Chapter 31 - The Nurse in Schools
bd
A child has multiple disabilities, and caring for the child has been both expensive and time consuming for the school. Once the child turns 16, which of the following actions should be taken by the nurse (Select all that apply.) a. As an adult, the child is no longer eligible for school services without charge. b. The school must continue to provide needed appropriate education for the child. c. The school can exclude the child from any extra special activities. d. The school should prepare an updated individualized education plan.
b
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? a. Consultant b. Community outreach c. Counselor d. Researcher
The school nurse at the intermediate level arrangements for a presentation by the trauma educator at the local regional medical center bicycle and helmet safety will be the primary topic of the school's open house this is an example of which of the following school nurse roles A. Community outreach B. Counselor C. Consultant D. Case manager
A. Community outreach
b
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? a. "I'm sorry you're upset, but your child cannot return to school until this problem is addressed." b. "Most lice are found in clean hair. Children often share combs. Let me tell you how to fix the problem." c. "You may have been traveling. Lice are often found in motels." d. "I'm sure you're correct; one of my volunteers probably made an error. I'll recheck."
b
An urban school-based clinic is located in a school district where many of the children lack health insurance. The school nurse continues to provide screening, assessment, first aid, and record keeping but can refer students who require additional services to the nurse practitioners that staff the school-based health center (SBHC) on the school grounds. The SBHC is federally funded under which of the following? a. CDC's Federal School Health Program b. The Affordable Care Act c. Healthy People 2010 d. School-linked program
The future of school nursing is very strong and will be further enhanced by the future trend in which of the following A. Development of an HIV/AIDS health curriculum B. Enhanced use of picture boards C. Improving the air quality of school buildings D. Telehealth and telecounseling
D. Telehealth and telecounseling
abde
Secondary prevention activities are the largest responsibility of the school nurse and may include which of the following? Select all that apply. a. Establishing an emergency plan when a child or staff member needs immediate care b. Giving medications to children during the school day c. Participating in developing an individual education plan (IEP) for students with long-term health needs d. Screening for vision, hearing, height and weight, oral health, TB, and scoliosis e. Teaching standard precautions to all staff
d
The future of school nursing is very strong and will be further enhanced by the future trend in which of the following? a. Development of an HIV/AIDS health curriculum b. Enhanced use of picture boards c. Improving the air quality of school buildings d. Telehealth and telecounseling
c
The principal of a school was upset over a rumor that one of the children had engaged in a violent activity that injured a younger sibling. The principal asked the nurse who the children were so that the involved teachers could both support the injured child and guard other children from the violent child. Which of the following would be the best response by the nurse? a. "I'll get the names to you and the involved teachers immediately." b. "Let me get the parents' consent, and then I'll get you the names." c. "Rumors are often inaccurate; let me follow up and see what happened and what needs to be done." d. "Why don't we coordinate a school-wide program on preventing accidents instead"
a
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? a. Primary b. Secondary c. Tertiary d. Both primary and secondary
a
The school nurse at the intermediate level arranges for a presentation by the trauma educator at the local regional medical center. Bicycle and helmet safety will be the primary topic at the school's open house. This is an example of which of the following school nurse roles? a. Community outreach b. Counselor c. Consultant d. Case manager
abc
Which of the following activities are included in the Centers for Disease Control and Prevention's school health program (Select all that apply.) a. Ensuring a healthy school environment b. Assisting teachers with education related to health c. Encouraging nutritious school meals d. Giving immunizations to students, staff, teachers, and their families
b
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? a. Case manager b. Consultant c. Counselor d. Health educator
a
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? a. Educate students about injury prevention measures b. Provide free condoms to sexually active students c. Screen for signs and symptoms of cancer d. Invite a guest speaker to talk about living with HIV
ad
A new student's parents had not yet submitted an immunization record, although the nurse had sent a reminder home with the student twice. Which of the following actions should be taken by the nurse to keep the child in school (Select all that apply.) a. Call the parents or mail another reminder. b. Report the problem to the teacher and the principal. c. Send the child home with a note saying the child cannot return until the immunization record is received. d. Suggest to the parents that if they don't have health care insurance, they may qualify for programs that provide immunizations free.
1. A unique characteristic of the standards of practice for school nurses is which of the following? Alignment with the American Academy of Pediatrics (AAP) guidelines for providing health care to students Requirement of bachelor's degrees in nursing and special certification in school nursing Restriction on delegation of care to other school personnel Use of research findings in the practice of school nursing
A In general, the National Association of School Nurses (NASN) standards align with those developed by the American Academy of Pediatrics (AAP) regarding giving health care to students in the schools. The AAP developed its own ideas about how nurses function in schools based on its assessment of school children's health needs. These guidelines are very similar to those written by the NASN. Additionally, the AAP recommends that the nurse be the head of a health care team that includes a physician (preferably a pediatrician), school counselors, the school psychologist, and members of the school staff including the administrators and teachers. DIF: Cognitive Level: Comprehension REF: Page 569
7. A school district in the Midwest has included health education, physical education, health services, nutrition services, and counseling, psychological, and social services as components of the student health services. Additionally, the district has integrated family/community involvement, staff health promotion, and a commitment to a healthy school environment in its program design. This school district has adopted the school health service program scope of which of the following? CDC's Federal School Health Program Healthy Schools, Healthy Communities program Healthy People 2020 School-linked program
A The federal government, through the coordination of the CDC, has developed the Federal School Health Program. The plan includes eight parts: health education; physical education; health services; nutrition services; counseling, psychological, and social services; healthy school environment; health promotion for staff; and family/community involvement. DIF: Cognitive Level: Application REF: Pages 570-571
2. A second-grade child with cerebral palsy receives services from a physical therapist and occupational therapist during the child's academic day. The school nurse sets up the schedule to ensure that the therapists' visits do not unnecessarily affect the child's academic day negatively. This role of the school nurse is best described as which of the following? Case manager Counselor Consultant Direct caregiver
A The school nurse is expected to function as a case manager, helping to coordinate the health care for children with complex health problems. This may include the child who is disabled or chronically ill, who may be seen by a physical therapist, an occupational therapist, a speech therapist, or another health care provider during the school day. The nurse sets up the schedule for the child's visits so that those appointments do not unnecessarily have a negative effect on the child's academic day. Direct caregiver is the traditional role of the school nurse where immediate nursing care is provided. 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 school nurse as counselor occurs when children go to the nurse to share important health information. DIF: Cognitive Level: Application REF: Page 570
9. The school nurse at the intermediate level arranges for a presentation by the trauma educator at the local regional medical center. Bicycle and helmet safety will be the primary topic at the school's open house. This is an example of which of the following school nurse roles? Community outreach Counselor Consultant Case manager
A When participating in community outreach, nurses can be involved in community health fairs, reaching others about influenza immunization programs, promoting health education fairs, and coordinating with local charities to provide education to 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. The school nurse is expected to function as a case manager, helping to coordinate the health care for children with complex health problems. The school nurse as counselor is available to students who need to discuss confidential health matters. DIF: Cognitive Level: Application REF: Page 570
d
A child with severe macular degeneration and some hearing loss will be attending the third grade in a local school. A tertiary prevention intervention the school nurse should perform would be which of the following? a. Assess the child's language skills, motor abilities, and social abilities. b. Ensure that a telephone is available for calling emergency personnel or parents. c. Lead educational programs to address coping strategies and stress management techniques. d. Meet with the assigned teachers to discuss classroom seating to enhance the child's learning experience.
b
A disaster has occurred in the community. Which of the following actions should be taken by the school nurse? a. Continue activities as much as possible as if nothing had happened b. Continue to assess for shock and stress c. Help teachers discuss the disaster with their class d. Maintain school routines and activities
a
A group of nursing students are scheduled to present a program on healthy hearts to various community groups, with a daycare center being the first location. What of the following advice should be given to them by their instructor? a. Base the program on the audience's development and maturity. b. Bring (borrow if necessary) a model of the heart to help explain its functioning. c. Focus on entertaining the learners. d. Have lots of handouts to reinforce the lesson.
b
A middle school student approaches the school nurse and asks, "Can I speak with you about something important?" The school nurse responds affirmatively but should also state which of the following? a. "Anything you tell me will be kept private and confidential." b. "If anything you tell me indicates that someone is in danger, the parents and school officials must be told." c. "It may be best for me to set up an appointment with the school counselor." d. "You can always speak to me if you are in trouble or when you need someone to talk to."
a
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? a. Call in another nurse to care for this client. b. Explain, from the nurse's perspective, all the reasons that abortion should be made illegal. c. Offer the student a combination of oral contraceptives to induce spontaneous abortion. d. Provide information on alternatives to abortion and give the client information on adoption agencies.
a
A school district in the Midwest has included health education, physical education, health services, nutrition services, and counseling, psychological, and social services as components of the student health services. Additionally, the district has integrated family/community involvement, staff health promotion, and a commitment to a healthy school environment in its program design. This school district has adopted the school health service program scope of which of the following? a. CDC's Federal School Health Program b. Healthy Schools, Healthy Communities program c. Healthy People 2020 d. School-linked program
abd
A school nurse describes to teachers the characteristics of an adolescent who may be thinking about drastic violence. Which of the following behaviors would suggest the adolescent was having such problems (Select all that apply.) a. Being a gang member b. Damaging property c. Leaving the scene if another student is being bullied or hurt d. Mood swings
c
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? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Both primary and secondary prevention
a
A school nurse is administering medications at the school. Which of the following guidelines should be followed? a. A current drug reference should be available in case information is needed b. The nurse should administer medications brought in from home by the child c. Medications cannot be administered without a physician order d. Narcotics and controlled substances should be kept in a locked cabinet
c
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? a. Primary b. Secondary c. Tertiary d. Both primary and secondary
d
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? a. Ask the student if abuse has occurred. b. Call in the named student and ask him to remove his shirt. c. Discuss the conversation with the student's parents. d. Notify the legal authorities.
a
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? a. Adolescent suicides b. Bullying c. Obesity d. Teenagers engaging in violence
a
A second-grade child with cerebral palsy receives services from a physical therapist and occupational therapist during the child's academic day. The school nurse sets up the schedule to ensure that the therapists' visits do not unnecessarily affect the child's academic day negatively. This role of the school nurse is best described as which of the following? a. Case manager b. Counselor c. Consultant d. Direct caregiver
a
A unique characteristic of the standards of practice for school nurses is which of the following? a. Alignment with the American Academy of Pediatrics (AAP) guidelines for providing health care to students b. Requirement of bachelor's degrees in nursing and special certification in school nursing c. Restriction on delegation of care to other school personnel d. Use of research findings in the practice of school nursing
A second grade child with cerebral palsy receive services from a physical therapist and occupational therapist during the child's academic day the school nurse that's up a schedule to ensure that the therapist visits do not unless they are really affect the child's academic de- lis this role of the school nurse is best described as which of the following A. Case manager B. Counselor C. Consultant D. Direct caregiver
A. Case manager
10. Secondary prevention activities are the largest responsibility of the school nurse and may include which of the following? (Select all that apply.) Establishing an emergency plan when a child or staff member needs immediate care Giving medications to children during the school day Participating in developing an individual education plan (IEP) for students with long-term health needs Screening for vision, hearing, height and weight, oral health, TB, and scoliosis Teaching standard precautions to all staff
A, B, D, E Secondary prevention involves caring for children when they need care and is the largest responsibility of the school nurse. It may include such activities as caring for ill or injured children or staff (including the development of an emergency plan and appropriate training of staff in standard precautions, first aid, and relevant emergency procedures); screening and assessing children; making appropriate referrals; giving medications; identifying abuse and neglect; communicating with health care providers; preventing suicide and violence; and responding to disasters. DIF: Cognitive Level: Application REF: Pages 574-575
A unique characteristic of the standards of practice for school nurses is which of the following A. Alignment with the American Academy of Pediatrics (AAP) guidelines for providing health care to students B. Requirement of bachelor's degrees in nursing and special certification in school nursing C. Restriction on delegation of care to other school personnel D. Use of research findings in the practice of school nursing
A. Alignment with the american academy of pediatrics guidelines for providing healthcare to student
A school district in the Midwest has included health education, physical education, health services, nutrition services, and counseling, psychological and social services as components of the Student Health Services additionally the district has integrated family community involvement staff health promotion and a commitment to the help school environment and its program design this school district has adopted the school health service program scope of which of the following A. CDC's Federal School Health Program B. Healthy Schools, Healthy Communities program C. Healthy People 2020 D. School-linked program
A. CDC's federal school health program
Secondary prevention activities are the largest responsibilities of the school nurse and may include which of the following A. Establishing an emergency plan when a child or staff member needs immediate care B. Giving medications to children during the school day C. Participating in developing an individual education plan (IEP) for students with long-term health needs D. Screening for vision, hearing, height and weight, oral health, TB, and scoliosis E. Teaching standard precautions to all staff
A. Establishing an emergency plan when a child or staff member needs immediate care B. Giving medications to children during the school day D. Screening for vision, hearing, height and weight, oral health, TB, and scoliosis E. Teaching standard precautions to all staff
b
At the end of each school term, the school nurse schedules an equipment safety assessment of each school playground in the district. The school nurse uses the guidelines of the U.S. Consumer Protection Safety Commission and prepares a report of the findings for the school board for planning purposes. This intervention by the school nurse is an example of which of the following? a. Community outreach b. Primary prevention c. Secondary prevention d. Tertiary prevention
c
According to the American Academy of Pediatrics, which of the following activities are expectations for a school health nurse? a. Ensuring that children with health problems are accepted by their peers b. Driving children home if parents can't pick them up c. Giving emergency care in the school or during school events d. Giving medications as needed if children are ill
4. At the end of each school term, the school nurse schedules an equipment safety assessment of each school playground in the district. The school nurse uses the guidelines of the U.S. Consumer Protection Safety Commission and prepares a report of the findings for the school board for planning purposes. This intervention by the school nurse is an example of which of the following? Community outreach Primary prevention Secondary prevention Tertiary prevention
B Injuries are the leading cause of death in children and teenagers. The school nurse educates children, teachers, and parents about preventing injuries. School nurses also provide information on how to prevent playground injuries. They assess school playgrounds for equipment safety on the basis of the U.S. Consumer Product Safety Commission guidelines. DIF: Cognitive Level: Application REF: Page 573
8. An urban school-based clinic is located in a school district where many of the children lack health insurance. The school nurse continues to provide screening, assessment, first aid, and record keeping but can refer students who require additional services to the nurse practitioners that staff the school-based health center (SBHC) on the school grounds. The SBHC is federally funded under which of the following? CDC's Federal School Health Program The Affordable Care Act Healthy People 2010 School-linked program
B School-based health centers are family-centered, community-based clinics run within schools under a federally funded program. These clinics give expanded health services, including mental health and dental care, in addition to the more traditional health care services. The Affordable Care Act of 2010 appropriated $200 million to improve and expand services at SBHC. They can vary in size, hours, and days of operation, or administrative model (i.e., school clinic, health center, school-linked program). They are successful because they focus on bringing health care services to children in a community school location and are coordinated with the school health program. DIF: Cognitive Level: Knowledge REF: Page 571
3. A middle school student approaches the school nurse and asks, "Can I speak with you about something important?" The school nurse responds affirmatively but should also state which of the following? "Anything you tell me will be kept private and confidential." "If anything you tell me indicates that someone is in danger, the parents and school officials must be told." "It may be best for me to set up an appointment with the school counselor." "You can always speak to me if you are in trouble or when you need someone to talk to."
B The school nurse may be the person whom children trust to tell important secrets about their health. The school nurse has a reputation as being a trustworthy person to whom the children can go if they are in trouble or when they need to talk to someone. Nurses in this situation should tell the children that if anything they reveal points out that someone is in danger, the parents and school officials must be told. DIF: Cognitive Level: Application REF: Page 570
A middle school student approaches the school nurse and asks can I speak with you about something important the school nurse responds affirmative Lee but should also state which of the following A. "Anything you tell me will be kept private and confidential." B. "If anything you tell me indicates that someone is in danger, the parents and school officials must be told." C. "It may be best for me to set up an appointment with the school counselor." D. "You can always speak to me if you are in trouble or when you need someone to talk to."
B. If anything you tell me indicate that someone is in danger the parents and school officials must be told
At the end of each school term the school nurse schedules and equipment safety assessment of each school playground in the district the school nurse uses the guidelines of the US consumer protection Safety Commission and prepares a report of the findings for the school board for planning purposes this intervention by the school nurse is an example of which of the following A. Community outreach B. Primary prevention C. Secondary prevention D. Tertiary prevention
B. Primary prevention
An urban school based clinic is located in a school district where many of the children like health insurance the school nurse continues to provide screening, assessment, first aid, and recordkeeping but can refer students who require additional services to the nurse practitioners the staff the school based health center on the school grounds the SBHC is federally funded under which of the following A. CDC's Federal School Health Program B. The Affordable Care Act C. Healthy People 2010 D. School-linked program
B. The Affordable Care Act
6. The future of school nursing is very strong and will be further enhanced by the future trend in which of the following? Development of an HIV/AIDS health curriculum Enhanced use of picture boards Improving the air quality of school buildings Telehealth and telecounseling
D The amount of health care being given in the schools is increasing. In the future, school nursing will use telehealth and telecounseling to teach health education. School nurses will use the Internet to work with children and parents. The school nurse is responsible for keeping up with the latest changes in health care and health practice so that the health of children in the schools can be enhanced by new trends in health care. DIF: Cognitive Level: Knowledge REF: Page 581
5. A child with severe macular degeneration and some hearing loss will be attending the third grade in a local school. A tertiary prevention intervention the school nurse should perform would be which of the following? Assess the child's language skills, motor abilities, and social abilities. Ensure that a telephone is available for calling emergency personnel or parents. Lead educational programs to address coping strategies and stress management techniques. Meet with the assigned teachers to discuss classroom seating to enhance the child's learning experience.
D The school nurse gives nursing care related to tertiary prevention when working with children who have long-term or chronic illnesses or with special needs. This may include participation in the development of an individual education plan (IEP); identification of medication, therapy needs, and/or physical, auditory, or visual limitations; and interventions to ensure the appropriate placement of the child in the classroom environment or physical accommodations required, which enhances the child's learning experience. DIF: Cognitive Level: Application REF: Page 578
A child with severe macular degeneration and some hearing loss will be attending the third grade in a local school and tertiary prevention intervention the school nurse should perform would be which of the following A. Assess the child's language skills, motor abilities, and social abilities. B. Ensure that a telephone is available for calling emergency personnel or parents. C. Lead educational programs to address coping strategies and stress management techniques. D. Meet with the assigned teachers to discuss classroom seating to enhance the child's learning experience.
D. Meet with the assigned teachers to discuss classroom seating to enhance the child's learning experience
c
Which of the following would be the best way for the school nurse to fulfill his or her responsibilities in an emergency situation? a. Tell all staff to call 911 if the nurse is not in the building. b. Arrange to always be available, even if only by phone. c. Create and share an emergency plan with all teachers and staff. d. Wear a pager so that the nurse can come as soon as humanly possible.
b
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? a. Primary b. Secondary c. Tertiary d. Both primary and secondary
a
The mother of a high school student newly diagnosed with a condition that will require special health care services is concerned that the student will be required to be home-schooled away from the friends he has developed. Which of the following would be the most appropriate response by the school nurse? a. "Federal legislation requires that the school make provisions for those with various challenges, so your child will be able to remain in school as long as he is able." b. "I realize that this will be a difficult adjustment, but home-schooling has improved over recent decades and the Internet will allow your child to connect with friends." c. "Whether your child can remain in school will depend on state funding for those with disabilities. You might want to contact your congressman on this issue." d. "Your child may remain in school as long as he can manage the course requirements and doesn't flunk out."
b
Which of the following best describes services that are offered at a school-based health center? a. Employee care at a discounted cost at the school b. Care to others in the community c. Sex education, birth control, family planning, and care throughout pregnancy d. Referral and networking with other health care services in the community
b
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? a. Because children won't know if someone doesn't tell them b. Because injuries are the leading cause of death in children and most injuries are preventable c. Because it is a dangerous world and someone has to warn children about the dangers d. Because teaching is easy and more fun than passing out bandages and documenting care
d
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? a. Teacher shortages have required nurses to be increasingly involved in teaching life skills. b. Because so many nurses want to be employed in schools, this responsibility was assumed to increase employment opportunities. c. States are requiring nurses to screen and to teach life skills. d. Nurses have been enlisted in this role to help reduce risk factors for future health problems in school children.
bd
Which of the following best explains why the federal government is beginning to fund school-based health centers (Select all that apply.) a. These centers help young children avoid becoming addicted to drugs while still in elementary school. b. Attendance and learning are higher in schools with health clinics. c. These centers help keep children in school longer by distributing birth control and thus avoiding pregnancies. d. Many children have no other source of health care services.
b
Which of the following is most important for school nurses to master in order to prepare for health care delivery in the future? a. Complementary and alternative therapies such as acupuncture b. Computer and technology use c. Psychoanalytical techniques d. Self-defense techniques
b
Which of the following is the leading cause of children being absent from school because of a chronic illness? a. Allergies b. Asthma c. Diabetes d. Upper respiratory infections
c
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? a. There is a shortage of baccalaureate-prepared nurses with national school health nurse certification. b. Most nurses prefer to be employed in hospitals giving direct care. c. Most school districts are unable to afford a nurse in every school. d. School districts and taxpayers see no need for nurses in schools.
acd
Which of the following supplies or equipment should a nurse have available in the school health office (Select all that apply.) a. Cervical spine collars b. Complete emergency kit that fulfills American Hospital Association requirements c. Epinephrine autoinjector kit d. Material for splints