Hi all,
I'm not sure if I am posting this in the correct spot or not, so apologies if I am not. The NBCSN Liaisons from various states have committed to posting weekly study tips and/or content review for everyone getting ready for the exam.
Kudos to all of you for taking this next step in your professional journey! My name is Becky Rosbolt. I am the NBCSN Liaison for the State of Michigan. I have been a school nurse for almost 13 years. I pursued my NCSN back in 2020 during the COVID era. The world was locked down and I was studying for my exam while supporting my district.
Some study tips I recommend:
1. Get a buddy. Studying with a colleague will help you stay accountable. Plan weekly study sessions to make sure you stay on track. A great tool to use to make sure you cover all of the topics is the NBCSN Study Road Map: https://nbcsn.org/exam-prep/study-road-map
2. Purchase or borrow the School Nurse Certification Review Book. Here is the link: https://nbcsn.org/exam-prep/school-nurse-certification-review-book. My study partner and I spent a lot of time reviewing topics in this book. At the end of each chapter are review questions and answers with rationale.
3. Invest in the Practice Exams. I know they are spendy but they are well worth it to get familiar with how questions are worded. We definitely used the practice exams as part of our path. The exams include answers and rationale. Link to on-line NBCSN Practice Exam: https://nbcsn.org/exam-prep/nbcsn-practice-exam
4. I did not take the Review Course with Janice Selekman, but I have heard great things from those that did. If you aren't that great with staying on track and reviewing on your own, this may be a good option. Here is the link through Nurse Builders: https://ecourses.nursebuilders.net/courses/2025-nationally-certified-school-nurse-ncsn-review-e-course
5. Look at preparing for the exam through a national lens. In Michigan, our health departments do our vision and hearing screening, so these were areas I needed to strengthen myself in. I used this free tutorial for vision screening education: https://cybersight.org/library/tutorial-school-nurse-vision-screening/. Here is a free overview of hearing screening: https://www.youtube.com/watch?v=Obw70P-CZe4. Also, in Michigan, with one-of or the lowest school nurse to student ratio, many of us function as district nurses. Remember, the exam is national so many questions are related to direct care if you were one nurse in a building.
6. Reach out to your State Liaison. They can help connect you to other school nurses, with permission, to help link you to those study groups. With all of our virtual options, it's easy to connect with other nurses, even if they are on the other side of the state.
Study Topic: Vaccines
Beginning with the Summer 2026 exam, all immunization-related questions will align with the schedule established by the American Academy of Pediatrics (AAP). Make sure this is vaccine schedule that you are studying. Here is a link to that schedule: https://downloads.aap.org/AAP/PDF/AAP-Immunization-Schedule.pdf
Make sure you know the recommended dates to receive:
· Birth: Hep B
· 2 months: Hep B, Rota, DTP, HIB, PCV, IPV
· 4 months: Rota, DTP, HIB, PCV, IPV
· 6 months: Hep B, Rota, DTP, HIB, PCV, IPV
· Birth-6months: 1st dose of RSV vaccine (nirsevimab, clesrovimab) during RSV season depending on maternal RSV vaccine status
· 8 months to 19 months if high risk: 1st or 2nd dose of nirsevimab during RSV season
· 12-15 months: DTP, HIB, PCV, IPV (if not at 6 months), MMR, Varicella, Hep A (2-dose series at least 6 months apart)
· COVID and Flu (1-2 doses annually): starting at 6 months, then annually
· 4-6 years: DTP, IPV, MMR, Var
· 9 years: Dengue if living or traveling to endemic area (3 dose series at 0-6-12 months from first dose of series) including Puerto Rico, American Samoa, US Virgin Islands, and others
· 11-12 years: Tdap, HPV (2 dose series), Men ACWY
· 16 years: Men ACWY and Men B (2 dose-series definitely before living in a college dorm)
Know the time intervals with catch-up vaccinations ie. Varicella immunizations must be at least 3 months apart before receiving another dose, MMR must be at least 4 weeks apart
Know calculation intervals between doses (4 weeks- 28 days), intervals of >4 months are determined by calendar months
Know the Hep B intervals: at least 4 weeks between dose 1 and dose 2, at least 8 weeks between dose 2 and 3 (and at least 16 weeks after 1st dose)
Remember, vaccines are not valid if > or equal to 5 days before recommended intervals or age and will need to be repeated and spaced out appropriately (minimal interval).
Know that there is now a Recommended Child and Adolescent Immunization Schedule by Medical Indication
Know which vaccines are live viruses and would impact immunocompromised students: MMR, Varicella, Live Attenuated Influenza Vaccine (FluMist)
Remember live virus vaccines must be given on the same day (ie. MMR and Varicella) or separated by at least 28 days
Make sure you check out the contraindications/precautions for particular vaccines (all have precautions of receiving vaccines while moderately or severely ill and allergic reaction/anaphylaxis to previous doses of the vaccine)-these are all located within the AAP vaccine schedule document linked above:
· COVID-19: myocarditis or pericarditis within 3 weeks of previous COVID vaccine, MIS-C/MIS-A
· Influenza: Guilliane-Barre within 6 weeks of previous vaccine, severe allergy to vaccine, anaphylaxis to egg, or with moderate/severe illness. Close contacts (eg, household contacts) of severely immunosuppressed persons who require a protected environment, those with asthma 5 years or older, chronic pulmonary, cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus): should not receive LAIV3 (Live-Attenuated Influenza Vaccine: FluMist). If LAIV3 is given, they should avoid contact with, or caring for such immunosuppressed persons for 7 days after vaccination.
· DTP: encephalopathy within 7 days of a previous dose not attributable to another cause, Guillain Barre within 6 weeks of previous dose, Arthrus-type reaction after previous dose, Progressive neuro disorder (infantile spasms, epilepsy, encephalopathy)
· MMR: Severe immunodeficiency, pregnancy, recent receipt of Ab-containing blood products within 11 months, h/o ITP, need for TB testing, seizures (MMRV only)
· Men ACWY: severe allergy to DTP
· Rota: h/o intussusception, Severe Combined Immune Deficiency (SCID), chronic GI disease, RV1 only with spina bifida or bladder exstrophy
· VAR: Severe immunodeficiency, pregnancy, recent Ab-containing blood transfusion in last 11 months, use of aspirin, receipt of anti-viral drugs, MMRV only-HIV or seizures
Best of luck to you all! You've got this! Becky
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Rebecca Rosbolt NCSN, RN, BSN
RN
Oakland Schools
Ray, MI United States
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