Mock National Exam Flashcards
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
Late
A comprehensive assessment is due 14 days after admission or by Nov 24th. It was late
The ___ has ultimate legal responsibility for the operation of a nursing facility
Governing body
The governing body has ultimate responsibility for management of the facility
Per OBRA 1987 air temperature is measured
Just above the floor
Air temperature is measured just off the floor
The ___ requires employers to give worker time off for illness or to care for a sick family member
Family Medical Leave Act
The ___ hires supervises and can fire the administrator
Governing body
he administrator discovers the DON has been giving nursing aides 6 months to complete their state certification requirements. The administrator should
Reprimand the DON
120 days they can work after completing the course before getting their license
The rights of an individual determined by a court to be incompetent would be exerciesd by a
A person appointed by a court or court guardian
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
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
Per OBRA 1987 a resident has the right to review all their records within ___ of an oral or written request (excluding weekends and holidays)
24 hours
The comprehensive assessment was completed on June 1. The care plan was completed on June 6th. The care plan was completed ___
Timely
Care plan must be done within 7 days of comprehensive assessment or by June 8th
The comprehensive assessment must be signed by
Registered Nurse
The ___ has legal responsibility or the day to day operation of a skilled nursing home
Administrator
The governing board has ultimate responsibility for resident are and managing the facility. The administrator is responsible for day to day operation
The ___ is responsible for the day to day management of the facility’s nursing program
DON
The DON is a registered nurse is responsible to manage the nursing staff to follow physician order to adhere to professional standards
CMS stands for
Centers for Medicaid and Medicare Services
HHS stands for
Health and Human Services
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
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
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
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
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
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
The ___ has legal responsibly to adopt an implement facility policies
Governing body
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
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
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
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
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
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
____ is not n element of a Total Quality Management TQM program
Centralize decision making to improve customer service
The main focus of TQM is to train front line workers to make decisions
The ___ is responsible to prepare and serve nutritious meals under sanitary conditions
Dietary Department
All furniture, equipment, boxes and supplies must be elevated ___ inches above the floor to allow the floor directly underneath to be cleaned
6
____ is the most comprehensive and effective improvement model
Total Quality Management
The ___ coordinates all work activities in the facility and resolves conflict between departments
Administration department
HCFA stands for
Health Care Financing Administration
Telephone cords must be a minimum of
29 inches
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
Reprimand the administrator
Must employ a dietary manager full time. The administrator should be reprimanded
Adding baking soda to food will primarily
affect its
Nutritive value
Overcooking food in boiling water, adding baking soda and poorly storing food diminishes the vitamin and mineral content of food
The residents quality of life and physical condition is the focus of
Outcomes are focused o actual results and not processes
___ is not typical of a TQM program
Minimal training of staff
Extensive staff training so residents do need to wait for the NHA to come in for a bed pan
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
Social Services director
Social services provides emotional support and interventions for psychosocial and financial problems
Electrical switches must be located at a minimum of ___ inches above the floor
15
Stooped posture, shuffling gait, garbled speech and tremors are symptoms of
Parkinsons Disease
Nursing homes must have hearing aid compatible phones with volume between a minimum of ___ and a maximum of ___ decibels above normal
12,18
Any public telephones or other phones available to residents shoudl be hearing aid compatible with volume controls
Grab bars and railings must support a minimum weight of ___ pounds
250
The emergency generator must be visually inspected and checked
Weekly
Federal resident care standards are now ___ and ___ and are not longer considered minimal standards
State of art, maximal
The largest payor source for long term care is
Medicaid
The average short term stay for a Medicare resident is
30 days, they leave after 21-20 days when their $124 a day copay kicks in or $3000 a month
ANSI stands for
American National Standards Institute
Non compliance affecting a limited number of residents and locations would be assigned a scope of
Isolated
TQM is not characterized by
Minimal involvement of upper management
TQM involves engagement by upper management
Administrators consult ___ to compare outcomes to expectatons
Policies and plans of actions
A resident with Parkinsons would not benefit by
Bed rest
Parkinsons involves muscle rigidity and cognitive impairment resident benefit by exercise programs and reality orientation and memory exercised
The states cannot ___ to compel facilities to correct class 1 deficiencies found during inspections
Impose civil or criminal penalties
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
Level 3
Parking spaces must be at least ___ wide with an accessible handicap aisle at least ___ wide
96” 60”
A broad statement of goals is a ___
Policy
Long term residents should be surveyed regarding satisfaction with services
Annually
Which is not true of the Joint Commission on Accreditation of Healthcare Organizations JCAHO
JCAHO can impose civil fines
Communication occurs when
A message is transmitted by one person and received an decoded and understood by the other person
NFPA stands for
National Fire Protection Association
The emergency generator must run under full load for ___ every___
30 minutes, month
The fire alarm can be silenced during a fire drill conducted between the hours of
10pm and 6am
The ___ is responsible to assemble and analyze incident reports, infection rates, safety issues, medication errors and restraint use
Quality assurance committee
___ publishes and promotes fire safety in nursing homes
NFPA
Listening intently, acceptance, empathy and understanding the message descries
Active listening
Patients and family look for ___ when selecting a nursing home
Variety and quality of food
The Americans with Disabilities act construction standards are enforced by
Architecture and Transportation Barriers Compliance Board
The Americans with Disabilities Act construction standards were developed by
ANSI
ANSI is a private organization that researches and publishes the ADA
A mechanism to monitor consumer satisfaction and address other concerns is called the
Strucure
The nursing home survey/inspection process focuses on
Outcomes
All nursing facilities must be licensed by the
State
Facilities that are licensed by the state and certified to receive Medicare and Medicaid reimbursement must submit to
State and federal inspection
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
Informal dispute resolution process
Per OBRA 1987 a nursing home must maintain the highest ___ for residents
Physical, mental, and psychosocial well being
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
Formal dispute resolution process
Federal inspection of resident care in nursing facilities is overseen by
CMS
Quality Indicator QI reports for nursing homes available through the CMS would not include which of the following
Nursing home watch list
Prior to entering a facility a state survey team would not review the
Resident council minutes
The ___ is responsible to identify and address safety hazards that can injure residents and staff and is required by OSHA
Safety committee
The federal nursing home certification survey program has a total of ___ different survey types
Off site preparation
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
Off site preparation
The online Survey and Certification Reports contains all MDS data is setup by the CMS
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
Information analytics
Nursing homes must be inspected every
15 months
An electronic medium that allows instantaneous communication internally and externally to thousands of people through a computer server is called
A finding of ‘substandard care’ requires the survey team to have evidence of
Immediate jeopardy to resident care that has or likely to cause serious injury or death
A ___ tag would indicate substandard care was found
F377 J
A tag of G or above is indicative of substandard care
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
Exit conference
When services in a facility are not consistent from day to day and from sift to shift this is called
Inconsistency rule
Communication between staff of equal rank or status is called
Horizontal comunication
When consumers perceive a facility renders poor care because of the performance of one employee, this is called
Inseparability rule
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
Notice of isolated deficiencies
The administrator has ___ days to prepare a plan of correction for all deficiencies cited in the survey
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
Communication from subordinates directed to upper management is called
Upward communication
A violation or deficiency with the potential for no more than minor negative impact on a resident is a ___ deficiency
Level one
____ has/have the least impact on influencing a resident or their family in choosing a facility
Media ads
Short term residents should be surveyed ___ about satisfaction with services
Within 30 days from discharge
A technology that connects cell phones, hand held devices and keyboards to a computer by high speed cable is called
Fire wire
Implementation of a TQM program takes between
5-10 year
The key consideration in determining the minimum level of staffing in a nursing facility is
Patient acuity levels
Managing risks of negative outcomes is called
Risk management
The key to a successful TQM program is
Training
An organizational chart shows the reporting relationship between staff. A solid line on the chart denotes
Line authority
A parking lot with 100 parking spaces would require ___ handicap accessible parking spots
4
1 handicap spot per 100 spots
The most effective marking tool for a nursing home ot attract new residents is/are
A tour of the facility
A violation with no more than minimal physical, mental or psychological discomfort is a ___ deficiency
Level 2
A level 1 would be no more than minor impact a level 2 involves actually discomfort
Believing something that is not based in reality is caled
Delusion
Communication directed from upper management to lower level managers and staff is called
Downward communication
Non compliance affecting more than a limited number of residents and locations would be assigned a scope of ___
Patterned
___ can provide nursing aide services and be included in calculated minimum staffing hours
A licensed practical nurse employed by the facility
Managing risks of negative outcomes is called
Risk management
The nosing on a stair. must project no more than
1 1/2
Smoke detectors must be located no further than ___ feet apart and no more than ___ feet from any wall
30, 15
Minimum wheelchair passing width for two wheelchairs is ___ inches
60”
Minimum clear width for a single wheelchair is ___” continuously and ___” at any one point
36”, 32”
There must be a passing space in an accessible route for wheelchairs every ___ feet
200
A passenger loading zone must be at least ___” wide and ___” long
60”wide and 20” long
The force required to open all doors, flush a toilet, operate faucet handles, and operate a water fountain cannot exceed ___ lbs of pressure
5
Minimum wheelchair turning space is ___ inches
60”
The high forward reach from a wheelchair is
48”
The side reach from a wheelchair is between ___” and ___” off the floor
9”-54”
A change in level surface over 1/2 inch
Requires ramp treatment
A change between 1/4 and 1/2 inch in level surface
Requires a beveled edge
A fire extinguisher is checked ___ and serviced ___
Quarterly, annualy
Each level or story of a building that houses patient sleeping and treatment areas must be divided into ___ smoke compartments
2
Vision panels are ___ in swinging doors
Required
The maximum window sill height for a window in a resident’s room is ___ inches above the floor
36”
Doors must be ___’ thick, solid bodied ___ core, or with ___ minutes of resistance fire rating
1 3/4, wood, 20 minutes
The facility quality assessment and assurance committee. must meet at least
Quarterly
The QA&A Committee does not need to include
The administrator
Communicating though memos, meetings and follows lines of the organization chart is an example of ___
Formal communication
Staff hatting informally in the break room is an example of ___
Informal communication
ADA guidelines and standards are developed and approved by
ANSI
Railings and grab bars must bear the weight of ___ lbs or more
250 lbs
The maximum audible alarm decibel level is ___
120
A nursing home must have a/n ___ operated fire alarm system that is ___ monitored
Manually, electronically
The fire alarm is manually operated because you need to ‘pull’ the alarm
Activating or puling a fire alarm automatically activates all of the following except
Emergency generator
Phones must be fitted with a cord no shorter than ___ inches
29”
Landlings are required at teh bottom and top of each stairway run and must have a minimum width of
60 square inches
Doors must have a clear width of ___” at openings and must be at a ___ “ angle to an accessible route
32”, 90degree
The automatic smoke and fire detection systems must be connected to each other
Electronically
The ___ specifies the number of directors, number of shares to be issued, and governs how the corporation is to be run
Bylaws
A review of care provided patients for appropriateness and cost effectiveness is called
Utilization review
A permit required before a nursing facility can begin construction is called a
Certificate of need
A violation with a severity requiring immediate action due to risk of injury, harm, impairment, or death to a resident is a
Level 4
The states and the CMS cannot impose
Civil and criminal penalties
A leader who makes decisions based on staff consensus is using the
Democratic style
A leader who delegates decision making to subordinates while setting larger objectives is using the
Laizze faire style
An effective leader would not
Have one set response for every situation
A manager must adapt their style and response to different situations
The fastes growing sector of the health care industry is
Home health care
The current trend is to move individuals from institutional care to ___ which is less expensive
Home health care
Management by Walking Around does not involve
Taking action on the spot
An employee who has decision making authority with the same force and effect as if made by the administrator has
Line authority
Upper managers do not
Usually write procedures
Middle managers do not
Adopt policies
Nursing aides are required to have a minimum of ___ hours of inservice trining per year under OBRA 1987
12 hours
The ___ ultimately determines if a nurse aide is competent
State surveyors
A charge nurse is __
Lower management
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
4 months
A nurse aide must be complete 16 hours of initial training in all of the following except
How to apply physical restraints
A nurse aide must complete initial 16 hours of training in all of the following except
How to administer medication
An intentional act or threat causing fear in another with reasonable expectation of harm is called a/an
Assault
The ___ is the foundation that guides an organization
Philosophy
The ___ communicates the purpose of the organization
Mission statement
The ___ specifies the composition of the governing body, functions, timing of corporate meetings and the purpose of a corporation
Bylaws
The ___ establishes the strategic plan
Governing body
The overall style of governing how people relate to each other and that binds an organization is called
Corporate culture
Authority granted to the governing body by state law is called
Express authority
The ___ has ultimate responsibility for management and quality of care in a facility
Governing body
The governing body of a facility is generally ___ for acts of employees
Not personally liable
The mission statement and facility policies are created and implemented by the ___
Governing body
