COHN(C) common mistakes
COHN(C) · Understand the traps and how to avoid them.
Applying the hierarchy of controls by naming a control category (e.g., 'administrative control') without choosing the specific highest-order feasible control for the scenario, such as substituting a less hazardous chemical or enclosing a process.
Candidates memorize the five-tier list but practice recalling labels rather than ranking interventions against a described exposure, so they stop at the first plausible-sounding category.
What to do instead
For every hazard scenario, write out elimination, substitution, engineering, administrative, and PPE options in order, then select the highest tier that is technically and economically feasible and justify why lower tiers alone are insufficient.
Treating OSHA recordkeeping criteria as equivalent to workers' compensation or clinical severity criteria, for example recording a case because it required prescription antibiotics or because the worker filed a claim.
Candidates conflate three separate systems (OSHA 300 log, state workers' compensation, and clinical management) and rely on memory of 'first aid vs. medical treatment' lists without checking the specific regulatory triggers.
What to do instead
Build a one-page decision tree from the general recording criteria: death, days away, restricted work or transfer, medical treatment beyond first aid, loss of consciousness, and significant injury or illness diagnosed by a physician; test each scenario against those triggers only.
Recommending immediate full-duty return for a worker with restrictions, or clearing a worker without confirming essential function demands against documented functional capacity.
Candidates focus on the diagnosis or the physician's note rather than on the physical and cognitive demands of the job, and they fear being seen as obstructive to the employee.
What to do instead
Practice the sequence: obtain a current job description with essential functions, compare to treating provider restrictions, identify temporary modified duties or accommodations, document the interactive process, and set a review date.
Choosing a screening test or surveillance interval based on general health promotion logic rather than on regulatory or consensus surveillance requirements tied to the specific exposure (e.g., audiometric testing schedule, spirometry for respirator users, lead or cadmium biological monitoring).
Candidates generalize from primary care prevention schedules and do not distinguish exposure-driven surveillance from general wellness screening.
What to do instead
Create an exposure-to-surveillance matrix pairing each agent (noise, lead, cadmium, silica, asbestos, respirator use, bloodborne pathogens) with the required test, baseline timing, and frequency, and rehearse it against scenario stems.
Answering ethical or legal items by protecting the employer's interest or disclosing more worker health information than necessary, instead of applying confidentiality, need-to-know, and the nurse's independent obligation to the worker.
Candidates import a loyalty-to-employer reflex from general nursing employment and are unsure how ADA confidentiality, HIPAA, and state law interact in occupational settings.
What to do instead
Memorize the decision rule: share only work-restriction and accommodation information with managers, keep diagnoses and treatment details in the confidential medical record, and escalate conflicts through the chain of command and licensure obligations.
Managing a workplace emergency scenario by jumping to treatment or transport without first establishing scene safety, incident command roles, and hazard isolation.
Clinical urgency pulls candidates straight to patient care, and they underestimate how chemical, electrical, or structural hazards change the correct first action.
What to do instead
Use a fixed prompt for every emergency item: isolate the hazard, don PPE, activate the response plan and incident command, triage, treat within scope, then document and conduct post-incident review.
Designing a wellness or education program around a single awareness session or printed handout rather than a needs assessment, measurable objectives, and an evaluation plan.
Candidates equate health promotion with delivering content and have limited practice writing program objectives or selecting evaluation levels.
What to do instead
Draft each program answer with four components: needs assessment data, SMART objectives, an evidence-informed intervention matched to the population, and process plus outcome evaluation measures.
Confusing the roles and legal authority of OSHA, NIOSH, MSHA, state-plan states, and consensus bodies such as ACGIH or ANSI when answering standards questions.
The agencies are taught together and candidates remember names without attaching enforcement authority, research versus regulatory function, or the legal status of consensus guidelines.
What to do instead
Build a comparison table of each body's mandate, whether it enforces, whether its limits are legal requirements or recommendations, and how state plans and general duty clauses alter obligations.
Selecting a quality improvement method or metric without linking it to a measurable program outcome, such as tracking the number of trainings delivered instead of the change in injury rates or compliance.
Candidates default to activity counts because they are easy to collect and are unfamiliar with structure, process, and outcome distinctions in program evaluation.
What to do instead
For each QI item, name the outcome indicator, the data source, the benchmark, and the improvement method (PDSA, root cause analysis, or audit and feedback) before choosing an answer.
Performing a worksite or walk-through assessment and reporting only observed hazards, omitting exposure characterization, worker interviews, and comparison to occupational exposure limits.
Candidates treat the walk-through as a visual inspection task and skip the quantitative and participatory steps that make an assessment defensible.
What to do instead
Follow a standard assessment sequence: review injury and illness data, observe tasks and interview workers, characterize exposure routes and duration, sample or estimate against limits, then prioritize controls and schedule reassessment.