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NBCSN School Nurse Certification Exam – Practice Q&A Guide, Exams of Nursing

Ace your NBCSN School Nurse Certification Exam with this targeted Q&A guide, featuring real-world questions and concise, authoritative answers. Crafted to solidify key concepts in school nursing practice, this resource is your go-to study companion. Tested Questions & Answers covering: National School Lunch Program — administered by USDA. Scope of School Nursing Practice — outlining the who, what, when, where, and how of school nursing

Typology: Exams

2024/2025

Available from 07/04/2025

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NBCSN - School Nurse Certification
Exam
Who administers the National School Lunch Program?
- USDA (US dept of agriculture)
What does the scope of school nursing practice describe?
- The who, what, where when and how of school nursing practice
What are the standards of school nursing?
- The authoritative statements of the duties school nurses are expected to perform
competently
What legal document describes school nurse delegation?
- State Nurse Practice Act
Impetigo
- Begins as a single lesion which spreads to secondary lesions that crust or scale.
Staph bacteria skin infection. Honey colored crust
Pinworm
- A student who is tired, can't sit still, itching bottom
Describe the primary objective of the school nurse
- to protect and promote student health, facilitate optimal development and advance
academic success. Goal is to strengthen the educational process through improvement
of the health status and learning of students
Sickle cell anemia
- may cause painful events in hands feel and or long bones. Treatment oxygen and
fluids. Monitor for fever, cough, rapid heartbeat that accompany an acute chest
syndrome
Adolescents are commonly deficient in which vitamins
- Calcium, Iron, Vit D
Connors Rating Scale
- ADHD short form Similar to the Vanderbilt Assessment Scales. Practitioner must
purchase rights
Tanner staging
- staging of sexual maturity
Denver Developmental Screening Test (DDST)
- To chart normal progress between the ages of 1 mo. to 6 yrs. To identify children who
are NOT developing normally. Does not measure intelligence
Wechsler Adult Intelligence Scale
- the WAIS is the most widely used intelligence test; contains verbal and performance
(nonverbal) subtests
How often is PPT review required?
- Annually
What to do if suspected hearing loss?
- Conduct audiometric screening
Cleaning product for Norovirus, C Diff
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NBCSN - School Nurse Certification

Exam

Who administers the National School Lunch Program?

  • USDA (US dept of agriculture) What does the scope of school nursing practice describe?
  • The who, what, where when and how of school nursing practice What are the standards of school nursing?
  • The authoritative statements of the duties school nurses are expected to perform competently What legal document describes school nurse delegation?
  • State Nurse Practice Act Impetigo
  • Begins as a single lesion which spreads to secondary lesions that crust or scale. Staph bacteria skin infection. Honey colored crust Pinworm
  • A student who is tired, can't sit still, itching bottom Describe the primary objective of the school nurse
  • to protect and promote student health, facilitate optimal development and advance academic success. Goal is to strengthen the educational process through improvement of the health status and learning of students Sickle cell anemia
  • may cause painful events in hands feel and or long bones. Treatment oxygen and fluids. Monitor for fever, cough, rapid heartbeat that accompany an acute chest syndrome Adolescents are commonly deficient in which vitamins
  • Calcium, Iron, Vit D Connors Rating Scale
  • ADHD short form Similar to the Vanderbilt Assessment Scales. Practitioner must purchase rights Tanner staging
  • staging of sexual maturity Denver Developmental Screening Test (DDST)
  • To chart normal progress between the ages of 1 mo. to 6 yrs. To identify children who are NOT developing normally. Does not measure intelligence Wechsler Adult Intelligence Scale
  • the WAIS is the most widely used intelligence test; contains verbal and performance (nonverbal) subtests How often is PPT review required?
  • Annually What to do if suspected hearing loss?
  • Conduct audiometric screening Cleaning product for Norovirus, C Diff
  • 5 - 6% hypochlorite solution (chlorine bleach) Amblyopia (lazy eye)
  • If corrected early, affected eye can have normal vision. Treatment before kindergarten Ethical and professional behavior is guided by responsibility to who?
  • the student chicken pox communicability
  • 1 - 2 day before and 4-5 day after onset of rash When is an adolescent considered obese?
  • BMI >95% for age

120% IBW (Ideal Body Weight) Are active Tuberculosis patients always symptomatic?

  • active TB may be asymptomatic and only diagnosed with chest x-ray Does a positive mantoux test indicate presence of disease? Why or why not?
  • Anyone who has been exposed to TB may have positive Mantoux test Does BCG vaccine prevent TB?
  • No but may decrease incidence of sever disease When is an adolescent with active TB no longer infections?
  • Beyond 2 weeks of medication therapy What happens if BP cuff too small
  • Will give a high reading. Opposite also true. Should have a bladder length 80% of the arm circumference, length to width 2:1, How long can Hepatitis B Virus survive on surfaces?
  • 1 week Signs of MDMA intoxication
  • jaw clenching, teeth grinding, N&V, muscle cramping, blurred vision, inc HR what does snorting drugs cause
  • nose bleeds and nasal lesions Osgood-Schlatter disease
  • inflammation or irritation of the tibia at its point of attachment with the patellar tendon. Can cause a painful, bony bump on shinbone below knee. Occurs in children and adolescent experiencing growth spurt during puberty. Swelling over ANTERIOR tibial tuberosity Contraindications of second pertussis dose
  • encephalopathy within 7 days of first dose or anaphylaxis Guanfacine (Intuniv, Tenex)
  • non stimulant ADHD med (antihypertensive) BP should be taken for student Kehr's sign
  • Referred pain down the left shoulder; indicative of a ruptured spleen. Wilms tumor
  • malignant tumor of the kidney occurring in childhood. One of the cancers more common to children prior to school age Shoulder tenderness and inability to shrug shoulder against resistance most likely due to which nerve affected
  • Accessory (spinal accessory) nerve tongue piercing

Booster Seat until

  • 8 years old, 80 pounds Precocious Puberty Girls
  • for caucasian girls before 7, african american before 6yo. May be caused by pituitary tumor Precocious Puberty Boys
  • Development of secondary sexual characteristics before the age of 9. May be caused by pituitary tumor Delayed puberty may be caused by
  • lack of gonadotropins (pituitary gland) Shortest time period you can give HBV vaccines
  • 6 months Paiget
  • cognitive development Ericson
  • psychosocial Kohlberg
  • Moral development (preconventional - concern of self, conventional - rules to be good person, postconventional - rules for the good of all of us) Erikson Psychosocial Stages
  • 1 - 3Autonomy vs. Shame and Doubt, 3-6Initiative vs. Guilt, 6-11 Industry vs. Interiority, 12 - 17 Identify vs. Role Confusion Piaget's stages of cognitive development
  • 2 - 7 preoperational (world revolves around them, one thing at a time, fairies), 7- 11 concrete operational (can use logic, group objects), 11 and older - formal operational (abstract thought, predict outcomes) When does moral development begin?
  • age 9 When do kids first lose teeth
  • age 6. Perm teeth in by 12 earliest normal puberty
  • 8 years old When does puberty start for boys
  • age 11. Sperm devp around age 13 before growth spurt and pub hair Apical pulse location
  • Mid-clavicular Over 7 yo Fifth intercostal space and it is called PMI- point of maximum impulse (4th intercostal space under 7yo) What to document for murmur
  • rhythm, rate quality of sound Normal HR
  • Up to 8 75- 115 8 - 11 70- 110 teens 60- 100

Book says 6-10 yo 65-125. Just remember higher for younger child Respiratory Rate

  • 3 - 7yo 20- 25 8 - 11 yo. 14- 22 over 12 12- 20 Or remember average 15- 20 Which arm for BP
    1. Dominant first
  1. other arm
  2. Use highest BP arm next time Blood Pressure
  • 3yo 90/ 7yo 97/ 11 104/ teens 113/ Retake BP how often if abnormal with HA, flushing, weak pulse, bounding pulse, pallor, dizziness
  • 5 min Bell of stethoscope is used for
  • soft, low-pitched sounds McKinney-Vento Act
  • the nation's first law to provide assistance to homeless persons, including free public education for children. School stability (can remain in school for duration of academic year), transportation is required. Homeless = children, youth who lack a fixed regular and adequate nighttime residence including sharing a residence, motel or campgrounds Freud's stages of development
  • oral stage, anal stage, phallic stage, latency stage, genital stage Maslow's Hierarchy of Needs
  • (level 1) Physiological Needs, (level 2) Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization 6 steps of nursing process (ADOPIE)
  • Assessment, diagnosis (nursing), outcome identification, planning, implementation, evaluation. FIRST step ASSESSMENT ALWAYS. Hib
  • Haemophilus influenzae type B - Not given after 5yo HBV
  • hepatitis B vaccine TIPS for head injury
  • Time of Injury, Impact position, Positional assessment, Saw it? Federal Car Seat Regulations
  • Booster seat until 4'9" and 8-12 years old, under 13 back seat MMR first dose
  • after 12months Tdap
  • 11 - 12 years old
  • deals with professional scope and standards of practice
  • addresses ethics, public policy, and economic/general welfare of nurses
  • mission = advance profession of nursing NBCSN
  • provides cert exam voluntary Primary Assessment
  • ABCDE (Airway, breathing, circulation, disability and exposure) Secondary Assessment
  • EFGHI: expose, farenheit (temp), get VS, H head assessment I- inspect and isolate if infection or immune compromised CIAMPEDS (mneumonic for pediatric triage)
  • Chief complaint, Immunizations/Isolation, Allergies, Medications/Medical history, Parent's impression of the situation, Events surrounding, Diet/Diapers, Symptoms associated with illness/injury Treatment of Shock
  • lay supine with legs slightly elevated CPR rescue breathing rate
  • 12 - 20 bpm for child, 10-12 for adult Respiratory arrest
  • under 8 yo - 1 min rescue breath then 911, over 8 call first Heimlich
  • heel of one hand in middle of abd slightly over navel with other hand on top. Thrust up 5 times Treatment of burns
  • apply room temp water 2-5 min, remove clothes/jewelry, no ointment Hemorage
  • rapid weak pulse, cool moist skin, pale, bluish, excessive thirst, low BP, restless, unconscious How often to assess head injury/spinal cord injury
  • every 5 min What do you do with body parts torn from body
  • wrap in clean damp cloth and place in sealed plastic bath with cold water (not ice) transport with child How much does fever increase respiratory rate or heart rate
  • increase 10 pulse beats and 4 breaths per min for every degree of fever Sign of CHF in child
  • inc in RR, resp congestion, dry cough, SOB, crackels, diaphoresis Anemia
  • Most common abnormal blood condition in children. a symptom, not a disease, impaired production, poor diet, pica, blood loss, kidney disease. Symptoms - pallor, inc HR/RR, muscle weakness, fatigue, dizzy, HA, dec attention, jaundice Hemophilia
  • A hereditary disease where blood does not coagulate to stop bleeding. Non contact sports only Peptic Ulcer Disease cause
  • H. pylori. Seen in boys 12- 18

Hep A and E transmission

  • fecal-oral. Can live up to 3 hours on objects. Boil or disinfect with bleach 5 rights of delegation
  • right procedure, situation, personnel, training, oversight. RN retains accountability for the task and outcome Student Health Record
  • part of cumulative education record in public school. Protected by FERPA Burns (degrees)
  • 1st -- minor damage/epidermis -- ERYTHEMA. Sunburn 2nd- Partial-thickness- painful superficial/Papillary dermis-- BLISTERS deep/reticular dermis -- RUPTURED blisters 3rd - Full/destroy-dermal appendages - no* sensation white, leathery, charred Call EMS if 10% of body burned (1% = students palm) HEEADSSS is:
  • home, education/employment, eating, activities, drugs, sexuality, suicide, safety prominent bone for otoscope exam
  • Malleus prominent bone Addison's disease
  • a condition that occurs when the adrenal glands do not produce enough cortisol or aldosterone Cushing's syndrome
  • caused by prolonged exposure to high levels of cortisol, causes swelling Graves disease
  • (hyperthyroidism) bulging eyes, nervous, weight loss, heat intolerance, insomnia Hypothyroidism symptoms
  • Fatigue, lethargy. Modest weight gain with anorexia. Dry, coarse skin and cold intolerance. Swelling of face, hands, and legs. Constipation. Weakness, muscle cramps, arthralgias, paresthesias, impaired memory and hearing. Prader-Willi Syndrome
  • genetic disorder, obesity, intellect disability, short When does eye anatomy mature
  • last of the senses, around 6 strabismus
  • crossed eyes appendicitis
  • RLQ pain and rebound tenderness. Pain may inc with cough and walk. N&V Romberg test
    • ask client to stand with feet at comfortable distance apart, arms at sides, and eyes closed
  • hunger, fatigue, weakness, sweating, headache, dizziness, low bp, cold or clammy skin If unconscious give glucagon most common childhood cancer
  • leukemia muscular dystrophy
  • group of hereditary diseases characterized by degeneration of muscle and weakness. Most are in wheel chair by late teens and dies in 20's Achondroplasia
  • dwarfism., bowed legs, spine is curved osteogenesis imperfecta
  • brittle bone disease Juvenille Rheumatoid Arthritis
  • peak ages onset of 2-5 and 9-12 years old usually occurs in girls cerebral palsy
  • paralysis caused by damage to the area of the brain responsible for movement. May be seizures, intellectual disability or attention deficit disorders Tourette's syndrome
  • effects boys 4x's as much as girls, associated with OCD, ADHD, Impulse control, anxiety and depression febrile seizures
  • Seizures that result from sudden high fevers, particularly in children. Usually less than 7 yo status epilepticus
  • A condition in which seizures recur every few minutes or last more than 30 minutes. Up to 75% of children having first seizure will have status epilepticus. Infection and metabolic disorders usually trigger. Call EMS if first seizure over 5 min or known epileptic over 10 min signs of shunt malfunction (hydrocephalus)
    • Irritability
  • Headache
  • Diplopia
  • Nausea/vomiting
  • Lethargy
  • Loss of milestones
  • Change in seizure pattern
  • Decreased level of consciousness
  • They also will sometimes show signs of infection and not a blockage Mantoux test
  • TB test, read 48-72 hours. 15mm positive w/o risk factors, 10mm positive with risk factors. Common Cold
  • Symptoms 2-8 days after exposure and last up to 10 days Chicken pox
  • rash develops 10-21 days after exposure and person is infective 24-48 hours before rash until they scab over viral meningitis
  • usually self limiting within 7-10 days and is less severe than bacterial meningitis Disaster Preparedness should prepare to care for students for
  • 3 days How much time in between doses of same live vaccine?
  • 4 weeks Can a student get all vaccines needed to start school in one sitting?
  • Yes and then attend school the next day. Youth Risk Behavior Surveillance System (YRBSS)
  • National Youth Behavior Survey conducted by the CDC. Given by states every 2 years to a selection of students in 9-12 grade. It elicits info about tobacco, alcohol, drug use, risky behaviors School Health Index (SHI)
  • made by CDC to improve health promotion programs Most effective hand hygiene?
  • antibacterial soap for 30 seconds, paper towels. Alcohol foams, gels must have 60- 95% alcohol Fungal infections
  • should be treated for 24 hours then covered well during sports match treatment of avulsed tooth
  • handle by crown, put in Hanks balanced salt solution or milk, normal saline, water and student and tooth transported to dentist Dietary requirements for children
  • 4 - 8 years old kids need 1400-1600 cal. Goes up from there. Teen girls 2000 boys 2400 - 2800 Underweight BMI
  • less than 5 percentile. Normal 5-84% What governs staff health information?
  • HIPPA Piercing care
  • If it swells or itches, remove metal causing reaction. Otherwise wash twice a day with abx soap and rotate piercing. Do not use alcohol or hydrogen peroxide Title X (The Education Amendment Act of 1972)
  • schools cannot discriminate against pregnant or parenting teen Determining malpractice
  • school nurses' actions are judged on the basis of whether the nurse performed as a prudent person would do. Determined by using American Nurses association and NASN practice standards. Failure to act properly is negligence Consent for screenings
  • If parent consents but child does not do not do it and notify parents of the refusal. Document Scope of school health services
  • seek to remove all health barriers to education Consequence of violations of confidentiality
  • from mechanical dysfunction that interferes with sound waves (including chronic or frequent otitis media) sensorineural hearing loss
  • the most common form of hearing loss, also called nerve deafness; caused by damage to the cochlea's receptor cells or to the auditory nerves. Head injury, prolonged music, rubella cause this. Hand-foot-mouth disease
  • Coxsackie virus. Blisters in mouth and hands but can be afebrile. Can return to school after fever gone and no draining lessions. Children can spread the virus even w/o symptoms and may be in stools for weeks after symptoms Treatment of insect stings
  • Do not remove with tweezers. Can use flat edge like ID card, soap, water, ice. Monitor for anaphylaxis. Herpes simplex lesions
  • contagious, reoccur, can spread on skin to skin contact even when no sore visible Signs of CHF
  • Visible swelling of the legs, ankles, eyelids, face, and (occasionally) abdomen. Abnormally fast breathing. Shortness of breath or labored breathing. - Wheezing Fatigue. Nausea. Falling asleep when feeding or becoming too tired to eat. Lack of appetite. Tension pneumothorax treatment in school setting

Scabies

  • intense itching, especially at night Lowest contraceptive failure rate
  • Birth control pills, then diaphragm, then condom cleft lip and palate
  • may have speech and language problems, ear infections hypovolemic shock
  • shock resulting from blood or fluid loss. Tachycardia, cool, clammy skin, low BP, general weakness vision impairment
  • normal (20/10-20/25), moderate (20/70-20/100), legal blindness (20/200) with best conventional correction