Community Nursing Chapter 30

A 6-year-old child fails a routine vision screening on a Snellen chart at a school-based health center. The appropriate action by the nurse is to a. rescreen the child in the following year. b. refer the child to an eye specialist. c. use a Rosenbaum chart instead of a Snellen chart. d. do an internal ophthalmologic examination.

b. refer the child to an eye specialist. The role of the nurse in a school-based health center includes vision, hearing, and scoliosis screening and first-aid and medication administration, but the nurse should refer the individual to an appropriate specialist for diagnosis and treatment.

A school nurse evaluates the implementation of health promotion in a high school staff. Which indicates a need for more education? a. A flyer advertising an ice cream and pizza party for the student awards program b. Condoms being provided in all restrooms of the school c. A decrease in missed days at school d. The discontinuation of the availability of soft drinks and candy in vending machines during school instructional hours

a. A flyer advertising an ice cream and pizza party for the student awards program School nurses facilitate positive student responses to normal development; promote health and safety, including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning.

A priority health education topic for school-age children is a. schoolyard safety. b. motor vehicle safety. c. sports safety. d. immunization schedules.

a. schoolyard safety. Schoolyard injury accounts for 200,000 injuries yearly and is one of the greatest health concerns for elementary children. Motor vehicle safety should be included in programs for adolescents who are beginning to drive. Sports safety is particularly important among adolescents as participation in sports continues to grow, especially among girls. Immunization schedules are an important topic of education for parents of younger children and babies.

A school nurse knows that under the Family Educational Rights and Privacy Act, a student's health record can be released a. if the student is not a minor. b. in an emergency. c. to educators not involved in the student's education. d. without the student's or guardian's permission.

b. in an emergency. School health records are confidential, and without permission, releasing them is unethical and improper unless in an emergency.

A week before finals, a school nurse assesses a 15-year-old girl complaining of vague symptoms. All symptoms or behaviors should result in an immediate request for parent or guardian conference and referral to a physician for further evaluation except a. problems eating or sleeping. b. problems making decisions. c. frequent requests for a visit to the school nurse. d. inability to concentrate.

c. frequent requests for a visit to the school nurse. Problems eating or sleeping, use of alcohol or other substances, problems making decisions, persistent angry or hostile feelings, inability to concentrate, increased boredom, frequent headaches or ailments, and inconsistent school attendance are all warning signs of stress. The nurse should be aware that these symptoms can negatively affect an adolescent's mental and physical health, and the student should be screened for depression and suicide.

A comprehensive school health program should include all except a. health promotion for staff and health education. b. health services and health education. c. physical examinations and comprehensive health history. d. nutrition services and counseling.

c. physical examinations and comprehensive health history. The eight components of a comprehensive school health program are health education, physical education, health services, nutrition services, counseling, psychological and social services, healthy school environment, health promotion for staff and family, and community involvement. Physical examinations and comprehensive health history are not included.

A goal set by Healthy People 2020 includes education to middle, junior, and senior high school students in priority areas. These areas include (Select all that apply.) a. lack of physical activity. b. poor nutrition. c. alcohol and drug use. d. poor organizational skills. e. injury and violence.

a, b, c, e, An objective of Healthy People 2020 sets a goal that middle, junior, and senior high schools provide health education courses in priority areas. Centers for Disease Control and Prevention (CDC) (2012a) identified six high-risk behaviors that need to be targeted in health education courses. The six behaviors identified by the CDC include (1) alcohol and drug use, (2) injury and violence (including suicide), (3) tobacco use, (4) poor nutrition, (5) lack of physical activity, and (6) sexual behavior that results in sexually transmitted diseases or unwanted pregnancies.

While verifying compliance with immunization requirements, a school nurse notices that three students from the same family have not completed their immunizations. How should the nurse address this problem? a. Discuss with the principal the lack of immunizations. b. Expel the children from school. c. Contact the parents and educate them about the immunization requirements. d. Pull the students from class and immunize them.

c. Contact the parents and educate them about the immunization requirements. All states require proof of current immunization status or evidence of immunity unless there is an exception (religious, moral belief, or medical contraindication). It is the nurse's responsibility to assess the situation and educate the family. The nurse's responsibility is not to expel the students or immunize them herself.

A 10-year-old boy visits the nurse complaining of a headache and nausea. The nurse recognizes the boy from an earlier conference with a teacher about the boy's declining school performance. The nurse has been concerned because the boy's father and mother are recently divorced, and his mother works nights. An appropriate nursing intervention would be to investigate the boy's eligibility for a. The Nutritional Education and Training Program (NET). b. Youth Risk Behavior Surveillance System. c. Adult and Child Protective Services. d. Federally funded breakfast and lunch program.

d. Federally funded breakfast and lunch program. The school nurse has several federal resources available to assist children in need. The nurse must be able to recognize children and families that may be eligible for assistance. Options A, B, and C are not appropriate referrals for a child in the specified situation. NET focuses on healthy nutritional choices and health promotion and disease prevention topics in school and child care settings. The Youth Risk Behavior Surveillance System identifies and trends youth risk behavior. Adult and Child Protective Services assess and protect children from abuse.

Healthy People 2020 addresses all goals for children and adolescents except a. physical activity. b. sex education and HIV prevention. c. smoking prevention. d. cardiovascular accidents, stroke, and diabetes.

d. cardiovascular accidents, stroke, and diabetes. Healthy People 2020 does not address cardiovascular accidents, stroke, or diabetes in its objectives for children and adolescents. The other options are addressed.