CNA Occupational Health Nursing Certification Exam — Information & Free Practice

About CNA Occupational Health Nursing Certification Exam

CNA Occupational Health Nursing Certification Exam · CA

Key exam facts

Provider

Canadian Nurses Association (CNA) certification examination, developed collaboratively with occupational health nurses and Meazure Learning–Yardstick; Meazure Learning administers in-person testing and ProctorU provides remote proctoring.

Format

Computer-based multiple-choice examination, available remotely with ProctorU or at selected Canadian Meazure Learning test centres. Specialty blueprint: 60–70% independent questions and 30–40% case-based questions.

Exam questions

Total questions: 160–165.

Time limit

Four hours (240 minutes) to answer the examination questions; appointment preparation and check-in are separate.

Passing score

Criterion-referenced pass mark set by the specialty exam committee using a modified Angoff method and statistical review. CNA does not publish the numerical pass mark; results are pass or unsuccessful.

Exam fee

Initial application: $588 for CNA members or $780 for non-members, plus applicable taxes. Additional appointment fee: $85 remote (ProctorU) or $110 in person (Meazure Learning). Reduced rewrite application fee: $378 member or $500 non-member for unsuccessful candidates within the next two calendar years. Application fees include a non-refundable $130 administrative fee. Fees are reproduced in the dollar notation published by CNA; the public fee table does not explicitly label an ISO currency code.

Topics covered

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

• Occupational Health Nursing Practice — Official range: 5–10% (Practice allocation: 6.82%)

  • Practices in accordance with nursing standards and code of ethics, as well as provincial, territorial and federal legislation.
  • Advises stakeholders on occupational health and safety hazards and risks, using effective leadership, communication strategies and decision making.
  • Recommends risk-reduction strategies related to identified health and safety risks.
  • Ensures the security, privacy and confidentiality of employee health records (e.g., levels of security in relation to electronic and paper documentation, access, transfer, release, retention and disposal).
  • Ensures documentation meets legislative requirements (e.g., immunization reports, exposure management, respiratory fit testing, incident reports and investigations, WCB/WSIB data).
  • Delivers nursing services based on current occupational health nursing best practices, critical inquiry, and culturally appropriate and evidence-informed practice.
  • Uses program planning principles (e.g., needs assessment, planning, implementation and evaluation) to develop programs.
  • Assists with reporting to governmental agencies as required by the applicable legislation.

• Assessment, Control and Evaluation of Workplace Hazards — Official range: 25–30% (Practice allocation: 25%)

  • Implements a comprehensive hazard assessment and identification process.
  • Assesses the following potential and existing workplace hazards:
  • Chemical hazards in relation to the following sources:
  • solids (e.g., lead, cadmium, nickel, asbestos, welding fumes, silica)
  • liquids (e.g., solvents, degreasers, acids, alkali)
  • gases (e.g., carbon monoxide, chlorine, anesthetic gases, cyanide)
  • Biological hazards in relation to the following sources:
  • bacteria (e.g., tuberculosis, MRSA)
  • viruses (e.g., COVID-19, influenza, hepatitis)
  • fungi (e.g., toxoplasmosis, mould)
  • insects (e.g., insect bites or stings)
  • plants (e.g., poison ivy, stinging nettle, baneberry ivy)
  • zoonotic (e.g., rabies, Q-fever)
  • Physical hazards in relation to the following:
  • thermal stress (e.g., heat, cold)
  • noise (e.g., impact noise, high-frequency noise)
  • vibration (e.g., segmental, whole-body)
  • ionizing and non-ionizing radiation (e.g., lasers, X-rays, nuclear materials, radioactive isotopes, electromagnetic radiation, welding-arc vision)
  • air pressure (e.g., hydraulic, pneumatic, pressurized environments, pressure changes, G-force)
  • energy (e.g., steam, electrical, kinetic)
  • environmental factors (e.g., confined space, heights)
  • powered mobile equipment (e.g., robotics, vehicles, scissor lifts, boats, forklifts)
  • Ergonomic hazards in relation to the following:
  • workplace environment (e.g., lighting, stressors, distractions, workplace design, work-station setup, person–machine interface)
  • physical demands (e.g., lifting/carrying, pushing/pulling, prolonged sitting and standing, positioning, force, repetition, duration, frequency, unsafe work practices and procedures, driving)
  • Psychosocial hazards in relation to the following:
  • organizational risk factors (e.g., organizational change, shift work, job demands, role conflict)
  • workplace harassment and violence (e.g., sexual harassment, bullying, verbal or written threats, verbal abuse, physical altercations)
  • impairment in the workplace (e.g., substance use, fatigue, impairment caused by health issues)
  • failure to address workforce diversity and culture (e.g., varying physical and intellectual abilities, literacy issues, multi-cultural issues, multi-generational issues, aging workers, gender and non-binary-identity)
  • emergency situations (e.g., bomb threat, pandemic, extreme violence, natural disaster, stress and fear caused by significant injury in the workplace)
  • Assesses the level of risk based on frequency, severity and probability of harm by:
  • Collaborating with internal and/or external stakeholders for recommendations.
  • Facilitating the appropriate risk assessment (e.g., air sampling, ergonomic risk assessment, noise survey).
  • Analyzing the results of the assessment.
  • Recommends and implements control measures based on:
  • Engineering controls (e.g., elimination, substitution, containment, design)
  • Administrative controls (e.g., work practices, policies and procedures, musculoskeletal- injury prevention programs, respiratory-protection programs)
  • Personal protective equipment (e.g., gloves, safety footwear, respirators, face protection)
  • Evaluates the effectiveness of the implemented control measures.

• Health Surveillance — Official range: 25–30% (Practice allocation: 25%)

  • Develops and implements appropriate health surveillance policies, programs and procedures to support employee health.
  • Assesses the health status of employees in relation to job-specific hazards or demands upon initial pre-placement or job transfer, or periodically as required by occupational need, standards or legislation (e.g., vision and audiometric screening, immune status).
  • Develops and implements health surveillance in relation to the following:
  • Chemical hazards (e.g., pulmonary function test, blood lead levels, CBC)
  • Biological hazards (e.g., antibody and antigen levels, tuberculosis screening, immunizations, infectious-disease testing)
  • Physical hazards (e.g., audiometry, personal dosimetry)
  • Ergonomic hazards (e.g., ergonomic assessments, employee questionnaires or surveys)
  • Psychosocial hazards (e.g., violence risk assessment, Employee Assistance Program review)
  • Evaluates and improves health surveillance policies, programs and procedures (e.g., type of tests, frequency of measurements, nature of reports and follow-up, incident statistics review, compliance audits, disability management program review).
  • Provides health counselling in relation to workplace exposures.

• Assessment, Care and Case Management of Illnesses and Injuries — Official range: 15–20% (Practice allocation: 15.91%)

  • Implements appropriate interventions to minimize effects of occupational and non-occupational illness and injury by:
  • Managing acute and non-acute illnesses and injuries.
  • Collecting occupational and relevant non-occupational histories (e.g., employment history, exposures, lifestyle, hobbies, previous illnesses and injuries).
  • Providing care and treatment options.
  • Providing health counselling.
  • Liaising with the appropriate health-care providers (e.g., collaboration, referral).
  • Facilitating psychological support (e.g., crisis support, referral to the Employee Assistance Program).
  • Analyzing internal and external reports and consultations (e.g., health-care provider reports, independent medical evaluations, vocational assessments, nursing documentation, changes in work performance).
  • Identifies fitness-to-work implications based on physical and psychological health limitations and restrictions (e.g., type 2 diabetes, cognitive impairment, physical limitations, ability to concentrate, asthma).
  • Identifies fitness-to-work implications in relation to the potential transmission of infectious diseases in the workplace (e.g., COVID-19, tuberculosis, varicella, influenza, hepatitis, staph and strep infections).
  • Identifies fitness-to-work implications in relation to specialized roles or specialized job functions (e.g., safety-sensitive role, substance-use–related harms when applicable).
  • Recommends workplace accommodation based on occupational and non-occupational illness, injury and disability.
  • Provides and coordinates case management by:
  • Communicating as needed with an ill or injured employee and the employee’s supervisor and/or manager.
  • Identifying an employee’s needs and rehabilitation challenges (e.g., counselling, assistive devices).
  • Identifying organizational barriers that impede an employee’s ability to return to work or continue to work (e.g., interpersonal conflicts, policies, organizational culture, environment).
  • Identifying personal or psychosocial barriers that may affect a successful return to work (e.g., family dysfunction, childcare responsibilities, substance use).
  • Facilitating evaluations in relation to fitness to work (e.g., physical demands analyses, functional assessment evaluations, independent medical evaluations, health-care provider assessments, cognitive assessments, job matching).
  • Facilitating an employee’s return to work and accommodation in collaboration with stakeholders (e.g., manager, union representative, human resources representative, insurance representative, workers’ compensation, health-care provider).
  • Works with employees to prevent and manage occupational and non-occupational illnesses and injuries by:
  • Identifying behavioural or physical manifestations for potential psychological or physical health issues.
  • Identifying employees at risk of medical emergencies and intervening when required (e.g., suicidal thoughts, hypoglycemic episode, cardiac event).
  • Developing and facilitating a comprehensive rehabilitation plan.
  • Facilitating referrals to appropriate community, health-care and workplace resources (e.g., Employee Assistance Program, allied health professionals, lifestyle counselling, addiction counselling).
  • Advocating for employees’ rights to rehabilitation, accommodation and the return-to- work process.
  • Understanding the process for diagnosing substance-use disorders (i.e., according to the DSM-5), the severity, and the variation within and between specific substance-use disorder diagnoses.
  • Understanding that substance use and substance-use disorders are multidimensional, complex, biopsychosocial and spiritual conditions.
  • Communicating respectfully by refraining from judging, labelling, demeaning, stigmatizing or humiliating clients (e.g., uses substances, LGBT2Q+).

• Health, Safety and Wellness Promotion — Official range: 15–20% (Practice allocation: 15.91%)

  • Provides leadership to promote the development of individual and/or organizational health, safety and wellness.
  • Identifies individual employees’ health, safety and wellness needs (e.g., health-risk assessments, health screenings).
  • Identifies organizational health, safety and wellness needs (e.g., environmental scans, demographic analyses, absenteeism rates, time-loss reports, overtime-usage statistics, perception surveys, Employee Assistance Program utilization).
  • Recommends the development of health promotion programming for the organization (e.g., psychological health and safety program, body-mechanic training).
  • Develops and provides individual and organizational educational activities using the principles of adult education (e.g., literacy level, established program objectives, delivery format, appropriate learning atmosphere, cultural sensitivity).
  • Empowers employees to take actions to improve their health behaviours to reduce their risk of illness and injury (e.g., motivational interviewing techniques, educational programs using evidence-based resources).
  • Determines whether learning outcomes are achieved and aligned with program objectives (e.g., questionnaires, evaluation sheets, audits, direct observation).

• Health, Safety and Wellness Management — Official range: 10–15% (Practice allocation: 11.36%)

  • Health, safety and wellness services management:
  • Demonstrates leadership in relation to service development and implementation (e.g., gap analyses, needs assessments, environmental scans, benchmarking).
  • Sets goals, objectives, policies and procedures that align with organizational strategies, and supports service development and implementation.
  • Coordinates the provision of services with internal and external resources (e.g., emergency preparedness and response, health surveillance, injury management, training/education, hazard recognition).
  • Demonstrates the cost effectiveness of health, safety and wellness services to senior management (e.g., cost–benefit analyses, business plans, return on investment).
  • Collaborates with senior management to incorporate health and safety into the organization’s strategic plan.
  • Collaborates with stakeholders in relation to health, safety and wellness services (e.g., employees, management, occupational health and safety committees, unions, infection control committees).
  • Identifies appropriate internal and external resources (e.g., auditors, Employee Assistance Program providers, industrial hygienists, safety professionals, benefit providers).
  • Facilitates continuous improvement through the ongoing evaluation and revision of services.
  • Research into health, safety and wellness services:
  • Collects and analyzes internal and external aggregate data (e.g., vaccination rate, sick-days rate, type of injury, lost days, number of wellness initiatives, number of accommodations, number of job matches).
  • Applies research outcomes to health, safety and wellness services.
  • Communicates research findings to internal and external stakeholders (e.g., publication, research, government agencies reports, legislative reporting).
  • Participates in research to advance the field of occupational health nursing.
  • Cultural sensitivity in health, safety and wellness services:
  • Seeks out ongoing professional development opportunities to enhance cultural competence and cultural safety for themselves, and for their Indigenous colleagues and clients and other marginalized clients (e.g., Black, People of Colour, Sikh, LGBT2Q+, religious minorities).
  • Demonstrates ways to acknowledge and value Indigenous knowledges with respect to the health and well-being of Indigenous clients (e.g., about specific people-groups, about the ways of knowledge transmission: e.g., story-telling).
  • Recognizes the value of Indigenous healing practices and uses them in the treatment of Indigenous clients in collaboration with Indigenous healers and Elders when requested by Indigenous clients.

How to prepare

Work through the topics, read the explanation after each answer, and revisit the areas where you miss questions. Use the official outline and reference materials below to guide your study.

These independent practice questions are not actual exam items and do not guarantee a passing result.

Frequently asked questions

Official sources and references

• CNA Exam Competencies and Blueprints

  Exam Competencies & Blueprints, introductory paragraphs

• CNA Exam Competencies and Blueprints

  Specialty document link

• CNA Occupational Health Nursing Exam Blueprint and Specialty Competencies

  p. 3, Table 1: Competency Sampling

• CNA Occupational Health Nursing Exam Blueprint and Specialty Competencies

  p. 5, Table 2

• CNA General Competencies

  General Competencies

• CNA maid core competencies

  p. 3, competency 1.1

• CNA culture core competencies

  p. 4, competency 1.10

• CNA substance core competencies

  p. 4, competency 1.2

• CNA Occupational Health Nursing Exam Blueprint and Specialty Competencies

  p. 4, Exam Length

• CNA CBT Exam Tips

  CBT exam tips, time budget

• CNA Exam Results and Retesting

  Exam Results and Retesting, first paragraph

• CNA Initial Exam Fees

  Initial Exam Fees, fee table and footnotes

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