CSN Chronic Disease Management 1 — Questions and Answers
Question 1: 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?
- Administer the student's prescribed short-acting bronchodilator (rescue inhaler) (Correct answer)
- Call 911 immediately
- Have the student rest and monitor for 30 minutes without medication
- Notify the teacher and send the student back to class
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 2: When developing an Individualized Healthcare Plan (IHP) for a student with Type 1 diabetes, which component is MOST critical to include?
- A schedule of all school field trips for the year
- Blood glucose monitoring parameters and hypoglycemia/hyperglycemia action steps (Correct answer)
- The student's full medical history since birth
- A list of all classmates who should be aware of the condition
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 3: 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?
- Restrain the student to prevent injury during the postictal phase
- Place the student in the recovery position and monitor airway, breathing, and circulation (Correct answer)
- Administer emergency anti-seizure medication immediately
- Begin CPR because the student is unresponsive
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 4: 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 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
- The student should be sent home as a precaution
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 5: 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
- Administer epinephrine via auto-injector and call 911 (Correct answer)
- Give the student water to drink and have them sit down
- 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 6: Which sign is MOST consistent with hypoglycemia in a student with Type 1 diabetes?
- Fruity breath, polyuria, and Kussmaul respirations
- Shakiness, diaphoresis, and confusion (Correct answer)
- Flushed skin, dry mucous membranes, and abdominal pain
- Hypertension, bradycardia, and widened pulse pressure
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 7: 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?
- Anxiety attack; administer calm reassurance and deep breathing exercises
- Acute chest syndrome; activate EMS and notify parents immediately (Correct answer)
- Asthma exacerbation; administer rescue inhaler and monitor
- Musculoskeletal strain; apply ice and rest the student
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.
CSN Chronic Disease Management 1
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?