Chapter 30: School Health Nursing School Test Banks

Chapter 30: School Health
Test Bank

MULTIPLE CHOICE

1. What are todays children and adolescents more likely to confront as health problems in comparison with previous generations?
a. Problems resulting from alcohol and tobacco use
b. Problems resulting from sexually transmitted diseases
c. Problems resulting from high-risk behaviors
d. Problems resulting from communicable diseases
ANS: C
Formerly, children and adolescents had to confront contagious diseases, but today adolescents face risks related to high-risk behaviors. Adolescents die from motor vehicle crashes, other unintentional injuries, homicides, and suicide.

DIF: Cognitive Level: Knowledge REF: p. 750

2. What was the primary reason why Lillian Wald was able to develop the practice of school nursing in this country in the early twentieth century?
a. Concern over the increasing number of school absences
b. Expansion of public health care from adults to children
c. Government mandate to have nurses in the schools
d. Additional funds available to finance health care in school systems
ANS: A
Walds project with Lina Rogers Struthers, the first school nurse, demonstrated that school nursing decreased school absences significantly, down 90% within 1 year.

DIF: Cognitive Level: Knowledge REF: p. 750

3. Although originally school nursings purpose was preventing the spread of contagious diseases, what additional responsibility was quickly added?
a. Incorporating health education into the curriculum
b. Replacing physicians for those children whose parents could not afford a physician
c. Substituting for classroom teachers when the teacher was ill
d. Teaching safety, first aid, and universal precautions to teachers
ANS: A
The health issues seen by the school nurses expanded the nursing practice to include prevention, examination, treatment, and advocacy.

DIF: Cognitive Level: Knowledge REF: p. 750

4. What has been a traditional focus of school health programs since the 1980s?
a. Drug abuse
b. Environment
c. First aid and safety
d. Sexual behaviors
ANS: B
The traditional school health approach included the three domains of health services, health education, and environment.

DIF: Cognitive Level: Knowledge REF: p. 751

5. Which of the following would be considered a key element of a comprehensive school health education program?
a. Offering daily physical education classes
b. Ensuring safety on the school playground
c. Involving parents and the community members in health education programs
d. Facilitating a well-balanced diet through the school lunch program
ANS: C
Key elements of a comprehensive school health education program include a documented, planned, and sequential program of health instruction for students in grades kindergarten through 12; a curriculum that addresses and integrates education about a range of categorical health problems; activities that help young people develop skills to avoid health problems; instruction for a prescribed amount of time at each grade level; management and coordination by an educational professional; instruction from teachers who are trained to teach the subject; involvement of parents, health professionals, and community members; and periodic evaluation. Involving parents and community members in health education programs meets the identified key elements. The other options, although important, are not part of a comprehensive school health education program.

DIF: Cognitive Level: Application REF: p. 752

6. A school nurse attended school-wide parents meetings and gave a report on the health education courses currently being taught and some of the feedback from students in those courses. What would be the primary reason for the nurse to share such information on a regular basis?
a. To ensure job security in the future with all the school budget cuts
b. To convince the principal of the importance of having a school nurse on staff
c. To increase awareness and, it is hoped, support from the local community
d. To show progress in meeting state school standards
ANS: C
Curriculum must accommodate the unique local needs and preferences of each community to increase support from and awareness of community members.

DIF: Cognitive Level: Application REF: p. 753

7. What would a nurse who is aware of national statistics regarding mortality, morbidity, and epidemics in the United States emphasize at school meetings for parents and staff?
a. Dangers of bioterrorism and how staff must be prepared for disasters
b. How to react in the safest manner if violence breaks out in the school
c. Importance of not sharing personal items to avoid spread of infections and parasites
d. Need for physical exercise for each student on a daily basis
ANS: D
One of the biggest epidemics in the United States today is that of obesity. Benefits of regular physical activity are clearly documented. The 2006 School Health Policies and Programs Study (SHPPS) recommended an increase in quantity and quality of physical exercise.

DIF: Cognitive Level: Application REF: p. 753

8. What might be a school health nurses concern regarding the No Child Left Behind Act?
a. The law does not meet local needs as the school boards perceive them.
b. The law is based on erroneous assumptions.
c. The law meets the needs of urban states but not rural ones.
d. The law will divert funds from health services and physical education.
ANS: D
Because the law focuses exclusively on academic progress to determine the funding that schools receive, it encourages schools and districts to funnel resources in ways that limit support for necessary but indirect influences on academic outcomes. This has resulted in diminished support for health services, which are shown to improve learning readiness, promote student retention rates, and improve academic performance.

DIF: Cognitive Level: Comprehension REF: p. 754

9. Which of the following primarily determines the school nurses role in a community?
a. The communitys priorities for its schools
b. The local school systems goals as influenced by federal and state legislation
c. The nurse practice act of the state in which the nurse practices
d. The employed nurses education, credentials, and skill level
ANS: B
School health programs vary markedly across the United States. The local schools primarily define their program but are influenced by federal, state, and local regulations.

DIF: Cognitive Level: Comprehension REF: p. 759

10. The school nurse reported suspected child abuse to the appropriate local authorities. The parents became very upset and stormed into the school, demanding a copy of all the records related to their child, including the health record that led the nurse to make such an accusation. What would be the nurses best response?
a. No; I will need to get permission from the principal before I release those records to you.
b. No; you are unable to view these because school health records are not part of your childs educational record.
c. Yes; as parents you have the right to your childs records, but you must allow me time to pull the records together.
d. Yes; you have every right to a copy of the records, although not the originals, which must remain at the school.
ANS: B
School-based health clinical and center records, records connected to drug or alcohol abuse, and records connected with child abuse or neglect are not considered part of the educational record available to the parents.

DIF: Cognitive Level: Application REF: p. 757

11. A nurse is working with nonprofessional staff in the school setting. Which of the following actions is important for the nurse to take?
a. Writing grants for funds to support the use of nonprofessional staff in the school
b. Engaging in political action to educate legislators about the need for funding for school health
c. Keeping records that document training and ongoing evaluation of the nonprofessional staff
d. Providing direct care services as needed for the children and staff in the school system
ANS: C
School personnel in general have no training in health-related fields and generally do not anticipate having to perform health care functions when they accept employment as teachers or school employees. Because lack of funding impedes the presence of full-time nurses at many school buildings, school nurses must train and delegate some tasks to unlicensed school staff. Thus, keeping documentation of the training and evaluation of their performance of the skills that have been delegated is essential.

DIF: Cognitive Level: Application REF: p. 758

12. In addition to being licensed as a registered nurse to practice in that state, what academic preparation is recommended for a school nurse?
a. A baccalaureate degree in any academic subject
b. A baccalaureate degree in nursing
c. A masters degree in nursing
d. An associate degree plus a certificate in school nursing
ANS: A
To be a school nurse, the nurse should have academic credentials comparable with those of other faculty members in the school. The minimum qualification that the National Association of School Nurses (NASN) advocates is a baccalaureate degree.

DIF: Cognitive Level: Knowledge REF: p. 759

13. Which of the following situations would be the best time for the school nurse to engage in informal teaching?
a. When a student asks a question, thereby creating a teachable moment
b. When a written request is submitted by a classroom teacher
c. When parents have requested information on a particular topic
d. When the principal has concluded that specific content should be added to the curriculum
ANS: A
Although any of the options might cause a school nurse to consider teaching a specific program of study, teaching is most effective when the learner (an individual or a group) has a teachable moment or has expressed a desire or need to know.

DIF: Cognitive Level: Application REF: p. 759

14. What would be the school nurses primary goal when choosing to teach a class about the importance of daily physical activity?
a. Fulfilling federal legislation requirements
b. Fulfilling state legislation requirements
c. Helping the children avoid disease and injury
d. Motivating the children to promote their own health and well-being
ANS: D
Although all of the options may be the nurses goals, the primary purpose of health education is to promote health maintenance and wellness, not just to prevent disease and injury.

DIF: Cognitive Level: Application REF: p. 760

15. Why might the school nurse want to examine students academic achievement?
a. Academic failure is a risk factor for adolescent drug use.
b. Some teachers may need the nurses help to be effective in health education.
c. Students are easier to teach if divided into groups by academic ability.
d. The nurse may want to discuss the failure with the students family and friends.
ANS: A
Nurses are responsible for case finding, or identifying children at risk and developing appropriate interventions. Common risk factors for drug use include academic failure, low degree of commitment to education, and low level of attachment to teachers and schools.

DIF: Cognitive Level: Application REF: p. 760

16. The nurse was teaching refusal skills, coping with peer pressure, and avoiding certain situations. A group of parents visiting the school asked why the nurse was using their tax dollars to teach social skills. What might the nurse need to explain?
a. These skills help students avoid smoking, use of drugs, and early sexual intercourse.
b. The nurse was providing information that the teacher had requested.
c. The nurse was fulfilling state-mandated standards under the No Child Left Behind Act.
d. These students had been identified as being at high risk and needed this education.
ANS: A
Such life skills are components of successful programs that help students avoid smoking, drug use, and other high-risk behaviors.

DIF: Cognitive Level: Application REF: p. 761

17. Why would a school nurse encourage the school district to create a violence prevention program?
a. A government-endorsed teaching unit that focused on this topic is available.
b. Additional funds are being offered in the state to provide this educational program.
c. The prevalence of violence, including homicide, among adolescents is recognized.
d. High-risk behaviors are common among adolescents.
ANS: C
Violence and abusive behaviors are major causes of death and injury. Violence prevention programs have been established in many schools. One of the most important recommendations made by the Centers for Disease Control and Prevention (CDC) is to implement violence prevention programs to promote substantial reductions in antisocial and delinquent behaviors.

DIF: Cognitive Level: Application REF: p. 761

18. Why would a school nurse seek funds to implement a program to teach adolescents how to recognize depression and low self-esteem in their peers?
a. Funds are available for such mental health programs.
b. Such programs are a priority in Healthy People 2020.
c. The incidence of adolescents considering or attempting suicide is high.
d. The nurse has expertise in this area and wants to share this knowledge with others.
ANS: C
Suicide is the third leading cause of death among young people; 6.3% of high school students report making at least one suicide attempt.

DIF: Cognitive Level: Application REF: p. 763

19. A school nurse completed a needs assessment and concluded that illegal use of drugs, including alcohol and tobacco, was a major problem. What would be the nurses first intervention?
a. Ask police officers to educate the students about the penalties for illegal drug use.
b. Create, with administrative support, a policy of no smoking while on school grounds.
c. Inform teachers that smoking on school grounds will not be tolerated.
d. Tell the local newspapers of the findings so that the media can inform parents.
ANS: B
One of the recommendations for school substance use prevention programs is to develop and enforce a school policy on substance abuse; creating a no-smoking policy meets this recommendation. The other interventions, although important, do not address the recommendations addressed in the text.

DIF: Cognitive Level: Analysis REF: p. 764

MULTIPLE RESPONSE

1. What conclusions were drawn from the 2006 School Health Policies and Programs Study? (Select all that apply.)
a. Progress toward meeting goals had improved since the 2000 data was collected.
b. Progress toward meeting goals had declined since the 2000 data was collected.
c. Teachers delivering health education were appropriately prepared.
d. Teachers delivering health education were inadequately prepared.
e. The percentage of states mandating the adoption of health education standards decreased.
f. The percentage of states mandating the adoption of health education standards increased.
ANS: A, D, F
A comparison of data gathered in 2000 with that collected in 2006 reveals progress made in regard to the core components of comprehensive school health and stressed in Healthy People 2020. The findings show that the percentage of states that have adopted a policy mandating schools and districts to follow national or state health education standards or guidelines has increased from 60.8% to 74.5%. However, only 25% of teachers delivering required health curricula received training in any of the 14 identified health topics.

DIF: Cognitive Level: Comprehension REF: p. 762 | pp. 764-765 | p. 768

2. What findings would be expected if a school nurse collected data related to the health issues experienced by students? (Select all that apply.)
a. Almost half of all high school students have had sexual relations.
b. Asthma is a common cause of absenteeism.
c. Dental caries is the most common chronic health problem of children.
d. Children may be psychologically affected by skin disorders that affect their physical appearance.
e. Scabies and pediculosis necessitate that the student stay home.
f. Tinea capitis and impetigo are major contributors to absenteeism.
ANS: A, B, C, D
The 2009 Youth Risk Behavior Survey (YRBS) revealed that 46% of all high school students had engaged in sexual intercourse. Asthma is a major public health problem; it accounts for millions of missed school days each year. Dental caries is the most common chronic childhood disease in the country, five times more common than asthma. Dermatologic disorders affect many children psychologically, especially if they affect their physical appearance or will cause their exclusion from school. Scabies and pediculosis are not reasons to have students stay home, because they are not dangerous. Tinea capitis and impetigo do not usually necessitate exclusion from school.

DIF: Cognitive Level: Application REF: p. 767

3. What would be the school nurses motivation for educating adolescent girls about self-esteem and body image? (Select all that apply.)
a. Body image is strongly related to a tendency to engage in bullying and verbal violence.
b. Bulimia is associated with major depression.
c. Disturbed eating patterns are associated with distorted body image and low self-esteem.
d. Eating disorders have the highest mortality rate of any psychiatric disorder.
e. Obesity is strongly related to distorted body image.
f. Obsessive-compulsive disorder commonly accompanies anorexia.
ANS: B, C, D, F
Both anorexia nervosa and bulimia nervosa are characterized by disturbed eating patterns. Major depression commonly accompanies both anorexia and bulimia, and obsessive-compulsive disorder is associated with anorexia. These eating disorders have the highest mortality rate of any psychiatric disorder.

DIF: Cognitive Level: Application REF: p. 762

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