Study Guide for the Proctored Exam and Final ATI

Overall Community Health Nursing

 One role of the community health nurse (CHN) is to be an advocate. It is important to

be aware of health disparities of each group and the goal is to minimize those disparities.

 How did it all happen? Look at the history of community health nursing in the ATI and your

text books. The Sisters of Mercy from 1812 were nuns who took care of the disadvantaged.

Florence Nightingale established a training for nurses in 1860. Clara Barton established the

Red Cross in 1864. Lillian Wald from 1893 is most known for her establishment of the Henry

Street Settlement (visiting nurses and community assessment/changes). Mary Breckinridge

established the Frontier Nursing Service in 1925.

 Nightingale’s Environmental Theory ● Highlights the relationship between an individual’s

environment and health ● Depicts health as a continuum ● Emphasizes preventive care

Health Belief Model

● Purpose is to predict or explain health behaviors ● Assumes that preventive health actions are

taken primarily for the purpose of avoiding disease ● Emphasizes change at the individual level

● Describes the likelihood of taking an action to avoid disease based on the following ●

Perceived susceptibility, seriousness, and threat of a disease ● Modifying factors

(demographics, knowledge level) ● Cues to action (media campaigns, disease effect on

family/friends, recommendations from health care professionals) ● Perceived benefits minus

perceived barriers to taking action.

Community Health = Public Health – studies the population and community as a whole. Helps

improve the health of the community and not just individually.

Community –oriented and community–based both comprise community health nursing

Community based nursing- focus on illness care, which can be acute/chronic. Example: Home

health nurse would do wound care and school nurse would focus on asthma care

Ethics

 Autonomy- respect for self-determination- example: respect the cancer patient who

discontinues chemo

 Nonmaleficence- Do No Harm!

 Beneficence- Do what is best

 Distributive justice- fair allocation of resources in the community- example- COVID- not

hoarding PPE or toilet paper, is fair and justly distributed

Culture

It is important to assess cultural beliefs and practices when determining a plan of care.

Community health nurses need to consider that not all cultures are similar and there are variations

within each culture.

The uniqueness of each client needs to be considered.

It is important for community health nurses to become familiar with culture represented within the

local community.

The nurse's first action when beginning a cultural assessment is to collect self-identifying data about

the client, including specific information about how the client's cultural beliefs influence family

structure, food patterns, religious preferences, and health practices.

 Culturation= adopting traits of a different culture

 Ethnocentrism= belief your own culture is superior to all others – you need to be open minded

Cultural Assessment Parameters ● Ethnic background ● Religious preferences ● Family structure ●

Language and literacy needs ● Communication needs ● Education ● Cultural values ● Food patterns ●

Health promotion and maintenance practices ● Types of health practitioners used ● Medicines,

remedies, treatments, and therapies used

Using an Interpreter

● The nurse should use an interpreter when it is difficult for a nurse or client to understand the