NBCSN-NCSN : NBCSN National Certified School Nurse Exam

Question: 1
When assessing a pediatric patient with an abdominal injury, which of the following signs would indicate the need for immediate medical intervention?
A. Mild abdominal tenderness upon palpation.
B. Slightly elevated temperature.
C. Absence of bowel sounds.
D. Presence of bruising around the navel.
Answer: C
Explanation: The absence of bowel sounds in a pediatric patient with an abdominal injury suggests a possible bowel obstruction or perforation, which requires immediate medical intervention. Mild abdominal tenderness, a slightly elevated temperature, or bruising around the navel may indicate less urgent conditions or injuries.
Question: 2
When providing oral health education to students, which of the following statements is accurate?
A. "Using a toothpick is an effective way to remove plaque between your teeth."
B. "Regular dental check-ups are important for maintaining oral health."
C. "Flossing should be done at least once a week."
D. "Brushing your teeth immediately after consuming acidic foods helps protect your tooth enamel."
Answer: B Explanation: "Regular dental check-ups are important for maintaining oral health" is an accurate statement. Toothpicks are not as effective as dental floss for removing plaque between teeth, brushing immediately after consuming acidic foods can damage tooth enamel, and flossing should be done at least once a day, not just once a week.
Question: 3
A student sustains a burn injury involving the entire surface area of their right arm and hand. According to the rule of nines, what percentage of the student's total body surface area is affected?
A. 9%.
B. 36%.
C. 27%.
D. 18%.
Answer: D
Explanation: According to the rule of nines, the entire surface area of the right arm and hand accounts for approximately 9% of the total body surface area. Therefore, if the injury involves the entire surface area of the right arm and hand, it would affect 9% of the student's total body surface area.
Question: 4
When managing a laceration, which of the following steps is essential to promote wound healing?
A. Applying antibiotic ointment.
B. Applying a tight bandage.
C. Leaving the wound open to air.
D. Irrigating the wound with sterile saline.
Answer: D
Explanation: Irrigating the wound with sterile saline is essential to promote wound healing. It helps remove debris, bacteria, and contaminants from the wound, reducing the risk of infection. Applying antibiotic ointment, leaving the wound open to air, and applying a tight bandage may hinder the healing process or increase the risk of infection.
Question: 5
In a patient with severe hemorrhage, which of the following interventions should be prioritized?
A. Applying direct pressure to the bleeding site.
B. Elevating the lower extremities.
C. Administering intravenous fluids.
D. Assessing vital signs.
Answer: A
Explanation: Applying direct pressure to the bleeding site is the highest priority intervention in a patient with severe hemorrhage. It helps control the bleeding and prevent further blood loss. Elevating the lower extremities, administering intravenous fluids, and assessing vital signs are important interventions but should follow direct pressure application.
Question: 6
Which of the following cardiac conditions is characterized by an abnormal heart rhythm originating from the atria?
A. Ventricular fibrillation.
B. Atrial fibrillation.
C. Atrial flutter.
D. Ventricular tachycardia.
Answer: B
Explanation: Atrial fibrillation is a cardiac condition characterized by an abnormal heart rhythm originating from the atria. It is characterized by rapid, irregular, and chaotic atrial contractions. Ventricular fibrillation, atrial flutter, and ventricular tachycardia are different types of abnormal heart rhythms originating from the ventricles.
Question: 7
A student is experiencing difficulty breathing and wheezing. The nurse suspects an asthma exacerbation. Which of the following medications should the nurse administer first?
A. Montelukast (leukotriene receptor antagonist).
B. Prednisone (oral corticosteroid).
C. Ipratropium (anticholinergic).
D. Albuterol (short-acting beta-agonist).
Answer: D
Explanation: In the management of an asthma exacerbation, the nurse should administer short-acting beta-agonist medication (such as albuterol) as the first-line treatment to relieve bronchospasm and improve airflow. Prednisone, ipratropium, and montelukast may be included in the treatment plan but are not the initial medication of choice for immediate relief of symptoms.
Question: 8
A student sustains a deep laceration on their forearm. The wound is actively bleeding. Which of the following actions should the nurse take first?
A. Elevate the student's arm above the level of the heart.
B. Apply direct pressure to the wound with a clean cloth or gloved hand.
C. Cleanse the wound with antiseptic solution.
D. Apply a sterile dressing to the wound.
Answer: B
Explanation: The first action the nurse should take for a actively bleeding laceration is to apply direct pressure to the wound with a clean cloth or gloved hand. This helps control the bleeding by promoting clotting. Elevating the arm, cleansing the wound, and applying a sterile dressing can be done after controlling the bleeding.
Question: 9
A student presents to the nurse's office with symptoms of overdose, including altered mental status, pinpoint pupils, and respiratory depression. The nurse suspects opioid overdose. Which of the following interventions should the nurse prioritize?
A. Administer naloxone (Narcan).
B. Perform rescue breathing.
C. Monitor vital signs.
D. Call emergency medical services (EMS).
Answer: D Explanation: In a suspected opioid overdose, the nurse should prioritize calling emergency medical services (EMS) for immediate medical intervention. While administering naloxone, performing rescue breathing, and monitoring vital signs are important interventions, they should be done after seeking emergency medical assistance.
Question: 10
Which of the following respiratory conditions is characterized by the inflammation and narrowing of the airways?
A. Chronic obstructive pulmonary disease (COPD).
B. Pneumonia.
C. Asthma.
D. Pulmonary embolism.
Answer: C
Explanation: Asthma is a respiratory condition characterized by the inflammation and narrowing of the airways. It leads to symptoms such as wheezing, shortness of breath, coughing, and chest tightness. Pneumonia is an infection of the lungs, COPD is a chronic lung disease primarily caused by smoking, and a pulmonary embolism is a blockage of the pulmonary artery.
Question: 11
In the case of a suspected drug overdose, which of the following should the school nurse do first?
A. Administer activated charcoal.
B. Gather information about the ingested substance.
C. Assess the student's vital signs.
D. Call emergency medical services (EMS).
Answer: D
Explanation: When a drug overdose is suspected, the first action should be to call emergency medical services (EMS) for immediate professional intervention. Administering activated charcoal, assessing vital signs, and gathering information about the ingested substance are important steps but should be done after contacting EMS.
Question: 12
A student presents to the school nurse's office with severe abdominal pain and tenderness. Which of the following conditions should the nurse suspect?
A. Appendicitis.
B. Gastroenteritis.
C. Urinary tract infection (UTI).
D. Pancreatitis.
Answer: A
Explanation: Severe abdominal pain and tenderness are common symptoms of appendicitis. Appendicitis is an inflammation of the appendix and requires immediate medical attention. Gastroenteritis typically presents with symptoms such as diarrhea and vomiting. A UTI may cause lower abdominal pain and urinary symptoms. Pancreatitis is characterized by upper abdominal pain and can be severe.
Question: 13
In the management of anaphylaxis, which of the following is the first-line medication for immediate administration?
A. Albuterol.
B. Diphenhydramine.
C. Epinephrine.
D. Corticosteroids.
Answer: C
Explanation: Epinephrine is the first-line medication for the immediate treatment of anaphylaxis. It acts quickly to reverse the severe allergic reaction and should be administered promptly. Diphenhydramine, albuterol, and corticosteroids may be used as adjunctive therapies but are not the primary initial treatment.
Question: 14
When caring for a patient with a burn injury, which of the following interventions is the highest priority?
A. Assessing the patient's pain level.
B. Applying a sterile dressing.
C. Initiating fluid resuscitation.
D. Administering analgesics.
Answer: C
Explanation: Initiating fluid resuscitation is the highest priority when caring for a patient with a burn injury. Burns can cause significant fluid loss and hypovolemia, which can lead to shock. Assessing pain, applying a sterile dressing, and administering analgesics are important interventions but are of lower priority compared to fluid resuscitation.
Question: 15
During an anaphylactic reaction, which of the following is the primary cause of airway obstruction?
A. Bronchoconstriction.
B. Laryngeal edema.
C. Mucus production.
D. Nasal congestion.
Answer: B
Explanation: Laryngeal edema, or swelling of the larynx, is the primary cause of airway obstruction during anaphylactic reactions. While bronchoconstriction, mucus production, and nasal congestion can contribute to airway narrowing, laryngeal edema poses the greatest risk to the patency of the airway.
Question: 16
A student presents to the school nurse with a head injury after falling from a bicycle. Which of the following signs would indicate the need for immediate medical evaluation?
A. Mild headache.
B. Complaint of dizziness.
C. Small abrasion on the forehead.
D. Brief loss of consciousness.
Answer: D Explanation: A brief loss of consciousness following a head injury indicates a potentially more serious injury and should prompt immediate medical evaluation. Mild headache, a small abrasion on the forehead, and complaints of dizziness may be common symptoms following a head injury but do not necessarily require immediate medical evaluation.
Question: 17
A student is brought to the school nurse's office with a head injury after falling from a bicycle. The student is conscious but complains of a severe headache and dizziness. Which of the following actions should the nurse prioritize?
A. Administer pain medication.
B. Perform a neurological examination.
C. Apply ice to the injured area.
D. Assess the student's level of consciousness using the Glasgow Coma Scale.
Answer: D
Explanation: When assessing a head injury, the nurse should prioritize evaluating the student's level of consciousness using the Glasgow Coma Scale. This assessment helps determine the severity of the injury and guides further management. Administering pain medication, applying ice, and performing a neurological examination may be appropriate interventions but should be done after assessing the student's level of consciousness.

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