Question 1

An occupational health nurse is working with the manager to change the assignment of an employee from working with heavy metal to using machinery to assist with loading and unloading boxes at the truck dock.Which of the following best explains the rationale for this change?

Accepted Answer

Interventions aimed at disability limitation are intended to prevent further harm or deterioration,and they include referral for counseling and treatment of an employee with an emotional or mental health problem whose work performance has deteriorated and removal of workers from heavy metal exposure who manifest neurological symptoms.The repetitive work with handling heavy metal may have already caused harm or previous injury to this employee.Thus,the goal is to limit disability rather than to prevent injury.Primary prevention would occur to prevent the injury from occuring,such as teaching safe lifting or operation of the equipment.Tertiary prevention strategies would follow treatment to prevent recurrence and to prevent more serious problems related to any incident or injury.

Question 2

A nurse makes the suggestion that the 2-week shift rotations should be set up so that the next rotation in shifts is later rather than earlier.Which of the following is the nurse attempting to prevent through this suggestion?

Accepted Answer

An estimated 10% of Americans do some form of shift work that has the potential to lead to a variety of psychological and physical problems,including exhaustion,depression,anxiety,and gastrointestinal disturbance.Strategies to minimize the adverse effects of shift work,such as rotating shifts clockwise,are beneficial.Family turmoil,physical illnesses,and sleeping disorders all have the potential to occur.However,there is evidence that anxiety,depression,and exhaustion are the more prevalent physical and psychological problems that are reported.

Question 3

The occupational health nurse suggests that an employee work only half-days for three weeks and then return to full-time employment.Which of the following best describes the rationale for this suggestion?

Accepted Answer

Rehabilitation strategies such as return-to-work programs after a heart attack or limited duty programs after a cumulative trauma injury are examples of tertiary prevention.Tertiary prevention is intended to restore health as fully as possible and assist individuals to achieve their maximum level of functioning.The method described is focusing on an effective method of rehabilitation.Rehabilitation strategies are not used as a form of punishment to employees or to ensure employment for all workers.

Question 4

A nurse is interviewing a person who has stated on her entry health form that she is retired.Which of the following is the most crucial question for the nurse to ask?

Accepted Answer

The most crucial question is,"Where were you previously employed and what did you do there?" The occupational health history is an indispensable component of the health assessment.All persons should be questioned about their employment history.To describe only a current status of "retired" may lead to the omission of needed data.Even for retired persons,the nurse must ask about employment history,because many problems take years to manifest in signs and symptoms.All of these questions are appropriate during a routine physical for a person who has retired,because they relate to current problems,recreation,and mental health.However,they are not as crucial as asking for additional information about employment history.The client's answer to this question may alert to potential problems that the nurse should focus on.

Question 5

The occupational health nurse makes certain all employees have and know how to use personal protective equipment (PPE).Which of the following factors will most likely determine how effective the PPE is in keeping employees safe?

Accepted Answer

The employee will only be safe if the employee uses the PPE.If the employee doesn't use the PPE or uses only part of the equipment,then the employee will be at risk.The primary determination of whether the PPE is used correctly and used all the time is the psychosocial norms of the setting.If others are careless in PPE use,then such carelessness is the norm.If everyone is extremely careful to use their PPE,then that is the norm in that setting.Through education,employees have the knowledge and skills available to correctly use PPE.The educational session should also make the employees comfortable with its use.The use of PPE does not depend on the effectiveness of the teaching,rather the employees choice to correctly put into practice the knowledge and skills that that they have received.

Question 6

An occupational health nurse periodically conducts spirometry testing of employees who work around hazardous gases.Which of the following levels of prevention is being implemented?

Accepted Answer

Secondary prevention involves health surveillance and periodic screening to identify an illness at the earliest possible moment in its course and elimination or modification of the hazard-producing situation.Primary prevention would occur to prevent the injury from occuring,such as teaching the employees about how to protect themselves from exposure to hazardous gases .Tertiary prevention strategies would follow treatment to prevent recurrence and to prevent more serious problems related to the exposure to the hazardous gas.

Question 7

A nurse who works for a hospital in employee health notes that several nurses from one unit have missed work after contracting a communicable disease from a patient.Which of the following best describes the host factor?

Accepted Answer

Each worker represents a host within the worker population group.The communicable disease and the patient are considered the agent,the factor associated with the illness or injury.The hospital is part of the physical environment.

Question 8

An employee in a laboratory drops a flask,resulting in a chemical splash into the employee's eyes,which in turn results in burns to the eyes.Which of the following would be considered the agent?

Accepted Answer

Agents represent potential dangers or risk to the health and safety of workers.However,in the case given,the chemical itself caused the damage.If the flask had broken and glass got into the employee's eye,then the flask would be an agent.However,in the case given,the chemical itself caused the damage.The employee is considered the host and the laboratory is considered part of the environment.

Question 9

An occupational health nurse sees the various injuries and diseases that persons can acquire from employment.Which of the following recommendations would the nurse most likely provide about safety in the workplace?

Accepted Answer

Most adults spend about one third of their time at work.No work is completely risk free.Every single industry grapples with serious hazards related to work.

Question 10

Which of the following is the most common disabling condition when measured by days away from work?

Accepted Answer

In 2014,sprains,strains,and tears were by far the most frequent disabling conditions,accounting for 420,870 days-away-from-work cases and an incidence rate of 38.9 cases per 10,000 full-time workers (Bureau of Labor Statistics,2015d).Bruises,cuts and lacerations,and mental illness are not among the most common disabling conditions that are reported.

Question 11

Which of the following groups should the occupational health nurse devote the most time to regarding education and follow-up evaluation?

Accepted Answer

The population group at greatest risk for experiencing work-related accidents with subsequent injuries is new workers with less than 1 year of experience on the current job.Because of the inherent risks,the nurse should spend extra time with this group to decrease risk.Older workers with more experience are less likely to experience injury even if they have underlying issues of chronic disease.Women on childbearning age are not at any greater risk than the general population of employees.

Question 12

Which of the following is the primary reason that large companies are becoming more involved in their employees' personal health and well-being?

Accepted Answer

A significant increase in the number of health promotion and employee assistance programs offered has occurred.Health promotion programs focus on lifestyle choices that cause risks to health such as obesity or smoking.Employee assistance programs are designed to address personal problems (e.g.,marital/family issues,substance abuse,financial difficulties)that affect the employee's productivity.Such efforts are cost effective for businesses.Becoming more involved in employees' health and well-being would most likely not change the relationship between the manager and the employee.This also would not change the public relations in the community.Becoming more involved is the right thing for companies to do; however,the main motive behind this shift is to save the company money.

Question 13

As the single occupational health employee at a company,a nurse is busy with safety programs and first aid when employees are hurt.However,the nurse still finds time to walk through the entire facility once a day.Which of the following best explains the rationale for this action by the nurse?

Accepted Answer

The nurse may conduct an assessment of the workplace itself,which is known as a worksite walk-through or survey.Direct observation allows the nurse to learn about the work processes and the materials; the requirements of various jobs; the presence of actual or potential hazards; and the work practices of employees.Such information is directly useful in planning programs,assessing their effectiveness,and reinforcing safety with individuals who have been seen behaving in a less than safe manner.It is not within the scope of the occupational health nurse's role to document employee efficiency and effectiveness.The nurse may observe how PPE is being used or if employees are taking care of themselves while on the job; however,this is not the main purpose of a worksite walk-through assessment.

Question 14

Which of the following hospital employees are most at risk for being exposed to and possibly developing active drug-resistant TB?

Accepted Answer

Transmission of tuberculosis (TB)within health care settings has reemerged as a major public health problem.Outbreaks of this type of TB have been reported in hospitals,and some workers have developed active drug-resistant TB.Many workers in these settings are employed as maintenance workers,security guards,aides,or cleaning people,who tend not to be well protected from inadvertent exposures,which include contaminated bed linen in the laundry,soiled equipment,and trash containing contaminated dressings or specimens.Ward clerks have limited contact with acutely ill patients.Medical and nursing staff are more likely to have the proper equipment and education to be well-protected from inadvertent exposures.

Question 15

In which of the following settings have nurses most often reported being the victims of violence,especially by patients and their families?

Accepted Answer

Nonfatal violence in the health care worker's workplace is a serious problem that seems to be underreported.Much of the study of health care worker violence has been in psychiatric settings and emergency departments.Violence is not reported in as high of an incidence in acute care settings,community clinics,or in client homes in comparison to emergency departments and psychiatric units.

Question 16

Which of the following interventions regarding worker safety would be the least effective?

Accepted Answer

Personal protective control is the last resort and requires the worker to actively engage in strategies for protection such as use of gloves,masks,and gowns to prevent blood/body fluid exposure.Various control strategies are used to eliminate or reduce exposure and hence risk.Engineering controls can reduce worker exposure by modifying the exposure source.Administrative controls reduce exposure through job rotation,workplace monitoring,and employee training and education.External controls-the way equipment is built or manufacturing processes are established-are controllable and much more effective than asking a great many individuals to engage in behaviors that they may not want to do (such as using personal protective equipment).Humans are much less programmable than external controls.

Question 17

An occupational health nurse is removing a foreign body from a patient's eye.Which of the following levels of prevention is being implemented?

Accepted Answer

The nurse is engaging in secondary prevention when providing treatment for the injury.This does not meet the criteria for injury prevention because the injury has already occurred.Primary prevention would occur to prevent the injury from occuring,such as teaching the employee about use of protective eyewear.Tertiary prevention strategies would follow treatment to prevent recurrence and to prevent more serious problems related to the foreign body from developing.

Question 18

The occupational health nurse continually reminds employees to wear their safety goggles and ear plugs.Which of the following levels of prevention is being implemented?

Accepted Answer

Delivery of primary prevention services to employees is directed toward promoting health and averting a problem.Primary prevention is attempting to avoid harm through protecting measures,in this case reducing ear damage due to high noise levels and eye damage from flying particles or fluids.Secondary prevention involves screening for the disease or detecting the disease at the earliest stage possible.Tertiary prevention aims at rehabilitation and restoring the client to the highest possible level of functioning.

Question 19

A nurse keeps ongoing documentation of all the clients seen at the community health clinic.The nurse enters the demographic data and the primary diagnoses into the computer to have a comprehensive perspective of the clinic's clients.Which of the following best explains why the nurse is collecting this data?

Accepted Answer

When health data are considered collectively,the nurse may determine some patterns in risk factors associated with the occurrence of particular injuries and illnesses in a total population of clients.There is no mention of consent,so the nurse should not be collating research data.Grants for funding typically require current client data rather than trends.

Question 20

A nurse is completing a health history on a client during a routine physical exam.Which of the following questions,which is often omitted,should be asked by the nurse?

Accepted Answer

The question often omitted is,"Where do you work and what do you do there?" The occupational health history is an indispensable component of the health assessment of individuals.Because work is a part of life for most people,including an occupational health history in all routine nursing assessments is essential.All of these questions are appropriate during a routine physical.However,it is likely that the nurse asks about family,current problems and current health concerns to clients on a routine basis.

Quiz 32: The Nurse in Occupational Health