COHN Certification

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The Certified Occupational Health Nurse (COHN) credential is issued by the American Board for Occupational Health Nurses, Inc. (ABOHN). ABOHN was created in 1971, and its first certification exam was administered in 1974. In 1995, the certification program was split into two credentials, the COHN and the COHN-Specialist (COHN-S), with the latter credential having stricter educational and work experience requirements.[1][2]

The COHN exam has been revised several times since its creation in response to the findings of Practice Analysis studies. These Practice Analysis studies survey practicing Certified Occupational Health Nurses to reveal which knowledge areas and skills are most crucial for a COHN to be successful in that role. The most recent Practice Analysis was completed in 2011, and the revised exam was implemented in 2012.[1]

Function of the Test

COHN Study Guide

The COHN certification is a credential intended to be earned by experienced registered nurses (RNs) who "have demonstrated mastery in occupational health nursing through education, experience, and knowledge."[3] It is a nationally-recognized certification.

Because candidates must already be RNs, certification in Occupational Health Nursing does not confer any additional licensure privileges. However, certification is beneficial as an exercise in professional development, motivating candidates to improve their skills and abilities and enhancing their future career prospects.[3]

In 2013, 81 candidates took the COHN exam, of whom 51 (63%) passed.[4] As of the end of 2013, there were 1,009 active holders of COHN certification compared to 2,853 active holders of COHN-S certification.[5]

Test Administration

COHN Flashcards

The COHN examination is administered at more than 190 AMP Assessment Centers across the United States and 83 centers in other countries.[3] The fee to take the exam is $400.[6] After candidates have paid the fee and had their testing applications approved by ABOHN, they may schedule an examination date directly with AMP within 120 days.[3]

Candidates have three hours in which to complete the 160-question exam.[3] Candidates receive score reports immediately following the examination indicating pass/fail status and scaled score. Unsuccessful candidates who wish to retake the examination must wait 45 days before applying to retake the examination. There are no limits to the number of times a candidate may take the exam, but a new exam fee must be paid each time.[3]

Candidates who require special testing accommodations for a disability should submit a request for accommodation to ABOHN at least 45 days before the intended testing date. The request must include a Request for Special Examination Accommodations form (included in the candidate handbook) as well as the relevant medical documentation of the disability.[3]

Test Format

Sections of the COHN Test
COHN Test Subject Areas # of Questions
Clinician Role 48
Coordinator Role 41
Advisor Role 22
Case Manager Role 24
Total 135

Test Structure

The Certified Occupational Health Nurse exam is made up of 160 questions that have to do with four major content areas: Clinician Roles; Coordinator Roles; Advisor Roles; and Case Manager Roles. Out of these 160 questions, 25 of them are unscored, pretest questions that will not count towards scoring. The exam is computer based, and all 160 questions are multiple choice.[7]

Test Environment

The COHN takes place at AMP Assessment Centers. For admission, a government issued, photo identification containing a signature is required. A secodnary form of identification containing a name and signature is also required. Once in the testing room, no personal items are allowed. A locker will be provided to store hats, watches, wallets, keys, notes, bags, and any other personal items. Pencils and scratch paper will be provided by the testing center. The time allotted to complete all 160 questions is three hours.[8]

Test Content

  • Sample COHN Questions
  1. Which of the following is the most common on-the-job injury among hospital workers?
    A. Back injury
    B. Eye injury
    C. Head injury
    D. Burn injury
  2. Repetitive manual tasks and lifting or moving heavy objects in the workplace are examples of:
    A. Physical hazards
    B. Biological hazards
    C. Reproductive hazards
    D. Mechanical hazards
  3. Initial treatment of De Quervain disease consists of:
    A. Thumb spica splint and a 2-week course of NSAIDs
    B. Corticosteroid injections
    C. Surgery
    D. Physical therapy
  4. Which of the following is true about occupational hazards?
    A. Rates of occupational injury to healthcare workers have decreased in the past 10 years
    B. Stress is not considered an occupational hazard
    C. Agriculture and construction industries are more hazardous today than they were 10 years ago
    D. Violence can be a workplace hazard
  5. A clinical hazard in the semiconductor industry that could be associated with adverse reproductive outcomes is:
    A. Methanol
    B. Benzene
    C. Dioxin
    D. Glycol ethers
  6. The most common type of forklift accident is:
    A. Tipping over
    B. Running over a coworker
    C. Being struck by material falling off the forklift
    D. Falling onto the forks


The COHN exam consists of 135 scored multiple-choice questions and 25 unmarked, unscored pretest items which are being assessed for inclusion on future versions of the COHN exam.[3] The distribution of questions on the exam is as follows:

Distribution of questions on the COHN exam[3]
Category Domains of Practice # of items  % of items
I Clinician Role 48 35.6%
II Coordinator Role 41 30.4%
III Advisor Role 22 16.3%
IV Case Manager Role 24 17.8%
Total 135 100%

There is no penalty for guessing. Incorrect answers and omitted answers are counted the same way.[3] Candidates' raw scores are converted to some form of scaled score, though ABOHN does not describe the scale in the COHN candidate handbook.[3] ABOHN also does not provide a pass score, reporting instead that the pass score is determined by the exact level of difficulty of the form of the examination the candidate takes. In other words, candidates who take easier versions of the COHN must answer more questions correctly to pass than candidates who take more difficult versions of the COHN.[3]

The passing rate for the COHN exam in 2013 was 63%.[4]

Answers to Sample Questions

1;A 2;D 3;A 4;D 5;D 6;A


  1. ^ a b ABOHN - History March 2 2015
  2. ^ ABOHN - Eligibility March 2 2015
  3. ^ a b c d e f g h i j k l ABOHN - Candidate Handbook - COHN March 2 2015
  4. ^ a b ABOHN - Report Spring 2014
  5. ^ ABOHN - Report Fall 2014 March 2 2015
  6. ^ ABOHN - Exam Payment March 2 2015
  7. ^ Day of Exam 08 April 2015
  8. ^ Day of Exam 08 April 2015