Mock National Exam

Question 1

A resident was admitted to a facility on November 10. The comprehensive assessment was completed on November 27th. Per OBRA 1987 the comprehensive assessment was completed

Answer 1

Late

A comprehensive assessment is due 14 days after admission or by Nov 24th. It was late

Question 2

The ___ has ultimate legal responsibility for the operation of a nursing facility

Answer 2

Governing body

The governing body has ultimate responsibility for management of the facility

Question 3

Per OBRA 1987 air temperature is measured

Answer 3

Just above the floor

Air temperature is measured just off the floor

Question 4

The ___ requires employers to give worker time off for illness or to care for a sick family member

Answer 4

Family Medical Leave Act

Question 5

The ___ hires supervises and can fire the administrator

Answer 5

Governing body

Question 6

he administrator discovers the DON has been giving nursing aides 6 months to complete their state certification requirements. The administrator should

Answer 6

Reprimand the DON

120 days they can work after completing the course before getting their license

Question 7

The rights of an individual determined by a court to be incompetent would be exerciesd by a

Answer 7

A person appointed by a court or court guardian

Question 8

The maintenance director submitted a request for a family leave to care for his ailing mother. He has worked 1350 hours in the nine months he has worked for the facility. The administrator should

Answer 8

Inform the maintenance director he must have worked 12 months to be eligible for FMLA

Employee must work both 1250 hours and 12 months to use FML; and must continue to pay for insurance premiums while employee is on leave

Question 9

Per OBRA 1987 a resident has the right to review all their records within ___ of an oral or written request (excluding weekends and holidays)

Answer 9

24 hours

Question 10

The comprehensive assessment was completed on June 1. The care plan was completed on June 6th. The care plan was completed ___

Answer 10

Timely

Care plan must be done within 7 days of comprehensive assessment or by June 8th

Question 11

The comprehensive assessment must be signed by

Answer 11

Registered Nurse

Question 12

The ___ has legal responsibility or the day to day operation of a skilled nursing home

Answer 12

Administrator

The governing board has ultimate responsibility for resident are and managing the facility. The administrator is responsible for day to day operation

Question 13

The ___ is responsible for the day to day management of the facility’s nursing program

Answer 13

DON

The DON is a registered nurse is responsible to manage the nursing staff to follow physician order to adhere to professional standards

Question 14

CMS stands for

Answer 14

Centers for Medicaid and Medicare Services

Question 15

HHS stands for

Answer 15

Health and Human Services

Question 16

The new administrator starts December 1 2007 and reviews the minutes of the Quality Assurance Committee. The committee met the second Tuesday on January 7 2007., June 21 2007, and November 15 2007. The administrator should

Answer 16

Change the meeting dates to the first Tuesday of January, April, July, October to bring the facility into compliance with OBRA 1987

The quality assurance committee must meet at least quarterly per OBRA 1987

Question 17

A resident was only given lunch that day, was given the wrong medication in the morning, had her room changed without notification and was not given a bath as requested. Per OBRA 1987 how many resident rights were violated

Answer 17

3

A bath is not a resident right.

RULE OF THUMB. If they give two examples then the answer is one right was violated. If they give you three examples then 2 rights were violated. If they give you 4 examples then 3 rights were violated

Question 18

A resident was admitted on June 1. The attending physician charted a visit and physical examination on June 27 2007, July 29, and sept 4. With respect to required physician visits per OBRA 1987 the facility

Answer 18

Was in compliance and would not be cited

With the 10 day grace period, the physician has 40 days to visit and examine resident the first 3 months and they have 70 days to visit the resident from 4th month on. The facility will be cited if the physician visits are not timely

Question 19

The ___ has legal responsibly to adopt an implement facility policies

Answer 19

Governing body

Question 20

A resident was admitted on June 1. The addending physician charted a visit and physical examination of the resident on June 27, July 29, Sept 4, and November 17 2007. Per OBRA 1987 with respect to required physician visits, the facility

Answer 20

Would be cited for a late visit in November

Physician had 70 days to visit resident. The next visit after Sept 4 was due Nov 3 and with the 10 day grace period the last day was Nov 13. The visit occurred on Nov 17

Question 21

A state surveyor learns in interviews with residents that when residents are admitted they were provided with a written list of names of physicians who cared for residents in the facility in their admission packet. The facility assigned an attending physician to each resident prior to admission from a rotating list of physicians. Per OBRA 1987 the facility

Answer 21

Was out of compliance and would be cited

Facility must inform residents both orally and in writing that they have a right choose physician and must provide them with the names, addresses, and phone numbers of attending physicians. Their personal physician can see them if they agree to

Question 22

A housekeeper notices a resident is asleep in the room she needs to clean. She knocks on the residents door, identifies herself as a housekeeper, and seeing there is no response from the resident, decides to enter the room and begins cleaning. Te housekeeper should be

Answer 22

In-serviced

Although the housekeeper knocked an announced who she was, the resident had to acknowledge her presence and giver permission to enter the room and it did not happen

Question 23

____ is not n element of a Total Quality Management TQM program

Answer 23

Centralize decision making to improve customer service

The main focus of TQM is to train front line workers to make decisions

Question 24

The ___ is responsible to prepare and serve nutritious meals under sanitary conditions

Answer 24

Dietary Department

Question 25

All furniture, equipment, boxes and supplies must be elevated ___ inches above the floor to allow the floor directly underneath to be cleaned

Answer 25

6

Question 26

____ is the most comprehensive and effective improvement model

Answer 26

Total Quality Management

Question 27

The ___ coordinates all work activities in the facility and resolves conflict between departments

Answer 27

Administration department

Question 28

HCFA stands for

Answer 28

Health Care Financing Administration

Question 29

Telephone cords must be a minimum of

Answer 29

29 inches

Question 30

To safe money the administrator of a 100 bed facility reduced the hours of the dietary service manager to 20 hours per week. The governing body should

Answer 30

Reprimand the administrator Must employ a dietary manager full time. The administrator should be reprimanded

Question 31

Adding baking soda to food will primarily | affect its

Answer 31

Nutritive value Overcooking food in boiling water, adding baking soda and poorly storing food diminishes the vitamin and mineral content of food

Question 32

The residents quality of life and physical condition is the focus of

Answer 32

Outcomes are focused o actual results and not processes

Question 33

___ is not typical of a TQM program

Answer 33

Minimal training of staff Extensive staff training so residents do need to wait for the NHA to come in for a bed pan

Question 34

A resident recently lost her husband and is tearful and depressed and is worried how she will pay for her stay. The administrator would ask the ___ to help her

Answer 34

Social Services director Social services provides emotional support and interventions for psychosocial and financial problems

Question 35

Electrical switches must be located at a minimum of ___ inches above the floor

Answer 35

15

Question 36

Stooped posture, shuffling gait, garbled speech and tremors are symptoms of

Answer 36

Parkinsons Disease

Question 37

Nursing homes must have hearing aid compatible phones with volume between a minimum of ___ and a maximum of ___ decibels above normal

Answer 37

12,18 Any public telephones or other phones available to residents shoudl be hearing aid compatible with volume controls

Question 38

Grab bars and railings must support a minimum weight of ___ pounds

Answer 38

250

Question 39

The emergency generator must be visually inspected and checked

Answer 39

Weekly

Question 40

Federal resident care standards are now ___ and ___ and are not longer considered minimal standards

Answer 40

State of art, maximal

Question 41

The largest payor source for long term care is

Answer 41

Medicaid

Question 42

The average short term stay for a Medicare resident is

Answer 42

30 days, they leave after 21-20 days when their $124 a day copay kicks in or $3000 a month

Question 43

ANSI stands for

Answer 43

American National Standards Institute

Question 44

Non compliance affecting a limited number of residents and locations would be assigned a scope of

Answer 44

Isolated

Question 45

TQM is not characterized by

Answer 45

Minimal involvement of upper management TQM involves engagement by upper management

Question 46

Administrators consult ___ to compare outcomes to expectatons

Answer 46

Policies and plans of actions

Question 47

A resident with Parkinsons would not benefit by

Answer 47

Bed rest Parkinsons involves muscle rigidity and cognitive impairment resident benefit by exercise programs and reality orientation and memory exercised

Question 48

The states cannot ___ to compel facilities to correct class 1 deficiencies found during inspections

Answer 48

Impose civil or criminal penalties

Question 49

A___ violation is where the severity of negative outcomes that compromises a resident's ability to maintain the highest physical, mental and psychosocial well being

Answer 49

Level 3

Question 50

Parking spaces must be at least ___ wide with an accessible handicap aisle at least ___ wide

Answer 50

96" 60"

Question 51

A broad statement of goals is a ___

Answer 51

Policy

Question 52

Long term residents should be surveyed regarding satisfaction with services

Answer 52

Annually

Question 53

Which is not true of the Joint Commission on Accreditation of Healthcare Organizations JCAHO

Answer 53

JCAHO can impose civil fines

Question 54

Communication occurs when

Answer 54

A message is transmitted by one person and received an decoded and understood by the other person

Question 55

NFPA stands for

Answer 55

National Fire Protection Association

Question 56

The emergency generator must run under full load for ___ every___

Answer 56

30 minutes, month

Question 57

The fire alarm can be silenced during a fire drill conducted between the hours of

Answer 57

10pm and 6am

Question 58

The ___ is responsible to assemble and analyze incident reports, infection rates, safety issues, medication errors and restraint use

Answer 58

Quality assurance committee

Question 59

___ publishes and promotes fire safety in nursing homes

Answer 59

NFPA

Question 60

Listening intently, acceptance, empathy and understanding the message descries

Answer 60

Active listening

Question 61

Patients and family look for ___ when selecting a nursing home

Answer 61

Variety and quality of food

Question 62

The Americans with Disabilities act construction standards are enforced by

Answer 62

Architecture and Transportation Barriers Compliance Board

Question 63

The Americans with Disabilities Act construction standards were developed by

Answer 63

ANSI ANSI is a private organization that researches and publishes the ADA

Question 64

A mechanism to monitor consumer satisfaction and address other concerns is called the

Answer 64

Strucure

Question 65

The nursing home survey/inspection process focuses on

Answer 65

Outcomes

Question 66

All nursing facilities must be licensed by the

Answer 66

State

Question 67

Facilities that are licensed by the state and certified to receive Medicare and Medicaid reimbursement must submit to

Answer 67

State and federal inspection

Question 68

When the administrator writes a letter to the local state survey office to challenge the findings and citations issued during a survey the administrator is using the

Answer 68

Informal dispute resolution process

Question 69

Per OBRA 1987 a nursing home must maintain the highest ___ for residents

Answer 69

Physical, mental, and psychosocial well being

Question 70

When a facility requests a hearing before an administrative law judge to challenge the findings made during a state survey, the facility is using the

Answer 70

Formal dispute resolution process

Question 71

Federal inspection of resident care in nursing facilities is overseen by

Answer 71

CMS

Question 72

Quality Indicator QI reports for nursing homes available through the CMS would not include which of the following

Answer 72

Nursing home watch list

Question 73

Prior to entering a facility a state survey team would not review the

Answer 73

Resident council minutes

Question 74

The ___ is responsible to identify and address safety hazards that can injure residents and staff and is required by OSHA

Answer 74

Safety committee

Question 75

The federal nursing home certification survey program has a total of ___ different survey types

Answer 75

Off site preparation

Question 76

The phase of the state survey where the survey team gathers information from. OSCAR the ombudsman and other sources prior to entering a facility is called

Answer 76

Off site preparation The online Survey and Certification Reports contains all MDS data is setup by the CMS

Question 77

The phase of the state survey where the survey team analyzes and compares observations and findings and determines if any violations were found and their severity is called

Answer 77

Information analytics

Question 78

Nursing homes must be inspected every

Answer 78

15 months

Question 79

An electronic medium that allows instantaneous communication internally and externally to thousands of people through a computer server is called

Answer 79

Email

Question 80

A finding of 'substandard care' requires the survey team to have evidence of

Answer 80

Immediate jeopardy to resident care that has or likely to cause serious injury or death

Question 81

A ___ tag would indicate substandard care was found

Answer 81

F377 J A tag of G or above is indicative of substandard care

Question 82

The phase of the sate survey where they survey team sits down with the administrator ,the DON and department heads to discuss the finding of the survey team is called

Answer 82

Exit conference

Question 83

When services in a facility are not consistent from day to day and from sift to shift this is called

Answer 83

Inconsistency rule

Question 84

Communication between staff of equal rank or status is called

Answer 84

Horizontal comunication

Question 85

When consumers perceive a facility renders poor care because of the performance of one employee, this is called

Answer 85

Inseparability rule

Question 86

Upon completion of a survey, the surbey team sends the administrator which of the following if the facility was substantially in compliance, has only insoated or minor problems which caused no actual harm, and no plan of correction is required

Answer 86

Notice of isolated deficiencies

Question 87

The administrator has ___ days to prepare a plan of correction for all deficiencies cited in the survey

Answer 87

10 days You only have 30 days from the time the survey team exits to achieve full compliance- your date certain for resurvey is 30 days, they have 10 days to submit the 2567 to you and you have 10 days to the plan of correction

Question 88

Communication from subordinates directed to upper management is called

Answer 88

Upward communication

Question 89

A violation or deficiency with the potential for no more than minor negative impact on a resident is a ___ deficiency

Answer 89

Level one

Question 90

____ has/have the least impact on influencing a resident or their family in choosing a facility

Answer 90

Media ads

Question 91

Short term residents should be surveyed ___ about satisfaction with services

Answer 91

Within 30 days from discharge

Question 92

A technology that connects cell phones, hand held devices and keyboards to a computer by high speed cable is called

Answer 92

Fire wire

Question 93

Implementation of a TQM program takes between

Answer 93

5-10 year

Question 94

The key consideration in determining the minimum level of staffing in a nursing facility is

Answer 94

Patient acuity levels

Question 95

Managing risks of negative outcomes is called

Answer 95

Risk management

Question 96

The key to a successful TQM program is

Answer 96

Training

Question 97

An organizational chart shows the reporting relationship between staff. A solid line on the chart denotes

Answer 97

Line authority

Question 98

A parking lot with 100 parking spaces would require ___ handicap accessible parking spots

Answer 98

4 1 handicap spot per 100 spots

Question 99

The most effective marking tool for a nursing home ot attract new residents is/are

Answer 99

A tour of the facility

Question 100

A violation with no more than minimal physical, mental or psychological discomfort is a ___ deficiency

Answer 100

Level 2 A level 1 would be no more than minor impact a level 2 involves actually discomfort

Question 101

Believing something that is not based in reality is caled

Answer 101

Delusion

Question 102

Communication directed from upper management to lower level managers and staff is called

Answer 102

Downward communication

Question 103

Non compliance affecting more than a limited number of residents and locations would be assigned a scope of ___

Answer 103

Patterned

Question 104

___ can provide nursing aide services and be included in calculated minimum staffing hours

Answer 104

A licensed practical nurse employed by the facility

Question 105

Managing risks of negative outcomes is called

Answer 105

Risk management

Question 106

The nosing on a stair. must project no more than

Answer 106

1 1/2

Question 107

Smoke detectors must be located no further than ___ feet apart and no more than ___ feet from any wall

Answer 107

30, 15

Question 108

Minimum wheelchair passing width for two wheelchairs is ___ inches

Answer 108

60"

Question 109

Minimum clear width for a single wheelchair is ___" continuously and ___" at any one point

Answer 109

36", 32"

Question 110

There must be a passing space in an accessible route for wheelchairs every ___ feet

Answer 110

200

Question 111

A passenger loading zone must be at least ___" wide and ___" long

Answer 111

60"wide and 20" long

Question 112

The force required to open all doors, flush a toilet, operate faucet handles, and operate a water fountain cannot exceed ___ lbs of pressure

Answer 112

5

Question 113

Minimum wheelchair turning space is ___ inches

Answer 113

60"

Question 114

The high forward reach from a wheelchair is

Answer 114

48"

Question 115

The side reach from a wheelchair is between ___" and ___" off the floor

Answer 115

9"-54"

Question 116

A change in level surface over 1/2 inch

Answer 116

Requires ramp treatment

Question 117

A change between 1/4 and 1/2 inch in level surface

Answer 117

Requires a beveled edge

Question 118

A fire extinguisher is checked ___ and serviced ___

Answer 118

Quarterly, annualy

Question 119

Each level or story of a building that houses patient sleeping and treatment areas must be divided into ___ smoke compartments

Answer 119

2

Question 120

Vision panels are ___ in swinging doors

Answer 120

Required

Question 121

The maximum window sill height for a window in a resident's room is ___ inches above the floor

Answer 121

36"

Question 122

Doors must be ___' thick, solid bodied ___ core, or with ___ minutes of resistance fire rating

Answer 122

1 3/4, wood, 20 minutes

Question 123

The facility quality assessment and assurance committee. must meet at least

Answer 123

Quarterly

Question 124

The QA&A Committee does not need to include

Answer 124

The administrator

Question 125

Communicating though memos, meetings and follows lines of the organization chart is an example of ___

Answer 125

Formal communication

Question 126

Staff hatting informally in the break room is an example of ___

Answer 126

Informal communication

Question 127

ADA guidelines and standards are developed and approved by

Answer 127

ANSI

Question 128

Railings and grab bars must bear the weight of ___ lbs or more

Answer 128

250 lbs

Question 129

The maximum audible alarm decibel level is ___

Answer 129

120

Question 130

A nursing home must have a/n ___ operated fire alarm system that is ___ monitored

Answer 130

Manually, electronically The fire alarm is manually operated because you need to 'pull' the alarm

Question 131

Activating or puling a fire alarm automatically activates all of the following except

Answer 131

Emergency generator

Question 132

Phones must be fitted with a cord no shorter than ___ inches

Answer 132

29"

Question 133

Landlings are required at teh bottom and top of each stairway run and must have a minimum area of

Answer 133

60 square inches

Question 134

Doors must have a clear width of ___" at openings and must be at a ___ " angle to an accessible route

Answer 134

32", 90degree

Question 135

The automatic smoke and fire detection systems must be connected to each other

Answer 135

Electronically

Question 136

The ___ specifies the number of directors, number of shares to be issued, and governs how the corporation is to be run

Answer 136

Bylaws

Question 137

A review of care provided patients for appropriateness and cost effectiveness is called

Answer 137

Utilization review

Question 138

A permit required before a nursing facility can begin construction is called a

Answer 138

Certificate of need

Question 139

A violation with a severity requiring immediate action due to risk of injury, harm, impairment, or death to a resident is a

Answer 139

Level 4

Question 140

The states and the CMS cannot impose

Answer 140

Civil and criminal penalties

Question 141

A leader who makes decisions based on staff consensus is using the

Answer 141

Democratic style

Question 142

A leader who delegates decision making to subordinates while setting larger objectives is using the

Answer 142

Laizze faire style

Question 143

An effective leader would not

Answer 143

Have one set response for every situation A manager must adapt their style and response to different situations

Question 144

The fastes growing sector of the health care industry is

Answer 144

Home health care

Question 145

The current trend is to move individuals from institutional care to ___ which is less expensive

Answer 145

Home health care

Question 146

Management by Walking Around does not involve

Answer 146

Taking action on the spot

Question 147

An employee who has decision making authority with the same force and effect as if made by the administrator has

Answer 147

Line authority

Question 148

Upper managers do not

Answer 148

Usually write procedures

Question 149

Middle managers do not

Answer 149

Adopt policies

Question 150

Nursing aides are required to have a minimum of ___ hours of inservice trining per year under OBRA 1987

Answer 150

12 hours

Question 151

The ___ ultimately determines if a nurse aide is competent

Answer 151

State surveyors

Question 152

A charge nurse is __

Answer 152

Lower management

Question 153

A nurse aide enrolled in a state approved training program but has not completed the program at time of hire, has ___ to complete the program

Answer 153

4 months

Question 154

A nurse aide must be complete 16 hours of initial training in all of the following except

Answer 154

How to apply physical restraints

Question 155

A nurse aide must complete initial 16 hours of training in all of the following except

Answer 155

How to administer medication

Question 156

An intentional act or threat causing fear in another with reasonable expectation of harm is called a/an

Answer 156

Assault

Question 157

The ___ is the foundation that guides an organization

Answer 157

Philosophy

Question 158

The ___ communicates the purpose of the organization

Answer 158

Mission statement

Question 159

The ___ specifies the composition of the governing body, functions, timing of corporate meetings and the purpose of a corporation

Answer 159

Bylaws

Question 160

The ___ establishes the strategic plan

Answer 160

Governing body

Question 161

The overall style of governing how people relate to each other and that binds an organization is called

Answer 161

Corporate culture

Question 162

Authority granted to the governing body by state law is called

Answer 162

Express authority

Question 163

The ___ has ultimate responsibility for management and quality of care in a facility

Answer 163

Governing body

Question 164

The governing body of a facility is generally ___ for acts of employees

Answer 164

Not personally liable

Question 165

The mission statement and facility policies are created and implemented by the ___

Answer 165

Governing body