Occupational Health Nurse Specialist (COHN-
S)Proctored Exam with Screenshot Questions &
100% Verified Answers
,Domain 1: Clinical Practice (Questions 1-25)
1. A 45-year-old employee presents to the occupational health clinic with a dime-sized, pearly, translucent papule with
telangiectasias on the face. The COHN-S should recognize this lesion as suspicious for:
a) Malignant melanoma
b) Squamous cell carcinoma
c) Basal cell carcinoma
d) Actinic keratosis
Answer: c) Basal cell carcinoma
Rationale: Basal cell carcinoma (BCC) classically presents as a pearly, translucent papule with rolled borders and prominent
telangiectasias. It is the most common form of skin cancer and is strongly associated with cumulative sun exposure, an
occupational risk for outdoor workers.
,2. An employee who works with lead presents with a blue-black line along the gingival margin. This clinical finding is
known as:
a) Mees' lines
b) Burton's line
c) Koilonychia
d) Kayser-Fleischer rings
Answer: b) Burton's line
Rationale: Burton's line is a blue-purplish line on the gums seen in chronic lead poisoning. It is caused by a reaction
between circulating lead and sulfur ions released by oral bacteria, forming lead sulfide deposits.
3. According to the CDC's Adult Immunization Schedule, which vaccine is specifically recommended for adults born
between 1945 and 1965 due to their increased risk?
a) Human Papillomavirus (HPV)
b) Herpes Zoster
c) Hepatitis C
d) Hepatitis B
Answer: c) Hepatitis C
, Rationale: The CDC recommends a one-time Hepatitis C screening for all adults born between 1945 and 1965 (Baby
Boomers), as this population has a five times higher prevalence of HCV infection than other adults. While not a vaccine,
this screening recommendation is a critical public health measure the COHN-S should promote.
4. When performing spirometry, what is the minimum acceptable exhalation time for a valid forced expiratory maneuver
in an adult?
a) 2 seconds
b) 4 seconds
c) 6 seconds
d) 10 seconds
Answer: c) 6 seconds
Rationale: The American Thoracic Society (ATS) and European Respiratory Society (ERS) standards require an exhalation
time of at least 6 seconds (or a plateau in the volume-time curve of at least 1 second) to ensure the patient has exhaled
completely and an accurate Forced Vital Capacity (FVC) is obtained.
5. A worker reports to the clinic with sudden onset of severe, sharp chest pain and shortness of breath after lifting a heavy
object. The COHN-S's immediate priority is to:
a) Administer oxygen and call 911.
b) Obtain a 12-lead ECG.
S)Proctored Exam with Screenshot Questions &
100% Verified Answers
,Domain 1: Clinical Practice (Questions 1-25)
1. A 45-year-old employee presents to the occupational health clinic with a dime-sized, pearly, translucent papule with
telangiectasias on the face. The COHN-S should recognize this lesion as suspicious for:
a) Malignant melanoma
b) Squamous cell carcinoma
c) Basal cell carcinoma
d) Actinic keratosis
Answer: c) Basal cell carcinoma
Rationale: Basal cell carcinoma (BCC) classically presents as a pearly, translucent papule with rolled borders and prominent
telangiectasias. It is the most common form of skin cancer and is strongly associated with cumulative sun exposure, an
occupational risk for outdoor workers.
,2. An employee who works with lead presents with a blue-black line along the gingival margin. This clinical finding is
known as:
a) Mees' lines
b) Burton's line
c) Koilonychia
d) Kayser-Fleischer rings
Answer: b) Burton's line
Rationale: Burton's line is a blue-purplish line on the gums seen in chronic lead poisoning. It is caused by a reaction
between circulating lead and sulfur ions released by oral bacteria, forming lead sulfide deposits.
3. According to the CDC's Adult Immunization Schedule, which vaccine is specifically recommended for adults born
between 1945 and 1965 due to their increased risk?
a) Human Papillomavirus (HPV)
b) Herpes Zoster
c) Hepatitis C
d) Hepatitis B
Answer: c) Hepatitis C
, Rationale: The CDC recommends a one-time Hepatitis C screening for all adults born between 1945 and 1965 (Baby
Boomers), as this population has a five times higher prevalence of HCV infection than other adults. While not a vaccine,
this screening recommendation is a critical public health measure the COHN-S should promote.
4. When performing spirometry, what is the minimum acceptable exhalation time for a valid forced expiratory maneuver
in an adult?
a) 2 seconds
b) 4 seconds
c) 6 seconds
d) 10 seconds
Answer: c) 6 seconds
Rationale: The American Thoracic Society (ATS) and European Respiratory Society (ERS) standards require an exhalation
time of at least 6 seconds (or a plateau in the volume-time curve of at least 1 second) to ensure the patient has exhaled
completely and an accurate Forced Vital Capacity (FVC) is obtained.
5. A worker reports to the clinic with sudden onset of severe, sharp chest pain and shortness of breath after lifting a heavy
object. The COHN-S's immediate priority is to:
a) Administer oxygen and call 911.
b) Obtain a 12-lead ECG.
