Question 1: A school nurse is reviewing an asthma action plan for a student. The green zone indicates peak flow readings of 80-100% of personal best. What does this mean for daily management?

• The student should be sent home as a precaution
• The student should use their rescue inhaler every 4 hours prophylactically
• The student can proceed with normal activities and does not need rescue medication (Correct answer)
• The student must stay in the nurse's office all day

Correct answer: The student can proceed with normal activities and does not need rescue medication

The green zone (80-100% of personal best) indicates good asthma control, allowing normal activity without the need for rescue medication.

Question 2: Why is it important for school nurses to understand legal requirements regarding student health?

• To influence teacher scheduling.
• To ensure compliance with state laws and ensure student safety. (Correct answer)
• To avoid administrative duties.
• To monitor classroom behavior.

Correct answer: To ensure compliance with state laws and ensure student safety.

It is important for school nurses to understand legal requirements regarding student health to ensure compliance with state laws and ensure student safety. This knowledge guides their scope of practice, documentation, confidentiality practices, and emergency response, protecting both the students and the school from legal liabilities. Adherence to laws ensures ethical and responsible care.

Question 3: A student is found with a nosebleed that has lasted 20 minutes without stopping. The school nurse should:

• Have the student lean forward, pinch the nose, and activate EMS if bleeding continues (Correct answer)
• Continue nasal pressure and tilt the head back
• Pack the nose with gauze and send the student back to class
• Apply ice to the forehead to constrict nasal vessels

Correct answer: Have the student lean forward, pinch the nose, and activate EMS if bleeding continues

Leaning forward prevents blood from going down the throat; a nosebleed not controlled after 20 minutes warrants EMS activation.

Question 4: Why should school nurses document student health assessments?

• To evaluate classroom activities.
• To monitor attendance rates.
• To maintain accurate health records for legal and care coordination purposes. (Correct answer)
• To track academic performance.

Correct answer: To maintain accurate health records for legal and care coordination purposes.

School nurses must meticulously document student health assessments to maintain accurate and comprehensive health records. These records serve as a vital legal document, protecting both the student and the school by detailing all health-related interactions, interventions, and communications. Furthermore, accurate documentation is essential for effective care coordination, ensuring that all school staff and external healthcare providers have the necessary information to support the student's health needs consistently.

Question 5: Which statement BEST describes the school nurse's role in a student's Section 504 plan for a mental health condition?

• The nurse serves as the 504 coordinator for all health-related disabilities
• The nurse approves or denies accommodations based on medical necessity
• The nurse provides medical documentation, recommends health-related accommodations, and monitors implementation of health-related plan components (Correct answer)
• The school nurse has no formal role in 504 plans

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.

Question 6: What is the primary goal of health education in schools?

• To increase student academic performance.
• To monitor students' behavior.
• To reduce class disruptions.
• To educate students about healthy habits and disease prevention. (Correct answer)

Correct answer: To educate students about healthy habits and disease prevention.

The primary goal of health education in schools is to equip students with the knowledge and skills necessary to adopt and maintain healthy habits and prevent diseases. By teaching about nutrition, physical activity, hygiene, and risk behaviors, students learn to make informed choices that positively impact their physical and mental well-being. This foundational education empowers them to lead healthier lives and contribute to a healthier community.

Question 7: Which action is MOST appropriate when a student presents with signs of a diabetic emergency but the nurse cannot determine if it is hypoglycemia or hyperglycemia?

• Withhold all treatment until a blood glucose reading is obtained
• Call the parent and wait for further instructions
• Administer oral glucose if the student is conscious and able to swallow (Correct answer)
• Inject glucagon immediately

Correct answer: Administer oral glucose if the student is conscious and able to swallow

If blood glucose cannot be checked and the student is conscious and able to swallow, giving oral glucose is safe because treating hypoglycemia with sugar is life-saving while mild additional glucose in hyperglycemia is not immediately harmful.

Question 8: A parent requests that their child with ADHD receive methylphenidate at lunch in the school nurse's office. What is the school nurse's primary responsibility before administering this medication?

• Administer the medication based solely on parental verbal instructions
• Confirm the student's behavior in class with the teacher before giving medication
• Adjust the dose based on the student's classroom performance that day
• Verify a current signed physician's order and signed parental consent form are on file (Correct answer)

Correct answer: Verify a current signed physician's order and signed parental consent form are on file

A valid physician's written order and signed parental consent are mandatory legal and safety requirements before a school nurse may administer any prescription medication.

Question 9: What infection control measure is most critical during patient care standards procedures?

• Wearing a mask at all times regardless of procedure
• Wearing gloves only when visible contamination is present
• Using hand sanitizer once per shift
• Performing hand hygiene before and after every patient contact (Correct answer)

Correct answer: Performing hand hygiene before and after every patient contact

Hand hygiene before and after every patient contact is the single most effective measure for preventing healthcare-associated infections.

Question 10: What is the nurse's primary responsibility in infection control?

• Following physician orders without question
• Completing documentation as quickly as possible
• Advocating for patient safety and well-being (Correct answer)
• Minimizing time spent with each patient

Correct answer: Advocating for patient safety and well-being

In infection control, the nurse's primary responsibility is advocating for patient safety and well-being through competent, evidence-based care.

Question 11: A student with cystic fibrosis needs to perform airway clearance therapy (ACT) at school. How should the school nurse facilitate this need?

• Coordinate a private space, train designated staff, and incorporate ACT into the student's IHP (Correct answer)
• Recommend the student complete ACT exclusively at home before and after school
• Deny the request because medical procedures cannot be performed at school
• Allow the therapy only if a parent is present during every session

Correct answer: Coordinate a private space, train designated staff, and incorporate ACT into the student's IHP

Under Section 504 and IDEA, schools must provide necessary health services; the nurse facilitates ACT by establishing a plan, ensuring trained personnel, and documenting the procedure in the IHP.

Question 12: A student is brought to the health office with a 2-inch laceration on the forearm that is bleeding heavily. Which intervention is the FIRST priority?

• Apply a tourniquet proximal to the wound
• Assess the student's tetanus immunization status
• Apply direct pressure with a clean cloth or gauze (Correct answer)
• Irrigate the wound with normal saline

Correct answer: Apply direct pressure with a clean cloth or gauze

Direct pressure is the first-line intervention for controlling hemorrhage from a laceration.

Question 13: Many students and families in the district, according to a school nurse who works with elementary and middle school students, might benefit from the services offered by family health and human services organizations. Which of the following tactics is most likely to be successful in helping families use these services, according to the school nurse?

• educating students about the types of support their families are eligible to receive through health and human services agencies
• asking health and human services agencies to provide information that the nurse can share and discuss with all families (Correct answer)
• providing relevant health and human services agencies with contact information for families who appear to be in the greatest need
• requesting that health and human services agencies maintain a sign-up sheet at the school for families to request assistance

Correct answer: asking health and human services agencies to provide information that the nurse can share and discuss with all families

A school nurse's primary responsibilities include informing kids and families about community and governmental options for health-related issues and aiding families in finding resources to address the physical, mental, and emotional needs of pupils. The school nurse can respond quickly and link families to necessary services by forming and maintaining ties with neighborhood organizations, doctors, and health advocacy groups. For instance, school nurses might help families sign up for state or federal health insurance programs or find groups that support students with physical or mental challenges.

Question 14: A student with a history of bipolar disorder is observed to be extremely energetic, speaking rapidly, and claiming they haven't slept in three days. The school nurse should:

• Assess the student, contact the parent regarding possible manic episode, and recommend evaluation by the student's psychiatrist (Correct answer)
• Encourage the student to rest and return to class when calmer
• Restrict the student from all activities until they see a doctor next week
• Administer a PRN sedative from the student's emergency medication file

Correct answer: Assess the student, contact the parent regarding possible manic episode, and recommend evaluation by the student's psychiatrist

Symptoms of mania including decreased need for sleep and pressured speech require prompt parent notification and psychiatric evaluation.

Question 15: How can school nurses help ensure a healthy school environment?

• By focusing on academics.
• By following health policies, conducting screenings, and educating students and staff. (Correct answer)
• By monitoring student behavior.
• By focusing on school sports.

Correct answer: By following health policies, conducting screenings, and educating students and staff.

School nurses help ensure a healthy school environment by following health policies, conducting screenings, and educating students and staff. These actions proactively identify health concerns, prevent the spread of illness, and empower the school community with health knowledge. Their comprehensive approach contributes significantly to a safe and supportive learning atmosphere.

Question 16: How should a nurse respond to a change in patient condition during care planning?

• Wait for the physician to notice during rounds
• Immediately assess, intervene if within scope, and notify the provider using SBAR (Correct answer)
• Document the change and move to the next patient
• Ask a family member for their opinion first

Correct answer: Immediately assess, intervene if within scope, and notify the provider using SBAR

Prompt assessment, appropriate intervention, and structured communication using SBAR ensures rapid response to changes in patient condition.

Question 17: Which medical information must be provided to each state before a student can enroll in school?

• Birth information including weight and height.
• Notes for possible changes in after-school care.
• Immunization record for the student. (Correct answer)
• Mother and Father’s history with significant illness.

Correct answer: Immunization record for the student.

State laws include requirements for immunization records, and parents who opt not to immunize their children must sign a release. In the event of an epidemic of an infectious disease, it is critical for the school nurse to be aware of which pupils lack the necessary vaccinations. Birth information, after-school care history, and parental health history are solely sought on a school-by-school basis and are not required by the state.

Question 18: A teacher refers a student for repeated school refusal and somatic complaints with no identifiable medical cause. The school nurse's BEST response is:

• Recommend the student be evaluated for truancy
• Inform the teacher that the student is faking illness to avoid class
• Require medical documentation before the student can visit the health office again
• Conduct a comprehensive assessment including psychosocial history and collaborate with the school counselor (Correct answer)

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 19: Which of the following best sums up a reason backed by research for why school nurses are urged to maintain extra supplies of epinephrine on hand in addition to the stockpiled medication for individual students?

• In addition to treating anaphylaxis, epinephrine can also be used in heart-related emergencies involving asystole.
• Epinephrine administrations by teachers or other lay people are often ineffective on the first dose; school nurse–administered second doses are often needed.
• A significant number of epinephrine administrations to students are for allergies unknown at the time of anaphylaxis. (Correct answer)
• Because epinephrine deteriorates over time, the shelf life of epinephrine auto-injectors is typically only one year; therefore, backup supplies are needed.

Correct answer: A significant number of epinephrine administrations to students are for allergies unknown at the time of anaphylaxis.

Maintaining a nonpatient supply of epinephrine to give in the event of life-threatening events at schools is supported by an official policy statement from the National Association of School Nurses (NASNN A S N). Nearly 25% of all epinephrine administrations in K–12 schools involved students or employees who were unaware they had a life-threatening allergy, according to a two-year study of 48 school districts that was published in the journal Pediatrics. According to the Illinois Emergency Epinephrine Act, schools are permitted to keep epinephrine auto-injectors on hand, and school nurses are authorized to give epinephrine to any student they suspect is having anaphylaxis.

Question 20: When a conflict arises during medication administration, what is the appropriate nursing action?

• Ignore the conflict and continue working
• Document concerns on social media
• Use the chain of command to escalate concerns through proper channels (Correct answer)
• Confront the individual publicly

Correct answer: Use the chain of command to escalate concerns through proper channels

The chain of command provides an established pathway for resolving conflicts and escalating concerns appropriately.

Question 21: What assessment technique is fundamental to patient care standards?

• Reading the previous shift's notes only
• Relying solely on monitor readings
• Checking only the chief complaint area
• Systematic head-to-toe assessment combined with patient interview (Correct answer)

Correct answer: Systematic head-to-toe assessment combined with patient interview

A systematic head-to-toe assessment combined with patient interview provides the comprehensive data needed for safe nursing care.

Question 22: How should a nurse prioritize tasks related to infection control?

• By room number sequence
• Based on the acuity and urgency of patient needs (Correct answer)
• According to family member requests
• Alphabetical order of patient names

Correct answer: Based on the acuity and urgency of patient needs

Task prioritization in nursing should always be based on patient acuity and the urgency of clinical needs.

Question 23: Which of the following BEST describes the school nurse's role in transitioning a student with a complex chronic condition from elementary to middle school?

• Collaborate with the student, family, new school nurse, and healthcare team to update the IHP and ECP and orient new staff (Correct answer)
• Advise the family to seek a private school with more resources
• Withhold health information until the parent formally requests a transfer
• Transfer all records and assume the new school will handle everything independently

Correct answer: Collaborate with the student, family, new school nurse, and healthcare team to update the IHP and ECP and orient new staff

Transition planning requires proactive collaboration among the student, family, healthcare providers, and receiving school staff to ensure continuity of care and updated, accurate health documentation.

Question 24: A student is found unresponsive and not breathing normally. What is the school nurse's FIRST action?

• Administer epinephrine from the emergency kit
• Place the student in the recovery position
• Begin rescue breathing immediately
• Activate the emergency response system and call 911 (Correct answer)

Correct answer: Activate the emergency response system and call 911

Activating the emergency response system and calling 911 is the first step in any cardiac emergency to ensure advanced help is en route.

Question 25: Which type of health education program is most beneficial for students?

• Programs focusing solely on disease prevention.
• Programs focused on fitness only.
• Comprehensive health education programs that cover nutrition, mental health, and physical activity. (Correct answer)
• Academic-focused health education.

Correct answer: Comprehensive health education programs that cover nutrition, mental health, and physical activity.

Comprehensive health education programs are most beneficial because they address the multifaceted nature of student health. By covering nutrition, mental health, and physical activity, these programs provide a holistic understanding of well-being. This integrated approach ensures students develop a broad range of knowledge and skills necessary for a healthy life.

Question 26: How should a nurse prioritize tasks related to clinical procedures?

• Alphabetical order of patient names
• According to family member requests
• Based on the acuity and urgency of patient needs (Correct answer)
• By room number sequence

Correct answer: Based on the acuity and urgency of patient needs

Task prioritization in nursing should always be based on patient acuity and the urgency of clinical needs.

Question 27: A student with a known seizure disorder has a generalized tonic-clonic seizure lasting 2 minutes and then stops. The student is postictal and breathing normally. What should the school nurse do next?

• Administer emergency anti-seizure medication immediately
• Restrain the student to prevent injury during the postictal phase
• Begin CPR because the student is unresponsive
• Place the student in the recovery position and monitor airway, breathing, and circulation (Correct answer)

Correct answer: Place the student in the recovery position and monitor airway, breathing, and circulation

After a self-resolving seizure, placing the student in the recovery position protects the airway and allows monitoring while the student recovers from the postictal state.

Question 28: What is an effective method for promoting healthy behaviors in schools?

• Encouraging regular physical activity and healthy eating. (Correct answer)
• Focusing on academic subjects.
• Offering rewards for healthy eating.
• Increasing homework assignments.

Correct answer: Encouraging regular physical activity and healthy eating.

Encouraging regular physical activity and healthy eating is a direct and proactive method for promoting healthy behaviors. This approach focuses on instilling positive habits and knowledge in students, which are fundamental for long-term well-being. It goes beyond temporary incentives to foster a culture of health within the school community.

Question 29: Which chronic condition requires the school nurse to monitor for signs of adrenal crisis, including sudden hypotension, vomiting, and extreme fatigue?

• Cystic fibrosis
• Juvenile idiopathic arthritis
• Tourette syndrome
• Addison's disease (primary adrenal insufficiency) (Correct answer)

Correct answer: Addison's disease (primary adrenal insufficiency)

Students with Addison's disease are at risk for life-threatening adrenal crisis during physical or emotional stress because their adrenal glands cannot produce adequate cortisol.

Question 30: What infection control measure is most critical during clinical procedures procedures?

• Wearing gloves only when visible contamination is present
• Wearing a mask at all times regardless of procedure
• Using hand sanitizer once per shift
• Performing hand hygiene before and after every patient contact (Correct answer)

Correct answer: Performing hand hygiene before and after every patient contact

Hand hygiene before and after every patient contact is the single most effective measure for preventing healthcare-associated infections.

Question 31: A student with Type 2 diabetes has a blood glucose reading of 312 mg/dL at lunchtime and reports feeling fatigued and thirsty. No insulin is ordered for school administration. What is the nurse's BEST action?

• Give the student a snack and recheck glucose in one hour
• Send the student back to class and document at end of day
• Notify the parent/guardian and healthcare provider per the student's care plan and document the event (Correct answer)
• Administer insulin from the school's general supply

Correct answer: Notify the parent/guardian and healthcare provider per the student's care plan and document the event

Without specific insulin orders for school, the nurse must follow the student's care plan, which typically directs notification of parents and the provider when glucose exceeds established thresholds.

Question 32: Which screening tool is commonly used by school nurses to identify depression in adolescents?

• CAGE Questionnaire
• Columbia Suicide Severity Rating Scale (C-SSRS)
• Patient Health Questionnaire for Adolescents (PHQ-A) (Correct answer)
• AUDIT-C

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 33: 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:

• Inform the parents of the concern before making a report
• Consult with the principal before making any report
• Gather more evidence over the next few weeks to confirm suspicion
• Immediately report the suspicion to child protective services as a mandated reporter (Correct answer)

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 34: How should a nurse prioritize tasks related to health assessment?

• Based on the acuity and urgency of patient needs (Correct answer)
• By room number sequence
• According to family member requests
• Alphabetical order of patient names

Correct answer: Based on the acuity and urgency of patient needs

Task prioritization in nursing should always be based on patient acuity and the urgency of clinical needs.

Question 35: Why are school health policies important for school nurses?

• They monitor student academic progress.
• They help in organizing classroom activities.
• They ensure that health care practices align with legal and professional standards. (Correct answer)
• They regulate teacher conduct.

Correct answer: They ensure that health care practices align with legal and professional standards.

School health policies are important for school nurses because they ensure that health care practices align with legal and professional standards. These policies provide a framework for the nurse's responsibilities, scope of practice, and procedures, guiding their actions and ensuring consistency and compliance. They protect both the students receiving care and the nurse providing it.

Question 36: When providing first aid for a student with a suspected fracture of the forearm, the school nurse should:

• Attempt to realign the bone before splinting
• Apply heat to reduce swelling and pain
• Splint the limb in the position found and immobilize joints above and below the injury (Correct answer)
• Encourage the student to move the arm to assess range of motion

Correct answer: Splint the limb in the position found and immobilize joints above and below the injury

Splinting in the position found and immobilizing the joints above and below the fracture site prevents further injury and reduces pain.

Question 37: A student returns to school after hospitalization for a severe asthma exacerbation. What is the MOST important nursing action before the student's return?

• Update the asthma action plan with the student's current medication regimen and confirm emergency medication is available (Correct answer)
• Place the student on permanent indoor recess restriction
• Require weekly physician visits before allowing the student to attend school
• Schedule the student to retake all missed exams immediately

Correct answer: Update the asthma action plan with the student's current medication regimen and confirm emergency medication is available

After hospitalization, the asthma action plan must reflect any medication changes, and emergency medications must be current and accessible to ensure safe return to school.

Question 38: What is one key legal responsibility for school nurses?

• To enforce the school dress code.
• To monitor academic grades.
• To ensure student health information is kept confidential. (Correct answer)
• To supervise classroom behavior.

Correct answer: To ensure student health information is kept confidential.

One key legal responsibility for school nurses is to ensure student health information is kept confidential. This is mandated by federal laws such as the Family Educational Rights and Privacy Act (FERPA) and, in some cases, the Health Insurance Portability and Accountability Act (HIPAA). Upholding confidentiality protects student privacy and maintains trust within the school community.

Question 39: Why should school nurses participate in policy development?

• To focus on student behavior.
• To reduce teacher workload.
• To ensure that health policies meet the needs of students and comply with laws. (Correct answer)
• To increase school funding.

Correct answer: To ensure that health policies meet the needs of students and comply with laws.

School nurses should participate in policy development to ensure that health policies meet the specific needs of students and comply with relevant laws. Their expertise provides a crucial perspective on the practical implications and effectiveness of policies, ensuring they are student-centered, evidence-based, and legally sound. This involvement strengthens the overall health framework of the school.

Question 40: When a conflict arises during clinical procedures, what is the appropriate nursing action?

• Use the chain of command to escalate concerns through proper channels (Correct answer)
• Confront the individual publicly
• Ignore the conflict and continue working
• Document concerns on social media

Correct answer: Use the chain of command to escalate concerns through proper channels

The chain of command provides an established pathway for resolving conflicts and escalating concerns appropriately.

Question 41: 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)
• Send for the school psychologist before taking any action
• Immediately call the student's parents to take them home

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 42: A student collapses on the athletic field and has no pulse. The AED is 2 minutes away. The school nurse should:

• Wait for the AED before starting any intervention
• Give 2 rescue breaths before starting compressions
• Check for pulse every minute until the AED arrives
• Begin high-quality CPR immediately while someone retrieves the AED (Correct answer)

Correct answer: Begin high-quality CPR immediately while someone retrieves the AED

High-quality CPR must begin immediately to maintain perfusion; the AED is brought to the nurse, not the other way around.

Question 43: What is the nurse's primary responsibility in health assessment?

• Advocating for patient safety and well-being (Correct answer)
• Following physician orders without question
• Completing documentation as quickly as possible
• Minimizing time spent with each patient

Correct answer: Advocating for patient safety and well-being

In health assessment, the nurse's primary responsibility is advocating for patient safety and well-being through competent, evidence-based care.

Question 44: Why is it important for school nurses to follow legal and ethical guidelines?

• To ensure that care provided is safe, ethical, and legally sound. (Correct answer)
• To avoid professional scrutiny.
• To meet student expectations.
• To avoid additional responsibilities.

Correct answer: To ensure that care provided is safe, ethical, and legally sound.

It is important for school nurses to follow legal and ethical guidelines to ensure that the care provided is safe, ethical, and legally sound. Adherence to these standards protects students' rights, ensures quality of care, and safeguards the nurse from professional misconduct claims. This commitment upholds the integrity of the nursing profession and the school's health services.

Question 45: A student with hemophilia sustains a knee injury with visible swelling. The school nurse should:

• Administer ibuprofen for pain and swelling
• Apply heat to promote blood flow and reduce stiffness
• Apply R.I.C.E. and contact the student's parent and hematologist promptly (Correct answer)
• Apply a compression bandage and have the student walk it off

Correct answer: Apply R.I.C.E. and contact the student's parent and hematologist promptly

Students with hemophilia require prompt parental and specialist notification for joint bleeds, which can cause permanent joint damage without factor replacement.

Question 46: A student presents with signs of heat stroke: hot dry skin, temperature of 104°F, and altered mental status. The MOST important immediate intervention is:

• Begin rapid cooling by removing clothing and applying cool water or ice packs to pulse points, and call 911 (Correct answer)
• Move the student to an air-conditioned room and monitor closely
• Administer acetaminophen to reduce the fever
• Give the student cool water to drink to rehydrate

Correct answer: Begin rapid cooling by removing clothing and applying cool water or ice packs to pulse points, and call 911

Heat stroke is a life-threatening emergency; rapid cooling and EMS activation are the immediate priorities, and oral fluids are contraindicated in an altered-consciousness patient.

Question 47: How should a nurse respond to a change in patient condition during clinical procedures?

• Document the change and move to the next patient
• Immediately assess, intervene if within scope, and notify the provider using SBAR (Correct answer)
• Wait for the physician to notice during rounds
• Ask a family member for their opinion first

Correct answer: Immediately assess, intervene if within scope, and notify the provider using SBAR

Prompt assessment, appropriate intervention, and structured communication using SBAR ensures rapid response to changes in patient condition.

Question 48: What is a common method for health promotion in schools?

• Organizing school health fairs.
• Conducting health education sessions and campaigns. (Correct answer)
• Scheduling doctor visits for every student.
• Monitoring sports activities.

Correct answer: Conducting health education sessions and campaigns.

A common and effective method for health promotion in schools is conducting regular health education sessions and campaigns. These initiatives provide students with vital information on topics such as nutrition, hygiene, mental health, and disease prevention. By actively engaging students through structured learning and awareness campaigns, school nurses empower them to make informed decisions and adopt healthy lifestyle choices that benefit their long-term well-being.

Question 49: What kind of solace can you provide a pupil who has ear pain?

• Apply warm packs to the external ear. (Correct answer)
• Schedule a doctor’s appointment.
• Apply ice packs.
• Irrigate the ears.

Correct answer: Apply warm packs to the external ear.

The child with ear discomfort will feel better if you apply a warm compress to the troublesome ear on the outside. Ice or extremely cold temperatures shouldn't be used because they can make ear pain worse. The purpose of ear irrigation is often to remove impacted cerumen or foreign items from the ear canal and is not a suitable remedy for ear pain. If the pain doesn't go away or if the child develops a fever, tell the parents to make an appointment with a doctor.

Question 50: What assessment technique is fundamental to care planning?

• Systematic head-to-toe assessment combined with patient interview (Correct answer)
• Relying solely on monitor readings
• Reading the previous shift's notes only
• Checking only the chief complaint area

Correct answer: Systematic head-to-toe assessment combined with patient interview

A systematic head-to-toe assessment combined with patient interview provides the comprehensive data needed for safe nursing care.

Question 51: How should a nurse prioritize tasks related to patient care standards?

• Alphabetical order of patient names
• By room number sequence
• According to family member requests
• Based on the acuity and urgency of patient needs (Correct answer)

Correct answer: Based on the acuity and urgency of patient needs

Task prioritization in nursing should always be based on patient acuity and the urgency of clinical needs.

Question 52: Why is health education important for students?

• It empowers students to make healthy choices. (Correct answer)
• It enhances physical fitness.
• It prepares students for careers.
• It improves test scores.

Correct answer: It empowers students to make healthy choices.

Health education is critically important for students because it empowers them with the knowledge and skills to make informed, healthy choices throughout their lives. By understanding topics like nutrition, mental health, and disease prevention, students can take an active role in managing their own well-being. This empowerment leads to better health outcomes, reduced risk of chronic diseases, and a greater capacity to thrive academically and personally.

Question 53: Which documentation should be maintained in the school health record for every student with a chronic health condition?

• Only emergency contact information and allergy list
• A copy of all physician visit notes from the past five years
• Teacher observation logs of classroom behavior
• An Individualized Healthcare Plan (IHP) and Emergency Care Plan (ECP) with current medical orders (Correct answer)

Correct answer: An Individualized Healthcare Plan (IHP) and Emergency Care Plan (ECP) with current medical orders

An IHP outlines routine daily management while an ECP details emergency response steps; both are required and must be supported by current medical orders from the healthcare provider.

Question 54: What assessment technique is fundamental to medication administration?

• Systematic head-to-toe assessment combined with patient interview (Correct answer)
• Checking only the chief complaint area
• Relying solely on monitor readings
• Reading the previous shift's notes only

Correct answer: Systematic head-to-toe assessment combined with patient interview

A systematic head-to-toe assessment combined with patient interview provides the comprehensive data needed for safe nursing care.

Question 55: Which of the following is the recommended blood glucose range for managing a student with Type 1 diabetes during the school day according to standard guidelines?

• 70-180 mg/dL (Correct answer)
• 40-70 mg/dL
• 180-300 mg/dL
• 200-250 mg/dL

Correct answer: 70-180 mg/dL

A blood glucose range of 70-180 mg/dL is generally considered a safe target range during school hours to prevent both hypoglycemia and hyperglycemia.

Question 56: How can school nurses maintain professional boundaries with students?

• By socializing with students outside of school hours.
• By sharing personal information with students.
• By establishing clear roles and professional limits. (Correct answer)
• By offering rewards for students' good behavior.

Correct answer: By establishing clear roles and professional limits.

School nurses maintain professional boundaries with students by establishing clear roles and professional limits. This involves defining the nature of their relationship as a healthcare provider and educator, avoiding personal disclosures, and refraining from social interactions outside of their professional capacity. Clear boundaries are essential for fostering trust, respect, and a safe therapeutic environment.

Question 57: A student is suspected of having a severe asthma attack and does not have their rescue inhaler at school. The school nurse should:

• Administer epinephrine from the emergency kit as a substitute
• Send the student home immediately to use their inhaler
• Use a stock albuterol inhaler per standing orders and call 911 if no improvement (Correct answer)
• Have the student sit quietly until their parent arrives with the inhaler

Correct answer: Use a stock albuterol inhaler per standing orders and call 911 if no improvement

Many states allow schools to stock albuterol for emergencies; using it per physician standing orders while monitoring and calling 911 if needed is the appropriate protocol.

Question 58: What is the nurse's primary responsibility in patient care standards?

• Minimizing time spent with each patient
• Completing documentation as quickly as possible
• Following physician orders without question
• Advocating for patient safety and well-being (Correct answer)

Correct answer: Advocating for patient safety and well-being

In patient care standards, the nurse's primary responsibility is advocating for patient safety and well-being through competent, evidence-based care.

Question 59: A student who is experiencing lightheadedness requests the nurse's assistance in the gym. The child is described by the nurse as being pale and diaphoretic. His baseline heart rate is greater than 180. What should the nurse do as soon as possible?

• Scream for someone to call 911 now.
• Bring the student to the nursing office to rest and excuse the student from gym for the remainder of the period.
• Call the student’s parents or emergency contact to pick up the student, and excuse the student from gym for the remainder of the week.
• Reassure the child, apply cool rags to the forehead, reassess, and be prepared to call the parents and 911. (Correct answer)

Correct answer: Reassure the child, apply cool rags to the forehead, reassess, and be prepared to call the parents and 911.

The shift into a risky rhythm, such as supraventricular tachycardia, may occur at a pulse rate of 180, which is extremely high and dangerous (tachycardia). The fact that the pupil is dizzy indicates that the tachycardia is unstable and impairing the child's capacity to perfuse vital organs. In order to swiftly identify whether emergency treatment is required or if the child grew overheated during activity, the school nurse must maintain the child's composure, provide a cool cloth for comfort, and review the pulse rate after a brief break. The child's heart rate can be naturally lowered by applying a cool cloth (or piece of ice) to the head. Regardless of the reasons, parents should be informed and advised to take their children for evaluation. Call 911 and the parents for a cardiac evaluation if the child's symptoms persist after a few minutes of rest since a sustained heart rate of 180 is too high to allow adequate perfusion.

Question 60: A student with celiac disease needs accommodations in the school cafeteria. Which nursing action BEST supports this student's chronic disease management?

• Collaborate with food service staff and the family to ensure a completely gluten-free meal plan (Correct answer)
• Notify the student's teacher to monitor for behavioral changes after lunch
• Recommend the student bring lunch from home and take no further action
• Advise the student to simply avoid bread during lunch

Correct answer: Collaborate with food service staff and the family to ensure a completely gluten-free meal plan

Comprehensive collaboration with food service and the family ensures a safe, completely gluten-free environment, which is medically necessary for students with celiac disease.

Question 61: A school nurse is screening students and identifies a 10-year-old with a BMI at the 97th percentile. What is the nurse's BEST initial response?

• Conduct a holistic assessment, communicate confidentially with the family, and refer to the healthcare provider (Correct answer)
• Immediately place the student on a calorie-restricted diet at school
• Announce results to the student's teacher for classroom monitoring
• Advise the student to exercise more and eat less

Correct answer: Conduct a holistic assessment, communicate confidentially with the family, and refer to the healthcare provider

A confidential, holistic approach—including family communication and referral—is the standard of care to address childhood obesity while preserving dignity and avoiding stigmatization.

Question 62: How should a nurse prioritize tasks related to medication administration?

• According to family member requests
• Alphabetical order of patient names
• By room number sequence
• Based on the acuity and urgency of patient needs (Correct answer)

Correct answer: Based on the acuity and urgency of patient needs

Task prioritization in nursing should always be based on patient acuity and the urgency of clinical needs.

Question 63: What is the role of ethics in school nursing practice?

• Ethics help guide decisions that protect students and promote trust. (Correct answer)
• Ethics are only important in emergencies.
• Ethics are irrelevant to school nursing.
• Ethics only apply to medical professionals outside of schools.

Correct answer: Ethics help guide decisions that protect students and promote trust.

Ethics play a crucial role in school nursing practice by guiding decisions that protect students and promote trust. Ethical principles ensure that nurses act in the best interest of students, respect their autonomy, maintain confidentiality, and provide equitable care. This framework builds confidence in the nurse's professional judgment and fosters a safe, supportive environment.

Question 64: What infection control measure is most critical during care planning procedures?

• Performing hand hygiene before and after every patient contact (Correct answer)
• Wearing a mask at all times regardless of procedure
• Using hand sanitizer once per shift
• Wearing gloves only when visible contamination is present

Correct answer: Performing hand hygiene before and after every patient contact

Hand hygiene before and after every patient contact is the single most effective measure for preventing healthcare-associated infections.

Question 65: A student with peanut allergy begins showing signs of anaphylaxis including hives, throat tightening, and difficulty breathing. What is the nurse's immediate priority intervention?

• Administer an oral antihistamine and observe
• Give the student water to drink and have them sit down
• Administer epinephrine via auto-injector and call 911 (Correct answer)
• Apply a cool compress and wait for symptoms to resolve

Correct answer: Administer epinephrine via auto-injector and call 911

Epinephrine is the only effective first-line treatment for anaphylaxis; antihistamines alone are insufficient for a life-threatening allergic reaction, and 911 must be called for emergency transport.

Question 66: Following a student suicide at school, the nurse's role in the postvention response includes:

• Only communicating with parents — student grief support is the counselor's responsibility
• 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
• Immediately announcing the cause of death over the school intercom to prevent rumors

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 67: A student sustains a suspected cervical spine injury after a fall. The school nurse should:

• Apply a cervical collar from the first aid kit
• Have the student walk to the health office for assessment
• Immobilize the head and neck and avoid moving the student (Correct answer)
• Help the student to a chair to keep them comfortable

Correct answer: Immobilize the head and neck and avoid moving the student

Immobilizing the head and neck in the position found and avoiding movement protects against worsening a potential spinal cord injury.

Question 68: When a conflict arises during care planning, what is the appropriate nursing action?

• Document concerns on social media
• Ignore the conflict and continue working
• Use the chain of command to escalate concerns through proper channels (Correct answer)
• Confront the individual publicly

Correct answer: Use the chain of command to escalate concerns through proper channels

The chain of command provides an established pathway for resolving conflicts and escalating concerns appropriately.

Question 69: What assessment technique is fundamental to infection control?

• Systematic head-to-toe assessment combined with patient interview (Correct answer)
• Relying solely on monitor readings
• Checking only the chief complaint area
• Reading the previous shift's notes only

Correct answer: Systematic head-to-toe assessment combined with patient interview

A systematic head-to-toe assessment combined with patient interview provides the comprehensive data needed for safe nursing care.

Question 70: A student with a history of absence seizures frequently stares blankly during class and does not respond. Teachers believe the student is daydreaming. What is the school nurse's BEST role?

• Discipline the student for inattentiveness
• Advise teachers to seat the student in the back of the room
• Educate teachers about absence seizure characteristics and develop a classroom observation plan (Correct answer)
• Recommend the student change schools

Correct answer: Educate teachers about absence seizure characteristics and develop a classroom observation plan

Educating staff helps them distinguish absence seizures from inattention, enabling accurate observation, documentation, and timely communication with parents and healthcare providers.

Question 71: How can a school nurse assist in managing students with chronic health conditions?

• Monitoring classroom behavior.
• Sending students home when they feel sick.
• Creating individualized health plans and educating staff. (Correct answer)
• Providing long-term medication prescriptions.

Correct answer: Creating individualized health plans and educating staff.

School nurses assist in managing students with chronic health conditions by creating individualized health plans (IHPs) tailored to each student's specific needs. These plans detail medication administration, emergency procedures, and daily care requirements. Furthermore, nurses educate school staff, including teachers and administrators, on how to recognize symptoms, respond to emergencies, and support the student's health needs throughout the school day, ensuring a safe and inclusive environment.

Question 72: What is the nurse's primary responsibility in clinical procedures?

• Completing documentation as quickly as possible
• Minimizing time spent with each patient
• Advocating for patient safety and well-being (Correct answer)
• Following physician orders without question

Correct answer: Advocating for patient safety and well-being

In clinical procedures, the nurse's primary responsibility is advocating for patient safety and well-being through competent, evidence-based care.

Question 73: A student is referred for suspected eating disorder behaviors including skipping meals and excessive exercise. The school nurse's BEST initial action is:

• Send a letter home to the parents describing the concerning behaviors
• Inform the physical education teacher to restrict the student's exercise
• Weigh the student daily and report results to the coach
• Conduct a private, non-judgmental assessment and refer to an eating disorder specialist while maintaining a trusting relationship (Correct answer)

Correct answer: Conduct a private, non-judgmental assessment and refer to an eating disorder specialist while maintaining a trusting relationship

A private, non-judgmental conversation that leads to appropriate referral preserves trust while ensuring the student receives specialized evaluation.

Question 74: How should a nurse prioritize tasks related to care planning?

• According to family member requests
• By room number sequence
• Alphabetical order of patient names
• Based on the acuity and urgency of patient needs (Correct answer)

Correct answer: Based on the acuity and urgency of patient needs

Task prioritization in nursing should always be based on patient acuity and the urgency of clinical needs.

Question 75: A student with sickle cell disease reports sudden severe pain in their chest and arms and is having difficulty breathing. What condition should the school nurse suspect and how should they respond?

• Musculoskeletal strain; apply ice and rest the student
• Asthma exacerbation; administer rescue inhaler and monitor
• Acute chest syndrome; activate EMS and notify parents immediately (Correct answer)
• Anxiety attack; administer calm reassurance and deep breathing exercises

Correct answer: Acute chest syndrome; activate EMS and notify parents immediately

Chest pain with dyspnea in a student with sickle cell disease suggests acute chest syndrome, a life-threatening emergency requiring immediate EMS activation.

Question 76: During an anaphylactic reaction, a student's epinephrine auto-injector has been administered. What is the next priority action?

• Observe the student for 15 minutes and discharge to class
• Give oral antihistamines as a follow-up treatment
• Administer a second dose of epinephrine immediately
• Call 911 and transport to the emergency department (Correct answer)

Correct answer: Call 911 and transport to the emergency department

Even after epinephrine administration, the student must be transported to the ED because biphasic reactions can occur hours later.

Question 77: When a conflict arises during infection control, what is the appropriate nursing action?

• Document concerns on social media
• Confront the individual publicly
• Use the chain of command to escalate concerns through proper channels (Correct answer)
• Ignore the conflict and continue working

Correct answer: Use the chain of command to escalate concerns through proper channels

The chain of command provides an established pathway for resolving conflicts and escalating concerns appropriately.

Question 78: How should a nurse respond to a change in patient condition during health assessment?

• Ask a family member for their opinion first
• Immediately assess, intervene if within scope, and notify the provider using SBAR (Correct answer)
• Wait for the physician to notice during rounds
• Document the change and move to the next patient

Correct answer: Immediately assess, intervene if within scope, and notify the provider using SBAR

Prompt assessment, appropriate intervention, and structured communication using SBAR ensures rapid response to changes in patient condition.

Question 79: What infection control measure is most critical during medication administration procedures?

• Using hand sanitizer once per shift
• Wearing a mask at all times regardless of procedure
• Performing hand hygiene before and after every patient contact (Correct answer)
• Wearing gloves only when visible contamination is present

Correct answer: Performing hand hygiene before and after every patient contact

Hand hygiene before and after every patient contact is the single most effective measure for preventing healthcare-associated infections.

Question 80: The frequent absence seizures that define a high school student's seizure disease. Which of the following best captures the most significant impact of this circumstance on the student's learning?

• Additional social support may be needed to facilitate positive peer relationships for the student.
• The student may be at risk for low academic achievement due to gaps in concentration and missed information. (Correct answer)
• Additional reinforcement may be needed to ensure the student maintains focus on personal and academic interests.
• The student's ability to regulate his or her mood and behavior may be diminished due to a limited attention span.

Correct answer: The student may be at risk for low academic achievement due to gaps in concentration and missed information.

In comparison to classmates without epilepsy, pupils with epilepsy typically perform less well on activities requiring attention, concentration, and short-term (working) memory. The epileptic seizure known as an absence seizure (formerly known as a petit mal) is marked by modest symptoms, including a sudden, temporary cessation of activity lasting 10 to 30 seconds, a trance-like appearance, fluttering eyelids, and lip or mouth movements. It's possible for a pupil having an absence seizure to merely appear to be daydreaming. The student can struggle to digest new knowledge and miss important details concerning assignments that were discussed in class. Seizures at night may interfere with sleep and make students more tired throughout the school day. Additionally, sleepiness and issues with memory and concentration are side effects of anti-seizure drugs.

Question 81: A student has a headache, a fever of more than 102°F, and a loose cough. What course of action would the school nurse take in response to these symptoms?

• Attempt to call a parent or emergency contact and send the child home. (Correct answer)
• Arrange to transport the child to the nearest emergency department.
• Call the child’s doctor for an antibiotic.
• Offer fluids and a rest period.

Correct answer: Attempt to call a parent or emergency contact and send the child home.

The nurse should make every effort to call a parent before sending a student home with a loose cough, a fever over 102°F, and a headache. The child should be sent home until the fever has subsided for 24 hours because a fever and cough are symptoms of communicable infections. Sending the pupil to the emergency room at this time is not acceptable because this is not an emergency medical condition unless the student is exhibiting signs of respiratory distress or a higher fever. In the event that the student's health deteriorates, the school nurse should discuss with the emergency contact any indications or symptoms that call for immediate medical attention. While a suitable course of treatment, fluid intake and relaxation should be encouraged at home to stop the spread of illness to other students. Additionally, it is the parent's responsibility to take the student to the doctor in order to discuss potential pharmaceutical therapies like antibiotics.

Question 82: The school nurse is assisting in developing a reintegration plan for a student returning after a psychiatric hospitalization. Which action is MOST important?

• Coordinate with the treatment team, parents, and school staff to create a gradual return-to-learn plan with appropriate supports (Correct answer)
• Require the student to have a normal schedule immediately to establish routine
• 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 83: The school nurse is developing a support plan for a student with ADHD. Which intervention is MOST within the school nurse's scope?

• Coordinating administration of prescribed ADHD medications and communicating with parents and teachers about behavioral patterns (Correct answer)
• Prescribing a stimulant medication trial
• Designing the student's 504 plan independently
• Administering psychological testing to confirm the diagnosis

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 84: What is the best practice when handling a student's personal health information?

• Discussing it with non-medical staff.
• Posting it on school bulletin boards.
• Sharing it with other students.
• Sharing it only with authorized individuals and keeping it confidential. (Correct answer)

Correct answer: Sharing it only with authorized individuals and keeping it confidential.

The best practice when handling a student's personal health information is sharing it only with authorized individuals and keeping it strictly confidential. This adheres to legal requirements like FERPA and HIPAA, which protect student privacy. Maintaining confidentiality builds trust and ensures that sensitive health data is managed responsibly and securely.

Question 85: What should school nurses do if they encounter conflicts of interest in professional practice?

• Try to resolve the conflict by themselves.
• Ignore the situation.
• Handle the situation privately without seeking help.
• Report the conflict and seek guidance from appropriate authorities. (Correct answer)

Correct answer: Report the conflict and seek guidance from appropriate authorities.

If school nurses encounter conflicts of interest, they should report the conflict and seek guidance from appropriate authorities. This transparent approach ensures that potential biases are acknowledged and addressed, protecting the integrity of their professional judgment and the welfare of students. Ignoring or privately resolving conflicts can compromise ethical practice and student trust.

Question 86: What is the primary purpose of school health policies?

• To enforce dress codes.
• To monitor student behavior.
• To ensure a safe and healthy environment for students. (Correct answer)
• To create academic standards.

Correct answer: To ensure a safe and healthy environment for students.

The primary purpose of school health policies is to ensure a safe and healthy environment for students. These policies establish guidelines and procedures for health services, emergency response, disease prevention, and health promotion. They are fundamental in creating a supportive setting where students can thrive physically and mentally, facilitating their learning.

Question 87: A student with asthma reports that symptoms worsen every time they go to gym class. What is the BEST nursing action to address exercise-induced bronchoconstriction (EIB)?

• Collaborate with the provider to update the asthma action plan and consider pre-exercise bronchodilator use (Correct answer)
• Permanently excuse the student from all physical activity
• Advise the student to push through symptoms since exercise is beneficial
• Refer the student to the school counselor for anxiety management

Correct answer: Collaborate with the provider to update the asthma action plan and consider pre-exercise bronchodilator use

Updating the asthma action plan to include pre-exercise use of a short-acting bronchodilator 15-20 minutes before activity is the evidence-based approach for managing EIB.

Question 88: Which approach BEST supports trauma-informed care in the school health setting?

• Maintaining strict behavioral expectations to provide structure for traumatized students
• Creating a safe, predictable environment and responding to behavior with curiosity about underlying needs rather than punishment (Correct answer)
• Asking students directly about their trauma history at every visit
• Referring all students with behavioral problems for trauma counseling

Correct answer: Creating a safe, predictable environment and responding to behavior with curiosity about underlying needs rather than punishment

Trauma-informed care focuses on creating safety, building trust, and understanding behavior as a response to underlying experiences rather than defiance.

Question 89: When developing an Individualized Healthcare Plan (IHP) for a student with Type 1 diabetes, which component is MOST critical to include?

• A list of all classmates who should be aware of the condition
• The student's full medical history since birth
• Blood glucose monitoring parameters and hypoglycemia/hyperglycemia action steps (Correct answer)
• A schedule of all school field trips for the year

Correct answer: Blood glucose monitoring parameters and hypoglycemia/hyperglycemia action steps

The IHP must include specific blood glucose target ranges and clear action steps for both hypoglycemia and hyperglycemia to ensure safe management during the school day.

Question 90: How can school nurses promote mental health awareness?

• By organizing physical fitness programs.
• By ensuring students attend academic classes.
• By providing counseling services and mental health education. (Correct answer)
• By conducting extracurricular activities.

Correct answer: By providing counseling services and mental health education.

School nurses can effectively promote mental health awareness by directly offering counseling services and providing mental health education. This allows them to identify students in need, offer support, and equip all students with knowledge about mental well-being and resources. Their role is crucial in destigmatizing mental health issues and fostering a supportive school environment.

Question 91: How should a nurse respond to a change in patient condition during patient care standards?

• Document the change and move to the next patient
• Wait for the physician to notice during rounds
• Immediately assess, intervene if within scope, and notify the provider using SBAR (Correct answer)
• Ask a family member for their opinion first

Correct answer: Immediately assess, intervene if within scope, and notify the provider using SBAR

Prompt assessment, appropriate intervention, and structured communication using SBAR ensures rapid response to changes in patient condition.

Question 92: A student discloses they have been self-harming by cutting but states they do not want to die. How should the school nurse respond?

• Immediately inform the student's entire support team without further discussion
• Tell the student they must stop or face disciplinary action
• Dismiss the concern since the student denies suicidal intent
• Provide a caring, non-punitive response, assess for suicide risk, and connect the student with mental health support (Correct answer)

Correct answer: Provide a caring, non-punitive response, assess for suicide risk, and connect the student with mental health support

Non-suicidal self-injury still requires a thorough safety assessment and mental health referral; a compassionate, non-punitive response supports engagement in care.

Question 93: What is a key component of care management in school nursing?

• Monitoring physical education classes.
• Creating a health plan for each student. (Correct answer)
• Providing immediate first aid.
• Managing the school cafeteria.

Correct answer: Creating a health plan for each student.

A key component of care management in school nursing is creating individualized health plans (IHPs) for students, especially those with chronic conditions or special healthcare needs. These plans outline specific medical needs, required interventions, medication administration, and emergency protocols. IHPs ensure that all relevant school staff are aware of a student's health requirements and can provide consistent, appropriate care throughout the school day, promoting safety and well-being.

Question 94: Which of the following tactics would be most useful for assisting in the documentation and oversight of the caliber of school nursing interventions and practices?

• conducting ongoing research into school nursing practices and publishing findings in professional journals
• seeking local media coverage of unexpected health cases or situations as they occur
• maintaining daily program data sheets and detailed records of individuals served (Correct answer)
• forming a task force to critically evaluate current practices and local standards related to school nursing

Correct answer: maintaining daily program data sheets and detailed records of individuals served

According to Illinois regulations regulating student health records and privacy legislation, student visits to the school health office should be recorded. The keeping of individual student visit records enables school nurses to monitor and assess the use of the student health center over time, look at data like the frequency and purpose of visits for specific students, and go through nursing notes to help with diagnoses and health issues.

Question 95: A student discloses to the school nurse that they have been having thoughts of suicide. The nurse's FIRST action is:

• Document the disclosure and schedule a follow-up appointment
• 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

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 96: How can school nurses support students with mental health needs?

• By referring students to mental health professionals and providing ongoing support. (Correct answer)
• By organizing classroom behavior charts.
• By monitoring physical fitness.
• By providing academic tutoring.

Correct answer: By referring students to mental health professionals and providing ongoing support.

School nurses play a crucial role in supporting students with mental health needs by serving as a vital link to professional care. They can identify students exhibiting signs of mental health concerns, provide initial emotional support, and then facilitate referrals to appropriate mental health professionals or community resources. Additionally, nurses offer ongoing support within the school setting, collaborating with families and staff to ensure the student receives consistent care and accommodations, promoting their overall well-being.

Question 97: What is the nurse's primary responsibility in care planning?

• Advocating for patient safety and well-being (Correct answer)
• Minimizing time spent with each patient
• Following physician orders without question
• Completing documentation as quickly as possible

Correct answer: Advocating for patient safety and well-being

In care planning, the nurse's primary responsibility is advocating for patient safety and well-being through competent, evidence-based care.

Question 98: A student with epilepsy is prescribed diazepam rectal gel for prolonged seizures. Under what circumstance is the school nurse authorized to administer this medication?

• Only when a seizure lasts longer than the duration specified in the student's emergency action plan (Correct answer)
• Whenever the student reports feeling a seizure aura
• At the beginning of each school day as a preventive measure
• Whenever any staff member observes unusual behavior

Correct answer: Only when a seizure lasts longer than the duration specified in the student's emergency action plan

Emergency rescue medications like diazepam rectal gel are administered per the student's physician-authorized emergency action plan, which specifies seizure duration thresholds for administration.

Question 99: Why is it important for school nurses to collaborate with teachers and parents?

• To ensure the student's health needs are being met and provide appropriate care. (Correct answer)
• To monitor academic progress.
• To enforce school policies.
• To improve classroom behavior.

Correct answer: To ensure the student's health needs are being met and provide appropriate care.

Collaboration between school nurses, teachers, and parents is paramount to ensuring a student's health needs are comprehensively met and appropriate care is provided. Teachers spend significant time with students and can observe daily health changes or concerns, while parents provide crucial medical history and home context. By working together, this team can develop and implement effective health plans, communicate vital information, and create a supportive environment that addresses the student's holistic well-being.

Question 100: Which sign is MOST consistent with hypoglycemia in a student with Type 1 diabetes?

• Fruity breath, polyuria, and Kussmaul respirations
• Hypertension, bradycardia, and widened pulse pressure
• Flushed skin, dry mucous membranes, and abdominal pain
• Shakiness, diaphoresis, and confusion (Correct answer)

Correct answer: Shakiness, diaphoresis, and confusion

Shakiness, diaphoresis (sweating), and confusion are classic signs of hypoglycemia resulting from adrenergic and neuroglycopenic responses to low blood glucose.

Question 101: What assessment technique is fundamental to clinical procedures?

• Reading the previous shift's notes only
• Relying solely on monitor readings
• Checking only the chief complaint area
• Systematic head-to-toe assessment combined with patient interview (Correct answer)

Correct answer: Systematic head-to-toe assessment combined with patient interview

A systematic head-to-toe assessment combined with patient interview provides the comprehensive data needed for safe nursing care.

Question 102: Why is confidentiality important in professional practice for school nurses?

• It reduces workload.
• It helps maintain trust and ensures compliance with laws. (Correct answer)
• It keeps parents informed.
• It prevents the spread of rumors.

Correct answer: It helps maintain trust and ensures compliance with laws.

Confidentiality is paramount in school nursing because it helps maintain trust with students and families, encouraging them to seek necessary health services without fear of disclosure. Furthermore, it ensures compliance with legal mandates such as FERPA and HIPAA, protecting sensitive personal health information. Upholding confidentiality is fundamental to ethical and legal professional practice.

Question 103: During a fire drill, a student with a physical disability cannot evacuate independently. The school nurse's role includes:

• Ensuring the student is included in the school's individual emergency evacuation plan
• Both B and C, per the student's pre-established emergency plan (Correct answer)
• Carrying the student down the stairs immediately
• Leaving the student in a safe area and notifying emergency personnel

Correct answer: Both B and C, per the student's pre-established emergency plan

An individual emergency evacuation plan should pre-identify procedures, including designating a safe area and notifying first responders, tailored to the student's specific needs.

Question 104: When educating a student on proper metered-dose inhaler (MDI) technique, which instruction is MOST important to prevent ineffective drug delivery?

• Shake the inhaler, exhale fully, then inhale slowly and steadily while actuating (Correct answer)
• Hold the inhaler upside down to maximize medication release
• Exhale immediately after actuation to distribute medication evenly
• Inhale rapidly and deeply to ensure medication reaches the lungs

Correct answer: Shake the inhaler, exhale fully, then inhale slowly and steadily while actuating

Shaking distributes propellant, exhaling empties the lungs, and slow steady inhalation during actuation ensures optimal medication deposition in the lower airways.

Question 105: Which of the following strategies is most likely to be successful in helping a school nurse work with families in a considerate and inclusive manner?

• remaining friendly and curious while asking specific questions about families' backgrounds and living situations
• being professional and sensitive to factors related to socioeconomic, ethnic, and cultural backgrounds (Correct answer)
• attempting to discover pertinent characteristics of families' backgrounds before meeting with them
• acknowledging obvious differences in background right away and using humor to put families at ease

Correct answer: being professional and sensitive to factors related to socioeconomic, ethnic, and cultural backgrounds

Families are essential to the growth and development of their kids. Initial interactions between a school nurse and families should assist the establishment of a positive, culturally sensitive rapport that fosters successful communication and collaboration, which is crucial in the event of a challenging health-related issue. A school nurse who is culturally competent is aware that culture might encompass beliefs, lifestyle, place of residence, experiences in life, gender identity, language, food customs, and social structure. A school nurse can work toward developing rapport, fostering understanding, and encouraging collaboration with the families of students with health problems while being aware of and keeping sensitive to these cultural traits.

Question 106: How should a nurse respond to a change in patient condition during infection control?

• Document the change and move to the next patient
• Wait for the physician to notice during rounds
• Ask a family member for their opinion first
• Immediately assess, intervene if within scope, and notify the provider using SBAR (Correct answer)

Correct answer: Immediately assess, intervene if within scope, and notify the provider using SBAR

Prompt assessment, appropriate intervention, and structured communication using SBAR ensures rapid response to changes in patient condition.

Question 107: A student accidentally ingests an unknown chemical from the science lab. The school nurse should FIRST:

• Have the student drink large amounts of water immediately
• Call Poison Control (1-800-222-1222) for guidance (Correct answer)
• Induce vomiting to remove the substance
• Administer activated charcoal from the emergency kit

Correct answer: Call Poison Control (1-800-222-1222) for guidance

Poison Control provides real-time expert guidance on managing ingestions and should be called before any intervention is attempted.

Question 108: An 11-year-old female pupil complains of lower stomach ache to the school nurse. She doesn't feel ill to her stomach and doesn't have a temperature. What kind of action should the school nurse take?

• This age group may be ready to start menstruating and a call home to a parent is advised to discuss the symptoms and provide education if needed. (Correct answer)
• Abdominal pain in this age group may precede nausea and vomiting, therefore anti-nausea medications should be considered.
• Allow the student to rest in the nursing office until the pain resides, and she may return to class.
• Often females of this age group falsely report stomach aches when attempting to get out of class and should be sent back to class if no other symptoms are present.

Correct answer: This age group may be ready to start menstruating and a call home to a parent is advised to discuss the symptoms and provide education if needed.

Girls as young as 8 may begin exhibiting early menstrual symptoms. If this is your child's first period, it's a good idea to phone home and inform the parent about your tummy ache. Children's lower abdomen ache may also be caused by constipation; in this case, water may be administered to the pupil. Nurses must consistently treat the patient's statement of pain until confirming otherwise, despite the fact that students may falsely claim illnesses for a variety of reasons. The school nurse does not have the authority to administer medication that has not been prescribed and approved by the parent, thus giving anti-nausea drugs is not suitable.

Question 109: What is the main purpose of health assessment in school nursing?

• To diagnose chronic conditions.
• To identify health problems early. (Correct answer)
• To prevent school bullying.
• To treat illnesses.

Correct answer: To identify health problems early.

The main purpose of health assessment in school nursing is to identify potential health problems in students at an early stage. By conducting screenings and observations, school nurses can detect signs of physical, mental, or developmental issues that might impact a student's learning or well-being. Early identification allows for prompt intervention, referral to appropriate healthcare providers, and the implementation of necessary accommodations to support the student's health and academic success.

Question 110: What is the role of the school nurse in managing health education materials?

• To provide updated and accurate health education resources. (Correct answer)
• To manage classroom discipline.
• To monitor attendance.
• To organize health education fairs.

Correct answer: To provide updated and accurate health education resources.

The school nurse's role in managing health education materials is to provide updated and accurate resources. As a health professional, the nurse ensures that information shared with students, staff, and parents is evidence-based, reliable, and relevant to current health guidelines. This is crucial for effective health promotion and education within the school.

Question 111: The family of a third-grade kid has lately gone through trying times. One of the student's younger siblings suffers from a health condition, and both parents have been out of work for six months. The parents have displayed depressive episodes. The school nurse should be aware of the likelihood that these factors will have the greatest impact on the student's development in which of the following areas?

• higher-order thinking
• motor development
• social relationships (Correct answer)
• receptive language

Correct answer: social relationships

Family marital conflict, which is linked to adjustment issues for the children in the home, including impairments in social and academic performance, is at risk when there is unemployment and depression in the home. Greater kid emotional insecurity is directly linked to parent or caregiver depression. According to research, kids whose parents have been depressed are more likely to struggle in school and have interpersonal and social difficulties than kids whose parents have never been depressed.

Question 112: Examining for visual impairments is the nurse. Which pupil would require a recommendation for an eye doctor?

• A student with 20/20 vision.
• A student with 20/30 in both eyes.
• A student with 20/90 in the right eye and 20/80 in the left eye. (Correct answer)
• A student with 20/20 in the right eye and 20/30 in the left eye.

Correct answer: A student with 20/90 in the right eye and 20/80 in the left eye.

Any student who has vision in either eye of 20/90 or better should follow up with an ophthalmologist. This child has to be 20 feet away in order to differentiate what a typical child can see and distinguish at a distance of 90 feet. This may hinder the child's capacity to study in a classroom setting and create challenges in the child's day-to-day activities. The sooner this repair may be performed, the better; this child would significantly benefit from spectacles. It is usual for one eye to have vision that is 10 feet worse than the other, with 20/20 vision being regarded as ideal. 20/30 vision does not necessitate a referral to an ophthalmologist, but this youngster should still be closely watched to make sure that their vision is not rapidly deteriorating.

Question 113: What role do school nurses play in managing emergencies?

• Administering first aid and calling emergency services.
• Creating academic assessments.
• Organizing student extracurricular activities.
• Running school-wide fire drills.

In managing emergencies, school nurses play a critical role as the primary healthcare providers on site. They are responsible for promptly administering first aid and immediate medical care to students or staff experiencing an emergency. Crucially, they also assess the situation, determine the need for advanced medical attention, and initiate calls to emergency services, ensuring a rapid and appropriate response.

Question 114: 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
• When it is necessary to protect the health or safety of the student or others in an emergency (Correct answer)
• Never — mental health information is absolutely protected in all circumstances
• 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.

Question 115: A student is stung by a bee and states 'I've had reactions before.' The school nurse's FIRST assessment priority is:

• Removing the stinger with tweezers
• Calling the parent for medication authorization
• Assessing for signs of anaphylaxis including respiratory distress and urticaria (Correct answer)
• Documenting the time and location of the sting

Correct answer: Assessing for signs of anaphylaxis including respiratory distress and urticaria

History of prior reactions elevates anaphylaxis risk; immediate assessment of airway and systemic signs is the top priority.

Question 116: 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
• Call the student's parents to pick them up
• Administer the student's prescribed anxiolytic immediately
• Use grounding techniques and calm reassurance while monitoring vital signs (Correct answer)

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 117: A student with asthma arrives at the school nurse's office with mild wheezing and an oxygen saturation of 95%. What is the most appropriate first action?

• Have the student rest and monitor for 30 minutes without medication
• Notify the teacher and send the student back to class
• Administer the student's prescribed short-acting bronchodilator (rescue inhaler) (Correct answer)
• Call 911 immediately

Correct answer: Administer the student's prescribed short-acting bronchodilator (rescue inhaler)

A short-acting bronchodilator (e.g., albuterol) is the first-line treatment for acute asthma symptoms per the student's asthma action plan.

Question 118: What is the primary responsibility of a school nurse in professional practice?

• To promote academic performance.
• To enforce school policies.
• To discipline students.
• To provide health care services and educate students about health. (Correct answer)

Correct answer: To provide health care services and educate students about health.

The primary responsibility of a school nurse is to provide health care services and educate students about health. This dual role encompasses direct medical care, managing chronic conditions, responding to emergencies, and promoting health literacy among the student population. They act as a vital link between healthcare and education, ensuring student well-being supports their learning.

Question 119: The school nurse is implementing a mental health awareness program. According to best practices, which approach is MOST effective in reducing mental health stigma among students?

• Presenting statistics about how rare mental illness is to reassure students
• Warning students about the dangers of mental illness to promote help-seeking
• Teaching students to identify mentally ill peers so they can offer support
• Sharing personal stories of recovery and emphasizing that mental health conditions are treatable medical conditions (Correct answer)

Correct answer: Sharing personal stories of recovery and emphasizing that mental health conditions are treatable medical conditions

First-person recovery narratives combined with education that frames mental health conditions as medical and treatable are most effective at reducing stigma.

Question 120: How can a school nurse support professional ethics during an emergency?

• By making decisions based on personal preferences.
• By following established protocols and providing appropriate care. (Correct answer)
• By focusing on non-medical aspects.
• By choosing the quickest solution.

Correct answer: By following established protocols and providing appropriate care.

During an emergency, a school nurse supports professional ethics by following established protocols and providing appropriate, evidence-based care. This ensures that decisions are guided by professional standards and the student's best interest, rather than personal bias or panic. Adhering to protocols helps maintain order, efficiency, and the highest quality of care in critical situations.

Question 121: Why should schools implement healthy eating programs?

• To improve student behavior.
• To reduce school expenses.
• To promote overall health and academic success. (Correct answer)
• To increase school attendance.

Correct answer: To promote overall health and academic success.

Schools should implement healthy eating programs primarily to promote overall health and academic success. Good nutrition is directly linked to improved physical health, better concentration, and enhanced cognitive function, all of which contribute significantly to a student's ability to learn and perform well academically. It supports both their immediate well-being and future potential.

Question 122: During a lockdown drill, a student with a known anxiety disorder begins hyperventilating. The nurse's FIRST intervention is:

• Administer a PRN anxiolytic from the student's emergency medication plan
• Have the student breathe into a paper bag
• Guide the student in slow, controlled diaphragmatic breathing while maintaining lockdown (Correct answer)
• Escort the student to the health office for monitoring

Correct answer: Guide the student in slow, controlled diaphragmatic breathing while maintaining lockdown

Coaching slow diaphragmatic breathing addresses hyperventilation while keeping the student and nurse safe within the lockdown protocol.

Question 123: How can school nurses contribute to improving public health in schools?

• By improving health policies and educating students on health issues. (Correct answer)
• By reducing teacher workload.
• By organizing after-school events.
• By monitoring classroom behavior.

Correct answer: By improving health policies and educating students on health issues.

School nurses contribute to improving public health in schools by improving health policies and educating students on health issues. By advocating for and implementing effective health policies, they create a healthier environment. Simultaneously, educating students empowers them with knowledge and skills to make healthy choices, extending public health benefits beyond the school walls.

Question 124: What assessment technique is fundamental to health assessment?

• Systematic head-to-toe assessment combined with patient interview (Correct answer)
• Reading the previous shift's notes only
• Relying solely on monitor readings
• Checking only the chief complaint area

Correct answer: Systematic head-to-toe assessment combined with patient interview

A systematic head-to-toe assessment combined with patient interview provides the comprehensive data needed for safe nursing care.

Question 125: How do school nurses ensure compliance with health policies?

• By conducting routine tests without informing parents.
• By disregarding state regulations.
• By avoiding student health assessments.
• By educating staff and monitoring health protocols. (Correct answer)

Correct answer: By educating staff and monitoring health protocols.

School nurses ensure compliance with health policies by educating staff and monitoring health protocols. They serve as a resource for health information, train school personnel on emergency procedures, and oversee the implementation of health-related guidelines. This proactive approach helps maintain a consistent and safe health environment for all students.

Question 126: How can school nurses assist in developing health-related school policies?

• By organizing extracurricular activities.
• By ignoring student health concerns.
• By providing input on policies related to student health and safety. (Correct answer)
• By focusing solely on first aid.

Correct answer: By providing input on policies related to student health and safety.

School nurses can assist in developing health-related school policies by providing expert input on policies related to student health and safety. Their clinical knowledge and understanding of student health needs are invaluable in creating effective, evidence-based policies that protect and promote the well-being of the school community. They bridge the gap between healthcare and education.

Question 127: A student arrives at the health office after a seizure. The seizure has stopped and the student is postictal. Which finding requires IMMEDIATE emergency activation?

• The student bit their tongue during the seizure
• The student is confused and sleepy
• The seizure lasted longer than 5 minutes (Correct answer)
• The student had a known history of epilepsy

Correct answer: The seizure lasted longer than 5 minutes

A seizure lasting more than 5 minutes is considered status epilepticus, a life-threatening emergency requiring immediate EMS activation.

Question 128: Which of the following is an example of a health promotion activity in schools?

• Club activities.
• Health fairs and wellness programs. (Correct answer)
• Math tutoring.
• Physical education class.

Correct answer: Health fairs and wellness programs.

Health fairs and wellness programs are excellent examples of health promotion activities in schools because they actively engage the entire school community in health-related topics. These events often feature interactive booths, screenings, educational materials, and demonstrations focused on nutrition, fitness, mental health, and disease prevention. By making health information accessible and engaging, they encourage students, staff, and families to adopt healthier lifestyles and make informed decisions about their well-being.

Question 129: What infection control measure is most critical during health assessment procedures?

• Wearing a mask at all times regardless of procedure
• Wearing gloves only when visible contamination is present
• Performing hand hygiene before and after every patient contact (Correct answer)
• Using hand sanitizer once per shift

Correct answer: Performing hand hygiene before and after every patient contact

Hand hygiene before and after every patient contact is the single most effective measure for preventing healthcare-associated infections.

Question 130: Why is it important for school nurses to assess students' immunization status?

• To promote academic excellence.
• To monitor student health progress.
• To ensure compliance with state laws. (Correct answer)
• To reduce school absenteeism.

Correct answer: To ensure compliance with state laws.

It is crucial for school nurses to assess students' immunization status primarily to ensure compliance with state laws and public health regulations. Most states require specific immunizations for school entry to prevent the spread of communicable diseases within the school community. By verifying immunization records, nurses help protect the health of all students and staff, contributing to a safe and healthy learning environment.

Question 131: What should a school nurse do if they observe unethical behavior?

• Ignore the behavior.
• Tell other staff members but take no further action.
• Report the behavior to the appropriate authorities. (Correct answer)
• Discipline the individual.

Correct answer: Report the behavior to the appropriate authorities.

If a school nurse observes unethical behavior, their professional and ethical obligation is to report it to the appropriate authorities. This ensures that the behavior is addressed through proper channels, protecting students, maintaining professional standards, and upholding the integrity of the school environment. Ignoring it or taking informal action is not an acceptable response.

Question 132: At a nearby medical facility, a student with a health condition is getting therapy from a psychologist. The psychologist is willing to speak with the school nurse. What actions should the nurse take to facilitate consultation from the list below?

• requesting that the student's parent set up a meeting between the nurse, the psychologist, and the parent
• inviting the psychologist to a meeting with the student's parent at the school to compare information about the student
• asking the student's parent for written permission to exchange information with the psychologist (Correct answer)
• telling the student's parent that psychologist reports would be beneficial and asking the parent to pass updates along

Correct answer: asking the student's parent for written permission to exchange information with the psychologist

To request health status information from a student's outside health-care provider, a school nurse must have written consent or authorization from the parent/guardian or eligible student. Although a psychologist or other provider may relay or clarify treatment orders to a school nurse or other people involved in a student's treatment, the provider and the school nurse should both respect the legal principle of confidentiality related to student health records and refrain from disclosing information about a student's health status without first obtaining signed authorization.

Question 133: When a conflict arises during patient care standards, what is the appropriate nursing action?

• Use the chain of command to escalate concerns through proper channels (Correct answer)
• Document concerns on social media
• Confront the individual publicly
• Ignore the conflict and continue working

Correct answer: Use the chain of command to escalate concerns through proper channels

The chain of command provides an established pathway for resolving conflicts and escalating concerns appropriately.

Question 134: What is the nurse's primary responsibility in medication administration?

• Following physician orders without question
• Completing documentation as quickly as possible
• Advocating for patient safety and well-being (Correct answer)
• Minimizing time spent with each patient

Correct answer: Advocating for patient safety and well-being

In medication administration, the nurse's primary responsibility is advocating for patient safety and well-being through competent, evidence-based care.

Question 135: A student reports that a classmate has been making threats of violence on social media. The school nurse's appropriate action is:

• Assess the classmate medically and determine if they need medication adjustment
• Advise the reporting student to block the classmate online
• Maintain confidentiality and monitor the situation
• Report the threat to school administration and document the report immediately (Correct answer)

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 136: The school nurse is updating the school's emergency action plan for a student with a food allergy. Which element is MOST critical to include?

• The student's favorite foods to avoid accidental exposure
• The student's home address for parent notification
• The specific trigger foods, symptoms of reaction, and step-by-step emergency treatment including epinephrine location (Correct answer)
• The name of the student's allergist for routine communication

Correct answer: The specific trigger foods, symptoms of reaction, and step-by-step emergency treatment including epinephrine location

An effective allergy emergency action plan must specify triggers, recognize symptoms, and detail exactly what to do including where epinephrine is stored.

Question 137: The school nurse is educating staff about recognizing signs of student substance use. Which finding is MOST consistent with opioid intoxication?

• Dilated pupils and increased energy
• Agitation, rapid heartbeat, and elevated blood pressure
• Red eyes, increased appetite, and laughter
• Pinpoint pupils, sedation, and slowed breathing (Correct answer)

Correct answer: Pinpoint pupils, sedation, and slowed breathing

Classic signs of opioid intoxication include miosis (pinpoint pupils), central nervous system depression, and respiratory slowing.

Question 138: The school nurse is training staff on CPR. According to current American Heart Association guidelines for child CPR, the compression-to-ventilation ratio for a single rescuer is:

• 30:2 (Correct answer)
• 30:1
• 15:1
• 15:2

Correct answer: 30:2

Current AHA guidelines recommend a 30:2 compression-to-ventilation ratio for single-rescuer CPR for children and adults.

Question 139: The school nurse repeatedly observes numerous bruises on a male student's face, arms, and neck. When speaking to this child, what would the school nurse need to keep in mind?

• Consider the possibility of physical or sexual/physical abuse, and question and act accordingly. (Correct answer)
• The nurse is under the obligation to report the concern to the parents.
• Boys often play rough and should be encouraged to participate in less aggressive play.
• The nurse should consider this a private matter and make no comments unless the child seeks assistance.

Correct answer: Consider the possibility of physical or sexual/physical abuse, and question and act accordingly.

If a pupil has unexplained bruises, it's crucial to take the likelihood of physical or sexual abuse into account. Whether or not the student confesses to abuse, the nurse must report any suspicions of abuse and must take appropriate action. The nurse should be aware that the student might make up the story about where the bruises came from, but this should not alter how they go about reporting the problem. In this situation, the nurse shouldn't approach the parents because they might be the ones causing the harm. Instead, the nurse should adhere to protocol when informing the relevant agency of suspected abuse.

Question 140: When a conflict arises during health assessment, what is the appropriate nursing action?

• Use the chain of command to escalate concerns through proper channels (Correct answer)
• Document concerns on social media
• Ignore the conflict and continue working
• Confront the individual publicly

Correct answer: Use the chain of command to escalate concerns through proper channels

The chain of command provides an established pathway for resolving conflicts and escalating concerns appropriately.

Question 141: What is the role of the school nurse in health education?

• Managing student academic records.
• Providing health education and promoting wellness. (Correct answer)
• Administering medication to students.
• Organizing school events.

Correct answer: Providing health education and promoting wellness.

The school nurse plays a pivotal role in health education by serving as a credible and accessible health resource for students, staff, and families. They are responsible for providing accurate health information, leading educational sessions on topics like puberty, hygiene, and disease prevention, and promoting overall wellness initiatives. By educating the school community, nurses empower individuals to make informed health decisions and foster a culture of health within the school environment.

Question 142: How should a nurse respond to a change in patient condition during medication administration?

• Wait for the physician to notice during rounds
• Ask a family member for their opinion first
• Document the change and move to the next patient
• Immediately assess, intervene if within scope, and notify the provider using SBAR (Correct answer)

Correct answer: Immediately assess, intervene if within scope, and notify the provider using SBAR

Prompt assessment, appropriate intervention, and structured communication using SBAR ensures rapid response to changes in patient condition.

Question 143: What infection control measure is most critical during infection control procedures?

• Using hand sanitizer once per shift
• Performing hand hygiene before and after every patient contact (Correct answer)
• Wearing a mask at all times regardless of procedure
• Wearing gloves only when visible contamination is present

Correct answer: Performing hand hygiene before and after every patient contact

Hand hygiene before and after every patient contact is the single most effective measure for preventing healthcare-associated infections.