Challenge the School Nurse Archive | National Board for Certification of School Nurses (NBCSN)

November 2026

Measles was declared eliminated from the United States in 2000. However, since early 2025, U.S. measles cases have been increasing and there have been several large outbreaks of more than 50 cases. Measles can cause serious health complications in all age groups. In an effort to educate the school community about measles, the School Nurse should inform the group that measles can be spread:

1. through the air when an infected person talks, coughs or sneezes up to four days before the rash occurs.

2. through contact by touching the infected person’s rash up to four days after the rash occurs.

3. through contact by touching items that the infected person has also touched.

4. through droplets by touching items that the infected person has coughed or sneezed on the prior 24 hours.

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October 2026

A student is found unresponsive on the football practice field. Upon arrival, the nurse assesses the following: respirations shallow and rate of 12, pulse thready, skin diaphoretic. A fellow student reports witnessing the athlete ingesting a small pill prior to practice. The nurse suspects an opioid overdose/poisoning. What is the most appropriate response of the school nurse?

1. The student is breathing on his own. The nurse will continue to closely monitor and reassess every 5 minutes.

2. Call 911 and continue to monitor the student and report current vitals upon EMS arrival.

3. Administer naloxone and call 911.

4. Instruct the coach to notify the administrator to call 911, according the current school emergency plan.

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Non-NCSN
September 2026

A school nurse serves on a district committee updating school medication protocols and policy. Which action aligns with the Leadership Domain of the NASN School Nursing Practice Framework?

1. Utilize best practice and national guidelines to draft policy language expanding the utilization of stock rescue inhalers and nebulizers.

2. Train unlicensed assistive personnel (UAP) on use of rescue inhalers and nebulizers.

3. Audit student emergency contact forms at the start of the school year to track baseline compliance.

4. Administer rescue inhaler immediately to a student exhibiting signs of severe respiratory distress related to asthma.

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NCSN

Non-NCSN
June 2026

Which of the following conditions would qualify a student as having a specific learning disorder (SLD)?

1. New onset of emotional lability

2. Inattention and hyperactivity

3. Poor hand-eye coordination

4. Taking a daily stimulant

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NCSN

Non-NCSN
May 2026

Which scenario best demonstrates proper adherence to the rights of medication administration in the school setting?

1. The nurse administers a student’s medication without assessing the student’s current symptoms, since the dose was previously ordered.

2. The nurse confirms the right student, medication, dose, time, route, and documents the administration, then monitors the student for effectiveness and adverse effects.

3. The nurse gives the medication early because the student requests to return to class quickly.

4. The nurse administers a medication even though the order seems incorrect, assuming the prescriber intended it.

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NCSN

Non-NCSN
April 2026

Included in the focused nursing assessment of the child presenting with ear pain may include use of an otoscope. Which of the following best describes the use of this assessment tool?

1. Select the smallest size speculum for use.

2. Use of the otoscope can assist the school nurse in diagnosing otitis media.

3. Proper assessment includes bracing your little finger against the child’s cheek.

4. Carefully pull on the red and inflamed pinna and insert an otoscope into the inflamed and swollen ear canal.

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NCSN

Non-NCSN
March 2026

Which statement reflects a best practice for school nurses when implementing and using Electronic Health Records (EHRs)?

School nurses should rely on copy-and-paste documentation to save time, since EHRs automatically prevent errors.

EHR systems must comply with FERPA, HIPAA, and COPPA, and nurses should receive training on proper documentation practices, including late entries and corrections.

Password protection alone is sufficient for securing electronic health records in school settings.

Electronic records do not require monitoring for unauthorized access because the system automatically blocks improper use.

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NCSN

Non-NCSN
February 2026

Several students in a classroom are diagnosed with pertussis. What is the school nurse’s first responsibility?

1. Exclude all students without documented pertussis immun

2. Notify the local public health department and follow guidance for exposure management.

3. Send an email to all parents about pertussis cases.

4. Treat all exposed students with prophylactic antibiotics.

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Non-NCSN
January 2026

A student transfers from another state with incomplete immunization records. What is the school nurse’s most appropriate action?

1. Enroll the student and postpone immunization follow-up.

2. Review state immunization requirements and obtain appropriate documentation or coordinate a catch-up vaccination schedule.

3. Permit the student to attend school without restrictions.

4. Require parental consent for all future immunizations regardless of status.

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Non-NCSN
December 2025

A teacher asks for detailed lab results of a student’s chronic illness. Under FERPA and HIPAA, the nurse’s best response is:

1. Share the lab results since the teacher works directly with the student.

2. Decline to share lab results but provide information necessary for the student’s educational safety and success.

3. Refer the teacher to the parent for all medical information.

4. Post the health plan in the classroom for quick access.

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NCSN

Non-NCSN
November 2025

Which of the following best demonstrates the school nurse’s role in population-based health promotion?

Teaching CPR to staff and students.

Coordinating an annual flu vaccination clinic at school.

Helping a student manage individual asthma symptoms.

Counseling a parent about healthy lunches.

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NCSN

Non-NCSN
October 2025

A student with epilepsy has a seizure in the classroom lasting three minutes. The seizure ends spontaneously, and the student is drowsy but breathing. What is the nurse’s priority?

Call EMS immediately.

Place the student in a recovery position and monitor airway, breathing, and circulation.

Return the student to class after recovery.

Contact the parent and request medication changes.

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