core examination

Question 1

Normal psychological aging in the elderly includes all of the following except:

1. slowed memory retrieval
2. difficulty handling change
3. loss of memory
4. depression

Answer 1

loss of memory

Question 2

Normal physiological aging of the elderly does not include:

1. loss of skin elasticity
2. glaucoma and cataracts
3. depressed immune system
4. dementia

Answer 2

dementia

Question 3

Which of the following disorders is more likely to go unnoticed by the staff?

1. incontinence
2. Irritable bowel syndrome
3. Depression
4. Very slight strokes

Answer 3

Very slight strokes

Question 4

What procedures have been found to be most effective for a resident with depression?

1. Spending two or three weeks in a psychiatric program in a hospital
2. Medications, family involvement, and staff attention
3. Counseling, activities, and medications
4. Treatment in a local mental health center

Answer 4

Counseling, activities, and medications

Question 5

Which of the following is not a symptom of depression?

1. Hallucinations
2. Sleep disturbance
3. Social isolation
4. Impaired verbal communications

Answer 5

Hallucinations

Question 6

A most effective way to plan for setting up a program for residents who tend to wander is to:

1. complete an immediate assessment to determine the potential to wander
2. determine at or before admission if the resident tends to wander
3. plan a program to which all residents tending to wander must adhere
4. place all wanderers in some type of physical or chemical restraint

Answer 6

determine at or before admission if the resident tends to wander

Question 7

HIPAA requires records meet all of the following standards except be:

1. maintained by a professionally qualified Registered Health Information Technician (RHIT)
2. complete
3. readily assessable to staff and family
4. systematically organized according to subject matter

Answer 7

maintained by a professionally qualified Registered Health Information Technician (RHIT)

Question 8

Which two classes of food are mostly likely to cause allergic reactions in residents?

1. Bread and cereal
2. Diary products and seafood
3. Fats and oils
4. Eggs and beef

Answer 8

Dairy products and seafood

Question 9

A facility had an average daily census of 110 residents during the month of June. Total food costs for the average month was $30,000. What was the food cost per resident day?

1. $8.25
2. $ 8.75
3. $9.09
4. $9.52

Answer 9

$9.09

Question 10

What type of activity seems to be most effective for persons afflicted with Alzheimer’s Disease?

1. Morning walks
2. A game of bingo
3. An activity that utilizes music
4. An activity that involves physical exercise

Answer 10

An activity that utilize music

Question 11

In planning a resident activities program, a primary goal should be to:

1. develop individual skills
2. provide satisfaction of making a finished product
3. provide participation and enjoyment
4. lessen the work load on the CNA’s by keeping the residents busy

Answer 11

provide participation and enjoyment

Question 12

What is the first thing a nurse should do when a resident refuses to take his medicine?

1. Call the physician for instructions
2. Explain the consequences to the resident
3. Contract the family for their help
4. Simply document the problem as the resident has the right to refuse

Answer 12

Explain the consequences to the resident

Question 13

A resident’s activity program should be designed to stimulate the resident’s cognition, motor skills, and affective needs. Which of the following activities will accomplish all three of these goals?

1. Showing a humorous movie
2. Bringing in a music group to entertain
3. Organizing a hand-bell choir
4. Conducting a sing-along activity

Answer 13

Organizing a hand-bell choir

Question 14

The essential difference between verbal abuse and mental abuse of a resident is:

1. verbal is any use of spoken or written disparaging remarks; mental abuse is mistreatment
2. verbal abuse is any use of disparaging remarks; mental abuse is the use of actions that humiliate, harass, or threaten
3. there is no actual difference as both actions embarrass, humiliate, and demean the resident
4. verbal abuse is demeaning derogatory remarks, while mental abuse includes sexual abuse

Answer 14

verbal abuse is any use of disparaging remarks; mental abuse is the use of actions that humiliate, harass, or threaten

Question 15

Robert Hornbeck is only 65 years old and suffers from dementia. His family struggles with his condition, but is determined to do whatever they can to ensure that he has the highest quality of life possible. They have consulted with the local Alzheimer's Association and learned that there are care areas that can " make a significant difference in his quality of life." Which of the following is not one of these recommended areas?
1/ Food and fluid consumption
2. Pain management
3. Social engagement
4. Physical exercises

Answer 15

Physical exercises

Question 16

Warren Cruz suffers from Alzheimer’s Disease. Due to his disease, his behavior has become such that his wife and adult children can no longer care for him at home. Thus, they make the decision to place him in a post-acute, long-term care facility. The staff notices at once that Mr. Cruz is very agitated and will not stay situated in one place for any length of time. He is in and out of other resident’s rooms. He picks up objects from tables and walks around almost constantly. Which of the following should the facility do?

1. The problems Mr. Cruz presents are so great that the facility must notify the family that they cannot meet his needs and they are transferring him to a geriatric psychiatric hospital
2. The staff notices that Mr. Cruz’s bad behavior seems to escalate at 4 o’clock each evening, so they determine that they will put him to bed, turn the lights off in his room, and turn on easy listening music
3. The charge nurse is very concerned that Mr. Cruz will fall due to his continuous walking and requests an order from the attending physician for a geriatric chair so Mr. Cruz can be placed in a reclining position which will make it difficult for him to arise
4. The social worker learns that Mr. Cruz had been a carpenter during his professional life, Along with activities, the social worker sets up a work station with Lincoln Logs and Legos for MR. Cruz

Answer 16

The social worker learns that Mr. Cruz had been a carpenter during his professional life, Along with activities, the social worker sets up a work station with Lincoln Logs and Legos for MR. Cruz

Question 17

Sharon Willis’s mother is a resident in a long0term care facility. Ms. Willis receives complaints from her mother that each morning her breakfast arrives late, is always cold, and is never what she ordered. On a Sunday morning she arrives at the facility in time to observe her mother’s breakfast, The following morning the administrator receives a call from the daughter who is complaining loudly about the lack of service her mother is receiving and the fact that her mother received a cold biscuit, scrambled eggs, and sausage for breakfast when she ordered raisin toast, a poached egg, and bacon. How should the administrator handle this issue?

1. Assume the daughter is accurate in her account of the events and complete a disciplinary action on the Dietary Manager, as she is responsible for the preparation and delivery of all meals
2. Listen carefully to the daughter’s accusations and take detailed notes. Visit with the staff who were working on Sunday morning, and implement procedures that will help ensure the dietary staff is following the resident’s meal request and delivery of the meals is timely
3. Listen intently to Ms. Willis’ concerns, investigate the complaints by interviewing staff members who were involved as well as the dietary manager, and implement corrective actions immediately
4. Listen intently to Ms. Willis’ concerns, take notes, investigate the concerns, and report findings to Ms. willis. Next implement corrections, if necessary, and evaluate the processes to help ensure an efficient and effective program

Answer 17

Listen intently to Ms. Willis’ concerns, take notes, investigate the concerns, and report findings to Ms. willis. Next implement corrections, if necessary, and evaluate the processes to help ensure an efficient and effective program

Question 18

Which of the following is the leading cause of vision loss in people over the age of 65?
1. Age-related Macular Degeneration
2. Cataracts
3/ Glaucoma
4. Diabetic retinopathy

Answer 18

Age-Related Macular Degeneration

Question 19

The potentially blindly effect of which of the following can be drastically reduced in the United States through an effective and safe surgery?

1. Age-Related Macular Degeneration
2. Cataracts
3. Glaucoma
4. Diabetic retinoptahy

Answer 19

Cataracts

Question 20

Which of the following is not defined as a fall in a long-term care facility?

1. When a resident loses his balance and would have fallen, if not for staff intervention
2. When a resident slips and lands on a sofa and is not injured
3. When the staff finds a resident on the floor but cannot determine how he landed there
4. When the staff witnesses one resident push another to the ground

Answer 20

When the staff witnesses one resident push another to the ground

Question 21

A resident in a long-term care facility is very confused. She is in her 80’s but insists on finding her elderly grandfather as it is her responsibility to care for him. Which of the following treatment programs would a facility most likely use with this resident?

1. Staff will use re-motivation techniques to encourage her to become more interested in her immediate surroundings
2. Staff members will reassure and reaffirm her feelings and thoughts through validation therapy
3. Staff will remind the resident of the current year and date and that her grandfather is no longer alive through reality orientation
4. Staff will refer the resident to a Speech Language Pathologist to work on her cognition

Answer 21

Staff members will reassure and reaffirm her feelings and thoughts through validation therapy

Question 22

The administrator is responsible for ensuring a safe environment for the persons residing in long-term care facility. Dietary staff must have a system in place to ensure the proper cooking temperatures of the food in order to prevent foodborne illnesses. Which of the following cooking temperature is not correct?

1. Poultry and stuffed foods must be cooked to 18=65 degrees F
2. ground meat such as beef must be cooked to 155 degrees F
3. Fin fish must be cooked to 135 degrees F
4. Pork and Ham must be cooked to 145 degrees F

Answer 22

Fin fish must be cooked to 135 degrees F

Question 23

Bladder incontinence is common lace among elders. In many cases a resident can regain control of his/her bladder function through various treatment programs. Which of the following is not an effective means of treatment?

1. Catherization
2. Kegal exercise
3. Physical exercises
4. Prompted voiding

Answer 23

Catherization

Question 24

Which of the following medications is considered a Scheduled II drug?

1. Valium
2. Percocet
3. Didrex
4. Imodium

Answer 24

Percocet

Question 25

A staff member is accused of abusing a resident in a long-term care facility. What must the administrator do?

1. Immediately suspend the employee pending investigation and notify local authorities and the appropriate state agency
2. Terminate the employee and notify local authorities and the appropriate state agency
3. Change the employee’s assignment so he will not have contract with the alleged victim,, notify the family, the local authorities, and the appropriate state agency
4. Report the alleged violations to the state agency and to all other agencies as required, and take all necessary corrective actions depending on the results of the investigation

Answer 25

Report the alleged violations to the state agency and to all other agencies as required, and take all necessary corrective actions depending on the results of the investigation

Question 26

Which of the following is not normally associated with infections in long-term care facilities?

1. Legionnaires Disease
2. Urinary Tract Infections
3. Methicillin-resistant Staphylococcus aureus
4. Clostridium difficile

Answer 26

Legionnaires Disease

Question 27

A resident’s medical records belong to which of the following?

1. The resident
2. The physician
3. The administrator
4. The facility

Answer 27

The facility

Question 28

Social workers in a long-term care facility can perform all of the following services except:

1. counseling
2. psychiatric treatment
3. utilization of community resources
4. assistance with discharge planning

Answer 28

psychiatric treatment

Question 29

Falls are a major cause of injuries among residents in long-term care facilities; therefore it is imperative that Falls Prevention Programs are in place. Which of the following is least likely to be considered a common cause of falls within a facility?

1. Residents who have just finished a large meal, which may result in lowering the blood pressure when the resident stands up
2. Extensive physical therapy causing the resident to tire more easily, thus increasing the probability of falls
3. A resident has a medical diagnosis of osteoporosis and suffers a level of dementia which prohibits safety awareness
4. Family bringing in furniture that is too large for the room, thus creating barriers for safe ambulation

Answer 29

Extensive physical therapy causing the resident to tire more easily, thus increasing the probability of falls

Question 30

Who is the key person(s) to handle an employee problem or grievance?

1. The grievance committee
2. the department head
3. The immediate supervisor
4. the administrator

Answer 30

The immediate supervisor

Question 31

Under its Ergonomics Guidelines, OSHA list three factors that long-term care employees encounter. Which one of the following is not a factor?

1. Force- the amount of physical effort required to perform a task or to maintain control of equipment
2. Repetition- continual and/or frequent performance of the same motion or series of motions
3. walking and standing- too much time without sitting and relaxing thus causing undue hardship on knees and ankles
4. Awkward postures- assuming positions that place stress on the body, such as leaning over a bed

Answer 31

walking and standing- too much time without sitting and relaxing thus causing undue hardship on knees and ankles

Question 32

What is the first step in counseling an employee who has a problem?

1. Ask the employee what they can do about the problem
2. Let the employee express her feelings about the problem
3. Reassure them their problem is not all that bad
4. Tell them the solution and give them specific directions on how to resolve the problem

Answer 32

Let the employee express her feelings about the problem

Question 33

Shady Grove Retirement Center spends an average of $1,500 to recruit, hire and train a new employee. Shady Grove employs 100 staff members. During the past 12 months, 25 of its employees were either terminated or resigned voluntarily. How much money did the turnover cost the facility?

1. $37,500
2. $39,00
3. $36,000
4. $40,000

Answer 33

$37,500

Question 34

What are the recommended steps in correcting an employee’s work error?

1. Check their understanding of how the task is supposed to done, point out the error, and discuss the consequences of the error
2. But why they did not do the work as they were trained and state the consequences of the error
3. Tell them first that they usually do a good job, confront them with their error and tell them the consequences of any further errors
4. Confront them with the error, tell them how you feel about such mistakes, and tell them what to do next

Answer 34

Check their understanding of how the task is supposed to done, point out the error, and discuss the consequences of the error

Question 35

Communication between staff and management is often a major problem, Why is face-to-face communication considered the most effective method of communication?

1. Management can more readily obtain feedback to determine the employee’s level of understanding
2. Employees generally prefer this method over written communication as they understand that once it is written there are no alternatives
3. It is easier for employers to retain spoken information over a written memorandum
4. Management can more strongly impress the meaning of the message to employees

Answer 35

Management can more readily obtain feedback to determine the employee’s level of understanding

Question 36

The key to a good pay scale is:

1. including shift differentials
2. always including an increment pay plan
3. starting above the minimum wage set by the Wage and Hour Administration
4. starting at the fair wage standard of the community

Answer 36

starting at the fair wage standard of the community

Question 37

What is generally considered the first priority in an employee training program?

1. resident care policies and procedures
2. Fire prevention and control
3. Corporate compliance and ethics
4. Prevention and control of infections

Answer 37

Fire prevention and control

Question 38

What is meant by respondent superior?

1. The employer is responsible only for the work of its full time employees
2. The employer may be responsible for the actions of non-contract workers who perform task in the facility
3. The employer is partially liable for the work of technical and professional actions of non-contract and contract employees
4. The employer is responsible for actions of employees performed within the course of their employment

Answer 38

The employer is responsible for actions of employees performed within the course of their employment

Question 39

What is the primary purpose of developing policies, procedures, and rules?

1. To make it easier to keep employees in line and doing their work properly
2. To meet requirements of the Department of Labor
3. To provide employees with information concerning what is expected of them and what they can expect from the employer
4. To provide a framework in which employees cannot get by with poor work and behavior and the supervisor has the right to hold the employee accountable for their performance

Answer 39

To provide employees with information concerning what is expected of them and what they can expect from the employer

Question 40

A job description should include all of the following except:

1. the qualifications of the potential employee in terms of education, experience, etc
2. the specific work assignments of an employee in their department level
3. distinguishing the features of work such as routine, technical, and professional
4. identifying the person who gives them instructions and monitors their work performance

Answer 40

the specific work assignments of an employee in their department level

Question 41

Which of the following is not a governmentally-mandated employee benefit?

1. Unemployment compensation
2. Worker’s compensation
3. Family and Medical Leave
4. Vacation and Sick leave

Answer 41

Vacation and SIck Leave

Question 42

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provides for the following?

1. To Provide the continuation of life insurance coverage for 15 months after termination from a job, regardless of the reason of separation
2. To allow a former employee to maintain group health insurance for medical benefits for up to 18 months regardless of the reason for separation from the job
3. To provide certain employees with up to 12 weeks of unpaid leaver per year to care for an ill spouse, child, or parent
4. To allow a former employee to maintain group health insurance for medical benefits for a period up to 18 months after separation

Answer 42

To allow a former employee to maintain group health insurance for medical benefits for a period up to 18 months after separation

Question 43

Which one of the following would the EEOC probably approve as an advertisement for employees?

1. Healthy females who like working with the elderly
2. Man to work with elderly, frail male residents
3. Male or female who can read and write and who likes to work with the elderly
4. Man to work weekends only - 11pm to 11am

Answer 43

Male or female who can read and write who likes to work with elderly

Question 44

All of the following qualify an employee for Family and Medical Leave except:

1. to care for a sick brother
2. birth of a newborn child
3. to care for an ill spouse, child, or parent
4. time off when employee has a serious health condition

Answer 44

to care for sick brother

Question 45

What is the essential difference between bookkeeping and accounting?

1. Bookkeeping is making entries of all financial transactions, paying bills, and writing receipts; accounting is budgeting and financial reports
2. Bookkeeping is making original entries of transactions and can be done by a clerk; accounting includes bookkeeping, budgeting, financial reports, auditing, and more
3. There is no essential difference except a clerk does bookkeeping and an accountant does accounting
4. Bookkeeping is the financial recording done by the nursing home; accounting is done by the corporate office

Answer 45

Bookkeeping is making original entries of transactions and can be done by a clerk; accounting includes bookkeeping, budgeting, financial reports, auditing, and more

Question 46

Working capital, as distinguished from other types of capital, means the:

1. cash used to purchase real estate and equipment
2. expenditures that increase book value of assets
3. excess of current assets over current liabilities
4. cash used in capital expenditures

Answer 46

excess of current assets over current liabilities

Question 47

What is the difference between fixed and variable expenses?

1. Fixed expenses remain constant without regard to the number of residents; variable expenses change with the volume of business
2. fixed expenses are expenditures for equipment; variable expenses are expenditures for all types of supplies and utilities
3. Fixed expenses are expenditures for buildings, equipment, and automobiles; variable expenses are for the maintenance and upkeep of the building
4. There is really no difference as all expenditures vary from one year to the next

Answer 47

Fixed expenses remain constant without regard to the number of residents; variable expenses change with the volume of business

Question 48

There are several types of budgets. Which budget outlines the facility’s projects income and anticipated revenues for the upcoming fiscal year?

1. Capital
2. cash
3. Operating
4. Integrated

Answer 48

operating

Question 49

The long-term care administrator receives a $45,000 order for raw food in the month of June. The accounting department records that purchase in June even though the invoice is not paid until July. This type of accounting is known as:

1. GAAP
2. cost basis accounting
3. cash basis acccounting
4. accrual basis accounting

Answer 49

accrual basis accounting

Question 50

During the year a long-term care entity provided 30,000 days of care. The operational costs were $6,390,000 and the reimbursement rate was $220 per day. What was the profit per resident day?

1. $7
2. $8
3. $9
4. $10

Answer 50

$7

Question 51

A van is purchased for your facility at a cost of $40,000. You depreciate the cost in five years at the end of which time there will be a salvage value of $5,000. Using straight-line depreciation, what will be the accumulated depreciation taken after three years?

1. $15,000
2. $17,000
3. $ 18,000
4. $21,000

Answer 51

$21,000

Question 52

The owner of a single post acute care entity notices that her expenses continue to increase. Since her profit margins are very slim, she asks the administrator to come up with a plan on how to better keep the cost of purchases down. Which of the following should not be included in the administrator’s recommendations?

1. Standardize products
2. Centralize purchasing into one department
3. Always buy the least expensive products
4. Minimize the number of people who are authorized to purchase

Answer 52

Always buy the least expensive products

Question 53

What is the major purpose of having a good risk management program?

1. To protect staff from injury or illness as required by OSHA
2. To reduce occurrences that result in legal action against the facility or damage to its reputation
3. To promote a positive public image and convince the media the facility is doing the best for its residents
4. To protect the residents from injuries and improper care

Answer 53

To reduce occurrences that result in legal action against the facility or damage to its reputation

Question 54

The first step in developing a risk management program is:

1. developing a program in each department and incorporating it into the facility program
2. identifying and enumerating the risk factors in each department
3. inviting OSHA to conduct a no-fault survey and then using their consultation to formulate a plan of action
4. verifying that you have enough insurance to over all risk factors

Answer 54

identifying and enumerating the risk factors in each department

Question 55

Your post-acute operation has the capacity to provide care to 120 participants per day. In June, the operations provided care to 3,060 clients. The operations provided care to what percentage of possible clients?

1. 85%
2. 88%
3. 90%
4. 92%

Answer 55

85%

Question 56

There are three principal values in maintaining a petty cash fund. Which of the following is not one of those values?

1. The convenience in payment of small items
2. The use as a fund from which a resident can draw money
3. The reduction of check writing, as one check is written to reimburse petty cash rather than a check for every expenditure
4. The reduction of the number of entries to small accounts that clutter accounting records

Answer 56

The reduction of the number of entries to small accounts that clutter accounting records

Question 57

Cost management may involve having an accountant complete a sensitivity analysis. What does the sensitivity analysis accomplish?

1. Provide an idea of what can be expected if prices increase over time
2. Indicates impact of a sudden increase on the facility,, as in energy costs or vegetables prices
3. Indicates what the facility’s financial status will be at the end of the fiscal year based on the current rate of spending
4. Analyze various costs and helps to plan cost controls

Answer 57

Analyze various costs and helps to plan cost controls

Question 58

The owners of a new long-term care operation are concerned that they are not realizing a profit as quickly as they had projected. This is causing a severe financial strain as the owner are being forced to use the line of credit they have with a local lender. As an administrator, there are three things you can recommend be done to lower the operation’s break-even point and help the owner realize a profit. Which one of the following should not be included?

1. Sell off excess supplies and unused equipment
2. Increase prices to private pay participants
3. Reduce fixed costs by refinancing long-term debts
4. Reduce variable costs by joining a Group Purchasing Organization

Answer 58

Sell off excess supplies and unused equipment

Question 59

As the administrator of a long-term care operation, you are negotiating terms with a new vendor. The vendor wants to see your financial ratio that will indicate the facility’s ability to pay on a timely basis. Which of the following ratios would the vendor be most interested in reviewing?

1. Current ratio
2. Acid test ratio
3. Equity ratio
4. Efficiency ratio

Answer 59

Acid test ratio

Question 60

what is the best way to ensure that your landscape adds to the attractiveness of the physical plant?

1. At least initially, employ an expert in horticulture to plan the landscaping
2. Hire a person experienced and capable in lawn care maintenance
3. Make your maintenance workers responsible for the continuous care of the grounds
4. Request that the resident family council plan and monitor the landscaping

Answer 60

At least initially, employ an expert in horticulture to plan the landscaping

Question 61

All employees, with some exceptions, are required to use the alcohol-based rubs for hand-hygiene. The strategic placement of the dispensers is important. Which of the following is not a requirement?

1. Corridors, where a dispenser is placed, must have a minimum width of six(6) feet
2. Dispensers installed directly over a carpeted area are permitted only in smoke compartments equipped with a sprinkler head
3. Dispensers must display safety data which informs the user of the chemical contents of the rubs
4. Dispensers cannot be placed within one inch above, beneath, or to the side of an electrical outlet

Answer 61

Dispensers must display safety data which informs the user of the chemical contents of the rubs

Question 62

The Americans with Disability Act Accessibility Guidelines (ADAAG) are regulations that ensure buildings are available to and usable by the physically handicapped. Which of the following is true of ADAAG regulations?

1. In long-term care settings, ten percent of all toilets must meet Americans with Disability Act requirements
2. Handicapped parking spaces must be at least eight feet wide with a five foot aisle that may be utilized for two parking spaces
3. Dining room tables must have a minimum 30-inch clearance from floor to dining room table frame
4. Spouts of a water fountain for the handicapped can be no more than 32 inches from the floor

Answer 62

Handicapped parking spaces must be at least eight feet wide with a five foot aisle that may be utilized for two parking spaces

Question 63

Which of OSHA’s programs require preparation and distribution of Safety Data Sheets (SDS)?

1. Infection control
2. Hazar communication
3. Needlestick
4. Bloodborne pathogens

Answer 63

Hazard communication

Question 64

What is the purpose of the lockout/tagout program?

1. To protect employees from hazardous energy
2. To prevent residents from tinkering with A.C and heating controls
3. To limit access to areas of the facility where an injury may occur
4. To prevent theft of linens and the personal property of residents

Answer 64

To protect employees from hazardous energy

Question 65

How should staff react to the clutter they feel a resident brings into his room or apartment?

1. Advise the resident to bring very few items as they probably will be either stolen or broken
2. Inform the resident that he must not place items in the room that will get in the way of providing services
3. Say nothing about it, since the item is of value only to the resident
4. Recognized that each item reflects a pleasant memory and that it is of value to the resident

Answer 65

Recognized that each item reflects a pleasant memory and that it is of value to the resident

Question 66

An easy way to promote a real change in the social environment is to:

1. train staff to speak and touch each client as they pass them in the hallways
2. teach every staff member to make eye contact, smile, and speak every time they meet one of their clients
3. have the administrator practice MBWA and speak to every employee daily
4. initiate a program to reward the staff member who residents feel is the friendliest

Answer 66

teach every staff member to make eye contact, smile, and speak every time they meet one of their clients

Question 67

Which of the following is not a true value of a preventive maintenance program?

1. Ensures the safe operation of systems and equipment
2. Saves money in many cases by avoiding major repair bills
3. Extends the life of the equipment and systems
4. Reduces the number of fulltime maintenance personnel

Answer 67

Reduces the number of fulltime maintenance personnel

Question 68

A person walks into a facility carrying a machete. According to Homeland Security which of the following is not recommended?

1. Hide from the person carrying the machete
2. Run from the person carrying the machete
3. Negotiate with the person to deescalate the situation
4. If necessary, fight using any weapon available

Answer 68

Negotiate with the person to deescalate the situation

Question 69

Which of the following would not be considered a recordable incident by OSHA?

1. An injury that requires drilling into a fingernail or toenail to relieve pressure
2. An injury that results in an employee missing work days
3. An injury that results in the death of an employee
4. An injury or illness that requires a diagnosis from a doctor or physician assistant

Answer 69

An injury that requires drilling into a fingernail or toenail to relieve pressure

Question 70

Leadership has many, varied meanings, but what are the basic things a leader does?

1. Assures that employees do their jobs with the least amount of friction
2. Establish goals and then initiates and monitors actions that will attain desired results
3. develops plans and motivates staff to carry them out
4. Serves as a boss who keeps employees in line and working productively

Answer 70

Establishes goals and then initiates and monitors actions that will attain desired results

Question 71

Leaders are managers. What are the two types of management that leaders frequently use to make management effective?

1. Total Quality Management and Management by walking Around
2. Management by walking Around and dictatorial
3. Total Quality Management and less supervision
4. Management by Objectives and Laissez Faure

Answer 71

Total Quality Management and Management by Walking Around

Question 72

Leaders/managers carry out five functions to a greater or lesser degree depending on where they are in the administrative hierarchy. Which of the following is not identified as a function?

1. Planning
2. Organizing
3. Staffing
4. Coordinating

Answer 72

Coordinating

Question 73

Which one of the following is considered the central function of management as it is a part of all management functions and actions in the organization?

1. Planning
2. Organizing
3. Directing/Leading
4. Staffing

Answer 73

Palnning

Question 74

When a plan is developed indicating the task to be accomplished, when, and by whom, what must a leader/manager do?

1. Determine what staff will be needed and employ them
2. Orient staff to the facility policies and procedures and train them for their individual tasks
3. Determine what activities will be needed, group them, and set up the organization’s structure
4. Initiate action that puts the plan into operation

Answer 74

Determine what activities will be needed, group them, and set up the organization’s structure

Question 75

What is the essential difference in marketing and public relations?
1. Marketing focuses on selling services to the potential user; public relations focuses on developing a good image with the entire public
2, Essentially, they are the same thing as both focus on news media and government
3. Marketing focuses on people; public relations focus on news media and government
4. Marketing must be done by a professional in mass communications; public relations is done by the entire staff

Answer 75

Marketing focuses on selling services to the potential user; public relations focuses on developing a good image with the entire public

Question 76

Your professional organization is sponsoring a bill in the legislature that will have a strong impact on the entire industry. Every administrator is asked to help get the legislation enacted. What is the most effective action you can take?

1. Appear before the legislative committee when it considers the bill
2. Contact your local legislators and ensure they understand the bill and will support it
3. Request the bill be published in your local newspaper so everyone is informed
4. Contact as many local business people as you can and try to enlist their support

Answer 76

Contact your local legislators and ensure they understand the bill and will support it

Question 77

What is the essential difference in bylaws and policies and procedures?

1. Bylaws are really no different than policies and procedures as both specify actions to be taken
2. Bylaws are rules and regulations that govern the corporation; policies govern the day-to-day operations of the organization
3. Bylaws are developed by the corporate office; policies and procedures are developed and implemented by the administrator
4. Bylaws are required by the federal government; policies and procedures are mandated by CMS

Answer 77

Bylaws are rules and regulations that govern the corporation; policies govern the day-to-day operations of the organization

Question 78

A primary value to the administrator of a good set of policies, procedures, and rules is that the administrator will:

1. spend less of her time on employee evaluations
2. not have to participate in training as her department supervisors can handle the training
3. not have supervisors bringing many problems to her
4. be in charge of the operations whether she is present or not

Answer 78

be in charge of the operations whether she is present or not

Question 79

How can you tell when authority is properly delegated?

1. Every employee fully understands procedures governing their duties
2. Instructions are given in specific terms and in a strong positive manner
3. Directions by every department head and consultant are given in a language employees understand
4. Decisions are made by the lowest, authorized person in the echelon

Answer 79

Decisions are made by the lowest, authorized person in the echelon

Question 80

You have a very strict supervisor who says, “I don’t care if my employees like me or not. I just want them to get their work done.” What leadership style is the supervisor using?

1. Democratic
2. Laissez-faire
3. Dictatorial
4. Benevolent Autocratic

Answer 80

Dictatorial

Question 81

In traditional organizations who uses line authority and who uses staff authority?

1. The administrator and Director of Nursing uses line authority; charge nurses use staff authority
2. The administrator and Director of Nursing uses line authority; consultants use staff authority
3. The attending physician uses line authority; the pharmacist and dietitian use staff authority
4. Department heads direct and control the employees in their charge therefore there is no staff authority in health care organizations

Answer 81

The administrator and Director of Nursing uses line authority; consultants use staff authority

Question 82

Why must the administrator carefully monitor the informal organizations in his long-term care facility?

1. They often become competitive and cause trouble
2. They are often clannish and have as little contact as possible with other employees
3. They have undue influence on decision-making in the facility
4. They spend too much time drinking coffee and eating together

Answer 82

They have undue influence on decision-making in the facility

Question 83

Two of your key employees do not like each other. They do not always work well together and will hardly speak to one another. How can you best resolve this conflict?

1. Call them together, let each tell his/her side of the story without interruption, then the other repeats what was said
2. Call them in and tell/sell them on the idea they must work together and cooperate while on the job
3. Call them in, tell them you don’t care how they feel about each other, but they must keep their differences out of the work place.
4. Terminate them both as no method can resolve this type of conflict

Answer 83

Call them together, let each tell his/her side of story without interruption, then the other repeats what was said

Question 84

What is considered the key to good communications in any long-term care or post-acute care setting?

1. Putting the message in the employees’ language
2. Obtaining immediate feedback on what was said
3. Recognizing that poor retention is a normal factor among employees
4. Listening, which should take up almost 40% of one’s time

Answer 84

Listening, which should take up almost 40% of one’s time

Question 85

One of your key administrative team members talks to you about a problem. She is upset and asks you to do something about her problem. How should you proceed?

1. Reassure her that the problem is not as bad as she feels it is at the moment
2. Let her know that you think she is over reacting and that she should calm down and think the problem through
3. Allow her to express her feelings, without a comment from you, and let her get it off her chest
4. Give her a solution that you feel will surely work

Answer 85

Allow her to express her feelings, without a comment from you, and let her get it off her chest

Question 86

Upward communication in health care organizations is often a problem. What do supervisors tend to do when they report to the administrator?

1. Place the blame for any mishaps on some other employee
2. Neglect to tell the boss some things he really needs to know
3. Filter out information that might adversely reflect them or someone they are trying to protect
4. Beat around the bush so long that the administrator does not really learn what is the real problem

Answer 86

Filter out information that might adversely reflect them or someone they are trying to protect

Question 87

In order to promote good relationships among all departments, which approach has proven very successful?

1. Holding regular department head meeting
2. Emphasizing that departmental goals are an integral part of the operation’s overall goals and not an entity within themselves
3. Having department heads dine together occasionally or on a regular basis
4. Allowing no charge in any department until all other departments know about the change and have time to prepare for any impact the change may have on them

Answer 87

Allowing no charge in any department until all other departments know about the change and have time to prepare for any impact the change may have on them

Question 88

A laissez-faire type of leadership that involves telling employees what they are to do and leaving them alone to do it, may work with what type of employee?

1. Technical employee such as a rehabilitation therapist
2. Professional staff such as social workers and pharmacists
3. Well trained line worked such as housekeepers and food service aides
4. None of the staff as all of them need close supervision

Answer 88

Professional staff such as social workers and pharmacits

Question 89

Which of the following is not a primary duty of an organization’s governing board?

1. Overseeing the day-to-day operations of the post-acute care facility
2. Establishing measurable goals for each of its organization entities
3. Approving the fiscal budgets for all entities within the organization
4. Establishing and approving organizational policies and procedures for each of its entities

Answer 89

Overseeing the day-to-day operations of the post-acute care facility

Question 90

Your organization has a very strict dress code policy that requires the nurse aide to wear blue scrubs and closed-toed shoes. One Saturday morning you receive a call from the third shift charge nurse who informs you that the facility has experience multiple call-offs, causing a severe staffing shortage. The charge nurse has called PRN staff as well as staff members who are not scheduled in an attempt to rectify the staffing problem. No one she has called is willing to come in to work, except for CNA Mary Jane. She says she can come in but unfortunately all her scrubs are dirty and she has no ride to get to work. What will the administrator instruct the charge nurse to do?

1. Call the various staffing agencies for their assistance, but since the dress code policy prohibits Mary Jane from coming to work, her offer must be declined
2. Reassign CNAs on the first shift so to accommodate each section of the facility as best as possible as the corporate office has a rule that prohibits agency usage and since dress code policy prohibits Mary Jane from coming to work
3. Call agencies for their assistance and to allow Mary Jane to come to work in jeans and a Polo-typed shirt, thus ignoring the corporate rule prohibiting agency usage and the dress code policy
4. Allow Mary Jane to come to work in jeans and a Polo-type shirt and to reassign the CNAs so to provide the best overall coverage for the facility as possible

Answer 90

Allow Mary Jane to come to work in jeans and a Polo-type shirt and to reassign the CNAs so to provide the best overall coverage for the facility as possible

Question 91

In which of the following management functions do many experts feel that new leaders and mangers in health care administration are least proficient in the early stages of their careers?

1. Directing
2. Planning
3. Staffing
4. Controling

Answer 91

Directing

Question 92

Which of the following is not a recommended step in correcting an employee’s work performance?

1. Correcting the error
2. Being specific and factual about the deficiency noted in his performance
3. Threatening him by telling him you will be “keeping a close eye” on him
4. Being objective and serious and not making excuses for the employee’s substandard work performance

Answer 92

Threatening him by telling you will be “keeping a close eye” on him

Question 93

The human resource department has which of the following types of authority?

1. Line authority
2. Staff authority
3. Functional authority
4. Lateral authority

Answer 93

Functional authority

Question 94

Tommy Toms is the administrator of a post-acute, long-term care organization and he believes in leadership by example. He allows considerable employee input when it comes to finalizing many of his decisions and directives. He is more of a moderator who seeks to use the knowledge as well as the skills of his employees. He strongly believes in involving his employees in problem solving. However, he understands that he must maintain the ultimate power of veto in cases where employee decisions or actions are inappropriate. Which style of leadership is Mr.Toms using?

1. Laissez-faire
2. Paternal
3. Democratic
4. Dictatorial

Answer 94

Democratic

Question 95

It was late November and employees had worked steadily, filling in for each other when needed. Work output and quality of care and services were excellent. The employees sent a committee to the administrator requesting that he ask the owners if they could have a half-day off to shop for the holidays. Employees would cover for those absent and there would be no problem meeting the needs of the clients. The administrator knew the owners felt that the six holidays employees already had were sufficient. He knew they would deny the request. How does the administrator handle this situation?

1. He takes the request to the owners and indicates that he knows they don’t like such requests but he felt he had to ask them regardless
2. He tells the staff that it is a waste of his time because the owner would never approve such request
3. He reassures the staff that he will present the request to the owners; however he files the request away and never mentions it to the owners
4. He submits the request with the explanation that the staff has worked hard and should be rewarded, and he recommends the half-day be granted

Answer 95

He submits the request with the explanation that the staff has worked hard and should be rewarded, and he recommends the half-day be granted

Question 96

The administrator of a post-acute facility is under a lot of pressure to build census. She meets with her leadership team to discuss possible public relations events that may help boost their numbers. Which of the following would be considered the most effective?

1. The marketing director sets up appointments at various physician clinics and provides lunches from a popular restaurant
2. Host an event at the facility so the general public can tour the facility and witness first-hand the quality of care and services provided
3. Purchase digital bill board advertising complete with pictures reflecting residents in the facility participating in various activities
4. Arrange for the administrator to speak to various civic and business groups so she can promote the facility and answer any questions regarding post-acute care issues

Answer 96

Host an event at the facility so the general public can tour the facility and witness first-hand the quality of care and services provided

Question 97

There are many things an incoming administrator should do in very quick order. Which of the following is something he should not do?

1. Discuss the previous administrator with the staff
2. Review the operation’s financials
3. Meet with the Medical Director
4. Review the risk management program

Answer 97

Discuss the previous administrator with the staff

Question 98

The management approach that builds employee interrelationships through team building is known as:
1/ Management by Walking Around
2. Management by Objectives
3. Total Quality Management
4. Participatory Management

Answer 98

Total Quality Management

Question 99

A new regional director of several healthcare entities incorporates a style of management where he dictates every move that the administrator makes. What is the likely the result of this micro-management style?

1. The administrator will carry out his functions in greater detail as the guidelines he must follow are very clearly dictated, leaving little room for independent judgement
2. The administrator and his entire staff will become more energized as they finally have a leader at the top to tell them exactly what, when, where and how to do their jobs
3. The operations will very quickly become more effective and efficient as the new regional manager will leave no room for inefficiencies
4. The quality of care and services will suffer because the administrator will become less motivated to succeed and his staff’s attitude will soon follow suit

Answer 99

The quality of care and services will suffer because the administrator will become less motivated to succeed and his staff’s attitude will soon follow suit

Question 100

The primary purpose of the Life Safety Code is to:

1. provide a reasonable degree of safety from fire
2. ensure the building is assessible to the physically challenged
3. prohibit employment discrimination against individuals with physical disabilities
4. require fire drills and disaster drills specific to the facility location

Answer 100

provide a reasonable degree of safety from fire

Question 101

The wage and hour division of the department of labor requires businesses keep certain employee records. Which of the following is a DOL requirement?

1. Employer must keep employee health records for 30 years after an exposure incident
2. Employer must keep employee payroll records and time records for a minimum of three years
3. Employer must keep employee payroll records for at least three years and time records for a minimum of two years
4. Employer must pay all employees at least the federal minimum wage and overtime for any hours over 40 in a one-week pay period or 80 in a two-week overtime system

Answer 101

Employer must keep employee payroll records for at least three years and time records for a minimum of two years

Question 102

Worker’s Compensation premiums are based on all of the following except the:

1. total payroll, including all full-time and part-time employees
2. claims experience rating of the organization
3. risk class of the occupations within the organization
4. facility policies and procedures contained in its Risk Management program

Answer 102

facility policies and procedures contained in its Risk Management program

Question 103

An employee is terminated from his job due to circumstances outside his control. Which of the following Acts allows him to maintain his group health insurance for up to 18 months after termination?

1. The Civil Rights Act of 1991
2. The Consolidated Omnibus Budget Reconciliation Act of 1985
3. The deficit Reduction Act of 2005
4. The National Labor Relation Act of 1935

Answer 103

The Consolidated Omnibus Budget Reconciliation Act of 1985

Question 104

Management of health care organization learns that a notional union has plans to organize its employees. The management team meets to develop a strategy on how prevent the unionization of its employees. Which of the following cannot be a part of their strategy?

1. Conduct an employee meeting and tell them the disadvantages of unions, using specific instances concerning employees who organized and were later dissatisfied
2. Discipline employees who discuss the union or handout literature while on the job, including the uses of emails for union-related solicitations
3. Tell employees if they go out on strike they can be replaced and cannot be guaranteed their job when the strike is over, providing the strike is for better wages and/or benefits
4. Conduct meetings with employees on an individual basis to get a better understanding of the union strategies, including the grievances they are using as a basis for the union campaign

Answer 104

Conduct meetings with employees on an individual basis to get a better understanding of the union strategies, including the grievances they are using as a basis for the union campaign

Question 105

Which of the following is true of a union campaign?

1. The National Labor Relations Board will conduct a certification election when 3- percent of the organization’s employees sign cards calling for an election
2. Management is permitted to give key employees additional pay and benefits as an encouragement to campaign against the Union
3. The outcome of a Union election is determined by a vote of 50 percent plus 1 of those who cast a ballot
4. Prior to calling for an election, the NLRB must certify that at least 35 percent of those employees who signed cards will be eligible to vote in the election

Answer 105

The outcome of a Union election is determined by a vote of 50 percent plus 1 of those who cast a ballot

Question 106

Human Resource specialists have determined that the number of employees a supervisor can effectively supervise depends upon several variables. Which of the following typically does not have an effect on the number of employees one can supervise?

1. The difficulty of the task the employees are undertaking
2. The position the supervisor holds in the management hierarchy
3. How clearly the organization’s policies and procedures are communicated and understood
4. The supervisor’s communication’s skill

Answer 106

The position the supervisor holds in the management hierarchy

Question 107

Nancy Stone is a nurse consultant for St. Barbara’s Health Care Organization. She provides consultation to the Director of Nursing at the various post-acute, longterm care facilities managed by St. Barbara’s. Ms. Stone is considered to have what type of authority?

1. Staff Authority
2. Line Authority
3. Functional Authority
4. Administrative Authority

Answer 107

Staff Authority

Question 108

Which of the following is true of the storage and preparation of food?

1. Potentially Hazardous Foods (PHF) must be stored at 41 degrees F or below and cooked and served at a minimum of 140 degrees F; frozen foods must be kept frozen in a solid state and cold foods served at no more than 41 degrees F
2. Potentially Hazardous Foods (PHF) must be stored at 41 degrees F or below and cooked served at minimum of 145 degrees; frozen foods must be kept frozen at a 0 degrees F and cold foods must be served cold according to community standards
3. Potentially Hazardous Foods (PHF) must be kept refrigerated at 45 degrees F or below and hot foods must be served at no less than 135 degrees F; frozen foods must be kept frozen at a 0 degrees F and cold foods served at a maximum of 50 degrees F
4. Potentially Hazardous Foods (PHF) must be kept refrigerated at 41 degrees F or below and hot foods must be served hot according to community standards; frozen foods must be kept frozen solidly and cold foods served cold according to community standards

Answer 108

Potentially Hazardous Foods (PHF) must be kept refrigerated at 41 degrees F or below and hot foods must be served hot according to community standards; frozen foods must be kept frozen solidly and cold foods served cold according to community standards

Question 109

In developing a falls prevention program, the CDC recommends all of the following except to:

1. assess a resident’s risk factors related to falls
2. review a resident’s medication regimen to assess potential risk and benefits
3. place residents who are at high risk for falling in the least constrictive physical restraint feasible
4. analysis the physical plant to ensure the safest possible environment

Answer 109

place residents who are at high risk for falling in the least constrictive physical restraint feasible