevents the disinfectant from evaporating too quickly
• It satisfies OSHA documentation requirements

Correct answer: Premature wiping leaves active pathogens viable

Disinfectants require a minimum wet contact (dwell) time to kill pathogens; wiping before that time leaves organisms alive.

Question 27: Which category of fire extinguisher is specifically required for energized electrical equipment fires?

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

Correct answer: Class C

Class C extinguishers use non-conductive agents rated for fires involving energized electrical equipment.

Question 28: The term 'half-life' in pharmacology refers to:

• Half the recommended therapeutic dose
• The time for a drug to reach maximum plasma concentration
• The time required for half the drug dose to be eliminated from the body (Correct answer)
• The duration of the drug's peak effect

Correct answer: The time required for half the drug dose to be eliminated from the body

Half-life is the time needed for the plasma concentration of a drug to decrease by 50%, guiding dosing frequency.

Question 29: Which element is considered essential when documenting informed consent for an athletic training treatment procedure?

• The cost of the procedure and billing codes
• The supervising physician's co-signature on all forms
• The athlete's agreement to waive all liability
• The risks, benefits, and alternatives explained to the athlete (Correct answer)

Correct answer: The risks, benefits, and alternatives explained to the athlete

Informed consent documentation must include that risks, benefits, and alternatives were explained to the athlete so they could make a voluntary, educated decision.

Question 30: A treatment protocol incorporates a 'work hardening' component. This means the program:

• Removes the worker from all physical activity
• Focuses exclusively on pain management
• Simulates actual job tasks to build the worker's capacity for return to work (Correct answer)
• Reduces work hours permanently

Correct answer: Simulates actual job tasks to build the worker's capacity for return to work

Work hardening uses real or simulated job tasks to progressively build the physical and functional capacities required for return to work.

Question 31: Which bloodborne pathogen poses the greatest occupational exposure risk due to its high concentration in infected blood and its ability to survive on environmental surfaces for up to 7 days?

• Hepatitis B (HBV) (Correct answer)
• MRSA
• Hepatitis C (HCV)
• HIV

Correct answer: Hepatitis B (HBV)

HBV can survive on dry surfaces for up to 7 days and is 50–100 times more infectious than HIV, making it the highest bloodborne transmission risk.

Question 32: An athlete's body weight drops 3% during a two-hour practice session. This level of dehydration most likely impairs:

• Sleep quality and immune response only
• Bone density and calcium absorption
• Testosterone production and protein synthesis
• Aerobic performance, cognitive function, and thermoregulation (Correct answer)

Correct answer: Aerobic performance, cognitive function, and thermoregulation

A 2-3% body weight loss from dehydration measurably impairs aerobic capacity, decision-making, and the body's ability to regulate core temperature.

Question 33: A newly certified coach is asked to deliver training in a specialized area beyond their current competence. They should:

• Accept only if they can find a textbook to consult during the session
• Accept the assignment and research the topic independently during delivery
• Decline and refer the client to a coach with appropriate expertise in that area (Correct answer)
• Complete the training and disclose their limitations only if asked

Correct answer: Decline and refer the client to a coach with appropriate expertise in that area

Practicing outside one's competence risks participant safety and violates professional ethics; referral to a qualified specialist is the appropriate action.

Question 34: What is the primary purpose of a professional code of ethics for IHSA Certified Coaches?

• To outline the minimum hours required for certification renewal
• To limit legal liability for the certifying organization
• To establish a hierarchy of authority within coaching teams
• To guide professional behavior and protect the public, clients, and the profession's integrity (Correct answer)

Correct answer: To guide professional behavior and protect the public, clients, and the profession's integrity

A professional code of ethics establishes standards that protect all stakeholders and maintain public trust in the coaching profession.

Question 35: What is the correct procedure for IHSA professionals when a medication error occurs?

• Assess the patient, notify the provider, document the event, and report through the incident reporting system (Correct answer)
• Hide the error to avoid liability
• Only tell the patient if they ask
• Wait to see if any adverse effects develop

Correct answer: Assess the patient, notify the provider, document the event, and report through the incident reporting system

When a medication error occurs, the immediate priority is patient safety—assess the patient, notify the physician, provide any necessary interventions, then document accurately and report through the facility's incident reporting system.

Question 36: In IHSA practice, what is evidence-based practice?

• Integrating best research evidence with clinical expertise and patient values (Correct answer)
• Using only manufacturer recommendations
• Following only the most recent research studies
• Relying solely on personal clinical experience

Correct answer: Integrating best research evidence with clinical expertise and patient values

Evidence-based practice combines the best available research evidence with the clinician's professional expertise and the individual patient's preferences and values to guide clinical decision-making.

Question 37: Which AVPU level best describes a patient who only responds when you apply a sternal rub?

• Pain (Correct answer)
• Alert
• Unresponsive
• Voice

Correct answer: Pain

A patient who responds only to painful stimuli is classified as 'P' (Pain) on the AVPU scale.

Question 38: What is the primary reason functional outcome measures should be documented throughout an athlete's rehabilitation?

• To justify the cost of treatment to insurance carriers only
• To create marketing materials showing program effectiveness
• To satisfy the athlete's curiosity about their own progress
• To track progress objectively, guide treatment decisions, and support return-to-play determinations (Correct answer)

Correct answer: To track progress objectively, guide treatment decisions, and support return-to-play determinations

Serial outcome measure documentation provides objective evidence of progress, informs clinical decisions, and creates defensible criteria for safe return to sport.

Question 39: In IHSA documentation, what does the acronym SMART stand for in goal setting?

• Specific, Measurable, Achievable, Relevant, Time-bound (Correct answer)
• Simple, Moderate, Accurate, Reliable, Tested
• Scientific, Meaningful, Applied, Reviewed, Therapeutic
• Standard, Medical, Appropriate, Recorded, Tracked

Correct answer: Specific, Measurable, Achievable, Relevant, Time-bound

SMART goals in healthcare documentation must be Specific (clearly defined), Measurable (quantifiable), Achievable (realistic), Relevant (related to patient needs), and Time-bound (with a target date).

Question 40: Which of the following best describes ergonomic hazards?

• Conditions that cause environmental pollution
• Hazards from electrical equipment
• All of the above
• Conditions that cause strain on the body (Correct answer)

Correct answer: Conditions that cause strain on the body

Ergonomic hazards are workplace conditions or job demands that put stress on the body, leading to musculoskeletal disorders (MSDs) over time. These can include repetitive motions, awkward postures, excessive force, or poorly designed workstations. Addressing ergonomic hazards involves designing tasks, tools, and environments to fit the worker, reducing physical strain.

Question 41: What does 'enteral' administration mean in medication delivery?

• Delivered directly into a vein
• Administered via skin patch
• Delivered through the gastrointestinal tract (oral, rectal, sublingual) (Correct answer)
• Inhaled through the respiratory tract

Correct answer: Delivered through the gastrointestinal tract (oral, rectal, sublingual)

Enteral administration involves delivery through the GI tract, including oral, rectal, and sublingual routes.

Question 42: Which type of hazard is most commonly overlooked during standard site inspections because it is not immediately visible?

• Unguarded rotating equipment
• Noise-induced hearing loss from chronic exposure (Correct answer)
• Unsecured scaffolding components
• Slip, trip, and fall hazards

Correct answer: Noise-induced hearing loss from chronic exposure

Chronic noise exposure causes cumulative hearing loss that has no immediate visible symptom and is often missed during physical site inspections.

Question 43: An athlete is prescribed methylprednisolone (an oral corticosteroid) for a severe allergic reaction during a competition period. Which anti-doping action is required?

• The prescription must be reported to USADA only after competition
• No action needed; corticosteroids are always permitted
• A TUE must be obtained before or retroactively as permitted (Correct answer)
• The athlete must withdraw from competition

Correct answer: A TUE must be obtained before or retroactively as permitted

Oral, intravenous, and intramuscular corticosteroids are prohibited in-competition and require a TUE, which can sometimes be retroactive in emergencies.

Question 44: OSHA 29 CFR 1910.132(f) requires employers to provide PPE training to each employee. Which element is NOT required to be covered in PPE training?

• Limitations of the PPE
• How to properly put on, adjust, and remove PPE
• When PPE is necessary
• The purchase cost and replacement schedule of each PPE item (Correct answer)

Correct answer: The purchase cost and replacement schedule of each PPE item

OSHA's PPE training requirements focus on when, how, and limitations of PPE use; cost and procurement details for PPE items are not a mandated training element under 1910.132(f).

Question 45: When a IHSA practitioner faces a conflict between beneficence and patient autonomy, what is the correct approach?

• Seek a court order to proceed
• Ignore the conflict and document nothing
• Override the patient's wishes for their own good
• Respect the patient's informed decision even if it differs from the recommended treatment (Correct answer)

Correct answer: Respect the patient's informed decision even if it differs from the recommended treatment

When a competent, informed patient makes a decision that conflicts with what the practitioner believes is best, patient autonomy generally takes precedence. The provider should ensure the patient understands the implications and document the discussion.

Question 46: What is a common obstacle in safety coaching?

• A lack of employee engagement or resistance to change (Correct answer)
• Employees being too enthusiastic about safety practices.
• Too much focus on theoretical information.
• Employees ignoring their job duties.

Correct answer: A lack of employee engagement or resistance to change

A significant obstacle in safety coaching is a lack of employee engagement or resistance to change. If employees are disengaged or unwilling to adapt their behaviors, even the best coaching strategies will be ineffective. Overcoming this requires building trust, demonstrating the value of safety, and involving employees in the safety process to foster a sense of ownership and commitment.

Question 47: When a minor athlete's parent requests access to their child's health records, what is the generally appropriate response?

• Require a court order before releasing any information
• Deny the request because minors have independent healthcare rights
• Provide access, as parents or legal guardians typically have rights to minor records (Correct answer)
• Only provide records if the minor athlete consents in writing

Correct answer: Provide access, as parents or legal guardians typically have rights to minor records

Parents or legal guardians of minor athletes generally have the right to access their child's health records unless a legal exception applies.

Question 48: Which of the following best defines 'informed consent' in the context of youth athletic participation?

• An athlete's signature on an equipment use form
• A school district's blanket approval for all extracurricular activities
• A parent or guardian's written acknowledgment of risks after receiving relevant information (Correct answer)
• A verbal agreement between the coach and athlete about practice intensity

Correct answer: A parent or guardian's written acknowledgment of risks after receiving relevant information

Informed consent requires that parents or guardians receive clear information about participation risks and voluntarily agree in writing before the athlete participates.

Question 49: The practice of 'universal precautions' in athletics means treating:

• All blood and certain body fluids from every person as potentially infectious (Correct answer)
• Infectious materials only from athletes with known diagnoses
• Only visibly soiled blood as potentially infectious
• All body fluids equally, including sweat and saliva

Correct answer: All blood and certain body fluids from every person as potentially infectious

Universal precautions assume all blood and specified body fluids are potentially infectious regardless of the perceived infection status of the source.

Question 50: Which of the following best describes the role of documentation in supporting an athlete's return-to-play (RTP) decision?

• Documentation of RTP is only required for catastrophic or life-threatening injuries
• Only the final RTP clearance note is needed; interim progress notes are optional
• Documentation is unnecessary once an athlete reports feeling ready to compete
• Documented objective criteria, progress milestones, and physician clearance create a defensible RTP record (Correct answer)

Correct answer: Documented objective criteria, progress milestones, and physician clearance create a defensible RTP record

A documented trail of objective criteria, progressive milestones, and formal clearance creates a legally defensible record showing the RTP decision was evidence-based and appropriate.

Question 51: A post-exposure evaluation for a staff member after an HIV needlestick should be initiated within:

• 72 hours to consider post-exposure prophylaxis (PEP) (Correct answer)
• 1 hour for emergency surgical wound debridement
• 7 days for baseline serologic testing only
• 24 hours to begin mandatory antiretroviral therapy

Correct answer: 72 hours to consider post-exposure prophylaxis (PEP)

HIV PEP must be started as soon as possible and ideally within 72 hours of exposure; efficacy decreases significantly after that window.

Question 52: A coach is pressured by an employer to overlook a serious safety hazard to avoid production downtime. Ethically, the coach must:

• Document the hazard and report it through appropriate channels regardless of employer pressure (Correct answer)
• Defer to the employer's judgment as they bear ultimate responsibility
• Resign immediately without reporting the hazard
• Agree to overlook the hazard temporarily if corrective action is promised

Correct answer: Document the hazard and report it through appropriate channels regardless of employer pressure

Professional ethics and legal obligations require coaches to report serious safety hazards regardless of employer pressure, as worker safety is paramount.

Question 53: What is the primary purpose of maintaining an injury surveillance log for a sports program?

• To document athlete academic eligibility status
• To replace the need for individual athlete health records
• To satisfy insurance billing requirements exclusively
• To identify injury patterns and inform prevention strategies (Correct answer)

Correct answer: To identify injury patterns and inform prevention strategies

Injury surveillance logs track patterns across the team, enabling coaches and medical staff to identify risk factors and implement targeted prevention programs.

Question 54: When documenting a coaching session involving a workplace near-miss incident, which standard should guide the coach's record-keeping?

• Record only the positive outcomes to encourage future participation
• Minimize detail to avoid creating legal liability
• Document facts accurately, objectively, and in a timely manner (Correct answer)
• Share records widely so all staff are informed

Correct answer: Document facts accurately, objectively, and in a timely manner

Accurate, objective, and timely documentation upholds professional integrity and ensures records are reliable for safety improvement and legal compliance.

Question 55: A worker is found unresponsive with suspected heat stroke (hot, dry skin; core temp >104°F). What cooling method is most effective in the field?

• Applying ice packs only to forehead and neck
• Cold water immersion of the torso and limbs (Correct answer)
• Oral rehydration with sports drinks while in shade
• Moving to an air-conditioned vehicle and monitoring

Correct answer: Cold water immersion of the torso and limbs

Cold water immersion of the torso and limbs provides the fastest cooling rate and is the gold-standard field treatment for exertional heat stroke.

Question 56: Under IHSA guidelines, how often should coaches review and practice the facility's Emergency Action Plan?

• Only before championship events
• Only when staff changes occur
• At least annually and with all new staff (Correct answer)
• Once every five years

Correct answer: At least annually and with all new staff

EAPs must be reviewed and rehearsed at least annually and whenever new personnel join the program to ensure readiness.

Question 57: A patient's pupils are unequal in size after a head trauma. This finding is called:

• Miosis
• Anisocoria (Correct answer)
• Mydriasis
• Nystagmus

Correct answer: Anisocoria

Anisocoria refers to unequal pupil sizes, which after head trauma can indicate increased intracranial pressure or brain herniation.

Question 58: An athlete has an anaphylactic reaction at a remote training site. A coach trained in first aid should administer which medication first, if available?

• Oral antihistamine (diphenhydramine)
• Epinephrine auto-injector (EpiPen) (Correct answer)
• Oral corticosteroid
• Inhaled albuterol

Correct answer: Epinephrine auto-injector (EpiPen)

Epinephrine is the first-line treatment for anaphylaxis; antihistamines and corticosteroids are adjuncts and act too slowly for emergencies.

Question 59: Which factor most significantly affects how quickly an oral medication is absorbed in an athlete who just completed an intense workout?

• Reduced gastrointestinal blood flow due to blood redistribution during exercise (Correct answer)
• The color of the pill coating
• The athlete's height and wingspan
• Whether the medication was swallowed with hot or cold water

Correct answer: Reduced gastrointestinal blood flow due to blood redistribution during exercise

Intense exercise diverts blood from the GI tract to working muscles, slowing intestinal absorption of oral medications.

Question 60: OSHA requires quantitative or qualitative fit testing for tight-fitting respirators. How often must fit testing be repeated for workers who continue to use the same respirator model?

• Only at initial assignment
• Every 2 years
• Annually (Correct answer)
• Every 6 months

Correct answer: Annually

OSHA 29 CFR 1910.134 requires respirator fit testing annually, and whenever the employee reports or the employer observes changes in physical condition that could affect respirator fit.

Question 61: Which scenario best illustrates a 'dynamic risk assessment'?

• An annual safety audit conducted by the health and safety committee
• Completing a written JHA before starting a routine maintenance task
• A worker re-evaluating hazards on the spot when site conditions change unexpectedly (Correct answer)
• A HAZOP study performed during facility design

Correct answer: A worker re-evaluating hazards on the spot when site conditions change unexpectedly

Dynamic risk assessment is an on-the-spot evaluation performed in real time when conditions deviate from what was anticipated.

Question 62: In a multi-casualty situation during a large track meet, which triage color tag indicates a victim who is deceased or has unsurvivable injuries?

• Red
• Black (Correct answer)
• Yellow
• Green

Correct answer: Black

In START triage, a black tag indicates the victim is deceased or has injuries too severe to survive with available resources.

Question 63: An IHSA-certified coach notes a worker's protocol lacks a discharge criteria section. Why is this a significant omission?

• Discharge criteria are only required for surgical cases
• Without discharge criteria, there is no clear endpoint to guide tapering and prevent unnecessary dependency (Correct answer)
• It has no practical impact on treatment
• Discharge is always determined by the employer

Correct answer: Without discharge criteria, there is no clear endpoint to guide tapering and prevent unnecessary dependency

Defined discharge criteria establish the endpoint for care, prevent treatment dependency, and ensure resources are used appropriately.

Question 64: Under OSHA's multi-employer worksite policy, which employer type is responsible for hazards it creates, even if its own employees are not exposed?

• Correcting employer
• Creating employer (Correct answer)
• Exposed employer
• Controlling employer

Correct answer: Creating employer

The 'creating employer' bears responsibility for hazards it generates on a multi-employer worksite regardless of whose workers are exposed.

Question 65: Which OSHA requirement mandates that a sufficient number of trained persons be available to render first aid when a medical facility is NOT in near proximity to the worksite?

• 29 CFR 1926.21(b)
• 29 CFR 1926.50(c)
• 29 CFR 1910.151(b) (Correct answer)
• 29 CFR 1910.38(a)

Correct answer: 29 CFR 1910.151(b)

29 CFR 1910.151(b) requires that in the absence of an infirmary or clinic near the workplace, a person trained to render first aid must be available.

Question 66: A stimulant medication prescribed for ADHD (e.g., amphetamine) used by a competing athlete without a TUE would be classified as:

• A permitted therapeutic drug
• A prohibited substance in-competition requiring a TUE (Correct answer)
• A supplement under the athlete's own discretion
• Legal without restriction in US domestic competitions only

Correct answer: A prohibited substance in-competition requiring a TUE

Amphetamines are prohibited in-competition under the stimulants category and athletes with ADHD must obtain a TUE to compete while taking them.

Question 67: What does 'de-identified' health information mean in the context of HIPAA?

• Health information that has been shredded or destroyed
• Health information from which all 18 HIPAA identifiers have been removed, making re-identification unlikely (Correct answer)
• Health information shared only within a single organization
• Health information that has been encrypted but can be recovered with a key

Correct answer: Health information from which all 18 HIPAA identifiers have been removed, making re-identification unlikely

De-identified information has had all 18 HIPAA-specified identifiers removed, such that the risk of identifying the individual is very small, and is no longer considered PHI.

Question 68: What is the IHSA professional's duty when they witness a colleague practicing unsafely?

• Ignore it to avoid conflict
• Discuss it only with friends
• Report the concern through proper institutional channels to protect patients (Correct answer)
• Confront them publicly

Correct answer: Report the concern through proper institutional channels to protect patients

Healthcare professionals have an ethical and often legal obligation to report unsafe practices through proper channels (supervisor, risk management, licensing board) to protect patients from potential harm.

Question 69: What does the term 'scope of practice' mean for a IHSA professional?

• Any treatment the professional feels comfortable performing
• Only procedures learned in school
• The legally defined activities, procedures, and processes that a professional is authorized to perform (Correct answer)
• Activities assigned by the employer

Correct answer: The legally defined activities, procedures, and processes that a professional is authorized to perform

Scope of practice defines the legal boundaries of what procedures and services a licensed professional is qualified and authorized to perform, based on education, certification, and state regulations.

Question 70: OSHA requires employers to review and update their emergency action plan when which condition occurs?

• When the plan is determined to be inadequate, or after a drill (Correct answer)
• Only when a fatality happens on site
• Every five years regardless of changes
• When employee headcount doubles

Correct answer: When the plan is determined to be inadequate, or after a drill

29 CFR 1910.38(e) states the EAP must be reviewed with employees when the plan is first developed, when responsibilities change, or when the plan is updated due to inadequacy.

Question 71: A coach disagrees with an organization's safety policy they believe is inadequate. The most professionally appropriate response is to:

• Raise concerns through proper channels while continuing to coach within current policy requirements (Correct answer)
• Implement personal modifications to the policy without authorization
• Openly advise participants to disregard the policy
• Refuse to conduct any coaching until the policy is changed

Correct answer: Raise concerns through proper channels while continuing to coach within current policy requirements

Professionals address policy disagreements through legitimate channels while maintaining current standards, balancing advocacy for improvement with responsibility to participants.

Question 72: A certified coach discovers that a colleague is falsifying safety inspection records at a job site. What is the coach's ethical obligation?

• Wait to see if the colleague self-corrects
• Report the falsification to the appropriate authority or supervisor (Correct answer)
• Ignore it to avoid workplace conflict
• Confront the colleague privately and take no further action

Correct answer: Report the falsification to the appropriate authority or supervisor

IHSA professional standards require coaches to report safety violations and misconduct to protect workers and uphold the integrity of the profession.

Question 73: In ICS, the Planning Section is responsible for which primary function?

• Collecting, evaluating, and disseminating incident information and maintaining resource status (Correct answer)
• Procuring and issuing all equipment to responders
• Coordinating with external agencies and media
• Directing all tactical field operations

Correct answer: Collecting, evaluating, and disseminating incident information and maintaining resource status

The Planning Section collects and processes incident information, tracks resource status, and produces the Incident Action Plan (IAP).

Question 74: A 'critical incident stress' following a workplace fatality can affect risk perception by:

• Permanently improving workers' ability to identify hazards
• Eliminating the need for formal risk assessments for six months
• Reducing the statistical probability of a recurrence
• Causing workers to underestimate future risks once initial shock fades (Correct answer)

Correct answer: Causing workers to underestimate future risks once initial shock fades

After initial heightened awareness fades, workers may revert to or exceed prior risk normalization, a phenomenon known as risk habituation.

Question 75: During a football game, an athlete sustains a laceration that bleeds through the initial dressing. The proper protocol is to:

• Clean the wound with hydrogen peroxide and tape it closed immediately on the sideline
• Remove the athlete, change the dressing, and ensure the wound is adequately controlled before return (Correct answer)
• Allow return to play if the athlete says the bleeding has slowed
• Apply a second layer of bandage over the saturated one and allow play to continue

Correct answer: Remove the athlete, change the dressing, and ensure the wound is adequately controlled before return

A saturated dressing indicates inadequate hemorrhage control; the athlete must be removed, the wound reassessed, and bleeding controlled before return.

Question 76: When storing medications for an athletic team, which temperature condition is most critical for many biologics such as insulin or vaccines?

• Refrigerated 36–46°F (2–8°C) (Correct answer)
• Room temperature 68–77°F (20–25°C)
• Frozen below 32°F (0°C)
• Warm storage above 98°F (37°C)

Correct answer: Refrigerated 36–46°F (2–8°C)

Most biologics require refrigeration at 2–8°C (36–46°F) to maintain potency and prevent degradation.

Question 77: During a thunderstorm, work at height must be suspended based on the 30-30 lightning safety rule. What does the second '30' represent?

• Move workers at least 30 feet lower in elevation
• Wait 30 seconds after thunder before resuming work
• Maintain a 30-foot clearance from all tall structures
• Wait 30 minutes after the last thunder before resuming work (Correct answer)

Correct answer: Wait 30 minutes after the last thunder before resuming work

The second 30 of the 30-30 rule means waiting at least 30 minutes after the last clap of thunder before resuming outdoor work, accounting for residual storm cell danger.

Question 78: Which condition requires a coach to deny an athlete participation until cleared by a physician, regardless of the athlete's or parent's protests?

• Mild delayed onset muscle soreness from the previous practice
• A single episode of exercise-induced bronchospasm six months ago
• A healed Grade I ankle sprain with full range of motion
• An uncleared prior concussion with ongoing symptoms (Correct answer)

Correct answer: An uncleared prior concussion with ongoing symptoms

An athlete with unresolved concussion symptoms must not participate until symptom-free and medically cleared; no-return-to-play overrides all other considerations.

Question 79: The Exposure Control Plan (ECP) required by OSHA's Bloodborne Pathogens Standard must be reviewed and updated at minimum:

• Only when an exposure incident occurs
• Annually and whenever tasks or procedures change that affect exposure risk (Correct answer)
• Every 2 years as part of a biennial compliance audit
• Every 5 years or when new technology becomes available

Correct answer: Annually and whenever tasks or procedures change that affect exposure risk

OSHA mandates annual ECP review and updates whenever new tasks are introduced or procedures change that could affect bloodborne pathogen exposure.

Question 80: Who should be trained in emergency response procedures?

• All employees, regardless of their role. (Correct answer)
• Only managers and supervisors.
• Only the safety officers.
• Only the designated emergency response team.

Correct answer: All employees, regardless of their role.

All employees, regardless of their role, should be trained in emergency response procedures. Every individual in the workplace has a part to play in ensuring their own safety and potentially assisting others during an emergency. Universal training creates a collective understanding and capability, leading to a more coordinated and effective response when an incident occurs.

Question 81: In IHSA practice, what is evidence-based practice?

• Using only manufacturer recommendations
• Relying solely on personal clinical experience
• Following only the most recent research studies
• Integrating best research evidence with clinical expertise and patient values (Correct answer)

Correct answer: Integrating best research evidence with clinical expertise and patient values

Evidence-based practice combines the best available research evidence with the clinician's professional expertise and the individual patient's preferences and values to guide clinical decision-making.

Question 82: Which situation represents an appropriate use of social media for an IHSA Certified Coach?

• Connecting with coaching participants on personal social media to maintain rapport
• Discussing confidential organizational safety challenges to seek public advice
• Posting identifiable details about a participant's safety failure as a cautionary example
• Sharing general industry safety tips and certified professional resources on a public profile (Correct answer)

Correct answer: Sharing general industry safety tips and certified professional resources on a public profile

Coaches may use social media professionally to share general educational content, but must never share confidential or identifiable participant information.

Question 83: What is the standard precaution approach in IHSA clinical practice?

• Relying on patient self-reporting of infections
• Wearing gloves only during surgery
• Only using precautions for diagnosed infections
• Treating all patients as potentially infectious and using appropriate protective measures (Correct answer)

Correct answer: Treating all patients as potentially infectious and using appropriate protective measures

Standard precautions treat all blood, body fluids, non-intact skin, and mucous membranes as potentially infectious, requiring appropriate PPE for all patient interactions regardless of diagnosis.

Question 84: Which of the following practices most effectively reduces the risk of infection transmission in shared athletic facilities?

• Limiting facility use to varsity athletes only
• Routine disinfection of high-contact surfaces and prohibition of personal equipment sharing (Correct answer)
• Athletes sharing water bottles to maintain hydration efficiency
• Increasing ventilation only during peak usage hours

Correct answer: Routine disinfection of high-contact surfaces and prohibition of personal equipment sharing

Regular disinfection of shared surfaces and prohibiting sharing of personal items (towels, water bottles) are evidence-based infection control measures in athletic settings.

Question 85: Which of the following is an example of personal protective equipment (PPE)?

• Office chair
• None of the above
• Water cooler
• Safety goggles

Personal Protective Equipment (PPE) refers to any equipment worn to minimize exposure to hazards that cause serious workplace injuries and illnesses. Safety goggles are a classic example, specifically designed to protect the eyes from impacts, chemicals, dust, and other potential hazards. Items like office chairs or water coolers are general workplace amenities, not protective gear.

Question 86: Which is the correct sequence in a risk management process?

• Control → Identify → Assess → Monitor
• Assess → Control → Identify → Review
• Monitor → Identify → Control → Assess
• Identify → Assess → Control → Monitor (Correct answer)

Correct answer: Identify → Assess → Control → Monitor

The standard risk management cycle is: identify hazards, assess their risk, implement controls, then monitor effectiveness.

Question 87: A coach receives confidential health information about a worker during a safety assessment. Under what circumstance may this information be disclosed?

• When a coworker asks about the worker's fitness for duty
• When the information would benefit the overall coaching program
• When disclosure is required by law or there is an imminent safety risk (Correct answer)
• When management requests a general health update on the workforce

Correct answer: When disclosure is required by law or there is an imminent safety risk

Confidential information may only be disclosed when legally mandated or when there is an imminent risk of serious harm that cannot otherwise be prevented.

Question 88: Under IHSA's medication management protocol, who bears ultimate responsibility for an athlete's compliance with anti-doping rules regarding medications?

• The national federation's medical director
• The athlete themselves (Correct answer)
• The team coach
• The team physician

Correct answer: The athlete themselves

Under WADA's strict liability principle, athletes bear personal responsibility for any substance found in their body, regardless of who administered it.

Question 89: An IHSA coach discovers that their own certification has lapsed due to failure to complete continuing education. What is the ethical course of action?

• Complete the continuing education retroactively before telling anyone
• Continue coaching until the next renewal cycle
• Disclose only to the employer and continue coaching with supervision
• Immediately cease coaching activities and work to reinstate certification (Correct answer)

Correct answer: Immediately cease coaching activities and work to reinstate certification

Practicing without a valid certification is unethical and potentially illegal; the coach must stop immediately and take steps to restore their credentials.

Question 90: In a multi-sport facility, why is it important for the IHSA certified coach to maintain separate documentation for each sport's injuries and safety inspections?

• Separate records allow sport-specific pattern analysis to target appropriate prevention measures (Correct answer)
• Regulatory bodies prohibit combining records from different sports
• Separate records simplify deletion of outdated information by sport
• Insurance carriers require separate files sorted by revenue generated per sport

Correct answer: Separate records allow sport-specific pattern analysis to target appropriate prevention measures

Sport-specific documentation enables meaningful injury surveillance analysis by revealing sport-specific risk patterns that would be obscured in combined records.

Question 91: A construction worker is found unresponsive after a fall. What is the FIRST step in the primary assessment?

• Check for breathing
• Open the airway
• Check for a pulse
• Establish scene safety and form a general impression (Correct answer)

Correct answer: Establish scene safety and form a general impression

Scene safety and forming a general impression of the patient's condition must occur before any hands-on assessment begins.

Question 92: Which principle best describes 'risk transfer' in an athletic risk management program?

• Shifting financial liability to another party through insurance or waivers (Correct answer)
• Reducing participation numbers to lower overall exposure
• Training coaches to personally handle all medical incidents
• Eliminating all hazardous activities from the program schedule

Correct answer: Shifting financial liability to another party through insurance or waivers

Risk transfer moves financial or legal responsibility to another party, typically through liability insurance or properly executed waivers.

Question 93: Why is risk assessment important in hazard identification?

• To prevent the identification of new risks.
• To avoid any kind of hazard.
• To ensure hazards are ignored.
• To determine the most effective risk reduction strategies. (Correct answer)

Correct answer: To determine the most effective risk reduction strategies.

Risk assessment is important in hazard identification because it helps determine the most effective risk reduction strategies. After identifying hazards, risk assessment evaluates the likelihood and severity of harm, allowing organizations to prioritize which risks need immediate attention. This systematic evaluation ensures that resources are allocated efficiently to implement controls that will have the greatest impact on safety.

Question 94: A certified coach receives a subpoena for an athlete's health records. What is the appropriate first response?

• Release all records immediately to comply with the legal order without delay
• Immediately destroy any records that could be harmful to the program
• Contact legal counsel or the institution's risk management office before releasing any records (Correct answer)
• Inform only the athlete and take no other action

Correct answer: Contact legal counsel or the institution's risk management office before releasing any records

Upon receiving a subpoena, consulting legal counsel or risk management before releasing records ensures compliance with both the legal order and applicable privacy laws.

Question 95: Which principle should guide a coach when an athlete self-reports taking a new herbal supplement: advise them to stop immediately, continue without concern, research the ingredients for potential prohibited substances, or report it only if performance improves?

• Research the ingredients for potential prohibited substances before continuing (Correct answer)
• Report it only if performance noticeably improves
• Continue without concern since herbal supplements are natural
• Advise them to stop immediately without discussion

Correct answer: Research the ingredients for potential prohibited substances before continuing

Coaches should help athletes verify supplement ingredients against the prohibited list, as natural origin does not guarantee safety or legality in sport.

Question 96: What is the correct procedure for IHSA professionals when a medication error occurs?

• Only tell the patient if they ask
• Wait to see if any adverse effects develop
• Assess the patient, notify the provider, document the event, and report through the incident reporting system (Correct answer)
• Hide the error to avoid liability

Correct answer: Assess the patient, notify the provider, document the event, and report through the incident reporting system

When a medication error occurs, the immediate priority is patient safety—assess the patient, notify the physician, provide any necessary interventions, then document accurately and report through the facility's incident reporting system.

Question 97: In maintaining records for an IHSA program, what is the recommended approach for storing paper health records?

• In the team equipment room sorted by jersey number
• In the athlete's personal locker for their own safekeeping
• In an open filing cabinet in the coaching office for easy access
• In a locked, secure location accessible only to authorized personnel (Correct answer)

Correct answer: In a locked, secure location accessible only to authorized personnel

Paper health records must be stored in a locked, secure location to prevent unauthorized access and comply with privacy regulations.

Question 98: What is the standard reassessment interval for an unstable patient in the field?

• Every 10 minutes
• Every 5 minutes (Correct answer)
• Every 15 minutes
• Every 2 minutes

Correct answer: Every 5 minutes

Unstable patients require reassessment every 5 minutes to detect rapid changes in condition.

Question 99: Which element distinguishes a 'near miss' from an 'incident' in IHSA safety reporting frameworks?

• A near miss only applies to vehicle-related events on a job site
• A near miss involves property damage exceeding $1,000
• A near miss requires OSHA recordkeeping the same as a recordable incident
• A near miss is an unplanned event with potential for harm but no actual injury or damage occurring (Correct answer)

Correct answer: A near miss is an unplanned event with potential for harm but no actual injury or damage occurring

A near miss is an unplanned event that did not result in injury, illness, or damage but had the potential to do so, making it a leading indicator for hazard correction.