CSN CSN Mental Health & Behavioral Support 1 — Questions and Answers
Question 1: A student discloses to the school nurse that they have been having thoughts of suicide. The nurse's FIRST action is:
- Contact the student's parents and have them take the student home
- Conduct a safety assessment and ensure the student is not left alone (Correct answer)
- Refer the student directly to the school counselor and return to other duties
- Document the disclosure and schedule a follow-up appointment
Correct answer: Conduct a safety assessment and ensure the student is not left alone
Conducting an immediate safety assessment and maintaining supervision of the student are the first priorities when suicidal ideation is disclosed.
Question 2: Which screening tool is commonly used by school nurses to identify depression in adolescents?
- CAGE Questionnaire
- Patient Health Questionnaire for Adolescents (PHQ-A) (Correct answer)
- AUDIT-C
- Columbia Suicide Severity Rating Scale (C-SSRS)
Correct answer: Patient Health Questionnaire for Adolescents (PHQ-A)
The PHQ-A is a validated, widely used screening tool for depression specifically adapted for adolescents in school health settings.
Question 3: A teacher refers a student for repeated school refusal and somatic complaints with no identifiable medical cause. The school nurse's BEST response is:
- Inform the teacher that the student is faking illness to avoid class
- Conduct a comprehensive assessment including psychosocial history and collaborate with the school counselor (Correct answer)
- Require medical documentation before the student can visit the health office again
- Recommend the student be evaluated for truancy
Correct answer: Conduct a comprehensive assessment including psychosocial history and collaborate with the school counselor
Somatic complaints without organic cause often have a psychosocial basis; a comprehensive assessment and multidisciplinary collaboration are essential.
Question 4: The school nurse is developing a support plan for a student with ADHD. Which intervention is MOST within the school nurse's scope?
- Prescribing a stimulant medication trial
- Coordinating administration of prescribed ADHD medications and communicating with parents and teachers about behavioral patterns (Correct answer)
- Administering psychological testing to confirm the diagnosis
- Designing the student's 504 plan independently
Correct answer: Coordinating administration of prescribed ADHD medications and communicating with parents and teachers about behavioral patterns
The school nurse's role in ADHD management includes safe medication administration, monitoring for side effects, and serving as a communication bridge between home, school, and healthcare providers.
Question 5: A student is exhibiting signs of an acute anxiety attack including rapid breathing, chest tightness, and trembling. After ruling out a medical emergency, the nurse's BEST intervention is:
- Send the student back to class to avoid reinforcing avoidance behavior
- Use grounding techniques and calm reassurance while monitoring vital signs (Correct answer)
- Administer the student's prescribed anxiolytic immediately
- Call the student's parents to pick them up
Correct answer: Use grounding techniques and calm reassurance while monitoring vital signs
Grounding techniques (e.g., 5-4-3-2-1 sensory exercise) and calm reassurance are evidence-based first-line interventions for acute anxiety.
Question 6: Under FERPA and HIPAA, when may a school nurse share a student's mental health information with a teacher without parental consent?
- Whenever the teacher asks, as they have a professional need to know
- Never — mental health information is absolutely protected in all circumstances
- When it is necessary to protect the health or safety of the student or others in an emergency (Correct answer)
- Only after obtaining written consent from the student if they are 18
Correct answer: When it is necessary to protect the health or safety of the student or others in an emergency
FERPA permits disclosure of student records without consent when there is a legitimate safety emergency requiring immediate action to protect the student or others.
CSN CSN Mental Health & Behavioral Support 1
A student discloses to the school nurse that they have been having thoughts of suicide.
The nurse's FIRST action is: