CH Test 3: Ch 22
The history of school nursing can be traced back to 1902, when Lillian Wald was working in a New York City public school. She viewed school nursing services as a way to decrease which problem? A) Nutrition deficiencies B) Dental cavities C) Excessive absenteeism D) Seasonal allergies
C Feedback: She believed that school nursing services were a way to decrease excessive absenteeism, not to decrease nutrition deficiencies, dental cavities, or seasonal allergies.
The community health nurse addresses cyber bullying in the local middle schools. Currently, there are no policies in place for this issue. The most appropriate first step is to: A) Explore current programs to prevent bullying and youth violence B) Develop rules for acceptable and safe use of all electronic media for all students C) Ban use of the Internet at all schools D) Actively monitor students' social media postings
A Feedback: The most appropriate first step to take would be to explore current programs to prevent bullying and youth violence. Many of the programs developed to prevent face-to-face aggression address topics such as school climate and peer influences that are likely to be important for prevention of electronic aggression. By researching and perhaps adopting an existing program, the nurse will not have to develop a program from scratch. Developing rules for acceptable and safe use of all electronic media for all students is not likely to be effective because there would be no way to enforce them. This would be a more appropriate action for parents and caregivers. Banning all use of the Internet at all schools would be impractical, as the Internet is increasingly being incorporated into learning, and impossible to enforce. Actively monitoring students' social media postings would be impractical, as no one would have time for this, and cyber bullying can occur on many different sites and devices.
On the basis of the eight recommended components of a comprehensive school health program, which should be included in a K-12 health education curriculum? (Select all that apply.) A) Consumer health education B) Environmental health education C) Sexuality education D) Nutrition counseling E) Physical development activities
A, B, C, D Feedback: K-12 health education curriculum should discuss personal health, family health, community health, consumer health, environmental health, sexuality education, mental and emotional health, injury prevention and safety, nutrition, prevention and control of disease, and substance use and abuse. K-12 physical education curriculum should promote optimum physical, mental, emotional, and social development, as well as activities and sports that all students enjoy and can pursue throughout their lives.
Which services are reimbursable by Medicaid? (Select all that apply.) A) Speech/language therapy and evaluations B) Occupational therapy and evaluations C) Physical therapy and evaluations D) Nutrition screening and evaluations E) Allergy testing and evaluations
A, B, C, E Feedback: Services reimbursable by Medicaid include speech/language therapy and evaluations, occupational therapy and evaluations, and physical therapy and evaluations. Medicaid does not cover nutrition or allergy screening and evaluations.
The school nurse at a public high school recently noticed an increase in students smoking before and after school. Using the community school model to reduce tobacco use among your students, which interventions are appropriate? (Select all that apply.) A) Starting an after-school tobacco cessation program with the assistance of local representatives of the American Cancer Society B) Having a local clinical oncologist speak at a PTA meeting about the hazards of tobacco use among children C) Confronting groups of students while they are smoking with information regarding the school's smoking policy and the dangers of smoking D) Promoting the community's "great smoke-out" smoking cessation event each year E) Encouraging the school's administration to designate a single smoking area outside to limit nonsmokers' exposure to the smoke
A, B, D Feedback: One solution for the provision of comprehensive school health services is called the community school model. This model is a collaborative design that uses the resources of a community to provide structured preventive services such as after-school programs, parent outreach, and crisis intervention. These preventive services are designed to promote changes throughout the school environment. Confronting a group of smokers by yourself is not an example of collaboration or of drawing on community resources to promote changes throughout the school environment. Encouraging the designation of a smoking area, although it might benefit nonsmokers, will not decrease smoking among students and might even encourage it. All of the other examples demonstrate collaborative, community-based approaches to smoking cessation.
An elementary school student comes to school nurse's office reporting a headache. The nursing assessment begins by gathering which subjective data? (Select all that apply.) A) Where it hurts on the child's head B) Whether the pain is constant, throbbing, or intermittent C) What the child's temperature is on arrival D) How bad the pain is on a scale of 1 to 10 E) The presence of a bruise on the child's forehead
A, B, D Feedback: The nurse should begin by collecting subjective data gathered from the child, teacher, or parent, or any other witness to the complaint. Subjective data are those that are reported by the client or others but that are not directly observable by the nurse. Data should include location, frequency, duration and severity, quality, quantity, setting, associated symptoms, and factors that make the symptom better or worse. Objective data are those that are directly observable by the nurse, such as the child's temperature on arrival and the presence of a bruise on the child's forehead.
Which strategies have been shown successful for preventing adolescent pregnancy? (Select all that apply.) A) Responsible sexual behavior education B) Abstinence education C) Mandated religious education on sex practices D) Contraceptive counseling E) Confidential reproductive services
A, B, D, E Feedback: Successful strategies for preventing adolescent pregnancy vary from responsible sexual behavior education, which includes abstinence education, to improved contraceptive counseling and confidential reproductive services, but not mandated religious education on sex practices.
Which common problems should a school nurse be prepared to identify in students? (Select all that apply.) A) Vision impairment B) Malignant melanoma C) Attention deficit hyperactivity disorder (ADHD) D) Scoliosis E) Need for orthodontia
A, C, D Feedback: The school nurse must have skills in health assessment, including the ability to identify common problems that impact a child's learning, such as vision impairment, ADHD, and scoliosis. A school nurse would not be qualified to identify malignant melanomas or the need for orthodontia in children.
The Youth Risk Behavior Surveillance Survey (YRBSS) outlines common risk behaviors influencing the health of the nation's youth. Which risk factors are included on this survey? (Select all that apply.) A) Unintentional injury B) Sports-related trauma C) Sleep deprivation D) Sexual behaviors E) Alcohol use
A, D, E Feedback: Youth Risk Behavior Surveillance Survey risk behavior categories include the following: unintentional injury, violence, tobacco use, alcohol use, drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. Sports-related trauma and sleep deprivation are not risk behavior categories.
Which of the eight recommended components of a comprehensive school health program should include the physical, emotional, and social conditions that affect the well-being of students and staff? A) Family/community involvement B) Healthy and safe school environment C) Counseling and psychology services D) Health promotion for staff
B Feedback: A healthy and safe school environment should include the physical, emotional, and social conditions that affect the well-being of students and staff. Family/community involvement should include school health advisory councils, coalitions, and broadly based constituencies for school health. Counseling and psychology services should include individual and group assessments, interventions, and referrals. Health promotion for staff should encourage staff to pursue a lifestyle that contributes to their improved health status and morale and to develop a greater personal commitment to the school's overall coordinated health program.
The school nurse works with a 12-year-old girl who is obese and has type 2 diabetes. As client advocate, which would be most appropriate nursing action? A) Scold the client when she buys a soda from a vending machine at school. B) Schedule a conference with the client's parents to discuss how to collaboratively manage her blood glucose level and encourage her to select appropriate foods in the cafeteria for lunch. C) Perform a finger stick and check the client's blood glucose level when she reports feeling weak and dizzy one day. D) Weigh the client each week in the office to help track her weight and hold her accountable to her weight loss goals.
B Feedback: Because advocacy involves teaching, empowering, and networking, scheduling a conference with the client's parents to discuss blood glucose management and nutrition would be the most appropriate action to take as her advocate. Performing a finger stick and checking her blood glucose level and weighing her weekly are not good examples of advocacy because they do not involve teaching, empowering, or networking. Scolding the client for buying a soda would not empower her but would likely shame her and would not be an effective intervention.
Which is one of the most important strategies recommended by the Centers for Disease Control and Prevention (CDC) for reducing the spread of HIV? A) Excluding students from school who have symptoms of sexually transmitted infections B) Routinely screening all adolescents and adults aged 13 to 64 C) Requiring parents to take their adolescent children who have sexually transmitted infections for treatment D) Keeping detailed records of all new cases of sexually transmitted infections in people aged 15 to 24 years
B Feedback: Making HIV testing a routine part of healthcare for adolescents and adults 13 to 64 years of age is one of the most important strategies recommended by the CDC for reducing the spread of HIV. Accurate measures of sexually transmitted infections (STIs) in the 15- to 24-year-old population are difficult to obtain because many affected people have few, if any, identifiable symptoms. Symptomatic adolescents who are suspected of having an STI cannot be excluded from school. Federal law stipulates that adolescents can go directly to a health department-operated STI clinic for diagnosis and treatment of their disease without parental consent.
Being a school nurse requires which combination of practice type and decision making? A) Collaborative practice and interdependent decision making B) Autonomous practice and independent decision making C) Collaborative practice and dependent decision making D) Autonomous practice and interdependent decision making
B Feedback: School nursing requires autonomous practice and independent decision making, not collaborative practice or dependent or interdependent decision making.
Which individual health assessment would a school nurse most likely perform? A) Immunization check B) Assessment of a playground injury C) Vision screening D) Height and weight measurements
B Feedback: Visits for acute illness, playground injury, initial immunization screenings, and counseling require that the nurse assess the child individually. Population-based screening programs may include periodic vision and hearing tests, height and weight measurements, or immunization checks.
The Centers for Disease Control and Prevention (CDC) recommends which methods for improving the food environments of school-aged children and adolescents? (Select all that apply.) A) Preserving social norms of adolescents B) School-based prevention C) Policy and regulatory strategies D) Strategic use of media E) Coordination of statewide and local activities
B, C, D, E Feedback: The CDC has established a self-assessment and planning tool (School Health Index) and guidelines that can be used in school health programs in an effort to improve the food environments of school-aged children and adolescents. These current CDC guidelines focus on changing the social norms and environments of adolescents. In addition to school-based prevention, the guidelines recommend policy and regulatory strategies, community participation, establishment of public and private partnerships, strategic use of media, development of local programs, coordination of statewide and local activities, linkage of school-based activities to community activities, and use of data collection and evaluation techniques, such as the School Health Index, to monitor program impact.
Which health education interventions are appropriate for the school nurse to perform? (Select all that apply.) A) Teaching faculty members how to assess their students for upper respiratory illnesses B) Teaching a student how and when to use her EpiPen C) Teaching a 6th-grade class about the consequences of cyber bullying D) Counseling a student about tobacco use E) Teaching a group of students with eating disorders about a healthy view of food
B, C, D, E Feedback: The school nurse must seek to accomplish health teaching in encounters with students and families, in the classroom, in individual counseling sessions (e.g., teaching a child how and when to use his or her EpiPen), and in group meetings. It is recommended that the focus of health education be health promotion based on concerns addressed in the National Health Objectives of Healthy People 2020. These issues include use of drugs and alcohol, sexual behavior, tobacco use, nutrition, physical activity, and violence prevention. It would not be appropriate for the nurse to teach faculty members how to assess their students for upper respiratory illnesses, as this is the nurse's responsibility.
Which actions exemplify the school nurse's role as a child advocate? (Select all that apply.) A) Injecting a child with her EpiPen during an anaphylactic reaction to peanuts B) Convincing the cafeteria manager to include low-sugar options in the lunch menu for students with diabetes C) Taking the temperature of a child who is exhibiting signs of an upper respiratory infection D) Teaching a child who has recently been diagnosed with asthma how to use an inhaler E) Instructing a group of faculty members on the proper way to respond to a child having an epileptic seizure in class
B, D, E Feedback: Advocacy involves both teaching children and empowering others who care for the children to ensure quality care. The child with a chronic health condition presents a unique challenge for nurses as advocates. As many as 10% to 15% of children in schools are affected with chronic conditions, such as asthma, diabetes, and seizure disorders, that require daily treatment. The nurse as advocate has two important roles: spreading knowledge and networking. Spreading knowledge does not ensure health, but a person's sense of being able to control his or her own healthcare does promote healthy behaviors. Networking is also important. Working together, the school nurse, parents, teachers, and healthcare providers can ensure that the child with special healthcare needs has access to all educational resources and opportunities. Injecting a child with an EpiPen during an anaphylactic reaction and taking a child's temperature are basic nursing interventions and do not exemplify advocacy, as the nurse is not teaching, networking, or empowering others. All of the other answers are characterized by these behaviors.
Which occurred as a result of the passage of the Education for All Handicapped Children Act in 1975? A) Children with disabilities were provided tax-funded tutors for home education. B) Children with mental disabilities were entitled to a tax-funded education at a special education private school. C) Children with chronic or complex medical issues were entitled to a public education. D) Children with physical disabilities were provided grants to attend the college of their choice.
C Feedback: The biggest change in school nursing practice came in 1975 with the passage of the Education for All Handicapped Children Act of 1975 (Public Law 94-142). Children who had previously not been able to attend school because of chronic or complex medical issues were now entitled to a public education, and they began attending public schools.
In which phase of a school-based substance abuse program is information most likely to have meaning and applicability to students? A) Inoculation B) Primary C) Early relevance D) Tertiary
C Feedback: The three phases during which introducing interventions is most likely to produce results are as follows: (1) the primary prevention or inoculation phase, which is designed to introduce knowledge; (2) the secondary prevention or early relevance phase, when information is likely to have meaning and applicability to students; and (3) the tertiary prevention or later relevance phase, when young people are actually being exposed to new situations involving experimentation.
Which is the most appropriate intervention to use in a school-based substance abuse program? A) Integrating students' goals with those of a prevention program B) Assessing the needs and interests of the group carefully after selecting a program C) Designing a program that is knowledge based D) Designing an interactive, behavior-focused program
D Feedback: Integrating the goals of the school (not those of the students) with those of the prevention program, assessing the needs and interests of the group carefully before (not after) the selection of any program, and designing programs that are behavior focused rather than knowledge based are important principles to use in education programs.
The school nurse is concerned about the lack of nutritional choices available in the food vending machines at the school. Which is the best tool to address this situation? A) Food-Safe Schools Action Guide B) Health Education Curriculum Analysis Tool C) Improving the Health of Adolescents and Young Adults: A Guide for States and Communities D) Making It Happen!
D Feedback: Making It Happen! is a health tool that provides examples and success stories of 32 schools and school districts that have implemented innovative approaches to improve the nutritional quality of foods and beverages sold outside the school meals program. Food-Safe Schools Action Guide (FSSAG) helps schools work with Cooperative Extension, health departments, and families in efforts to make schools food-safe. Health Education Curriculum Analysis Tool helps schools, school districts, and other school personnel responsible for curricular redesign to analyze health education curricula on the basis of alignment with national health education standards and characteristics of effective health education curricula. Improving the Health of Adolescents and Young Adults: A Guide for States and Communities helps guide people and organizations through public health processes that address the 21 Critical Health Objectives identified in Healthy People 2010 for adolescents and young adults.
