CSN CSN Mental Health & Behavioral Support 2 — Questions and Answers
Question 1: A school nurse suspects a student may be experiencing abuse at home based on unexplained bruising and behavioral changes. The nurse's legal obligation is to:
- Consult with the principal before making any report
- Immediately report the suspicion to child protective services as a mandated reporter (Correct answer)
- Gather more evidence over the next few weeks to confirm suspicion
- Inform the parents of the concern before making a report
Correct answer: Immediately report the suspicion to child protective services as a mandated reporter
School nurses are mandated reporters in all US states and must report suspected child abuse immediately without needing proof or supervisor approval.
Question 2: The school nurse is assisting in developing a reintegration plan for a student returning after a psychiatric hospitalization. Which action is MOST important?
- Require the student to have a normal schedule immediately to establish routine
- Coordinate with the treatment team, parents, and school staff to create a gradual return-to-learn plan with appropriate supports (Correct answer)
- Restrict the student from participating in physical education until cleared by the psychiatrist
- Inform all teachers about the student's diagnosis to promote awareness
Correct answer: Coordinate with the treatment team, parents, and school staff to create a gradual return-to-learn plan with appropriate supports
A coordinated, gradual return-to-learn plan developed collaboratively supports the student's successful reintegration and prevents relapse.
Question 3: A student with autism spectrum disorder becomes dysregulated and engages in self-injurious behavior in the health office. The nurse's FIRST response is:
- Physically restrain the student to prevent injury
- Reduce environmental stimulation, speak calmly, and implement the student's known de-escalation strategies from their behavior plan (Correct answer)
- Immediately call the student's parents to take them home
- Send for the school psychologist before taking any action
Correct answer: Reduce environmental stimulation, speak calmly, and implement the student's known de-escalation strategies from their behavior plan
Reducing sensory input and using individualized de-escalation strategies from the student's behavior support plan is the safest evidence-based first response.
Question 4: Following a student suicide at school, the nurse's role in the postvention response includes:
- Immediately announcing the cause of death over the school intercom to prevent rumors
- Participating in the crisis response team, identifying at-risk students, and providing grief support resources (Correct answer)
- Returning to normal health office operations to maintain school routine
- Only communicating with parents — student grief support is the counselor's responsibility
Correct answer: Participating in the crisis response team, identifying at-risk students, and providing grief support resources
School nurses are integral to the crisis response team during postvention, identifying vulnerable students and coordinating mental health support.
Question 5: A student reports that a classmate has been making threats of violence on social media. The school nurse's appropriate action is:
- Advise the reporting student to block the classmate online
- Report the threat to school administration and document the report immediately (Correct answer)
- Assess the classmate medically and determine if they need medication adjustment
- Maintain confidentiality and monitor the situation
Correct answer: Report the threat to school administration and document the report immediately
Threats of violence must be reported to administration immediately; the school nurse documents the report and participates in the threat assessment process.
Question 6: Which statement BEST describes the school nurse's role in a student's Section 504 plan for a mental health condition?
- The school nurse has no formal role in 504 plans
- The nurse provides medical documentation, recommends health-related accommodations, and monitors implementation of health-related plan components (Correct answer)
- The nurse serves as the 504 coordinator for all health-related disabilities
- The nurse approves or denies accommodations based on medical necessity
Correct answer: The nurse provides medical documentation, recommends health-related accommodations, and monitors implementation of health-related plan components
The school nurse contributes medical expertise, recommends health accommodations, and monitors compliance for health-related components of a student's 504 plan.
CSN CSN Mental Health & Behavioral Support 2
A school nurse suspects a student may be experiencing abuse at home based on unexplained bruising and behavioral changes.
The nurse's legal obligation is to: