COHN-S EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS, Exams of Nursing

Download COHN-S EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS and more Exams Nursing in PDF only on Docsity! COHN-S EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS Tolulene - Answer An isocyanate, is a respiratory sensitizer that can lead to occupational asthma Primary concern of a kerosene splash - Answer Lung irritation Benzene - Answer Adversely affects the hematopoietic system. Therefore, individuals with a history of thrombocytopenia would be at increased risk if exposed to Benzene SWOT - Answer Strengths Weaknesses Opportunities Threats; way to asses an environment Jaundice is a common symptom of - Answer Carbon tetrachloride poisoning/1 OSHA PEL for airborne lead exposure - Answer 50ug/m3 Action level for lead blood levels - Answer 30ug/100g What unique contribution can the OHN make to workplace safety and health programs? - Answer Provide screening to specific exposures What are other problems that usually accompanies sleep apnea? - Answer Diabetes and cardiovascular disease Doxycycline - Answer And anti-malarial preventative. Take the drug daily one or two days before travel and for 28 days after a trip. The occupational health and safety OSHA's 18001 is described as? - Answer An international consensus standard for occupational health and safety management systems What are the five classes of drugs tested for DOT purposes? - Answer Cannabinoids, cocaine, amphetamines, opiates, PCP Primary prevention - Answer Actions that change overall background conditions to prevent some unwanted event or circumstance, such as injury, disease, or abuse. For example immunizations Approximately 80 to 90% of all types of skin disease can be classified as? - Answer Contact dermatitis Sensitizing agents - Answer Response after single or multiple exposures and only and some individuals Systemic responses include difficulty breathing, inflammation of Airways, pulmonary edema Common chemical sensitizing agents - Answer Phenol, epoxy, rubber, acrylics, nickel, plant resins Approximately 20% of common contact dermatitis comes from? - Answer Poison ivy, oak and sumac Solvents that most frequently cause occupational skin disease: - Answer Acetone, coronated hydrocarbons, toluene, xylene, petroleum distillate, alcohol Chloracne - Answer Swelling sebaceous glands from exposure to hydrocarbons for, example dioxin Macule - Answer flat, colored spot on the skin, Freckles, measles papule - Answer small, solid, raised lesion on surface of the skin; wart, insect bite Pustules - Answer pus-filled sacs such as those seen in acne, or pimples Vesicles - Answer Fluid filled blister such as those seen in chicken pox Nodules - Answer small lumps, lesions, or swellings that are felt when the skin is palpated; solid mass wheal - Answer hives Tetanus (lockjaw) - Answer Clostridium tetani Results in tectonic or tonic contractions of the muscles Incubation: 2 days - 2 months (mostly two weeks) Electrical burns cause? - Answer Neurologic, vascular and dermal injuries Electrical burns travel? - Answer Least to most path of resistance; nerve, blood, vessel, muscles, skin, tendon, fat, bone Chemical burns; acidic/alkali - Answer Irrigate with copious amounts of water for at least 20 minutes; Except for dry lime brush first Neutralizing is obsolete Hydrofluoric acid - Answer Use calcium gluconate gel and square inject after iced Zephirin irrigation to stop deep burning heat cramps - Answer muscle pain and spasm resulting from exposure to heat and inadequate fluid and salt intake Treatment: Fluids, electrolytes, cool area heat exhaustion - Answer Skin cool, clammy and pale: Circulatory collapse from sodium depletion and ineffective circulating blood volume, the pulse will be weak and respiratory rapid and shallow Heat stroke - Answer Altered mental state, unconscious, convulsions Temperature >106°F, skin hot and dry Dilated peoples, respirations deep to shallow Pulse rapid strong to week rapid Treatment for heat stroke and heat exhaustion - Answer Cool quickly until temperature is 102 or below Strip clothes, turn on side, expose more skin 60° water spray, cold water lavage is necessary Chemicals with a "C" notation with their TLVs: - Answer Have ceiling TLV limits assigned to them Viton - Answer The type of glove material that offers protection against chlorinated solvents Quantitative fit testing - Answer Quantitative fit testing checks for leakage that results in the employee smelling or sensing the presence of the fit test material. Employees assigned to the hazardous waste site must receive a minimum of__________ Hours of offsite training prior to assignment. - Answer 40 hours The amount of a chemical that kills 50% of the organisms exposed to it in the air is the: - Answer LC50 The nature, degree and extent of undesirable effects of a substance is known as? - Answer Toxicity The most powerful epidemiological study design is: - Answer Prospective cohort The study of the frequency and distribution of injury and disease in the human population is: - Answer Epidemiology When establishing a bio monitoring program for workers exposed to benzene, one would love for the metabolite ____________in the urine? - Answer Phenol Shaver's Disease - Answer Caused by silica and aluminum dust and fumes A client comes in to your medical department complaining of wrist weakness, constipation, anemia, loss of appetite, and a peculiar linear discoloration of the gingival tissue, you would suspect: - Answer Lead poisoning Thoracic Outlet Syndrome - Answer Is a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. This can cause pain in your shoulders and neck and numbness in your fingers. General Duty Clause - Answer Statement in U.S. Occupational Safety and Health Act that requires employers subject to OSHA to provide employees with a safe and healthy work environment. OSHA - Voluntary Protection Program - Answer This is to ensure so far as possible every working man and woman in the nation safe and Healthful work and conditions And to preserve our human resources by encouraging employers and employees and their efforts to reduce the number of occupational safety and health hazards other places of employment, and to stimulate employers and employees to institute new into perfect existing programs for providing safe and Healthful working conditions Process Safety Management (PSM) - Answer A reference to OSHA standard 29 CFR 1910.119 and 1926.64, which covers all employers who either use or produce highly hazardous chemicals exceeding specified limits Freon - Answer Can cause respiratory problems and excess pressure on the heart. Very high concentrations result in cardiac arrhythmias and palpitations Psittacosis - Answer Bacteria from bird droppings US EPA levels of protection - Answer Level A is the most protective, Level D is the least protective Level A - Answer Should be selected when greatest level of skin, respiratory and eye protection is required or conditions not known. SCBA used. Level B - Answer Pressure-demand, full face-piece, SCBA or pressure demand air line respirator with escape SCBA Niosh First work comp law - Answer Wisconsin 1911 Purpose of Worker's Compensation law - Answer To provide income benefits to employees for lost wages caused by occupational injury or disease as well as benefits to survivors of fatal injuries to workers Temporary partial indemnity - Answer Partially disabled. Able to do some work, but not all of job at for wages, for a temporary period of time Temporary total indemnity - Answer Disabled. Unable to work for a temporary period of time Permanent partial indemnity - Answer Reduce capacity to earn wages permanently Permanent total indemnity - Answer Unable to return to any type of work permanently Biological Hazards - Answer Viruses, bacteria, and other organisms in the environment that harm human health are classified as Chemical Hazards - Answer Various forms of chemicals that are potentially toxic or irritating to the body system, including medications, solutions, and gases Environmental Hazards - Answer Factors in countered in the work environment that causes our potentiate accidents, injuries, strain, or discomfort (I.e. Poor equipment or lifting devices, slippery floors, deficient workstations) Physical hazards - Answer Agents within the work environment such as radiation, electricity, extreme temperatures, and noise that can cause tissue trauma. Examples are vibration and noise Physiological hazards - Answer Factors and situations in countered or associated with one's job or work environment that create or potentiate stress, emotional strain, and or interpersonal problems. 90% of what we are exposed to is? - Answer Inhalation Gases - Answer Chemicals gaseous at room temp vapors - Answer gaseous state of any substance that normally exists as a liquid or solid fumes - Answer Gas with solid particles in it produced by condensation of volatized solid or gaseous combustion product for example in welding or molten metal's Time Weighted Average (TWA) - Answer an evaluation of exposures that are time-weighted over an established period. It allows the exposure levels to be averaged generally over an 8- hour time period Permissible Exposure Limit (PEL) - Answer PEL; the maximum legal limits established by OSHA for regulated substances; these are based on employee exposure that are time-weighted over an 8 hour work shift; when these limits are exceeded, employers must take proper steps to reduce employee exposure; for formaldehyde, the PEL is .75 ppm NIOSH (National Institute for Occupational Safety and Health) - Answer tests and certifies respiratory protective devices and air sampling detector tubes, recommends occupational exposure limits for various substances, and assists OSHA inoccupational safety and health investigations and research.Part of the department of health and human services under the CDC ACGIH: American conference of governmental industrial hygiene - Answer Provides guidelines for protection against toxic chemicals. They establish threshold limit value TLV A weber test that lateralized is to the good year would be positive for a? - Answer Sensorineural loss A Rinne test resulted in bone conduction being heard longer than air conduction, the loss would be a? - Answer Conductive hearing loss How many phases are required to be included in the hearing conservation program? - Answer 5 What is the length of time before the OHN must be recertified in hearing conservation? - Answer 5 years Wagner Act (1935) - Answer (National Labor Relations Act) gives workers the right to organize a union and bargain with management Five step grievance arbitration procedure - Answer Grievant, union steward, chief steward, local union president, last step arbitration OSHA (Occupational Safety and Health Administration) - Answer Establish and modify mandatory standards Falls under the department of labor NIOSH (National Institute for Occupational Safety and Health) - Answer Federal agency that is nonregulatory and provides national and worldwide leadership to prevent work-related illnesses and injuries. Developed criteria for the national standards Does not cite or give penalties DOT exam blood pressure qualification - Answer Driver qualified if blood pressure is less than or equal to 140/90 DOT vision requirement - Answer At least 20/40 acuity in each eye with or without correction DOT hearing requirement - Answer Must first perceive force whispered voice greater than or equal to 5 feet, with or without hearing aid or average hearing loss and better ear less than or greater than 40 dB DOT qualifications and diabetes - Answer Must have no establish medical history or clinical diagnosis of diabetes mellitus currently requiring insulin for control, if condition controlled by use of oral medication and diet, then individual may be qualified under the present rule. GINA - Answer prohibits discrimination based on genetic information Limitations are medical exams before making job offer: - Answer Cannot ask or require applicant to take medical examination Cannot inquire about disability or nature of severity of disability May ask questions about ability to perform specific job functions May ask person to describe or demonstrate how to perform essential function Make condition job offer on satisfactory result of post offer medical examination Blood borne pathogen training - Answer On initial assignment and each year Exposure incident - Answer specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee's duties. Hepatitis B vaccine should be given or offered - Answer Within 10 working days of assignment Healthcare professionals written opinion should be provided within - Answer 15 days Level two information to assist HR Level III this level is the most controlled and this is personal health information 29 CFR 1910.1020 - Answer Access to employee exposure and medical records General Recording Criteria - Answer Death Days away, restricted, or transferred Medical treatment beyond first aid Loss of consciousness Significant injury/illness diagnosed by a P/LHCP Determination of a new case - Answer Reappearance of signs or symptoms from completely recovered injury or illness event related to work environment. Restricted work - Answer Cannot perform one or more routine functions (Work activities the employee regularly performs at least once per week) Of his/her job; or Cannot work a full workday, or A P/LHCP recommends either of the above first aid - Answer Non-prescription medication at non-prescription strength Tetanus immunization's Cleaning, Flushing, soaking surface wounds When coverings, butterfly bandages, Steri-Strips Hot or cold therapy Nonrigid means of support Temporary immobilization device used to transport accident victims Drilling fingernail or toenail, draining fluid from blister Eyepatches Removing foreign bodies from the eye with only irrigation or cotton swab Removing splinters, foreign material from areas other than the eye by irritation, tweezers, cotton swabs or simple means. Finger guards Massages not PT Drinking fluids to relieve his stress Special recording criteria - Answer Needle sticks Medical removal Hearing loss Tuberculosis MSD's Recording criteria for blood and body fluid exposure - Answer Record all work related needlestick injuries and sharp object cuts contaminated with blood or other potentially infectious material. Record as injury on the OSHA 300 log without employees name Record blood or body fluids exposures if results in blood borne illness diagnosis Medical removal recording - Answer Record all mandatory medical removal cases per status for example restricted duty etc. Record chemical exposure as poisoning Hearing loss recording - Answer Record confirmed, work related STSF total hearing level is 25 dB or greater above audiometric zero, average at 2000, 3000, and 4000 Hz and same here as STS Work related tuberculosis recording - Answer Record if occupationally exposed to known active case of TB resulting in positive skin test or P/LHCP diagnosis. Do not record is non-occupational exposure for example household contact, community exposure, previous exposure with skin test. Rule of Nines (adult) - Answer Head 9%, Back 18%, Chest 9%, Abdomen 9%, Arms 9% each, Groin 1%, Upper Leg 9% each, Lower Leg 9% each. Electrical Burns - Answer Least to most resistant path; Nerve, blood, vessels, muscle, skin, tendon, fat, bone Entrance one site will be chard. Common entrance site hands Exit wound site resembles blast injuries. Common exit site, lower extremities High voltage interrupts hearts electrical system resulting in rhythm disturbances usually? - Answer Ventricular fibrillation Hydrofluoric acid - Answer Use calcium gluconate gel and sq inject after iced Zephiran irrigation to stop the burning Delayed or type IV allergic contact dermatitis - Answer Itchy, red, mildly swollen rash like poison ivy, appears only on areas touched by latex Symptoms develop 10 to 30 hours after contact irritant contact dermatitis is not a true latex allergy Immediate hypersensitivity or type I latex allergy - Answer Hives, itchy welts, hayfever like symptoms, wheezing, coughing Symptoms occur within minutes of exposure Allergic reaction may involve parts of body not touch my latex May involve airway reaction and anaphylaxis Rocky Mountain Spotted Fever - Answer Caused by Rickettsia rickettsii Sx: rash on palms and soles (migrating to wrists, ankles, then trunk), HA, fever. Endemic to East Coast (in spite of its name). Hypnozoite - Answer Dormant liver stage parasites that may reactivate after symptom less intervals of 2 to 4 years Malaria - Answer After 1 sporozoite ( parasite from female mosquito)- invades the liver cell Parasite grows in six days producing 30 to 40,000 daughter cells merozoites One merozoite invades a red blood cell, grows in 48 hours producing 8 to 24 daughter cells Most common antimalarial drugs - Answer Chloroquine Quinine sulfate (qualaquin) Hydroxychloroquine (plaquinil) Check visual acuity - Answer 24 hours after patch/treatment or post injury Injuries can cause closed angle glaucoma the signs and symptoms are - Answer Severe eye pain Rapid increase in intraocular pressure Halos around light Headache Nausea and vomiting Common alkalis - Answer Lye Cement Lime Ammonia Irrigate for 45 minutes Hyphema - Answer blood in the anterior chamber of the eye Oral hygiene-swollen, puffy gums can be? - Answer A vitamin C deficiency Koplik spots - Answer Rubeola (measles)- Red measles White areas on Buechel Makossa opposite first and second molars inside the cheek Histoplasmosis - Answer fungal infection of the lungs from bird droppings Toxoplasmosis - Answer a parasite that is most commonly transmitted from pets to humans by contact with contaminated animal feces Cat feces Farmer's lung - Answer RLD; lung reaction against thermophilic bacteria in moldy hay Psittacosis - Answer zoonotic respiratory fungal infection of birds; AKA parrot fever Brucellosis - Answer Bacteria in unpasteurized raw dairy products First degree Heart Block EKG - Answer PR segment >.20 apical impulse or point of maximal impulse (PMI) - Answer where the apex touches the anterior chest wall at approximately the fourth or fifth intercostal space just medial to the left midclavicular line most common heart murmur - Answer mitral valve prolapse Mid-systolic ejection murmur's Diastolic murmur's - Answer Almost always indicate heart disease CPK-MB (CK-2) - Answer Only released from heart muscles Abnormal (> 6% CPK) 2-6 hours Peaks up to 24 hours; Returns to normal 24 to 48 hours Continues after three days=Progressing MI metabolic syndrome - Answer A syndrome marked by the presence of usually three or more of a group of factors (as high blood pressure, abdominal obesity, high triglyceride levels, low HDL levels, and high fasting levels of blood sugar) that are linked to increased risk of cardiovascular disease and Type 2 diabetes. Blood pressure values - Answer 120/80 : normal 120-139/80-89 : prehypertension 140-159/90-99 : hypertension stage 1 >160/>100 : hypertension stage 2 >180/110 : hypertensive crisis Hip pelvis fracture - Answer Affected leg is shorter External rotation is normally seen Hip dislocation - Answer Thigh rotates internally Low Back Pain (LBP) - Answer a non-specific symptom that affects people for a number of reasons, including mechanical problems, excess body weight, injuries, and chronic diseases. Exercise is considered one of the cornerstones of both prevention and treatment. Oldest occupational health problem; leading cause of absenteeism Appendicitis - Answer Peri-umbilical pain first to McBurney's point (Right lower quadrant) Hepatitis A - Answer inflammation of the liver caused by the hepatitis A virus (HAV), usually transmitted orally through fecal contamination of food or water -Monitor for signs of hypothyroidism -Patient should not cough or expectorate Treatment potassium iodide Radiation sickness - Answer a condition that results from a large dose of ionising radiation, causing significant cell death; symptoms include nausea, vomiting, fever, hair loss and diarrhoea Example; Hiroshima, Nagasaki, Chernobyl Prussian blue-1704-dye military uniforms - Answer Traps cesium and thallium to excrete through intestines COPD (chronic obstructive pulmonary disease) - Answer Airflow out of the lungs is obstructed/ decreased airflow Obstructive lung diseases - Answer asthma, emphysema, chronic bronchitis FEV1 is low= Decrease speed of outflow, difficult getting out of lungs FVC is normal restrictive lung disease - Answer disease of the lung that causes a decrease in lung volumes The flow of air into the lungs is restricted Ability of the lungs to expand Decrease volume of air FEV1/FVC is high=95 to 100% FVC is lower = Decreased amount of total air Forced Vital Capacity (FVC) - Answer The volume of air expired during a forced maximal expiration after a forced maximal inspiration. FEV1 - Answer forced expiratory volume in 1 second pulmonary function testing ratio - Answer The amount of air that can be forcibly excelled in the first second FEV1 compared to the total amount that is exhaled FVC FEV1/FVC% Normal PFT - Answer Greater or equal to 80% of predicted value Number one route of entry of contaminant - Answer Respiratory system Air Purifying Respirator - Answer A respirator with an air-purifying filter, cartridge, or canister that removes specific air contaminants by passing ambient air through the air-purifying element. Atmosphere Supplying Respirators - Answer Provide clean, breathable air from and uncontaminated source from outside the area Three resistance to filter degradation - Answer N = not resistant to oil R = resistant to oil P = oil proof Change Model Perspective - Answer Four conditions are necessary for change to occur: 1. Employees must understand the reasons for change and agree with those reasons 2. Employee must have the skills needed to implement the change 3. Employees must see that managers and other employees in powerful positions support the change 4. Organizational structures, such as compensation and performance management systems, must support the change. Type 2- Involves a worker client relationship Type 3- Includes worker-worker incidents, current or past employees who threaten or attack other current or past employees Type 4- Involves persons who have a personal relationship with the worker, stocking, threats, and harassment, maybe a spill over of domestic violence Types three and four are the most preventable categories of workplace violence Stages of grieving process - Answer denial, anger, bargaining, depression, acceptance Airborne contaminants can be classified into the following groups: - Answer Gases, vapors, particulates Acute effects refer to: - Answer Headaches Increase in zinc photoporphyrin levels Abdominal pain incidence rate formula - Answer (# new cases in population during specific time period)/(# persons exposed to risk of developing disease over period of time) New cases divided by at risk population prevalence rate - Answer Total number of people infected at one time in a population, regardless of when the disease began. All cases/total population Toxicity reactions - Answer Synergism-occurs when chemicals with the same toxicity have a greater than additive effect for example smoking and asbestos 2+2 = 20 Potentiation-occurs when a chemical that does not produce a specific toxicity nevertheless increases the toxicity caused by another chemical 2+0 = 10 Antagonism-Occurs when chemicals are combined and they decrease each other's measured effect 4+6 = 8 The inherent ability of a chemical to do harm cause injury, regardless of the situation in which it is use is referred to as: - Answer Toxicity Factors that influence the toxicity of a substance include: - Answer The basic anatomical structure Duration and frequency of exposure Vinyl chloride was recognized as an occupational carcinogen because: - Answer The type of tumor it causes is usually very rare The most important route of entry according to how easily a chemical can be absorbed into the blood stream is: - Answer Lung dose-response relationship - Answer Relationship between an administered dose and the effect on an organism Vinyl chloride is considered to be a: - Answer Carcinogen and toxic agent Mc Gregor's theory X and theory Y - Answer X-Not a good work environment Y-Good work environment Planning is the first function of - Answer Management