DEFINED ANSWERS LATEST ALREADY GRADED
A+ (2025/2026) Occupational Health
Nurse/Case Manager (COHN/CM) Practice
Examination
1. In the case management process, the initial comprehensive assessment of an
injured worker's medical, psychosocial, vocational, and financial needs occurs
during which phase?
A) Planning
B) Implementation
C) Intake and Assessment
D) Outcome Evaluation
Answer: C
Rationale: The case management process begins with intake and comprehensive
assessment, which identifies the employee's needs, barriers to recovery, and
strengths across all biopsychosocial domains before planning interventions.
2. A case manager is working with an employee who has been off work for 6
weeks following a low back strain. The employee expresses fear that returning to
work will cause permanent damage. This fear is BEST described as:
A) Malingering.
B) Symptom magnification.
C) Fear-avoidance behavior (kinesiophobia).
,D) A normal grief reaction to injury.
Answer: C
Rationale: Kinesiophobia is an excessive, irrational fear of physical movement and
activity resulting from a feeling of vulnerability to painful injury or re-injury. It is a
strong predictor of delayed recovery and chronic disability, distinct from
conscious malingering.
3. The "Disability Duration Guidelines" (e.g., ODG, MDGuidelines) are primarily
used by case managers to:
A) Set mandatory return-to-work dates that cannot be exceeded.
B) Establish evidence-based benchmarks for expected recovery and return-to-
work timelines.
C) Determine the exact dollar value of a workers' compensation settlement.
D) Replace the treating physician's clinical judgment.
Answer: B
Rationale: Disability duration guidelines provide objective, evidence-based
benchmarks for typical recovery by diagnosis and procedure. They help identify
cases that deviate from expected timelines, prompting case manager intervention
for potential barriers.
4. An employee on transitional duty has a temporary restriction of "no lifting over
15 pounds." The supervisor asks the employee to carry a 25-pound box "just this
once." The case manager's MOST appropriate response is to:
A) Support the supervisor's request to maintain production.
B) Reinforce that exceeding the restriction violates the medical order, jeopardizes
worker safety, and may transfer liability for re-injury.
C) Immediately file a complaint with OSHA.
D) Discharge the employee from the RTW program for non-compliance.
,Answer: B
Rationale: The case manager must advocate for the integrity of the medical
restrictions. Allowing exceptions undermines the transitional duty plan, risks re-
injury, and exposes the employer to liability. Education and firm reinforcement
are key.
5. Which of the following is the BEST example of an "objective" finding in a case
management medical record?
A) "Employee reports his pain is 8/10."
B) "Employee states she feels depressed about her injury."
C) "Observed limping; lumbar range of motion restricted to 30 degrees flexion
with palpable paraspinal muscle spasm."
D) "Employee's supervisor says he seems unmotivated."
Answer: C
Rationale: Objective findings are measurable, observable, and verifiable by the
clinician. Reports of pain, feelings, and unverified observations are subjective.
Measured range of motion and observed physical signs are objective.
6. A tool that quantifies an employee's physical abilities, such as lifting, carrying,
pushing, and pulling, to determine readiness to perform specific job demands is
called a:
A) Work Hardening program.
B) Functional Capacity Evaluation (FCE).
C) Pre-placement physical.
D) Independent Medical Examination (IME).
Answer: B
, Rationale: An FCE is a systematic, comprehensive, and objective measurement of
an individual's physical functional abilities. It is used to determine physical
capacity to work, match abilities to job demands, and guide return-to-work
planning.
7. The primary difference between an Independent Medical Examination (IME)
and a standard treating physician visit is that the IME physician:
A) Establishes a treating therapeutic relationship with the patient.
B) Is selected and paid for by the employee's attorney.
C) Conducts a one-time evaluation to answer specific questions for the payer or
employer, with no treatment relationship.
D) Can prescribe new medications and treatments during the visit.
Answer: C
Rationale: An IME is a forensic evaluation by a physician who does not have a
treatment relationship with the patient. The purpose is to provide an objective,
unbiased opinion on causality, treatment necessity, impairment, and work
capacity for the requesting party.
8. A case manager uses the phrase "Return to Work (RTW) is therapeutic." What
does this mean?
A) Any work is better than physical therapy for all conditions.
B) Structured, safe work promotes physical and psychological recovery, maintains
the employment bond, and reduces the risk of chronic disability.
C) The employer is required to provide physical therapy on-site.
D) Return to work will guarantee 100% healing before complete medical recovery.
Answer: B
Rationale: Evidence supports that prolonged absence from work is associated
with poorer health outcomes, depression, and social isolation. Safe,
A+ (2025/2026) Occupational Health
Nurse/Case Manager (COHN/CM) Practice
Examination
1. In the case management process, the initial comprehensive assessment of an
injured worker's medical, psychosocial, vocational, and financial needs occurs
during which phase?
A) Planning
B) Implementation
C) Intake and Assessment
D) Outcome Evaluation
Answer: C
Rationale: The case management process begins with intake and comprehensive
assessment, which identifies the employee's needs, barriers to recovery, and
strengths across all biopsychosocial domains before planning interventions.
2. A case manager is working with an employee who has been off work for 6
weeks following a low back strain. The employee expresses fear that returning to
work will cause permanent damage. This fear is BEST described as:
A) Malingering.
B) Symptom magnification.
C) Fear-avoidance behavior (kinesiophobia).
,D) A normal grief reaction to injury.
Answer: C
Rationale: Kinesiophobia is an excessive, irrational fear of physical movement and
activity resulting from a feeling of vulnerability to painful injury or re-injury. It is a
strong predictor of delayed recovery and chronic disability, distinct from
conscious malingering.
3. The "Disability Duration Guidelines" (e.g., ODG, MDGuidelines) are primarily
used by case managers to:
A) Set mandatory return-to-work dates that cannot be exceeded.
B) Establish evidence-based benchmarks for expected recovery and return-to-
work timelines.
C) Determine the exact dollar value of a workers' compensation settlement.
D) Replace the treating physician's clinical judgment.
Answer: B
Rationale: Disability duration guidelines provide objective, evidence-based
benchmarks for typical recovery by diagnosis and procedure. They help identify
cases that deviate from expected timelines, prompting case manager intervention
for potential barriers.
4. An employee on transitional duty has a temporary restriction of "no lifting over
15 pounds." The supervisor asks the employee to carry a 25-pound box "just this
once." The case manager's MOST appropriate response is to:
A) Support the supervisor's request to maintain production.
B) Reinforce that exceeding the restriction violates the medical order, jeopardizes
worker safety, and may transfer liability for re-injury.
C) Immediately file a complaint with OSHA.
D) Discharge the employee from the RTW program for non-compliance.
,Answer: B
Rationale: The case manager must advocate for the integrity of the medical
restrictions. Allowing exceptions undermines the transitional duty plan, risks re-
injury, and exposes the employer to liability. Education and firm reinforcement
are key.
5. Which of the following is the BEST example of an "objective" finding in a case
management medical record?
A) "Employee reports his pain is 8/10."
B) "Employee states she feels depressed about her injury."
C) "Observed limping; lumbar range of motion restricted to 30 degrees flexion
with palpable paraspinal muscle spasm."
D) "Employee's supervisor says he seems unmotivated."
Answer: C
Rationale: Objective findings are measurable, observable, and verifiable by the
clinician. Reports of pain, feelings, and unverified observations are subjective.
Measured range of motion and observed physical signs are objective.
6. A tool that quantifies an employee's physical abilities, such as lifting, carrying,
pushing, and pulling, to determine readiness to perform specific job demands is
called a:
A) Work Hardening program.
B) Functional Capacity Evaluation (FCE).
C) Pre-placement physical.
D) Independent Medical Examination (IME).
Answer: B
, Rationale: An FCE is a systematic, comprehensive, and objective measurement of
an individual's physical functional abilities. It is used to determine physical
capacity to work, match abilities to job demands, and guide return-to-work
planning.
7. The primary difference between an Independent Medical Examination (IME)
and a standard treating physician visit is that the IME physician:
A) Establishes a treating therapeutic relationship with the patient.
B) Is selected and paid for by the employee's attorney.
C) Conducts a one-time evaluation to answer specific questions for the payer or
employer, with no treatment relationship.
D) Can prescribe new medications and treatments during the visit.
Answer: C
Rationale: An IME is a forensic evaluation by a physician who does not have a
treatment relationship with the patient. The purpose is to provide an objective,
unbiased opinion on causality, treatment necessity, impairment, and work
capacity for the requesting party.
8. A case manager uses the phrase "Return to Work (RTW) is therapeutic." What
does this mean?
A) Any work is better than physical therapy for all conditions.
B) Structured, safe work promotes physical and psychological recovery, maintains
the employment bond, and reduces the risk of chronic disability.
C) The employer is required to provide physical therapy on-site.
D) Return to work will guarantee 100% healing before complete medical recovery.
Answer: B
Rationale: Evidence supports that prolonged absence from work is associated
with poorer health outcomes, depression, and social isolation. Safe,
