1
Q
Which one of the following is a normal psychological change in the elderly?
- Dementia
- Loss of vision
- Becoming incontinent
- Problem handling change
A
Problem handling change
2
Q
Mental changes in elderly residents are usually caused by:
- diabetes
- arteriosclerosis
- inadequate diet
- frequent minor accidents
A
arteriosclerosis
3
Q
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
A
make the process understandable to the resident and family
4
Q
Developmental disability can mean any of the following except:
- autism
- epilepsy
- cerebral palsy
- mental illness
A
mental illness
5
Q
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
A
Civil Money Penalities
6
Q
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
A
the number of medications not administered plus the number improperly administered divided by the opportunities for error
7
Q
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
A
needs of those using the facility’s services
8
Q
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
A
Computers will select 3 discharge charts to be reviewed: one because of death, one to the community, and one to home
9
Q
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
A
provide an interchange of medical and other information to assure adequate resident care
10
Q
By repeatedly rejecting the dependent behavior of an elderly person, such behavior shall:
- increase
- decrease
- be stabilized
- be eliminated
A
increase
11
Q
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
A physician’s order for immediate care
12
Q
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
A
glaucoma
13
Q
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
A resident has the right to receive mail unopened, uncensored on the day mail is delivered to the nursing home
14
Q
Who is responsible for the implementation of resident care policies?
- Administrator
- Medical Director
- Board of Directors
- Director of Nursing
A
Medical Director
15
Q
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
A
Food Service Manager
16
Q
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
A
anxiety related to the unknown
17
Q
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
A
before or during admission
18
Q
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
A
social service
19
Q
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
A
listening and asking questions
20
Q
The most common psychological condition affecting older adults is:
- tension
- anxiety
- delirium
- depression
A
depression
21
Q
Adaptive feeding equipment can be prescribed by the physician or the:
- family
- speech therapist
- director of nursing
- occupational therapist
A
occupational therapist
22
Q
Which of the following would not help a person with osteoporosis?
- Calcium
- Vitamin D
- Decrease smoking
- Staying out of the sun
A
Staying out of the sun
23
Q
The best time for the dietary supervisor to weigh, inspect, and verify food orders is when it is:
- served
- received
- prepared
- purchased
A
received
24
Q
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
A
peanuts
25
One of the major problems resulting from serving food trays to residents in their rooms is that the:
1. the resident eats less food
2. trays are not properly labeled
3. amount of food is usually limited
4. food is cold before it is consumed
food is cold before it is consumed
26
The formula to determine the percent of body weight loss is as follows:
1. divide the actual weight by the usual weight times 100
2. divide the usual weight by the actual weight times 100
3. divide the current weight by the average weight time 100
4. 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
27
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?
1. 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
2. It must be ongoing and comprehensive, primarily dealing with the nursing and rehabilitation
3. 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
4. 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
28
Under OBRA, Which of the following committees may not be replaced by the quality improvement committee?
1. Safety committee
2. Infection control committee
3. Pharmaceutical services committee
4. Interdisciplinary care planning committee
Interdisciplinary care planning committee
29
What specifically does the law require regarding dental care for a nursing home resident?
1. An annual dental check up
2. Care as needed by the residents dentist
3. Basic minimum dental care furnished by the facility
4. Assist residents in obtaining 24-hour emergency dental care
Assist residents in obtaining 24-hour emergency dental care
30
Nephritis is correctly defined as inflammation of the:
1. liver
2. kidneys
3. pancreas
4. gall bladder
kidneys
31
Quality improvement is correctly defined as the:
1. sum of all activities to achieve quality care
2. degree of conformity to accepted principles
3. development and maintenance of quality care programs
4. policies and procedures designed to maintain quality care
development and maintenance of quality care programs
32
An ophthalmologist treats residents with:
1. visual disorders
2. hearing disorders
3. speech disorders
4. arthritic disorders
visual disorders
33
Benign is defined as :
1. acute
2. cancer
3. terminal
4. non-malignant
non-malignant
34
Triggered Care Area Assessments (CAA) are used by the interdisciplinary team (ID):
1. when calculating the acuity level of the resident
2. in review of the resident's drug regiment each months
3. when the resident has a particular problem such as incontinence
4. in determining how many minutes of therapy the resident can tolerate daily
when calculating the acuity level of the resident
35
Which of the following specialists primarily treats patients with cancer?
1. Otologist
2. Oncologist
3. Geriatrician
4. Cardiologist
Oncologist
36
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?
1. Nursing homes are required to provide a notice to the residents about their rights a identified by HIPAA
2. A staff member should be designated to ensure the facility complies with HIPAA rules and regulations
3. HIPAA mandates that medical records must be kept for a minimum of 5 years post death or discharge of a resident
4. 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
37
The specialized field of recreational services designed to aid recovery or adjustment to illness, disability or specific social problems is called:
1. gerokinesiatrics
2. diagnostic activities
3. therapeutic recreation
4. recreational programming
therapeutic recreation
38
A professional activity director should closely involve families by:
1. listing events on the bulletin boards
2. inviting the community to holiday events
3. holding frequent resident/family activity programs
4. requesting the residents invite their families to facility events
holding frequent resident/family activity programs
39
In a nursing facility, volunteers are primarily utilized by the :
1. dietary department
2. activity department
3. nursing department
4. social-services department
activity department
40
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:
1. daily schedule
2. weekly schedule
3. monthly schedule
4. yearly schedule
yearly schedule
41
Which of the following is not an activity?
1. Taking a field trip
2. Promoting cognitive health
3. Attending a religious program
4. Taking a resident for a walk to improve ambulation
Taking a resident for a walk to improve ambulation
42
Recent studies indicate facilities that have adopted the Eden approach have experienced al of the following except:
1. reduced turnover
2. higher occupancy
3. increased mediation
4. reduced absenteeism
increased mediation
43
To determine those activities in which a resident will participate, the choice should focus on the :
1. desire of the resident
2. availability of the activity
3. ability of the activity director
4. current activities of the resident
desire of the resident
44
Medical records must be properly stored:
1. in the drug room
2. under lock and key
3. at the nurses' station
4. in the director of nursing's office
under lock and key
45
Reviewing groups of medical records may identify various conditions and problems that could be addressed:
1. by administration
2. by resident councils
3. during family conferences
4. during in-service training programs
during in-service training programs
46
Which of the following serves as the basis for a comprehensive care plan?
1. The MDS trigger
2. The medical record manager
3. The resident assessment protocol
4. The minimum data set comprehensive assessment
The minimum data set comprehensive assessment
47
The medical record manager is not responsible for:
1. setting up a record on each resident
2. disposal of records at appropriate times
3. the adequacy and accuracy of all records
4. supervising the checking in and out of records
the adequacy and accuracy of all records
48
The CAA Review Process impacts current alert documentation systems for:
1. need statements
2. system approaches
3. changes in the resident status
4. interdisciplinary care planning
changes in the resident status
49
The pharmacist is responsible for:
1. checking all drug records
2. recording drug destruction
3. assisting in the administration of drugs
4. obtaining written prescriptions directly from all physicians
checking all drug records
50
Residents under Medicaid may be charged for all of the following except:
1. cosmetics
2. a telephone
3. over-the-counter drugs
4. a television for personal use
over-the-counter drugs
51
Abbreviations are used by nurses in completing charts and other medical records. As an example, the abbreviation t.i.d means:
1. triple dosage
2. three times daily
3. continue for three day
4. administer every three days
three times daily
52
Internal and external medications must be kept:
1. in separate areas
2. in separate rooms
3. at the nurses' station
4. together by resident name
in separate areas
53
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:
1. medications are not narcotic
2. pharmacist approves the request
3. attending physician has given written permission
4. residents or their responsible parties sign a release
attending physician has given written permission
54
The agency or act that monitors proper storage and destruction of scheduled drugs is the:
1. Health Care Finance Act
2. Drug Enforcement Administration
3. Omnibus Budget Reconciliation Act
4. Comprehensive Drug Abuse Prevention & Control Act
Drug Enforcement Administration
55
Rehabilitation for a resident should start:
1. at the family's request
2. upon the resident's request
3. when decided by the nurse
4. as soon as possible after the onset of the disability
as soon as possible after the onset of the disability
56
Paralysis of the lower half of the body is referred to as:
1. paresis
2. paranoia
3. paraphia
4. paraplegia
paraplegia
57
In addition to assisting residents with various types of speech and language disorders, today the speech language pathologist spends considerably more time:
1. preventing memory loss
2. teaching residents to swallow
3. teaching the English language
4. working with post surgical residents
teaching resident to swallow
58
One of the best methods used by administrators to communicate immediately and directly with employees is a management style known as :
1. employee recognition
2. management by objective
3. performance enhancement
4. management by walking around
management by walking around
59
Communication within nursing facilities is the duty of:
1. every person in the organization since everyone is a sender and a receiver
2. the supervisors since they are responsible for seeing that procedures are carried out
3. the line workers since they carry out specific tasks and report back to their supervisors
4. 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
60
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 :
1. vertical communication
2. upward communication
3. downward communication
4. horizontal communication
downward communication
61
Before communicating with an employee, it is important that the administrator and/ or supervisor:
1. obtain a witness
2. prepare an outline
3. write the remarks out first
4. anticipate the employee's reaction
anticipate the employee's reaction
62
Work should be assigned based on:
1. individual abilities
2. the effect on morale
3. previous assignments
4. the requirements to complete the job
individual abilities
63
The primary responsibility for the implementation and success of a nursing facility's in-service training program belongs to:
1. the consultants
2. each supervisor
3. the administrator
4. the director of nursing
the administrator
64
All of the following are staffing alternatives that can usually reduce cost except the use of:
1. part-time help
2. peak-time staffing
3. a varied work week
4. agencies for temporary employment
agencies for temporary employment
65
To determine the employee absentee rate, the administrator must:
1. divide the number of days in the month by the lost workdays and then multiply by the number of employees and multiply by 100
2. subtract the number of lost workdays from the number of days in the month times the total number of employees and multiply by 100
3. after subtracting the number of lost workdays from the number of days in the month, multiply by the number of employees and multiply by 100
4. divide the number of lost workdays by the number of days in the month multiplies by the total number of employees and multiply by 100
divide the number of lost workdays by the number of days in the month multiplies by the total number of employees and multiply by 100
66
A policy on sexual harassment should include all of the following except:
1. disciplinary actions such as fines
2. the definition of sexual harassment
3. the establishment of action for violations
4. prohibition of retaliation against reporting somplainst
disciplinary actions such as fines
67
The appraisal of a job in relation to standards is referred to as a job:
1. analysis
2. evaluation
3. description
4. specification
evaluation
68
An employee wage-evaluation program should be based primarily on:
1. merit
2. seniority
3. personality
4. wages paid in comparable faclities
merit
69
Fringe benefits do not include:
1. holidays
2. overtime
3. sick leave
4. group insurance
overtime
70
Which of the following is the least contributing cause of high employee turnover?
1. Limited orientation
2. Inadequate in-service training
3. Lack of policies and procedures
4. Incomplete reference check and hiring practices
Lack of policies and procedures
71
The first person who should resolve employee problems and grievances is the:
1. administrator
2. department head
3. personnel director
4. immediate supervisor
immediate supervisor
72
Administrators agree that the primary purpose of the job interview is to:
1. review the job description
2. discuss the history and philosophy of the facility
3. determine if the applicant is suitable for the position
4. ask those questions that cannot be asked i=on the application
determine if the applicant is suitable for the position
73
A union will be established if the results of the election indicate that the number voting to join a union is at least:
1. 33 percent
2. 50 percent
3. 50 percent plus one employee
4. 51 percent
50 percent plus one employee
74
Regarding the Family Medical Leave Act of 1993, which of the following statements is false?
1. When an employee has worked 1,250 hours, they are qualified for benefits
2. The employee should be reinstated in the former or an equivalent position
3. During the duration of FMLA leave, the employer must maintain the employee's health insurance
4. Upon return from FMLA leave, an employee cannot lose any of his/her benefits accrued during employment
When an employee has worked 1,250 hours, they are qualified for benefits
75
The Equal Employment Opportunity Commission requires that the workplace maintain a non-hostile environment relative to:
1. disciplinary action
2. sexual harassment
3. a grievance committee
4. equal wages for equal work
sexual harassment
76
Which of the following is not covered under the Americans With Disabilities Act?
1. Dyslexia
2. Depression
3. Retardation
4. Homosexuality
Homosexuality
77
According to FMLA, paid or unpaid leave can usually be for any of the following reasons except:
1. birth of a child
2. divorce and/or legal separation
3. placement of a child for adoption
4. caring for a spouse with a serious health condition
divorce and/or legal separation
78
The process which ensures that financial resources are obtained and used effectively and efficiently in the accomplishment of the institution's objectives is correctly defined as:
1. budgeting
2. accounting
3. cost controlling
4. financial management
financial management
79
All of the following are intangible assets except:
1. leases
2. goodwill
3. copyrights
4. accounts receivable
accounts receivable
80
Which of the following categories account for the largest portion of expenses in a healthcare facility?
1. Labor
2. Inventory
3. Insurance
4. Equipment
Labor
81
A marginal return occurs when revenues equal expenses. It is also referred to as:
1. Liquidity
2. net profit
3. ration analysis
4. break-even point
break-even point
82
How do you calculate the average cost per resident day?
1. Divide the monthly expenses by the average number of residents days in the month
2. Subtract the monthly expenses from the monthly gross income and divide by the number of residents per day
3. Divide the total monthly expenses by the number of beds in the facility and then multiply by the number or residents per day
4. Divide the total monthly expenses by the number of resident days in the months and divide by the average number of residents per day
Divide the total monthly expenses by the number of resident days in the months and divide by the average number of residents per day
83
Before a resident is eligible under Title XVIII for inpatient care in a skilled nursing facility, the resident must be in a hospital for the same condition for at least:
1. 2 consecutive days
2. 3 consecutive days
3. 3 intermittent days
4. 5 intermittent days
3 consecutive days
84
According to the Internal Revenue COde, which type of business organization may choose any twelve-month period as its fiscal year?
1. Partnerships
2. S corporations
3. C Corporations
4. Sole Proprietorships
C corporations
85
When the annual net income of a facility is divided by the total shareholder's equity, the result is the:
1. cash flow
2. net worth
3. return on equity
4. change in fund balance
return on equity
86
Working capital and return on equity are:
1. fixed assets
2. financial rations
3. reserve accounts
4. related to cash flow
financial rations
87
How do you calculate a monthly depreciation amount using straight-line depreciation?
1. divide the cost of the equipment by 12
2. Divide the salvage value by the number of years to be depreciated and then divide by 12
3. Add the salvage value to the cost of the equipment and divide by the number of years to be depreciated times 12
4. Subtract the salvage value to the cost of the equipment and divide by the number of years to be depreciated and then divide by the number of months per year
Subtract the salvage value to the cost of the equipment and divide by the number of years to be depreciated and then divide by the number of months per year
88
Current assets include all of the following except:
1. cash
2. inventory
3. working capital
4. accounts receivable
working capital
89
According to IRS, records for payroll taxes must be kept for at least:
1. 3 years
2. 4 years
3. 5 years
4. 7 years
3 years
90
IRS tax form 1099 must be completed annually by an employer:
1. for all employees
2. in lieu of a W-2 form
3. for employees who work only part-time
4. for all outside providers and companies who provide contract service
for all outside providers and companies who provide contract service
91
How do you calculate the approximate percentage of gross profit?
1. Divide the expenses by the income
2. Divide the income by the expenses
3. Subtract the income by the expenses and multiply by 100
4. Add the fixed expenses and the variable expenses and subtract from the gross income. Divide the difference(net profit) by the gross income
Add the fixed expenses and the variable expenses and subtract from the gross income. Divide the difference(net profit) by the gross income
92
A Medicaid agency need not be notified if a change occurs in the :
1. ownership
2. stock value
3. nursing home administrator
4. officers of the managing company
stock value
93
Income statements are prepared directly from the:
1. journals
2. balance sheet
3. general ledger
4. revenues statements
general ledger
94
Equities are correctly defined as:
1. profit
2. cash flow
3. owner's assets of a business
4. accounts receivable minus accounts payable
owner's assets of a business
95
A listing of every account in the general ledger and the corresponding debit or credit balance is called a:
1. trail balance
2. balance sheet
3. general journal
4. profit and loss statement
trail balance
96
How do you calculate the average percent of occupancy?
1. Divide the total number of beds by the number to days and multiply by 100
2. Divide the number of occupied beds by the number of total beds and multiply by 100
3. Subtract the number of vacant beds from the number of occupied beds and divide by the total number of beds and multiply by 100
4. Divide the number of occupied-bed days by the total number of days in the period and then divide by the total number of beds and multiply by 100
Divide the number of occupied-bed days by the total number of days in the period and then divide by the total number of beds and multiply by 100
97
When forced air ventilation is used in a nursing home, the system should change the air at least once every:
1. six minutes
2. twelve minutes
3. fifteen minutes
4. thirty minutes
six minutes
98
In chemical disinfection what is the most important thing to remember for satisfactory operation?
1. The surface must be cleaned first
2. The chemical used should have antiseptic qualities
3. The solution concentration should be at least five percent
4. Liquids should be maintained at temperatures of at least 80 degrees
The surface must be cleaned first
99
What is the principal reason for requiring the food service department to have its own housekeeping supplies and materials and not allow housekeeping personnel to clean the food service area?
1. It is more efficient and economical
2. It prevents disease spreading from resident care areas
3. Morale among housekeeping would be lowered if they were required to do food service cleaning
4. Food preparation and food-service housekeeping are too closely related to allow housekeeping personnel to participate
It prevents disease spreading from resident care areas
100
Proper hand hygiene is critically important except:
1. before putting on gloves
2. before handling soiled linen
3. before passing medication
4. before handling clean linen
before handling soiled linen
101
The Medicare and Medicaid requirement (1995) establish:
1. signage for the blind
2. audible and visible emergency alarms
3. the maximum number of residents per bedroom
4. telephones accessible to wheelchair-confined residents
the maximum number of residents per bedroom
102
The minimum width of a bedroom is determined by:
1. ANSI
2. OBRA
3. the state
4. Life Safety Code
the state
103
Bedrooms must meet all of the following standards except:
1. have a floor at or above grade level
2. have a direct access to an exit corridor
3. accommodate no more than four residents
4. provide 100 square feet per resident in a multiple-resident bedroom
provide 100 square feet per resident in a multiple-resident bedroom
104
According to ANSI 4.2.3, the space required for a wheelchair to make a 180 degree turn shall be a clear space:
1. 60 inches in diameter
2. 66 inches in diameter
3. 72 inches in diameter
4. 78 inches in diameter
60 inches in diameter
105
A facility must provide each resident's bedroom with an individual closet space that has a clothes rack and:
1. shelves
2. a shoe rack
3. locked doors
4. a safety box for valuables
shelves
106
ANSI/ADAAG requires nursing homes make it s physical plant assessable to all of the following except?
1. Deaf
2. Blind
3. Mentally ill
4. Uncoordinated
Mentally ill
107
OBRA requires that resident rooms meet the following parameters with the exception of:
1. requiring hot water temperature to be set between 100-110 Degrees F.
2. resident room temperature being maintained between 71-81 Degrees F.
3. resident rooms having 80 square feet per person per room or 100 sq. ft in private rooms
4. installing ceiling-suspended curtains that provide full visual privacy for each resident
requiring hot water temperatures to be set between 100-110 Degrees F.
108
The role of developing and implementing a written hazard communication program is the responsibility of the:
1. supplier
2. importer
3. employer
4. manufacturer
employer
109
ANSI ( American National Standards Institute) establishes the:
1. schedule for the fire drills
2. availability of the water source and supply
3. Width of a parking space for handicapped
4. requirement for at least one window to the outside for every bedroom
width of a parking space for the handicapped
110
The principal cause of death resulting from a fire is:
1. burns
2. cuts and bruises
3. smoke inhalation
4. trampling at exits
smoke inhalation
111
In a nursing home when an item disappears, first:
1. call the police department
2. search al cars and employees
3. check to determine if it could be misplaced
4. check those on duty and/or attending meetings
check to determine if it could be misplaced
112
According to ANSI, all handrails on ramps and stairs must be between:
1. 26-30 inches from the floor
2. 28-32 inches from the floor
3. 30-34 inches from the floor
4. 32-36 inches from the floor
30 - 34 inches from the floor
113
If a nursing home has 16 parking spaces reserved for the disabled, how many spaces must be van accessible?
1. 1
2. 2
3. 3
4. 4
2
114
After the interruption of normal power, the emergency generator must start and transfer power within:
1. 10 seconds
2. 15 seconds
3. 30 seconds
4. 60 seconds
10 seconds
115
Draperies and bed cubicle curtains must not interfere with smoke detectors and sprinkler heads. Therefore, a thin mesh that will not interfere with their functioning can be used or they can be hung below the sprinkler and detectors by at least:
1. 8 inches
2. 12 inches
3. 18 inches
4. 24 inches
18 inches
116
A housekeeper is cleaning the hallway mopping the entire width of the floor as she goes. She leaves her housekeeping cart, far down the hall, unlocked and unattended and puts out visible wet floor signs. When she is finished she stores her cart in an unlocked room. How many housekeeping procedures did she ignore?
1. four
2. three
3. two
4. none
two
117
The distance from the door into a resident room to the nearest exit door may be no more than:
1. 75 feet
2. 100 feet
3. 125 feet
4. 150 feet
100 feet
118
The Life Safety Code was developed and published by:
1. ANSI
2. NFPA
3. OSHA
4. OBRA
NFPA
119
Which of the following applies if the administrator and the board of governors carry out their respective duties?
1. The governing body should be equally concerned about management techniques and their effectiveness
2. The governing body not only hires the administrator, but also should review and approve the management techniques he/she uses
3. The administrator is responsible for management and the governing body is responsible for determining the effectiveness of management
4. The governing body is concerned with the management techniques the administrator uses and the administrator is concerned about effectiveness
The administrator is responsible for management and the governing body is responsible for determining the effectiveness of management
120
The primary objective of utilization review for Medicare is to assure:
1. compliance with the law
2. high quality resident care
3. the Title VI is being obeyed
4. that the facility is covered by an intermediary
high quality resident care
121
Which of the following is not a survey task?
1. Tour of the facility
2. Information gathering
3. Reviewing the budget and financial reports
4. Information analysis for deficiency determination
Reviewing the budget and financial reports
122
The Title XIX fiscal intermediary is selected by the:
1. facility
2. DHHS regional office
3. state Medicaid agency
4. state nursing home association
state Medicaid agency
123
Regulations have affixed the primary responsibility for utilization review with the:
1. intermediary-third party payee
2. governing body of the facility
3. Social Security Administration
4. medical staff or medical profession
medical staff or medical profession
124
Which of the following is not a major function of a governing board or an advisory board?
1. hiring staff
2. Stewardship
3. Approval of budgets
4. Approval of policies and procedures
Hiring staff
125
When the administrator establishes goals, they should be expressed in:
1. managerial terms
2. accounting terms
3. measurable terms
4. terms of objectives
measurable terms
126
Most administrators agree that the most essential step in decision-making is:
1. reviewing all the known facts
2. developing a plan of approach
3. choosing from the alternatives
4. correctly identifying the problem
correctly identifying the problem
127
Delegation of administrative authority is a recommended practice primarily because it:
1. relieves the administrator of all tedious details
2. leads to greater efficiency by allocating specific duties to individuals
3. divides the work load more equitably according to individuals abilities
4. gives each assistant the opportunity to learn new skills which can lead to advancement
leads to greater efficiency by allocating specific duties to individuals
128
In a nursing home, a line supervisor can effectively supervise no more than:
1. 4 to 6 people
2. 5 to 9 people
3. 8 to 12 people
4. 15 people
8 to 12 people
129
Strategies are general plans of action that focus largely on:
1. the staff
2. long-range goals
3. the method of solving problems
4. the involvement of all employees
long-range goals
130
Organizational management begins with:
1. the ownership
2. the administrator
3. a governing body
4. the executive staff
a governing body
131
When compared with a hospital administrator, a nursing home administrator is , of necessity, more frequently involved with:
1. relationships with staff
2. establishing volunteer services
3. relationships with residents' families
4. facilitating interdisciplinary cooperation
relationships with residents' families
132
An organizational chart fails to show:
1. the top levels of management
2. every position in the organization
3. the relationships between departments
4. the informal channels of an organization
the informal channels of an organization
133
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When the subordinate and the supervisor jointly set the subordinate's goals, this is referred to as:
1. constructive planning
2. creative problem-solving
3, management by exception
4. management by onjective
```
management by objective
134
Which of the following makes it possible for organizations to expand?
1. Staffing
2. Directing
3. Controlling
4. Organizing
Organizing
135
Procedures are step-by-step guides to:
1. thinking
2. attain a goal
3. in-service training
4. policy development
attain goal
136
Effective delegation has been established when decision are made:
1. very quickly
2. by first-line supervisors
3. at the lowest level authorized to make them
4. through the contribution of ideas by several people
at the lowest level authorized to make them
137
A major duty of the governing body is to establish:
1. a clear statement of the facility's mission
2. measurable goals for each unit of the facility
3. specific guidelines for management of the facility
4. a means to determine the efficiency of management actions
a clear statement of the facility's mission
138
When a nursing home administrator is contacted by a union representative for collective bargaining, a prudent administrator should first:
1. call a staff meeting
2. prepare a list of supportive personnel
3. contact the National Labor Relations Board
4. seek legal counsel from an attorney specializing in labor relations
seek legal counsel from an attorney specializing in labor relations
139
From the management point of view, the difference between the terms "objective" and "policy" is that a management objective:
1. needs to be spelled out, whereas a policy is self-explanatory
2. represents a definitely set goal, whereas a policy is subject to change
3. is a course projected into the future, whereas a policy is a course adopted for the present
4. is an end result to be achieved, whereas a policy serves as a guide for achieving the objective
is an end result to be achieved, whereas a policy serves as a guide for achieving the objective
140
Regarding advance directive, the facility must:
1. maintain written policies and procedures
2. provide care that may conflict with an advance directive
3. conduct in-service training at least annually for all employees
4. require a copy of the advanced directive for every resident prior to admission
maintain written policies and procedures
141
The Ombudsman program is funded nationally by the Administration on Aging and is administered by:
1. CMS
2. OBRA
3. Medicaid
4. state agencies
state agencies
142
The process of organizing that continues throughout the life of the facility is guided primarily by all of the following principles except:
1. authority
2. span of control
3. unity of command
4. resource allocation
resource allocation
143
the best time for religious counseling is:
1. following religious services
2. during the admission process
3. whenever the resident's religious concerns are manifested
4. whenever the services of a religious leader can be secured
whenever the resident's religious concerns are manifested
144
The primary duty of the Ombudsman program is to:
1. review resident records
2. assist in the survey process
3. counsel with residents and families
4. investigate and resolve complaints made by residents
investigate and resolve complaints made by residents
145
The state Medicaid agency must contact the long-term care ombudsman under all of the following circumstances except:
1. when a facility is scheduled for a survey
2. for participation in the state survey process
3. to allow the ombudsperson to observe the exit conference
4. if the state grants a waiver of licensed nursing requirement
for participation in the state survey process
146
Significant changes in a nursing home resident's condition include all of the following except:
1. side effects from psychotic drugs while determining dosage level
2. loss of ability to ambulate freely or to use hands to grasp small objects
3. deterioration in two or more ADL's, in cognitive abilities, or communications that appear permanent in nature
4. improvement in behavior, mood, or functional capacity to the extent the care plan no longer addresses the needs of the resident
deterioration in tow or more ADL's, in cognitive abilities, or communications that appear permanent in nature
147
The best public relations program is:
1. the news media
2. printed material
3. a tour of facility
4. sponsoring professional organization
a tour of the facility
148
Marketing and public relations are different, but work together. The principle manner in which marketing uses public relations is in:
1. advertising the service being marketed
2. handling research of market conditions and potentials
3. media relations, new releases, and press conferences
4. promoting present services and identifying target groups
media relations, news releases, and press conferences
149
Penalties for HIPAA violations can range from $100 per violation to 10 years in prison dependent upon the circumstances. Which of the following enforces these penalties?
1. CMA
2. OCR
3. OBRA
4. HIPAA
OCR
150
One of the best ways fir nursing facilities to become part of the community is to:
1. avoid negative publicity
2. support of the community business and activities
3. support community interests that support the facility
4. develop good public relations and marketing programs
support of the community businesses and activities
practice to pass
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