Question 1

Which of the following activities are expectations for a school health nurse?

Accepted Answer

School nursing responsibilities include making sure that children get the health care they need,including emergency care in the school; keeping track of the state-required vaccinations that children have received; carrying out the required screening of the children based on state law; and ensuring that children with health problems are able to learn in the classroom.The nurse cannot convince children to accept other children as peers,although certainly efforts should be made.HIPAA would not allow individual examples of health problems to be shared,other than providing group statistics.It would not be appropriate for the school nurse to provide transportation services to the students attending the school.

Question 2

Which of the following would be the best way for the school nurse to fulfill his or her responsibilities in an emergency situation?

Accepted Answer

The American Health Association recommends that the school nurse create an emergency plan with at least two different staff members identified and responsible for implementing the plan if the nurse is not in the building at the time of the emergency.The plan would include when to call 911 and how to get a child to the hospital via ambulance if needed.Depending on the emergency,it may or may not be appropriate to call 911; thus,having an emergency plan in place is a more appropriate response.It is impossible for the nurse to be available at all times.Depending on where the nurse is and what other roles the nurse is fulfilling,it may not be possible for the nurse to respond quickly to an emergency.

Question 3

A school health nurse is requested by the board of education to assist in choosing new playground equipment for an elementary school that meets safety standards.Which of the following best describes the nurse's role in this scenario?

Accepted Answer

The school nurse is the person best able to provide health information to school administrators,teachers,and parent-teacher groups.As a consultant,the school nurse can provide professional information about proposed changes in the school environment and their effect on the health of the children.The nurse also can recommend changes in the school's policies or ask community organizations to help make the children's schools healthier places.As a case manager,the school nurse helps to coordinate the health care for children with complex health problems.As a counselor,the school nurse is considered a trustworthy person to whom the children can go if they are in trouble or when they need to talk.In the health educator role,the school nurse may be asked to teach children both individually and in the classroom.

Question 4

A school nurse has developed a special class for pregnant teens to teach them everything from anticipated body changes to methods for managing common pregnancy-associated problems.The classes also allow the nurse to be in close frequent contact with the students to monitor their health status.Which of the following levels of prevention is being used by the nurse?

Accepted Answer

Many teenage girls who are pregnant attend school; therefore,the school nurse may provide ongoing care to the mother.Although this may appear to be secondary prevention,it is tertiary prevention because adolescent pregnancies are considered to be high risk.Primary prevention involves providing education before a problem or disease occurs.Secondary prevention addresses screening and early detection of the disease or problem.Because the teenager is already pregnant,the nurse is addressing how to assist the teen to achieve the highest level of functioning possible (tertiary prevention).

Question 5

A school nurse is administering medications at the school.Which of the following guidelines should be followed?

Accepted Answer

A current drug reference should always be available so that it can be consulted for information.The nurse should develop a series of guidelines to help with the legal administration of medications in the school.The prescribed drugs should have the original prescription label on it and be in the original container.There should be a current,signed parental consent form for giving the medication,and the nurse should have a means of contacint a pharmacist to ask questions.A physican's order is not needed to administer the medications.All medications,including narcotics,should be kept in a locked container so that they are not accessible to others.

Question 6

Which of the following best explains why school nurses are involved in helping teachers with the task of teaching children how to practice problem solving,communication,and other life skills?

Accepted Answer

Nurses fulfilling the health educator role assist in teaching children both individually and in the classroom.This teaching should assist in helping reduce the risk factors among children in the future.Potential teacher shortages have not impacted the role of the school nurse as a health educator.Use of the role of health educator has not changed the need for school nurses in the school setting.There are not state requirements for required school screening or teaching life skills.

Question 7

A pregnant teen asks the school nurse to provide information on abortion and a list of health care providers who offer such services.If the school nurse has very strong personal beliefs against abortion,which of the following actions should be taken by the nurse?

Accepted Answer

This creates an ethical dilemma for the nurse.If the nurse feels so strongly that he or she cannot work with the situation,another school nurse should be called for help or the student should be referred to other health providers who can provide the care the student needs.It is important that the nurse be able to keep an open mind when working when this teen,and if that is not possible,another nurse needs to be asked to care for this client.The incorrect options all address the nurse discussing his/her personal beliefs against abortion which may not be therapeutic for the teen.

Question 8

A disaster has occurred in the community.Which of the following actions should be taken by the school nurse?

Accepted Answer

After a disaster,the school nurse has many responsibilities-for instance,continuing to assess the school community for the presence of shock and stress; encouraging parents to minimize how much their children view the disaster coverage on TV; providing grief counseling; continuing to communicate with the children,parents,and school personnel; and following up with assessment of children for anxiety,depression,regression,and posttraumatic stress disorder.It would not be appropriate for the nurse to ignore that a disaster has occurred or to assume that routines will remain the same; it is important for the nurse to assist the community to cope with the disaster.The nurse may use counselors in the community to assist the children to cope with the disaster as this may not be an appropriate role for the nurse or for the teacher to perform.

Question 9

The school health nurse has enlisted the assistance of high school role models in the areas of sports and scholarship to provide an antidrug presentation to their peers.Which of the following levels of prevention is being implemented?

Accepted Answer

Primary prevention interventions by the school nurse include educating children and adolescents about the effects of drugs.In preventing use,students are taught by the school nurse to stay away from drugs such as marijuana,cocaine,crack,heroin,and alcohol.Secondary prevention involves screening and intervening with at risk populations.Tertiary prevention aims for rehabilitation and returning to the highest functioning possible.

Question 10

Which of the following best describes the primary reason that school health nurses spend so much time on educational programs that teach children the importance of water and fire safety,using a seatbelt in the car,and wearing a helmet when biking or skateboarding?

Accepted Answer

The school nurse,as the trusted person at school,is able to quickly give information to help prevent injuries from occurring,since most injuries are preventable.Injuries are the leading cause of death in children and teenagers.The nurse is a trustworthy person,but the children may likely have heard this information from someone else.The role of health educator is an appropriate and important role of the school nurse which is the same as the role of the direct caregiver in caring for injured children and documenting care.

Question 11

A school nurse suggests to teachers that they have a session on coping strategies and stress management techniques.The nurse also sets up a peer counseling program.Which of the following is the school nurse most likely trying to prevent?

Accepted Answer

Suicide is the second leading cause of death among adolescents,ages 15 to 19.To reduce the incidence of suicide in teenagers,the nurse can emphasize coping strategies and stress management techniques and organize a peer assistance program to help teenagers cope with school stresses.Bullying may result in adolescents feeling that suicide is the only answer.However,the strategies that the nurse is completing would not necessarily promote a decrease in bullying.The strategies suggested would not impact the prevalence of obesity or the incidence of violence.

Question 12

Which of the following statements best explains why many school nurses are not able to ensure that all children receive needed health care in the schools?

Accepted Answer

In Healthy People 2020,objective ECBP-5 states that there should be one nurse for every 750 children in each school (U.S.Department of Health and Human Services,2010).Most schools have not achieved this objective.In 2006,approximately 40% of the nation's schools met that standard.The new objective is that 44.7% of the country's elementary,middle,junior high,and senior high schools have this many nurses by 2020 (U.S.Department of Health and Human Services,2010).Having fewer nurses in the schools means that the nurses are expected to perform many different functions.It is therefore possible that they are unable to provide the amount of comprehensive care that the students need.There is not a national requirement that school nurses must have baccalaureate preparation or school nurse certification.Preference of employers by nurses does not impact why school nurses are unable to ensure that adequate care if provided.School districts may see that the need for nurses is important,but may have insufficent funds to be able to afford to pay for their services.

Question 13

At the annual community health fair,the school health nurse displays a science booth that examines the hazards of ineffective hand washing.Which of the following best describes the nurse's role in this scenario?

Accepted Answer

When participating in community outreach,nurses reach out to residents in the community.One common way this occurs is when nurses are involved in activities such as community health fairs or festivals in the schools.As a consultant,the school nurse can provide professional information about proposed changes in the school environment and their effect on the health of the children.As a counselor,the school nurse is considered a trustworthy person to whom the children can go if they are in trouble or when they need to talk.As a researcher,the nurse can study outcomes related to school nursing services which may advance the practice of school nursing.

Question 14

Which of the following is the leading cause of children being absent from school because of a chronic illness?

Accepted Answer

Asthma is one of the leading cause of children being absent from school because of a chronic illness.Upper respiratory infections are an acute problem,not a chronic one.Diabetes and allergies are not leading causes of chronic disease that result in children being absent from school.

Question 15

A school nurse is demonstrating the use of a peak flow meter to help children with chronic asthma recognize when they need to use a rescue inhaler.Which of the following levels of prevention is being used by the nurse?

Accepted Answer

Tertiary prevention includes caring for children with long-term health needs,including asthma and disabling conditions.The nurse is teaching disease management (i.e.,when to use an inhaler).Primary prevention involves providing education before a problem or disease occurs.Secondary prevention addresses screening and early detection of the disease or problem.

Question 16

A nurse would like to implement a primary prevention effort to decrease the leading cause of death among children and teenagers.Which of the following actions would the nurse most likely take?

Accepted Answer

Injuries are the leading cause of death in children and teenagers; therefore,prevention measures should focus on injury prevention.Because the question asks for primary prevention efforts,the intervention must occur before injury.Common interventions by the school nurse include educational programs reminding children to use their seatbelts or bicycle helmets to prevent injuries.Other classes can be on crossing the street,water safety,and fire safety.Providing free condoms to sexually active students would be an secondary prevention intervention as these students are at risk to contract a sexually transmitted disease.Screening for signs and symptoms of cancer is an example of secondary prevention,aimed at early detection.Inviting a guest speaker to speak about HIV would address primary prevention,but it does not address the leading cause of death among children.

Question 17

A school nurse listens as one student talks about another student being upset because his father frequently spanks him with a leather belt that leaves big marks on the student's back.But the student begs the nurse not to tell anyone because he promised the friend that the information would never be shared.Which of the following actions should be taken by the nurse?

Accepted Answer

When the nurse identifies a child who may be abused or who receives information from someone else that a child may have been abused,the nurse must contact the appropriate legal authorities and the school's principal.Asking the student about the abuse will not always elicit a truthful answer,because children will protect their parents.A confidential file should be made about the incident; however,the nurse should let the government authorities,usually the state or county child protection department,look into the suspected case.In all cases,the child should be protected from harm,and those who have no right to know that child abuse or neglect is suspected should not be given any information.

Question 18

Which of the following best describes services that are offered at a school-based health center?

Accepted Answer

These are family-centered,community-based clinics that are run within school,often in low income populations.These centers provide primary care services to students of preK-12 and may offer expanded health services,including mental health and dental care.The intention of school-based health centers is to provide care specifc to preK-12 grade students,not employees.These clinics provide a variety of services,depending on the clinic.Based on the size and services of the clinic,they may not provide family planning services,referral,or networking with other health care services.

Question 19

An upset mother calls the school nurse and says,"How dare you say my child has lice? My child is clean and I keep a clean house! You've obviously made an error." Which of the following would be the best response by the nurse?

Accepted Answer

The nurse must reassure the mother that no insult was intended; in fact,lice are most often found on middle-class children with clean hair.Lice travel easily when children share items such as combs or other property in school.Lice are not life-threatening,and the necessary shampoo and other items to treat lice are widely available over the counter.Most school policies are more caring and less exclusionary and allow children with lice to attend school.It is more likely that the student contracted the lice from another student than from traveling to a motel.If the nurse has delegated the reponsibility of assessing for lice to a volunteer,the nurse should reassess the findings of the volunteer to confirm that the child has lice before contating the parent.

Question 20

The school nurse has arranged for volunteers to help check each child's hearing and vision.Any child that the volunteers feel did not "pass" will be sent to the nurse for follow-up.The nurse will then send a note to the parents that a physician should be seen.Which of the following levels of prevention is being implemented?

Accepted Answer

Because secondary prevention involves caring for children when they need health care,this is the largest responsibility for the school nurse.This includes caring for ill or injured students and school employees.It also involves screening and assessing children and referral to appropriate health agencies or providers.Primary prevention involves providing education before a problem or disease occurs.Tertiary prevention aims at rehabilitation after the disease or problem has occurred and intends to get the client to the highest possible level of functioning.

Quiz 31: The Nurse in the Schools