Iowa Nab Exam Part 1

Question 1

Significant Weight Loss Percentages

Answer 1

1 Month: 5% 3 Month: 7.5% 6 Month: 10%

Question 2

Risk Factors for Residents to become Dehydrated

Answer 2

1. Coma/Decreased Sensorism
2. Fluid loss due to diarrhea/fever
3. Fluid restriction secondary to renal dialysis
4. Dementia resident forgets to drink
5. Refusal of fluids

Question 3

Risk factors for decreased R.O.M

Answer 3

1. Immbolization (bedfast)
2. Deformities arising out of neuro deficits (stroke, MS, CP, polio)
3. pains, spasms, and immobility assoc. with arthritis or late stages Alzheimer’s disease

Question 4

3 Stages of Alzheimer’s Disease (the most common form of dementia is persons 60+/intellectual impairment that is irreversible/also known as primary degenerative dementia/aging is the greatest risk factor).

Answer 4

1st Stage: Forgetfulness or early stages
2nd Stage: Confusion or mild stage
3rd Stage: Dementia or terminal stage

Question 5

Three major causes of senile dementia

Answer 5

60% Alzheimer Type
25% Infraction of brain tissue due to cerebrovascula disease
15% to other diseases: Paresis, Huntingtons, Picks Disease, Parkinson’s

Question 6

Arteriosclerosis

Answer 6

Disease that may lead to dementia in the elderly, may also be referred to as a multi infarct dementia

Question 7

Aphasia

Answer 7

Inability to interpret and formulate language

Question 8

Excessive Aphasia

Answer 8

inability to express in words what the individual really wants to communiate

Question 9

Contractures

Answer 9

a deformity that results when the muscle has shortened and pulls the adjacent joint into a flexed position. Foot, hips, legs, hand and wrist areas effected. Best form of treatment: exercise the joints of those who are unable to do so for themselves (passive range of motion)

Question 10

Drug Error

Answer 10

60 minutes earlier or later than scheduled but only if that wrong time error can causde the resident discomfort or jeopardize the residents health and safety. 5% or higher error rate on survey to be cited.

Question 11

Lower Tract UTI

Answer 11

Infection of the uretha or bladder

Question 12

Upper Tract UTI

Answer 12

Infection of the Ureter or kidney

Question 13

Urosepsis

Answer 13

systematic inflammatory response to infection that originates from a urinary tract source may present with symptoms such as fever, hypotension, reduces urine output or acute change in mental status.

Question 14

Two most common causes of organic brain syndrome

Answer 14

Alzheimer’s and Cerebrovacular insufficiency or reduced blood flow to the brain

Question 15

Registered Nurse

Answer 15

8 Consecutive hours per day/ 7 days per week

Question 16

Director of Nursing

Answer 16

may serve as charge nurse for a building that has an average census of 60 or less

Question 17

Physician

Answer 17

Doesn’t need to review the total plan of care each visit but must review the plan at least once every 30 days for the first 90 days and at least once every 60 days there after. There is a 10 day grace period. Each visit review residents total program of care including medications and treatments and also write, sign and date progress notes for each visit. Sign and date all orders.

Question 18

Five Essential ADL’s

Answer 18

Eating, Dressing, Toileting, Bathing, Transferring

Question 19

Comp. Assess

Answer 19

Dietary, drugs and routine care to maintain or improve residents functional abilities until a comp assess and care plan are written. Discharge potential=within 3 months-must conduct assessment within 14 days of admission then at least quarterly.

Question 20

Significant Changes (2 or more)

Answer 20

Decline on ADL’s, Increase in # of area’s for behavioral symptoms, decision making changes, incontinence pattern changes or placing an indwelling cath, sad or anxious mood, unplanned weightloss, use of trunk restraint, disease/condition in which resident is judged to be unstable, stage 2 pressure ulcer.

Maintain 15 months of assessment data in the active records and MDS.

Question 21

Care Plans

Answer 21

Needs to have measureable objectives and timetables to meet a residents medical, nursing, mental health and psychosocial needs that are identified in the assessment. The plan should describe services that will be provided to attain or maintain the residents highest practicable, physical, mental and psychosocial well being. SHOULD BE DEVELOPED WITHIN 7 DAYS AFTER THE COMPLETION OF THE ASSESSMENT and be prepared by the IDT which includes attending DOC, RN with responsibility of the resident and other appropriate disciplines and can also include resident family and legal representative.

Question 22

Discharge Summary

Answer 22

Recapitulation of stay and final summary of residents status. (MDS orginiated thru OBRA of 1987)

Question 23

Facility must post daily:

Answer 23

Facility name, date, total number and actual hours worked by all nurses and aides, census. (Keep records for 18 months)

Question 24

Qualified Dietician

Answer 24

8 Hours/Month at minimum.

Question 25

Must meet NFPA 2000 Life Safety Code

Answer 25

Emergency power supplies lights for entrance and exits, equipment to maintain the fire protection system and life support systems.

Question 26

Transfer Agreements

Answer 26

Have one with 1 or more hospitals. Can utilize other SNF’s/Sister facilities

Question 27

Type of actions drugs will produce

Answer 27

1. Block of nerve impulses
2. Stimulating nerve impulses
3. Working directly on living cells
4. working to replace body deficiencies
5. Any combo of the above

Question 28

5 Rights to Medication Adminstration

Answer 28

1. Right Med
2. Right Dose
3. Right Time
4. Right Route
5. Right Patient

Question 29

Diuretics

Answer 29

Work by forcing the body to excrete excess fluids

Question 30

Digoxin

Answer 30

Slows the heart rate. Side effect: loss of appetite, nausea, confusion

Question 31

Schedule II

Answer 31

Separately locked permanently affixed compartments

Question 32

Arteriosclerosis

Answer 32

Blood vessels are not as responsive as they previously were.
1. Aortic stenosis narrowing of the aorta which results in CHF symptoms, difficulty in breathing, dizzy, hypertension, chest pain

Question 33

Atheriosclerosis

Answer 33

Progressive build up of fat deposits

Question 34

Signs of Parkinsons

Answer 34

Tremors, rigidity or muscle stiffness, stooped posture while standing, walking with short shuffling steps, garbled speech, facial droop

Question 35

Dementia

Answer 35

Drugs used: Halperidol, Resperidone, Olanzapine
Denoting cognitive loss
Behaviors: forgetfulness, deterioration in personality and a decrease in intellectual function

Question 36

Alzheimer Stages

Answer 36

1. Memory loss, time disorientated, anxiety, irritability, agitation, inability to concentrate
2. Excessive hunger, aphasia, temper tantrums, restlessness, muscle twitching, aimless wandering, inability to read
3. Usually the shortest stage, unable to perform purposeful movement, poor appetite, poor articulation, incontinence, seizure

Question 37

Arthritis

Answer 37

Inflammation of a joint

1. Osteoarthritis or degenerative joint disease usually in knee, hips, and ankles
2. Rheumatoid arthritis (serious form)

Question 38

Income Statement

Answer 38

Profit and loss, summarizes operating performance over a period of time

Question 39

Balance Sheet

Answer 39

Records the financial position of the facility at one point in time

Assets=Liabilities and Capital

Current Assets are assets that can be turned into cash in 12 Months

Question 40

Statement of Changes

Answer 40

Shows the major transactions over the period covered by 2 balance sheets. It shows how working capital changed

Question 41

Sources of Funds

Answer 41

An excess of revenue over expenses of operations, interest income and contributions to the facility or owners equity

Question 42

Chart of Accounts

Answer 42

List of every account in the facility including assets, liabilities, capital, revenues, expenses, fund accounts

Question 43

Handrails

Answer 43

Not less than 34’’ nor more than 38” above the surface of the tread

Question 44

Stairwell

Answer 44

2 HR Fire resistance and a door with a 1 1/2 hr fire protection rating.
150 ft max distance between corridor and exit/ 50 ft from room to exit

Question 45

Smoke Detectors

Answer 45

No further than 30 feet and not more than 15 feet from any wall

Question 46

Corridor Door

Answer 46

1 3/4 thick and 20 minute fire rating

Question 47

Journals

Answer 47

First place transactions are recorded as a debit and credit called T-Accounts

Journals—>General Ledger—>Trial Balance

Question 48

GAAP Requires 4 Reports

Answer 48

1. Income Statement
2. Balance Sheet
3. Statement of changes in financial position
4. Note to fin st.

Question 49

Closing the books

Answer 49

Bringing expenses and revenue accounts to 0