CSN Chronic Disease Management 2 — Questions and Answers
Question 1: When educating a student on proper metered-dose inhaler (MDI) technique, which instruction is MOST important to prevent ineffective drug delivery?
- Inhale rapidly and deeply to ensure medication reaches the lungs
- 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
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 2: A student with epilepsy is prescribed diazepam rectal gel for prolonged seizures. Under what circumstance is the school nurse authorized to administer this medication?
- Whenever the student reports feeling a seizure aura
- Only when a seizure lasts longer than the duration specified in the student's emergency action plan (Correct answer)
- 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 3: 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)?
- Permanently excuse the student from all physical activity
- Collaborate with the provider to update the asthma action plan and consider pre-exercise bronchodilator use (Correct answer)
- 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 4: 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?
- 40-70 mg/dL
- 70-180 mg/dL (Correct answer)
- 200-250 mg/dL
- 180-300 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 5: 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?
- Confirm the student's behavior in class with the teacher before giving medication
- Verify a current signed physician's order and signed parental consent form are on file (Correct answer)
- Administer the medication based solely on parental verbal instructions
- Adjust the dose based on the student's classroom performance that day
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 6: A student with celiac disease needs accommodations in the school cafeteria. Which nursing action BEST supports this student's chronic disease management?
- Advise the student to simply avoid bread during lunch
- Collaborate with food service staff and the family to ensure a completely gluten-free meal plan (Correct answer)
- Recommend the student bring lunch from home and take no further action
- Notify the student's teacher to monitor for behavioral changes after 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 7: 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
- An Individualized Healthcare Plan (IHP) and Emergency Care Plan (ECP) with current medical orders (Correct answer)
- A copy of all physician visit notes from the past five years
- Teacher observation logs of classroom behavior
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.
CSN Chronic Disease Management 2
When educating a student on proper metered-dose inhaler (MDI) technique, which instruction is MOST important to prevent ineffective drug delivery?