National Certification Exam Candidates

Hello All, I have not seen a lot of interaction in this group lately.   This  group can be a valuable resource for your studying as you interact with others. I hope that you have found the content useful as you are preparing.  The reflection questions also help create conversation amongst each other to engage in the content and help further our understanding.    Everyone doing okay?   What other needs do you have to help be better prepared? 

Here are the answers to this week 5 Challenge questions: 

Question 1:  Occasionally due to an absence, a substitute nurse would need the following prior to replacing the school nurse in the clinic:

A.  Leave a note with instructions on the desk with the keys to the medication cabinets. 

B.  Refer the substitute to the secretary for any treatment questions. 

C.  Allow for access to an orientation manual with school day procedures and a map and health room management issues.

D. Lock the files with student records and allow no access to the electronic health record system due to FERPA guidelines.   

Answer: C.  Allow for access to an orientation manual with school day procedures and a map and health room management issues.

Rationale:  Ideally the school nurse should have a substitute manual with details including a map, school procedures, medications to be administered, specific health needs of students and instructions for all IHP's. A note with keys on the desk is a violation of FERPA and arrangements should be made to safely pass the keys.  The secretary may be a great reference for campus details and will know the students and which classrooms to find them, but should not be the medical reference.  A phone number to a neighboring district nurse would be helpful.  Files should not be locked and the substitute should have their own EHR login for documentation.  

Domain: 4.  Professional Responsibility.  

Resources:  Selekman, J. & Knox, E. (Eds.). (2025). School Nursing Certification Review. (4th edition). National Board for Certification of School Nurses. P. 280-281.

Question 2 : A student receives Medicaid benefits at school.  The nurse may be responsible for seeking medicaid reimbursement for the following:    

A. All special education services.

B. Eligible only for those special education services the student qualifies for under Early, Periodic Screening, Diagnosis, and Treatment (EPSDT) from ages 5-18.

C. Nursing related services identified on the IEP, potentially including procedures and treatments defined on the IHP.

D. Only those daily services which are medically necessary.  

Correct Answer: C.  Nursing related services identified on the IEP, potentially including procedures and treatments defined on the IHP.

Rationale:  Not all special education services are eligible for reimbursement by the nurse.  Each Local Education Agency (LEA) must define this process through the state Medicaid agency.   EPSDT services through the child health program may be provided between birth and 22 years.  Services provided daily and as needed may be covered by Medicaid.  Best practice is to check with your state and district regarding Medicaid reimbursement funds.    

Domain: 4.  Professional Responsibility.  

Resources:   Selekman, J. & Knox, E. (Eds.). (2025). School Nursing Certification Review. (4th edition). National Board for Certification of School Nurses. P. 277-283.

R. Shannon, & C. Yonkaitis, C. (Eds.). (2025). School Nursing: A Comprehensive Text (4th edition). F.A. Davis Company. P 131-138, 139-140, 162, 275, 594.  Scan chapters 25, 31 & 32. 

Hi Alana,

Hello, so good to hear from you. On the exam,  Medicaid questions usually will not test on state specific but more on general topics such as federal regulations, documentation requirements, possible scope of what is reimbursable in the school nursing environment.   When taking the test it is important to think about the general across the country this is what nurses would do versus states specific.  Hope this helps.   I know it can be hard when your district doesn't utilize Medicaid reimbursement but important to review over what the professional responsibility would be if they do. 

Course link:
https://extension.missouri.edu/courses/comprehensive-school-nursing

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Christine S
RN, BSN
Massachusetts
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Hello,  I love that you are utilizing multiple resources to help you understand the concepts better. The reading can be overwhelming.  I found that trusting what I already knew and skimming that content while really diving deep into the content I wasn't really familiar with helped a lot. The review course at the end, helped when I took it right before testing. When is your test date?  Have you been practicing a lot of study questions and reading the rationale?  Seemed like the more questions I took the more I understood the whole picture and made the test a little easier.   You got this. 

Thank you for reaching out! I am buried deep in all this reading! I finally ordered the Nurse Builders Ecourse and have enjoyed listening to that while I'm trying to keep up with the amount of dishes and laundry now that my kids are home all day for the summer. So thank you for those who have recommended that course!

Medicaid Billing - I know a little bit. I live in Wisconsin and bill for medicaid at my school. Currently I bill for students who have an IEP and what I have been taught is that the student has to have and IEP, qualify for a health service (such as medication administration, GTube feeding, ect), the service and minutes have to be listed in the IEP and we have to have consent from a parent in order to submit for reimbursement. My understanding is medicaid billing does vary from state to state. I know here in WI ours recently expanded so we will be able to get reimbursed for students who don't have an IEP, but will still need some sort of "health plan" showing what care is needed. With all that being said, hopefully the questions are somewhat broad since if seems to vary. I have never heard of the EPSDT listed in option B in the question. Also, I know other staff such as speech, psych and para's also submit for reimbursement - para's for attendant care services like toileting 

How will I know when I'm ready to take the test? I plan to purchase the practice exams - but was hoping to make it through all this material first. Do you think that's a good idea to gauge how prepared I feel?

Thank you,

Alli

Hello,   I found the practice tests to be hugely beneficial to whether or not I felt was ready.   The more I did them and read the rationale I learned a lot from the reasoning. I love that you are listening to the content.  Listening, taking note cards, watching videos and using all the learning methods helps to recall the information when it is needed to.   Once you get through the content, I recommend the review course and questions and then you trust in yourself and when ready do your best.   Depending on if you have any testing anxiety, reviewing over calming techniques might help too....deep breathing and refocusing might help if you get anxiety.   Good luck.    Let me know when you take the test, really rooting for you!