Question 1

Which of the following is one of the most challenging areas for the occupational health nurse (OHN)?

Accepted Answer

The OHN is a worker advocate and has the responsibility to uphold professional standards and codes. The OHN is also responsible to management, is usually compensated by management, and must practice within a framework of company policies and guidelines. Ethical dilemmas arise because the nurse is loyal to both workers and management.

Question 2

A nurse had 5 years of experience in a community health clinic when she accepted a position in occupational health. Which of the following best explains how the nurse will know what to do in this new setting?

Accepted Answer

As a newcomer to the site, although experienced in other areas of nursing, the nurse would probably have sufficient experience to recognize a range of practice issues and function comfortably in such roles as clinician and case manager. But to be competent in the new role, the nurse should follow company procedures and rely on assessment checklists and clinical protocols to provide treatment. To go beyond that (i.e., adapt protocols and immediately recognize what is relevant in these new situations) will require experience in the new role.

Question 3

An employee had recently had a heart attack and was just discharged from the hospital. Which of the following would be an appropriate action for the nurse to take?

Accepted Answer

The nurse may work with the employer to create a transitional duty pool. The goal is to provide temporary work that is less physically demanding in nature than the employee's regular work. This facilitates the employee's return to the workplace earlier than if required to wait until full strength and health are regained.

Question 4

Which of the following best explains why occupational health nurses (OHNs) felt a need to create the Factory Nurses Conference?

Accepted Answer

Few specialties existed at the time the Factory Nurses Conference was created. Industrial nurses were practicing in single-nurse settings and recognized the benefit of uniting as a group for the purpose of sharing ideas with peers practicing in the same nursing arena. External funding was not available. This group was open only to graduate, state-registered nurses affiliated with the ANA.

Question 5

Which of the following best describes what the Occupational Safety and Health Act of 1970 requires?

Accepted Answer

OSHA promulgates occupational health and safety standards, which are published in the Code of Federal Regulations and updated on a regular basis. Having access to the most recent publication of these standards is a crucial responsibility of the occupational health nurse (OHN). The OHN must be knowledgeable of Title 29 of the code and other sections of the code that apply to specific hazards in the workplace.

Question 6

An occupational health nurse (OHN) realizes that an injured employee is going to be temporarily disabled. Which of the following actions can the nurse take to avoid the employee having disability syndrome? (Select all that apply.)

Accepted Answer

The behavioral change of the individual to avoid returning to work, even after medical clearance has been granted, is called the disability syndrome. The process of returning an individual to work begins with the onset of injury or illness. The nurse works closely with the primary care provider to monitor the progress of the worker and to identify and eliminate potential barriers in the return-to-work process. The nurse must know the workplace and the physical requirements necessary for the employee to work, perhaps by doing a physical demands analysis of the various jobs. The OHN can facilitate the employee being temporarily assigned less physically demanding work, perhaps on a part-time basis, until full employment can be resumed. Then the nurse would continue to monitor and support the employee to avoid adverse health effects. The nurse would most likely not collaborate with legal consultant or negotiate to try to decrease the employee's workers' compensation benefits.

Question 7

If not at a meeting or giving an educational program, which of the following best describes why an occupational health nurse (OHN) would be absent from the health station during the nurse's employment hours?

Accepted Answer

Performing "walk-throughs" in the workplace on a regular basis, recognizing potential and existing hazards, and maintaining communications with safety and industrial hygiene resources to prevent illness and injury from occurring will continue to be critical work for the OHN. It is unlikely that the nurse is reviewing position descriptions in the main company office or using a company computer when these are tasks that could most likely be done in the health station. It is also unlikely that the nurse is taking a quick bathroom break.

Question 8

Which of the following arguments would the occupational health nurse (OHN) use when trying to convince a large employer of the need for a breast cancer education program?

Accepted Answer

Women who believe their employers are interested in the well-being of themselves and their families are more apt to be productive and satisfied employees. Thus, the large employer can demonstrate this belief by offering a breast cancer education program. The primary purpose of offering this program would not be to provide media coverage for the employer, spark the interest of the female employees, or help balance the male-oriented programs.

Question 9

Which of the following entities has been most active in creating change and alternative approaches in health care delivery?

Accepted Answer

Corporations have become driving forces in shaping the development of alternative approaches to health care. Businesses, that is, employers, have consistently fought to keep health care costs down and to maximize the value of their dollars spent on health care services. Corporations have taken the most active force in health care delivery in comparison to consumers, health care professionals, and state legislators.

Question 10

An occupational health nurse has been asked to perform a complete physical examination, including drug testing, on both a prospective and a current employee. Which of the following best describe the purposes of these examinations? (Select all that apply.)

Accepted Answer

The preplacement evaluation is performed before the worker begins employment in a new company or is placed in a different job. The evaluation is a baseline examination that consists of a medical history, an occupational health history, and a physical assessment that should target the type of work that the employee will be performing. The preplacement examination may also include medical tests to determine specific organ functions that may be affected by exposure to existing agents in the employee's workplace. Examinations of individuals transferring to other jobs are critical to document any changes in health that may have occurred while the employee was working in a specific area or with a specific process. Preplacement health examinations by law will be permitted only if phrased in terms of the applicant's general ability to perform job-related functions rather than in terms of any disability and only after a job offer has been made. The examination must be job related and consistently conducted for all applicants performing similar work.

Question 11

Which of the following is a current challenge for occupational health nurses? (Select all that apply.)

Accepted Answer

At the beginning of the twenty-first century, sweeping transformations in industry are influencing the direction of occupational health nursing. These transformations include changing workforce demographics, rising health care costs, diversity of health care systems with the integration of managed care, influence of the world economy, shift in production from goods to services, and proliferation of advanced technologies. The focus of U.S. industry is moving away from large manufacturing facilities to smaller, service-based businesses. The increasing availability of older workers, women, minorities, and immigrants will have far-reaching implications for employers and pose specific challenges for occupational health professionals. Rather than expanding, health care facilities are consolidating in the ongoing quest to give care more economically. Health care costs are rising and are not becoming more affordable.

Question 12

In which of the following ways are occupational health nurses (OHNs) role models of good community health nursing? (Select all that apply.)

Accepted Answer

OHNs focus on the promotion, prevention, and restoration of health within the context of a safe and healthy work environment. Focus includes prevention of adverse health effects from occupational and environmental hazards. Approximately 60% of these 35,000 nurses work alone, making decisions regarding health and safety issues, influencing policy in health and safety, and planning and implementing myriad health programs. More than 65% of nurses practicing in occupational health are prepared at the baccalaureate level or higher. OHNs do not usually make home visits. Most collaboration is done with occupational health professionals, such as industrial hygienists and ergonomists, rather than physicians. Studies show that physician collaboration occurs in up to only 8% of cases.

Question 13

A candidate's resume demonstrates a perfect fit for a position, but one glance showed the candidate was wheelchair bound. Which of the following suggestions should the nurse make to the employer?

Accepted Answer

The Americans with Disabilities Act prohibits discrimination on the basis of disability. The core of this law requires employers to adjust facilities and practices for the purpose of making "reasonable accommodations" to enhance opportunities for individuals with disabilities. The occupational health nurse has the duty to provide or facilitate reasonable accommodations based on the nurse's familiarity with the physical requirements of jobs in the workplace. If this candidate was indeed the perfect fit for the position, not hiring the candidate because of the disability would be considered discrimination. If other employees are not kind to this candidate after the candidate is hired, they will likely face reprimand by the employer.

Question 14

Which of the following best explains why job opportunities for occupational health nurses (OHNs) have continued to expand?

Accepted Answer

The cost-effectiveness of providing health care to employees was achieving increased recognition, and by 1912, after workers' compensation legislation had been instituted, 38 nurses were employed by business firms. As businesses seek ways to maximize the value of their dollars spent on health care services, OHNs and other health professionals face an opportunity from being able to demonstrate that cost-effective, quality health programs do improve the health of employees and their dependents, positively influencing their company's attempts to control rising health care costs.

Question 15

Which of the following led to a vast increase in the number of occupational health nurses?

Accepted Answer

Industrial nurses have always been autonomous in their practice and received appropriate pay, except during the Great Depression when many nurses lost their positions. The focus of health care for employees changed as a result of many factors, including the impact of the two world wars. During World War I, the government demanded health services for workers at factories and shipyards holding defense contracts. In 1942, during WWII, the U.S. Surgeon General told an audience of nurses that the health conservation of the "industrial army" was the most urgent civilian need during the war. Not all societies have industrialized.

Question 16

Which of the following responsibilities does the occupational health nurse (OHN) have in relation to an injured employee and the Workers' Compensation Act?

Accepted Answer

The Workers' Compensation Act protects the employer if the compensation received by the employee precludes legal suits against the employer. Workers receive an average of 66% of their take-home pay before taxes. The OHN educates the employee regarding benefits under the Workers' Compensation Act and is often the one who files the claim. The goal is to limit the worker's disability and provide an opportunity for early return to work through appropriate workplace accommodations.

Question 17

An occupational health nurse (OHN) works in a state that requires continuing education units per year for renewing a nursing license. Which of the following courses would probably be most helpful in the role?

Accepted Answer

Any of the programs might be helpful, but only Ergonomics and Toxicology are inherent in the science needed to function in occupational health. Evaluating Risks is relevant to the job description, but many OHNs are the only professionals in the area, so there are no personnel to manage. Health Assessment is relevant, but rarely would a home visit be made for health care; rather a referral would be done.

Question 18

An occupational health nurse (OHN) is walking through a hospital. Which of the following observations would be concerning to the nurse? (Select all that apply.)

Accepted Answer

The OHN should identify work-related agents and exposures that are potentially hazardous so problems can be prevented. Some of the hazards found in the hospital that the nurse would want to note include biological-infectious hazards, such as may be found in bodily fluids; chemical hazards such as unlabeled medications or solutions; enviromechanical hazards, including any environmental hazards that could cause an accident such as slippery floors; and physical hazards such as noise, which can cause tissue trauma, or electrical equipment with a short so that persons get shocked when they touch it. The census of the floor would not be of concern to the nurse.

Question 19

An occupational health nurse (OHN) reminds employees to put on their safety glasses and use other personal protective equipment. Which of the following levels of prevention is being implemented?

Accepted Answer

The OHN uses a variety of primary prevention methods, with one-on-one interaction as an important strategy for evaluating risk reduction behavior for individuals. Understanding appropriate engineering and administrative controls and personal protective equipment specific to preventing workplace health hazard exposures is one of the responsibilities of the OHN. Secondary prevention strategies are aimed at early diagnosis, early treatment interventions, and attempts to limit disability. On a tertiary level, the OHN plays a key role in the rehabilitation and restoration of the worker to an optimal level of functioning. Health promotion is not a level of prevention.

Question 20

Which of the following best describes what the Code of Federal Regulations, especially Title 29, requires of the occupational health nurse (OHN)?

Accepted Answer

OSHA has record-keeping requirements that mandate the employer to keep records of work-related injuries, illnesses, and deaths. These records must be posted in the workplace for 1 month per year and made available for review by OSHA at any time. In many cases, the OHN has full responsibility for compliance with this standard.

Quiz 30: Occupational Health

Which of the following is one of the most challenging areas for the occupational health nurse (OHN) ?