NR442/ NR 442 Community Health Nursing Exam 2
Objectives (chap 13, 15, 19, 21, 23, 24, 25, 28, 29, 30, 31, 32,
33, 34) 2024/2025 new update
Exam 2 Objectives (chap 13, 15, 19, 21, 23, 24, 25, 28, 29, 30, 31, 32, 33, 34)
Chapter 13: Cultural Diversity and Community Health Nursing
-Describe ethical definitions of Autonomy, Non-maleficence, Beneficence, Distributive Justice and how
lack of can affect health care and access to all.
• Autonomy- patient independence, making own decisions, a self-governing state
• Non-maleficence- to do no harm
• Beneficence- doing good
• Distributive justice- perceived fairness of how rewards and costs are shared by
(distributed across) group members. Distributive justice concerns the equitable distribution
of scarce resources among all socioeconomic groups and population sectors.
Chapter 19: Senior Health
-Identify age-related risk factors and education for Senior Health
• Nutrition status and exercise
• Falls
• Dental, hearing, & vision problems
• Abuse/maltreatment
• Medication safety
o When applicable, anti-inflammatory medications may be administered before physical
activity to address accompanying pain
• Cold and heat stress:
o Hypothermia (very serious)- keep the patient warm; watch for the signs: confusion or
sleepiness, slowed slurred speech, weak pulse, shivering, poor control of body
movements
o Heatstroke (life-threatening) - wrap a wet sheet, move to a cooler area; watch for
hot dry skin that’s usually red, mottled, or cyanotic, loss of consciousness, or
convulsions
-What are functional assessments and why are they used when assessing the elderly?
• Examinations and Tests; a continuous collaborative process that combines observing, asking
meaningful questions, listening to family stories, and analyzing individual child skills and
behaviors within naturally occurring everyday routines and activities across multiple situations
and settings.
• For All Older Adults
o Complete physical: Annually
o Blood pressure: Annually; more frequently if hypertensive or at risk
o Blood glucose: Annually; more frequently if diabetic or at risk
o Serum cholesterol: Every 5 years; more frequently if at high risk

o Dental examination: Annually for those with teeth with cleaning every 6 months;
cleaning every 2 years for denture wearers
o Hearing test: Every 2 to 5 years
• For Women
o Breast self-examination: Monthly
o Clinical breast examination: Annually
o Mammogram: Every 1 to 2 years if aged 40 years or older; check with health care
provider if 74 years or older
o Pelvic examination and Papanicolaou smear: Annually; may check with health
care provider about discontinuation at 66+ years or after three consecutive
negative Pap test results or >2 consecutive negative HPV and Pap tests, no
abnormal results in previous 10 years and not otherwise at risk, or have had a
total hysterectomy
o Digital rectal examination: Annually with pelvic examination
o Bone density: Once after menopause and more frequently if at risk
• For Men
o Digital rectal examination and prostate examination: Annually
o Prostate-specific antigen (PSA) blood test: Annually
• Immunizations for All Older Adults
o Tetanus, diphtheria, pertussis (Tdap): Every 10 years
o Influenza/flu vaccine: Annually
o Pneumonia vaccine: Once after age 65 years; ask physician about booster every 5
years
o Hepatitis A (liver infection found in stool and blood very contagious )and B(is
spread when blood, semen, or other body fluids from a person infected)those at
risk
o Herpes zoster (shingles): One-time dose
o Varicella (chickenpox): If evidence of lack of immunity and significant risk for
exposure
Chapter 21: Populations Affected by Disabilities
-Medicare and Medicaid access and funding
• medicare
o Medicare is the federal health insurance program for:
▪ people 65 or older
▪ certain younger people with disabilities
▪ people with ESRD (end stage renal disease)
▪ funded by the social security administration (tax payers)
• medicaid
o For low-income families w/ disability and pregnant women
o Funded by federal and state government

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eligibility is based off of household size and income and priority given to
children, pregnant women, and those with a disability (federally funded)
-What protection is provided to those who identify having a disability
• Contemporary disability policy minimizes the disadvantaged view and maximizes
opportunities for people with disabilities to live productively in their communities.
Public policy on disability (these are your programs) includes civil rights protections,
skill enhancement programs, and income and in-kind assistance programs (e.g., Social
Security Disability Insurance [SSDI] and Medicare)
-What does ADA accommodations mean and do they refer to
• The Americans with Disabilities Act (ADA) (PL 101-336) became a law in July 1990. This
landmark civil rights–styled legislation prohibits discrimination against people with
disabilities by guaranteeing equal opportunities for people with disabilities in relation to
employment, transportation, public accommodations, public services, and
telecommunications
• A qualified individual with a disability must meet legitimate skill, experience, education,
or other requirements of an employment position. The person must be able to perform
the essential job functions, such as those contained within a job description, with or
without reasonable accommodation(s). Reasonable accommodations should make it
easier to be successful in job duties and may either involve altering the duties or the
tasks of the job performed. Qualifying organizations must provide reasonable
accommodations unless they can demonstrate that the accommodation will cause
significant difficulty or expense, producing an undue hardship.
-Discuss the Ticket to Work Act and how it affects Medicaid or Medicare
• Addresses employment and benefit issues for persons with disabilities.
• Increase access to vocational services and provided methods for retaining health insurance.
• Provided higher cap to accommodate earnings when beneficiaries make progress in their
employment plans but before they reach the level of earnings that would terminate their
benefits
Chapter 23: Homeless Populations (ati pg 64)
-Identify health care workers engagement and care with homeless populations
• Refer those who have underlying mental health disorders to therapy and counseling
• Enhance parenting skills that can prevent teens from running away
• Assist in temporary shelter, long-term shelter
• Advocate and provide efforts towards political change
• Make referrals for employee assistance and emotional programs
o Provides insurance to people of low socioeconomic status and children,

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Chapter 24: Rural and Migrant Health
-Identify factors that place farmers and migrant workers at risk for illness and accidents
• Working in highly variable environmental conditions (e.g., temperature extremes, a wide
variety of work tasks, and unpredictable circumstances) is associated with an increased
frequency of accidents and fatalities.
• Occupational asthma and more exotic fungal or toxic gas–related conditions also occur
in higher frequency in agricultural than nonagricultural populations. Exposure to
pesticides, herbicides, and other chemicals is also a major concern for farmers and their
families.
-Discuss the impact of barriers and access to health care on rural aggregates
• In general, migrant and seasonal farmworkers (MSFWs) may have the poorest health of
any aggregate in the United States and the least access to affordable health care.
• Barriers: distance from services, lack of transportation, unpredictable weather/travel
conditions, inability to pay for care, shortage of rural hospitals/HCP
-Describe the Migrant Health Centers (MHCs) under the Migrant Health Program
• The MHC program provides comprehensive nursing and medical care and support
services to MSFWs (migrant and seasonal farmworkers) and their families. The
centers provide culturally sensitive care to a racially and culturally diverse farm labor
force from many countries in Latin America and the Caribbean. Bilingual, bicultural
health personnel, including lay outreach workers, use culturally appropriate protocols to
provide primary care, preventive health care, transportation, dental care,
pharmaceuticals, and environmental health services.
Chapter 25: Populations Affected by Mental Illness
-Factors that influence mental health
• Genetic factors
• Abnormalities of Brain Structure and Functioning (schizophrenia, depression, and Alzheimer
disease)
• Social factors (school shootings, public bombings, bullying, domestic violence, and other tragic
events, unemployment, bereavement). Another social concern is the tendency of communities
to make use of prisons rather than psychiatric hospitals as a solution to the “mental health
problem.
• Gender, racial, & sexual orientation disparities
• Natural & human-made disasters and mental illness
• Political factors

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2024-2025 NR442 Community Health Nursing Exam 2 with Answers (41 Solved Questions)

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