School Nurse Certification Exam (NBCSN - unofficial) 447 Questions with Verified Answers
What is the first sign of puberty in females? - CORRECT
... [Show More] ANSWERS Breast development
approx age 10 (7-13), about 3 years to develop
When does Menses begin? - CORRECT ANSWERS ages 8-16
first is irregular and w/o ovulation
What is FSH?
What does it do in females? - CORRECT ANSWERS FSH - follicle stimulating hormone
Females - stimulates ovarian development and estrogen production.
What is FSH?
What does it do in males? - CORRECT ANSWERS FSH - follicle stimulating hormone
males - develops tubes in testes --> spermatogenesis & fertility
What age does penis reach adult size? - CORRECT ANSWERS 17
What age does sperm emission start? - CORRECT ANSWERS age 13
What is the first sign of puberty in males, and around what age? - CORRECT ANSWERS Testicular enlargement - around age 11-15
What is LH? - CORRECT ANSWERS Luteninizing hormone (LH)
What does LH do? - CORRECT ANSWERS stimulates testosterone release from leydig cells
(testicular enlargement)
Does sperm emission happen before or after pubic hair development and growth spurt - CORRECT ANSWERS Before
Role of Pituitary gland in puberty - CORRECT ANSWERS Releases Luteninizing hormone (LH) and follicle stimulating hormone (FSH)
Role of Hypothalamus in puberty - CORRECT ANSWERS produces gonadotropin-releasing hormone. starts the process.
this tells the Pituitary gland to start
Define Puberty - CORRECT ANSWERS the physical changes to the body due to hormone activity as per the Tanner Scale
What is the Tanner Scale - CORRECT ANSWERS The hormone activity which produces secondary sex characteristics.
13-19 Developmental Tasks
- Physical
(2 major answers) - CORRECT ANSWERS - Rapid period of growth, completes physical growth
- May appear clumsy while adjusting
Young males and breast growth - CORRECT ANSWERS Some kids may have growth and tenderness. Will resolve as testosterone level increase.
ASSURE child this is normal
When does growth spurt start and stop for males? - CORRECT ANSWERS 2 years after girls
increases until age 20
When does growth spurt start and stop for females? - CORRECT ANSWERS during puberty
finished 2 years after menarche
What are secondary sex characteristics for males? - CORRECT ANSWERS chest growth, facial hair, deep voice
Define secondary sex characteristics - CORRECT ANSWERS Physical traits that are not directly involved in reproduction but that indicate sexual maturity.
Difference of body fat changes in boys vs girls - CORRECT ANSWERS Boys - decrease body fat from 14.3% at Tanner Stage 1 to 11.2%
Girls - INCREASE body fat from 15.7% (Tanner 1) to 26.7% (Tanner 4)
What are secondary sex characteristics for females? - CORRECT ANSWERS fatty tissue on thighs, hips, breasts, hips broaden,
What body fat is needed for Menarche? - CORRECT ANSWERS 17% to start, but need 22% to maintain menstruation.
What are secondary sex characteristics for both? - CORRECT ANSWERS pubic hair, increase of sweat glands --> body odor, increase activity of sebaceous glands --> acne
Psychosocial growth ages 10-13 (early adolescence) - CORRECT ANSWERS copes with changes in physical self
- fantasy role play in different situations
- test their independence
- peers are important
Psychosocial growth ages 14-17 (middle adolescence) - CORRECT ANSWERS explores and identifies personal values and defines self
- influenced by peers and their values, fads
- need to conform
- interest in sex increases, attraction
- may initiate sexual relationships
- family tensions may increase
Psychosocial growth ages 18-19 (late adolescence) - CORRECT ANSWERS independence from parents
developing a plan for the future
participating in society
gender identity - CORRECT ANSWERS the gender with which you identify and feel most comfortable regardless of biologic gender
sexual orientation - CORRECT ANSWERS the gender(s) that a person is attracted to emotionally, physically, sexually, and romantically
Cis-gender - CORRECT ANSWERS Individuals whose gender identity corresponds to their biological sex
Transgender - CORRECT ANSWERS umbrella term for all gender-variant people who by nature do not conform to gender-based expectations
Bisexual - CORRECT ANSWERS a person who is sexually attracted to both sexes
Cognitive development for adolescence - CORRECT ANSWERS abstract thinking
ability to analyze and synthesize
use logic
Begins awareness of the long-term consequences of their actions.
Nutritional intake influences adult health status how? - CORRECT ANSWERS Calcium - needed for bone health
High cholesterol can compromise cardiovascular health
Diet habits of teens - CORRECT ANSWERS skipping meals (esp bkst)
increased snacking
fast food
- a social event, influenced by peers
May become weight-conscious and develop unhealthy dieting habits
Dental concerns for teens - CORRECT ANSWERS good oral hygiene
bi-annual dentist appts
final molars (wisdom teeth) may finally erupt
Most common childhood chronic disease - CORRECT ANSWERS Dental Caries
Health promotion for teens - CORRECT ANSWERS internet safety (sexting, cyberbullying)
attention to body hygiene, self-care
pregnancy
STI
focus on personal responsibility for health
Methods to talk to teens - CORRECT ANSWERS motivational interviewing
active listening
open-ended questions
remain nonjudgmental
obtain health-related information
maintain privacy, modesty
Be alert for (when talking to teens) - CORRECT ANSWERS bullying/cyberbullying
sexual harrassment/abuse
dating violence
human trafficking
self-harm
social determinants of health - CORRECT ANSWERS The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels
Adverse Childhood Experiences (ACEs) - CORRECT ANSWERS Traumatic events that occur in childhood that have a dose-response relationship to social and emotional problems
High ACE Score risks increase... - CORRECT ANSWERS alcohol abuse
depression
heart disease
suicide attempts
smoking
early sexual activity
teen pregnancy
poor academic outcome
Pair of ACEs - CORRECT ANSWERS Adverse Childhood Experiences + Adverse Community Environments
Biologic family - CORRECT ANSWERS born into
Source Family - CORRECT ANSWERS legally and pragmatically functions as the biologic family
Non-compliant parent - CORRECT ANSWERS - seek and understanding of the issues and rationales for their decision
- assist family to overcome barriers
Angry parent - CORRECT ANSWERS - let them vent, then refocus convo into an action
- do not reciprocate with anger
- assure your own safety
- respect their feelings
- give a copy of the policy or the name of person responsible for the policy
Definition of family - CORRECT ANSWERS two or more people who consider themselves related by blood, marriage, or adoption and residing together. May also include those who "act" as parents or guardians
Family Systems Theory - CORRECT ANSWERS view the family as a whole system that continually acts with its members and the environment
How does the family system theory affect each member? - CORRECT ANSWERS a change for one results in a change for another
Family dysfunction - CORRECT ANSWERS a result of interaction among members and is not caused by any one person
% of children raised by grandparents - CORRECT ANSWERS 4%
% of children raised by 2 parents - CORRECT ANSWERS 66% (2/3)
% children living in one parent homes - CORRECT ANSWERS 23%
What type of rules govern foster care? - CORRECT ANSWERS Guardianship/kinship care
What type of rules govern rights of children and families? - CORRECT ANSWERS State Laws
What type of rules supersede state laws? - CORRECT ANSWERS Tribal or federal laws
Define homelessness - CORRECT ANSWERS living temporarily without a permanent address (includes living with friends or family)
Homeless children are higher risk of: - CORRECT ANSWERS behavioral/emotional problems
child abuse & neglect
communicable diseases
chronic absenteeism
lower academics
lower graduation rates
McKinney-Vento Homeless Assistance Act - CORRECT ANSWERS The primary piece of federal legislation dealing with the education of homeless children in public schools.
What does M/V Act assure? - CORRECT ANSWERS FAPE (Free and appropriate education)
How does a child indirectly see domestic violence in their home? - CORRECT ANSWERS Observe bruises, broken furniture, etc.
How does a child indirectly HEAR domestic violence in their home? - CORRECT ANSWERS listening to a parent discuss it with someone else
Issues seen at school in Children experiencing domestic violence - CORRECT ANSWERS fear
depression
developmental delays
anxiety
acting out
problems learning and interacting with others
Responsibility of school regarding immigrant children - CORRECT ANSWERS address language barriers
Children in immigrant families are higher risk for: - CORRECT ANSWERS tuberculosis
inadequate immunization levels
undiagnosed pre-existing conditions
Define culture - CORRECT ANSWERS the pattern of information composed of thoughts, values, beliefs, actions, attitudes, communications and customs shared by a group of people and passed from one generation to the next
How culture affects health - CORRECT ANSWERS Affects how families interpret wellness &
cause, presence and prognosis of illness
- may determine use of recommendations
Cultural Sensitivity - CORRECT ANSWERS not doing or sayings things that would be offensive to members of another group
cultural competence - CORRECT ANSWERS having an awareness and acceptance of cultures and the ability to interact effectively with people of diverse cultures
cultural congruence - CORRECT ANSWERS applying nursing practice that is in agreement with the client's preferred cultural values
cultural humility - CORRECT ANSWERS communal reflection to analyze the root cause of suffering and create a more inclusive world view.
goal of cultural humility - CORRECT ANSWERS to address health disparities and inequities in medicine
What assumption cannot be made about a family and their culture? - CORRECT ANSWERS That they follow all of the prescribed practices of that culture. ASK
define school nursing - CORRECT ANSWERS a specialized practice of nursing, protects and promotes student health, facilitates optimal development, and advances academic success.
Role of school nurse - CORRECT ANSWERS Bridges health care and education
delivers care
provides health education
help keep children healthy, safe, and ready to learn
What does a wellness program include? - CORRECT ANSWERS health promotion and disease prevention
Difference between School Nursing and public health - CORRECT ANSWERS School nursing - student focused
PH = focuses on the group and not the individual
Principles of Public Health - CORRECT ANSWERS 1. focus on the aggregate
2. promote prevention
(mass screening & herd immunity)
3. encourage community organization
4. ethical theory of the greater good
5. leadership in health
6. use of epidemiologic knowledge and methods
(surveillance)
Primary disease prevention - CORRECT ANSWERS Prevent disease occurrence (e.g., HPV vaccination)
- Promoting health
- bike safety, seat belts, sun safety
Secondary disease prevention - CORRECT ANSWERS Screening early for disease
- (ex: COVID screening, hearing, vision, dental)
- resolve health problems and prevent consequences
Acanthosis nigricans - CORRECT ANSWERS thickening and darkening of skin near axillary region, A/w Diabetes Type II and gastric carcinoma
What type of disease prevention is Disability Limitation? - CORRECT ANSWERS Secondary
- aim to interrupt the progression to decrease the amount of morbidity or complications
- ex: Asthma - identifying triggers
Tertiary disease prevention - CORRECT ANSWERS Treatment to reduce disability from disease
- adaptions in the school to promote inclusion
- supportive care
5 key principles of NASN Framework for 21st century school nursing practice - CORRECT ANSWERS 1. Standards of Practice
2. Care Coordination
3. Leadership
4. Quality Improvement
5. Community/Public Health
Where do we get standards of practice? - CORRECT ANSWERS Nasn's Scope & Standards of Practice
Nurse Practice Acts
NASN Position statements
clinical competence with evidence-based practice
Components of Quality Improvement - CORRECT ANSWERS documentation
data collection
performance appraisal
research
What is the WSCC model? - CORRECT ANSWERS Whole School, Whole Community, Whole Child
- School Health Services is a component
How is academic achievement defined by WSCC? - CORRECT ANSWERS academic performance
education behaviors
cognitive skills and attitudes
10 Components of WSCC Model - CORRECT ANSWERS Health Education
PE and Activity
Nutrition services
Health services
Counseling
Social & Emotional Climate
Physical Environment
Employee Wellness
Family engagement
Community Involvement
Nursing Process - CORRECT ANSWERS Assessment
Diagnosis
Planning
Implementation
Evaluation
3 Focuses of school health programs - CORRECT ANSWERS - wellness
- health promotion
- disease prevention
What do school nurses do? - CORRECT ANSWERS - identify health needs
- deliver services
- refer students to other professionals in community
Define health promotion - CORRECT ANSWERS activities directed toward increasing level of well-being and actualizing the health potential
Goal of early detection - CORRECT ANSWERS - earlier intervention
- improved outcomes
Role of school nurse re: immunizations - CORRECT ANSWERS - audit new students
- assist in getting immunizations
- recommend exclusion of unprotected students
Is immunization compliance increasing or decreasing? - CORRECT ANSWERS DECREASING
Role of the School Nurse with parent to resists immunizations - CORRECT ANSWERS - dispel fears and address myths
- provide health education materials
- promote the principle of herd immunity to protect the most vulnerable by having the majority protected
when can the deltoid be used for injections? - CORRECT ANSWERS when enough muscle mass
What muscle should never be used for vaccines? - CORRECT ANSWERS dorsogluteal buttock site
7 rights of vaccines - CORRECT ANSWERS - right patient
- right vaccine
- right time (correct age)
- right dose
- right interval
- right route (including correct needle & technique)
- right site
- right documentation
How are live vaccines created? - CORRECT ANSWERS by attenuating (altering by heat or chemicals) the pathogen that causes the disease
(ex: MMR)
Risk of live vaccines - CORRECT ANSWERS cause a modified, typically weaker, form of the disease
How are inactivated vaccines made? - CORRECT ANSWERS Grown in a lab then killed or inactivated
- cannot cause disease - therefore need boosters
ex: Dtap, Polio
Example of vaccines from recombinant DNA technology - CORRECT ANSWERS - Hep B
- HiB
- pneumococcal
- meningococcal
What do additives in vaccines do? - CORRECT ANSWERS prevent bacterial growth
holds antigen in tissue longer to prolong immune response
What food allergy can cause issues with vaccines? - CORRECT ANSWERS Chicken eggs
- some additives are grown in chicken eggs
What preservative was removed from vaccines and why? - CORRECT ANSWERS Thimerosal - a mercury preservative
- possible links to neurodevelopmental deficits
What life-threatening allergies are contraindicated for some vaccines? - CORRECT ANSWERS MMR - gelatin
Polio - neomycin, streptomycin, polymyxin B
Why do you not want to be sick(ill) when get a vaccine? - CORRECT ANSWERS side effects would be hard to differentiate from illness
Signs of adverse reaction to vaccine - CORRECT ANSWERS difficulty breathing, wheezing
hives
pallor
tachycardia
high fever
behavior changes
Which vaccine should never be frozen? - CORRECT ANSWERS Influenza
Which vaccine should be protected from light (in storage)? - CORRECT ANSWERS MMR
Where in the fridge should vaccines be stored? - CORRECT ANSWERS on the middle shelf, not the door
Which vaccine has a 3 wk min, not a 4 wk min? - CORRECT ANSWERS Varicella
Who makes the requirements for vaccine? - CORRECT ANSWERS State rules
- CDC updates recommendations every January.
Define incubation period - CORRECT ANSWERS the interval between the receipt of the infectious agent and the onset of clinical disease
Define Prodromal Stage - CORRECT ANSWERS Stage where early symptoms occur before the full blown symptoms of disease hit
Define period of communicability - CORRECT ANSWERS when the disease is contagious (transmissible)
may be before symptoms appear
Define convalescent period - CORRECT ANSWERS time between decrease of disease symptoms and complete return to wellness
What OTC med should NOT be given for pain relief after vaccine? - CORRECT ANSWERS Aspirin
Three focuses of Student Athlete Sports Nutrition - CORRECT ANSWERS hydration, fueling, recovery
Low economic status would be associated with which types of hazards - CORRECT ANSWERS psychological
There are two primary sources for obtaining the data necessary for building a successful employee wellness program - CORRECT ANSWERS an employee health risk appraisal
and an individual interest survey
Blood levels of 10 mcg/dL of lead have been shown to produce a drop in IQ of - CORRECT ANSWERS 7.4 points
Screening tools must be specific and sensitive for the targeted health issue. They must measure what it says it does and correctly classify participants. This quality is which of the following? - CORRECT ANSWERS validity
The Individualized Education Program for students eligible for the services of IDEA has two general purposes. These are: - CORRECT ANSWERS to set reasonable learning goals and to state the services that the school district will provide
In terms of semantics related to the computerization of medical and health records, the first-level product that brings together information for other sources is known as which of the following? - CORRECT ANSWERS automated medical record
When an award for malpractice is based on the percentage of fault of the respective parties it is known as which of the following? - CORRECT ANSWERS comparative negligence
School nurses must consider the ethical principles that guide everyday practice. When beneficent care-giving begins to conflict with the family's decision-making autonomy, this creates a(n) - CORRECT ANSWERS ethical dilemma
What system is affected by Diphtheria? Complications? - CORRECT ANSWERS Bacteria that grows in Respiratory tract
respiratory Tract
Complications: renal, cardiac, CNS Damage
where does tetanus travel to? Symptoms? - CORRECT ANSWERS exotoxin goes To nerves
Voluntary muscle contraction, rigidity, painful paroxysmal seizures. Starts as Trismus (lockjaw) and difficulty swallowing
Complications of tetanus - CORRECT ANSWERS Laryngospasm, respiratory distress, intramuscular hemorrhage, death
How is tetanus transmitted? - CORRECT ANSWERS Through organism entering through open skin, often through soil or exposure to rust
Guidelines for tetanus vaccine after penetrating wound - CORRECT ANSWERS - If wound is clean, 1st series completed and booster w/in 5 years - just clean wound
- If wound is contaminated, 1st series completed and booster > 5 years ago, Toxoid (Td) is given
- If wound is dirty, 1st series incomplete - give toxoid AND Tetanus immune serum globulin
Define passive immunity - CORRECT ANSWERS the short-term immunity that results from the introduction of antibodies from another person or animal.
How is pertussis transmitted? - CORRECT ANSWERS respiratory droplets
Complications of pertussis - CORRECT ANSWERS infants and children: pneumonia, convulsions, apnea, encephalopathy, death
teens/adults: weight loss, loss of bladder control, passing out, rib fractures
Schedule for DTaP - CORRECT ANSWERS 2, 4, 6, 15-18 months and between 4-6 years
Contraindication for pertussis vaccine - CORRECT ANSWERS an active neurologic condition ie: seizures
When will you see side effects of Dtap? - CORRECT ANSWERS w/in 72 hours.
fever, irritability, site pain somnolence, loss of appetite
Another name for M, M, & R - CORRECT ANSWERS Measles (Rubeola)
Mumps (Parotitis)
Rubella (German Measles)
How are MMR spread? - CORRECT ANSWERS by respiratory drops
Symptoms of congenital rubella - CORRECT ANSWERS -miscarriage
-defects
-cardiac abnormalities
-ocular lesions
-deafness
- intellectual disability
- growth retardation
Schedule for MMR vaccine - CORRECT ANSWERS 2 doses; between 12-15 months, between 4-6 years
Must be distanced by 4 weeks
Why isn't oral polio vaccine given anymore? - CORRECT ANSWERS disease was contracted by immunocompromised people who handled the feces of vaccinated infants
Is IPV a live vaccine? - CORRECT ANSWERS No. It is a trivalent enhanced inactivated (killed) vaccine
What is the difference between the nasal Flu vaccine and the Injected Flu vaccine? - CORRECT ANSWERS - Nasal is a live attenuated vaccine. Has been approved for > 24mos but usually > age 5. Can have a small case of the flu
- Injected flu is inactivated. Recommended for all children & adults.
When are hand sanitizers most effective? - CORRECT ANSWERS when alcohol solution is 60-95% alcohol
What is recommended agent for cleaning up body fluids? - CORRECT ANSWERS Bleach
- 1 park bleach to 10 parts water
What do risk reduction programs do? - CORRECT ANSWERS - identify and correct deficient patterns of health care
- thereby preventing an increase of the spread of disease and a decrease in risk-taking behaviors
- Infection control is one part
- Safety education is one part
Goal for risk reduction programs - CORRECT ANSWERS - improved students' academic performance
- contribute to their health and productivity outside the school environments
Leading cause of death for ages 5-9 - CORRECT ANSWERS unintentional injury/accidents
congenital anomalies
homicide
flu/pneumonia
- NOT cancer
Leading cause of death for ages 1-4 - CORRECT ANSWERS unintentional injury/accidents
congenital anomalies
homicide
cancer
flu/pneumonia
Leading cause of death for ages 10-14 - CORRECT ANSWERS unintentional injury/accidents
congenital anomalies
homicide
cancer
SUICIDE
Leading cause of death for ages 15-24 - CORRECT ANSWERS unintentional injury/accidents (MVA)
homicide
cancer
SUICIDE
HEART DISEASE
What is resiliency Model? - CORRECT ANSWERS a process where one competently adapts to stressors.
- balance between risk and protective factors
- includes adjustment and adaption
Define risk factor (in resiliency Model) - CORRECT ANSWERS environmental stressors or conditions that increase the likelihood that a child will experience poor overall adjustment or negative outcomes
What is a strengths-based approach? - CORRECT ANSWERS use protective factors and strengths to build resiliency and help youth succeed in the face of adversity
External Factors that promote or deter risky behavior - CORRECT ANSWERS - family cohesion (feeling loved, cared for, supported)
- family supervision
- safety of the environment / neighborhood
- peer pressure
- positive or negative role models
- parental resilience
- parental drug/alcohol use or sexual promiscuity
- parents knowledge of parenting
- prevention education provided at home
- media advertising
- access to preventative services
- access to illicit substances/activities
- feeling connected - to parents, peers, school
- ensuring that the student's emotional needs are met
Internal factors that promote/deter risky behavior - CORRECT ANSWERS - emotional competence
- self-control over actions & impulses
- student's intelligence
- academic success
- social skills
- ability to be empathetic
- sense of humor
- genetic predisposition
- temperament
- comorbid psychiatric conditions
What is needed when a student engages or indicates they will harm self or others? - CORRECT ANSWERS IMMEDIATE psychological evaluation and intervention
Principles of good teaching - CORRECT ANSWERS - assess needs
- determine goals & objectives
- materials - developmentally appropriate
- organize the space
- respect & rapport
- engagement
- provide feedback
- evaluate outcomes
Define Anticipatory guidelines - CORRECT ANSWERS providing information to students and parents of what might happen next and what to expect
- ie: before puberty, or next developmental task [Show Less]