Mock National Exam 12

Question 1

Normal psychological aging in the elderly would not include

• slowed memory retrieval
• difficulty handling change
• loss of memory
• depression

Answer 1

Loss of memory

Question 2

Normal aging in the elderly would not include

• loss of skin elasticity
• glaucoma and cataracts
• depressed immune system
• dementia

Answer 2

Dementia

Question 3

With respect to restraints the CMS wants nursing facilities to ultimately

Answer 3

be restraint free

Question 4

What is a nursing home initially required to do when an incontinence resident is admitted or develops incontinence after admission

Answer 4

Assess the resident to see if they are appropriate for an incontinence training program

Question 5

Which of the following would most likely go unnoticed by staff

• incontinence
• irritable bowel syndrome
• depression
• slight strokes

Answer 5

slight strokes

Question 6

What is a facility’s primary responsibility for a resident with hearing and vision problems

Answer 6

ensure residents receive proper treatment and assistive devices

Question 7

which is more effective for residents with depression

• spending 2 weeks in a psychiatric program in a hospital
• medications, family involvement and staff attention
• counseling, activities and medications
• treatment in a local mental health center

Answer 7

-counseling, activities and medications

Question 8

Which of the following has not proven to be effective for residents with Dementia

• remotivation
• reality orientation
• validation therapy
• sensitivity training

Answer 8

Sensitivity training

Question 9

Most effective way to plan for a resident who has a tendency is to wander is

• identify the potential to wander through an immediate assessment
• determine at or before admission if an individual has the tendency or potential to wander
• plan a program that all residents must adhere to if they tend to wander
• place all wanderers into some type of restraint

Answer 9

determine at or before admission if an individual has the tendency or potential to wander

Question 10

If a resident complains they have trouble sleeping because of cold or odd feelings in their legs, this is most likely caused by

Answer 10

A neurological disorder called restless leg syndrome

Question 11

A resident admitted for a fractured leg with no history of cognitive problems would not need which of the following

• a physicians order for therapy
• a chest x ray
• a level 2 preadmission screening
• verification of hospital admission and discharge dates

Answer 11

A level 2 permission screening

Question 12

A Medicaid resident must have an assessment how often

Answer 12

days 5, 14, 30, 60

upon any significant change

Question 13

An advantage of a PEG tube over nasogastric tube is

Answer 13

PEG tubes are better tolerated

Question 14

A long term resident is readmitted to the facility after treatment for a hip fracture. She will need physical therapy. The RN must document care assessments according to which schedule

Answer 14

days 5,14,30,60

Question 15

Once an MDS is completed which of the following statements is correct

• The MDS is electronically sent to the Medicaid Agency, Medicare is sent to the CMS and the completed forms are kept in resident chart for 15 months
• Both Medicaid and Medicare forms are sent to the CMS and the completed forms are kept in resident chart for 15 months
• Both the Medicaid and Medicare forms are sent to the State Medicaid Office and the completed forms are kept in resident chart for 15 months
• Both Medicaid and Medicare forms are filed in the resident records and only sent to the state upon request

Answer 15

-The MDS is electronically sent to the Medicaid Agency, Medicare is sent to the CMS and the completed forms are kept in resident chart for 15 months

Question 16

HIPPA requires resident records be maintained per the following requirements except for

• they be complete
• they be readily accessible
• they be systematically organized
• they be maintained by a MRA

Answer 16

They be maintained by a MRA

Question 17

If a resident requests a copy of their records on Friday, the facility must comply with the request by

Answer 17

Tuesday

Question 18

Who is responsible for implementation of resident care policies

Answer 18

The medical director

Question 19

Which activity would be most effective for Alzheimer residents

• morning walks
• bingo
• an activity involving music
• physical exercise

Answer 19

An activity involving music

Question 20

which of the following is not an OBRA requirement

• The pharmacy must label medications with an appropriate cautionary statement
• the pharmacy must label medications with the name of the resident and the prescribing physician
• Labels must identify the expiration date
• The name and strength of the medication must be listed

Answer 20

The pharmacy must label medications with an appropriate cautionary statement

Question 21

An antipsychotic drug may be prescribed when a resident is

• wandering
• delusional
• experiencing anxiety
• restless

Answer 21

-delusional

Question 22

If families want to form a family council the administrator is not required to do which of the following

• provide space and needed materials
• provide a resource person for the group
• implement recommendations when possible
• periodically attend the meetings

Answer 22

Periodically attend the meetings

Question 23

Which is most effective to prevent pressure sores

• egg crate overlay
• massage pressure points on residents body
• bandage all pressure points to prevent a pressure sore
• provide a pressure relieving mattress

Answer 23

Provide a pressure relieving mattress

Question 24

Which committee is responsible to identify any issue that affects quality of care

• infection control committee
• quality assurance committee
• risk management committee
• safety committee

Answer 24

quality assurance committee

Question 25

What is the first thing a nurse should do if a resident refuses to take his medication

• call the physician
• document refusal
• explain the consequences to the resident
• contact the family for help

Answer 25

Explain the consequences to the resident

Question 26

Which type of change in resident condition would not require the facility to notify the family

-resident appears to have a chill
-a injury with potential for physician intervention
-A slight bruise on the leg
Any type of injury that may occur

Answer 26

Resident appears to have a chill

Question 27

A resident wants to volunteer to work for the facility to performa. specific task. What must the facility do

Answer 27

If he does work for the facility make sure it is noted in his plan of care

Question 28

True or False

A facility can discharge a resident without advanced written notice if they have not resided in the facility for the prior 30 days

Answer 28

True

Question 29

The Patient Self Determination Act requires the facility to

Answer 29

Recognize a residents living will or power of attorney as their advance directive

Question 30

Which is considered the first priority isn an employee training program

• resident care policies and procedures
• fire prevention and control
• resident rights
• prevention and control of affections

Answer 30

Fire prevention and control

Question 31

What is the key to a good employee pay scale

Answer 31

Starting with a fair wage standard fo the community

Question 32

What is the primary purpose of developing policies procedures and rules

Answer 32

Explain to employees what is expected of them and what they can expect from the facility

Question 33

Does FMLA provide leave for a sick brother or sister

Answer 33

No

Question 34

Why does the OIG recommend facilities have a corporate compliance program

Answer 34

Corporations can now be held liable for criminal acts of employees

Question 35

Why is face to face communication considered the most effective form of communication

Answer 35

Can more readily obtain feedback to determine level of understanding

Question 36

What is the difference between the states role in medicare and medicaid

Answer 36

The state licenses and certifies and monitors medicaid facilities

Question 37

Which of the following must surveyors invite to the facility exit interview

• medical director and ombudsman
• medical director and key staff members
• resident council representative and ombudsman
• interested family members and DON

Answer 37

resident council representative and ombudsman

Question 38

Which of the following are basic things a leader does

• get employees to do what they are paid to do
• set goals and then initiate and monitor actions that attain desired results
• develop plans and motivate staff to carry them out
• serve as a boss who keeps employees in lien and are productive

Answer 38

set goals and then initiate and monitor actions that attain desired results

Question 39

Which of the following are two types of management methods that effective managers use

Answer 39

TQM and MBWA

Question 40

Which of the following is not one of the 5 key functions of management

• planning
• organizing
• directing/leading
• staffing

Answer 40

Staffing

Question 41

As soon as plans are developed explaining what needs to be done and how the task will be accomplished and when and by whom what must a leader do

Answer 41

Determine what activities will be needed, group them and set up the organizations structures

Question 42

In order to promote good relationships among all departments which approach has proven most successful

• hold regular department head meetings
• make departmental goals an integral part of the facility goals
• have department heads dine together on a regular basis
• allow no changes in any one department until all other departments have time to prepare for any impact on them

Answer 42

-allow no changes in any one department until all other departments have time to prepare for any impact on them

Question 43

What is the primary duty of the governing body

Answer 43

Develop guidelines for management and operations

Question 44

An individual who leases a nursing home to a management company needs a large amount of money to meet their retirement goals. Consequently the individual decides to double the lease payments which are much higher than lease payments in the area. Which law has been violated

Answer 44

Safe harbor regulations

Question 45

Upward of communication has some drawbacks that an administrator must be aware concerning employees that report to them. What do supervisors tend to do most often

Answer 45

Filter out information that may reflect badly on themselves or someone else they may be protecting

Question 46

Which of the following would be considered immediate jeopardy

• stage 2 sore on heel
• staff not identifying themselves before entering a resident room
• an inoperative nurse call system
• dietary staff not wearing a hairnet

Answer 46

An inoperative nurse call system

Question 47

What is considered communication in a nursing home

• putting the message in a language the resident understands
• obtaining immediate feedback on what was said
• recognizing that employees normally have poor retention
• listening which should be 40% of ones time

Answer 47

-putting the message in a language the resident understands

Question 48

Under Medicare’s consolidated billing, which of the following services to residents may a facility not bill for

• PT
• non emergency medical transportation
• durable medical equipment
• physician visits to ehe resident

Answer 48

physician visits to the resident

the physician must bill medicare separately

Question 49

When building a new nursing home, doors must be a minimum width of ___ inches wide

Answer 49

44

Question 50

What is the main purpose of a risk management program

Answer 50

To reduce occurrences that result in legal action against the facility

Question 51

Which agency promulgates the widest range of standards for nursing homes

Answer 51

CMS

Question 52

Which form is used to bill for Medicare services

Answer 52

UB04