Test Questions Flashcards
- A reason for having all normal power (non-emergency) branch circuits fed from a single distribution panel, at a particular patient bed location, it to minimize.
A. the occurrence of electrical fires.
B possible micro-shock to a patient
C. the number of outlets at the bedside
D. possible potential difference between outlet grounds
D. This requirement (NFPA 99-2005 paragraph 4.3.2.2.1.1) minimizes the difference in potential (voltage) between grounds on the normal branch circuits. If differenced in potential are substantial. There can be adverse effects on connected medical equipment. It also is easier to trace the circuits back toa single distribution panel rather than to multiple panels, which can be important when emergency conditions might require rapid restoration of power.
2. According to Guidelines for Design and Construction of Health Care Facilities (2010 edition), Which of the following medical gas systems are required in a typical medical/surgical patient room? A. vacuum and oxygen B. medical air and oxygen C. vacuum and medical air D. nitrous oxide and oxygen
A. This is the correct answer based on the Guidelines for Design and Construction of Health Care Facilities
- A piece of equipment must be delivered immediately for installation. It does not fit into the original logistics plan for primary product delivery. The only logical delivery site is next to the main entry where there is adequate area for the delivery vehicle. Which of the following modifications to the logistics plan needs to me implemented?
A. Notify the fire department
B. Schedule delivery for an off-hours installation
C. Coordinate with hospital security to maintain access
D. Require the driver to relocate and deliver to another location
C. Parking a large vehicle at the main entrance may obstruct patient and visitor access, requiring assistance in directing traffic and pedestrians during the delivery period.
- The owner of an outpatient diagnostic center is planning an expansion and considers adding several new imagining modalities. The owner asks for the construction manager’s input on when the medical imagining equipment selections should be made. Which of the following is construction manager’s BEST response?
A. Modalities and manufacturer of equipment can be decided at any point, as long as it is before the concrete foundations are poured.
B. the modalities should be determined before the end of Schematic Design and equipment manufactures considered for each modality should be arranged prior to completion of Design Development.
C. The MRI and CT scanner manufacturer and model need to be selected at Schematic Design, but the catherization lab equipment can be selected at any time prior to start of construction.
D. All of the medical imagining equipment decision should be made prior to starting Schematic design in order to properly size the rooms.
B. This response allows the design team to accommodate all the anticipated final equipment features into the project. A decision on a specific model can be made later, often well into the construction process depending on the structure and location of equipment.
5. A new hospital is being developed on a steep sloping site. Several level will have doors existing to grade from different levels of the building. Perimeter lengths of the building at each level are as follows. Level 8 all above ground Level 7 all above ground Level 6 5% of the perimeter is a grade Level 5 30% of the perimeter is a grade Level 4 20% of the perimeter is a grade Level 3 40% of the perimeter is a grade Level 2 5% of the perimeter is a grade Level 1 entirely below ground
According to NFPA 101-2000(Life Safety Code), which of the following levels of this building is the primary level of exit discharge?
A. Level 6 B. Level 5
C. Level 4 D. Level 3
C. Paragraphs 18.1.6.1 (for new buildings) and 19.1.6.1 (for existing buildings) of NFPA 101-2000 detail that “Primary level of exit discharge of a building shall be the lowest story whose floor is level with or above finished grade on the exterior wall for 50% or more of its perimeter.” In this case, there perimeter at grade for Level 4 and above is the sum of each of those levels. That is 5% at Level 6, 30% at Level 5, and 20% at Level 4 for a total of 55% at Level 4 or above. This is information may become important when deciding whether a new building will be considered a high rise building and there by requiring additional fire protection features under the code.
- Which of the following treatment areas requires lead as a shielding material?
A. Magnetic resonance imaging (MRI) suite
B. Electromyography (EMG) laboratory
C. Computerized tomography (CT) scanning suite
D. Ultrasound examination room
C. CT devices use ionizing radiation (x-ray) in their operation. Lead shielding blocks ionizing radiation and protects CT operators and other people in adjacent areas.
7. Which of the following departments of an acute care hospital must be staffed 24 hours a days, 7 days a week? A. Surgery B. Pharmacy C. Emergency D. Physical Therapy
C. Guidelines for the Design and Construction of Health Care Facilities (2010 edition) clause 2.2.3.1.1.1 define emergency services as the capacity to perform initial and definitive emergency care 24 hours a day , 7 days a week.
- During construction, it is likely that normal fire response plans will be inappropriate and staff will be required to use alternate evacuation routes and techniques. Which of the following BEST describes the Interim Life Safety Measures (ILSM) required?
A. Temporary exits should be designated and inspected daily, and at least two fire drills per quarter per shift should be performed.
B. Temporary exits should be designated and clearly marked, staff should be trained, and at least two fire drills per quarter per shift should be performed.
C. Have the local authority having jurisdiction approve temporary exits.
D. Provide additional firefighting equipment and train staff on usage.
B. This answer includes The Joint Commission requirements in the Life Safety Chapter at LS.01.02.01, EP2 regarding signage on temporary exits. Staff training and additional fire drills would also be appropriate in this situation.
- The electrical service to the medical air compressors must be shut down to relocate the electrical feed to a different distribution panel. Which of the following is MOST likely to be affected?
A. Critical care, NICU, HVAC controls, and surgery air-powered instruments
B. surgery air powered instruments, laboratory automated analyzer, physical therapy, and intensive cate
C. NICU, ability to calibrate respiratory therapy equipment, critical care, and coronary care.
D. HVAC controls, coronary care, ability to calibrate respiratory therapy equipment, and physical therapy
C. The Guidelines for the Design and Construction of Health Care Facilities (2010 edition) require medical air outlets be included in critical care, coronary critical cate, and newborn intensive care NICU). This information is contained in Table 2.1-6. NFPA 99 allows medical air to be used for the calibration of equipment used for respiration. According to NFPA 99-202 paragraph 5.1.3.5.2, medical air source shall be connected to the medical air distribution system only and shall be used only for air in the application of human respiration and calibration of medical devices for respirator application.
10. A radiology renovation project in an occupied hospital must be constructed in five phases. The department must remain in operation 8:00 am – 5:00 pm, M-Sat. Each phase of the renovation requires an 8-hour electrical shutdown in order to make the final electrical tie-in of the new panels. Electricians are paid $70/hr., $105/h. for time worked after 5:00pm and $140/hr. for weekend work. The BEST cost per electrician that can be achieved on the project is A. $1,600 B. $2,800 C. $4,200 D. $5,600
C. Phasing is commonly used to keep the radiology department in a position where they can continue to offer services, even though those services offering may be limited due to construction. The contractor will not be able to conduct the electrical system shutdown during the operating hours of the department, as it would render the department incapable of providing any service the work should be preformed off-hours. By performing the work in the evening and on weekends, the contractor will be required to pay electricians $105/hr., but can avoid the weekend rate. The BEST cost per electrician is:
(5 shutdowns) x (8 hours/shutdown) x ($105/hr.) = $4,200
- A hospital is building a new bed tower on its campus next to an existing facility, the new facility will eventually tie into the existing facility by a new bridge walkway connection. The project is separated from the exiting hospital until the final phase when the bridge will be added. When should the project manager request the Infection Control Risk Assessment (ICRA)?
A. It does not need to be provided since the project site is separated form the existing facility
B. It does not need to provided until they get ready to tie in the new bridge walkway.
C. It should be completed before any work begins on the project site.
D. It should be completed before any work begins with any hazardous demolition.
C. According to the Guidelines for Design and Construction of Health Care Facilities (2010 edition), clause 1.2-3.1.2 “ICRA shall be conducted during the early planning phase of a project, before construction begins, and continue through the project construction and commissioning.” Although there may be no need to implemented any mitigative measures at the stage, it is vital to plan the construction, identify the risks, and set a mitigative strategy in advance of any work. This often requires significant discussion between the contractor and the health care facility. The earlier the process starts, the smoother construction is likely to progress.
- A worker receives a cut to the wrist while removing demolition debris from a hospital renovation site. Which of the following is the MOST appropriate course of action?
A. Clean the wound site, apply and antibiotic ointment, and the cover with clean gauze.
B. Treat the wound, report the incident to the contractor safety officer, and then see a physician for follow-up
C. Treat the wound, report the incident to the contractor safety officer, and then apply an antibiotic ointment
D. Clean the wound site, report the hospital safety director, and then see a physician for follow-up.
B. A construction worker is responsible to the employer and must report through the employer’s safety system. The incident should be reported to the contractor safety officer, if available. While the contractor may opt to share this information with the hospital, it’s not the worker’s responsibility to do so. The contractor may also be required by legislation to report the incident to various government agencies; however, that responsibility lies with the contractor safety officer. It may also be requirement to see a physician for follow-up, depending on the nature of the injury.
- Under which of the following delivery methods does a design team have a contract with an owner?
- construction manager at risk
- design/build
- design/bid/build
- Integrated project delivery
A. 1, 2 and 3 only
B. 1, 2, and 4 only
C. 1, 3, and 4 only
D. 2, 3, and 4 only
C. 1, 3 & 4. True. All construction delivery methodologies involve a contractual relationship between the design team and the owner with the exception of design/build.
2. False. In design/build, the owner contracting with the deliver team and the design team is a subtractor
- Before an employee enters a permit-required confined space, the internal atmosphere shall be teste with a calibrated direct-reading instrument for oxygen content and which of the following?
A. hydrogen sulfide, and flammable gasses and vapors
B. Carbon monoxide, and flammable gasses and vapors
C. Carbon monoxide and potential toxic air contaminants
D. Potential toxic air contaminants, and flammable gasses and vapors.
D. The OSHA standard for permit required confined space requires that the atmosphere be tested for flammable gases and vapors; however there is no specific requirement for testing the atmosphere for hydrogen sulfide and carbon monoxide. Testing for hydrogen sulfide and carbon monoxide should only occur if the gas is expected to be present.
The OSHA standard for permit-required confined spaces (29 CFR 1910.146) requires that the atmosphere be tested for flammable gasses and vapors and potential toxic air contaminants.
- Which of the following are the key components in preventing water intrusion through the external shell of the building?
A. Weather barrier, air gap, and exterior finish
B. Thermal barrier, vapor barrier, and weather barrier
C. Vapor barrier, thermal barrier, and exterior sheathing
D. thermal barrier, weather barrier and exterior finish
A. it is most important to stop water intrusion at the outside of the building. Newer water shedding systems employ the elements listed in option A to accomplish this. The weather barrier reduced air pressure and prevents moisture from penetrating to the interior. The air ap provides a reduction of wind pressure, allowing wind-driven water to drop to the weep locations in the wall systems. The exterior finish is the first lien of stopping water from penetration to the interior of the building.
- Renovation work is planned on the main corridor that connects the general oncology unit with the bone marrow transplant unit. Which of the following conditions should exist before start work?
A. both patient care areas should have negative air pressure relative to the work site.
B. the work site should have negative air pressure relative to the oncology unit and positive air pressure relative to the bone marrow unit
C. Air pressure relationships for all areas should be neutral relative to each other.
D. Both patient care areas should have positive air pressure relative to the work site.
D. air flow would be away from the patient care areas and in to the work site, assuring that dust as well as fungal bacterial contaminants form the work site do not flow into either of the patient care areas.
17. A hospital plans to build a 125,000-sf ambulatory care center on a green field site. The project scheduled requires occupancy with in 12 months and a target budget is fixed. The design will be approximately 50% complete at the scheduled time of construction start. To achieve the given schedule and target budget, which of the following is the BEST delivery module for this project? A. lump Sum B. Design/Build GMP C. Cost plus stipulated fee D. Cost plus GMP at design completion
D. Cost plus GMP (Guaranteed Maximum Price) at design completion allows the owner to start the project early, price the project for work beginning, and budget the project as the design progresses. A final GMP can accurately be created on the design is completed and before much of the construction is started.
- An outpatient unit with a separate CMS provider number is being constructed as an addition to a hospital. How should the addition be separated from the hospital?
A. With non-rated construction as long as both building are fully sprinkled with no separation.
B. by a two-hour fire rated barrier when both building have the same construction type
C. by a two-hour fire barrier with both building have independent or metered utilities
D. no separation is required when both buildings have the same construction type.
C. the option features both the separation of buildings and utilities. The federal anti-kickback status, 42 U.S.C 1320a-7b(b) prohibits individuals or entities from knowingly and willfully offering, paying solicitating, or receiving remuneration to include referral of items or services covered by Medicare Medicaid or any other federal funded program (except that Federal Employees Health Benefits Program). Given this requirement, most hospitals have to interpret this to mean the las applies when physician -owned or operated facilities are not included under the hospital’s licenses. These physician-operated facilities must be freestanding building with not support form the hospital, including utilities.
- Which of the following techniques does the CDC recommend for evaluating the integrity of temporary construction barriers?
A. airborne sampling by microbiological techniques of occupied areas and construction work zones
B. surface swab sampling of construction barriers
C. Microbiological surface swab sampling of floors and countertops in occupied areas adjacent to construction work zones
D. Airborne particle counting of occupied areas.
D. Correct. The CDC Guidelines for Environmental Infection Control in Healthcare Facilities acknowledge that particle counter may be useful to evaluating integrity of construction barriers.
A. airborne sampling by microbiological is only used for few specific circumstances; outbreaks investigation, research, microbial abatement validation, and infection control procedure evaluation.
- A fire alarm system is being taken out of service for three months and a temporary fire alarm system will be put into place. According to the Interim Life Safety Measures (ILSM), is testing required of this system?
A. Yes, testing must be conducted weekly
B. Yes, testing must be conducted monthly
C. No, testing is not necessary since the system is temporary
D. No, testing is not necessary if the system is in place for three months of less.
B. TJC Life Safety Chapter, LS.01.02.01 EP 12 requires testing monthly
- Which of the following tools is used by a hospital in developing an emergency management plan?
A. Defend-in-Place Analysis
B. Hazard Vulnerability Analysis (HVA)
C. Interim Life Safety Measures (ILSM)
D. Infection Control Risk Mitigation Recommendation (ICRMR)
B. Correct- HVA is used by hospitals to assets events that could trigger the emergency operations plan for the organization and the likelihood of those events occurring.
A. Defend-in-Place is part of project design
22. A health care constructor provides the following value analysis for four buildings on a healthcare campus: Deferred Building FCI Maintenance Cancer Center 0.45 $3,000,000 Women’s Health 0.25 $1,000,000 Children’s Center 0.35 $2,000,00 Ambulatory Surgery Center 0.15 $8,000,000
Based on these data, which of the following buildings should be replaced?
A. Cancer Center B. Women’s Health
C. Children’s Care D. Ambulatory Surgery Center
A. The higher FCI indicates that is has a higher percentage of deferred maintenance or costs associated with renewal as compare to its capital value.
- which of the following conditions would MOST likely compromise the integrity of a smoke barrier?
A. non-functional smoke dampers
B. non-functional door latching hardware
C. drywall construction that has water damage
D. oversized kick plates on cross-corridor doors
A. the integrity of a smoke barrier may be compromised by a non-functional smoke damper in ductwork that passes through the smoke barrier.
24. Assuming all Interim Life Safety Measures (ILSM) listed below were put into place during a hospital renovation project, which of the following are required to be inspected on a daily basis? A. Temporary fire alarm systems B. Additional fire sprinkler heads C. Portable firefighting equipment D. Alternate exits in the affected areas
D. TJC standards (LS.01.02.01) require hospitals to evaluate the need to implement various ILSM when NFPA 101-2000 (Life Safety Code) deficiencies cannot be immediately corrected and during periods of construction. Of the various ILSM that might be implemented, only inspection of exits in the affected are is required on a daily basis by TJC.
- Which of the following entities requires healthcare intuition to establish an emergency communications plan?
A. The Joint Commission
B. The Facility Guidelines Institute
C. The National Fire Protection Association
D. The Center for Disease Control and Prevention
A. The Joint Commission requires a plan be in place for emergency compunction. According to the 2011 Joint Commission Comprehensive Accreditation Manual for Hospitals (CAMH), EM02.02.01, the hospital prepares for how it will communicate during emergencies as part of its Emergency Operations Plan.
- A construction manager has been engaged to assist in replacement of the physiological monitors in an inpatient unit. The new monitors require that communication cables be preplaced. A meeting must be called to determine the requirements for the cable replacement project. The project requirements meeting should include the heads nurses, the hospital project manager, and which of the following?
A. IT department only
B. hospital safety officer only
C. IT department and infection control
D. Hospital safety officer and biomedical engineer
C. at a minimum, these perspectives must be addressed when planning replacement of the monitors, The IT department understands the impact on the overall network system, and infection control brings a patient safety perspective (on this unit and in nearby areas).
- The decline in exploratory surgery in recent years is primarily due to which of the following factors?
A. Aging of the baby boomer generation
B. Improved medical imagining capabilities
C. reduced levels of reimbursement for surgical costs
D. Increased concern among surgeons regarding legal liability
B. improved medical imagining capabilities, including advancements in magnetic resonance imagining (MRI), computer tomography (CT), ultrasound, and other modalities have allowed non-invasive visitation of internal anatomy with increased detail. This enables diagnoses that would have, in the past, required exploratory surgery for direct visualization of internal anatomy.
- According to the Bureau of Labor Statistics, which of the following is the MOST common cause of construction worker injury and death on a healthcare construction project?
A. lack of Personal Protective Equipment (PPE)
B. falls from a height
C. collisions with emergency vehicles
D. contact with bloodborne pathogens.
B. In addition to fatal workplace injuries, the Office of Safety and Health Statistics at the Bureau of Labor Statistics tabulates annual counts are rates of nonfatal occupational injuries and illnesses. Their data are available at www.bis.gov/iif they maintain data for injuries.
- After a hospital has vacated a space, a contractor begins performing demolition in a former patient care area. The contractor finds a trash receptacle containing a full red bas. Which of the following is the contractor’s MOST appropriate response?
A. Contact the hospital and request removal of the bag.
B. Tightly seal and dispose of the bag with the construction debris.
C. Dispose of the ag the same way that the hospital disposes of infectious waste.
D. the hospital has already removed any dangerous materials from the area, so the bag can be disposed of a regular trash.
A. A hospital should remove materials such as red bas (potentially infectious) and sharp containers from an area prior to construction of demolition. Is a contractor finds items, the hospital should be notified and the materials should not be handled.
30. Labor Delivery Recovery (LDR) and Labor Delivery Recover Postpartum (LDRP) rooms have same ventilation requirements as. A. GI Rooms. B. laboratories. C. patient rooms. D. surgical suites.
C. The patient room ventilation requirements in the Guidelines for Design and Construction of Health Care Facilities Tables 7-1. Are the same for LDR an LDRP.
GI room are not stated, multiple requirements for laboratories, Surgery and Caesarean delivery rooms are the same
31.The following Facility Condition Index (FCI) data are available for several buildings on a healthcare campus: Building FCI Heart Hospital 0.15 Behavioral Health Hospital 0.25 Women’s and Children’s Center 0.60 Ambulatory Surgery Center 0.45
Based only on the FCI data given which of the following building should be replaced? A. Heart Hospital B. Behavioral Health Hospital C. Women’s and Children’s Center D. Ambulatory Surgery Center
C. The Women’s and Children’s Center has the highest FCI. This indicates the building has a higher percentage of deferred maintenance of costs associated with renewal. A building with a FCI of .60 indicates that the cost of renewal of the building is 60% of the cost of replacement.
- Which of the following protocols should be followed when a construction worker breaks a sprinkler head in a patient care area of a hospital?
A. Call main company office, report the incident, put a bucket under the broken sprinkler head, and call for assistance.
B. Notify the hospital facilities personnel, assist in the shutdown, and clean up as directed by project superintendent
C. Attempt to turn off the water flow, call for assistance, and call the fire department
D. Call the fire department, notify the hospital facilities personnel, and call the main company office.
B. the most important step is to notify the hospital facilities personnel so they can manage the incident. The construction worker may then assist as directed.
- System commissioning is
A. not necessary.
B. only required for LEED certification.
C. only necessary if allowed by the budget.
D. recommended by the Facilities Guidelines Institute (FGI).
D. this is the correct answer based on the Guidelines for Design and Construction of Health Care Facilities (2010 edition), Clause 1.2-8 commissioning.
- Construction project in a NICU includes minor demolition, installation of new electrical outlets, and rebuilding of the nursing stations. In addition to Infection Control Risk Assessment (ICRA) requirements, the BEST protection against the risks of construction includes using tools that can demolish existing materials
A. quickly with permission from the facility manager before de-energizing the electrical system.
B. quickly with permission from the nurse manager before de-energizing the electrical system.
C. quietly with permission from the facility manager before de-energizing the electrical system.
D. quietly with permission from the nurse manager before de-energizing the electrical system.
C. Patients in the NICU are commonly premature babies or infants with significant medical challenges. These patients are often born before their bodies have fully developed. Studies have shown such patients to be highly sensitive to light and noise. As such, finding demolition methods to complete this work quietly is often a requirement in such areas of the hospital.
A contractor should never take and infrastructure system out to service without the permission of the healthcare facilities. In many cases, the facility will require that their own staff take such systems out of service. Although it is important to have the permission of the nurse manager before de-energizing the electrical system, it is not equally important to have the permission of the facility manager.
The facility manager is vital to ensure that no other areas of the hospital are impacted by the shutdown, or if they are impacted, the ability manager should ensure that hospital staff are available to mitigate risks caused by such an situation. The facility manager is responsible for ensuring that all impacted staff (including the NICU’s nurse manager) are aware of the shutdown and are prepared to respond.
- TJC standards require hospitals to identify security sensitive areas. Which of the following areas are MOST likely to have electronic security systems?
A. ICU, nursery and cashier
B. Central plant, nursery, and ICU
C. Nursery, Pharmacy, and cashier
D. oncology, pharmacy, and incident command center
C. The nursery is commonly identified as a security-sensitive area die to the risk of infant abduction. The pharmacy is commonly identified as a security-sensitive area due to the risk of theft of drugs. The cashier is commonly identified as a security-sensitive area due to the risk of theft of money, in area like these, it is likely that electronic security systems of various types will be implemented along with other security measures. See TJC stands, EC.02.01.01
- During construction, occupied areas shall be isolated from construction zones to prevent possible contamination based on processed established by
A. Hazard Vulnerability Analysis (HVA)
B. Interim Life Safety Measures (ILSM)
C. Infection Control Risk Assessment (ICRA)
D. Environmental Hazard Assessment (EHA)
C. ICRA establishes procedures required to minimize the distribution of facility operation and the distribution of dust, odors, and particulates. An ICRA is required by the Guidelines for Design and Construction of Health Care Facilities (2010 edition) clause, 1.2-3.
37. Which of the following is the quickest way to determine the financial viability of an energy-saving measure? A. simple payback B. net present value C. simple rate of return D. Internal rate of return
A. simple payback is the quickest calculation measure, as it simply divides capital project cost by the saving per year.
NPV is the difference between the present value of cash inflow and the present value of cash outflow- used capital budgeting to analyze the profitability of an investment or project.
Simple rate of return, shows the amount of time it will take to recover an investment.
Internal rate of return, defined the expected benchmark rate for go/no go decision on projects.
- An operating room renovation must be accomplished in a few days; therefore working during a period what the surgical suite is unoccupied is not an option. In preparation for the project, the infection prevention has insisted that the operating room under renovation e kept at negative pressure to semi-restrict corridor at all times. The contractor has sealed the renovation space and has provided negative pressure. Which of the following BEST assures that negative pressure is maintained at all times?
A. Keep the door to the room closed at all times do dust does not enter the corridor.
B. Provide a negative pressurized anteroom between the operating room and the corridor.
C. Place a HEPA filtered negative air machine in the operating room clos to the door in the corridor.
D. Install a mechanical air curtain at the door so dust does not enter the corridor.
B. The Center for Disease Control and Prevention (CDC) (www.cdc.gov) published Guidelines for Environmental Infection Control in Health-Care Facilities. The doc lists several mitigative measures for controlling the spread of dust and challenging in that the remaining operating room must continue to provide service and their patients typically fall in the highest risk categories. By providing a negatively pressurized anteroom between the work space and the clinical space the contractor reduces the potential for migration of airborne particulate to at-risk patients. These anterooms should be set up to insure that air flows from the semi-restricted corridor toward and through the anteroom to the renovation space.
39. A general hospital project is substantially complete. The owner is installing new equipment in the main distribution frame (MDF) room and I beginning to test the system. One of the punch-list items is to rebalance the air in the MDF room. To schedule this work, the contract should obtain approval from the A. owner. B. inspector. C. HVAC subcontractor. D. air balancing company.
A. As the computer equipment come online, it may provide access to patient records. In order to comply with HIPAA, the owner is responsible for maintaining confidentiality of patient records and information.
- Which of the following are critical for a site logistics plan?
A. emergency vehicle access, construction lay down area, and patient visitor access.
B. patient visitor access, erection sequence, and contractor parking
C. emergency vehicle access, erection sequence, and contractor parking
D. contractor parking, emergency vehicle access, and tower crane placement
A. All of the elements listed her impact the continuity of operations for a healthcare institution. The concern is continuity of operations.
- NFPA 241-2009 Standard for Safeguarding Construction, Alteration, and Demolition Operations requires that construction areas be separated from occupied areas within a non-sprinklered building by a minimum fire-rated barrier of
A. ½ hr. B. 1 hr.
C. 1 ½ hr. D. 2 hr.
B. According to NFPA 241-2009 Standard for Safeguarding Construction, Alteration, and Demolition Operations Section 8.6.2 a one-hour fire rate barrier is required.
- The CDC recommends that microbiologic sampling of air, water, and inanimate surfaces occur only in which of the following situations?
A. outbreak investigation, research, microbial abatement validation, and infection control procedure evaluation
B. outbreak investigation, research, verification of construction barrier effectiveness, and infection control practice evaluation
C. outbreak investigation, periodic air quality assessments, verification of construction barrier effectiveness, and microbial abatement validation.
D. research, microbial abatement validation, periodic air quality assessments, and infection control practice evaluation.
A. the CDC’s Guidelines for Environmental Infection Control in Health-Care Facilities acknowledges that microbiologic sampling is useful for specific applications, including outbreak investigation, research, microbial abatement validation, and infection control procedure evaluation.
Does not advocate to verify construction barrier effectiveness or periodic air quality test.
- A public hospital is assembling a project team for the design and construction of an expansion to the facility. The design team has been selected, and the owner’s preferred project delivery method it to select a contractor for pre-construction services with the intent to negotiate a Guaranteed Maximum Price for the project. Which of the following BEST describe the steps required to procure these services?
A. Create a pre-qualification process and select a general contractor.
B. Create a pre-qualification process and proceed with bidding qualified general contractor fees.
C. Create a list of general contractors based on previous experience with the hospital and proceed with bidding qualified general contractor fees.
D. Create a list of general contractors based on previous experience and select a general contractor.
B. in addition to the pre-qualification list, this option provides for the public procurement requirement by bidding the fees that contractors charge for performing this work.
- As part of a renovation project, the scope of work is tying new chilled water lines into the existing supply risers. Prior to beginning work, which of the following steps should be followed?
A. Verify the integrity of the system before turning off the branch line valves.
B. Verify the valves have been exercised before turning off the branch line valves.
C. Ask the owner where the riser valves and branch lines valves are located, and exercise the valves before turning off the branch line.
D. Ask the owner where the riser valves and branch line are located, have the owner turn off the valves and verify that the valves are functional.
D. It is crucial that critical system be identified by the owner and the owner take ultimate responsibility for shutting down these systems.
45. A function of the HVAC system unique to healthcare is A. filtration B. dehumidification C. infection control D. ventilation (outside air)
C. A necessary function of a healthcare HVAC system is to provide and maintain pressure differentials to control the movement of airborne particulates such as bacteria. The infection control functions include filtration and ventilation rates, as well as pressure differentials.
- A patient tower of a Joint Commission-accredited hospital was originally constructed in 2004. Smoke barriers divide the third-floor nursing unit into three smoke compartments:
Compartment A 9,500 Sq. ft.
Compartment B 15,750 Sq. ft.
Compartment C 16,250 Sq. ft.
Part of the compartment C is undergoing major renovation to create a new rehabilitation unit. When the ceiling is removed, it is discovered that a section of the smoke barrier between compartment A and C has an opening of apx. 4 feet by 3 feet with an 8-inch chilled water pipe and numerous IT cables padding through. Which of the follow is the contractor’s BEST response?
A. Notify TJC, temporarily seal the opening with fire rated plastic, and redraw the life safety drawings so that the compartment A and C are combined into one compartment.
B. Notify the healthcare facility, implement Interim Life Safety Measures (ILSM) and repair the opening to restore the integrity of the wall to that of a 20-minute fire-rated smoke barrier.
C. Notify the healthcare facility, implement Interim Life Safety Measures (ILSM), and repair the opening to restore the integrity of the wall tot that of an 1-hour fire-rated barrier.
D. Notify TJC, temporarily seal the opening with fire rated plastic, and seal the opening with dry wall material within 96 hours.
C. Notification of the healthcare facility is the first response, as they have responsibility for patient safety. They need to notify affected AHJs and implement the ILSM for the duration of the time it takes to restore the smoke barrier to the full 1-hour rating.
- A contractor is working in an area that uses the Guidelines for Design and Construction of Health Care Facilities as code. The contractor should use the version
A. is most current
B. used by the design team
C. that was used for permitting.
D. currently enforced by the federal AHJ.
C. The permitted documents are the official, legal project documents and represent that jurisdictional acceptance of the correct edition/version of the code.
- Which of the following steps are required by TJC to take the fire alarm system out of service for six hours in an occupied hospital facility during a construction project?
1. Add supplemental security
2. Notify the fire department or other emergency response group.
3. Initiate a fire watch.
4. Implement Interim Life Safety Measures (ILSM) where appropriate.
A. 1, 2, and 3 only
B. 1, 2, and 4 only
C. 1, 3, and 4 only
D. 2, 3, and 4 only
D. TJC standard, LS.01.02.01 requires implementation of ILSM as appropriate.
- Which of the following would TJC require as a response to a sentinel event that occurs in a hospital?
A. Close down the unit where the event occurred until the issues is corrected.
B. Report the event to the local law enforcement agency immediately.
C. Take disciplinary action against employees responsible for the unexpected occurrence.
D. Perform a root cause analysis to identify the underlying cause for the unexpected occurrence.
D. A sentinel event is a unexpected occurrence involving a death or serious physical or psychological injury, or the risk thereof. For example, an aspergillosis infection may be considered a sentinel event. Accredited organizations are expected to identify and respond appropriately to all sentinel events occurring in the organization. Appropriate response includes conducting a timely, thorough, and credible root cause analysis; developing an action plan designed to implement improvements to reduce risk; implementing the improvements; and monitoring the effectiveness of those improvements.
50. During what phase of construction is the cost of changing design feature the lowest? A. Schematic Design B. Design Development C. Construction Delivery D. Construction Documents.
A. The object of Schematic Design is to refine and build upon the scope, conceptual design, scale and relationships among the components of the project. The primary goal of this phase is to develop a clearly defined design based upon the client’s requirements, as defined by the facility program developed during predesign. Project quality scope, budget, and schedule will also be confirmed and refined. Design feature changes are least expensive in the earliest part of the process. As the time, less time and effort has been expanded in defining the project features.
- The following information is available for a hospital:
Cost to replace the hospital= $100,000,000
Sum of deficiencies = $24,000,000
Addition of sq ft if the existing building is renovated = $5,000,000
Expected annual net review increases if an MRI is added $1,000,000
Endowment for replacement of the facility = $10,000,000
Reduction in operating expenses if a replacement building is built $2,000,000
What is the Facility Condition Index (FCI) for the building?
A. 0.24 B. 0.25
C. 0.27 D. 0.37
A. FCI is calculated by dividing the sum of deficiencies by the cost for replacement. The FCI does not include additional services or additional square footage. The FCI also does not consider sourced of funding. It is simply the ratio of cost to renew an existing facility versus the cost to replace that facility without adding additional space or service:
$24,000,000/$100,000,000 = 0.24
52. Which of the following types of facilities must maintain operations 24 hrs. a day 7 days a week? A. acute care hospital B. ambulatory care center C. medical office building D. same day surgery center
A. Acute care hospitals provide facilities for invasive procedures that require overnight stays or are in operation for 24 hrs. per day. Patients needing this type of medical care have more serious conditions or higher acuity levels than patients in the other facilities listed.
53. According to the Guidelines for Design and Construction of Health Care Facilities (2010 edition), the owner shall be provided with which of the following upon occupancy of the building or portion thereof? A. lien release B. set of record documents C. clean, operational facility D. certificate of occupancy
B. this is correct per Guidelines for Design and Construction of Health Care Facilities (2010 edition), Clause 1.2-9.1.1
A. the lien is outside of the guidelines, this is a contractual issue in-between the contractor and owner.
C. guidelines does not state the facility must be clean
D. Cert of occupancy is a requirement of the local jurisdiction not the guidelines
- A hospital’s Hazard Vulnerability Analysis (HVA) identifies the possibility of treating a large number of patients exposed to hazardous chemicals due to the close proximity of a large chemical plant. Which of the following is the hospitals MOST likely to ask of a contractor based on the HVA?
A. Maintain access for emergency services at all times and have extra hoses available to assist with decontamination, if needed.
B. Be prepared to assist with moving patients and to vacate the construction site to provide a location for helicopter landing.
C. Secure approval prior to interrupting utilities and maintain access for emergency services at all times,
D. Have N95 masks available for each worker and have extra hoses available to assist with decontamination, if needed.
C. A contractor must always secure approval from the healthcare facility prior to interrupting utilities. Access to the Emergency department by emergency response personnel and the general public is critical and any interruption to the access or traffic flow must be planned and coordinated with the healthcare facility.
- A hospital is preparing to replace and existing roof. Leadership has voiced concerns about how to proceed based on past failed installations. Samples from the existing roof show moisture in the insulation and possible decking deterioration. Which of the following is the best practice?
A. Hire a contractor to remove the entire existing roof, repair any damage, and replace the roof in phases as soon as possible.
B. Hire a consultant to design the new roof, inspect installation, and have a contractor install the roof in phases to keep it sealed at the end of each day.
C. Hire a consultant to design the new roof, have contractor install in phases, and obtain extended warranties to deal with any future issues.
D. Hire a consultant to inspect the new roof installation, obtain extended warranties, and replace the roof in phases to keep it sealed at the end of each day.
B. While there may be some moisture in the insulation, a more imperative need is to keep the building dry during construction. Water intrusion into the building affords the possibility of conditions conducive to fungal growth on wet building materials, know potential hazards to immunocompromised patients. This approach ensures a correct design inspected for conformance with the design while keeping the interior of the operating hospital dry.
- A patient floor in a new patient tower has 32 patient sleeping rooms. The entire floor is 21,000 sq. ft. and is used for medical-surgical patients only. Which of the following is True?
A. Only one smoke compartment is needed since the Sq. Ft. is less than 22,500 Sq. ft.
B. Two smoke compartment are required regardless of size and the travel distance at any exit.
C. Only one smoke compartment is needed as long as the travel distance at any exit is not greater than 200 ft.
D. two smoke compartments are required since the total Sq. Ft. on the floor is greater than 20,000 Sq. Ft.
B. NFPA 101-2000 (Life Safety Code) paragraph 18.3.7.1, requires that every floor used for sleeping or treatment of patients in a new health care occupancy be divided into not less than two smoke compartments, with a maximum size of 22,500 Sq. ft. per compartment.
57. According to the Guidelines for Design and Construction of Health Care Facilities (2010 edition), “clean to dirty” refers to A. air flow. B. water flow. C. oxygen systems. D. vacuum systems.
A. This is the correct answer based upon the Guidelines for Design and Construction of Health Care Facilities, Section 1.2-7.1.1
58. A construction manager is constructing a comprehensive cancer center. Which of the following is MOST likely to have an effect on the construction sequencing? A. first patient day B. building commission C. installation of equipment D. imagining equipment testing
C. installation of equipment and all special need for moving equipment into place and installing is drive much of the sequence of work. For example: MRIs, CTs, and radiation therapy equipment might require moving parts of the equipment into place prior to the room being completely finished. Actual equipment connection and testing may occur later. For MRIs, temporary utilities may be required to protect the machine.
59. A Protective Environment (PE) room is typically used for which of the following type of patients? A. cardiac B. neonatal C. obstetric D. immunocompromised
D. A PE room is intended for use by immunocompromised patients, i.e., patients with compromised immune systems who are more susceptible to infection. Examples of immunocompromised patients are those who have received a bone marrow transplant, certain oncology patients, certain organ transplant patients, etc.
- A hospital exit discharge leading to a public way will be blocked by excavation and site work for four months during construction. Which of the following is the MOST appropriate application of Interim Life Safety Measures (ILSM)?
A. Post signage to identify alternate exits, provide temporary fire detection systems, and conduct additional fire drills.
B. Provide additional firefighting equipment, arrange for additional training on the use of firefighting equipment, and file a Statement of Conditions with the fire department.
C. Post signage to identify alternate exits, inspect exits on daily basis, and conduct education to promote awareness of the deficiency.
D. Inspect exits on a daily basis, conduct education to promote awareness of the deficiency, and file a Statement of Conditions with the fire department.
C. Signage must be posted. When exits are changed or altered, a daily inspection is also appropriate, as is training for staff on how and where to exit.
61. Which of the following is the newest methodology for project construction? A. design/build B. design/bid/build C. integrated project delivery D. construction manager at risk
C. Integrated project delivery is the latest methodology to be introduced to the industry. In many respects, it is similar to the construction manager at risk, but in integrated project delivery, the contract is a three-way contract between owner, design team, and delivery team. This methodology usually features shared financial risk and reward between the contracting parties.
Design/build started in the 1960’s, it is an integrated project delivery. The delivery team subcontracts the design team. Design/bid/build is the oldest form of project delivery. The owner contracting the design and delivery team separately. The Construction manager at risk, referred to as construction manager/general contractor (GMGC). The design and delivery team are separate contracts however they are brought on at the same time.
- Which of the following are the MOST likely sources of Legionella bacteria in a hospital setting?
A. cooling towers and hot water systems
B. domestic water systems and air handlers
C. sanitary sewer and storm water systems
D. water impregnated building features and under sinks in clinical areas
A. Cooling towers and hot water systems may provide the appropriate conditions (e.g. stagnant water and favorable temperatures) for proliferation of Legionella bacteria.
63. Which of the following facilities has the highest patient acuity? A. general hospital B. skilled nursing facility C. medical office building D. ambulatory care center
A. General hospitals have emergency rooms and intensive care units that treat higher acuity patients.
Acuity can be defined as the measurement of the intensity of nursing care that is required by a patient. An acuity-based staffing system regulates the number of nurses on a shift according to the patients’ needs and not according to raw patient numbers.
Ambulatory care does not care for patients longer than 23 ½ hrs.
- which of the following BEST describes the conditions under which Interim Life Safety Measures (ILSM) should be assessed for possible implementation?
A. when a hospital identifies Life Safety deficiencies that cannot be immediately corrected or during periods of construction
B. when the oxygen system must be taken out of service.
C. when there is a possibility that electrical power could be lost to the areas where a patient’s life is sustained by a ventilator
D. anytime construction occurs with a healthcare occupancy.
A. ILSM, as defined by The Joint Commission Life Safety Standard LS.01.02.02.01 are used to “protect occupants during periods when the NFPA 101-2000 (life safety code) cannot met during periods of construction “risk assessments should be used to determine the risk to patients, staff, and visitors for many situations including shutdowns of critical utilities (such as electrical distribution and medical gas systems) and measures implemented to offset those risks. However ILSM is by definition and application, related specifically to risk created when there are Life Safety Code deficiencies.
- The bed tower for a hospital project is two months behind schedule. It is late fall and the weather is inclement. The glazing for the curtain wall has been delayed and the constructor is under pressure to make up the time. The constructor elects to start interior fir-out prior to completion of envelope enclosure. Which of the following is MOST detrimental risk that might result from this action?
A. water infiltration would increase humidity levels, corroding the air handlers.
B. Water infiltration may find its way into the interior building, increasing the likelihood of flooring failure.
C. Water infiltration may find its way into the interior materials starting a cycle of mold infestation.
D. the glazing contractor will have to work around the interior finishes to install the glazing.
C. As building materials remain wet for extended time periods, the conditions become more favorable for allowing proliferation of mold. Extensive mold contamination may require replacement of building materials. Depending on the level of contamination.
66. Which of the following infrastructure systems is unique to healthcare? A. Medical gas B. HEPA filtration C. emergency electrical D. quick-response sprinklers
A. Many facilities may unitized piped gay systems, but only healthcare use medical gas systems.
67. The Central Sterile Processing Department needs to be shut down form 8:00 pm to 6:00 am due to a utility upgrade. Which of the following department’s operations would be MOST affected by this utility shutdown? A. Neonatal Care B. Plant Operations C. Surgical Services D. Diagnostic Imagining
C. A key function of Central Sterile Processing department is to clan and sterilize instruments used for surgery. Shutting down this department would have the most immediate effect on Surgical Services.
- For an inpatient behavioral health unit, the MOST important architectural design feature for patient safety is to
A. provide additional firewalls
B. include additional sprinkler heads
C. install features that reduce the likelihood of suicide
D. locate the nursing station to provide direct visual supervision.
C. the most important patient safety issue in locked inpatient behavioral health units are prevention of suicide and elopement (escaped from the unit). There are numerous architectural features that can reduce the likelihood of suicide by hanging, for example using recessed sprinkler heads and installing breakaway fixtures in patient bathrooms.
69. The OSHA bloodborne pathogen standard requires that biohazard warning labels be affixed to which of the following items? A. trash receptacles B blood analysis instruments C. container of regulated waste D. medical vacuum systems
C. Since contractors will work in many areas of the hospital, they should know how to identify item that may be potentially biohazardous. The OSHA bloodborne pathogen standard (29 CFR 1910.1030) does require biohazard warning labels on containers of regulated waste. Regulated waste means liquid or semi-liquid blood or other potentially infectious materials: contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid Sate if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials.
- Which of the following are major construction-related issues for magnetic resonance imagining (MRI) devices?
- delivery dimensions and path
- electrical power quality and capacity
- equipment weight and floor loading
- shielding for ionizing and microwave radiation
A. 1, 2, and 3 only
B. 1, 2, and 4 only
A. 1, 3, and 4 only
A. 2, 3, and 4 only
A. MRI devices are large and heavy which require attention to floor loading and delivery size and path, they also require substantial electrical power.
- A room used as the hospital incident command center must be temporarily relocated during a construction project. Which of the following will MOST likely be needed in the temporary incident command center?
A. television, emergency power, network connection, and whiteboards
B. emergency power, roll-away bed, network connectivity, and restroom
C. Personal Protective Equipment (PPE) for emergency responders, restroom, television, and provision for food storage
D. roll-away bed, provision for food storage, PPE for emergency responders, and whiteboards.
A. A hospital incident command center is used as the location from which the operations of the facility takes place when there are unusual circumstances, either external or internal. In the event of a prolonged power failure or other incidents that can cause a loss of power to the hospital, the incident command center would need to remain functional.
Network connections should be able to access internal information resources and the internet. Most hospitals want the ability to access television stations from the incident command center to monitor news and weather reports a whiteboard is almost always included in the incident command center to provide a place to document and take notes as plans are developed for emergency operations
- which of the following is the MOST effective method for reducing infant abductions from a hospital?
A. Install a closed-circuit video monitoring system.
B. Conduct infant abduction drills for hospital staff.
C. Install an electronic infant abduction security system.
D. Educate mothers to release their infant only to authorized personnel.
D. According to the National Center for Missing and Exploited Children (NCMEC), the most effective method for reducing infant abductions is to educate mothers to release their infants only to authorized personnel. This avoids having infants released to personas posing as healthcare workers, which is the most common technique for infant abduction Nursery personnel who are authorized to take babies from their mothers are typically identified by special name tags of other unique indicators that are explained to mothers.
- TJC standards for hospitals require emergency power for which of the following areas?
A. data centers, operating rooms, and urgent care areas
B. pathology laboratories, operating rooms, and kitchen facilities
C. urgent care areas, operating rooms and obstetrical delivery rooms
D. patient care units, obstetrical delivery rooms, and medical records storage
C. TJC standards (EC.02.05.03) require emergency power for the following:
- alarm systems (NFPA 101-2000 LSC)
- exit routes and signs illumination (LSC)
- elevators (at least one for nonambulatory patients)
- equipment that could cause harm when it fails (life-support systems, blood, bone and tissue storage, medical air/vacuum compressors)
- areas in which loss of power could result in patient harm (including operating rooms, recovery rooms, obstetrical deliver rooms, nurseries, and urgent care areas).
- Sustainability is important for health care institutions for which of the following reasons?
- marketing and community pressures
- lowers operational costs
- required by The Joint Commission
- required by the Green Guide for Health Care
A. 1 and 2 only
B. 2 and 3 only
C. 2 and 4 only
D. 3 and 4 only
- True. Community pressure and marketing are often big benefits on healthcare institutions pursuing sustainable features in a project.
- true. Energy consumption is one of the larger operational cost for facilities. Many of the sustainable issues, particularly “low-hanging fruit”, are related to energy.
- False. While TJC requires a sustainable water supply in the emergency management requirements, THJ defines sustainable as a continuity of water supply.
- False. The Green Guide for Health Care is a certification standard, and is only important if the owner wants to purse a certification.
75. Prior to shutting off utilities, notice should to be given to the facility owner as required by which of the following? A. The Joint Commission B. contractor’s construction schedule C. facility’s policies and procedures D. local authority having jurisdiction
C. The facilities polices and procedures, as defined by the owner’s representative, should always take precedence for utility shutdowns, the owner has ultimate responsibility for patient safety and is the only entity with control of systems that support patient safety.
- A general hospital’s fire alarm system needs to be taken out of service for an extended period of time while hot work is being performed. Which of the following special precautions should be taken by the contractor working on the project?
A. A hot work permit should be obtained, a fire watch implemented, and the system restored immediately after the work is completed.
B. A fire watch should remain in effect for 8 hours after the hot work permit is closed out and the system is reactivated.
C. A hot work permit should be obtained, a fire watch implemented and the system restored after closing out the hot work permit.
D. A fire watch should remain in effect for 1 hour after the hot work permit is closed out and the system is reactivated.
C. the appropriate sequence of events is to obtain a hot work permit, implement a fire watch, complete the work, observe the work site for a period of time specified in the hot work permit, close out the hot work permit (and end the fire watch), and reactivate the system.
77. The primary patient safety hazard for computed tomography (CT) imagining is. A. magnetic field. B. ionizing radiation. C. radiofrequency field. D. radioactive materials.
B. CT devices use ionizing radiation (x-rays) in their operation. Overexposure can cause serious health consequences, including an increased risk of cancer.
- Ventilation in an operation room typically has
A. low air changes per hour and negative pressure relative to surrounding areas.
B. low air changes per hour and positive pressure relative to surrounding areas.
C. high air changes per hour and negative pressure relative to surrounding areas.
D. high air changes per hour and positive pressure relative to surrounding areas.
D. Ventilation in an operating room typically has ahigh number of air changes per hour. This reduces surgical infection by supplying a large volume of highly-filtered air and exhausting potential contaminants. Operating room ventilation systems are typically balanced so the operating room is at positive pressure relative to surrounding areas. This also reduces surgical infections by keeping contaminants in surrounding areas out the operating room. As a result, all air coming into the operating room is from the highly-filtered supply rather than from surrounding areas that may be less sterile.
- An intensive Care department on the fourth floor of a seven-story high hospital has been expanded by adding four additional rooms. The medical gas system must be branched to add gas outlets in the new rooms. Which of the following locations MUST have verification tests performed after the breach is completed?
A. all zones in the ICU
B. all zones serving the fourth floor
C. the entire system to the primary shutoff valve
D. the system downstream from the nearest zone valve
D. Whenever modifications are made or maintenance is preformed that breaches the system, the verification tests specified in NFPA 99-2005, paragraph 5.1.12.3 and 9.8.6 shall be conducted on the downstream portions of the medical gas piping system.
- What is the minimum design efficiency for a HEPA filter?
A. 99.7% efficient against particles 0.3 microns in diameter
B. 99.9% efficient against particles 0.3 microns in diameter
C. 99.9% efficient against particles 3.0 microns in diameter
D. 99.97% efficient against particles 0.3 microns in diameter
D. HEPA filters have many applications in healthcare facilities and construction projects. They are often used with fans to generate negative pressure within a construction work zone. Contractors should understand their limitations and performance characteristics. A HEPA filet is at least 99.97% efficient against particles 0.3 microns in diameter as tested following the Institute of Environmental Sciences and Technology (IEST) test standard RP-CC001.4-2005.
