Free OEM Practice Questions

Question 1

A 38-year-old automobile refinisher developed asthma after several years of spraying two-component polyurethane coatings. Reversible airflow obstruction has been documented. Wheezing often begins several hours after a shift and improves during vacations; office spirometry after a weekend away is normal. Symptoms are currently mild, without previous severe exacerbations. During a clinically supervised evaluation, which investigation would most directly establish whether the asthma is work-related?

Accepted Answer

Record serial peak flows at work and away, alongside symptoms and medication use.

Answer

Repeat spirometry immediately before and after a single representative work shift.

Answer

Measure fractional exhaled nitric oxide once after several days away from workplace exposures.

Answer

Perform one methacholine challenge after a week away from work to assess airway hyperresponsiveness.

Question 2

Ten days after a lumbar strain, a warehouse worker still has pain with repeated bending and 25-kg lifts. Strength, reflexes, and sensation are normal; there is no fever, significant trauma, cancer history, saddle sensory loss, or bowel or bladder dysfunction. The employer offers inventory duties allowing position changes, no repeated bending, and lifting limited to 4 kg. The worker demonstrates these activities without a significant symptom increase. What should the work-status note recommend?

Accepted Answer

Begin the offered modified duties and reassess function in one week.

Answer

Remain off work until pain-free.

Answer

Obtain lumbar MRI before authorizing the proposed duties because pain persists after the injury.

Answer

Resume unrestricted warehouse duties because the neurologic examination shows no objective deficit.

Question 3

An agricultural worker is treated for confirmed organophosphate poisoning after a pesticide spill. Contaminated clothing has been removed, skin decontamination is complete, and oxygenation, suction, and assisted ventilation are being provided. Pralidoxime has been started. After initial intravenous atropine, the pulse rises from 52 to 124 beats/min, but copious bronchial secretions and bronchospasm continue to impair ventilation. The rhythm is sinus tachycardia without ischemic changes. How should atropine treatment proceed?

Accepted Answer

Give additional atropine, titrated to control bronchial secretions and improve ventilation.

Answer

Withhold further atropine until the pulse falls below 100 beats/min, while continuing ventilatory support.

Answer

Use pralidoxime alone to treat the remaining pulmonary manifestations.

Answer

Use a fixed low-dose infusion because tachycardia indicates adequate atropinization.

Question 4

An employee in a federal OSHA hearing-conservation program has a newly confirmed, work-related audiometric change. At 2,000, 3,000, and 4,000 Hz, right-ear baseline thresholds were 5, 5, and 10 dB HL; current thresholds are 20, 20, and 25 dB HL. The left ear is unchanged. A valid repeat test confirms the findings, no age correction is applied, and there is no other basis for recording the case. Which response correctly distinguishes a standard threshold shift (STS) from OSHA hearing-loss recordability?

Accepted Answer

Initiate STS follow-up without an OSHA 300 entry under the hearing-loss criterion.

Answer

Record the hearing loss because an STS is present.

Answer

Take no additional hearing-conservation action because the current three-frequency average remains below 25 dB.

Answer

Record the case because the current threshold reaches 25 dB at one of the tested frequencies.

Question 5

A machinist who has worked with copper-beryllium aerospace components for 18 years develops exertional dyspnea. Chest CT shows bilateral hilar adenopathy and small pulmonary nodules; lung biopsy reveals nonnecrotizing granulomas. Mycobacterial and fungal studies are negative. A provisional diagnosis of sarcoidosis is proposed. Before accepting that diagnosis, which test would best distinguish an occupational mimic?

Accepted Answer

Blood beryllium lymphocyte proliferation testing

Answer

Serum angiotensin-converting enzyme activity with serum calcium measurement

Answer

Bronchoalveolar lavage CD4-to-CD8 T-lymphocyte ratio determination

Answer

Urinary beryllium concentration measured after a work shift

Question 6

An occupational health clinic is applying USPSTF criteria for annual low-dose CT lung cancer screening. All four employees below are asymptomatic and have sufficient life expectancy and willingness to undergo curative treatment if needed. Which employee meets those screening criteria?

Accepted Answer

A 54-year-old with 28 pack-years of smoking who quit 9 years ago

Answer

A 48-year-old with 35 pack-years of smoking who currently smokes cigarettes

Answer

A 63-year-old with 18 pack-years of smoking who currently smokes and previously handled asbestos

Answer

A 71-year-old with 40 pack-years of smoking who quit 18 years ago

Question 7

A resident living near a former smelter brings a laboratory report showing total urinary arsenic of 146 micrograms/L. The laboratory has not reported individual arsenic species. The patient ate a large shellfish meal during the 24-hour urine collection and has no gastrointestinal symptoms, neuropathy, skin changes, or abnormalities on examination. Environmental sampling is being arranged. What is the most appropriate next step in interpreting the biomonitoring result?

Accepted Answer

Request urinary arsenic speciation and interpret it with the seafood history.

Answer

Measure blood arsenic to establish chronic exposure burden.

Answer

Confirm toxicity with a commercial hair arsenic analysis because it measures cumulative tissue deposition.

Answer

Initiate chelation while awaiting environmental results because the elevated total establishes inorganic arsenic poisoning.

Question 8

At an initial interstate commercial-driver medical examination, properly obtained blood pressures are 166/96 and 164/94 mm Hg after rest. The driver has no symptoms or evidence of target-organ injury and otherwise meets qualification requirements. Hypertension has not previously limited certification. Applying FMCSA hypertension guidance, which certification decision fits these findings?

Accepted Answer

Issue a one-time three-month certificate to allow blood pressure control.

Answer

Withhold certification until blood pressure is controlled, regardless of the absence of symptoms.

Answer

Issue a one-year certificate because the diastolic pressure remains below 100 mm Hg.

Answer

Issue a six-month certificate because systolic pressure is below 180 mm Hg.

Question 9

An immunocompetent nurse sustains a deep needlestick from a source patient who is HBsAg-positive. Her records document a complete hepatitis B vaccine series and an anti-HBs concentration of 86 mIU/mL measured six weeks after the final dose. A test obtained today, eight years later, shows anti-HBs of 4 mIU/mL. The wound has been washed and other bloodborne-pathogen risks are being addressed separately. Which hepatitis B postexposure intervention is indicated?

Accepted Answer

Neither hepatitis B vaccine nor hepatitis B immune globulin is indicated.

Answer

Give a hepatitis B vaccine booster without immune globulin.

Answer

Give immune globulin once and restart hepatitis B vaccination.

Answer

Give two doses of hepatitis B immune globulin one month apart without further vaccination.

Question 10

A refrigeration supervisor proposes a full-facepiece air-purifying respirator with ammonia cartridges for a brief entry into a room containing 500 ppm ammonia and 20.9% oxygen. The technician has current medical clearance and an appropriate quantitative fit test. The respirator's assigned protection factor is 50; the OSHA eight-hour permissible exposure limit for ammonia is 50 ppm, and the NIOSH immediately dangerous to life or health (IDLH) concentration is 300 ppm. Which assessment of the proposal is correct?

Accepted Answer

Reject it: the nominal APF-based limit is 2,500 ppm, but an air-purifying respirator is not acceptable in this IDLH atmosphere.

Answer

Accept it because dividing ambient concentration by the protection factor gives an estimated inside-mask concentration of 10 ppm.

Answer

Approve a powered air-purifying respirator instead, because its higher protection factor offsets the excess concentration.

Answer

Accept it if the entry is brief enough to keep the worker's eight-hour average exposure below 50 ppm.

Free OEM Practice Questions

Domain 1: Clinical Occupational Medicine 48% of exam

Question 1

Question 2

Question 3

Question 4

Domain 2: Health, Wellness, and Human Performance Optimization 8% of exam

Question 5

Domain 3: Work Fitness, Impairment, and Disability Prevention 15% of exam

Question 6

Question 7

Domain 4: Hazard and Disaster Prevention and Management 8% of exam

Question 8

Domain 5: Environmental Medicine 8% of exam

Question 9

Domain 7: Systems-based Practice and Administration 8% of exam

Question 10

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