Federal Review Flashcards
What was the quarterly turnover rate at a facility that had 18 separations in the quarter, and that averaged 225 employees in the first month, 220 employees in the second month, and 215 employees in the third month of the quarter?
A. 8 percent
B. 18 percent
C. 92 percent
D. 32 percent
A. 8 percent
First add all your averaged employees for the quarter 225 + 220 + 215 = 660. Take 660 and divide it by the number of months in the quarter to determine your average for the whole quarter which equals 220. Then take your total number of turnovers (18) and divide it with you average employees for the whole quarter (220) which equals 0.08..
Then you take your decimal (0.08) and multiply by a 100 to get your percentage.
Which of the following is part of standard precautions?
A. Wearing a gown each time there is a clothing change for an incontinent resident.
B. Placing soiled linens on the floor rather than on the bed or other furniture.
C. Washing hands after touching a residents blood or urine, if gloves were worn at the time of contact.
D. Using and anti microbial soak for routine hand washing.
C. Washing hands after touching a resident blood or urine, if gloves were worn at the time of contact.
Advantages of the participatory method of budget making include all except which one of the following?
A. Input into the budget by staff members who are knowledgeable about daily operations.
B. Low consumptions of time and effort.
C. Greater awareness by department heads of the facilities resources and the needs of other departments.
D. Greater willingness by department heads to comply with the budget.
B. Low consumption of time and effort
Which of the following describes the line staff relationship between a charge nurse and a nurse consultant?
A. The charge nurse is in a staff position and the consultant is in a line position.
B. The charge nurse is in a line position and the consultant is in a staff position.
C. Both are in a line position.
D. Both are in a staff position.
B. The charge nurse is in a line position and the consultant is in a staff position.
Which of the following is part of the managers controlling function?
A. Developing rules
B. Writing job descriptions
C. Discipline staff who break rules
D. Doing a SWOT analysis
C. Disciplining staff who break rules.
If a facility must notify a residents physician about a significant change in the residents status but the residents attending physician cannot be reached, which of these steps should the facility take first?
A. Call the medical director
B. Send the resident to the hospital ER
C. Call the physician designated by the attending physician to cover for him/her in his/her absence.
D. Assign another physician to the case.
C. Call the physician designated by the attending physician to cover for him/her in his/her absence
ADA accessibility standards are aimed at making buildings used by the public accessible to which of the following?
A. persons with dementia
B. persons with disabilities
C. the elderly
D. fire department and other emergency response teams
B. persons with disabilities
Which of the following professionals is authorized to dispense medications?
A. Registered Nurse
B. licensed nurse, physician, in some states, medication aide
C. Licensed nurse and physician
D. Pharmacist
D. Pharmacist
At the beginning of a standard federal certification survey, the facility will be expected to provide the survey team with all except which one of the following?
A. incident reports
B. Copies of menus’
C. copies of each of the facility’s types of admission contracts.
D. Names of all residents receiving psychoactive medication.
A. Incident reports
Note: They are protected under QA
A list of the types and amounts of services that have been rendered would be found in which of the following?
A. clinical record
B. care plan
C. Minimum Data Set (MDS)
D. policies and procedures manual
A. clinical record
Fire drills shall be conducted how often, at a minimum?.
A. once each quarter
B. once each quarter on each shift
C. once each year on each shift
D. Once each month on each shift.
B. once each quarter on each shift
A resident has been restrained against his will by a CNA. This resident has not been given a bath today, not has he been seen by his physician for a month. How many resident rights were violated?
A. none
B. One
C. Two
D. Three
B. Two
Note - being restrained is a form of abuse and not being seen by a physician in a month is neglect. In regards to the bath per state guidelines once a week is all that is required.
A corporation’s distributions of profit to its shareholders are called?
A. Contributions
B. participations
C. dividends
D. Surpluses
C. Dividens
A facility with more than 120 beds must employ a fulltime?
A. MDS coordinator
B. medical director
C. dietician
D. social worker
D. Social worker
Spread of cancer cells from on part of the body to another is referred to as…
A. dysphagia
B. metastasis
C. myasthenia
D. necrosis
B. metastasis
Which of the following is most likely to be an expression of tardive dyskinesia?
A. fainting
B. dry mouth
C. involuntary jaw movements
D. urinary incontinence
C. Involuntary jaw movements
For a facility to have a policy of serving breakfast more that 14 hours later than breakfast the following day, which of the following must occur?
A. The resident council or some other resident group agrees to this time span
B. An order is obtained from each resident’s attending physician
c. the evening meal must meet special standards regarding portion size and nutrient content
D. residents must have the option of having their breakfast served to them either in their bedrooms or in on or more dining rooms.
A. The resident council or some other resident group agrees to this time span.
A resident’s active record must contain all resident assessments completed..
A. since admission
B. within the previous 12 months
C. within the previous 15 months
D. within the previous two quarters
C. within the previous 15 months
Which of the following is not usually a sign of depression or other mood disorder?
A. feelings of sadness
B. bodily complaints
C. loss of appetite
D. complete loss of language skill
D. Complete loss of language skill
Last year’s total food cost for a 150 bed facility were $210,109. The facility averaged 82 percent occupancy. What was this facility’s food cost per resident day?
A. $4.68
B. $3.84
C. $5.04
D. cannot be determined
A. $4.68
Total number of resident days =
150 X 365 days in a year X .82 average occupancy rate =
150 X 365 = 54,750 X .82 = 44,895
Food cost per resident day =
total food cost $210,109 / 44,895 total number of resident days = $4.68
Which class of fire extinguishers is appropriate for use on a grease fire?
A. A
B. B
C. C
D. D
B. B class fire extinguishers should only be used on grease fires
what should be the temperature range in the dry storage area?
A. 50 to 70 degrees F
B. below 45 degrees F
C. 60 to 80 degrees F
D. 72 to 82 degrees F
A. 50 to 70 degrees F
A 125 bed facility has 100 residents. What is its occupancy rate?
A. 80 percent
B. 1.25
C. 100
D. Not possible to determine with these data
A. 80%
Occupancy rate 100 residents divided by total beds 125 = 0.80.
To convert to percent multiply 0.80 by 100
Which of the following types of drugs is given to a stroke victim?
A. antihistamine
B. anticoagulant
C. antipsychotic
D. antidepressant
B. Anticoagulant
A facility has $500,000 is assets and $450,000 in liabilities. Which of the following statements is best supported by this information?
A. The facility is in financial trouble
B. The facility has $50,000 in cash on hand
C. The facility has enough revenue to cover expenses
D. Owners equity is $50,000
D. Owners equity is $50,000
According to federal regulations, how many dietary staff are required in a certified nursing facility?
A. one for every 15 residents
B. on the day shift, one for every 0 and, on the evening shift, one for every 15 residents
C. A sufficient number competent to carry out the functions of the dietary service
D. Minimum dietary staffing is not addressed in the federal regulations
C. A sufficient number competent to carry out the functions of the dietary staff.
The type of therapeutic diet often prescribed for people with hypertension is
A. low fat
B. low sodium
C, bland
D. liquid
B. low sodium
Which of the following statements is true regarding the “8 and 80” option?
A. the maximum hours that can be worked by non-exempt staff are 8 in a 24-hour period and 80 in a 14-day period.
B. Wages at overtime rate are paid for all hours worked over 8 in each 24-hour period, but only after 40 hours have been worked in a 14-day period.
C. Wages at overtime rates are paid for all hours worked in excess of 8 in a 24-hour period and 80 in a 14-day period.
D. Wages at the overtime rate are paid for any hours over 40 in a 8-day period, and for any hours over 80 in a 14-day period.
C. Wages at overtime rates are paid for all ours worked in excess of 8 in a 24-hour period and 80 n a 14-day period.
The facility employee most likely to assist a resident who is about to be discharged in contracting an outside resource agency is the
A. physical therapist
B. nurse’s aide
C. social worker
D. director of nursing
C. Social worker
Effective delegation of authority occurs when…
A. subordinates are given the responsibility to complete a task, but all authority is retained by the supervisor
B. decisions are made by the lowest person in the organization who is capable and authorized to make decisions
C. tasks are delegated to subordinates who do not as yet have the necessary competence for the tasks, so that they will learn from the experience.
D. only part of the job, rather than the whole job, is delegated to subordinates.
B. decisions are made by the lowest person in the organization who is capable and authorized to make decisions
Which one of the following is an outcome measure of the quality of care provided to residents with urinary incontinence?
A. number of staff available to provide assistance with toileting
B. appropriate use by staff of prompted voiding behavioral programs
C. proper insertion and maintenance of urinary catheters
D. number of episodes of urinary incontinence
D. number of episodes of urinary incontinence
Mr. Luchetti, enjoys talking about his adventures as a merchant seaman and hardly ever talks about the present. When he brings up those memories what should a caregiver do?
A. tell him not to dwell on the past
B. tell him how interesting it must have been in those days and ask some questions about his experience
C. change the subject by telling him about the activities schedule for later in the day
D. ignore him
B. tell him how interesting it must have been in those days and ask some questions about his experience
If someone needs to be fed by a tube that is passed through an artificial opening in the abdomen into the stomach, that person would need a ________?
A. gastrostomy
B. jejunostomy
C. nasogastric
D. endotracheal
A. gastrostome
In collective bargaining, when labor and management select a third party to decide an issue, and agree to accept that third party’s decision as final and binding on both sides, the process is called?
A. mediation
B. arbitration
C. conciliation
D. subrogation
B. arbitration
A resident incurs a serious injury that may have been caused by a defect in the wheelchair he was using. After the facility learns about this event, among the reports that it must make is which of the following?
A. immediately to the FDA
B. within 10 working days to the FDA and to the wheelchair manufacturer
C. Immediate to the wheelchair manufacturer
D. within 10 working days to the wheelchair manufacurer
D. Within 10 days to the wheelchair manufacturer
The facility must notify each resident that receives Medicaid benefits when the personal funds in the resident’s account reaches _____ the limit at which the resident may lose Medicaid eligibility.
A. less than $200
B. exactly
C. greater that $200
D. anywhere between $200 less than and $200 greater than
A. less than $200
The facility must complete a preformance evaluation of every nurse aide at least once every ______
A. month
B. quarter
C. 12 months
D. two years
C. 12 months
The facility must disclose all persons an ownership interest in the facility. This must include any person or corporation holding which one of the following?
A. any amount of direct interest
B. a direct interest of 5% or more
C. a direct or indirect interest of 5% or more
D. a direct interest of 5% or more, and a indirect interest of 10% or more
C. a direct or indirect interest of 5% or more
A resident bedroom housing two residents must have at least how many square feet of floor space?
A. 80
B. 100
C. 160
D. 200
C. 160
When may residents organize and participate in resident groups?
A. according to a schedule set by the facility and posted at least one week in advance of the meetings
B. according to a schedule jointly determined by residents and facility staff
C. if the facility is able to provide the space and privacy for meetings, and staff support
D. whenever the residents wish
D. whenever the residents wish
A common mistake made in hiring is…
A. interviewing a lot of applicants
B. having a supervisor make the choice
C. hiring the first qualified person available
D. saying too much about what the job entails
C. hiring the first qualified person available
In financial recording, every transaction is first recorded in which one of the following?
A. Journal
B. Ledger
C. Prospectus
D. book of posting entries
A. Journal
A resident who is a medicaid recipient is hospitalized and the hospital stay exceed the bed hold period under the states Medicaid plan. Which one of the following statements describes the Medicaid-certified facility’s duty in readmitting the resident, if the resident still requires services provided by the facility?
A. readmit the person immediately to the bed he/she had prior to the hospital transfer
B. The facility is under no obligation to readmit this person
C. readmit the person as soon as a bed becomes available in a semi-private room shared with another resident of the same sex
D. place the person on the facility’s waiting list, and readmit as soon as possible after all the other persons already on the waiting list have been admitted.
C. readmit the person as soon as a bed becomes available in a semi-private room shared with another resident of the same sex
The Family Medical Leave Act (FMLA) requires employers to provide protected leave to eligible employees to care for all except which one of the following relatives when they have a serious health condition?
A. son or daughter
B. spouse
C. parent
D. mother-in-law or father-in-law
D. mother-in-law or father-in-law
Which of the following is NOT an advantage of a corporation?
A. continued existence despite the death or disability of the owners
B. ease in operating in various states because it is organized and created under federal statutes
C. potential for growth by the sale of stock
D. limited liability of stackholders
B. ease in opening in various states because it is organized and created under federal statuntes
Residents complain of lack of privacy when making use of the facility’s public pay phones. Which of the following statements best describes the most immediate response that the facility can make to fulfill its responsibility in this matter.
A. arrange to provide a phone and phone service for each resident
B. allow residents to use the telephones in staff offices or at the nurses station.
C. promptly lend out a cordless phone to those who request it and provide a place where it can be used without being overheard.
D. tell the resident to use the available phone at night when corridor traffic is lor
C. promptly lend out a cordless phone to those who request it and provide a place where it can be used without being overheard.
Medicare certified facilities must use which one of the following?
A. accrual basis of accounting
B. perpetual inventory
C. centralized meal service
D. paid feeding assistance
A. accrual basis for accounting
It is considered unacceptable and a reason for a comprehensive reassessment when a resident undergoes an unplanned weight loss that exceeds..
A. 5% on one month
B. 5% on one month or 10% in 6 months
C. 5% on 3 months or 10% in 6 months
D. 10% in one month
B. 5% on one month or 10% in 6 months
The person who should most often be called upon to resolve employee problems and grievances is
A. the nursing home administrator
B. the immediate supervisor
C. a labor union representative
D. the governing body
B. the immediate supervisor
Within how many days after admission must an admission MDS be completed for a resident not being admitted for a Medicare Part A covered stay?
A. 5 days
B. 7 days
C. 14 days
D. 21 days
C. 14 days
The initial orientation of new employees would not include a review of..
A. fire and disaster procedures
B. functions of all the departments
C. sick call policy
D. medication administration procedures
D. medication administration procedures
Who orders a therapeutic diet?
A. dietician
B. attending physician
C. food service manager
D. supervisory nurse
B. attending physician
A facility has an average census of 100 in December. Total cost per resident day were $80 and average daily revenues were $100. What was the facility’s profit for the month.
A. $248,000
B. $62,000
C. $2,000
D. Not possible to determine with this information
B. $62,000
Average daily profit = average daily revenues minus cost per resident day = $100 - $80 = $20 average profit
Total number of resident days = 31 days in December X 100 residents = 3,100 resident days
Profit for December = 3,100 resident days X $20 average daily profit = $62,000 facilities monthly profit
When immediate jeopardy has been found among the remedies that may be imposed is a per-day civil money penalty falling into which of the following ranges of amounts?
A. $50 to $3,050
B. $1,000 to $10,000
C. $3,050 to $10,000
D. $1,000 to $3,000
C. $3,050 to $10,000
For federal certification survey to result in a determination of substandard quality of care one or more deficiencies must be found in any except which one of the following sections of the federal rule?
A. Resident rights
B. Quality of Life
C. Quality of Care
D. Resident Behavior and facility practices.
A. Resident Rights
A facility hires 75 of the 100 persons of the majority race who submitted application for job openings. Under the “4/5th rule” used in the enforcement of the civil rights act the employer might have to defend itself against the charge of adverse impact in its hiring decisions if fewer than how many members of the minority race were hired?
A. 45
B. 36
C. 48
D. 60
B. 36
Selection rate for minority race = 75/100 = 75%
75% X 80% = 60%
60% of 60 minority race applicants = 36
A facility might have to turn over to a court a copy of a residents clinical record in response to an order called?
A. resondeat superior
B. subpoena duces tecum
C. warranty
D. habeas corpus
B. subpoena duces tecum
A material safety data sheet (MSDS) must contain which of the following sets of information about a hazardous chemical?
A. precautions for safe handling, emergency and first aid procedures, phone number of a poison control
B. signs and symptoms of exposure, known acute and chronic health hazards, recommended brands and sources
C. odor, signs and symptoms of exposure, emergency and first aid.
D. whether gloves, eye protectors, or other protective clothing is required during use; whether the chemical is listed as a carcinogen (cancer causing agent); net weights of containers commonly available for purchase.
C. odor, signs and symptoms of exposure, emergency and first aid.
Which of the following is NOT a requirement for handicapped parking spaces?
A. at lest one accessible space per 25 spaces in the parking lot.
B. an access aisle at least 60 inches wide
C. location on the shortest accessible route of travel from the adjacent parking lot to n accessible building entrance
D. cross-hatching across the entire width of the space.
D. cross-hatching across the entire width of the space.
Advertising is usually differentiated from public relations by which one of the following?
A. promotion of a product
B. targeting to market segments
C. use of paid media
D. concern with image
C. use of paid media
When a supervisor disciplines an employee for inappropriate attire based on a dress code that is supposed to apply to all staff, the supervisor is demonstrating ___
A. consistency
B. rigidity
C. the halo effect
D. management by objectives
A. consistency
Which of the following coordinates the completion of the MDS for a new resident?
A. The Director of Nursing
B. A registered nurse
C. a registered nurse or licensed practical nurse
D. any member of the professional team designated by the Director of Nursing
B. Registered nurse
Which of the following types of therapists is especially trained to assist a resident in regaining the ability to swallow food?
A. occupational therapist
B. physical therapist
C. orthotist
D. speech-language pathologist
D. speech-language pathologist
The facility submits a request for an IDR when it wishes to ____
A. refute survey findings that have resulted in a statement of deficiencies
B. expand its number of Medicare certified beds
C. challenge the reimbursement it has received under Medicare Prospective Payment System
D. obtain a determination as to whether a Medicare beneficiary meets the “need for skilled services” criterion for a Part A covered stay
A. Refute survey findings that have resulted in a statement of deficiencies
An A & O resident tells the staff that she does not want to see a person who has come to the facility to visit her/him. What would be the most appropriate response from the staff?
A. Tell the visitor how to contact the resident’s immediate family
B. Tell the visitor that the resident is not available and to come back at a later time
C. Tell the visitor that the resident refuses to see him and has the right to refuse to see visitors
D. Arrange for the resident and visitor to meet only when a staff member is present throughout the visit.
C. Tell the visitor that the resident refuses to see him and has the right to refuse to see visitors
The facility Administrator and other staff members should attend meetings of the resident council ____
A. only when invited by the council
B. whenever they feel a need to address the council on important issues or to respond to previous recommendations made by the council
C. routinely, whenever a meeting is held
D. only when the council is being organized
A. only when invited by the council
Under the accrual basis of accounting, revenues are recorded when _________ and expenses are recorded when _________
A. cash is received – cash is paid out
B. revenues are earned – expenses are incurred
C. revenues exceed expenses – expenses exceed revenues
D. the fiscal year ends – expenses are incurred
B. revenues are earned – expenses are incurred
When milk and meat must be refrigerated they should be held at or below how many degrees Fahrenheit?
A. 50
B. 32
C, 47
D. 0
C. 47
A chemical restraint is defined as psychoactive drug that ____
A. produces adverse reactions and side effects requiring the attention of the interdisciplinary team
B. is useful in managing agitation in persons with dementia
C. may serve as an appropriate substitute for a physical restraint
D. is impermissibly used for discipline or convenience and is not required to treat medical symptoms
D. is impermissibly used for discipline or convenience and is not required to treat medical symptoms
A patient develops an infection. Which of the following should be the facility’s response in every case?
A. place the resident in isolation
B. have the staff observe universal precaution
C. report the case to the public health authorities
D. ask the resident’s physician to prescribe an antibiotic
B. have the staff observe universal precautions
When an employee in the course of carrying out the job duties commits a negligent act that results in an injury to a resident, who may the resident sue in civil court for monetary damages?
A. the employee
B. the employer
C. the employer and the employee
D. the employer, the employee, and the employer’s labor union, if any
C. the employer and the employee
How many full time employee’s (FTEs) do you have if you have two employees who work 2,080 hours per pay, and 4 employees who work 1,040 hours per pay year?
A. 2
B. 4
C. 6
D. 3
B. 4
Number of hours per year that the positions are filled =
(2080 x 2) + (1040 x 4) = 8320
Number of FTEs = 8320/2080 = 4
In addition to placing wet floor signs to ensure that no one walks on a wet floor, which of the following is part of the correct procedures for mopping a hallway?
A. close off the entire hallway, mop the entire hallway, and then open the hallway only when it is dry
B. Mop no more that one yard of the full hallway width at a time
C. Mop the entire hallway, then place a non skid runner down the entire length until the hallway is dry
D. Mop one half of the length of the hallway at a time, leaving the other half open to traffic
D. mop one half of the length of the hallway at a time leaving the other half open to traffic
The facility emergency power source must be capable of providing illumination for all the means of egress how soon after loss of regular electric power?
A. immediately
B. within five seconds
C. within ten seconds
D. within thirty seconds
C. Within 10 seconds
A competent resident who is on a “no salt added” diet request to have her meals in the dining room. What should be the facility’s response?
A. refuse to allow the resident to eat in the dining room
B. allow the resident to eat in the dining room
C. allow the resident to eat in the dining room but only at a table with other residents who are on the same diet
D. allow the resident to eat in the dining room but only at a table by herself/himself
B. allow the resident to eat in the dining room
What is the meaning of the prefix “hemi”?
A. blood related
B. half
C. kidney related
D. whole
B. half
If a facility decides to serve breakfast more than 14 hours after the substantial evening meal, who must approve this decision?
A. a resident group
B. the state survey agency
C. the attending physician of the residents affected
D. the dietician
A. a resident group
Under the straight-line method, what would be the annual depreciation expense for a piece of equipment having a cost of $6,000, a manufacturer’s warranty for 2 years, and an estimated useful life of 6 years?
A. $1,000
B. $3,000
C. $6,000
D. An amount that decreases each year over a six year period
A. $1,000
Annual depreciation expense =
acquisition cost of $6,000/6 years in estimated useful life =
$1,000
(duration of the manufacturers warranty is irrelevant)
Which of the following would be the best agency to assist the facility in developing its Fire Safety Plan?
A. OSHA
B. NFPA
C. the state survey agency
D. the local fire department
D. the local fire department
Return on equity is calculated by ___
A. dividing annual net income by owners equity
B. subtracting liabilities from assets
C. subtracting expenses from revenues
D. dividing long-term dept by owners equity
A. dividing annual net income by owners equity
A certified nurses aide had a baby. By when does she have to return to work as a CNA so that she does not lose her certification?
A. 12 months
B. 18 months
C. 24 months
D. 36 months
C. 24 months
