NBCSN Chapter 4 (2025) Actual Exam
Questions and Answers A+ Graded
1. .A .10 .year .old .female .with .Type .2 .diabetes .comes .to .the .health .office .with .a
.pencil .stuck .through .her .upper .lip .just .below .the .gum .line. .There .is .significant
.bleeding. .She .is .pale. .shaking, .and .has .an .elevated .pulse. .The .School .Nurse
.should .first:
a. .Treat .for .shock .and .stabilize .the .pencil
b. .Remove .the .pencil, .then .apply .direct .pressure .to .stop .the .bleeding
c. .Direct .the .child .to .hold .the .pencil, .take .a .glucose .level .and .contact .EMS
d. .Contact .the .principal .and .parent .- .CORRECT .ANSWER .-1. .a: .Rationale:
.Tachycardia .and .pale .color .are .usually .the .earliest .sign .of .developing .shock .in
.children. .Treat .the .shock .first. .Children .in .shock .may .not .be .capable .of
.following .directions .(answer .c). .Do .not .remove .the .pencil, .as .it .may .be .helping
.to .control .bleeding. .Answer .d .will .occur .after .you .have .taken .initial .measures
2. .An .8 .year .old .male .presents .to .the .School .Nurse .after .a .playground .injury.
.He .complains .of .pain .in .the .left .upper .quadrant .of .the .abdomen .and .the .left
.shoulder. .He .is .pale, .diaphoretic, .and .tachycardic. .The .School .Nurse
.immediately .refers .for .possible:
a. .Appendicitis
b. .Ruptured .spleen
C. .Dislocated .shoulder .
d. .Lacerated .liver .- .CORRECT .ANSWER .-2. .b: .Rational: .Ruptured .spleen
.presents .as .pain .in .the .upper .left .quadrant .of .the .abdomen .with .referred
.shoulder .pain. .Tearing .of .the .spleen .can .cause .rapid .and .life-threatening
.internal .bleeding. .The .liver .and .appendix .are .on .the .right .side. .A .dislocated
.shoulder .would .result .in .limited .range .of .motion.
3. .A .student .with .which .diagnosis .should .have .physician .clearance .before
.participating .in .contact .sports?
a. .Marfan .Syndrome
b. .Color .blindness
c. .Allergy .to .oranges
d. .Latent .tuberculosis .- .CORRECT .ANSWER .-3. .a: .Rational: .Students .with
.Marfan .syndrome .are .at .risk .for .an .aortic .aneurysm .and .require .medical
.clearance .before .participating .in .contact .sports. .They .should, .however,
.exercise .regularly .through .low-intensity, .low-impact .activities .adapted .to .meet
.their .specific .needs. .There .are .no .clearances .needed .for .color .blindness, .other
, .than .safety .precautions. .Allergy .to .oranges .is .unrelated .to .contact .sports .and
.latent .tuberculosis .has .no .symptoms .and .requires .no .clearance.
4. .During .recess, .a .7 .year .old .girl .is .hie .in .the .mouth .and .loses .her .left .central
.incisor. .The .tooth .and .root .are .intact. .Which .of .the .following .is .a .correct .action
.by .the .school .nurse?
a. .Tell .the .child .not .to .worry; .chat .chis .is .a .baby .tooth .and .you .will .give .her .a
.special .container .for .the .tooth .to .put .under .her .pillow .for .the .tooth .fairy
b. .Clean .the .tooth .off .with .water .and .wrap .it .in .gauze .to .rake .to .the .dentist
.within .the .next .4 .hours
c. .Pack .the .tooth .in .ice .to .rake .to .the .dentist .within .the .next .hour
d. .Replace .the .tooth .in .the .socket .from .which .it .was .avulsed .and .call .the
.parent .to .immediately .rake .the .child .to .the .dentist .- .CORRECT .ANSWER .-4. .d:
.Rationale: .If .a .permanent .tooth .is .dislodged, .it .is .a .dental .emergency.
.Immediate .reimplantation .is .needed .within .one .hour .while .the .tooth's .cells .are
.still .alive. .Placing .the .tooth .in .its .socket .is .the .best .medium .to .protect .the
.periodontal .ligament; .milk .and .water .are .next .best. .Do .not .pack .in .ice.
5. .When .performing .CPR .on .a .9 .year .old, .the .pulse .is .best .assessed .in .which
.of .the .following .areas'
a. .Apical
b. .Brachia! .
c. .Carotid
d. .Radial .- .CORRECT .ANSWER .-5. .c: .Rationale: .In .Adult/Child .CPR, .the .most
.accessible .pulse .is .the .carotid .artery .in .the .neck, .just .below .the .jaw. .Infant
.CPR .uses .the .brachia! .pulse.
6. .Itching .from .poison .ivy .can .be .reduced .by:
a. .Application .of .cool .soaks .and .raking .Benadryl
b. .Application .of .warm .soaks .and .raking .corticosteroids
c. .Administration .of .epinephrine
d. .Application .of .a .saline .spray .to .the .area .and .raking .an .anti-inflammatory .-
.CORRECT .ANSWER .-6. .a: .Rationale: .Cool .wet .compresses .are .best .to .treat
.itching .from .poison .ivy. .Because .there .is .usually .no .risk .of .anaphylaxis,
.epinephrine .is .not .used. .Warm .soaks .increases .vasodilation .and .itching.
7. .A .15 .year .old, .250 .pound .male .is .referred .to .the .School .Nurse .for .habitually
.sleeping .in .class. .The .School .Nurse's .intervention .should .consider:
a. .Adolescents .have .increased .sleep .requirements .during .growth .spurts
b. .Sleeping .in .class .is .normal .for .adolescent .males
c. .Marijuana .side .effects .include .drowsiness .for .6-12 .hours
d. .Sleep .apnea .occurs .in .7% .of .obese .adolescents .- .CORRECT .ANSWER .-7. .d:
.Rationale: .Increased .weight .may .result .in .obstructive .sleep .apnea .causing
.interrupted .sleep .patterns .that .may .cause .sleepiness .in .school. .The .other
.answers .are .not .specific .to .this .student.
8. .A .9 .year .old .has .been .diagnosed .with .Osgood-Schlatter .Disease. .What
.measures .should .facilitate .healing?
a. .Prevent .weight .bearing
Questions and Answers A+ Graded
1. .A .10 .year .old .female .with .Type .2 .diabetes .comes .to .the .health .office .with .a
.pencil .stuck .through .her .upper .lip .just .below .the .gum .line. .There .is .significant
.bleeding. .She .is .pale. .shaking, .and .has .an .elevated .pulse. .The .School .Nurse
.should .first:
a. .Treat .for .shock .and .stabilize .the .pencil
b. .Remove .the .pencil, .then .apply .direct .pressure .to .stop .the .bleeding
c. .Direct .the .child .to .hold .the .pencil, .take .a .glucose .level .and .contact .EMS
d. .Contact .the .principal .and .parent .- .CORRECT .ANSWER .-1. .a: .Rationale:
.Tachycardia .and .pale .color .are .usually .the .earliest .sign .of .developing .shock .in
.children. .Treat .the .shock .first. .Children .in .shock .may .not .be .capable .of
.following .directions .(answer .c). .Do .not .remove .the .pencil, .as .it .may .be .helping
.to .control .bleeding. .Answer .d .will .occur .after .you .have .taken .initial .measures
2. .An .8 .year .old .male .presents .to .the .School .Nurse .after .a .playground .injury.
.He .complains .of .pain .in .the .left .upper .quadrant .of .the .abdomen .and .the .left
.shoulder. .He .is .pale, .diaphoretic, .and .tachycardic. .The .School .Nurse
.immediately .refers .for .possible:
a. .Appendicitis
b. .Ruptured .spleen
C. .Dislocated .shoulder .
d. .Lacerated .liver .- .CORRECT .ANSWER .-2. .b: .Rational: .Ruptured .spleen
.presents .as .pain .in .the .upper .left .quadrant .of .the .abdomen .with .referred
.shoulder .pain. .Tearing .of .the .spleen .can .cause .rapid .and .life-threatening
.internal .bleeding. .The .liver .and .appendix .are .on .the .right .side. .A .dislocated
.shoulder .would .result .in .limited .range .of .motion.
3. .A .student .with .which .diagnosis .should .have .physician .clearance .before
.participating .in .contact .sports?
a. .Marfan .Syndrome
b. .Color .blindness
c. .Allergy .to .oranges
d. .Latent .tuberculosis .- .CORRECT .ANSWER .-3. .a: .Rational: .Students .with
.Marfan .syndrome .are .at .risk .for .an .aortic .aneurysm .and .require .medical
.clearance .before .participating .in .contact .sports. .They .should, .however,
.exercise .regularly .through .low-intensity, .low-impact .activities .adapted .to .meet
.their .specific .needs. .There .are .no .clearances .needed .for .color .blindness, .other
, .than .safety .precautions. .Allergy .to .oranges .is .unrelated .to .contact .sports .and
.latent .tuberculosis .has .no .symptoms .and .requires .no .clearance.
4. .During .recess, .a .7 .year .old .girl .is .hie .in .the .mouth .and .loses .her .left .central
.incisor. .The .tooth .and .root .are .intact. .Which .of .the .following .is .a .correct .action
.by .the .school .nurse?
a. .Tell .the .child .not .to .worry; .chat .chis .is .a .baby .tooth .and .you .will .give .her .a
.special .container .for .the .tooth .to .put .under .her .pillow .for .the .tooth .fairy
b. .Clean .the .tooth .off .with .water .and .wrap .it .in .gauze .to .rake .to .the .dentist
.within .the .next .4 .hours
c. .Pack .the .tooth .in .ice .to .rake .to .the .dentist .within .the .next .hour
d. .Replace .the .tooth .in .the .socket .from .which .it .was .avulsed .and .call .the
.parent .to .immediately .rake .the .child .to .the .dentist .- .CORRECT .ANSWER .-4. .d:
.Rationale: .If .a .permanent .tooth .is .dislodged, .it .is .a .dental .emergency.
.Immediate .reimplantation .is .needed .within .one .hour .while .the .tooth's .cells .are
.still .alive. .Placing .the .tooth .in .its .socket .is .the .best .medium .to .protect .the
.periodontal .ligament; .milk .and .water .are .next .best. .Do .not .pack .in .ice.
5. .When .performing .CPR .on .a .9 .year .old, .the .pulse .is .best .assessed .in .which
.of .the .following .areas'
a. .Apical
b. .Brachia! .
c. .Carotid
d. .Radial .- .CORRECT .ANSWER .-5. .c: .Rationale: .In .Adult/Child .CPR, .the .most
.accessible .pulse .is .the .carotid .artery .in .the .neck, .just .below .the .jaw. .Infant
.CPR .uses .the .brachia! .pulse.
6. .Itching .from .poison .ivy .can .be .reduced .by:
a. .Application .of .cool .soaks .and .raking .Benadryl
b. .Application .of .warm .soaks .and .raking .corticosteroids
c. .Administration .of .epinephrine
d. .Application .of .a .saline .spray .to .the .area .and .raking .an .anti-inflammatory .-
.CORRECT .ANSWER .-6. .a: .Rationale: .Cool .wet .compresses .are .best .to .treat
.itching .from .poison .ivy. .Because .there .is .usually .no .risk .of .anaphylaxis,
.epinephrine .is .not .used. .Warm .soaks .increases .vasodilation .and .itching.
7. .A .15 .year .old, .250 .pound .male .is .referred .to .the .School .Nurse .for .habitually
.sleeping .in .class. .The .School .Nurse's .intervention .should .consider:
a. .Adolescents .have .increased .sleep .requirements .during .growth .spurts
b. .Sleeping .in .class .is .normal .for .adolescent .males
c. .Marijuana .side .effects .include .drowsiness .for .6-12 .hours
d. .Sleep .apnea .occurs .in .7% .of .obese .adolescents .- .CORRECT .ANSWER .-7. .d:
.Rationale: .Increased .weight .may .result .in .obstructive .sleep .apnea .causing
.interrupted .sleep .patterns .that .may .cause .sleepiness .in .school. .The .other
.answers .are .not .specific .to .this .student.
8. .A .9 .year .old .has .been .diagnosed .with .Osgood-Schlatter .Disease. .What
.measures .should .facilitate .healing?
a. .Prevent .weight .bearing
