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COHN Clinician Exam with Complete
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B - ANS-One of the problems with the old method of using cotton earplugs was the cerumen. Cerumen is also detrimental to some of the modern earplugs. What is cerumen? A. Ear canal hair cells B. Earwax. C. Fluids secreted by the cochlea D. Secretions of the hypothalamus A - ANS-The cochlea is essentially a coiled tube. At one end of the tube is the oval window. The function of the oval window is to: A. receive the vibrations from the eardrum. B. shield the semicircular canals from interference. C. protect the auditory canal. D. receive neural input from the auditory nerve. C - ANS-The correct term for hearing loss induced by occupational exposure to noise is: A. presbycusis. B. sociocusis. C. sensorineural loss. D. conductive loss. A - ANS-The main part of the body involved in maintaining the body's heat balance is the: A. skin. B. heart. C. lungs. D. hair. B - ANS-The middle ear contains a group of bones called the: A. stapes. B. ossicles. C. incus. D. eustachian tubes. B - ANS-Which of the following parts of the ear contain the hair-like cells that detect sound? A. Semicircular canals B. Cochlea
C. Stapes D. Anvil A - ANS-The risk of developing active pulmonary tuberculosis is substantially increased by exposure to: A. free crystalline silica dust. B. alpha radiation. C. arsenic. D. asbestos. C - ANS-Which of the following occupations is least likely to experience problems with occupational dermatoses? A. Leather Tanning B. Lumbering C. Asbestos processing D. Farm labor D - ANS-Which of the following is likely to increase susceptibility to skin disorders? A. Dry skin B. Oily skin C. Fair skin D. All of the above D - ANS-Which of the following is most appropriate in the routine examination of a machinist? A. Exercise stress test B. Serum protease inhibitor level C. Allergy history assessment D. Audiometric testing B - ANS-The three layers of skin are: A. Hair follicles, capillary, muscle B. Epidermis, dermis, subcutaneous tissue C. Epidermis, capillary, dermis D. Cuticle, blood vessel, muscle B - ANS-A worker's hand has been exposed to liquid nitrogen. What is the correct first aid? A. Immere hand in ice water B. Immerse hand in warm water C, Immerse hand in hot water D. Pack hand in ice C - ANS-A patient with headaches, nausea, vomiting, fatigue, jaundice and oliguria may have an occupational disease caused by: A. lead.
C. 2,3 and 4 D. All of the above B - ANS-Following an employee referral to an EAP, supervisor feedback should include:
- Contact verification
- Diagnosis
- Nature of treatment
- Prognosis A. 1 and 2 B. 1 only C. 1, 3 and 4 D. All of the above B - ANS-An EAP is utilized for both job and personal problems. Job-related problems may include:
- Work quality
- Work quantity
- Substance Abuse
- Safety A. 1 and 2 B. 1, 2 and 4 C. 3 only D. All of the above C - ANS-An agitated employee is sent to the medical department by supervision. She becomes wighdrawn and noncommunicative. The OHN should intervene by: A. asking simple questions. B. encouraging the person to discuss feelings. C. focusing on non-threatening topics. D. referring to the private physician. C - ANS-An employee admits to the OHN that he is an alcoholic and needs help. In addition to detoxification, you advise that the most effective form of treatment for alcoholism is: A. individual psychotherapy. B. routine medical managmemt. C. membership in Alcoholics Anonymous. D. outpatient treatment with Antabuse. B - ANS-Inhaled dust particles over ten microns in diameter: A. often penetrate to the alveoli. B. are filtered out by the upper respiratory tract. C. clog the terminal bronchioles. D. are highly toxic.
B - ANS-Silicosis is a disease caused by inhaling dust particles that contain: A. glass. B. crystalline silica. C. amorphous silica. D. aluminum silicate. B - ANS-The most common route of entry for parathion is: A. eyes. B. skin. C. ingestion. D. inhalation. B - ANS-The particle size which exhibits the greatest tendency to stay in the alveoli is: A. 0.5-1.0 micron. B. 1-5 micron. C. 5-10 micron. D. 0-.74 micron. D - ANS-Coal tar pitch volatile (CTPV) refer to a group of many compounds. CTPV's have been associated with lung cancer and: A. Acne and folliculitis B. Phototoxic skin reactions C. Allergic dermatitis D. All of the above C - ANS-Which of the following have all been associated with dermatitis? A. Alkalis, epoxy resins, solvents, arsine B. Phospine, solvents, arsenic C. Alkalis, epoxies, solvents D. Hydrofluoric acid, ammonia, radon B - ANS-Which of the following produces damage by penetrating the skin, tying up calcium and killing underlying tissue? A. Hydrochloric acid B. Hydrofluoric acid C. Chromium D. MEK A - ANS-The first phase for a systemic toxicant to exert an effect is: a. absorption. B. excretion. C. metabolism. D. distribution. D - ANS-Which of the following is true regarding the liver and the kidney?
A. managed care. B. cost containment strategies. C. litigation preparation. D. compliance with federal law. D - ANS-If an injured worker decides to litigate his case, the role of the OHN is to: A. Refer claim-related questions to workers' attorney B. Provide information regarding company policies only C. Coach supervisors to maintain a nonadversarial role D. All of the above C - ANS-A worker exposed to tritium should be monitored by a periodic: A. Red blood cell count. B. whte blood cell count. C. urine assay. D. X-ray D - ANS-Acute beryllium poisoning causes what symptoms? A. Contact dermatitis B. Mild respiratory inflammation C. Pneumonitis with pulmonary edema D. All of the above C - ANS-All of the following are carcinogens except: A. asbestos B. Beta-naphthylamine C. DDT D. Nickel carbonyl A - ANS-All of the following are proteins except: A. Hydrocortisone B. Collagen C. Hemoglobin D. Keratin D - ANS-All of the following tests may be used to identify the biochemical and hematological toxic effects of lead except: A. Delta-aminolevulinate (ALAD) in blood B. Delta-aminolevulinic (d-ALA) acid in urine C. Co-proporphyrin in urine D. P-nitro-m-cresol in urine D - ANS-Among the following, which one does not play an important role in the removal of dust particles from the inspired air before it reaches the alveoli? A. Nasal turbinates B. Nasopharyngeal mucous
C. Cilia of mucous membranes D. Tonsils C - ANS-Among the following, which is the most frequent type of occupational disease? A. Radioactive exposure B. Chemical poisoning C. Dermatitis D. Pulmonary infection C - ANS-By which mechanism do most toxicants cross cell membranes? A. Phagocytosis B. Specialized transport C. Passive diffusion D. Active transport D - ANS-Fibrosis of the lung, if extensive, is disabling because: A. Elasticity of lung tissue is greatly diminished B. Functioning alveoli are replaced by scar tissue C. Secondary pulmonary edema results D. A and B B - ANS-In the metabolism of carbohydrates, the starch macromolecule is hydrolyzed in the: A. stomach. B. intestine. C. liver. D. None of the above D - ANS-Skin irritants can damage the skin by which of the following mechanisms? A. Altering the pH of the skin B. Reacting with skin proteins C. Removing protective lipids from the skin surface D. All of the above C - ANS-Spirometric testing may include all the following except: A. FEV B. FVC C. PCO D. Airway resistance determination D - ANS-The direct waste product(s) of aerobic metabolism is/are: A. Water and carbon dioxide B. Carbon dioxide only C. Ammonia D. A and C
C - ANS-Copper is an essential nutrient. Enzymes such as the peroxidases, catalase and cyochrome oxidase require copper. Excess copper is stored in the liver and the: A. brain. B. blood. C. bone marrow. D. kidneys. B - ANS-Some irritants have a very low or very high pH. Which are tolerated better by the skin, high pH irritants or low pH irritants? A. High (basic solution) B. Low (acidic solution) C. Both are tolerated equally well. D. The skin only tolerates neutral solutions. D - ANS-Which of the following is not a means of removing particles from the alveoli? A. Phagocytosis B. Lymphatics C. Physical removal upward by thin fluid layer D. Cilia B - ANS-A compound absorbed from the gastrointestinal tract first enters the __________ circulation. A. peripheral B. portal C. systemic D. renal C - ANS-Solid-state carcinogens are not biotransformed or excreted, but remain permanently in the body. An example of such a carcinogen is: A. iron. B. saccharin. C. asbestos. D. oncogenic viruses. C - ANS-The term 'teratogenic potential' is generally used to refer to the ______________. A. range of effective doses. B. level of the effective dose. C. capacity to induce a birth defect. D. possibility of four times the risk. C - ANS-____________ are monocytes which have migrated into extravascular tissues such as the liver, spleen and bone marrow. A. Phagocytes B. Granulocytes C. Macrophages
D. Immunocytes A - ANS-Prolinged bleeding time, impaired clot retraction and petechial hemorrhage may all occur as a consequence of? A. thrombocytopenia. B. leukopenia. C. thrombocytosis. D. phagocytosis. C - ANS-An abnormally low erythrocyte count is commonly referred to at: A. erythropoiesis. B. erythropoietin. C. anemia. D. polycythemia. D - ANS-Which of the following substances may cause hypoxia? A. Carbon dioxide B. Cyanide C. Hydrogen sulfide D. Carbon monoxide D - ANS-An elevated level of which of the following enzymes is the most reliable indicator of parenchyma liver injury? A. Creatine phosphokinase (CPK) B. Cholinesterase (CHE) C. Gamma-glutamyl transpeptidase (8-GT) D. Glutamic-pyruvic transaminase (GPT) B - ANS-Which of the following is the functional unit of the liver? A. Portal space B. Liver acinus C. Hexagonal liver lobule D. Nephron B - ANS-Both the liver and kidney have the ability to compensate for chemical injury due to their: A. large reserve capacity. B. high regenerative capacity. C. A and B D. None of the above C - ANS-____________ is the region of the rspiratory tract in which the relative humidity is increased and temperature of the air is moderated. A. Alveolar region B. Tracheobronchial region C. Nasopharyngeal region
D. All of the above C - ANS-Which of the following is most useful in determining if a worker has abnormal lung function? A. FEV B. FVC C. FEV1/FVC ration D. Chest x-ray B - ANS-Which of the following is NOT classified as an obstructive type of lung impairment? A. Asthma B. Asbestosis C. Chronic bronchitis D. Emphysema D - ANS-Which of the following pairs is the least likely association? A. Eczema/metallic salts B. Acne/cutting oils C. Skin discoloration/silver D. Granulomas/arsenic trioxide A - ANS-One of the reasons that the lungs are a major route of exposure is their efficiency in collecting and absorbing toxicants. One reason for this ability is the: A .large surface area. B. location of the lungs in the chest. C. temperature differential. D. absorption coefficient of tissue. B - ANS-There are sometimes other diseases associated with silicosis. One of the most common is tuberculosis. Susceptibility to TB is thought to be enhanced because: A. workers associate extensively with TB carriers. B. silica is toxic to pulmonary macrophages. C. silica is toxic to goblet cells D. silica is toxic to type II epithelial cells. B - ANS-Some common causes of eye injury are: A. high energy arcs, compressed air, dilute boric acid. B. high energy arcs, methanol, compressed air. C. compressed air, metal filings, deionized water. D. deionized water, dilute boric acid, compressed air. B - ANS-A common problem of the wrist involving the median nerve producing tingling and numbnes is: A. wrist drop. B. carpal tunnel syndrome.
C. Raynaud's syndrome. D. white finger. A - ANS-Carpal tunnel syndrome involves an injury to the median nerve. The nerve is compressed due to encroachment in the carpal tunnel. Which of the following is not associated with CTS? A. Numbness in fifth finger B. Pain in the wrist upon exertion C. Pain in the second and third fingers D. Positive Tinel's sign B - ANS-Which of the following are side effects of aspirin? A. Tachycardia B. Tinnitus C. Bradycardia D. Renal failure B - ANS-A known diabetic employee complains of dizziness and hunger. You note that her skin is clammy. Which of the following is the appropriate primary assessment/response? A. Hyperglycemia/orange juice B. Hypoglycemia/orange juice C. Acidosis/Water D. Impending coma/immediate referral D - ANS-An empoyee is seriously injured when a fork lift truck flips over on him. Of the following, which is the best sequence of responses? A. Control bleeding, open an airway, immobilize spine B. Open an airway, immobilize spine, control bleeding C. Immobilize spine, control bleeding, open an airway D. Open an airway, control bleeding, immobilize spine A - ANS-An emplyee complains of stomach pain that often appears in mid-morning. The pain is relieved after food ingestion, but recures again in a few hours. You would suspect: A. Duodenal ulcer. B. Gastric ulcer. C. Esophageal ulcer. D. Lactose intolerance. B - ANS-An employee was recently diagnosed as a diabetic and takes NPH insulin at 6 A.M. each day. Based on your knowledge of peak effect, when is the best time for a snack? A. 10:00 A.M. B. 2:00 P.M. C. 6:00 P.M.
A. Toluene diisocyanate B. Formaldehyde C. Asbestos D. Wood dust Characteristics associated with occupational asthma include all of the following except: A. Shortness of breath B. Decrease in symptoms when away from work C. Occupational exposure to asbestos D. Wheezing - ANS-C Bernardino Ramazzini is best known as: A. the father of occupational medicine B. the first person to record the effects of lead C. the inventor of repiratory protection D. the author o the first text on occupational health - ANS-A The primary cause of occupational fatalities is: A. falls B. workplace violence C. motor vehicle accidents D. chemical exposures - ANS-C An OHN in XYZ Fabricating uses index cards to make notes on the complaints of workers who come to the occupational health unit andx the subsequent treatment they receive. Later, the nurse transcribes these notes onto the permanent health record of the employee. The main reason you recommend that this practice be changed is: A. the notes become the legal record. B. Worker's Compensation outlaws this practice. C. it violates the OSHA records standard D. just the index cards are sufficient - ANS-A In regard to the Occupational Safety and Health Act of 1970, which of the following statements is untrue: A. the Williams/Stieger Act authorized the Secretary of Labor to administer and enforce job safety and health standards. B. since January 1978 new OSHA recordkeeping form changes have combined the OSHA No. 100 and 102 into Form No. 300 with certain technical changes. C. the Hill-Burton Act, or Occupational Safety and Health Act's purpose and policy is "to assure so far as possible every working man and woman in the nation safe and healthful working conditions and to preserve our human resources." D. the OSHA 300 Log and Summary Injury/Illness records must be retained within the establishment for 5 years after the end of the year to which they relate. - ANS-C What is the most important aspect of budgeting as a management function? A. planning and control
B. planning C. communicating D. decision making - ANS-A Which of the following is the best example of a capital expenditure? A. OHN's salary B. spirometer purchase C. rent D. gas bill - ANS-B Which is the best way to disseminate research findings to reach the most people? A. publishing in peer-reviewed journals B. presenting at professional/scientific meetings C. doing a poster D. talkimng with colleagues about the results - ANS-A Hearing loss from repeated exposure to excessively loud noise usually occurs at: A. 2000 Hz B. 4000 Hz C. 6000 Hz D. 3000 Hz - ANS-B What spirometry tests are required according to the cottondust standard? A. FEV1 and FVC B. FVC1 and FEV C. FEV1 and FEF D. FEF and FVC - ANS-A The "general duty clause" of the Occupational Safety and Health Act refers to: A. responsibilities of the employer in cases not covered by specific standards B. responsibilities of the employee in cases not covered by specific standards C. responsibilities of the chemical producer in use of chemicals not covered by specific standards D. responsibilities of the union in cases not covered by specific standards - ANS-A Which of the following are not true?
- OSHA is within the Deparment of Labor
- NIOSH is within the Department of Education
- NIOSH is within the Department of Health and Human Services (formerly Health, Education and Welfare)
- OSHA is within the Centers for Disease Control and Prevention A. 1 and 3 B. 1 and 2 C. 3 and 4 D. 2 and 4 - ANS-D
A. 18%
B. 27%
C. 36%
D. 70% - ANS-C
According to the OSHA Hazard Communication Standard, when is it important for training to occur: A. within 10 days after exposure B. pre-employment C. prior to eposure and when exposed to a new hazard D. pre-employment and annually - ANS-C A patient with a headache,nausea, vomiting, fatigue, jaundice, hepatomegaly and oliguria is most likely to have an occupational disease caused by: A. lead B. mercury C. benzol D. carbon tetrachloride - ANS-D The best examples of restrictive lung disease are:
- asthma
- asbestosis
- emphysema
- silicosis A. 1 and 3 B. 2 and 4 C. 1 and 2 D. 3 and 4 - ANS-B A sensitizer in dermatitis generally refers to: A. immediate reaction to initial exposure B, substances as HCI and NaOH C. no mmediate reaction, but on re-exposure may cause reactions D. blisters and blebs caused by direction action on the skin - ANS-C Proponents of which management theory believe that workers need strict supervision in order to do a good job: A. McGregor's Theory X B. McGregor's Theory Y C. Herzberg's Theory Y D. Herzberg's Theory X - ANS-A In developing a workpace violence prevention program, the occupational health nurse recognizes that the most reliable predictor of violence is: A. a change from a neat to unkempt appearance
B. a change in work quality and quantity C. Loud, angry and threatening statements D. A history of violent acts - ANS-D What would you most likely expect to find on chest x-ray with chronic beryllium exposure? A. bronchial inflammation B. granulomatous lesioms C. scar tissure D. pre-cancerous tumors - ANS-B The most pertinent information about a worker's health status would be obtained from: A. the worker's personal physician B. co-workers C. an occupational health history D. a home assessment - ANS-C Nursing audits are typically used in which step of the nursing process: A. planning B. assessing C. implementing D. evaluating - ANS-D After reading the Americans with Disabilities Act, you determine that you can ask a prospective employee about existing health conditions and prior workers' compensation claims: A. before an offer of employment B. after an offer of employment C. never as this is prohibited D. whenever you wish - ANS-B OSHA Law 29 CFR 1910.1020, "Access to Employee Exposure and Medical Records," states that all medical and exposure records should be made accessible to employees by the employer except: A. material safety data sheets B. records of the employee's past or present exposure to toxic substances or harmful physical agents C. exposure records of other employees with past or present job duties of working conditions related to or similar to those of the employee D. voluntary assistance or counseling programs such as alcoholic rehabilitation and drug abuse rehabilitation - ANS-D The OHN can induce emesis after someone ingests which of the following substances? A. gasoline B. antifreeze C. kerosene
