NCSN Online Study Group – Week 5: Special Health Issues

Summer 2026 Exam Information

Thinking of testing this Summer? Be sure to review the key dates:

• Summer Testing Window: July 9 - August 16, 2026

• Registration Window: April 6 - June 9, 2026

Visit www.nbcsn.org to begin your application and download the Candidate Handbook.

Not ready to test yet? NBCSN has testing windows three times per year!

• Fall Testing Window: October 22 - November 22, 2026

• Registration Window: August 17 - September 22, 2026

Exam applications will not be visible/available until the registration window opens.

Updated Exam Content Outline – Summer 2025 and Beyond

As a result of the 2023 Job Task Analysis (JTA), the NBCSN streamlined and reorganized the Exam Content Outline (ECO) beginning with the Summer 2025 exam. The exam still covers the same essential content, just better organized into four updated domains:

New Exam Content Domains & Number of Questions

Content Overview – Week 5

This week focuses on the professional responsibilities of the school nurse. You will review topics such as ethics, legal considerations, documentation, confidentiality, delegation, communication, advocacy, and accountability, with attention to how professional judgment supports safe practice and strengthens the nurse’s role as a leader within the school community.

Reading – Week 5

Hopefully, this feels familiar to the members of this group.  Successfully passing the exam is experience, preparation, and test-taking strategies.  These weeks have flown by! We have one more week to go.

School Nursing Certification Review Book – Selekman & Knox, 2025

• Chapter 7: Professional Responsibility

• Complete the self-assessment at the end of the chapter

• Chapter 4: Health Problems and Nursing Management

• Complete the self-assessment at the end of the chapter

School Nursing: A Comprehensive Text – Shannon & Yonkaitis, Fourth Edition, 2025

• Chapter 3-8, 30-33

This Week's Assignment 

Reflection Prompt

Which part of professional responsibility in school nursing do you think has the greatest impact on daily practice—ethics, delegation, confidentiality, documentation, or advocacy—and why?

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.   

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. 

Please share your responses to the reflection prompt and challenge questions on this week's discussion thread! Answers and rationale will be shared on Monday.

More Test Taking Strategies

Test-taking strategies continued... From Nurselabs 11 Test-taking strategies

10. Be Alert to Relevant Information From Earlier Questions

Sometimes information from one test question can help you answer a later question. When this happens, remembering what you learned or reasoned through in an earlier item can give you a useful clue.

Example:
A client has an intestinal tube inserted for the treatment of intestinal obstruction. Intestinal suction can result in excessive loss of:

1. Protein enzymes 

2. Energy carbohydrates 

3. Water and electrolytes 

4. Vitamins and minerals 

The correct answer is:
3. Water and electrolytes

Now consider a later question:

Critical assessment of a client with intestinal suction should include observation for:

1. Edema 

2. Nausea 

3. Belching 

4. Dehydration 

The correct answer is:
4. Dehydration

If you remembered from the earlier question that intestinal suction can cause excessive loss of water and electrolytes, that clue could help you recognize why dehydration is the best answer in the later question.

A good strategy during testing is to stay mentally organized. Information from one item may reinforce a concept that shows up again later in the exam.

11. Make educated guesses

When you are unsure about a question, it is usually better to make an educated guess than to leave it unanswered. Even if you do not know the correct answer right away, you can often use partial knowledge to eliminate one or more distractors.

This improves your odds of choosing the correct answer.

For example:

1. If you guess randomly on a four-option question, you have a 25% chance of being correct. 

2. If you eliminate one wrong answer, your chances improve. 

3. If you eliminate two wrong answers, your chances increase to 50%. 

That is why it is so important to use the strategies you have been practicing:

• read carefully 

• identify keywords 

• eliminate clearly wrong answers 

• look for similar or related wording 

• use clues from other questions when possible 

Even when you are uncertain, those strategies can help you make a stronger choice.

Final Test Taking Strategies

1. Know the rules and follow instructions

1. Before you begin, make sure you understand the testing directions, time limits, and any special instructions. Following the rules carefully can help you avoid preventable mistakes.

2. Read each question carefully and thoroughly

1. Do not rush and assume you understand the question before reading the entire stem. Missing a single keyword or detail can change the meaning of the question.

3. For long questions, read the last sentence of the stem first

1. If a question is especially long, it can help to first read the last sentence, which usually contains the actual question being asked. This can help you understand what information matters most as you go back and read the full stem.

4. Try to predict the correct answer before looking at the options

1. After reading the question, pause and think about what answer you expect. This can help you stay focused on the question itself rather than being distracted by the answer choices.

5. Match your predicted answer to the options provided

1. Look to see whether one of the options matches the answer you had in mind. This can make it easier to identify the strongest choice.

6. If your response is there, still read all the options

1. Even if you see an answer that looks correct right away, take time to read every option before making your final selection. There may be a better or more complete response.

7. If your response is not there, re-read the question and begin eliminating distractor

1. If you do not see the answer you expected, go back to the question stem and carefully rule out options that are clearly incorrect or less appropriate.

8. If you are stuck, go back to the question stem

1. Do not keep rereading the options over and over. The correct answer comes from understanding the question, so return to the stem and focus on what is actually being asked.

9. If you are still stuck, make your best guess and move on

1. After using your strategies, choose the best answer you can, mark the question if needed, and keep going. Do not let one difficult item take too much time.

10. Double-check your answer selections

1. If time allows, review your answers to make sure you selected what you intended and did not miss any questions.

Let's Collaborate

Have a question about the content? Post it in the discussion! Refer to questions by chapter, number, and letter (e.g., Chapter 2, Question 4, Answer C).

Please do not copy questions or answers verbatim due to copyright.

Final Thoughts – You've Got This!

At this point, you have seen that strong test-taking is about much more than memorizing content. It also involves staying organized, reading carefully, recognizing patterns, and using reasoning when you are unsure. Remembering helpful information from earlier questions, making educated guesses, and following a consistent step-by-step approach can help you stay calm and avoid getting stuck on any one item.

These strategies are especially useful because they help you make the most of what you do know. Even when a question feels difficult, you can still work through it thoughtfully by returning to the stem, eliminating distractors, and choosing the best available answer. The goal is not perfection on every question, but steady, confident decision-making across the exam.

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Alana Parker MSN-Ed, BSN, RN, NCSN
Mesa, AZ United States
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Good afternoon,

Week 5 Prompt:

Which part of professional responsibility in school nursing do you think has the greatest impact on daily practice-ethics, delegation, confidentiality, documentation, or advocacy-and why?

I feel like this one is very hard to choose! I think I would have to say advocacy plays the biggest role on my daily practice. Every time I see a student I feel like I help them advocate for their health related needs. Often times I communicate with parents and help advocate for the students needs or families needs such as providing resources or recommended they utilize a healthcare facility. I also communicate with school staff regularly to promote health for either individuals or the school community. 

Practice Questions:

1) C

2) C

Thank you,

Alli

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Allison Mertens R.N.
Johnson Creek, WI United States
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