Pediatric Nursing Caring For Children And Their Families 3rd Edition by Nicki L. Potts – Test Bank

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Sample Questions Posted Below

 

CHAPTER 5: SCHOOL NURSING

MULTIPLE CHOICE

1.Which of the following nurses convinced the New York Board of Health to place a nurse in the school system, thus establishing school nursing?

a.	Dorothea Dix	c.	Esther Lucille Brown
b.	Lillian Wald	d.	Anne Goodrich

ANS: B

	Feedback
A	Incorrect: Dorthea Dix served as superintendent of the Union Army female nurses during the Civil War.
B	Correct: Lillian Wald convinced the New York Board of Health to place a nurse in the school system, thus establishing school nursing.
C	Incorrect: Ester Lucille Brown concluded in the Brown Report in 1948 that all nursing education programs should be affiliated with universities and have their own budget.
D	Incorrect: Anne Goodrich was the originator and dean of the Army School of Nursing and the first dean of Yale University School of Nursing, the first autonomous school of nursing in a university in the United States.

PTS: 1 REF: p. 120 – School Nursing OBJ: Cognitive Level: Knowledge

2.The first school nurse in the United States in 1902 was:

a.	Lavinia Dock	c.	Lina Rogers
b.	Mary Adelaide Nutting	d.	Isabelle Hampton Robb

ANS: C

	Feedback
A	Incorrect. Lavinia Dock was a public health nurse who started a visiting nurse service in Connecticut the 1880’s. She advocated for an international public health movement.
B	Incorrect. Mary Adelaide Nutting was a member of the first graduating class of Johns Hopkins Training School. In 1907 she became the first professor or nursing at Columbia University Teachers College.
C	Correct. In 1902, Lina Rogers became the first school nurse in the United States.
D	Incorrect. Isabelle Hampton Robb was the first superintendent of Johns Hopkins Training School in Baltimore, Maryland, in 1894.

PTS: 1 REF: p. 120 – School Nursing OBJ: Cognitive Level: Knowledge

3.What major accomplishment occurred as the result of the work of the first school nurse in the United States?

a.	The number of children excluded from school dropped significantly.
b.	The incidence of whooping cough decreased by 50%.
c.	The number of playground accidents dropped significantly.
d.	The number of immunized children increased by 50%.

ANS: A

	Feedback
A	Correct. Lillian Wald of New York City was astonished by the number of children who never returned to school after being excluded for a communicable disease. After the first school nurse was in place, the exclusion rates dropped significantly.
B	Incorrect. The noted major accomplishment as a result of adding the school nurse was not a decrease in whooping cough.
C	Incorrect. The noted major accomplishment as a result of adding the school nurse was not a decrease in playground accidents.
D	Incorrect. The noted major accomplishment as a result of adding the school nurse was not a increase in the number of immunized children.

PTS: 1 REF: p. 120 – School Nursing OBJ: Cognitive Level: Knowledge

4.The original role of the school nurse was:

a.	identifying, educating, and following up on communicable diseases
b.	developing, teaching, and evaluating a comprehensive health curriculum
c.	home health visits to the ill child
d.	assisting the classroom teacher with hygiene teaching

ANS: A

	Feedback
A	Correct. The original role of the school nurse was identifying, educating, and following up on communicable diseases.
B	Incorrect. The original role of the school nurse was not developing, teaching, and evaluating a comprehensive health curriculum.
C	Incorrect. The original role of the school nurse was not home health visits to the ill child.
D	Incorrect. The original role of the school nurse was not assisting the classroom teacher with hygiene teaching.

PTS: 1 REF: p. 120 – School Nursing OBJ: Cognitive Level: Knowledge

5.During the 1920’s the school nurse role expanded to include:

a.	classroom teaching on how to deal with bomb threats and set up bomb shelters
b.	prevention of injury during natural disasters such as tornadoes or hurricanes
c.	identification of physical defects in children and making referrals to correct the defects
d.	identification of children with alcohol and other drug problems and proper referrals

ANS: C

	Feedback
A	Incorrect. During the 1920’s the school nurse role was not expanded to include classroom teaching on how to deal with bomb threats and set up bomb shelters.
B	Incorrect. During the 1920’s the school nurse role was not expanded to include prevention of injury during natural disasters such as tornadoes or hurricanes.
C	Correct. During the 1920’s the school nurse role expanded to include identification of physical defects in children and making referrals to correct the defects.
D	Incorrect. During the 1920’s the school nurse role was not expanded to include identification of children with alcohol and other drug problems and proper referrals.

PTS:1REF:p. 120 – School Nursing

OBJ: Cognitive Level: Comprehension

6.At one point in the history of school nursing, staffing was cut back and tasks were delegated to teachers and other school personnel. This occurred during which time period?

a.	the Vietnam War	c.	the 1890s
b.	early 1900s	d.	World War II

ANS: D

	Feedback
A	Incorrect. School nursing did not face cut backs during the Vietnam War.
B	Incorrect. School nursing did not face cut backs during the early 1900s.
C	Incorrect. School nursing did not face cut backs during the 1890s.
D	Correct. Cutbacks in funding due to World War II led nurses to delegate tasks to teachers and other school personnel.

PTS: 1 REF: p. 120 – School Nursing OBJ: Cognitive Level: Knowledge

7.What minimum educational preparation is recommended for school nurses by both the American Nurses Association and the American School Health Association?

a.	licensed practical nurse certificate	c.	baccalaureate degree
b.	associate degree in nursing	d.	master’s degree

ANS: C

	Feedback
A	Incorrect. Minimal educational preparation recommended for school nurses is not licensed practical nurse certificate.
B	Incorrect. Minimal educational preparation recommended for school nurses is not associate degree in nursing.
C	Correct. Minimal educational preparation recommended by both the American Nurses Association and the American School Health Association for school nurses is a baccalaureate degree.
D	Incorrect. Minimal educational preparation recommended for school nurses is not master’s degree.

PTS: 1 REF: p. 120 – School Nursing OBJ: Cognitive Level: Knowledge

8.What factor in the 1970s played a major part in the changing role of the school nurse and prompted the need for additional education and expertise for school nurses?

a.	passage of the Education for All Handicapped Children Act
b.	greater numbers of children entering the school system
c.	the fact that teachers stopped teaching the health curriculum
d.	changes in the Medicaid laws affecting children

ANS: A

	Feedback
A	Correct. The passage of the Education for All Handicapped Children Act in 1975 forever changed the role of the school nurse and required additional education and expertise.This act required all states to provide a free and appropriate education in the least restrictive environment to children with handicaps. School nurses were responsible for caring for children with complex medical conditions.
B	Incorrect. The factor in the 1970s that played a major part in the changing role of the school nurse and prompted the need for additional education and expertise for school nurses was not the greater numbers of children entering the school system.
C	Incorrect. The factor in the 1970s that played a major part in the changing role of the school nurse and prompted the need for additional education and expertise for school nurses was not the fact that teachers stopped teaching the health curriculum.
D	Incorrect. The factor in the 1970s that played a major part in the changing role of the school nurse and prompted the need for additional education and expertise for school nurses was not changes in the Medicaid laws affecting children.

PTS:1REF:p. 121 – History of School Nursing

OBJ: Cognitive Level: Comprehension

9.What federal act requires that all states provide appropriate education at no cost and in the least- restrictive environment to children with handicaps?

a.	Handicapped Persons Environmental Act
b.	Individuals with Disabilities Education Act (IDEA)
c.	Children’s Educational Act (CEA)
d.	Handicapped Children’s Act

ANS: B

	Feedback
A	Incorrect. The federal act requiring that all states provide appropriate education at no cost and in the least- restrictive environment to children with handicaps is not the Handicapped Persons Environmental Act.
B	Correct. Individuals with Disabilities Education Act (IDEA) replaced the Education for All Handicapped Children Act in 1990. The act requires all states to provide a free and appropriate education in the least restrictive environment to children with handicaps. The act added autism and traumatic brain injury as disabilities, and extended educational services to age 21 years.
C	Incorrect. The federal act requiring that all states provide appropriate education at no cost and in the least- restrictive environment to children with handicaps is not the Children’s Educational Act (CEA).
D	Incorrect. The federal act requiring that all states provide appropriate education at no cost and in the least- restrictive environment to children with handicaps is not the Handicapped Children’s Act.

PTS: 1 REF: p. 121 – History of School Nursing OBJ: Cognitive Level: Knowledge

10.Included in the school nurse’s role is the provision of direct services and indirect services. Which of the following activities best exemplifies the indirect services that school nurses provide?

a.	gastrostomy feedings	c.	community referrals
b.	ventilator care	d.	clean intermittent catheterizations

ANS: C

	Feedback
A	Incorrect. Gastrostomy feedings is a direct service, i.e., a nursing procedure or care.
B	Incorrect. Ventilator care is a direct service, i.e., a nursing procedure or care.
C	Correct. Community referrals best exemplifies an indirect service that school nurses provide.
D	Incorrect. Clean intermittent catheterizations is a direct service, i.e., a nursing procedure or care.

PTS: 1 REF: p. 124 – School Health Services OBJ: Cognitive Level: Knowledge

11.One of the tasks of the school nurse is organizing and performing screening programs. Which one of the following screenings is most often included in a traditional screening program offered by schools?

a.	pediculosis	c.	cardiac
b.	dental	d.	neurological

ANS: A

	Feedback
A	Correct. Traditional screening programs offered in the schools include vision and hearing testing; height, weight and body mass index measurements; pediculosis screening; immunization monitoring; and, in some districts, dental and tuberculosis screening.
B	Incorrect. Dental screening is not always included in a traditional screening program offered by schools.
C	Incorrect. Cardiac screening is not included in a traditional screening program offered by schools.
D	Incorrect. Neurological screening is not included in a traditional screening program offered by schools.

PTS: 1 REF: p. 124 – School Health Services OBJ: Cognitive Level: Knowledge

12.Which of the following laws affecting education was based upon the concepts of accountability for results, education based on scientific research, expanded parent options, and local control?

a.	Elementary and Secondary Education Act
b.	Individuals with Disabilities Education Act (IDEA)
c.	No Child Left Behind Act
d.	Education for All Handicapped Children Act

ANS: C

	Feedback
A	Incorrect. The Elementary and Secondary Education Act of 1965 addressed the inequality of education for economically disadvantaged children.
B	Incorrect. The Individuals with Disabilities Education Act (IDEA) of 1990 replaced the 1975 Education for All Handicapped Children Act.
C	Correct. The No Child Left Behind Act of 2001 is an amendment to the Elementary and Secondary Education Act of 1965. The act is based upon four concepts, including accountability of results, education based on scientific research, expanded parent options, and local control.
D	Incorrect. The Education for All Handicapped Children Act of 1975 mandated the states provide free and appropriate education for all children with disabilities.

PTS:1REF:p. 122 – History of School Nursing

OBJ: Cognitive Level: Comprehension

13.The school nurse finds a child’s hearing at between 70 dB and 90 dB in a hearing screening test. If further testing confirms this hearing level, this child is most likely considered to be:

a.	hard of hearing	c.	normal
b.	deaf	d.	near deaf

ANS: A

	Feedback
A	Correct. Children with hearing loss between 70 and 90 dB are considered hard of hearing.
B	Incorrect. Children with hearing loss between 70 and 90 dB are not considered deaf.
C	Incorrect. Children with hearing loss between 70 and 90 dB are not considered normal.
D	Incorrect. Children with hearing loss between 70 and 90 dB are not considered near deaf.

PTS:1REF:p. 125 – School Health Services

OBJ: Cognitive Level: Comprehension

14.A teacher informs the school nurse that she is concerned about a student who is not responding when called on in class. The student often asks the teacher to repeat questions. When asked by the nurse, the student denies any trouble hearing. Which of the following interventions made by the school nurse would be most appropriate?

a.	encourage the student to come to the nursing office if the student has any trouble hearing
b.	arrange for the student to have a hearing exam
c.	notify the school psychologist that the student is having trouble concentrating in class
d.	contact the student’s guardian(s) to request assistance with monitoring for potential hearing loss

ANS: B

	Feedback
A	Incorrect. While it would be appropriate for the nurse to encourage the student to come to the nursing office for hearing difficulties, the nurse should take action based upon the situation.
B	Correct. According to the text, children do not often complain of vision or hearing loss. Thus, academic and behavioral difficulties may result. Therefore, it would be appropriate for the nurse to arrange to test the student’s hearing.
C	Incorrect. The nurse should not assume that the student was having trouble concentrating until after a hearing assessment has been completed.
D	Incorrect. While the nurse may wish to contact the student’s guardian, arranging for a hearing exam would be the best response.

PTS:1REF:p. 125 – School Health Services

OBJ: Cognitive Level: Application

15.When the school health nurse identifies vision or hearing problems in children while conducting vision and hearing screening programs, he or she realizes that the nurse’s role ends with:

a.	problem identification	c.	follow-up care
b.	notifying caregivers	d.	documentation

ANS: C

	Feedback
A	Incorrect. When the school health nurse identifies vision or hearing problems in children while conducting vision and hearing screening programs, he or she realizes that the nurse’s role does not end with problem identification.
B	Incorrect. When the school health nurse identifies vision or hearing problems in children while conducting vision and hearing screening programs, he or she realizes that the nurse’s role does not end with notifying caregivers.
C	Correct. When the school health nurse identifies vision or hearing problems in children while conducting vision and hearing screening programs, he or she realizes that the nurse’s role ends with follow-up care.
D	Incorrect. When the school health nurse identifies vision or hearing problems in children while conducting vision and hearing screening programs, he or she realizes that the nurse’s role does not end with documentation.

PTS:1REF:p. 125 – School Health Services

OBJ: Cognitive Level: Comprehension

16.Which of the following statements by the school nurse would most help a child make a transition to wearing glasses?

a.	“If you don’t wear glasses, you could lose your eyesight.”
b.	“The glasses will help you see really well and will help you make better grades. Let’s think about who else has glasses.”
c.	“Your parents will be really happy if you wear your glasses and so will your teachers.”
d.	“Glasses are a wonderful invention. Just think what the world would be like if glasses had never been invented.”

ANS: B

	Feedback
A	Incorrect. The use of fear will not help the child understand how wearing glasses will help them.
B	Correct. To help the child with the transition to wearing eye glasses, you can explain in developmentally appropriate terms, why the child is getting glasses and how they will help him or her.
C	Incorrect. This statement is not the best choice to most help a child make a transition to wearing glasses.
D	Incorrect. The history of eye glasses is of very little interest to a child, and will not always make them at ease with wearing them.

PTS:1REF:p. 125 – School Health Services

OBJ: Cognitive Level: Application

17.The school nurse’s role in communicable disease control is influenced by three factors necessary for the spread of communicable diseases. These three factors are:

a.	transmission, susceptibility, and favorable environment
b.	virility of the organism, life span of the organism, and resistance of the organism
c.	climate, temperature, and wind or water factors
d.	availability of a vaccine, methods to inoculate, and population

ANS: A

	Feedback
A	Correct. Specifically, the nurse’s role in communicable disease control revolves around the three factors necessary for spread of disease: transmission, susceptibility, and a favorable environment.
B	Incorrect. The school nurse’s role in communicable disease control is influenced by three factors necessary for the spread of communicable diseases. These three factors are not: virility of the organism, life span of the organism, and resistance of the organism.
C	Incorrect. The school nurse’s role in communicable disease control is influenced by three factors necessary for the spread of communicable diseases. These three factors are not: climate, temperature, and wind or water factors.
D	Incorrect. The school nurse’s role in communicable disease control is influenced by three factors necessary for the spread of communicable diseases. These three factors are not: availability of a vaccine, methods to inoculate, and population.

PTS:1REF:p. 127 – School Health Services

OBJ: Cognitive Level: Comprehension

18.Which of the following conditions or situations would most likely cause a child to be denied admission to a school?

a.	severe vision or hearing loss	c.	developmental disorders
b.	lack of proper immunizations	d.	medical condition

ANS: B

	Feedback
A	Incorrect. Individuals with Disabilities Education Act (IDEA) requires schools to admit children with severe vision or hearing loss.
B	Correct. Depending on individual state guidelines, a student could be denied entrance to a school or be required to obtain physician-approved schedule for immunization.
C	Incorrect. Individuals with Disabilities Education Act (IDEA) requires schools to admit children with developmental disorders.
D	Incorrect. Individuals with Disabilities Education Act (IDEA) requires schools to admit children with a medical condition.

PTS:1REF:p. 126 – School Health Services

OBJ: Cognitive Level: Comprehension

19.The school nurse keeps a list of enrolled students who have medical or religious objections to immunizations and those who are likely to have decreased immunity. The nurse likely keeps this list to:

a.	facilitate exclusion in case of an outbreak of a highly communicable disease in the school
b.	reassure the family that the nurse will respect the family’s wishes at all times
c.	meet state and federal requirements
d.	provide statistics for the state health department

ANS: A

	Feedback
A	Correct. Keeping a list of students enrolled in your school with medical or religious objections to immunizations or those with special health concerns that lessen their immunity makes exclusion of students easier in the event of an outbreak of a serious communicable disease.
B	Incorrect. The nurse does not keep this list to reassure the family that the nurse will respect the family’s wishes at all times.
C	Incorrect. The nurse does not keep this list to meet state and federal requirements.
D	Incorrect. The nurse does not keep this list to provide statistics for the state health department.

PTS:1REF:p. 127 – School Health Services

OBJ: Cognitive Level: Comprehension

20.Before dispensing any medications to a student at school, the nurse must:

a.	contact the child’s caregivers	c.	get the child’s assent
b.	document the medication	d.	know the school district medication policy

ANS: D

	Feedback
A	Incorrect. Medications that must be dispensed to a student at school should have written orders from their physician and written permission from their caregivers. Therefore, the nurse does not need to contact the child’s caregivers.
B	Incorrect. The documentation of the dispensation of medications should occur after the medication has been given, never before.
C	Incorrect. The child’s assent is not required, and the child will know the medication schedule in advance.
D	Correct. Before dispensing any medication, the nurse must first know the district medication policy. Regulations for medication administration vary from state to state and even from district to district, but generally children who must receive medication at school have written orders from their physician as well as written permission from their caregivers.

PTS:1REF:p. 129 – School Health Services

OBJ: Cognitive Level: Comprehension

21.A child has fallen in gym class and is complaining of pain in one ankle. The child cries out when trying to bear weight. The nurse should complete which of the following immediate actions if there is swelling, bruising, deformities, decreased movement, or decreased circulation and sensation in the deformity?

a.	splint the extremity as necessary	c.	apply heat
b.	continue to have the child bear weight	d.	call an ambulance

ANS: A

	Feedback
A	Correct. Given the nature of the pain, and the symptoms described, the nurse’s immediate action should be to splint the extremity as necessary.
B	Incorrect. The symptoms indicate a fracture; therefore, the nurse should keep the child from weight bearing on the injured ankle. However, this is not the appropriate immediate action.
C	Incorrect. Good first aid calls for application of a cold pack, not heat, given the symptoms.
D	Incorrect. Calling an ambulance should occur if the nurse’s assessment dictates the situation to be an emergency.

PTS:1REF:p. 129 – School Health Services

OBJ: Cognitive Level: Application

22.A child suffers a head injury in a tumbling accident in gym class. The nurse’s best course of action is to:

a.	leave the child and go get help
b.	stay with the child, keep assessing, and have someone call the caregivers
c.	leave the child in the care of an older child and go get help
d.	get the child up walking and make sure he or she stays awake

ANS: B

	Feedback
A	Incorrect. The nurse’s best course of action is to not leave the child and go get help.
B	Correct. In the event of a head injury, the nurse’s best course of action is to stay with the child, keep assessing, and have someone call the caregivers and emergency services as assessment dictates.
C	Incorrect. The nurse’s best course of action is to not leave the child in the care of an older child and go get help.
D	Incorrect. The nurse’s best course of action is to not get the child up walking and make sure he or she stays awake.

PTS:1REF:p. 129 – School Health Services

OBJ: Cognitive Level: Application

23.The school health nurse is aware that the most important aspect of caring for an injured child is knowing:

a.	there the first aid kit is located
b.	who in the school is to be called for backup
c.	when to call for help
d.	there the oxygen is located

ANS: C

	Feedback
A	Incorrect. Knowing there the first aid kit is located is advisable but not the most important aspect of caring for an injured child.
B	Incorrect. Knowing who in the school is to be called for backup is significant but not the most important aspect of caring for an injured child.
C	Correct. The school health nurse is aware that the most important aspect of caring for an injured child is knowing when to call for help.
D	Incorrect. Extensive medical supplies and equipment such as oxygen are not always available in schools. If they were, the nurse should know there the oxygen is located. However, it is not the most important aspect of caring for an injured child.

PTS:1REF:p. 129 – School Health Services

OBJ: Cognitive Level: Application

24.The school nurse’s quick assessment of a student hurt in a fall on the playground determines that the child has serious injuries and needs to be transported to the hospital by ambulance. To lessen the child’s fears, the nurse’s best course of action would be to:

a.	read the child a story about a boy who went to the hospital in an ambulance
b.	tell the child not to be afraid and that the ambulance is needed to get to the hospital fast
c.	have a familiar school staff person ride in the ambulance with the injured child if permitted by ambulance personnel
d.	wait for a caregiver to come to the school and have him or her ride in the ambulance

ANS: C

	Feedback
A	Incorrect. Once the nurse has determined that an injury is serious enough to require an ambulance transport to a hospital, reading the child a story about a boy who went to the hospital in an ambulance may lessen her or his fears but is not the best course of action.
B	Incorrect. Telling someone not to be afraid almost always makes them afraid. This is not the best course of action for the nurse.
C	Correct. To help lessen the fears of students the school nurse can have a familiar staff person from the school ride in the ambulance with the child if possible.
D	Incorrect. Once the nurse has determined that an injury is serious enough to require ambulance transport to a hospital, there is not time to wait for a caregiver to come to the school and have him or her ride in the ambulance. This is not the best course of action for the nurse.

PTS:1REF:p. 131 – School Health Services

OBJ: Cognitive Level: Application

25.Since the school nurse may not always be present in the school, the nurse develops Individual Health Plans (IHPs). These plans are best described as:

a.	plans written by the caregivers as to what to do in an emergency, such as how to reach the health care practitioner and the caregivers and what can and cannot be done for the child
b.	protocols for what needs to be done for each of several types of emergencies for any child
c.	documents of health history, assessment, medications, equipment, possible problems, interventions, and emergency plan for each child with a health problem
d.	written orders from health care practitioners on each child with a health problem

ANS: C

	Feedback
A	Incorrect. Individual Health Plans (IHPs) are to the school nurse what a nursing care plan is to a hospital nurse, written by the nurse for individual students.
B	Incorrect. Individual Health Plans (IHPs) are to the school nurse what a nursing care plan is to a hospital nurse, written by the nurse for individual students. They are not protocols for what needs to be done for each of several types of emergencies for any child. This is the Individual Emergency Plan (IEMP) which is developed from the IHP.
C	Correct. Individual Health Plans (IHPs) are documents, based upon the nurse’s assessment of the child, that outline the special needs, goals, interventions, and outcomes necessary to improve or maintain the health of the child and allow him or her to remain in school.
D	Incorrect. Individual Health Plans (IHPs) are to the school nurse what a nursing care plan is to a hospital nurse, written by the nurse for individual students.

PTS:1REF:p. 131 – School Health Services

OBJ: Cognitive Level: Comprehension

26.The school nurse works with a number of children who receive medication while they are at school. In order to give medication to a child at school, the nurse must have only:

a.	a call from the nurse in the pediatrician’s office or health care practitioner’s office
b.	written permission from the caregivers and a health care practitioner’s order
c.	verbal permission from the caregivers in case of herbal medicines
d.	a printout from the pharmacy in the case of over-the-counter medication

ANS: B

	Feedback
A	Incorrect. A call from the nurse in the pediatrician’s office or health care practitioner’s office is not adequate permission to dispense medication to a child at school.
B	Correct. Generally children who must receive medication at school have written orders from their physician as well as written permission from their caregivers.
C	Incorrect. No medication may be dispensed to a child at school without written permission from the caregivers and a health care practitioner.
D	Incorrect. A printout from the pharmacy in the case of over-the-counter medication is not adequate permission to dispense medication to a child at school.

PTS:1REF:p. 130 – School Health Services

OBJ: Cognitive Level: Comprehension

27.Children’s medications at school must be stored in:

a.	a warm, dry place too high for children to reach
b.	in the nurse’s office
c.	in a locked cabinet
d.	in an area not used by the schoolchildren

ANS: C

	Feedback
A	Incorrect. Children’s medications at school may need to be stored in a warm, dry place, a cold place, should be too high for children to reach, but must be locked.
B	Incorrect. Children’s medications at school may be stored in the nurse’s office, as long as it is locked.
C	Correct. Children’s medications at school must be stored in a locked cabinet.
D	Incorrect. Children’s medications at school may be stored in an area not used by the schoolchildren, as long as it is locked.

PTS:1REF:p. 130 – School Health Services

OBJ: Cognitive Level: Comprehension

28.Which of the following questions would be most important for the nurse to ask regarding the content of a health education curriculum before teaching it to a classroom of children?

a.	Will this presentation catch the children’s attention?
b.	Is the information in this content age-appropriate?
c.	Does this information reflect the latest research?
d.	Have the caregivers already taught this information at home?

ANS: B

	Feedback
A	Incorrect. “Will this presentation catch the children’s attention?” is not the most important question for the nurse to ask regarding the content of a health education curriculum before teaching it to a classroom of children.
B	Correct. Since not all topics are appropriate for children of all ages, it is important to be sure the information presented is age-appropriate.
C	Incorrect. “Does this information reflect the latest research?” is not the most important question for the nurse to ask regarding the content of a health education curriculum before teaching it to a classroom of children.
D	Incorrect. “Have the caregivers already taught this information at home?” is not the most important question for the nurse to ask regarding the content of a health education curriculum before teaching it to a classroom of children.

PTS:1REF:p. 136 – Health Education and Promotion

OBJ: Cognitive Level: Application

29.You notice that a school health nurse is teaching the children to wash their hands using a nontoxic powder that lights up under a black light. The nurse sprinkles the powder on the children’s hands and later shows them by using the black light that they have put these “germs” on their faces and everywhere they have touched. The students wash their hands and see if they made the germs disappear. Which of the following reasons best represents the most important rationale for why the school nurse teaches hand washing by this method instead of giving a talk?

a.	The glow-powder method is more fun for everyone.
b.	This method gets the children more active and provides exercise.
c.	Physically involving the children increases their understanding.
d.	Most other elementary teachers use the glow-powder method.

ANS: C

	Feedback
A	Incorrect. The glow-powder method is more fun for everyone, but physically involving the children increases their understanding.
B	Incorrect. This method gets the children more active and provides exercise, but the physical involvement is important because it increases their understanding.
C	Correct. Whatever program chosen for teaching hand-washing, physically involving the child in the learning increases understanding.
D	Incorrect. The most important rationale for using the Glo-germ powder is not because most other elementary teachers use the glow-powder method.

PTS:1REF:p. 137 – Health Education and Promotion

OBJ: Cognitive Level: Application

30.When the school nurse prepares sex education curricula, the primary goals are to increase knowledge and to:

a.	frighten students about the things that can happen to them
b.	encourage students to make positive health choices
c.	inform students whose caregivers are unlikely to inform them
d.	make certain the students know everything about sex

ANS: B

	Feedback
A	Incorrect. When the school nurse prepares sex education curricula, the primary goals are to increase knowledge and not to frighten students about the things that can happen to them.
B	Correct. When the school nurse prepares sex education curricula, the primary goals are to increase knowledge and to encourage students to make positive health choices.
C	Incorrect. When the school nurse prepares sex education curricula, the primary goals are to increase knowledge and not to inform students whose caregivers are unlikely to inform them.
D	Incorrect. When the school nurse prepares sex education curricula, the primary goals are to increase knowledge and not to make certain the students know everything about sex.

PTS:1REF:p. 139 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

31.When providing education on sexually transmitted diseases (STDs), it is essential to include which of the following?

a.	identification of the most life-threatening diseases
b.	names of famous teenagers who have died as a result of STDs
c.	information on how STDs are spread
d.	facts on the rate of transmission and prevalence among young adults

ANS: C

	Feedback
A	Incorrect. When providing education on sexually transmitted diseases (STDs), it is not essential to include identification of the most life-threatening diseases.
B	Incorrect. When providing education on sexually transmitted diseases (STDs), it is not essential to include names of famous teenagers who have died as a result of STDs.
C	Correct. When providing education on sexually transmitted diseases (STDs), it is essential to include information on how STDs are spread.
D	Incorrect. When providing education on sexually transmitted diseases (STDs), it is not essential to include facts on the rate of transmission and prevalence among young adult

PTS:1REF:p. 139 – Health Education and Promotion

OBJ: Cognitive Level: Application

32.Before teaching students about contraception, the nurse most needs to be aware of:

a.	what percent of students are sexually active
b.	sources of contraceptive materials for the students
c.	school district policies and community values
d.	local statistics on sexually transmitted diseases

ANS: C

	Feedback
A	Incorrect. Before teaching students about contraception, the nurse does not primarily need to be aware of what percent of students are sexually active.
B	Incorrect. Before teaching students about contraception, the nurse does not mostly need to be aware of sources of contraceptive materials for the students.
C	Correct. There is controversy regarding teaching the use of contraception, so before developing or implementing an education program, the nurse must be familiar with the policies of the school district and the values of the community.
D	Incorrect. Before teaching students about contraception, the nurse does not primarily need to be aware of local statistics on sexually transmitted diseases.

PTS:1REF:p. 139 – Health Education and Promotion

OBJ: Cognitive Level: Application

33.The school nurse is planning a health education curriculum. What topics would he or she select to begin the teaching of health education in the intermediate grades (4th, 5th, and 6th)?

a.	sex education and contraception
b.	the dangers of alcohol and drugs
c.	personal hygiene and self-esteem building
d.	hormonal changes that occur in the teens

ANS: C

	Feedback
A	Incorrect. Sex education and contraception is not age appropriate for 4th-6th graders.
B	Incorrect. The dangers of alcohol and drugs is not age appropriate for 4th-6th graders.
C	Correct. As children reach the intermediate grades (fourth, fifth, and sixth), health education can focus on personal hygiene and programs that enhance self-esteem.
D	Incorrect. Hormonal changes that occur in the teen years is not age appropriate for 4th-6th graders.

PTS:1REF:p. 138 – Health Education and Promotion

OBJ: Cognitive Level: Application

34.The school nurse is working with several teenage girls who are pregnant but remaining in school. The nurse must be prepared in case one of these students goes into labor at school. Which of the following actions is the most important for the nurse to take, in addition to making sure there is an emergency delivery kit in the school?

a.	Let the teachers know how to contact the nurse 24 hours a day.
b.	Make home health visits to the student and the student’s family.
c.	Provide information on how to include the father in the birth.
d.	Write an Individual Health Plan for each pregnant student.

ANS: D

	Feedback
A	Incorrect. Let the teachers know how to contact the nurse 24 hours a day is not the most important action.
B	Incorrect. Make home health visits to the student and the student’s family is not the most important action.
C	Incorrect. Provide information on how to include the father in the birth is not the most important action.
D	Correct. The school nurse must be prepared if students go into labor at school. Any school there a pregnant student is enrolled should have an emergency delivery kit available. An Individual Health Plan should be developed for each pregnant student for school personnel to follow in case of emergency.

PTS:1REF:p. 140 – Health Education and Promotion

OBJ: Cognitive Level: Application

35.In teaching students about the risks of smoking, which of the following methods would be most effective for the school nurse to use?

a.	lecture
b.	teacher-facilitated, student-led small group discussions
c.	animated video cartoons with popular cartoon characters
d.	role-play

ANS: B

	Feedback
A	Incorrect. In teaching students about the risks of smoking, the lecture method is not the most effective for the school nurse to use.
B	Correct. In teaching students about the risks of smoking, teacher-facilitated, student-led small group discussions would be most effective.
C	Incorrect. In teaching students about the risks of smoking, the use of animated video cartoons with popular cartoon characters is not the most effective for the school nurse to use.
D	Incorrect. In teaching students about the risks of smoking, role-play is not the most effective for the school nurse to use.

PTS:1REF:p. 140 – Health Education and Promotion

OBJ: Cognitive Level: Application

36.Antismoking education needs to be included into health promotion and wellness classes beginning in what grade and continuing through high school?

a.	kindergarten	c.	7th
b.	4th	d.	9th

ANS: B

	Feedback
A	Incorrect. Health education programs dealing with tobacco prevention and use can wait until 4th grade (elementary school).
B	Correct. Experimentation at an early age increases the risk of regular smoking. Therefore, health education programs dealing with tobacco prevention and use need to be taught before 7th grade (middle school).So antismoking education needs to begin in elementary school (4th grade).
C	Incorrect. Health education programs dealing with tobacco prevention and use cannot wait until middle school (7th grade).
D	Incorrect. Health education programs dealing with tobacco prevention and use cannot wait until high school (9th grade).

PTS:1REF:p. 140 – Health Education and Promotion

OBJ: Cognitive Level: Application

37.To be effective, antismoking education needs to be done before children:

a.	tries the first cigarette
b.	have a job and earn enough money to buy cigarettes
c.	reach adolescence and adolescent rebellion
d.	have too much stress from school and home to quit

ANS: A

	Feedback
A	Correct. Antismoking education must begin before the child tries the first cigarette.
B	Incorrect. Having a job and having money are not necessary for children to have access to tobacco.
C	Incorrect. The antismoking education needs to be done earlier than adolescence.
D	Incorrect. The timing of the antismoking education is age related, not stress related.

PTS:1REF:p. 140 – Health Education and Promotion

OBJ: Cognitive Level: Application

38.Which of the following descriptions best describes TAR WARS?

a.	a Star Wars movie in which smoking is declared as evil
b.	an antitobbaco program designed for 5th-grade students
c.	a campaign against students’ use of black tar heroin
d.	an effort to get students to influence caregivers to stop smoking

ANS: B

	Feedback
A	Incorrect. The best description of the TAR WARS program is not a Star Wars movie in which smoking is declared as evil.
B	Correct. The best description of the TAR WARS program is an anti-tobacco program designed for 5th-grade students.
C	Incorrect. The best description of the TAR WARS program is not a campaign against students’ use of black tar heroin.
D	Incorrect. The best description of the TAR WARS program is not an effort to get students to influence caregivers to stop smoking.

PTS:1REF:p. 140 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

39.What effect does alcohol and drug use by students have on school performance?

a.	little or none, as students attempt to cover use
b.	grades that drop somewhat but not significantly
c.	poor academic performance and often dropping out
d.	increased school performance in those who need to medicate

ANS: C

	Feedback
A	Incorrect. Alcohol and drug use has a serious effect on school performance.
B	Incorrect. Alcohol and drug use does cause grades and school performance to degrade.
C	Correct. Alcohol use and drug use have been associated with truancy, poor academic performance, higher dropout rates, and low self-esteem.
D	Incorrect. Alcohol and drug use does not increase school performance in those who need to medicate.

PTS:1REF:p. 142 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

40.Which of the following drugs have become the most used or abused by students below the eighth grade?

a.	marijuana	c.	inhalants
b.	methamphetamine	d.	LSD

ANS: C

	Feedback
A	Incorrect. Marijuana is not the most used or abused drug by students below the eighth grade.
B	Incorrect. Methamphetamine is not the most used or abused drug by students below the eighth grade.
C	Correct. The use of inhalants among children and teens has been an increasing concern for school nurses. Aerosol products such as cleaners, solvents, adhesives, hair spray, or even whipped cream are being misused by students to get high. In fact, because they are legal to purchase, they have become more popular with younger students than marijuana, with roughly one in ten students below eighth grade having tried inhalants.
D	Incorrect. LSD is not the most used or abused drug by students below the eighth grade.

PTS:1REF:p. 141 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

41.Which of the following substances is the most frequently used substance by adolescents?

a.	alcohol	c.	cocaine
b.	marijuana	d.	heroin

ANS: A

	Feedback
A	Correct. Current marijuana use is 23.9% and teens who use alcohol have been measured at 47.1%.
B	Incorrect. Marijuana is not the most frequently used substance by adolescents, 40% have reported having tried it.
C	Incorrect. Cocaine is not the most frequently used substance by adolescents, 8.7% have reported having tried it.
D	Incorrect. Heroin is not the most frequently used substance by adolescents.

PTS:1REF:p. 142 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

42.In teaching violence prevention, the school nurse knows that this needs to begin in grades:

a.	kindergarten to 3rd	c.	7th to 9th
b.	4th to 6th	d.	10th to 12th

ANS: A

	Feedback
A	Correct. A successful violence prevention education program is an integrated program with specific curricula for grade levels beginning in kindergarten to the 3rd grade.
B	Incorrect. A successful violence prevention education program begins earlier than 4th to 6th grades.
C	Incorrect. A successful violence prevention education program begins earlier than 7th to 9th grades.
D	Incorrect. A successful violence prevention education program begins earlier than 10th to 12th grades.

PTS:1REF:p. 143 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

43.For violence prevention teaching to be effective, the school needs to train and use as a role model(s):

a.	a small team of interested teachers	c.	only the nurse
b.	all teachers, nurses, and other staff	d.	the nurse and administrative staff

ANS: B

	Feedback
A	Incorrect. A small team of interested teachers trained and used as role models is not the most effective approach for teaching violence prevention.
B	Correct. Education provided by a handful of teachers is less effective than a violence prevention strategy involving all teachers, nurses and other staff.
C	Incorrect. Only the nurse trained and used as a role model is not the most effective approach for teaching violence prevention.
D	Incorrect. Only the nurse and administrative staff trained and used as role models are not the most effective approach for teaching violence prevention.

PTS:1REF:p. 143 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

44.In addition to a violence prevention curriculum, the school most needs to do which of the following things in order to prevent or keep school violence incidences low?

a.	Increase the punishment for aggressive acts.
b.	Talk with the caregivers about their responsibility to keep their children nonaggressive.
c.	Formalize a working agreement with the local police force.
d.	Have formal policies on how violence will be dealt with on the school grounds.

ANS: D

	Feedback
A	Incorrect. In addition to a violence prevention curriculum, the increase of punishment for aggressive acts is not the next most helpful thing to reduce incidents of violence.
B	Incorrect. In addition to a violence prevention curriculum, talk with the caregivers about their responsibility to keep their children nonaggressive is not the next most helpful thing to reduce incidents of violence.
C	Incorrect. In addition to a violence prevention curriculum, a formalized working agreement with the local police force is not the next most helpful thing to reduce incidents of violence.
D	Correct. After the development of an integrated violence prevention curriculum, the school must develop set rules and policies on how violence will be dealt with on school grounds.

PTS:1REF:p. 143 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

45.The school nurse is working in a culturally and ethnically diverse school in which there have been a large number of documented incidences of violence. Which of the following ideas would the nurse stress early in the health class before proceeding to training in such subjects as anger management?

a.	We are all unique in some way, and uniqueness is wonderful.
b.	You are going to end up hurt someday when you pick on the wrong person.
c.	Every child deserves courtesy and respect no matter what background the child has come from.
d.	Aggression is a bad way to interact with others and will be punished.

ANS: C

	Feedback
A	Incorrect. It is not better to stress that you are all unique in some way and uniqueness is wonderful.
B	Incorrect. It is not better to stress that you are going to end up hurt someday when you pick on the wrong person, fear of others differences is going the wrong direction.
C	Correct. Developing a curriculum with culture and ethnic sensitivity is important but difficult to implement in schools with an interracial mix of students; it is better to stress that every child deserves courtesy and respect no matter their background.
D	Incorrect. It is not better to stress that aggression is a bad way to interact with others and will be punished, a threat will be challenged and tested.

PTS:1REF:p. 143 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

46.Who is in the best position to teach anger management skills to schoolchildren?

a.	a school administrator	c.	an outside contracted facilitator
b.	the school nurse	d.	the classroom teacher

ANS: D

	Feedback
A	Incorrect. A school administrator is not in the best position to teach anger management skills to schoolchildren.
B	Incorrect. The school nurse is not in the best position to teach anger management skills to schoolchildren.
C	Incorrect. An outside contracted facilitator is not in the best position to teach anger management skills to schoolchildren.
D	Correct. The classroom teacher is in the best position to teach anger management skills to schoolchildren.

PTS: 1 REF: p. 126 – School Health Services OBJ: Cognitive Level: Knowledge

47.The school nurse’s main focus in child abuse or neglect issues is:

a.	running an abuse and neglect group
b.	doing psychological testing
c.	awareness: recognizing signs and symptoms and reporting to authorities
d.	working with the caregivers to change their behavior to less pathological behavior

ANS: C

	Feedback
A	Incorrect. The school nurse’s main focus in child abuse or neglect issues is not running an abuse and neglect group.
B	Incorrect. The school nurse’s main focus in child abuse or neglect issues is not doing psychological testing.
C	Correct. The school nurse’s main focus in child abuse or neglect issues is awareness. It is necessary to recognize the signs of abuse and report them to the appropriate authorities.
D	Incorrect. The school nurse’s main focus in child abuse or neglect issues is not working with the caregivers to change their behavior to less pathological behavior.

PTS:1REF:p. 143 – Health Education and Promotion

OBJ: Cognitive Level: Comprehension

MULTIPLE RESPONSE

1.Many schools have established protocols on specific instances when children should be sent home. Which of the following symptoms would likely be included in this protocol? Select all that apply.

a.	a temperature of 38.1 degrees C (100.6 degrees F)
b.	a red, nonraised rash on the chest and legs
c.	an occasional dry cough
d.	history of asthma

ANS: A, B

	Feedback
Correct	A temperature over 37.8 degrees C (100 degrees F) would likely meet the criteria for being sent home from school.  A red rash would likely meet the criteria for being sent home from school.
Incorrect	An occasional dry cough without other presenting symptoms would not likely meet the criteria.  A history of asthma alone would not be a reason to send a child home from school.

PTS:1REF:p. 129 – School Health Services

OBJ: Cognitive Level: Application

2.A student has sustained a fracture while playing on the swings during recess. The school nurse is required to document the event using a standardized injury form. Which of the following best describes the rationale for using this form? Select all that apply.

a.	serves as legal protection for the school district in the event the guardian files charges
b.	provides necessary documentation for insurance purposes for the student
c.	allows for the examination of patterns
d.	provides a standard format for examining data on injuries

ANS: C, D

	Feedback
Correct	Standardized injury forms are used for examining data on injuries, as well as looking for patterns. By identifying such patterns, interventions can be implemented to eliminate or minimize the risk associated with specific events or activities, such as playground equipment.  Standardized injury forms are used for examining data on injuries, as well as looking for patterns. The standardized injury forms provide a standard format for examining data on injury.
Incorrect	The intent of the form is not to serve as legal protection for the school.  The intent of the form is not intended to provide documentation for insurance purposes.

PTS:1REF:p. 130 – School Health Services

OBJ: Cognitive Level: Comprehension

3.A school nurse is preparing individualized health plans (IHPs) for students. Which of the following items would likely be included in the plans? Select all that apply.

a.	academic needs of the student
b.	goals and interventions to enhance health status
c.	outcomes that will allow the student to remain in school
d.	dietary considerations or restrictions

ANS: B, C, D

	Feedback
Correct	An IHP is a document that outlines the special health needs, goals, interventions, and outcomes necessary to enhance health status. An IHP is a document that outlines the special health needs, goals, interventions, and outcomes necessary to improve or maintain the health of the child and allow the student to remain in school. An IHP is a document that outlines the special health needs, goals, interventions, and outcomes necessary to improve or maintain the health of the child and allow the student to remain in school. Dietary considerations would also be included.
Incorrect	The academic needs of the student would not be included in the IHP.

PTS:1REF:p. 131 – School Health Services

OBJ: Cognitive Level: Comprehension

4.A student has been the recipient of significant bullying at school. The school nurse is aware that a student being bullied can present as having which of the following signs and symptoms? Select all that apply.

a.	complaints of loneliness or isolation
b.	signs of depression
c.	frequent reports of generalized discomfort
d.	chronic absenteeism from school

ANS: A, B, C, D

	Feedback
Correct	Students who are the recipient of peer bullying may present with complaints of loneliness or isolation.  Students who are the recipient of peer bullying may present with complaints of loneliness or isolation and signs of depression.  Students who are the recipient of peer bullying may present with complaints of loneliness or isolation, signs of depression, and reports of generalized discomfort. Students who are the recipient of peer bullying may present with complaints of loneliness or isolation, signs of depression, reports of generalized discomfort, or chronic absenteeism from school.
Incorrect	All answers are correct.

PTS:1REF:p. 142 – Health Education and Promotion

OBJ: Cognitive Level: Application