Certified Occupational Health Nurse Practice Test

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The American Board for Occupational Health Nurses (ABOHN) administers the Certified Occupational Health Nurse (COHN) examination, which is given to nursing candidates who wish to be qualified as occupational health nurses.

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COHN Exam Eligibility

To be eligible for the COHN exam, you must meet the following requirements:

  • You must hold a current, active RN license in the US
  • You must have accrued at least 3,000 hours of occupational health nursing practice within the last five years

COHN Exam Outline

The Certified Occupational Health Nurse exam contains 160 multiple-choice questions, 25 of which are unscored, and you will be given a time limit of 3 hours. The unscored questions are used to evaluate questions on future versions of the exam, and you will not know which questions are score or unscored when taking the exam.

The test material uses the Occupational Health Nurse’s (OHN’s) four process steps or methods used in the care of a patient that must be applied.

  1. Assessment is the process of collecting data, verifying the data, and communicating the data gathered to the patient in a way that they understand.
  2. Planning involves the process of establishing the desired outcome for the patient by designing strategies that will achieve those outcomes upon completion.
  3. Implementation is the process of initiating the correct nursing actions to accomplish a specific outcome.
  4. Evaluation is the process of measuring the way a patient responds to treatments, including medications they are taking and other nursing actions.

Exam Contents

The contents of the exam cover OHN roles as they pertain to the following four major categories:

1. Clinician (42%)

Assessment (15%)
  • Obtaining an occupational and environmental health history
  • Conducting health assessments
  • Assessing health needs of workers and worker populations
  • Identifying laws and regulations affecting nursing practice
  • Monitoring new developments related to emerging health care issues
  • Assessing workers with work restrictions or limitations and making appropriate job placement recommendations
  • Identifying physical requirements to fulfill essential job function
  • Identifying ethical issues in practice
  • Identifying health surveillance of individuals/groups for specific hazards
Planning (7%)
  • Interpreting results of screening tests and health history
  • Recommending changes in work to accommodate workers’ health status and history
  • Recommending programs and testing based on worker health needs
  • Formulating a response to emerging healthcare issues
Implementation (14%)
  • Using and maintaining a health recordkeeping system
  • Recognizing and responding to ethical issues in practice
  • Providing treatment of work-related injuries or illnesses
  • Providing direct care for non-work-related injuries and illnesses for workers
  • Providing health promotion and disease prevention screening tests
  • Referring workers to an employee assistance program
  • Providing individual counseling services for worker
  • Performing medical surveillance and regulatory compliance testing/screening
  • Assuring confidentiality of personal health information
  • Complying with OSHA occupational injury and illness recording and reporting requirements
Evaluation (6%)
  • Evaluating the quality of care provided by internal and external health services
  • Evaluating injuries, illnesses, and incidents using root cause analysis
  • Demonstrating the value of clinical services by internal occupational health services
  • Interpreting medical surveillance and regulatory testing and screening

2. Coordinator (27%)

Assessment (5%)
  • Monitoring laws and regulations affecting nursing practice
  • Analyzing injury, illness, and incident data
  • Referencing safety data sheets
  • Determining staffing requirements
  • Identifying hazards through work site walk-through surveys
  • Assessing ergonomic needs
  • Assessing and reporting on the organization’s regulatory compliance with applicable standards
Planning (5%)
  • Collaborating with other disciplines to protect and promote worker health and safety
  • Identifying appropriate personal protective equipment
  • Coordinating medical testing for DOT compliance
  • Developing occupational health and safety policies and procedures
  • Developing the components of a drug and alcohol screening program
  • Establishing goals and objectives for an occupational health and safety program
  • Developing nursing protocols
  • Incorporating knowledge of cultural beliefs and practices in implementing programs and services
  • Establishing guidelines related to workplace violence
  • Utilizing principles of ergonomics for worksite design
  • Developing emergency preparedness plans
Implementation (11%)
  • Coordinating health promotion and disease prevention strategies and programs
  • Coordinating surveillance programs
  • Incorporating computer technology for occupational health practice
  • Using software applications for health information management
  • Recommending control measures to reduce or eliminate exposures/hazards
  • Applying regulatory standards and guidelines
  • Preparing and provide testimony or documentation for legal proceedings
  • Participating in administrative proceedings related to occupational health
  • Preparing business reports for management
  • Adhering to policies and procedures for confidentiality
  • Implementing laws and regulations affecting nursing practice
  • Implementing workplace substance abuse programs
  • Establishing and monitor compliance with infection control guidelines
  • Coordinating and serve on interdisciplinary committees and teams
  • Providing resources and information to meet the health and safety needs of the organization
  • Developing programs based on health and safety management principles
  • Participating in audits
Evaluation (6%)
  • Conducting quality management/improvement program for occupational health and safety
  • Demonstrating the value of services provided
  • Interpreting the data obtained during a work site walk-through survey assessment

3. Advisor (13%)

Assessment (3%)
  • Assessing education and training needs
  • Determining management support for health, wellness, and safety programs
  • Assessing for opportunities for workplace, professional, and community involvement
Planning (3%)
  • Interpreting needs assessment results
  • Selecting teaching methods and content based on the characteristics of learners
  • Developing educational strategies to effectively communicate risks to workers
  • Planning new worker occupational health and safety orientation programs
  • Developing education and training programs
  • Developing business case to enlist management support
Implementation (5%)
  • Educating and training workers about health and wellness
  • Educating management at all levels about occupational health and safety programs
  • Educating and training occupational health and safety staff
  • Serving as a preceptor or mentor for students and health care professionals
  • Training workers on proper use and care of personal protective equipment
  • Serving on professional and community boards
Evaluation (3%)
  • Communicating the results and outcomes of educational and training programs
  • Evaluating value added service
  • Measuring program outcomes

4. Case Manager (18%)

Assessment (4%)
  • Identifying work-related cases that are appropriate for case management
  • Identifying non-work-related cases that are appropriate for case management
  • Identifying legal, labor, and regulatory implications related to case management
Planning (4%)
  • Developing case management plans for individuals
  • Developing and coordinating a network of resources for case management
  • Developing a multidisciplinary plan of care in collaboration with the worker and their support systems
Implementation (7%)
  • Managing short-term or long-term disability cases
  • Administering and managing integrated disability management strategies
  • Managing workers’ compensation cases
  • Referring workers for rehabilitation as indicated
  • Coordinating administration of case management with vendors and community resources
  • Communicating essential job functions information to providers
  • Recommending modified duty based on work restriction and fitness for duty
Evaluation (3%)
  • Analyzing workers’ compensation data
  • Monitoring treatment plan and outcomes
  • Evaluating health care delivery to workers provided by external providers

Core Content Areas

The core content is a compilation of subject matter that the questions on the test can pertain to. This core content is vital to the practice of occupational nursing, so you should learn as much about it as possible to be prepared for the exam and real-life nursing practice.

These are the core content areas and what they cover:

Chemical hazards
  • Solvents, cutting oils
  • Reproductive hazards
  • Asbestos, silica, and cotton dust
  • Carcinogens
  • Heavy metals
  • Latex allergy
  • Carbon monoxide and methane
  • Toxicology terms
  • Cyanide, hydrogen sulfide
  • Exposure routes
  • Chlorine and toluene isocyanates
  • Target organs
  • Ethylene oxide
  • Medical surveillance
  • Pesticides
Biologic hazards
  • Food- and water-borne pathogens
  • Bloodborne pathogens
  • Tuberculosis
  • Travel medicine
  • Immunizations/tetanus
Physical hazards/ergonomics
  • Noise vibration/hearing loss
  • Upper extremity disorders/algorithms
  • Radiation
  • Back disorders
  • Heat/cold stress
  • Work station design
  • Electrical
  • Job task analysis
  • Violence
  • Drug screening/chain of custody/hair samples
  • Shift work
  • Aging workers
  • Fitness for duty/job placement
  • Cultural differences
  • Stress/time management
  • Disaster planning
  • Employee assistance programs
Safety and industrial hygiene issues
  • Safety walkthrough
  • Personal protective equipment
  • Splash exposure
  • Engineering controls
  • Sampling
  • Administrative controls
  • Indoor air quality/radon
Standards and regulations
  • Hazard communication
  • OSHA standards
  • MSDSs
  • DOT
  • FMLA
  • Confined space
  • Lock out/tag out
  • Bloodborne pathogens
Emergency response
  • Burn care
  • Strains and sprains
  • Eye injuries
  • Crush injuries/amputation/bleeding
  • Cardiac emergencies/AEDs
  • Head injuries
Emergency response
  • Dermatitis
  • Cholesterol
  • Occupational asthma/acute respiratory distress
  • Hypertension
  • Pulmonary function testing
  • Disease state management
  • Case management/clinical outcomes
  • Chronic pain management
  • Diabetes
  • Wound care
  • Asthma
Health education/promotion
  • Smoking cessation
  • Adult learning theory
  • Counseling/health promotion
  • Levels of prevention
  • Confidentiality
  • Literacy/language issues
  • AIDS education
  • Communicating risk
  • Counseling
  • Health risk assessment
Management principles
  • Ethics
  • Legal/regulatory practice aspects
  • Principles of management/communication
Information management/recordkeeping
  • Confidentiality
  • Recordkeeping
  • Workers’ compensation
  • Research designs
  • Policy and procedures/protocols
Clinical practice
  • Pre-placement evaluation
  • Clinical assessment
  • Screening test results analysis
  • Return-to-work assessment
  • Performing screening tests
  • Work restriction management

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COHN Exam Registration

To register for the exam, you must submit an application via the ABOHN website. Your application must include any necessary eligibility documentation and the nonrefundable $!50 application fee.

Once your application is approved, you must schedule your examination appointment and pay the nonrefundable $400 examination fee within 90 days.

If you cannot take your examination within 120 days of paying your examination fee, you can apply for an extension, which costs $50. If approved, the extension will be for 60 days. You can only apply for an extension one time.

Test Day

On the day of your exam, you should arrive at the PSI testing center about 15-30 minutes early. If you are more than 15 minutes late, you will not be admitted, and your test will be canceled. Refunds are not provided for individuals who do not make their scheduled exam appointment.

Before the exam begins, you must secure any personal items in a provided locker. A pencil and a sheet of paper are provided, so there is no need to bring those items with you to the testing center.

During the exam, you can take a break whenever you need to, but the timer will keep going during your break.

How the COHN Exam is Scored

The passing score does vary, but generally, you will need to get 71% of the questions correct to earn a passing score for the examination. That means you need to answer at least 96 questions correctly.

If you do not know an answer, you are allowed to skip the question and come back to it at the end of the test. If an answer is left blank, that question is considered to be answered incorrectly.

Receiving Your Score

The score you earn will be mailed to you within 8 to 12 weeks following the examination. Scores will NOT be reported in any way other than a written examination delivered by mail.

Retaking the COHN Exam

If you do not pass the exam on your first attempt, you can apply to retake the examination as soon as you would like. You must submit a new application and pay the applicable fees for each retake.

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How many questions are on the COHN exam?


There are 160 multiple-choice questions on the exam.


How long is the COHN exam?


The time limit for the exam is 3 hours.


What is the passing score for the COHN exam?


There is not set passing score, but you should aim to answer at least 71% of the questions correctly.


How much does the COHN exam cost?


The application fee is $150, and, the examination fee is $400.

By Kate Nockunas

Kate has been Mometrix’s Nursing and Medical Editor for over four years. She has a bachelor’s degree in Communications from Vanderbilt University, a bachelor’s degree in Nursing from Marymount University, and a master’s degree in Education from Johns Hopkins. Kate is a critical care registered nurse who still works occasionally in the ICU and PACU.


by Mometrix Test Preparation | This Page Last Updated: January 4, 2024