Mock National Exam 19 Flashcards
The annual survey is the
standard survey
The ___ must review the medications taken by each resident on a monthly basis
Consultant pharmacist
Physical restraints must be released every 2 hours for
10 minutes
Which of the following must be on a resident trust fund surety bond
- resident and facility
- facility and state
- resident and state
- resident
The resident and state
No soliciting on facility premises would be contained in the
Employee handbook
Filling a vacant position such as a nurse aide position would customarily be filled through
Employee referrals
The pressure to open a door cannot exceed ___lbs
5
What is the minimum width for 2 wheel chairs to pass
60 inches
The key consideration in determining the minimum level of staffing in a nursing facility is
Patient acuity levels
Which departments attend the utilization review committee
- business office
- nuring
- social services
- rehab
- MDS
- All the above
all the above
An emergency power source does not have to power
- lights for all entrances and exits
- fire detection alarms and extinguishing systems
- medical prep areas
- administrators office
administrators office
The maximum audible alarm decibel level is __ decibels
120
What is the width of a single wheelchair
30
If a nurse aide applies for a job but has lived out of state, which registry should the facility check
multi state nurse registry
For questions concerning union election procedures the administrator must contact the
National labor relations board
If a union had a complaint against an employer it would file the complaint with which one of the following
NLRB
Which entity must supervise and approve a union election and union bargaining units
NLRB
The percentage of gross profit for a facility with a gross income of $555,000 fixed expenses of $195,000 and variable expenses of $305,000 is approximaitely
9.9%
To determine the net worth of a publicly traded company and investor would look at which financial statement to determine the financial well being of the company
balance sheet
The purchase of a building would be from which budget
Capital
Which of the following is responsible to ensure residents rights are respected by staff
Administrator
Assuming all medications are available and accounted for, the ___ would be responsible to check the medication records monthly
Consultant pharmacist
The most effective marketing tool for a nursing home is/are
a tour of the facility
When the DON compares nursing salaries to the nursing salaries being paid by other facilities in the area this is called
Benchmarking
When the DON compares nursing services to the quality of nursing services offered in other facilities in the area, this is called
Benchmarking
The administrator begins work when the owners or governing body set forth the. ___ for the organization
Mission statement
If a medication has an automatic stop order, the nurse must
notify the physician before the last dose is administered
The accrual method of accounting is required by Medicaid and Medicare and therefore income and expenses are recorded
When they are incurred
How are internal and external drugs stored in the facility
In separate compartments
The administrator while doing rounds in the facility notices a resident is more confused than normal and cannot locate their room. the administrators most appropriate action would be
- discuss the cognitive changes with the physician
- request a nurse to evaluate the residents condition and report it to the attending physician if necessary
- enter the observations in the residents medical chart
- require the nurses to report further changes to the administrator
-request a nurse to evaluate the residents condition and report it to the attending physician if necessary
If the administrator wants to know if the facility made money she would look at the
- balance sheet
- profit and loss statement
- income statement
- both 2 and 3
both 2 and 3
- profit and loss statement
- income statement
Medicare claims are billed on a form
UB 04
The ___ is permitted to dispense medications
Pharmacist
To establish a union in a nursing home the union must get ___% of the vote of all employees in a nursing home
50% plus 1
Where a manager and subordinate employees jointly set goals and priorities this is called
MBO
Hospitals with __ beds or less may have a limited number of beds certified for use as long term care beds or swing beds
99
When a resident participates in experimental research or an investigational drug, the facility must ensure all of the following except
- the resident has a right to participate in experimental research
- the resident may be identified by name by the researchers in any publication of the research results
- the resident must be fully informed of the nature of the experiment including treatment and consequences
- the resident must be given an opportunity to decline participation before the start of the experimental research
-the resident may be identified by name by the researchers in any publication of the research results
A swing bed is a bed that is certified in a hospital with fewer than ___ beds that may swing between being used as a certified acute care bed or as a medicaid/medicare certified nursing home bed for patients who no longer require acute care and need sub acute nursing home care, but there may not be any nursing homes close to the the hospital and the hospital is certified to serve the needs of patients who need both acute and sub acute nursing home care
100
A 200 bed facility with 140 occupied. beds would have a __% occupancy rate
70%
HIPAA stands for
Health insurance portability and accountability act
If the administrator wants to see the facility net worth he/she would look at the
balance sheet
The main objective of OSHAs Hazard Communication Standard does not include
- requiring employers to post MSDS for employees to review
- providing workers key information to protect themselves
- inform workers of the chemicals in the workplace
- reporting worker injuries
-reporting worker injuries
Facility written policies must be reviewed at least ___ as evidenced by written signed and dated minutes
annualy
True or false
all persons seeking admission to a nursing facility must be screened for severe mental illness or developmental disabilities (PASSR) prior to being admitted regardless of income, assets, or funding source
True
The main purpose of a pre admission screening for mental retardation or severe mental illness is
medicaid will not pay to keep someone in a nursing facility if their only diagnoses is mental illness or a developmental disability and they have no other condition requiring skilled care
If a level 1 PASSR screen indicated an individual has a mental illness or developmental disabilities then a more comprehensive Level ___ assessment must be completed by the appropriate state agency
2
Residents must be seen by their physician at least
once every 30 days for the first three months, and then every other month thereafter
The nursing assistant must successfully complete the training program within ___ days after the date of initial employment
120
Cost reports must be submitted to the state medicaid agency with ___ days at the end of the fiscal year of a facility
90
A resident wearing a physical restraint must have it release for 10 minutes at least once every
2 hours
An unnecessary drug is any drug used
- in an excessive does
- for an excessive duration
- without adequate indications or rationale for its use
- in the presence of adverse consequences that indicate the drugs should be reduced or discounted
- all of the above
all the above
True or False
residents may be prescribed anti psychotic drugs without documenting in the resident chart and comprehensive assessment a rationale for its use
false
duplicative drug therapy means
the use of two or more drugs whether from the same drug category or not that produce the same effect
An investor would look at which financial statement to determine the financial well being of the company
- income statement
- profit and loss statement
- balance sheet
- ledger
-balance sheet
Must have at east one registered nurse on duty 7 days per week, consecutive hours per day, in a skilled nursing facility
8
True or false
a facility may stock drugs that are regularly available without a prescription
true
stock drugs must be administered upon the order of a
licensed prescriber
A list of the contents of each emergency medication kit must be kept
inside the kit
The ___ must determine if there are irregularities in each residents drug regimen that may cause potential adverse reactions, allergies, contraindications, medication errors or ineffectiveness
consultant pharmacist
A medication order not specifically limiting the time or number of doses must
be automatically stopped
medications must be administered by
The same person who prepared the doses for administration
Tardives dyskinesia is a side effect of which type of medications
Anti psychotic
All treatments and procedures must be administered as ordered by
a physican
True or False
a physicians order to administer an anti depressant medication to a resident is justification for its use
false
A critical program to help residents attain and maintain their highest practicable physical mental and psychosocial well being is the
Therapeutic activities program
Hazardous food must be kept at a temperature of __f or below and ___ f or above EXCEPT during necessary periods of preparation and service
41 and 135
Food must be stored a minimum of __ inches above the floor
6 inches
a metal stem type product thermometer with a digital or numerical scale and accurate to plus or minus ___ F must be used to check internal food temperatures
3F
The middle compartment of a 3 compartment sink contains
Fresh water
The final rinse cycle on a hot water dishwasher is
180F
Ecoli is transmitted from
Beef
A therapeutic diet must be ordered by a
Licensed phycisian
All therapeutic diets must be medically prescribed by a physician and must be planned or approved by a
dietician
Must serve a minimum of ___ meals daily
3
All menus as actually served must be kept on file at the facility for not less than ___ days
30
Each diet change must be ordered by the
Physician
No more than ___ hours may elapse between a substantial evening meal and breakfast
14
True or false
a resident room cannot be used as a public pathway to access other parts of a facility
true
How often must a nursing facility provide a written record of all financial transactions involving a residents funds
at least quarterly
Title XIX (19) is the social security act is
medicaid
Title XVIII (18)of the social security act is
medicare
The national organization that sets the standards for the life safety code is teh
National fire Protection Association
Which agency is responsible for the prevention and control of infectious diseases int eh US
Centers for Disease Control and prevention
Which federal law prohibits discrimination based on race religion gender color and national origin
civil rights act of 1964
Guardian means
a person appointed by a court to make decisions for a person determined to be lack capacity
a residents chart should document progress in attaining goals set by the
resident
telephone orders must be transcribed into the residents medical record or a telephone order form and signed by the
nurse taking the order
A facility has ___ days from the date the survey team exits. a facility to dispute a tag that was challenged during the exit conference
10
The care plan must be reviewed at least how often
Quarterly
Personal functions like walking, bathing, shaving, brushing teeth, dressing, eating, getting out of bed and toileting are called
Activities of daily living
A power of attorney a healthcare directive or a living will are examples of
An advanced directive
Harm, injury or death of staff or residents (medication errors) or elopement of a resident are examples of
Incident
A group of residents that meet to address resident issues and to make recommendations to improve resident care and services is called the
Resident council
A written plan of care and services for each resident is called a
care plan
the process used bay a facility to examine its practices of providing care and identify ways to improve performance is called
Quality improvement
Short term care (a period of six weeks or less) provided to an individual to relieve the family members or called individuals caring for the individual but for not less than 24 hours is called)
respite care
A person authorized to make decisions for a resident is called the
responsible party
How often must facility policies be reviewed and updated
Annually
Staffing of nurses and nurses aides must be based on
Resident acuity
True or false- if a facility staffs according to minimum state staffing hours then it cannot be cited for insufficient staff
False
Which of the following is responsible for the implementation of policies and procedures that pertain to resident care and treatment
- administrator
- DON
- medical director
- governing body
medical director
Private sitteres and private duty nurses are/are not employees of the facility
are not
volunteers direct care volunteers and paid feeding assistants are/are not included in the minimum staffing requirements
are not
A discharge summary would not contain which of the following
- condition at discharge or transfer
- date and time of discharge or transfer
- the final bill
- instructions for self care
- instructions for obtaining post treatment or procedures emergency care
- signature of physician authorizing discharge or transfer
the final bill
resident records may be destroyed after ___ years
5
Resident records are the property of
the facility
Resident records are/are not confidential
are
Records of menus as served must be maintained for at least ___ days and be available for inspection
30 days
Per OBRA 1987 a dietician must be registered with teh
American Dietic Association
Therapeutic activities for residents are provided by teh
activities department
When state surveyors tour a facility in the early morning, they should observe residents
Neatly dressed and properly goomed
Caring for residents in recognition and respect for cultural differences and personal preferences is called
Resident centered care
A written report of the balance of resident finances must be physically provided to each resident on a __ basis
Quarterly
Any personal monies due a resident must be refunded within __ days
30
True or false
a facility can place reasonable restrictions on visiting hours for residents
true
Most post at least ___ months resident activity schedules in order for residents to be made aware of activities offered
One
Residents must be seen by the attending physician at least once every ___ days for the first 90 days unless more frequent visits are indicated
30
Which federal law sets the standards for OT and minimum wage
Fair Labor Standards Act
Physical therapy occupational therapy and speech therapy are services which must be ordered by
A licensed physican
Restrained residents must be allowed to move around and exercise at least every
2 hours
Other than residents transferred back to their home residents requiring care an/or supervision must be transferred to
a location that is licensed to provide the care that is appropriate to the residents needs
Which federal law establishes adverse impact as the current standard for discrimination in employment
EEOA
Workers compensation premiums depend on which of the following factors
- risk class of the occupation
- the claims experience of the facility
- state regulations
- total amount of payroll for both FT and PT workers
- all the above
-all the above
Incoming and outgoing licensed nurses must document and count all schedule II controlled substances how often
At the end of each shift
Keys to the medicine preparation room, cabinet, refrigerator, or medication cart at the staff work area must be under the control of
licensed nurse
___ is a legend medication
vicodin
Must serve a minimum of ___ meals in each 24 hour period
3
Cubicle curtains, window dressings, portable partitions, wastebaskets, mattresses and pillow must be ___ in accordance with NFPA 701
Non combustible, inherently flame resistant, or treated or maintained flame resistant
Each resident room must open directly to
an exit access corridor
plumbing fixtures hat require hot water and that area accessible to residents must be at least ___F
110
The facility must provide residents an environment that
Is homelike
Meal service operators must be separated from living and sleeping quarter by complete ceiling high walls, and self closing door made of ____ inch solid wood core
1 3/4
Emergency generators must be operated ___ for at least 30 minutes
monthly
When counseling an upset employee the administrator should do which of the following
- let the employee talk and listen intently
- provide the employee an oral warning that such behavior is disruptive and the next time it occurs the employee with be written up
- send the employee home to cool off
- anticipate what the employee with say
-let the employee talk and listen intently
The administrator works with three types of budgets
- operating
- cash
- capital
the operating budget would detail ___ and ___
revenues and expeneses
Specific and authoritative guidelines to specific action are called
procedures
which federal law requires a facility to inform residents of their right to make an advanced directive
patient self determination act
A class D fire extinguisher would be used for a ___ fire
metal
A class C fire extinguisher would be used for an ___ fire
electrical
a class B fire extinguisher would be used for a __ fire
grease or flammable liquids
A class A fire extinguisher would be used for a __ fire
Paper or ash
What does current ratio mean
Whether a facility can meet its current obligations
What does liquidity mean
A facility has sufficient assets to pay its debts
Residents in restraints must be released from restraints for at least __ minutes
10
What does a debt to equity ratio tell an administrator
whether a facility can pay its non current obligations
Grouping people and activities to carry out plans and accomplish goals is the function called
organizing
deciding what to do when to do it and who will do it is the function called
plannign
Influencing employees to strive to achieve company goals is the function of
Directing
Taking action to correct a deficient situation is the function fo
Controlling quality
Exercising limited authority or a specific restricted function is called
functional
The grapevine is an example of ___ communication
informal
The patient census reports is produced by
The nursing department
The patient census form is produced by
bookkeeper or business office
The average accounts receivables collection ratio is calculated as
365x account receivables/net operating revenues
ARNOR
The formula to calculate the average time it takes to pay the facility supplies expense
365x accounts payables/supplies expense
APSE
Which of the following would attend the utilization review committee meetings
- business office
- nursing
- therapists
- social workers
- MDS coordinator
- all of the above
all the above
What is the main purpose of the utilization review process
Ensure each resident receives all necessary and appropriate care and servcies
A person paralyzed on one side of their body would benefit from which type of therapy
occupational therapy
Which of the following snack times would you change
- 10am
- 1pm
- 4pm
- 9pm
1PM
General statements which guide thinking are
Policies
What does a quick ratio calculation tell an administrator
how much the facility has available immediately to pay urgent bills
What dos the acid test ratio calculation tell an administrator
How much the facility has available immediately to pay urgent bills
