NCSN Online Study Group – Week 2: Health Appraisal
Hello, I am so excited to begin this journey with you this week. Take time to collaborate together on the discussion board and truly work to reflect on the content provided. Remember to think of the content generally and not specific to your location. If you get testing anxiety, also take time to reflect on good study habits and ways to alleviate your testing anxiety. Examples could be deep breathing and tightening different muscle groups to refocus on the task at hand. This journey will greatly influence your practice and help you to be a strong leader in your school nursing practice. I look forward to reflecting with you each week and I am here to cheer you on as you prepare to take your exam. You got this!
❤️Alana Parker, MSN-Ed, RN, NCSN
Summer 2026 Exam Information
Thinking of testing this Summer? Be sure to review the key dates:
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!
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
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New Domain
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# of Questions
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Health Appraisal & Nursing Practice
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52
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Health Promotion/Disease Prevention
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41
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School Health Practice Considerations
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32
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Professional Responsibility
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50
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Content Overview – Week 2
This week focuses on health appraisal as a key part of school nursing practice. You will review the nursing process as it applies to the school setting, including collecting health histories, recognizing normal versus abnormal findings, conducting screenings and physical assessments, and determining when follow-up, intervention, or referral is needed.
Reading – Week 2
School Nursing Certification Review Book – Selekman & Knox, 2025
School Nursing: A Comprehensive Text – Shannon & Yonkaitis, Fourth Edition, 2025
Weekly Assignments
Reflection Prompt
How does using the nursing process during health appraisal help a school nurse decide what is normal, what needs monitoring, and what requires referral?
Challenge Questions
Question 1: Hypertension can be seen in 3.5% of children and youth. Which answer best defines the practice of the school nurse.
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Refer students to their primary care after single reading is above normal range for their age group.
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Initiate health education around nutrition, tobacco use, dating, and suicide.
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Use the pediatric cuff for all elementary school age children.
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Consider age and height when determining whether bp is within normal range.
Question 2: An Elementary age child requires daily glucose monitoring. Currently, there is not a nurse assigned to the school. As the floating RN, which tasks would you train an Unlicensed Assistive Personnel (UAP) to safely perform under your supervision.
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Adjusting the insulin pump dose based on the readings.
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Support UAP to manage hypoglycemia independently.
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Complete the glucose check as outlined in the plan of care and report the results to the RN.
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Create the student diabetes care plan from the physician’s orders.
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.
Test Taking Tips
As promised, here are a few nursing test-taking strategies for multiple-choice questions, adapted from 11 Test-Taking Tips & Strategies for Nurses from Nurseslabs.
1. Read Questions Carefully
Success on multiple-choice exams depends not only on knowing the content, but also on reading the question carefully. Before looking for the correct answer, take a moment to make sure you understand what the question is really asking.
When reading the stem, ask yourself:
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What is the question really asking?
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Are there any keywords?
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What information in the stem is relevant to answering the question?
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How would I restate the question in my own words?
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How would I answer the question in my own words?
Then, after reading the answer choices, ask:
A helpful reminder: answer the question as it is written. Do not read extra meaning into it, and do not answer the question you wish had been asked. Focus only on the information given.
For simpler recall questions, this process may take only a few seconds. For more complex questions, it may take longer, but it can help you clarify the item and choose the strongest answer.
2. Identify Keywords
Certain words in the stem or answer choices should signal that you need to slow down and read carefully. These keywords can completely change what the question is asking.
Be especially cautious with words such as:
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always
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never
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all
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every
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only
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must
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no
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except
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none
These words matter because they place limits or conditions on the answer. Since few things in nursing are absolute, options containing these words are often incorrect unless the statement is truly universally true.
Example:
All of the following are services of the National Kidney Foundation except:
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Public education programs
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Research about kidney disease
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Fund-raising affairs for research activities
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Identification of potential transplant recipients
In this example, the key words are all and except. Those words tell you that you are looking for the one option that does not belong.
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Options 1, 2, and 3 are all consistent with services or activities of the organization.
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Option 4 is the best answer because it is the choice that does not fit.
When you see words such as except, not, or phrases like all but one, remember that the correct answer is the exception rather than the usual correct statement.
Also, if more than one option seems correct, go back and reread the stem. You may have missed a keyword that changes the meaning of the question.
3. Pay attention to specific details
Well-written multiple-choice questions are precise. The stem usually includes only the information you need to answer the question, so small details often provide important clues.
When reading a question, pay close attention to:
Example:
A male client is told that he will no longer be able to ingest alcohol if he wants to live. To effect a change in his behavior while he is in the hospital, the nurse should attempt to:
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Help the client set short-term dietary goals
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Discuss his hopes and dreams for the future
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Discuss the pathophysiology of the liver with him
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Withhold approval until he agrees to stop drinking
In this question, the phrase “to effect a change in his behavior while he is in the hospital” is especially important. That detail helps narrow the best answer.
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Option 2 is not directly focused on changing alcohol-related behavior in the hospital.
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Option 3 may provide education, but it is less likely to produce an immediate behavioral change.
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Option 4 is nontherapeutic because it rejects the client rather than addressing the behavior.
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Option 1 is the best answer because it focuses on a realistic, short-term change that can begin during hospitalization.
Additional Resources
You may also want to review these additional test-prep resources:
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
Test-taking is a skill, and like any skill, it gets stronger with practice. As you study this week, try using these strategies intentionally when working through practice questions. The more comfortable you become with slowing down, spotting clues in the question, and eliminating distractors, the more confident you will feel when it is time to test.
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Alana Parker MSN-Ed, BSN, RN, NCSN
Mesa, AZ United States
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