43 - The Nurse in Occupational Health

Question 1

Which was the first legislation that specifically required certain prevention programs for workers?

a. ) Occupational Safety and Health Act
b. ) NIOSH
c. ) Mine Safety and Health Act
d. ) SIC Code

Answer 1

c.) Mine Safety and Health Act

The Mine Safety and Health Act was enacted in 1968. It was the first legislation that specifically required certain prevention programs for workers. The Occupational Safety and Health Act established OSHA and NIOSH to carry out the Act’s purpose of ensuring “safe and healthful working conditions for working men and women.” NIOSH examines potential hazards of new work technologies and practices. The SIC Code did not require certain protection programs for workers.

Question 2

An employer offers a limited duty program after an employee has experienced a cumulative trauma injury. Which of the following levels of prevention is being implemented?

a. ) Primary prevention
b. ) Secondary prevention
c. ) Tertiary prevention
d. ) Assessment

Answer 2

c.) Tertiary prevention

Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability—limited duty program after injury. Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Secondary prevention occurs after a disease process has already begun.

Question 3

An occupational health nurse has conducted a walk-through assessment and has identified potential hazards in the workplace. The nurse recognizes that it will be easiest to modify exposure to which hazard?

a. ) Bacteria
b. ) Aerosols
c. ) Noise
d. ) Burnout

Answer 3

c.) Noise

Controlling physical agents, such as noise, can usually be accomplished through engineering strategies and personal protective equipment. It is much harder to change biological agents (bacteria), chemical agents (aerosols), and psychosocial agents (burnout).

Question 4

A nurse in the occupational health arena is implementing a secondary prevention strategy. Which of the following best describes the action that was taken by the nurse?

a. ) Providing education on safety in the workplace to prevent injury
b. ) Working with chronically diabetic workers to ensure appropriate medications
c. ) Screening for hearing loss resulting from noise levels in the plants
d. ) Ensuring that a person with cardiovascular disease attends a rehab program

Answer 4

c.) Screening for hearing loss resulting from noise levels in the plants

Secondary prevention occurs after a disease process has already begun—screening for hearing loss. Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability—working with chronically diabetic workers and ensuring that a person with cardiovascular disease attends rehab. Primary prevention is aimed at prevention of a disease before it occurs—providing education on safety in the workplace to prevent injury.

Question 5

An occupational health nurse is involved in disaster planning. Which of the following actions would be most appropriate for the nurse to take?

a. ) Assess for possible disasters
b. ) Prevent injuries and death of workers
c. ) Store Medical Data Sheets in a safe place
d. ) Collaborate with government authorities to plan disaster management

Answer 5

b.) Prevent injuries and death of workers

The occupational health nurse is a key player in occupational disasters. The goals of a disaster plan are to prevent or minimize injuries and deaths of workers and residents, minimize property damage, provide effective triage, and facilitate necessary business activities. A disaster plan requires the cooperation of different personnel within the company and community. There are not Medical Data Sheets rather MSDSs.

Question 6

Which types of industries are noted for high degrees of hazards associated with the work?

a. ) Data entry, animal rescue, and hospice
b. ) Engineering, science, and laboratories
c. ) Manufacturing, mining, and agriculture
d. ) Aeronautics, plastics, and nursing

Answer 6

c.) Manufacturing, mining, and agriculture

Manufacturing, mines, construction, and agriculture are noted for their high degree of hazards associated with their work. However, no worksite is free of occupational health and safety hazards.

Question 7

A nurse is employed in an occupational health setting. Which of the following activities would be a primary role of the nurse?

a. ) Caring for employees and their families
b. ) Providing health promotion and emergency care
c. ) Updating the Material Safety Data Sheets (MSDSs)
d. ) Reporting communicable diseases

Answer 7

b.) Providing health promotion and emergency care

The customary role of the occupational health nurse extends beyond emergency treatment and prevention of illness and injury and also includes the promotion and maintenance of health, overall risk management, care for the environment, and efforts to reduce health- related costs in business. The occupational health nurse does not typically care for families of employees, update MSDSs, or report communicable diseases.

Question 8

An occupational health nurse is working in an occupational health and safety program. Which of the following services is the nurse most likely to provide? (Select all that apply.)

a. ) Health/medical surveillance
b. ) Health screening
c. ) Case management
d. ) Job task analysis
e. ) Counseling

Answer 8

a.) Health/medical surveillance

b.) Health screening

c.) Case management

d.) Job task analysis

The services provided by onsite occupational health programs range from those focused only on work-related health and safety problems to a wide scope of services that includes primary health care. An occupational health and safety program may include health/medical surveillance, health screening, case management, and job task analysis.

Question 9

Which population would have been the focus of care for an occupational health nurse in the early 1900s?

a. ) Injured workers
b. ) All workers
c. ) Families
d. ) The community

Answer 9

c.) Families

In the early days of occupational health nursing, the nurse’s work was holistic and centered on the family. The care provided by Betty Moulder and Ada Mayo Stewart focused on both ill workers and their families.

Question 10

A nurse is working in an occupational health setting. Which of the following roles will the nurse most likely have?

a. ) Administrator
b. ) Clinicians/practitioner
c. ) Consultant
d. ) Educator

Answer 10

b.) Clinicians/practitioner

An occupational health nurse could be employed in any of these roles. However, the majority of occupational health nurses work as nurse clinicians/practitioners.

Question 11

A nurse is assessing a worker who has had a health reaction to a “safe” low-level exposure. Which of the following most likely describes what has happened?

a. ) An allergic reaction
b. ) A compromised immune system
c. ) Hypersusceptibility
d. ) Malnutrition

Answer 11

c.) Hypersusceptibility

A number of host factors appear to be associated with this hypersusceptibility: light skin, malnutrition, compromised immune system, glucose-6-phosphae dehydrogenase deficiency, serum alpha1-antritrypsin deficiency, chronic obstructive pulmonary disease, sickle cell trait, and hypertension. A worker who has a health reaction to “safe” low-level exposures is experiencing hypersusceptibility.

Question 12

An occupational health has become a member of the AAOHN. Why would a nurse join this organization? (Select all that apply.)

a. ) To promote the health and safety of workers
b. ) To lobby in Congress for safer work places
c. ) To advance the profession by supporting research
d. ) To promote and provide continuing education in the specialty
e. ) To obtain certification as a specialist in occupational health nursing

Answer 12

a.) To promote the health and safety of workers

c.) To advance the profession by supporting research

d.) To promote and provide continuing education in the specialty

The AAOHN is the professional organization for occupational health nurses. It supports the work of the occupational health nurse and advances the specialty by: promoting the health and safety of workers, defining the scope of practice and setting the standards of occupational health nursing practice, developing the code of ethics for occupational health nurses with interpretive statements, promoting and providing continuing education in the specialty, advancing the profession through supporting research, and responding to and influencing public policy issues related to occupational health and safety. A nurse joining the AAOHN would most likely not go to lobby in Congress; rather, AAOHN provides a lobbyist to address pertinent issues. Joining the AAOHN will not assist the nurse in obtaining specialty certification.

Question 13

The nurse is doing a walk-through to identify workplace hazards. Which of the following levels of prevention is being implemented?

a. ) Primary prevention
b. ) Secondary prevention
c. ) Tertiary prevention
d. ) Assessment

Answer 13

a.) Primary prevention

Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. A walk-through is part of an assessment, which is part of primary prevention. Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Secondary prevention occurs after a disease process has already begun.

Question 14

An occupational health nurse refers an employee to an employee assistance program. Which of the following problems would most likely be addressed?

a. ) Obesity
b. ) Smoking
c. ) Alcohol abuse
d. ) Lack of exercise

Answer 14

c.) Alcohol abuse

Employee assistance programs are designed to address personal problems such as marital/family issues, substance abuse, or financial difficulties. These issues are addressed because they affect the employee’s productivity. These efforts are cost-effective for businesses.

Question 15

An occupational health nurse is assessing the need for MSDSs at the worksite. Which of the following items would require an MSDS?

a. ) Hand soap
b. ) Eye goggles
c. ) Aprons
d. ) Earplugs

Answer 15

a.) Hand soap

The Hazard Communication Standard requires that all worksites with hazardous substances inventory their toxic agents, label them, and provide information sheets, called MSDSs, for each agent. Hand soap is a toxic agent. Eye goggles, aprons, and earplugs are not toxic agents and therefore, do not need an MSDS.

Question 16

An occupational health nurse is educating employees about work-related hazards. Which of the following hazards would the nurse most likely discuss in the presentation?

a. ) Workplace stress leading to hypertension and cardiovascular disease
b. ) Asbestos, plastics, lead, and solvents leading to dermatitis
c. ) Cement dust and metals leading to bronchitis
d. ) Hormones and nitroglycerine leading to reproductive effects

Answer 16

a.) Workplace stress leading to hypertension and cardiovascular disease

Work-related stress or burnout has been defined as an important problem for many individuals. Responses to negative interpersonal relationships, particularly those with authority figures in the workplace, are often the cause of vague health symptoms and increased absenteeism. Education about stress would be pertinent to all workers, regardless of specific job or setting.

Question 17

A nurse is pursuing certification as an occupational health nurse. Which organization will provide this certification?

a. ) American Board for Occupational Health Nurses
b. ) Occupational Safety and Health Education and Research Center
c. ) National Institute for Occupational Safety and Health (NIOSH)
d. ) Occupational Safety and Health Administration (OSHA)

Answer 17

a.) American Board for Occupational Health Nurses

Certification in occupational health nursing is provided by the American Board for Occupational Health Nurses. The Occupational Safety and Health Education and Research Center supports master’s and doctoral education with emphases in occupational health nursing, industrial hygiene, occupational medicine, and safety. NIOSH examines potential hazards of new work technologies and practices. OSHA educates employers about occupational health and safety.

Question 18

The most disabling occupational condition reported in 2011 was/were:

a. ) cuts and punctures.
b. ) fractures.
c. ) bruises.
d. ) sprains and strains.

Answer 18

d.) sprains and strains.

In 2011, sprains and strains were by far the most frequent disabling conditions, accounting for 38% of the cases of days away from work.

Question 19

Which statement about chemical agents is accurate?

a. ) Chemicals are not ordinarily found in the body tissues of the general population.
b. ) Most chemicals have been studied to determine the effects of exposure on humans.
c. ) Chronic exposure to low-level doses of workplace chemicals below standards constitutes a potential health risk.
d. ) Human effects of chemical exposure are associated with single agents rather than with the interaction of agents.

Answer 19

c.) Chronic exposure to low-level doses of workplace chemicals below standards constitutes a potential health risk.

It is true that chronic exposure to low-level doses of workplace chemicals below standards constitutes a potential health risk. Most chemicals have not been studied epidemiologically to determine the effects of exposure on humans. As a consequence of general environmental contamination with chemicals from work, home, and community activities, a variety of chemicals have been found in the body tissues of the general population. Predicting human responses to chemical exposures are complicated because multiple chemicals often combine and interact to create a new chemical agent.

Question 20

A nurse is identifying agents that are part of the epidemiologic triad. Which of the following will the nurse most likely identify?

a. ) Environmental pollution
b. ) Radiation
c. ) Susceptible human beings
d. ) High-risk groups of individuals

Answer 20

b.) Radiation

Radiation is an example of an agent. The agents, factors associated with illness and injury, are occupational exposures that are classified as biological, chemical, enviromechanical, physical, or psychosocial. Environmental pollution is part of the environmental factor in the epidemiologic triad. Susceptible human beings and high-risk groups of individuals are part of the host factor of the epidemiologic triad.

Question 21

What is the purpose of NIOSH?

a. ) Examine potential hazards of new work technologies and practices
b. ) Educate employees about environmental risks and hazards
c. ) Develop and maintain a database of work-related deaths
d. ) Set standards that regulate workers’ exposure to potentially toxic substances

Answer 21

a.) Examine potential hazards of new work technologies and practices

NIOSH examines potential hazards of new work technologies and practices.

OSHA educates employees about environmental risks and hazards, develops and maintains a database of work-related deaths, and sets standards that regulate workers’ exposure to potentially toxic substances.

Question 22

A nurse is assessing host factors as part of the epidemiologic triad. Which of the following factors would the nurse most likely assess?

a. ) Crowding
b. ) Shift work
c. ) Worker’s family
d. ) Chemical exposure

Answer 22

c.) Worker’s family

The worker’s family is considered a part of the host factor. Crowding and shift work are environmental factors, and chemical exposure is the agent factor.

Question 23

The first industrial nurse is considered to be:

a. ) Betty Moulder.
b. ) Ada Mayo Stewart.
c. ) Lillian Wald.
d. ) Florence Nightingale.

Answer 23

b.) Ada Mayo Stewart.

Ada Mayo Stewart was hired in 1885 by the Vermont Marble Company; she is often considered the first industrial nurse. Betty Moulder provided care of ailing coal miners and their families. Lillian Wald is known as the founder of public health nursing. Florence Nightingale is one of the pioneers of the nursing profession.

Question 24

An occupational health nurse is assessing slippery floors as a safety hazard in the work setting. Which of the following best describes the type of hazard the nurse is assessing?

a. ) Enviromechanical
b. ) Physical
c. ) Chemical
d. ) Psychosocial

Answer 24

a.) Enviromechanical

Enviromechanical agents are those that can potentially cause injury or illness in the workplace. They are related to the work process or to working conditions, and they can cause postural or other strains that can produce adverse health effects when certain tasks are performed repeatedly. Slippery floors are known as enviromechanical hazards. They can cause or potentiate accidents, injuries, strain, or discomfort.

Question 25

An employee has come into contact with a biological agent. Which of the following considerations should be made by the nurse?

a. ) The biological agent may cause accidents in the work environment.
b. ) The biological agent is commonly found in the agriculture industry.
c. ) The biological agent may potentiate stress in the workplace.
d. ) The biological agent indicates exposure to bacteria, viruses, fungi, or parasites.

Answer 25

d.) The biological agent indicates exposure to bacteria, viruses, fungi, or parasites.

Biological agents are living organisms whose excretions or parts are capable of causing human disease, usually by an infectious process. Biological hazards are common in workplaces such as health care facilities and clinical laboratories where employees are potentially exposed to a variety of infectious agents, including viruses, fungi, and bacteria.

Question 26

A nurse is conducting an occupational health assessment. Which of the following best describes the rationale for this assessment?

a. ) It is required by OSHA.
b. ) It is required by NIOSH.
c. ) It helps to identify agent and host factors that place employees at risk.
d. ) It helps to educate workers about potential hazards.

Answer 26

c.) It helps to identify agent and host factors that place employees at risk.

The purpose of this assessment is to become knowledgeable of the work processes and the materials, the requirements of various jobs, the presence of actual or potential hazards, and the work practices of employees. This assessment allows the nurse to identify agents and host factors that place employees at risk. An occupational health assessment is not required by any organization.

Question 27

Which is a requirement of the Superfund Amendment and Reauthorization Act (SARA)?

a. ) Applying stricter rules to determine Superfund sites
b. ) Sharing written disaster plans with key resources in the community
c. ) Authorizing each industry to write their own disaster plan
d. ) Evaluating the effectiveness of a written disaster plan

Answer 27

b.) Sharing written disaster plans with key resources in the community

SARA requires that written disaster plans be shared with key resources in the community, such as fire departments and emergency departments. SARA does not apply stricter rules, authorize each industry to write their own disaster plan, or evaluate the effectiveness of a written disaster plan.

Question 28

An occupational health nurse is assessing workplace hazards. Which of the following would be the best method for the nurse to use?

a. ) Review incident reports
b. ) Walk through the worksite
c. ) Interview key employees
d. ) Read the Standard Industrial Classification (SIC) Code

Answer 28

b.) Walk through the worksite

One of the best methods an occupational health nurse can use in assessing workplace hazards is to walk through the worksite. Reviewing incident reports, interviewing key employees, and reading the SIC Code do not provide the nurse with as much information as walking through the worksite.

Question 29

What is the purpose of OSHA?

a. ) Educate occupational health and safety professionals
b. ) Identify and research occupational health and safety hazards
c. ) Distribute research findings relevant to occupational health and safety
d. ) Educate employers about occupational health and safety

Answer 29

d.) Educate employers about occupational health and safety

OSHA educates employers about occupational health and safety.

NIOSH identifies and researches occupational health and safety hazards, distributes research finding relevant to occupational health and safety, and educates occupational health and safety professionals.

Question 30

Which population is at the greatest risk for experiencing work-related accidents with subsequent injuries?

a. ) Workers of child-bearing age
b. ) Workers with less than 1 year of experience
c. ) Workers with diminished sensory abilities
d. ) Workers with chronic illnesses

Answer 30

b.) Workers with less than 1 year of experience

New workers with less than 1 year of experience on the current job are at the greatest risk for experiencing work-related accidents with subsequent injuries. The highest percentages were in mining; agriculture, forestry, and fishing; construction; and wholesale and retail trade.