Mock National Exam 16 Flashcards
When an asset can be quickly converted to cash without appreciable loss, it is said to be
Liquid
The minimum staffing level required by CMS is
2.0 PPD
2.5PPD
3.0PPD
Determined by the individual states
2.5 PPD
Under which circumstance may the DON serve as charge nurse
- The average census is less than 60
- A waiver has been obtained from the state health department
- No other licensed nurses are willing to serve as charge nurse
- The DON may never serve as charge nurse
-The average census is less than 60
Which of the following is NOT an indicator of inadequate nurse staffing
- Staff responding slowly to resident requests for help
- residents cannot locate staff quickly
- Nurse staffing information is not posted as required
- Residents have to make repetitive calls for help
-Nurse staffing information is not posted as required
The most important aspect of resident care is
-staff attitudes towards residents
-prevention and treatment of pressure ulcers
-a well rounded activities program
prompt attention to incontinence episodes
staff attitudes towards residents
Which of the following is NOT recommended as part of an infection control program
- Infection log
- antibiotic log
- infection record individualized for each resident
- facility floor plans used to track outbreaks
Antibiotic log
Which type of incontinence is characterized by urine leakage with coughing or laughing
- stress
- urge
- overflow
- functional
stress
Which type of vision problem is characterized by seeing straight lines as crooked
- glaucoma
- legal blindness
- macular degeneration
- cataracts
macular degeneration
Which type of behavioral intervention may not be appropriate for demented individuals
- remotivation
- reality orientation
- validation therapy
- sensory training
Sensory training
Door locks that are engaged by wandering residents can only work for how long
- 15 seconds
- 30 seconds
- 1 minute
- doors are never allowed to be locked
15 second
The single best preventative measure for pressure ulcer is
- prompt incontinence care
- adequate hydration
- use of ‘donut’ cushions when in a wheelchair
- frequent turning and repositioning
Frequent turning and repositioning
Which model of care attempts to use the presence of plans, pets, and children to combat boredom, loneliness, and helplessness in nursing facility residents
Eden Alternative
PASSAR is a process for
screening for mental illness or developmental disablities
Which of the following is permissible as part of an admission contract
- third party guarantee of payment
- waiver of the right to receive medicaid
- mandatory charitable contributions
- requirement of arbitration to resolve legal conflicts
Third party guarantee of payment
Under which situation would a MDS not need to be completed
- a residents payor source is private pay
- a resident on insurance only stays for 21 days
- a resident on Medicare stays for 12 days
- a resident on medicaid stays for 12 days
a resident on medicare stays for 12 days
Which of the following does not constitute a significant change for MDS purposes
- a resident has a stroke that causes dysphasia and aphasia
- a resident required IV therapy but has run out of available skilled days
- a resident has fallen and broker her hip
- a resident has mild case of pneumonia but is expected to recover within a week
A resident has a mild case of pneumonia but is expected to recover within a week
Who is required to coordinate the RAI process
any registered nurse
determines skill level/coding; directions for MDS
How soon after the MDS is completed must the care plan be developed
7 days
If state law does not say otherwise how long should clinical records be retained after the resident has been discharged
5 years
Which of the following is universally regarded as the best way to reduce food wastage
- utilize buffet lines in the dining room
- reduce meal portions to the smallest feasible amount
- provide more snacks in between meals
- prepare and serve attractive and tasty food
prepare and serve attractive food
OBRA 87 requires what of dietary managers
- licensure as a registered dietician
- certification as a certified dietary manager
- completion of a state approved course
- the ability to communicate with qualified dietician
The ability to communicate with a qualified dietician
Which of the following indicates a significant weight loss
- 5% over three months
- 7.5% over three months
- 7.5% over six months
- 10% over twelve months
-7.5% over three months
At what temperature must hot foods leave the kitchen
135
After a resident has been in the facility for 3 months, how often must they see a physician
every 60 days
How often must a pharmacist conduct a drug regimen review
monthly
Which of the following would not constitute a significant medication error
- two multivitamin tablets were administered when only one was ordered
- three ounces of water were given with a laxative
- twelve units of insulin were ordered and fifteen units were administered
- the licensed nurse failed to obtain an apical pulse before administering digoxin
-two multivitamin tablets were administered when only one was ordered
Which is not an OBRA approved indication for antipsychotic usage
- Hiccups
- Itching
- Schizophrenia
- wandering
itching
Which therapist would be able to best help a post stroke resident with aphasia who needs to improve her ability to use her hands (for buttoning and fastening clothing, turning on/off water faucets, etc)
Occupational therapists
Which individual is required to serve on the facility QAA committee
DON
Residents do NOT have which of the following rights
- Immediate access to the secretary of the US dept of health
- refuse to participate in research which consists only of aggregated statistics
- The right to work for a facility
- the right to self administer medications
Immediate access to the secretary of the US department of Health and Human Services
A person diagnosed with dementia usually
- complains a lot
- stresses failures
- displays a loss of intellectual capacity
- appears to be completely unconcerned
displays a loss of intellectual property
Gerontology is best defined as the study of the
aging process
One of the current proposals regarding the developmentally disabled stresses changing the emphasis in active treatment to
- independent living
- occupational therapy
- acquiring social skills
- individuals operating as sole proprietors
acquiring social skills
The most important factor in the treatment and care of the developmentally disabled is
- the process
- the end result
- documentation
- record keeping
the end result
A resident cannot be discharged or transferred if the
-resident contracts HIV
-residents needs cannot be met
0residents health has improved significantly
-resident has failed to pay after reasonable notice
resident contracts HIV
Assume that 150 doses of medication were prescribed by the residents physician to be administered in a given time period. however 2 doses ordered were not given and 3 doses were incorrectly administered as prescribed. What was the medication error rate
3.3
It is standard operating procedure to
- monitor restraints every 2 hours
- monitor restraints every 30 minutes
- release patients from restraints every two hours and leave them out of the restraint for at least one hour
- release patients from restraints every hour and leave them out of the restraint for at least 10 minutes
-release patients from restraints every hour and leave them out of the restraint for at least 10 minutes
The DON may serve as charge nurse only if the facility
- has applied for a waiver
- is licensed for less than 100 beds
- has an average daily occupancy of 60 residents or less
- accepts only residents requiring minimal nursing services
-has an average daily occupancy of 60 residents or less
The OBRA outcome oriented survey is focused on the
- review of physical resources
- quality of care actually provided
- monitoring of management procedures
- compliance with state and federal regulations
quality of care actually provided
When a new resident is admitted the social worker should help the family during the initial separation period by
- maintaining family contact regarding the residents condition
- telling the family that the facility will handle the residents condition
- advising the family not to visit until the resident has adjusted to the facility
- advising the family to have someone visit each day until the resident is adjusted
-maintaining family contact regarding the residents condition
Empathy may be the best defined as the
- capacity to share the interest of another person
- process whereby one strives to be like an other person
- unconscious conferring of undesirable traits or tendencies on another person
- ability to comprehend the meaning and relevance of the thoughts and feelings of another
-ability to comprehend the meaning and relevance of the thoughts and feelings of another
In most states which of the following cannot be appointed as the agent under an advance directive
- friend
- attorney
- family member
- attending physician
attending physician
The resident self determination act should be
- enforced by the social service department
- discussed during the resident assessment
- mailed out annually to all residents and families
- given to the resident and family at the time of admission
-given to the resident and family at the time of admission
To be effective a resident council should
- be controlled by the administrator
- have the participation of the residents and employees
- be given the opportunity to control the activities of the facility
- have continued support by the administrator and the residents
have continued support by the administrator and the residents
A curator as used in civil law equates to a
- payee
- guardian
- next of kin
- family member
guardian
the most common cause of food poisoning is
- infected food handlers
- communication with sick persons
- contamination of food by insects
- improper refrigeration fo perishable foods
improper refrigeration of perishable foods
nursing personnel should encourage a resident to eat in the dining area unless the resident
- is incontinent
- cannot eat unassisted
- is confined to a wheelchair
- Ha been contraindicated to do so by physician’s orders
has been contraindicated to do so by physicians orders
According to research studies the most indispensable mineral found to be lacking in the diet of the elderly is
iron
sodium
potassium
magnesium
iron
To maximize the destruction of bacteria on dinnerware the temperature of rinse water in dishwashers should be
180
Proper food storage is very important. of the following problems listed which is usually the most significant
- dented cans
- temperature control
- labeling of cans and leftovers
- utensils left in large containers
temperature control
An unplanned and/or undesired weight loss would be classified as significant if the percentage of loss during a si month interval was ___%
10%
Carcinoma is the medical term for
cancer
the physician who is primarily involved with the causes and histories of diseases is
- internist
- pathologist
- geriatrician
- general practitioner
pathologist
Who is responsible for implementation of the resident care policies in the facility
medical director
The physician must write, sign, and date progress notes
- each month
- at each visit
- as deemed necessary
- monthly for the first 90 days
At each visit
The social security act provides that a facility must have a written transfer agreement with one or more hospitals that are
- equipped with CAT scan and MRI
- within a radius of 5 miles of the facility
- able to provide ambulance transportation
- approved for participation under both Medicare and Medicaid
Approved for participation under both Medicare and Medicaid
Under OBRA the quality improvement committee is required to meet at least
Quarterly
Under OBRA the implementation of which of the following policies is not the responsibility of the medical director
- dietary
- admission
- personnel
- infection control
Personnel
A remotivation program as applied to the senile resident generally refers to a
group therapy program designed to stimulate the residents interest in the real world around them
Care plans address activities that are appropriate for each resident based on which of the following
- age and sex of the resident
- comprehensive assessment
- former lifestyle of the resident
- recommendations of the nursing staff
comprehensive assessment
Which of the following would not usually be a primary interdisciplinary team member
- activity director
- rehabilitation staff
- nursing facility administrator
- therapeutic recreation staff
Nursing facility administrator
A resident spends most of his time in his room alone and he has few interests except he watches the news on television. Which of the following activity approaches would perhaps be the most beneficial?
- take him on group walks in the community
- enroll him in male craft projects like building bird houses
- invite him to participate in current events including small group discussions
- suggest to the attending physician that antidepressant medication be considered
-invite him to participate in current events including small group discussions
The resident activity director has many roles and duties. However the first responsibility should be
- maintaining adequate records
- planning and organizing activity programs
- preparing care plans and writing progress notes
- completing the assessments and identifying the interests and needs of the residents
-completing the assessments and identifying the interests and needs of the residents
Activity coordinators must plan, coordinate, and direct the resident activity programs, and in addition must do which of the following
- supervise therapeutic programs
- record notes in the residents medical record
- conduct the interdisciplinary assessment program
- conduct in service training programs for all employees
supervise therapeutic programs
Medical records are also referred to as clinical records and are utilized by various members of the staff however the person ultimately responsible for accurate and adequate medical records is the
Medical records librarian
Medical records may be released by written permission fo the resident and if required by any of the following except
- a court order
- an attorney as law
- a third party contract including medicare
- another nursing home to which the resident is being transferred
an attorney at law
In cases in which facilities have created the option for an individual’s record to be maintained by computer rather than hard copy
- electronic signatures are acceptable
- electronic signatures are acceptable only for the medical staff
- signatures must be recorded both electronically and on hard copy
- electronic signatures can only be used by full time employees of the facility
electronic signatures are acceptable
The person designated as the clinical record clerk must be
- certified
- licensed
- a consultant
- a full time staff member
a full time staff member
according to Medicare and Medicaid requirements upon an oral or written request the residents must have access to all records, including clinical records, pertaining to himself/herself within
24 hours
Which of the following types of drugs are for external use only
- topical
- diuretic
- laxative
- sedative
topical
Stop order procedures were formerly developed by the pharmaceutical service committee but are now developed by the
- pharmacist
- medical director
- pharmacist and the medical director
- pharmacist and the DON
Pharmacist and the medical director