Study Guide 12 Flashcards
Normal psychological aging in the elderly would not include .
1. Slowed memory retrieval
2. Difficulty handling change
3. Loss of memory
4. Depression
3
Normal aging in the elderly would not include .
1. Loss of skin elasticity
2. Glaucoma and cataracts
3. Depressed immune system
4. Dementia
4
With respect to restraints, the CMS wants nursing facilities to ultimately .
1. Properly monitor physical restraints
2. Be restraint free
3. Use chemical restraints on a limited basis
4. Use door locks which meet the Life Safety Code Standards
2
What is a nursing home initially required to do when an incontinent resident is admitted or develops
incontinence after admission?
1. Assess the resident to see if they are appropriate for an incontinence training program
2. Develop and implement a specific bowel and bladder training program
3. Correct the underlying cause by the use of Kegel exercises
4. Notify the resident that neither Medicare nor Medicaid pays for incontinence briefs.
1
Which of the following would most likely go unnoticed by staff?
1. Incontinence
2. Irritable bowel syndrome
3. Depression
4. Slight strokes
4
What is a facility’s primary responsibility for a resident with hearing and vision problems?
1. Develop special programs that help them maintain or improve hearing and vision
2. Ensure residents receive proper treatment and assistive devices
3. Supply large print books and hearing headsets
4. Treatment them as you would regular residents
2
Which is more effective for residents with depression?
1. Spending 2 weeks in a psychiatric program in a hospital
2. Medications, family involvement and staff attention
3. Counseling, activities and medications
4. Treatment in a local mental health center
3
Which of the following has not proven to be effective for residents with Dementia?
1. Re-motivation
2. Reality orientation
3. Validation therapy
4. Sensitivity training
4
Most effective way to plan for a resident who has a tendency is to wander is .
1. Identify the potential to wander through an immediate assessment
2. Determine at or before admission if an individual has the tendency or potential to wander
3. Plan a program that all residents must adhere to if they tend to wander
4. Place all wanderers into some type of restraint
2
If a resident complains they have trouble sleeping because of cold or odd feelings in their legs, this is
most likely caused by .
1. An antibiotic
2. A neurological disorder called “Restless Leg Syndrome”
3. A Urinary tract infection
4. Leg cramps
2
A resident admitted for a fractured leg with no history of cognitive problems would not need which of
the following?
1. A physician’s order for therapy
2. A chest X-ray
3. A level 2 preadmission screening
4. Verification of hospital admission and discharge dates
3
A Medicaid resident must have an assessment how often?
1. First day of admission, then every 60 days thereafter and upon a significant change
2. On the 5th, 14th, 30th and 60th days, and upon a significant change
3. By the 14th day after admission, quarterly and then annually or upon significant change
4. Every 30 days after admission
2
An advantage of a PEG tube over a nasogastric tube is .
1. PEG tubes are better tolerated
2. Nasogastric tubes are better tolerated
3. PEG tubes are required for shorter stays
4. PEG tubes do not need to be monitored
1
A long term resident is readmitted to the facility after treatment for a hip fracture. She will need physical
therapy. The RN must document care assessments according to which schedule:
1. The 5th, 14th, 30th, 60th and 90th day after admission
2. The 5th, 20th, and 100th day of admission
3. The 21st day and then every 60 days thereafter
4. the 1st, 5th day and every 2 weeks from admission
1
Once an MDS is completed, which of the following statements is correct?
1. The MDS is electronically sent to the Medicaid Agency, Medicare is sent to the CMS and the
completed forms are kept in resident chart for 15 months
2. Both Medicaid and Medicare forms are sent to the CMS and the completed forms are kept in
resident chart for 15 months
3. Both the Medicaid and Medicare forms are sent to the State Medicaid Office and the completed
forms are kept in resident chart for 15 months
4. Both Medicaid and Medicare forms are filed in the resident records and only sent to the state
upon request
1
HIPPA requires resident records be maintained per the following requirements except for .
1. They be complete
2. They be readily accessible
3. They be systematically organized
4. They be maintained by a MRA
4
If a resident requests a copy of their records on Friday, the facility must comply with the request by .
1. Saturday
2. Sunday
3. Monday
4. Tuesday
4
Who is responsible for implementation of resident care policies?
1. The administrator
2. The DON
3. The Social Worker
4. The medical director
4
Which activity would be most effective for Alzheimer residents?
1. Morning walks
2. Bingo
3. An activity involving music
4. Physical exercise
3
Which of the following is not an OBRA requirement?
1. The pharmacy must label medications with an appropriate cautionary statement
2. The pharmacy must label medications with the name of the resident and the prescribing
physician
3. Labels must identify the expiration date
4. The name and strength of the medication must be listed
1
An anti-psychotic drug may be prescribed when a resident is .
1. Wandering
2. Delusional
3. Experiencing anxiety
4. Restless
2
If families want to form a family council, the administrator is not required to do which of the following:
1. Provide space and needed materials
2. Provide a resource person for the group
3. Implement recommendations when possible
4. Periodically attend the meetings
4
Which is most effective to prevent pressure sores?
1. Egg crate overlay
2. Massage pressure points on resident’s body
3. Bandage all pressure points to prevent a pressure sore
4. Provide a pressure relieving mattress
4
Which committee is responsible to identify any issue that affects quality of care?
1. Infection control committee
2. Quality Assurance Committee
3. Risk Management Committee
4. Safety Committee
2
What is the first thing a nurse should do if a resident refuses to take his medication?
1. Call his physician
2. Document refusal
3. Explain the consequences to the resident
4. Contact the family for help
3
Which type of change in resident condition would not require the facility to notify the family?
1. Resident appears to have a chill
2. An injury with potential for physician intervention
3. A slight bruise on the leg
4. Any type of injury that may occur
1
A resident wants to volunteer to work for the facility to perform a specific task. What must the
facility do?
1. Ask the resident to work as volunteer
2. Get his physician to approve it
3. Refer the matter to the resident council for approval
4. If he does work for the facility make sure it is noted in his plan of care
4
True or False – A facility can discharge a resident without advanced written notice if they have not
resided in the facility for the prior 30 days?
1. True
2. False
1
The Patient Self Determination Act requires the facility to .
1. Recognize a resident’s living will or power of attorney as their advance directive
2. Request all residents to complete an advanced directive
3. Advise all residents a living will is not required but an advanced directive is required to be
executed
4. Advise family member an advanced directive can be reversed if the resident becomes
incompetent
1
Which is considered the first priority in an employee training program?
1. Resident care policies and procedures
2. Fire prevention and control
3. Resident rights
4. Prevention and control of infections
2
What is the key to a good employee pay scale?
1. Starting with a fair wage standard of the community
2. Starting above the minimum wage
3. Having an increment pay plan
4. Paying for shift differentials
1
What is the primary purpose of developing policies, procedures and rules?
1. Make it easier to keep employees in line
2. Meet CMS and Medicaid requirements
3. Explain to employees what is expected of them and what they can expect from the facility
4. Ensure employees cannot get by with poor work or behavior
3
Does FMLA provide leave for a sick brother or sister?
1. Yes
2. No
2
Why does the OIG recommend facilities have a corporate compliance program?
1. To ensure physicians are not accepting money for referrals
2. Corporations can now be held liable for criminal acts of employees
3. To prevent intentional violations for anti-kickback laws
4. To educate employees on their legal responsibilities
2
Why is face to face communication considered the most effective form of communication?
1. Can more readily obtain feedback to determine level of understanding
2. Employees generally prefer this method over written communication
3. It is easier for employees to retain spoken language then written
4. Managers more strongly emphasize the importance of the information being communicated
1
What is the difference between the state’s role in Medicare and Medicaid?
1. There is no difference as the state administers both programs
2. The State licenses and certifies, and monitors Medicaid facilities
3. The State does all but handle funds for Medicaid; the state handles the entire program for
Medicare
4. The state sets the standards for Medicaid; CMS sets the standards for Medicare and handles the
funds for both
2
Which of the following must surveyors invite to the facility’s exit interview?
1. Medical director and ombudsman
2. Medical director and key staff members
3. Resident council representative and ombudsman
4. Interested family members and Director of Nursing
3
Which of the following are basic things a leader does?
1. Get employees to do what they are paid to do
2. Set goals and then initiate and monitor actions that attain desired results
3. Develop plans and motivate staff to carry them out
4. Serve as a boss who keeps employees in line and are productive
2
Which of the following are two types of management methods that effective managers use?
1. TQM and MBWA
2. MBWA and Dictatorial
3. TQM and less supervision
4. MBO and laissex faire
1
Which of the following is not one of the 5 key functions of management:
1. Planning
2. Organizing
3. Directing/Leading
4. Staffing
4
As soon as plans are developed explaining what needs to be done and how the task will be
accomplished, and when and by whom, what must a leader do?
1. Determine what staff will be needed and employ them
2. Orient staff to facility policies and procedures and train them for their tasks
3. Determine what activities will be needed, group them and set up the organizations structure
4. Initiate action that gets the operation started
3
In order to promote good relationships among all departments, which approach has proven most
successful?
1. Hold regular department head meetings
2. Make departmental goals an integral part of the facility goals
3. Have department heads dine together on a regular basis
4. Allow no changes in any one department until all other departments have time to prepare for
any impact on them
4
What is the primary duty of the governing body?
1. Hire an administrator
2. Develop guidelines for management and operations
3. Periodically evaluate the administrators internal management of the facility
4. Approve a budget
2
An individual who leases a nursing home to a management company needs a large amount of money
to meet their retirement goals. Consequently, the individual decides to double the lease payments
which are much higher than lease payments in the area. Which law has been violated?
1 False Claims Act
2 Stark Act
3 Safe Harbor Regulations
4 Fraud and Abuse
3
Upward communication has some drawbacks that an administrator must be aware concerning
employees that report to them. What do supervisors tend to do most often?
1. Place blame on others for any mistakes
2. Neglect to inform you of things you need to know
3. Filter out information that may reflect badly on themselves or someone else they may be
protecting
4. Not fully informing you of a problem you need to know about
3
Which of the following would be considered immediate jeopardy?
1. Stage 2 sore on a heel
2. Staff not identifying themselves before entering a resident room
3. An inoperative nurse call system
4. Dietary staff not wearing a hairnet
3
What is considered communication in a nursing home?
1 Putting the message in a language the resident understands
2 Obtaining immediate feedback on what was said
3 Recognizing that employees normally have poor retention
4 Listening which should be 40% of one’s time
1
Under Medicare’s consolidated billing, which of the following services to residents may a facility not bill
for:
1 Physical therapy
2 Non-emergency medical transportation
3 Durable medical equipment
4 Physician visits to the resident
4
When building a new nursing home, doors must be a minimum width of inches wide.
1. 42
2. 43
3. 44
4. 45
3
What is the main purpose of a risk management program?
1. To protect residents from improper care
2. To protect staff from injury
3. To reduce occurrences that result in legal action against the facility
4. To promote a positive public image
3
Which agency promulgates the widest range of standards for nursing homes?
1. OSHA
2. ANSI
3. NFPA
4. CMS
4
Which form is used to bill for Medicare services?
1 2567
2 UB 04
3 671
4 672
2
Working capital is distinguished from other types of capital as .
1 Cash used to purchase real estate and equipment
2 Expenditures that increase book value of assets
3 Current assets - current liabilities
4 Cash used in capital expenditures
3
