Occupational Health Nurse Specialist (COHN-S)
Practice Examination DEFINED ANSWERS
LATEST ALREADY GRADED A+ (2025/2026)
1. An occupational health nurse (OHN) is developing a hearing conservation
program for a manufacturing facility. Which of the following is the first required
element under OSHA’s Hearing Conservation Amendment?
A. Annual audiometric testing for all employees
B. Baseline audiogram within 6 months of first exposure at or above the action
level
C. Provision of hearing protection devices at no cost to employees
D. Employee training on the effects of noise on hearing
**Correct Answer: B**
**Rationale:** The OSHA Hearing Conservation Amendment (29 CFR 1910.95)
requires a baseline audiogram within 6 months of an employee’s first exposure at
or above the action level of 85 dBA as an 8-hour TWA. Training, annual
audiograms, and hearing protection follow, but the baseline establishes the
reference for future monitoring.
2. A COHN-S is reviewing a company’s injury and illness logs. Which type of
recordable injury requires reporting directly to OSHA within 24 hours?
A. Any work-related needlestick injury
B. An amputation, loss of an eye, or inpatient hospitalization
C. Any injury requiring first aid only
D. A sprained ankle treated with prescription pain medication
,**Correct Answer: B**
**Rationale:** OSHA requires employers to report work-related fatalities within 8
hours and amputations, loss of an eye, or inpatient hospitalizations within 24
hours. Needlestick injuries must be recorded but not necessarily reported within
24 hours unless they meet other criteria. First aid does not require reporting.
3. In a pre-placement physical examination, which component is most critical for
determining whether a candidate can safely perform essential job functions?
A. Comprehensive laboratory screening
B. Functional capacity evaluation matched to the job description
C. Chest X-ray for all candidates
D. Psychological evaluation for stress tolerance
**Correct Answer: B**
**Rationale:** The Americans with Disabilities Act (ADA) requires that post-offer,
pre-placement examinations be job-related and consistent with business
necessity. A functional capacity evaluation that measures the candidate’s ability
to perform specific physical demands of the essential job functions is the most
legally defensible approach.
4. An employee reports a persistent dry cough, shortness of breath, and chest
tightness while working with isocyanates in a spray painting operation. These
symptoms are most suggestive of:
A. Silicosis
B. Occupational asthma
C. Byssinosis
,D. Asbestosis
**Correct Answer: B**
**Rationale:** Isocyanates are potent sensitizers and a leading cause of
occupational asthma. Symptoms often begin after a latent period and may
worsen with re-exposure. Silicosis is associated with crystalline silica, byssinosis
with cotton dust, and asbestosis with asbestos fibers.
5. During a workplace walkthrough, the OHN notices several employees using
awkward postures while assembling products. According to the hierarchy of
controls, the most effective ergonomic intervention is:
A. Providing back belts for all assembly workers
B. Instituting a daily stretching program
C. Rotating workers to different tasks every hour
D. Redesigning the workstation to eliminate the awkward postures
**Correct Answer: D**
**Rationale:** The hierarchy of controls ranks elimination or engineering controls
(redesigning the workstation) as most effective. Administrative controls like job
rotation and stretching, and PPE like back belts, are less effective and do not
eliminate the hazard.
6. Which of the following laboratory tests is most appropriate for biological
monitoring of a worker exposed to lead?
A. Urinary phenol
B. Blood lead level (BLL) and zinc protoporphyrin (ZPP)
C. Serum creatinine
, D. Urine cotinine
**Correct Answer: B**
**Rationale:** Blood lead level is the primary biological exposure index for lead.
ZPP reflects metabolic effect and can indicate chronic exposure. Urinary phenol is
used for benzene, serum creatinine for kidney function, and urine cotinine for
tobacco smoke exposure.
7. The primary purpose of a medical surveillance program under OSHA standards
is to:
A. Treat work-related injuries and illnesses
B. Comply with workers’ compensation requirements
C. Identify early signs or symptoms of adverse health effects related to workplace
exposures
D. Provide annual physicals for all employees regardless of exposure
**Correct Answer: C**
**Rationale:** Medical surveillance aims to detect health effects at an early,
often reversible stage so that interventions can prevent progression. It is required
for specific exposures (e.g., lead, asbestos, noise) and focuses on those at risk. It is
not for general physicals or treatment.
8. A COHN-S is developing a case management plan for an employee recovering
from a back injury with temporary restrictions of no lifting >10 pounds. The best
initial step is:
A. Assign the employee to a permanent light-duty position
B. Communicate the restrictions to the supervisor and collaborate on appropriate
transitional duty tasks
Practice Examination DEFINED ANSWERS
LATEST ALREADY GRADED A+ (2025/2026)
1. An occupational health nurse (OHN) is developing a hearing conservation
program for a manufacturing facility. Which of the following is the first required
element under OSHA’s Hearing Conservation Amendment?
A. Annual audiometric testing for all employees
B. Baseline audiogram within 6 months of first exposure at or above the action
level
C. Provision of hearing protection devices at no cost to employees
D. Employee training on the effects of noise on hearing
**Correct Answer: B**
**Rationale:** The OSHA Hearing Conservation Amendment (29 CFR 1910.95)
requires a baseline audiogram within 6 months of an employee’s first exposure at
or above the action level of 85 dBA as an 8-hour TWA. Training, annual
audiograms, and hearing protection follow, but the baseline establishes the
reference for future monitoring.
2. A COHN-S is reviewing a company’s injury and illness logs. Which type of
recordable injury requires reporting directly to OSHA within 24 hours?
A. Any work-related needlestick injury
B. An amputation, loss of an eye, or inpatient hospitalization
C. Any injury requiring first aid only
D. A sprained ankle treated with prescription pain medication
,**Correct Answer: B**
**Rationale:** OSHA requires employers to report work-related fatalities within 8
hours and amputations, loss of an eye, or inpatient hospitalizations within 24
hours. Needlestick injuries must be recorded but not necessarily reported within
24 hours unless they meet other criteria. First aid does not require reporting.
3. In a pre-placement physical examination, which component is most critical for
determining whether a candidate can safely perform essential job functions?
A. Comprehensive laboratory screening
B. Functional capacity evaluation matched to the job description
C. Chest X-ray for all candidates
D. Psychological evaluation for stress tolerance
**Correct Answer: B**
**Rationale:** The Americans with Disabilities Act (ADA) requires that post-offer,
pre-placement examinations be job-related and consistent with business
necessity. A functional capacity evaluation that measures the candidate’s ability
to perform specific physical demands of the essential job functions is the most
legally defensible approach.
4. An employee reports a persistent dry cough, shortness of breath, and chest
tightness while working with isocyanates in a spray painting operation. These
symptoms are most suggestive of:
A. Silicosis
B. Occupational asthma
C. Byssinosis
,D. Asbestosis
**Correct Answer: B**
**Rationale:** Isocyanates are potent sensitizers and a leading cause of
occupational asthma. Symptoms often begin after a latent period and may
worsen with re-exposure. Silicosis is associated with crystalline silica, byssinosis
with cotton dust, and asbestosis with asbestos fibers.
5. During a workplace walkthrough, the OHN notices several employees using
awkward postures while assembling products. According to the hierarchy of
controls, the most effective ergonomic intervention is:
A. Providing back belts for all assembly workers
B. Instituting a daily stretching program
C. Rotating workers to different tasks every hour
D. Redesigning the workstation to eliminate the awkward postures
**Correct Answer: D**
**Rationale:** The hierarchy of controls ranks elimination or engineering controls
(redesigning the workstation) as most effective. Administrative controls like job
rotation and stretching, and PPE like back belts, are less effective and do not
eliminate the hazard.
6. Which of the following laboratory tests is most appropriate for biological
monitoring of a worker exposed to lead?
A. Urinary phenol
B. Blood lead level (BLL) and zinc protoporphyrin (ZPP)
C. Serum creatinine
, D. Urine cotinine
**Correct Answer: B**
**Rationale:** Blood lead level is the primary biological exposure index for lead.
ZPP reflects metabolic effect and can indicate chronic exposure. Urinary phenol is
used for benzene, serum creatinine for kidney function, and urine cotinine for
tobacco smoke exposure.
7. The primary purpose of a medical surveillance program under OSHA standards
is to:
A. Treat work-related injuries and illnesses
B. Comply with workers’ compensation requirements
C. Identify early signs or symptoms of adverse health effects related to workplace
exposures
D. Provide annual physicals for all employees regardless of exposure
**Correct Answer: C**
**Rationale:** Medical surveillance aims to detect health effects at an early,
often reversible stage so that interventions can prevent progression. It is required
for specific exposures (e.g., lead, asbestos, noise) and focuses on those at risk. It is
not for general physicals or treatment.
8. A COHN-S is developing a case management plan for an employee recovering
from a back injury with temporary restrictions of no lifting >10 pounds. The best
initial step is:
A. Assign the employee to a permanent light-duty position
B. Communicate the restrictions to the supervisor and collaborate on appropriate
transitional duty tasks
