Test Bank Occupational Health Nies: Community/Public Health Nursing, 7th Edition

1. An occupational health nurse (OHN) works in a state that requires continuing education units per year for renewing a nursing license. Which course would probably be most helpful in therole? a. Diversity and Human Caring b. Ergonomics and Toxicology c. Evaluating Risks and Personnel Management d. Health Assessment and Home Health Care ANS: B 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 jobdescription, but many OHNs are the only professionals in the area, so there are no personnelto manage. Health Assessment is relevant, but rarely would a home visit be made for health care; rather a referral would be done. DIF: Cognitive Level: Apply (Application) 2. Which best explains why job opportunities for occupational health nurses (OHNs) havecontinued to expand? a. Federal legislation has required an OHN at any site with more than 50 employees. b. Legislation has required eN mpR loyeI rs tG o enB g. agC e inM certain tasks, and nurses were the most expert at those tasks. U S N T O c. Nurses have done an excellent job of describing the role and its benefits to themedia. d. Nurses are able to document cost savings to employers. ANS: D The cost-effectiveness of providing health care to employees achieved recognition, and by 1912, following implementation workers' compensation legislation, 38 nurses were employedby 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 ableto 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. DIF: Cognitive Level: Understand (Comprehension) Your text here 1 Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM 3. Which best explains why occupational health nurses (OHNs) felt a need to create the FactoryNurses Conference? a. All the other specialties in nursing had created their own conferences and groups. b. Creating their own group would be less expensive to maintain membership thanjoining the American Nurses Association (ANA). c. Funding was made available by large employers for the nurses to meet. d. Most OHNs practiced alone and wanted to be able to interact with peers. Community Public Health Nursing 7th Edition Nies Test Bank ANS: D NURSINGTB.COM 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 groupfor 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. DIF: Cognitive Level: Understand (Comprehension) 4. Which led to a vast increase in the number of occupational health nurses? a. Increasing autonomy and salaries of nurses in that role b. Increasing industrialization of all societies c. Society demanding improvements in safety for all workers d. The health of workers involved in manufacturing during World War II was crucial ANS: D Industrial nurses provide health care and make nursing decisions within the scope of practicedetermined by state law. 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. In1942, 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. DIF: Cognitive Level: Understand (Comprehension) 5. Which entity has been most active in creating change and alternative approaches in health care delivery? a. Consumers b. Corporatio ns NU RS IN GT B.CO M c. Health care professionals d. State legislators ANS: B 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 comparisonto consumers, health care professionals, and state legislators. DIF: Cognitive Level: Remember (Knowledge) 6. Which is one of the most challenging areas for the occupational health nurse (OHN)? Community Public Health Nursing 7th Edition Nies Test Bank ANS: D NURSINGTB.COM a. Allocating time between direct service to employees and management tasks b. Collaborating with other worksite professionals and retaining leadership in thearena of employee health c. Managing ethical conflicts between responsibilities to management andresponsibilities to employees d. Maintaining competence through attending conferences and maintaining serviceswhen the nurse (sole provider) is absent Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM ANS: C The OHN is a worker advocate and has the responsibility to uphold professional standards andcodes. 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. DIF: Cognitive Level: Understand (Comprehension) 7. If not at a meeting or giving an educational program, which best describes why an occupational health nurse (OHN) would be absent from the health station during the nurse’semployment hours? a. The nurse is reviewing position descriptions in the main company office. b. The nurse is in the management office to use the company computer. c. The nurse planned a walk-through of the workplace. d. The nurse is taking a quick bathroom break. ANS: C 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 thehealth station. It is also unlikely that the nurse is taking a quick bathroom break. DIF: Cognitive Level: Understand (Comprehension) 8. An occupational health nurse (OHN) reminds employees to put on their safety glasses and useother personal protective equNipUmRenSt.IWNhGicThBle.vCelOoMf prevention is being implemented? a. Primary b. Secondary c. Tertiary d. Health promotion ANS: A 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. DIF: Cognitive Level: Apply (Application) Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM 9. Which argument would the occupational health nurse (OHN) use when trying to convince alarge employer of the need for a breast cancer education program? a. It will be excellent media coverage for the employer, especially if the public isinvited. b. A large number of female employees of childbearing age may be interested. c. This program would help balance all the male-oriented programs. Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM d. Women employees who believe their employers are interested in their well-beingare more productive and satisfied. ANS: D 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 ofoffering 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. DIF: Cognitive Level: Understand (Comprehension) 10. An employee had recently had a heart attack and was just discharged from the hospital. Whichwould be an appropriate action for the nurse to take? a. Plan a party for when the client is able to return to the workplace b. Develop a program on exercise and nutrition for all employees c. Determine appropriate temporary, perhaps part-time, responsibilities to ease theemployee’s reentry to the workplace d. Advocate for improvements in the food being offered by the vending machines inthe employees’ lounge ANS: C 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 towait until full strength and health are regained. DIF: Cognitive Level: ApplyN(AU pRplS icaItiN onG) T B.CO M 11. A nurse had 5 years of experience in a community health clinic when she accepted a positionin occupational health. Which best explains how the nurse will know what to do in this new setting? a. On the basis of past experience, she can focus on relevant aspects and adaptprotocols as deemed necessary b. By focusing immediately on critical aspects and determining priorities in thesetting c. By following company procedures and relying on assessment checklists andclinical protocols d. By using extensive previous experience, the nurse can grasp situations quickly andinitiate appropriate action(s) ANS: C 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 Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM 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. DIF: Cognitive Level: Apply (Application) Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM 12. Which best describes what the Occupational Safety and Health Act of 1970 requires? a. All employees are eligible for a free health examination before beginningemployment. b. Employers are required to make suggestions on standards for improving workersafety. c. Employers have the right to request an Occupational Safety and Health Administration (OSHA) inspection for ways to improve worksite safety. d. Employers must keep the worksite free from recognized hazards. ANS: D OSHA promulgates occupational health and safety standards, which are published in the Codeof 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 that apply to specific hazards in the workplace. DIF: Cognitive Level: Remember (Knowledge) 13. Which best describes what the Code of Federal Regulations, especially Title 29, requires ofthe occupational health nurse (OHN)? a. All employees must be trained in first aid. b. Postwork-related injuries, illnesses, and death records must be recorded yearly. c. The OHN must serve as an emergency warden, helping employees to theemergency exit in a safe manner. d. The Occupational Safety and Health Administration (OSHA) inspector must makea worksite inspection on an annual basis. ANS: B NU RS IN GT B.CO M 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 for1 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. DIF: Cognitive Level: Understand (Comprehension) 14. Which responsibility does the occupational health nurse (OHN) have in relation to an injuredemployee and the Workers’ Compensation Act? a. To assist the employee in obtaining legal representation to negotiate a financialsettlement b. To assist the employer to work out a settlement with the employee to avoid legalsuits against the employer Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM c. To file a claim for the employee with Workers’ Compensation to ensure continuedfull salary until the employee is able to return to work d. To work with the employee to keep the employee informed, limit disability, andprovide opportunity for rapid return to employment ANS: D Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM N R I G B.C M 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 underthe Workers’ Compensation Act and is often the one who files the claim. The goal is to limitthe worker’s disability and provide an opportunity for early return to work through appropriate workplace accommodations. DIF: Cognitive Level: Understand (Comprehension) 15. A candidate’s resume demonstrates a perfect fit for a position, but one glance showed the candidate was wheelchair bound. Which suggestion should the nurse make to the employer? a. Be as polite as possible, but point out how difficult it would be to fulfill jobresponsibilities while confined to a wheelchair b. Be sure that another candidate is more qualified and “fits more closely with ourcompany goals” c. Employ the candidate and rearrange the work area for easy access and exit forsomeone in a wheelchair d. Point out that other employees would probably not be kind to someone in a wheelchair who is unable to join in many of the physical recreational activities ANS: C 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 consideUredSdiscNrimTinationO. If other employees are not kind to this candidate after the candidate is hired, they will likely face reprimand by the employer. DIF: Cognitive Level: Apply (Application) MULTIPLE RESPONSE 1. Which are current challenges for occupational health nurses? (Select all that apply.) a. Changes in employee demographics including gender, ethnicity, and age b. Expansion in sites offering care using new, creative approaches c. Increased affordability of health care services d. Increase in managed care plans with need for case managers Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM e. Moving from large manufacturing facilities to smaller, service-based businesses f. Ongoing need to demonstrate cost-effectiveness of services rendered ANS: A, D, E, F Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM N R I G B.C M At the beginning of the 21st century, sweeping transformations in industry are influencing thedirection of occupational health nursing. These transformations include changing workforce demographics, rising health care costs, diversity of health care systems with the integration ofmanaged 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 availabilityof older workers, women, minorities, and immigrants will have farreaching 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. DIF: Cognitive Level: Understand (Comprehension) 2. In which ways are occupational health nurses (OHNs) role models of good community healthnursing? (Select all that apply.) a. The majority of OHNs are prepared at the baccalaureate level or higher. b. OHNs actively influence policy in health and safety within a particular area. c. OHNs are skilled at assessing both people and their home environment. d. OHNs focus on health promotion and avoidance of injury or disease. e. OHNs plan and implement health programs for populations of employees. f. OHNs work closely with physicians in planning and implementing care forindividuals and families. ANS: A, B, D, E 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 70% of occupational health nurses work alone, making decisions rUegaSrdinNg hTealth anOd safety issues, influencing policy in health and safety, and planning and implementing myriad health programs. Nearly 70% of nurses practicing in occupational health are prepared at the baccalaureate level or higher. OHNs donot usually make home visits. Most collaboration is done with occupational health professionals, such as industrial hygienists and ergonomists, rather than physicians. DIF: Cognitive Level: Understand (Comprehension) 3. An occupational health nurse (OHN) is walking through a hospital. Which observations wouldbe concerning to the nurse? (Select all that apply.) a. A nurse shares that the floor census is at capacity. b. A wet floor without a warning sign or a dry walk area on one side c. A nurse starts an IV without using gloves. d. An electric bed gives a shock when touched. e. Some biological substance on the floor and wall has not been cleaned. f. Volume has been turned very high on several TV sets, Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM necessitating very loudverbal interactions. ANS: B, C, D, E, F Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM N R I G B.C M The OHN should identify work-related agents and exposures that are potentially hazardous soproblems 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. DIF: Cognitive Level: Apply (Application) 4. 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 best describesthe purposes of these examinations? (Select all that apply.) a. To measure the strength of organs that may be affected by workplaceresponsibilities b. To document changes that may have occurred while the employee engaged inparticular processes or in a particular work area c. To establish a baseline before the employee is exposed to possible workplacehazards d. To help decide whether or not to hire the prospective employee e. To update employee records and fill in any missing information f. To warn the employer about specific weaknesses or disabilities in the prospectiveemployee ANS: A, B, C The preplacement evaluation is performed before the worker begins employment in a new company or is placed in a diffeUrentSjobN. ThTe evaluOation is a baseline examination that consists of a health history, an occupational health history, and a physical assessment that should target the type of work that the employee will be performing. The preplacement examinationmay also include medical tests to determine specific organ functions that may be affected byexposure 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 andconsistently conducted for all applicants performing similar work. DIF: Cognitive Level: Apply (Application) 5. A nurse tells a friend that he has recently changed jobs and will now be an Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM occupational healthnurse. Which places is the nurse most likely to be working? (Select all that apply.) a. Factory b. Outpatient cardiac rehabilitation c. Hospital employee health d. College/University e. Public health department f. Residential group home ANS: A, C, D, F Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM As workplaces have continued to change over the past few decades, the role of the occupational health nurse has become even more diversified and complex. Occupational health nurses work in a variety of settings including manufacturing such as meat packing, food production, battery manufacturing, and textiles; hospital employee health institutions;and service industries such as banking and government and academic centers. Nurses who work in outpatient cardiac rehabilitation, public health departments, and residential group homes are working in community health settings, but not occupational health. DIF: Cognitive Level: Apply (Application) 6. Which competencies should occupational health nurses be able to fulfill? (Select all thatapply.) a. Completing thorough physical assessments of employees b. Understanding of the business climate c. Managing total worker health independently as appropriate d. Knowing relevant federal, state, and local regulations e. Adhering to the principles of professional practice f. Practicing culturally appropriate nursing care ANS: B, C, E, F According to the American Association of Occupational Health Nurses, occupational and environmental health nurses should be able to fulfill the following competency categories: manages total worker health independently and with other team members; adheres to principles of professional practice; demonstrates understanding of the business climate and itsimpact on the health of the community; practices culturally appropriate, evidence-based nursing care within licensed scope of practice. The occupational health is not responsible for thorough physical assessmenN ts oR f emI ploG yeeB s o. rC forM knowing relevant federal, state, and local regulation s. U S N T O DIF: Cognitive Level: Understand (Comprehension) 7. Which best explains how occupational health nursing differs from other nursing specialties?(Select all that apply.) a. Occupational health nursing has a major focus on the environment. b. Occupational health nurses are required to have a master’s degree in occupationalhealth. c. Occupational health nurses are more autonomous and work independently. d. Occupational health nurses have a primary emphasis on health promotion anddisease prevention. e. Occupational health nurses may work with unions, as well as management groups. f. Occupational health nurses work in the community. Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM ANS: A, C, E Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM N R I G B.C M The occupational health nurse (OHN) focuses on the workplace environment, examining the environment for hazards. Within the worksite, 70% of occupational health nurses work alone.The nurse often meets with unions representing the employees, as well as management. The roles and responsibilities of the OHN must be clearly articulated to lay people, managers, workers, union representatives, and colleagues. The nurse may interact with occupational medicine professionals, industrial hygienists, safety professionals, employee assistance counselors, personnel professionals, and union representatives. Nurses who work in occupational health settings are not required to have a master’s degree in occupational health.It is hoped that all nurses emphasize health promotion and disease prevention. Several specialties such as home health nursing and school nursing also work in the community. DIF: Cognitive Level: Understand (Comprehension) 8. Which best explains why employers are putting more effort into ensuring a safe environmentfor their employees? (Select all that apply.) a. To avoid National Institute for Occupational Safety and Health (NIOSH)inspections b. To be sure employees are “on the job” c. To provide good public relations, which can be seen as being a good communitycitizen d. Safety is an ethical and moral responsibility e. To prevent expensive lawsuits when someone is hurt or injured f. The Occupational Safety and Health Administration (OSHA) can give penalties,fines, and sentences for safety violations ANS: E, F The Occupational Safety and Health Act of 1970 identifies the roles of the various government agencies, providesUforStheNestaTblishmOent of federal occupational safety and health standards, and identifies a structure of penalties, fines, and sentences for violations of regulations. Inspections are a responsibility of OSHA, not NIOSH. The Workers’ Compensation Act helps protect employers against lawsuits, but any citizen can sue anyone atany time, so it is less expensive to keep the environment and the employee as safe as possible.Although having a safe environment shows good public relations and is an ethical and moral responsibility, these are not the main reasons why more effort has been put into ensuring a safe environment for employees. DIF: Cognitive Level: Understand (Comprehension) 9. Which best describes when the nurse can share confidential information about an employee’shealth with others? (Select all that apply.) a. If needed for workers’ compensation documents b. If a life-threatening emergency occurs Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM c. If authorized by the employee to specific recipients, such as insurance companiesor health care providers d. If requested by the employer for management purposes e. In compliance with governmental laws and regulation f. In educational programs so others can avoid similar injuries and risks ANS: A, B, C, E Community Public Health Nursing 7th Edition Nies Test Bank NURSINGTB.COM Occupational health nurses sometimes experience ethical dilemmas because of dual responsibility to both their employer and employees. In dealing with health information, the employee has a right to privacy and should “be protected from unauthorized and inappropriatedisclosure of personal information” (AAOHN, 2004, p. 1). However, exceptions to legal protection of health information may require the nurse to provide health-related records without the worker’s knowledge or consent. These exceptions are cases in which public benefit from disclosure outweighs loss of individual privacy. Specific circumstances include life-threatening emergencies; workers’ compensation situations in which state regulations limiting information to carriers and/or employers are followed; examination for drug and alcohol testing in some circumstances; compliance with government regulations; OSHA-mandated surveillance and/or occupational injury or illness evaluations; and other situations as required by law (e.g., public health purposes, law enforcement, judicial proceedings, or court order). The nurse is unable to share confidential information about anemployee’s health with the employer for management purposes or during an educational program. DIF: Cognitive Level: Understand (Comprehension