nab4 Flashcards
Which one of the following is a normal psychological change in the elderly?
- Dementia
- Loss of vision
- Becoming incontinent
- Problem handling change
Problem handling change
Mental changes in elderly residents are usually caused by:
- diabetes
- arteriosclerosis
- inadequate diet
- frequent minor accidents
arteriosclerosis
Regarding the care planning process, the director of nursing should:
- insist that the attending physician attend all meetings
- require surrogates to attend the care-planning meeting
- make the process understandable to the resident and the family
- request that therapists (physical, speech, and occupational) be involved
make the process understandable to the resident and family
Developmental disability can mean any of the following except:
- autism
- epilepsy
- cerebral palsy
- mental illness
mental illness
CMS and states can impose remedies on facilities when they are found to be out of substantial compliance. For facilities with deficiencies classified as Category 1 (d” and “e” on the scope and Severity grid), which of the following remedies is not levied?
- State Monitoring
- Directed In-services
- Civil Money Penalties
- Directed Plan of Correction
Civil Money Penalities
The equation for calculating the medication error rate is as follows:
- the number of errors observed divided by the opportunities for error times 100
- the number of medications not administered divided by the opportunities for error
- the number of medication improperly administered divided by the opportunities for error times 100
- the number of medications not administered plus the number improperly administered divided by the opportunities for error
the number of medications not administered plus the number improperly administered divided by the opportunities for error
The starting point for the administrator in planning for long-term care services is the :
- available cash flow
- availability of land for expansion
- market area’s population census
- needs of those using the facility’s service
needs of those using the facility’s services
Which of the following is true of the latest survey protocols?
- Surveyors select a certain percentage of residents who are cognitively capable of being interviewed
- The survey team will conduct a detailed entrance interview with pertinent staff prior to making initial rounds
- Computers will select 3 discharge charts to be reviewed: one because of death, one to the community, and one to home
- Surveyors will accompany a nurse who is administering medications and will issue a deficiency should the nurse have an error rate of 3 percent or more
Computers will select 3 discharge charts to be reviewed: one because of death, one to the community, and one to home
Administrators must be aware that the major purpose of a transfer agreement between health care facilities is to:
- guarantee that each facility will accept all residents from the other facility
- establish a method of transporting residents to and from various health facilities
- assure the resident that each facility will provide a room at all times in case of transfer
- provide an interchange of medical and other information to assure adequate resident care
provide an interchange of medical and other information to assure adequate resident care
By repeatedly rejecting the dependent behavior of an elderly person, such behavior shall:
- increase
- decrease
- be stabilized
- be eliminated
increase
Which of the following is a mandatory condition of admission to a nursing home?
- A physician’s order for immediate care
- An admission contract that includes an arbitration clause
- A contract specifying the financial obligations of the legally responsible party
- An advanced directive signed by the resident and/or legally responsible party
A physician’s order for immediate care
A resident complains of discomfort in his eye and blurred vision. In her assessment, the nurse also discovers the resident is suffering from high blood pressure. She calls the attending physician who immediately refers the resident to an Ophthalmologist. After examination, the Ophthalmologist finds the eye pressure is abnormally high, causing the eyeball itself to harden. The final diagnosis is :
- cataracts
- glaucoma
- retina displacement
- macular degeneration
glaucoma
The rights of the residents living in a nursing home are protected under the Federal guidelines. Which of the following is not true of resident rights?
- A resident has the right to visit with immediate family members on a 24/7 basis
- A resident has the right to concerns without fear of reprisal from staff members
- A resident has the right to receive mail unopened, uncensored on the day mail is delivered to the nursing home
- A resident has the right to inspect medical records with 24hours of request, excepting weekends and holidays
A resident has the right to receive mail unopened, uncensored on the day mail is delivered to the nursing home
Who is responsible for the implementation of resident care policies?
- Administrator
- Medical Director
- Board of Directors
- Director of Nursing
Medical Director
Which of the following health care professionals is typically prohibited from assisting residents who need help eating?
- Food Service Manager
- Paid Feeding Assistant
- Licensed Practical Nurses
- Speech Language Pathologist
Food Service Manager
Social work has been defined as a problem-solving process geared to helping people help themselves. The problem most likely to affect residents when they are faced with nursing facility placement is :
- the fear of death
- the loss of self-respect
- the loss of social identity
- anxiety related to the unknown
anxiety related to the unknown
The best time to inform residents about their rights and responsibilities is:
- after they have “settled in”
- before or during admission
- after the assessment program
- during the physical examination
before or during admission
Assisting residents to determine what decisions they would like to make regarding their health care and arranging the provision of needed counseling services would usually be addressed by :
- administration
- social services
- the ombudsperson
- the nursing department
social service
The social worker must function as a counselor and as such spends most of his/her time:
- making decisions
- outlining plans of correction
- listening and asking questions
- finding the most feasible solutions to problems
listening and asking questions
The most common psychological condition affecting older adults is:
- tension
- anxiety
- delirium
- depression
depression
Adaptive feeding equipment can be prescribed by the physician or the:
- family
- speech therapist
- director of nursing
- occupational therapist
occupational therapist
Which of the following would not help a person with osteoporosis?
- Calcium
- Vitamin D
- Decrease smoking
- Staying out of the sun
Staying out of the sun
The best time for the dietary supervisor to weigh, inspect, and verify food orders is when it is:
- served
- received
- prepared
- purchased
received
Foods can be used not only for nutritional needs, but also in lieu of supplements and medication. As an example, potassium is high in all of the following except: 1. milk 2. peanuts 3. cantaloupe 4 baked beans
peanuts
One of the major problems resulting from serving food trays to residents in their rooms is that the:
- the resident eats less food
- trays are not properly labeled
- amount of food is usually limited
- food is cold before it is consumed
food is cold before it is consumed
The formula to determine the percent of body weight loss is as follows:
- divide the actual weight by the usual weight times 100
- divide the usual weight by the actual weight times 100
- divide the current weight by the average weight time 100
- divide the usual weight, minus the actual weight, by the usual weight times 100
divide the usual weight, minus the actual weight, by the usual weight times 100
Quality Assurance and Performance Improvement takes a systemic, comprehensive, and data-driven approach to maintaining and improving safety and quality in nursing homes. Which of the following statements is not true in regards to a facility’s QAPI program?
- The governing board and/or administration develops a culture that involves leadership by seeking input from the facility staff, residents and their family and/or legally responsible representatives
- It must be ongoing and comprehensive, primarily dealing with the nursing and rehabilitation
- A Performance Improvement Project (PIP) must be put in place to examine and improve care of services in areas that the facility identified as needing attention
- QAPI addresses all systems of care and management practices, and should always include clinical care, quality of life, and resident choice
It must be ongoing and comprehensive, primarily dealing with the nursing and rehabilitation
Under OBRA, Which of the following committees may not be replaced by the quality improvement committee?
- Safety committee
- Infection control committee
- Pharmaceutical services committee
- Interdisciplinary care planning committee
Interdisciplinary care planning committee
What specifically does the law require regarding dental care for a nursing home resident?
- An annual dental check up
- Care as needed by the residents dentist
- Basic minimum dental care furnished by the facility
- Assist residents in obtaining 24-hour emergency dental care
Assist residents in obtaining 24-hour emergency dental care
Nephritis is correctly defined as inflammation of the:
- liver
- kidneys
- pancreas
- gall bladder
kidneys
Quality improvement is correctly defined as the:
- sum of all activities to achieve quality care
- degree of conformity to accepted principles
- development and maintenance of quality care programs
- policies and procedures designed to maintain quality care
development and maintenance of quality care programs
An ophthalmologist treats residents with:
- visual disorders
- hearing disorders
- speech disorders
- arthritic disorders
visual disorders
Benign is defined as :
- acute
- cancer
- terminal
- non-malignant
non-malignant
Triggered Care Area Assessments (CAA) are used by the interdisciplinary team (ID):
- when calculating the acuity level of the resident
- in review of the resident’s drug regiment each months
- when the resident has a particular problem such as incontinence
- in determining how many minutes of therapy the resident can tolerate daily
when calculating the acuity level of the resident
Which of the following specialists primarily treats patients with cancer?
- Otologist
- Oncologist
- Geriatrician
- Cardiologist
Oncologist
Key components of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 have direct bearing on nursing homes. Which of the following is not true of the HIPAA regulations?
- Nursing homes are required to provide a notice to the residents about their rights a identified by HIPAA
- A staff member should be designated to ensure the facility complies with HIPAA rules and regulations
- HIPAA mandates that medical records must be kept for a minimum of 5 years post death or discharge of a resident
- HIPAA allows residents to have access to their medical records and gives them more control on how the information contained in the medical records is used
HIPAA mandates that medical records must be kept for a minimum of 5 years post death or discharge of a resident
The specialized field of recreational services designed to aid recovery or adjustment to illness, disability or specific social problems is called:
- gerokinesiatrics
- diagnostic activities
- therapeutic recreation
- recreational programming
therapeutic recreation
A professional activity director should closely involve families by:
- listing events on the bulletin boards
- inviting the community to holiday events
- holding frequent resident/family activity programs
- requesting the residents invite their families to facility events
holding frequent resident/family activity programs
In a nursing facility, volunteers are primarily utilized by the :
- dietary department
- activity department
- nursing department
- social-services department
activity department
In planning an activity calendar, the activity director must take into consideration holidays, projects community involvement, etc. Therefore, it is more prudent to begin with a:
- daily schedule
- weekly schedule
- monthly schedule
- yearly schedule
yearly schedule
Which of the following is not an activity?
- Taking a field trip
- Promoting cognitive health
- Attending a religious program
- Taking a resident for a walk to improve ambulation
Taking a resident for a walk to improve ambulation
Recent studies indicate facilities that have adopted the Eden approach have experienced al of the following except:
- reduced turnover
- higher occupancy
- increased mediation
- reduced absenteeism
increased mediation
To determine those activities in which a resident will participate, the choice should focus on the :
- desire of the resident
- availability of the activity
- ability of the activity director
- current activities of the resident
desire of the resident
Medical records must be properly stored:
- in the drug room
- under lock and key
- at the nurses’ station
- in the director of nursing’s office
under lock and key
Reviewing groups of medical records may identify various conditions and problems that could be addressed:
- by administration
- by resident councils
- during family conferences
- during in-service training programs
during in-service training programs
Which of the following serves as the basis for a comprehensive care plan?
- The MDS trigger
- The medical record manager
- The resident assessment protocol
- The minimum data set comprehensive assessment
The minimum data set comprehensive assessment
The medical record manager is not responsible for:
- setting up a record on each resident
- disposal of records at appropriate times
- the adequacy and accuracy of all records
- supervising the checking in and out of records
the adequacy and accuracy of all records
The CAA Review Process impacts current alert documentation systems for:
- need statements
- system approaches
- changes in the resident status
- interdisciplinary care planning
changes in the resident status
The pharmacist is responsible for:
- checking all drug records
- recording drug destruction
- assisting in the administration of drugs
- obtaining written prescriptions directly from all physicians
checking all drug records
Residents under Medicaid may be charged for all of the following except:
- cosmetics
- a telephone
- over-the-counter drugs
- a television for personal use
over-the-counter drugs
Abbreviations are used by nurses in completing charts and other medical records. As an example, the abbreviation t.i.d means:
- triple dosage
- three times daily
- continue for three day
- administer every three days
three times daily
Internal and external medications must be kept:
- in separate areas
- in separate rooms
- at the nurses’ station
- together by resident name
in separate areas
When residents under Title XVIII and Title XIX of the Social Security Act are discharged from a nursing home, the residents may take medications with them only if the:
- medications are not narcotic
- pharmacist approves the request
- attending physician has given written permission
- residents or their responsible parties sign a release
attending physician has given written permission
The agency or act that monitors proper storage and destruction of scheduled drugs is the:
- Health Care Finance Act
- Drug Enforcement Administration
- Omnibus Budget Reconciliation Act
- Comprehensive Drug Abuse Prevention & Control Act
Drug Enforcement Administration
Rehabilitation for a resident should start:
- at the family’s request
- upon the resident’s request
- when decided by the nurse
- as soon as possible after the onset of the disability
as soon as possible after the onset of the disability
Paralysis of the lower half of the body is referred to as:
- paresis
- paranoia
- paraphia
- paraplegia
paraplegia
In addition to assisting residents with various types of speech and language disorders, today the speech language pathologist spends considerably more time:
- preventing memory loss
- teaching residents to swallow
- teaching the English language
- working with post surgical residents
teaching resident to swallow
One of the best methods used by administrators to communicate immediately and directly with employees is a management style known as :
- employee recognition
- management by objective
- performance enhancement
- management by walking around
management by walking around
Communication within nursing facilities is the duty of:
- every person in the organization since everyone is a sender and a receiver
- the supervisors since they are responsible for seeing that procedures are carried out
- the line workers since they carry out specific tasks and report back to their supervisors
- primarily the administrator since he/she is the sender of policy and procedure information
every person in the organization since everyone is a sender and a receiver
When the administrator of a facility requests a meeting with the director of nursing for the purpose of requiring budget information, this would be an example of :
- vertical communication
- upward communication
- downward communication
- horizontal communication
downward communication