Occupational Health Nurse (COHN)
Comprehensive Final Exam with Verified
Rationales Practice Questions and Answers
with complete solution
,Clinical and Primary Care
1. A 35-year-old employee sustains a superficial partial-thickness burn to the forearm from a chemical splash. What is the
priority first-aid action?
a) Apply a neutralizing agent immediately.
b) Flush the area with copious amounts of water for at least 15 minutes.
c) Apply a sterile, dry dressing.
d) Pack the wound in ice.
Answer: b) Flush the area with copious amounts of water for at least 15 minutes.
Rationale: Immediate and prolonged irrigation with water is the universal first step for chemical burns to dilute and
remove the agent. Applying a neutralizing agent can cause an exothermic reaction, worsening the burn. Ice is
contraindicated as it can cause vasoconstriction and further tissue damage.
2. A vision screening test using the Snellen chart reveals an employee's vision is 20/50 in the right eye. How should the
occupational health nurse (OHN) interpret this result?
a) The employee sees at 20 feet what a person with normal vision sees at 50 feet.
b) The employee sees at 50 feet what a person with normal vision sees at 20 feet.
c) The employee is legally blind in the right eye.
,d) The employee has 50% better vision than normal.
Answer: a) The employee sees at 20 feet what a person with normal vision sees at 50 feet.
Rationale: The Snellen fraction 20/50 means the test subject can read a line at 20 feet that a person with normal visual
acuity can read at 50 feet. The larger the denominator, the worse the vision.
3. Which of the following findings on a pre-placement physical exam for a job requiring respirator use is a contraindication
to fit testing until further evaluated?
a) Uncontrolled hypertension (BP 160/100 mmHg).
b) Missing distal phalanx on the left index finger.
c) History of claustrophobia.
d) Well-controlled Type 2 diabetes.
Answer: a) Uncontrolled hypertension (BP 160/100 mmHg).
Rationale: The OSHA Respiratory Protection Standard requires a medical evaluation to determine the employee's ability to
use a respirator. Uncontrolled hypertension places additional stress on the cardiovascular system, which can be
dangerously exacerbated by the increased workload of breathing through a respirator. While severe claustrophobia is a
concern, acute physiological stress from uncontrolled hypertension is a direct medical contraindication requiring
immediate management before fit testing.
, 4. An employee presents with a needle stick injury from a patient known to be Hepatitis B surface antigen (HBsAg)
positive. The employee completed the Hepatitis B vaccine series 5 years ago but has never had a titer drawn. What is the
first step?
a) Administer Hepatitis B Immune Globulin (HBIG) immediately.
b) Administer a Hepatitis B vaccine booster.
c) Draw blood from the employee for anti-HBs titer.
d) Reassure the employee, as the vaccine provides lifelong protection.
Answer: c) Draw blood from the employee for anti-HBs titer.
Rationale: CDC guidelines state that for a vaccinated exposed person, their antibody response to the vaccine should be
assessed. If the anti-HBs titer is protective (≥10 mIU/mL), no further treatment is needed. If it is inadequate, both HBIG
and a vaccine booster are indicated. Drawing a titer is the first action to guide decision-making.
5. The most effective immediate treatment for a heat stroke victim at a construction site, while awaiting emergency
medical services, is to:
a) Administer salt tablets with cool water.
b) Have the worker drink large amounts of sports drinks.
c) Aggressively cool the worker using ice packs to the neck, axillae, and groin, and spray with cool water.
d) Move the worker to a shaded area and fan them without applying water.
Comprehensive Final Exam with Verified
Rationales Practice Questions and Answers
with complete solution
,Clinical and Primary Care
1. A 35-year-old employee sustains a superficial partial-thickness burn to the forearm from a chemical splash. What is the
priority first-aid action?
a) Apply a neutralizing agent immediately.
b) Flush the area with copious amounts of water for at least 15 minutes.
c) Apply a sterile, dry dressing.
d) Pack the wound in ice.
Answer: b) Flush the area with copious amounts of water for at least 15 minutes.
Rationale: Immediate and prolonged irrigation with water is the universal first step for chemical burns to dilute and
remove the agent. Applying a neutralizing agent can cause an exothermic reaction, worsening the burn. Ice is
contraindicated as it can cause vasoconstriction and further tissue damage.
2. A vision screening test using the Snellen chart reveals an employee's vision is 20/50 in the right eye. How should the
occupational health nurse (OHN) interpret this result?
a) The employee sees at 20 feet what a person with normal vision sees at 50 feet.
b) The employee sees at 50 feet what a person with normal vision sees at 20 feet.
c) The employee is legally blind in the right eye.
,d) The employee has 50% better vision than normal.
Answer: a) The employee sees at 20 feet what a person with normal vision sees at 50 feet.
Rationale: The Snellen fraction 20/50 means the test subject can read a line at 20 feet that a person with normal visual
acuity can read at 50 feet. The larger the denominator, the worse the vision.
3. Which of the following findings on a pre-placement physical exam for a job requiring respirator use is a contraindication
to fit testing until further evaluated?
a) Uncontrolled hypertension (BP 160/100 mmHg).
b) Missing distal phalanx on the left index finger.
c) History of claustrophobia.
d) Well-controlled Type 2 diabetes.
Answer: a) Uncontrolled hypertension (BP 160/100 mmHg).
Rationale: The OSHA Respiratory Protection Standard requires a medical evaluation to determine the employee's ability to
use a respirator. Uncontrolled hypertension places additional stress on the cardiovascular system, which can be
dangerously exacerbated by the increased workload of breathing through a respirator. While severe claustrophobia is a
concern, acute physiological stress from uncontrolled hypertension is a direct medical contraindication requiring
immediate management before fit testing.
, 4. An employee presents with a needle stick injury from a patient known to be Hepatitis B surface antigen (HBsAg)
positive. The employee completed the Hepatitis B vaccine series 5 years ago but has never had a titer drawn. What is the
first step?
a) Administer Hepatitis B Immune Globulin (HBIG) immediately.
b) Administer a Hepatitis B vaccine booster.
c) Draw blood from the employee for anti-HBs titer.
d) Reassure the employee, as the vaccine provides lifelong protection.
Answer: c) Draw blood from the employee for anti-HBs titer.
Rationale: CDC guidelines state that for a vaccinated exposed person, their antibody response to the vaccine should be
assessed. If the anti-HBs titer is protective (≥10 mIU/mL), no further treatment is needed. If it is inadequate, both HBIG
and a vaccine booster are indicated. Drawing a titer is the first action to guide decision-making.
5. The most effective immediate treatment for a heat stroke victim at a construction site, while awaiting emergency
medical services, is to:
a) Administer salt tablets with cool water.
b) Have the worker drink large amounts of sports drinks.
c) Aggressively cool the worker using ice packs to the neck, axillae, and groin, and spray with cool water.
d) Move the worker to a shaded area and fan them without applying water.
