Test Design and
Test Framework
Field 236: School Nurse
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The test design below describes general test information. The framework that follows is a detailed outline that explains the knowledge and skills that this test measures.
Test Design
| Format | Computer-based test (CBT) |
|---|---|
| Number of Questions | 100 multiple-choice questions |
| Time* | 3 hours, 15 minutes |
| Passing Score | 240 |
*Does not include 15-minute CBT tutorial
Test Framework
Pie chart of approximate test weighting outlined in the table below.
| Test Subarea | Number of Test Objectives | Number of Scorable Items | Number of Non-Scorable Items | subarea weight as percent of total test score |
|---|---|---|---|---|
| Subarea 1—Human Development, Health, Learning, and Diversity | 4 | 22 | 6 | 28 percent |
| Subarea 2—The Specialty Practice of School Nursing | 5 | 29 | 7 | 36 percent |
| Subarea 3—Health Promotion, Disease Prevention, and Coordinated Care | 5 | 29 | 7 | 36 percent |
| Totals | 14 | 80 | 20 | 100 percent |
Subarea 1—Human Development, Health, Learning, and Diversity
Objective 0001—Understand human growth and development, the learning process, and factors that affect development and learning of different school-age populations.
For example:
- Demonstrate knowledge of the stages and characteristics of human growth and development and their effects on learning.
- Demonstrate knowledge of characteristics and processes of brain development and the relationships between physical, emotional, social, and intellectual growth across the life span.
- Analyze the critical relationship between learning and health and the principles and intent of the Whole School, Whole Community, Whole Child (WSCC) collaborative approach to learning and health.
- Demonstrate knowledge of cultural, biological, psychosocial, socioeconomic, environmental, and technological factors and conditions that can influence human growth and development and learning.
- Analyze the relationship between adverse childhood experiences and unmet health needs and the concept that a student's basic human needs must be met for effective learning.
- Identify the role of the school nurse in supporting the physical, mental, emotional, and social health of students and their success in learning.
- Demonstrate awareness of health barriers and their effects on the development and learning of students.
- Identify how students' developmental characteristics and learning preferences affect the provision of health assessment, health services, and health teaching.
- Identify how knowledge of the progression of human growth and development informs the provision of a continuum of care and learning experiences that support the cognitive, social, emotional, and physical well-being of all students.
Objective 0002—Understand the roles and responsibilities of the school nurse as a health expert and resource person in the school community.
For example:
- Identify the importance of the school nurse's role in the development and evaluation of school health policies, protocols, procedures, and programs.
- Apply knowledge of best practices for sharing health information and resource materials to educate students, families, and staff about self-care.
- Apply knowledge of health literacy principles and techniques for providing guidance to students, families, and staff in locating and evaluating health-related resources.
- Demonstrate knowledge of how partnerships among schools, families, healthcare providers, and communities can maximize the use of resources and promote health and learning.
- Apply knowledge of the school nurse's role as liaison between the home, school, and community in enhancing health and wellness.
- Demonstrate knowledge of methods for interpreting and articulating health-related information and its potential effects on student learning within the school and community.
- Demonstrate knowledge of the components of resource management relative to school health services.
- Apply knowledge of the process of referral and follow-up in the provision of health and educational services.
- Identify the value of using the expertise of others as a resource for problem solving, generating new ideas, and seeking and giving feedback.
- Identify the importance of the school nurse's roles as health advocate, mentor, and role model for students, families, and staff.
- Demonstrate knowledge of the changing parameters of the professional school nurse's roles and scope of practice.
Objective 0003—Understand diversity among students, families, and communities; the influence of diversity; and strategies for communicating effectively in a diverse school community.
For example:
- Demonstrate knowledge of and sensitivity to diversity (e.g., culture, ethnicity, age, gender, gender identity, sexual orientation, language, religion, socioeconomic background, disability).
- Apply knowledge of ways in which health practices and learning are influenced by diversity in developmental stages, cognitive ability, individual strengths and needs, prior learning, and life experiences.
- Demonstrate knowledge of the effects of diversity and family dynamics on students' development and learning.
- Demonstrate knowledge of strategies for facilitating a learning environment in which individual differences and diversity are respected.
- Analyze ways in which similar behaviors may have various meanings in different cultures.
- Identify methods for delivering care in a nonjudgmental and nondiscriminatory manner that is sensitive to and respectful of student and family diversity.
- Demonstrate knowledge of language development, communication techniques and processes, and the role of communication in learning for diverse student populations.
- Demonstrate knowledge of the value, ethics, and dynamics of communication.
- Analyze the effects of diversity on communication and strategies for communicating effectively in a diverse school community.
- Identify effective methods for promoting and modeling the use of positive, effective communication methods and tools to enrich learning opportunities.
Objective 0004—Understand the characteristics and needs of students with disabilities and factors that affect their development and learning.
For example:
- Identify atypical human growth and development, including in the cognitive, physical, sensory, linguistic, social, and emotional domains.
- Analyze how genetic, environmental, socioeconomic, and familial factors can affect human growth and development.
- Demonstrate knowledge of types, characteristics, and etiologies of a variety of health impairments and how they affect development and learning.
- Demonstrate knowledge of the characteristics, exceptionalities, and needs of students with disabilities.
- Identify the areas of exceptionality in learning as defined by federal and state statutes.
- Demonstrate knowledge of the influence of diversity on the identification of, educational planning for, and learning of students with disabilities.
- Apply knowledge of the effects of medical conditions, health needs, and medications on student learning.
- Apply knowledge of the potential effects of disabilities on multiple aspects of students' lives, including academic, vocational, social, emotional, and recreational aspects.
- Demonstrate knowledge of the intent of local, state, and federal rules and regulations regarding special education, their application to students with disabilities, and their impact on the school community.
Subarea 2—The Specialty Practice of School Nursing
Objective 0005—Understand the provision and management of school nursing and student health services.
For example:
- Apply professional judgment, through the nursing process (i.e., assessment, diagnosis, outcome identification, planning, implementation, and evaluation), to school nursing practice.
- Identify effective methods for delivering care that support self-advocacy and promote and preserve students' and families' autonomy, dignity, diversity, and rights.
- Demonstrate knowledge of principles and techniques for assessing the school environment to promote health, safety, and risk reduction (e.g., assessing playgrounds, indoor air quality, and potential hazards).
- Identify principles, policies, and procedures for communicable disease surveillance reporting and management in the school environment.
- Identify principles and procedures for the administration, documentation, and compliance reporting of physicals and immunizations.
- Demonstrate knowledge of policies, guidelines, and standards for nursing procedures and medication administration.
- Apply knowledge of the complex effects of medications on the educational, cognitive, physical, social, and emotional behaviors of students.
- Apply knowledge of state and federal laws for the management and protection of student health records (e.g., guidelines regarding information required in student health records, access, and confidentiality).
- Demonstrate knowledge of the use of technology-based tools to document plans and interventions, enhance communication, and ensure efficient and safe storage and retrieval of student records.
Objective 0006—Understand the care and management of illnesses and chronic health conditions and the development of Individualized Healthcare Plans (IHPs).
For example:
- Apply knowledge of the nursing process in the physical, developmental, and psychosocial assessment of students.
- Identify principles and techniques for evaluating health complaints and providing direct care for injuries, health problems, and illnesses.
- Demonstrate knowledge of principles and methods of caring for students with chronic illnesses and conditions.
- Apply knowledge of how to develop, through collaboration with families and healthcare providers, Individualized Healthcare Plans (IHPs) for students with chronic conditions.
- Demonstrate knowledge of principles for developing IHPs and interventions that are educationally relevant, developmentally appropriate, and sensitive to the diverse characteristics of students and families.
- Identify effective methods for establishing IHPs that include student-focused, measurable outcomes and interventions based on health and learning needs.
- Identify how to use assessment and evaluation data to develop students' IHPs and determine strategies for assisting students in managing health issues in the school setting.
- Identify effective and appropriate methods for implementing timely nursing interventions identified in the IHP and for evaluating progress toward the attainment of desired outcomes in a systematic, continuous, and criterion-based manner.
- Analyze the importance of using multiple sources of information when prioritizing and developing individualized plans and interventions that provide for continuity of care and optimal learning.
Objective 0007—Understand the roles and responsibilities of the school nurse in the multidisciplinary evaluation of students and the development of Individualized Education Programs (IEPs) and Section 504 Plans.
For example:
- Apply knowledge of general procedures and legal requirements (e.g., least restrictive environment [LRE], free and appropriate education [FAPE]) for developing and implementing individualized plans for students with disabilities or learning differences and needs, including Individualized Education Programs (IEPs) and Section 504 Plans.
- Analyze the components of and differences between IHPs, IEPs, and Section 504 Plans and how to incorporate components of students' IHPs into IEPs and Section 504 Plans when indicated.
- Demonstrate knowledge of how to assess student health status using the medical review process; identify health issues that may create barriers to educational progress; and determine strategies, adaptations, resources, and assistive technology that are appropriate for students' individualized health needs.
- Identify how to use assessment and evaluation results to inform eligibility for IEPs and the development of individualized student goals, benchmarks, and modifications.
- Identify how to use assessment and evaluation results to inform eligibility for Section 504 Plans and determine accommodations.
- Demonstrate knowledge of the roles of multidisciplinary team members in the identification, evaluation, and placement of students into special education programs, including the role of the school nurse in identifying the impact of health needs and determining modifications and health/nursing services.
- Analyze the supervisory and management responsibilities of the school nurse in developing, implementing, monitoring, and amending individualized programs, including IEPs, Section 504 Plans, and transition plans for students with health-related needs.
- Identify the importance of involving students and their families in developing individualized programs and monitoring progress toward health and educational goals, as well as strategies for ensuring adequate communication and collaboration.
- Demonstrate knowledge of the rights of students and parents/guardians in relation to assessment and evaluation and the legal, regulatory, and ethical parameters regarding assessment, comprehensive evaluation, and data-based decision making.
Objective 0008—Understand laws, policies, ethical guidelines, and professional standards that influence the practice of school nursing and the provision of health services.
For example:
- Demonstrate knowledge of current federal, state, and local laws, policies, guidelines, and regulations that govern education, school health practice, and student safety, and their influence on professional school nursing practice and the school community.
- Demonstrate knowledge of the legal boundaries and the professional practices, standards, regulations, and policies inherent in the nursing licenses defined by the Illinois Nurse Practice Act.
- Demonstrate knowledge of the national competencies and scope and standards of school nursing developed by the American Nurses Association (ANA) and the National Association of School Nurses (NASN).
- Demonstrate knowledge of the legal and ethical bases for policies and guidelines that address management of medications, specialized healthcare, confidentiality, and student homelessness.
- Demonstrate knowledge of professional and legal guidelines and implications regarding confidentiality and personal privacy, including those related to the Illinois School Students Record Act (ISSRA), the Family Educational Rights and Privacy Act (FERPA), and the Health Insurance Portability and Accountability Act (HIPAA).
- Apply knowledge of professional code of conduct and ethical practice guidelines embodied in current professional standards of school nursing and in the Illinois Nurse Practice Act
- Identify signs and indicators of child maltreatment, including physical abuse, neglect, sexual abuse, and psychological abuse; and policies, regulations, and procedures for assessment, identification, support, intervention, mandated reporting, referral, and follow-up related to possible cases of child maltreatment.
- Identify the effects of social, economic, and political issues and the legislative process on the nature and provision of health services to students, families, and the community.
Objective 0009—Understand the importance of acquiring and maintaining current credentials and evidence-based knowledge and competency in school nursing practice.
For example:
- Identify the importance of maintaining professional credentials and participating in relevant continuing education.
- Identify the standards, statutes, guidelines, and policies that influence the evaluation of professional growth.
- Demonstrate knowledge of the importance of seeking, acquiring, and maintaining current knowledge and understanding of the skills required to practice in the specialty area of school nursing.
- Demonstrate knowledge of the evidence-based literature and resources that are available for professional development.
- Demonstrate knowledge of the benefits of engaging in self-assessment, critical-thinking, and problem-solving activities and principles for developing and implementing a plan for professional leadership.
- Demonstrate knowledge of how participation in regular professional dialogue, consultation with others, and continuous learning support development as a lifelong learner and health educator.
- Identify effective methods for using observation, data collection, and research as sources for active reflection, evaluation, and revision of practice.
- Identify the value of professional networking and participation in professional nursing and educational organizations.
- Identify advocacy strategies for increasing public awareness and institutional value of the roles and positive effects of school nurses on student success and for promoting school nursing as a professional nursing specialty.
Subarea 3—Health Promotion, Disease Prevention, and Coordinated Care
Objective 0010—Understand health promotion and disease prevention concepts underlying school health and nursing services.
For example:
- Demonstrate knowledge of major elements, principles, and processes of public health, health promotion, and disease and injury prevention as they apply to school populations.
- Identify the school nurse's role as a resource and expert in integrating principles of health education, health and wellness promotion, and disease prevention in the school community.
- Analyze ways in which environmental health concepts and issues affect school health and safety.
- Identify effective methods for applying health and wellness promotion, disease prevention, and environmental health concepts to address the healthcare and safety needs of all students and others in the school community.
- Apply knowledge of primary, secondary, and tertiary disease prevention concepts and practices.
- Identify major theories, frameworks, and models of health behavior and health education and their influences on the provision of nursing and health services.
- Apply knowledge of principles and procedures for early identification and health screenings (e.g., vision; hearing; dental; biometric data; mental health; Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services; Child Find).
- Apply knowledge of how to make appropriate referrals based on health screenings and assessments.
- Identify risk factors and warning signs and symptoms of mental health distress and disorders (e.g., depression, risk of harm to self and others) and methods and resources for helping at-risk students.
- Demonstrate knowledge of the principles of individual and group health counseling and teaching that incorporate individual strengths, offer maximum opportunity to make informed health choices, and promote students' self-advocacy in healthcare decisions and learning.
- Demonstrate knowledge of the application of holistic health principles.
- Apply knowledge of how to locate, analyze, and summarize social, cultural, environmental, behavioral, and other health-related data to identify, prioritize, and communicate health promotion, disease prevention, and health education goals.
Objective 0011—Understand curriculum development and instruction in the school health program.
For example:
- Identify and apply the structure, components, and benefits of an effective school health program and curriculum that is based on the Centers for Disease Control and Prevention's (CDC's) WSCC model.
- Demonstrate knowledge of health education curriculum development resources and evaluation tools across school-age populations.
- Demonstrate knowledge of the design, development, implementation, and evaluation of health-related curricula and educational materials.
- Apply knowledge of health education strategies that facilitate students' health literacy and that adhere to best practices and professional standards.
- Demonstrate knowledge of methods for adapting technology for school health programs and integrating technology into school health services.
- Demonstrate knowledge of methods of instruction aligned with current Illinois Learning Standards, reading processes and methods, social-emotional learning, English language learning (ELL), and students' developmental levels and learning characteristics.
- Apply knowledge of techniques and resources for providing health information to individual students and groups of students through health education, science, and other classes.
- Apply knowledge of how to foster students' knowledge and skills in using risk-assessment, goal-setting, decision-making, and problem-solving skills to enhance personal health.
- Identify effective, developmentally appropriate methods for promoting students' self-care and self-advocacy skills, providing opportunities for positive lifestyle choices, encouraging students' planning for their own healthcare, and supporting students' growth as knowledgeable healthcare consumers.
- Demonstrate knowledge of educational strategies and programs that address and enhance student safety and well-being, school connectedness, the reduction of student health risks, and the prevention of conflict, bullying, and violence.
Objective 0012—Understand the processes of assessment and evaluation in the development of school health programs.
For example:
- Demonstrate knowledge of methods for conducting school needs assessments to identify current health issues, evaluate the effectiveness of existing interventions and programs, evaluate ongoing health issues, and determine the need for additional programs.
- Identify valid and appropriate methods for accessing, collecting, prioritizing, and documenting health data from students, families, staff, and community agencies in a systematic, organized, and ongoing manner.
- Demonstrate knowledge of the roles of assessment, planning, implementation, and evaluation in supporting the process of continuous program improvement.
- Analyze how professional standards of practice, current trends, sources of funding, and school policies influence the development and implementation of school health programs.
- Identify appropriate methods for using health assessment and evaluation results to support educational and school health services that enhance health promotion, disease prevention, and safety.
- Apply knowledge of how to use aggregate health data to evaluate and suggest improvements for the school health program.
- Demonstrate knowledge of the role of assessment in determining how students learn, what they know and are able to do, and what additional instruction they need.
- Identify appropriate strategies for communicating assessment and evaluation findings.
- Apply knowledge of the rights of students and parents/guardians in regard to assessment and evaluation.
Objective 0013—Understand effective approaches to collaboration and delegation in the school health program.
For example:
- Apply knowledge of strategies for collaborating with the school community, board of education, health authorities, and community health agencies to develop and implement health policies and procedures consistent with evidence-informed practice that support a safe and healthy learning environment and promote students' success.
- Demonstrate knowledge of the benefits of and strategies for interdisciplinary collaboration and teaching to enhance health and learning.
- Identify a variety of approaches for collaboration with students, families, and community members in developing goals and timelines and in making decisions related to healthcare, service delivery, and the promotion of healthy lifestyles.
- Identify principles and techniques for collaborating and consulting with school professionals such as social workers, therapists, administrators, food-service personnel, teachers, coaches, psychologists, and counselors in providing school health services.
- Demonstrate knowledge of the responsibilities of orienting, training, supervising, and evaluating health assistants, aides, and unlicensed assistive personnel.
- Demonstrate knowledge of laws, rules, and standards for defining how the school nurse assigns or delegates nursing tasks based on assessment of a student's health needs to determine the level of training and supervision required for safe delegation for the student.
- Identify procedures for delegating healthcare tasks in accordance with state laws and professional guidelines and criteria (e.g., the right task, circumstances, person, directions, and supervision for the student and situation).
Objective 0014—Understand the role of the school nurse in preparedness response and coordination during emergencies, crises, and disasters.
For example:
- Apply knowledge of appropriate techniques and intervention strategies for assisting students and families facing crisis and emergency situations.
- Identify principles, models, and collaboration strategies for preventing, preparing for, and responding to emergencies and disasters in the school community.
- Apply knowledge of protocols, medical procedures, and resources for responding to student, staff, and visitor health-related emergencies.
- Apply knowledge of protocols, medical procedures, and resources for responding to potential large-number emergencies or crises, including mass illnesses or flu pandemics, physical plant incidents or hazards, and human-caused emergencies or crises (e.g., threats, violence, terrorism).
- Apply knowledge of protocols, medical procedures, and resources for responding to weather-related emergencies and disasters.
- Apply knowledge of triage and first-aid procedures, skills, and equipment for assessing and responding to unanticipated medical emergencies.
- Demonstrate knowledge of principles and procedures for developing Emergency Action/Care Plans for students with known health conditions and exceptional needs.
- Demonstrate knowledge of principles, procedures, and resources for helping students, families, and school personnel recover from a crisis or disaster.