Chapter 42: The Nurse in the Schools; Stanhope
In designing a tertiary prevention intervention to address the leading cause of school absences related to chronic illness, the school nurse should focus on: a. asthma. b. attention-deficit hyperactivity disorder. c. diabetes mellitus. d. digestive system problems.
ANS: A Asthma is the leading cause of children's absence from school as a result of a chronic illness. Children may be hospitalized with an asthma attack or have been recently discharged from the hospital to home. Asthma may be caused by allergic triggers with which the child comes into contact in the school, such as chalk dust, mold/mildew, or pet dander. There may also be concerns about the air quality in the school or specific classroom activities. The nurse can help students with asthma through medication administration, coaching in asthma management, and education of the student, teachers, other children, and parents. Cognitive Level: Analysis Associated Chapter Objective: 4 REF: p. 930
Since 1987, the Centers for Disease Control and Prevention (CDC) has funded the federal school health program, which today provides for: a. development of a health education curriculum that includes parents and community. b. development of school-linked programs. c. establishment of school-based health centers. d. hiring of school nurses to achieve a 1:750 nurse-to-student ratio.
ANS: A The federal school health program, an eight-part plan originally developed in 1987 with coordination and funding by the CDC, has led to the development of a comprehensive school health education program that includes the parents and the community in the children's care. By 2001, 20 states had school health programs funded by the CDC. The funding paid for the development of health education plans of study, or curricula that included policies, guidelines, and training for those programs. The states then used these courses to teach schoolchildren. The schools are actively involved in helping children practice problem solving, communication, and other life skills so they can reduce their risk factors. Cognitive Level: Analysis Associated Chapter Objective: 3 REF: pp. 920-922
The case manager role of the school nurse can best be described as: a. coordinating health care for children with complex health problems. b. counseling students to choose workable solutions to their problems and conflicts. c. referring students to available resources. d. screening students for common health problems.
ANS: A The school nurse's case manager role is to help coordinate the health care of children with complex health problems to ensure that students' health care appointments and visits have the minimum possible negative impact on their educational experience. Cognitive Level: Application Associated Chapter Objective: 2 REF: p. 920
The school nurse plans a health education program on diet and nutrition for adults attending a general equivalency degree (GED) program held at the local high school in the evenings. This best exemplifies which role of the school nurse? a. Community outreach b. Consultation c. Counseling d. Provision of direct care
ANS: A When performing community outreach, school nurses can participate in community health fairs in the schools, influenza immunization programs, and blood pressure screenings for school staff, among other things. The school nurse can also serve as the liaison for coordinating educational programs in the schools provided by local health charities. School nurses also provide health education to adult learning centers that conduct GED programs, job training, or instruction in English as a second language. Cognitive Level: Application Associated Chapter Objective: 2 REF: p. 920
The National Association of School Nurses (NASN) and standards of practice for school nurses set forth which of the following principles? (Select all that apply.) a. School nurses should have a bachelor's degree in nursing and a specialty certification. b. School nursing uses the nursing process. c. Credentialing is recommended but not required. d. American Academy of Pediatrics governs the school nurse's practice. e. School nurses must ensure the safety of the children, including when delegating care.
ANS: A, B, E In reality, the educational preparation of school nurses ranges from associate to master's degrees. However, the NASN, the professional organization for school nurses, recommends that school nurses be registered nurses with a bachelor's degree in nursing and specialty certification as a school nurse. The NASN identifies eight criteria for schools nurses in providing care. One of these criteria is ensuring the safety of the children, including when delegating care. The American Academy of Pediatrics is a physician organization that does not have regulatory power over nursing but has developed guidelines for providing health care to students in schools that compare well with the NASN standards of practice. Cognitive Level: Synthesis Associated Chapter Objective: 1 REF: p. 917
A middle school student approaches the school nurse and says, "Can I talk to you about something important?" The school nurse responds affirmatively but should clarify: a. "Anything you tell me will be kept private and confidential." b. "If anything you tell me indicates that you or someone else is in danger, I must tell the parents and school officials." 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."
ANS: B The school nurse may be the person whom children trust to be told important secrets about health. It is important that, as a counselor, the school nurse have a reputation as a trustworthy person to whom children can go when they are in trouble or when they need someone to talk to. Nurses in this situation should tell children that if anything they reveal indicates that they are in danger, the parents, and school officials must be told. However, privacy and confidentiality, as in all health care, are important. Cognitive Level: Application Associated Chapter Objective: 2 REF: p. 920
In designing a substance abuse primary prevention education program for the secondary schools in the community, it would be most important for the school nurse to include content related to the latest trend in the use of: a. cocaine. b. ecstasy. c. heroin. d. marijuana.
ANS: B There has been an increase in the use of "club drugs" such as lysergic acid (LSD), ketamine, gamma hydroxybutyrate (GHB), Rohypnol, and ecstasy (MDMA). The school nurse can teach students about the serious side effects of ecstasy, especially that it causes a very high body temperature, which can lead to death. Teaching students about the dangers of using all drugs is the responsibility of the school nurse. The school nurse can also teach parents and other members of the community about the latest drug use trends, increasing everyone's awareness of these dangerous trends. Cognitive Level: Analysis Associated Chapter Objective: 4 REF: p. 924
From August through May, an inner city school district provides primary health care services, including mental health and dental care, to children and youth. This is a specific example of which of the following? a. Child health improvement program b. Primary care clinic c. School-based health center d. School health system
ANS: C Because many children may not receive health care services other than screening and first aid care from the school nurse, the federal government began funding school-based health centers. School-based health centers are family-centered, community-based clinics run within schools. These clinics provide expanded health services, including mental health and dental care, as well as the more traditional health care services like primary care. They can be small or large and may provide services during the school year, during certain hours throughout the year, or 24/7 all year. Cognitive Level: Analysis Associated Chapter Objective: 3 REF: p. 922
The increased use of telehealth in the school system will be driven largely by: a. Healthy People 2020 objectives related to school health. b. increasing need for efficiency, documentation, and successful clinical outcomes in providing care to students. c. increasing need to provide health care services in the schools. d. National Association of School Nurses guidelines.
ANS: C The future of school nursing is strong. The amount of health care being given in the schools is increasing. In the future, school nursing will involve telehealth and telecounseling to teach health education. The internet will be used by school nurses to work with children and parents. Teleclinics operated out of the schools will be seen more frequently. Cognitive Level: Analysis Associated Chapter Objective: 5 REF: p. 933
The Child Nutrition and WIC (Women, Infants, and Children) Reauthorization Act of 2004 designates that each local education agency participating in federal school meal programs have: a. accommodations for services provided to special needs children. b. normal education experience for all children. c. school-based clinic. d. school wellness policy.
ANS: D To address obesity and to promote healthy eating and physical activity through changes in school environments, Congress passed the Child Nutrition and WIC Reauthorization Act of 2004 designating that each local education agency (LEA) participating in federal school meal programs, such as the National School Lunch or Breakfast Program, must establish a local school wellness policy. Cognitive Level: Analysis Associated Chapter Objective: 3 REF: p. 916