Question 1

The nurse is aware that most of the students prefer the fried food choices in the school cafeteria and that the many of the students are considered overweight by body mass index (BMI) standards. Strategies that the nurse can employ to ameliorate this concern include: (Select all that apply.)

Accepted Answer

2. Working with the food staff on menu planning can allow input about healthier choices to be given to the students for food selections. Presenting programs to students and families about nutrition, healthy choices, and school nutrition will allow all parties to become more aware of how nutritional choices affect overall health. Demanding that the food staff eliminate all fried foods is an unrealistic strategy, and will only alienate important members of the school team. Assigning mandatory exercise programs to students with overweight BMIs stigmatizes and targets them as well as displays insensitivity to their self-esteem.
3. Working with the food staff on menu planning can allow input about healthier choices to be given to the students for food selections. Presenting programs to students and families about nutrition, healthy choices, and school nutrition will allow all parties to become more aware of how nutritional choices affect overall health. Demanding that the food staff eliminate all fried foods is an unrealistic strategy, and will only alienate important members of the school team. Assigning mandatory exercise programs to students with overweight BMIs stigmatizes and targets them as well as displays insensitivity to their self-esteem.
4. Working with the food staff on menu planning can allow input about healthier choices to be given to the students for food selections. Presenting programs to students and families about nutrition, healthy choices, and school nutrition will allow all parties to become more aware of how nutritional choices affect overall health. Demanding that the food staff eliminate all fried foods is an unrealistic strategy, and will only alienate important members of the school team. Assigning mandatory exercise programs to students with overweight BMIs stigmatizes and targets them as well as displays insensitivity to their self-esteem.

Question 2

The nurse being interviewed for a position at a local school expects that the position responsibilities will entail screening, monitoring immunization status, and performing minor first-aid duties. However the nurse is surprised to learn that other duties include: (Select all that apply.)

Accepted Answer

1. An integrated school health program involves case finding and case management, counseling and referrals to other services, staff health promotion, and parental, student, and community involvement in school activities in addition to monitoring physical education activities at the school and the nutrition of the meals provided there. Reviewing community health policies is not a school nurse responsibility.
2. An integrated school health program involves case finding and case management, counseling and referrals to other services, staff health promotion, and parental, student, and community involvement in school activities in addition to monitoring physical education activities at the school and the nutrition of the meals provided there. Reviewing community health policies is not a school nurse responsibility.
3. An integrated school health program involves case finding and case management, counseling and referrals to other services, staff health promotion, and parental, student, and community involvement in school activities in addition to monitoring physical education activities at the school and the nutrition of the meals provided there. Reviewing community health policies is not a school nurse responsibility.
4. An integrated school health program involves case finding and case management, counseling and referrals to other services, staff health promotion, and parental, student, and community involvement in school activities in addition to monitoring physical education activities at the school and the nutrition of the meals provided there. Reviewing community health policies is not a school nurse responsibility.

Question 3

The nurse performs vision and hearing screening at the school to identify students who may need referrals for further testing. A responsibility of the nurse in screening is to:

Accepted Answer

3. A responsibility of the nurse in the screening category of secondary prevention is to follow up on referrals that result from screening in order to determine the outcome and ensure appropriate care results. Sending letters home to parents reminding the students to wear glasses may not translate to the classroom setting. It is not realistic to monitor students who wear glasses to ensure that this is done. It is appropriate to ask the teachers if they are aware of other problems, but this does not fall within the screening category. It falls within the counseling category.

Question 4

A ventilator-dependent student joins the school and does not need a personal care attendant. Before providing care to the student, the nurse should:

Accepted Answer

3. When a student with special needs attends a school, the student should have an Individualized Health Care Plan (IHP), which details the student's health history, identification of special needs, an overview of the student's basic health status, and information about any medications the student receives, including their administration, timing, dosage, etc. Other needs that are identified in the IHP include nutritional needs, activities with a care plan, and strategies for intervention. The teacher may become involved in the care of the student, but this is not the immediate priority nor is reviewing suctioning procedures. A joint conference may be called, but the IHP should be reviewed first by the nurse to determine its plan, complexity, and completeness.

Question 5

The nurse works in a school that is designated for students with special needs in the district. An important consideration specific to this population is to ensure that these students:

Accepted Answer

1. Students with special needs generally have conditions that make them vulnerable to illness, so an important consideration is that this population receives annual flu immunizations to protect them. All students should have sufficient time at lunch to eat and all students are to have time for physical activity. Personal care attendants are not always necessary for children with special needs.

Question 6

The population health nurse at an elementary school in the community has developed an integrated program of health promotion and health surveillance, which has resulted in much lower rates of student absence than other similar schools in the community. What is the best conclusion to draw from this?

Accepted Answer

3. A school health program that reduces school absenteeism could lead to better academic outcomes because the students are in the classroom more. While the students will probably learn healthy lifestyles, it does not necessarily result in better academic outcomes. There is no indication that the student body lives in an area that has a better health profile. There is also no indication of parental involvement in this program.

Question 7

The school nurse is completing a Continuous Quality Improvement Tool for School-based Health Centers. What should the nurse identify as sentinel events for high school students? (Select all that apply.)

Accepted Answer

1. Sentinel events for the high school version also include alcohol use, risk for violence, STI risk, and depression risk. After school employment hours is not considered a sentinel event.
2. Sentinel events for the high school version also include alcohol use, risk for violence, STI risk, and depression risk. After school employment hours is not considered a sentinel event.
3. Sentinel events for the high school version also include alcohol use, risk for violence, STI risk, and depression risk. After school employment hours is not considered a sentinel event.
4. Sentinel events for the high school version also include alcohol use, risk for violence, STI risk, and depression risk. After school employment hours is not considered a sentinel event.

Question 8

A local nursing program has contracted with an elementary school to conduct health teaching. As the school year closes, the nursing students plan to do one last health teaching program. What would be the most appropriate topic the nursing students should choose?

Accepted Answer

3. As the school year closes, the students will be out of school for the summer, so safety topics such as sun safety, bike safety, and other outdoor safety tips should be emphasized. The other topics are very appropriate, but can be done at any time during the school year; however, the timing of the safety topic is relevant to the upcoming vacation time.

Question 9

The nurse at the local high school is aware that students are particularly vulnerable during this developmental stage to many health challenges. What is an appropriate priority topic to support student self-development?

Accepted Answer

2. All of the topics presented are appropriate to this age level. A priority topic, however, is how to minimize stress and promote self-esteem. High school is a developmental time where students undergo many challenges to their identity and have the pressures of academic achievement and other societal pressures and expectations placed upon them. These challenges can lead to ineffective management and coping. Providing strategies to minimize stress and promote self-esteem can help to educate students about stress management and coping.

Question 10

A student joins the school and the parent tells the nurse that the child has a learning disability. The nurse should ask the parent if the child has:

Accepted Answer

2. A health restoration action is to prevent adverse effects of learning disabilities, so a new student with diagnosed learning disabilities should have an IEP to help the teacher plan appropriate teaching strategies. This will help the student learn as easily as possible. The nurse should be alert to any other conditions the student may have and any special equipment needs, but this is related to preventing complications and promoting adjustment. Information about the ability to make friends in a new environment is related to promoting adjustment, and is not a focus of health restoration.

Question 11

The school nurse is beginning an evaluation of the school-based health center as part of a school district annual report. Which tools should the nurse use that includes the eight components of the CDC model of a coordinated school health program? (Select all that apply.)

Accepted Answer

1. The School Health Index (SHI) and Healthy School Report Card are based on the eight components of the CDC model of a coordinated school health program. The Healthy People 2020 Objectives are primarily used at the national level. The Health Education Curriculum Analysis Tool is an assessment tool for analyzing health education curricula. The Physical Education Curriculum Analysis Tool evaluates the physical education curriculum.
2. The School Health Index (SHI) and Healthy School Report Card are based on the eight components of the CDC model of a coordinated school health program. The Healthy People 2020 Objectives are primarily used at the national level. The Health Education Curriculum Analysis Tool is an assessment tool for analyzing health education curricula. The Physical Education Curriculum Analysis Tool evaluates the physical education curriculum.

Question 12

In the program that the school nurse developed to teach children about health, the teachers assume responsibility for teaching the health principles. The nurse becomes aware that program outcomes are not being achieved. What should the nurse do to resolve this?

Accepted Answer

4. In order for a school health program to succeed, there needs to be involvement on all levels: in the classroom, in the home, and in the community. If program outcomes are not being achieved, the program needs to be modified so that teaching occurs in the classroom and the home. One person cannot hold the responsibility for teaching and reinforcing health concepts. Reinforcing to the teachers the importance of teaching health creates another burden upon them. Expecting the school nurse to assume all teaching responsibilities will quickly create burnout, and may create a neglect of other school nurse responsibilities. Asking for parental involvement to teach health concepts is a partial solution, but the better solution is an integrated approach.

Question 13

A student has been diagnosed with a pulmonary condition that necessitates the use of continuous oxygen. The student's family has limited means and expresses concerns about being able to pay for the use of the oxygen. An important action the nurse can take is to:

Accepted Answer

4. Referring the parents for financial aid for this condition helps to prevent complications and promote adjustment of the student and family to this condition, which is an area of emphasis in tertiary prevention. Listening to the parents and expressing concern is an important nursing intervention, but will not actively help the parents at this point. Educating the teachers about positioning and the school staff about the condition will help them understand and assist the student, but is not related to relieving parental fears about the costs associated with this condition.

Question 14

The majority of the student population at an inner city school is African American. The nurse should be alert to the number of students:

Accepted Answer

1. Sickle cell disease primarily affects African Americans. The nurse should be attentive to members of the student population who may be affected by this, because this can affect school attendance if students experience pain crises. While asthma is rising in the United States, the nurse should not assume that the student population has a disproportionate number of asthma cases. Being overweight is not solely a concern related to racial background. Many children in society today live in single parent homes. There is no indication that this is particularly true of this school population.

Question 15

The local school board has allowed students with certain chronic conditions to have their medications with them at all times. Which situation should the nurse be particularly alert to?

Accepted Answer

3. The child with asthma needs to have access to an inhaler when an attack occurs. Mitigating the effects of an asthma attack includes correct usage of the inhaler, so the nurse would need to assess the child's ability to correctly use the inhaler. ADHD medications are Schedule II medications and, as such, are not allowed to be carried by the child during school hours. A child with diabetes may not be able to use the glucagon in time should he or she become hypoglycemic, so the teacher should be able to know how to apply it. A child with a neurogenic bladder does not need medication to self-catheterize.

Question 16

After receiving a report from a teacher regarding a student who was previously outgoing and doing well in the classroom but is now appearing withdrawn, the nurse assesses the student. The nurse becomes aware that there is a possibility that abuse is happening in the home and notifies the appropriate agencies. In this example, the nurse is:

Accepted Answer

1. Referral in the presence of an identified problem is helping to resolve a health problem. The student that has a dramatic change in appearance and classroom behavior warrants further investigation and appropriate referrals for help, which is done in this situation. The nurse is not refusing to become involved in a domestic situation, as is evident in the referral that was made. The nurse is acting within the scope of practice and is legally obligated to report conditions that can threaten the health and safety of the student. The nurse remains obligated to help the student in this situation.

Quiz 22: Care of School Populations