10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The NCSN exam has 200 questions and runs 4 hours.
These 10 free NCSN questions are organized by exam domain, so you can see how each part of the Nationally Certified School Nurse (NCSN) blueprint is tested. Reveal the answer and explanation under each question.
A 15-year-old completes the PHQ-9 with a total score of 8 but marks "more than half the days" for thoughts of being better off dead or self-harm. The student is calm and says, "I would never actually do it." What should the school nurse do next?
Correct answer: B - Conduct a direct suicide-risk assessment now and keep the student under supervision
During physical education, an 11-year-old with an asthma action plan develops mild wheezing. Peak flow is 68% of personal best, the student speaks in full sentences, and oxygen saturation is 97%. The yellow-zone plan directs two puffs of albuterol through a spacer followed by reassessment. Which response best follows the plan?
Correct answer: D - Give the ordered albuterol through the spacer, observe the response, and recheck symptoms and peak flow
At lunch, a 13-year-old's diabetes medical management plan specifies 1 unit of rapid-acting insulin per 12 g carbohydrate, a correction factor of 50 mg/dL, a target of 120 mg/dL, and addition of the meal and correction doses rounded to the nearest whole unit. The meal contains 60 g carbohydrate, glucose is 270 mg/dL, and no active insulin is present. What dose is indicated?
Correct answer: A - 8 units
Minutes after eating a cookie, a 9-year-old at a school with a standing order for stock epinephrine develops generalized hives, repetitive vomiting, hoarseness, and an increasing cough. Blood pressure is 92/58 mm Hg. Which intervention has priority?
Correct answer: C - Give intramuscular epinephrine in the mid-outer thigh and activate EMS
During a pure-tone hearing screen in a quiet room, a second-grader responds at 20 dB HL to 1000 and 2000 Hz in both ears but misses 4000 Hz in the left ear. The headphones may have shifted. What should the nurse do before initiating a referral?
Correct answer: C - Reinstruct the student, reposition the headphones, and repeat the missed frequency
A student with no documented measles immunity arrives with fever, cough, coryza, conjunctivitis, Koplik spots, and a rash that began at the hairline and is spreading downward. The student has been sitting in a crowded waiting area. What is the most appropriate immediate response?
Correct answer: A - Mask and isolate the student, use airborne precautions, notify public health promptly, and arrange evaluation
A healthy 17-year-old received a first meningococcal ACWY vaccine at age 15 and has no condition that changes the routine schedule. A 2026 record review shows no later MenACWY dose. How should the nurse update the recommendation?
Correct answer: D - Give one MenACWY booster now
Blood splashes into a school nurse's eye while the nurse is assisting with a bleeding injury. The student is stable. Which action sequence is correct?
Correct answer: B - Irrigate the eye immediately, report the exposure, and obtain confidential follow-up
Step 4 of a clinician-supervised six-step return-to-play progression brings back an athlete's headache and dizziness after the athlete was symptom-free through step 3. Each stage requires at least 24 hours. How should the progression be managed?
Correct answer: A - Stop, contact the clinician, and repeat step 3 for at least 24 hours once symptom-free
Three students and a teacher in the same classroom develop headache, nausea, and dizziness within 20 minutes. All improve after moving into the hallway; conventional pulse oximetry readings are normal. Which explanation and response best fit the pattern?
Correct answer: C - Possible carbon monoxide exposure; evacuate, activate the emergency response, and obtain medical assessment
The NCSN exam also covers these domains. Drill them in the full free practice test:
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