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Question 1

The most likely single cause for the series of bankruptcies among larger nursing home chains around the year 2000 was

1. Too small increase in government reimbursement rates
2. Paying too much for acquisitions in 1998 and 1999
3. Not taking advantage of falling interest rates
4. Thinking too small

Answer 1

Paying too much for acquisitions in 1998 and 1999

Question 2

In a chance conversation with the owner of an eight-facility chain, the newly hired administrator for the oldest facility in the chain indicates that, because the mortgage is fully retired, the administrator will concentrate more on being effective than efficient since the Quality Indicators are all at or above the state’s average. The owner would likely

1. Be pleased
2. Be distressed
3. Be content
4. Praise the newly hired administrator

Answer 2

Be distressed

Question 3

Occupancy of Facility A has been a steady 70% since the Prospective Payment System was introduced. Two weeks ago, a new 120-bed, equally equipped facility opened several blocks away. The facility A administrator tells the admissions counselor to continue the usual recruitment approach. The chain owners ought to

1. Rest comfortably
2. Seek a new administrator
3. Appoint a new admissions counselor
4. take no action

Answer 3

Seek a new administrator

Question 4

Bankruptcies among larger nursing home chains prior to 2000

1. Were frequent
2. Were ubiquitous
3. Were highly unusual
4. Were routinely declared to avoid too much accumulated debt

Answer 4

Were highly unusual

Question 5

Under the Prospective Payment System, nursing facilities’ reimbursed costs

1. Were about the same as previously
2. Were more bundled
3. Used an unbundled cost structure
4. Were reimbursement for actual costs

Answer 5

Were more bundled

Question 6

In recent years, Medicare has

1. Allowed facilities to make a modest profit
2. Shifted more costs onto nursing facilities
3. Eased up on economic pressures previously placed on facilities
4. Remained relatively unchanged in its reimbursement structure

Answer 6

Shifted more costs onto nursing facilities

Question 7

The nurse newly promoted to director of nursing insists on giving four RN hours of patient care each day on the Alzheimer’s wing in the 175- bed facility. The administrator should

1. Praise the new director of nursing for her resident centeredness
2. Appoint an assistant director of nursing
3. Adapt the job description to fit her pattern
4. Seek a new director of nursing

Answer 7

Seek a new director of nursing

Question 8

The applicant for the administrator position in a facility near a large teaching hospital insists taht, as beforre in his rural facility, if hired he would no let the Medicare reimbursement policies affect his case mix. This applicant

1. Should be hired
2. Is likely to succeed if hired
3. Cn likely succeed in his goal
4. Is out of touch

Answer 8

Is out of touch

Question 9

The newly hired assistant to the administrator insists that the organizational chart dotted line between this position and the Department of Nursing be a solid line. The administrator should

1. Agree in general
2. Agree to this special case
3. Ask the director of nursing for his or her opinion
4. Be forewarned

Answer 9

Be forewarned

Question 10

The medical supplies provider tells the administrator of a facility that has not paid bills for the past 3 months but is now operating under a bankruptcy judge’s approved plan for restructuring, that no more deliveries will be made until past bills are fully paid. The medical supplies provider

1. Is smart to cut losses at that point
2. Does not understand how bankruptcy works
3. Will now likely get his past due bills paid
4. Is farsighted

Answer 10

Does not understand how bankruptcy works

Question 11

An administrator who adopts the leadership-by - walking around (LBWA) approach by walking through the facility weekly and intently observing has

1. Become an effective leader
2. CHosen a good management style
3. Failed to understand LBWA
4. Implemented a useful strategy

Answer 11

Failed to understand LBWA

Question 12

The nursing facility administrator who, using the leadership-by-walking around (LBWA) technique, succeeds in actually making appropriate corrections on the spot during her rounds

1. Is effectively implementing the concept
2. Gains additional power through the process
3. Exhibits appropriate leadership
4. Does not understand LBWA

Answer 12

Does not understand LBWA

Question 13

The rate on increase in the total number of nursing facilities in the United States during the years 2008- 2012 is

1. Likely to be about level
2. Likely to couble
3. Likely to triple to accommodate the baby boomer generation
4. Likely to decrease markedly

Answer 13

Likely to be about level

Question 14

The applicant for administrator of the facility insists that he has successfully used democratic leadership to the exclusion of all other leadership styles. The interviewer should

1. Recommend hiring this candidate
2. Praise the candidate
3. Be favorably impressed
4. Continue to interview candidates

Answer 14

Continue to interview candidates

Question 15

The candidate for administrator said that she used a variety of administrative styles, but could not say exactly which she would use in every circumstance. The interviewer should be

1. Favorably impressed
2. Unfavorably impressed
3. Concerned about possible indecisiveness
4. Looking for one leadership style

Answer 15

Favorably impressed

Question 16

The candidate for administrator indicated that he consistently chose the charismatic style of leadership. This should _____ the interviewer

1. Reassure
2. Alert
3. Confirm the candidate’s qualifications to
4. Please

Answer 16

Alert

Question 17

The costs of providing subacute care to nursing home residents

1. Is perhaps triple that of the more typical patient
2. Covered by Medicare
3. Absorbed by Medicaid if Medicare coverage is inadequate
4. Mostly covered by private insurance

Answer 17

Is perhaps triple that of the more typical patient

Question 18

The nurse supervisor who had just been appointed director of nursing announced at the first department head meeting that she had circulated a memo among the nurses that only formal communications were to be allowed in the nursing department. The administrator should

1. Be relived
2. Confirm the decision
3. Be supportive
4. Anticipate problems

Answer 18

Anticipate problems

Question 19

The department head was not surprised to learn that an employee had heard only the positive comments to the employee and ignored the criticisms. The department head’s grasp of the communication process is

1. Deficient
2. Appropriate
3. Out of focus
4. Inadequate

Answer 19

Appropriate

Question 20

The administrator routinely accepted as a nearly exclusive information source the director of nursing’s positive reports that nursing was going well. The administrator is

1. Showing appropriate confidence in the director of nursing
2. Utilizing the director of nursing properly
3. Realizing a successful appointment has been made
4. Placing himself at risk

Answer 20

Placing himself at risk

Question 21

Periodic shortage of nurses available for nursing home employment

1. Is being solved by community college programs
2. Is decreasing
3. Can be readily solved by hiring temporary nurses
4. Is likely to remain for the foreseeable future

Answer 21

Is likely to remain for the foreseeable future

Question 22

Congress and the federal rule makers behave as if the facility will run successfully if Congress and the Centers for Medicare and Medicaid Services can write enough rules/ They are

1. Incorrect
2. Correct, according to behavior theory
3. Pessimistic about the need for rules
4. Correct, according to emerging management theory

Answer 22

Incorrect

Question 23

When the administrator notices that the director of nursing seeks to turn as many duties as possible over to housekeeping, the administrator should conclude that the director of nursing is

1. Behaving normally
2. Holding a grudge against housekeeping
3. Unwilling to be cooperative
4. Wielding power desirably

Answer 23

Behaving normally

Question 24

The administrator insists that a timely copy of all reports generated within the facility come across her desk before anyone signs them. The administrator is

1. Not rationalizing her management information system
2. Making appropriate and desirable requests
3. Exercising good judgement
4. Initiating an appropriate management information system

Answer 24

Not rationalizing her management information system

Question 25

The administrator notices that incident reports are being insufficiently filled out, but does nothing, believing that the situation will likely correct itself. The administrator is 1. Practicing effective control 2. Likely to be correct 3. Failing to control effectively 4. Right to monitor the situation for a period of time

Answer 25

Failing to control effectively

Question 26

Corporate sends a directive to its flagship facility administrator directing the administrator's attention more toward the outcome of resident care then the cost of resident care during the coming 12 months. Corporate is more concerned with ___ than with___ 1. Effectiveness; efficiency 2. Efficiency' effectiveness 3. Expenses/ inputs 4. expenses/ troughput

Answer 26

Effectiveness; efficiency

Question 27

The long-term care sector receiving increased funding and attention from the federal government is the 1. Home health care sector 2. Volunteer hospice group association 3. Long term care hospital sector 4. Private insurance industry

Answer 27

Home health care sector

Question 28

The concept that nursing homes should be reimbursed by states for their actual costs was part of the 1. Emerging Medicare approach 2. Federal administration's goal as seen in new budgetary appropriations 3. Hatch amendment 4. Goal statements of most state governments

Answer 28

Hatch amendment

Question 29

The intense health care cost-shifting efforts among providers such as Medicare, Medicaid, and local governments are 1. On the wane 2. Likely to continue 3. Leading to increased reimbursements 4. Good for the nursing home profession

Answer 29

Likely to continue

Question 30

Worried about the level of actual resident care being achieved in the facility , the administrator directs the nurses to spend less time charting and more time focusing on the effectiveness of care being given to residents. The likely result will be 1. Better resident care, possibly increased deficiency citations 2. Better resident care, decreased deficiency citations 3. No real improvement in resident care, decreased charting 4. Likely to improve the case mix dramatically

Answer 30

Better resident care, possibly increased deficiency citations

Question 31

The new social worker informs the head of the nursing that admissions is all she has time for and that nursing must monitor and document each resident's sociopsychological experience. The new social worker is 1. Responding appropriately to priorities 2. Achieving a better balance of assignments within the facility 3. Responding inappropriately 4. Likely to improve the case mix dramatically

Answer 31

Responding inappropriately

Question 32

Today the twin forces of ____ and ___ are revolutionizing the delivery of healthcare 1. Technology/ patient rights 2. Obamacare/ patient data legislation 3. Technology / patient data legislation 4. New interventions/ rapid adoption of inventions

Answer 32

Technology / patient data legislation

Question 33

Most of the multiple new devices to monitor and diagnose each individuals' health status are creating new monitoring and diagnostic capacities 1. Outside the hospital 2. Outside the doctor's office 3. Outside the hospital and doctors office 4. Primarily within the hospital setting

Answer 33

Outside the hospital and doctors office

Question 34

For the nursing facility setting, the new capacities to monitor resident's health offer dramatic new opportunities to improve 1. Diabetes treatment 2. Pneumonia management 3. Infection control techniques 4. Chronic disease management

Answer 34

Chronic disease management

Question 35

Patient data legislation , such as the most recent health care legislation, has set into motion a nationwide policy to promote patient's access to their 1. Rights 2. Personal data 3. Medical records 4. Family history

Answer 35

Medical records

Question 36

Under the Affordable Care Act, the residents can access their own lab test results within 30 days of request 1. With their physicians permission 2. With nursing personnel's permission 3. If from a government lab 4. Without going through the physician who ordered the test

Answer 36

Without going through the physician who ordered the test

Question 37

The concept of lab-on-a-chip will 1. Speed up lab diagnoses in the nursiing facility 2. Eliminate the need for diagnoses 3. Increase the cost of diagnoses 4. Be done by the residents

Answer 37

Speed up lab diagnoses in the nursiing facility

Question 38

Attmepting to find the right person for each well-defined job is known as the management function of 1. Personnel work 2. Interviewing 3. Staffing 4. The job seaRCH

Answer 38

affingstf

Question 39

The administrator who takes steps that ensure that the goals are accomplished and that each job is done as planned is successfully 1. Getting results 2. Improving outputs 3. Controlling quality 4. Sensing organizational need

Answer 39

Controlling quality

Question 40

The administrator's job is to ensure that the___ employees do the tasks of the organization at an acceptable quality level 1. Best prepared 2. Trained 3. Appropriate 4. Unmotivated

Answer 40

Appropriate

Question 41

The administrator who conducts a national search for a director of nursing position and interviews 20 candidates from seven different surrounding states by phone is engaged in the managerial function of 1. Directing personnel development 2. Staffing 3. Broad personnel searches 4. In-depth interviewing

Answer 41

Staffing

Question 42

In the end, it can be said that the administrator's responsibility to meet resident care needs and facility financial needs are 1. Clearly unequal 2. A mismatch 3. Both about equal 4. unlcear

Answer 42

Both about equal

Question 43

Superior performance depends on taking exceptional care of residents via superior service and 1. Constant attention to the bottom line 2. Constant innovation 3. Attention to detail 4. a good attitude

Answer 43

Constant innovation

Question 44

Superior performance for a nursing facility comes through 1. Having all the beds full 2. Achieving consistent profitability 3. Innovation in ways to serve residents 4. Efficient management of budget

Answer 44

Innovation in ways to serve residents

Question 45

The superb nursing facility is superb by virtue of its 1. Success in attention to consistent profitability 2. Success in serving the residents 3. Reputation in the community as a friendly place 4. Achieving superior ratings

Answer 45

Success in serving the residents

Question 46

Answering the phones and resident call bells with common courtesy and doing things that work are examples of 1. Good sense 2. Uncommon perceptions 3. An ability to be practial 4. A blinding flash of obvious

Answer 46

A blinding flash of obvious

Question 47

Giving every employee the space to innovate at least a little; listening to residents and acting on thier ideas; and wandering around with residents, staff, and uplliers are examples of the difficult-to-achieve 1. Long-range 2. Short-range goals 3. Common sense, obvious 4. Typical facility approach

Answer 47

Common sense, obvious

Question 48

In facility of 120 beds, the administrator __ personally perform each of the management tasks 1. Need not 2. should 3. over a month will 4. over a year will

Answer 48

Need not

Question 49

To ensure that all management tasks are successfully accomplished, the administrator of a 120-ned facility will typically divide management into 1. 2 layers 2. 3 layers 3. 8 cooperating teams 4. 4 teams

Answer 49

3 layers

Question 50

A licensed person responsible for formulating and enforcing policies that will be applied to an entire facility is though of as/an 1. Upper level manager 2. Senior administrator 3. Board member 4. owner

Answer 50

Upper level manager

Question 51

The staff member responsible for reporting to upper-level management and at the same time interacting significantly with several lower-level managers is the 1. Director of finance 2. Director of nursing 3. Charge nurse 4. Assistant to the administrator

Answer 51

Director of nursing

Question 52

The staff person for whom both upward and downward communication skills are most necessary is the 1. Staff development coordinator 2. Director of nursing 3. Nursing supervisor 4. Assistant administrator for personnel

Answer 52

Director of nursing

Question 53

When the director of nursing makes an effective policy decision without consulting the administrator that impact all nursing personnel, the administrator should 1. Be pleased 2. Neverthe less be some what concerned 3. Counsel with the director of nursing about chain of command 4. Begin the search for a new director of nursing

Answer 53

Be pleased

Question 54

In the typical nursing facility, the decision-making process is __ establlishment of lower, middle and upper levels of management 1. Noticeably more complicated than the simple 2. Normally accomplished by the 3. Successful if the ownership ensures effective 4. Rendered relatively uncomplicated through

Answer 54

Noticeably more complicated than the somple

Question 55

Among the following positions, the __ has no authority to make decisions for the facility 1. Director of nursing 2. Supply room manger 3. Assistant to the administrator 4. Evening charge nurse

Answer 55

Assistant to the administrator

Question 56

Decisions made by persons on the staff to whom the administrator has delegated line authroity are, in the final ananlysis, regarded as decisions by 1. The owners 2. The board of directors 3. The administrator 4. The department head holding such line authority

Answer 56

The administrator

Question 57

When a nurse practitioner, who is more highly qualified than the director of nursing, gives orders to nurses in the hallways, the director of nurses should feel 1. Reaffirmed 2. Undermined 3. that quality of care is being reinforced 4. That a useful support system is functioning

Answer 57

underemined

Question 58

In times of crisis, corporate representatives, who hold a staff or advisory relationship with their counterparts in the local facility, may expect that their advice as staff be 1. Regarded as strong recommendations 2. Approached on a "take or leave it" basis 3. Respected 4. Acted on as carrying line authority

Answer 58

Acted on as carrying line authority

Question 59

``` As a generalization, it can be asserted that managerial success belongs to those who 1. Successfully prepare for the future 2 Are reactive on every front. 3. Constantly take initiatives 4. Conserve resources ```

Answer 59

Successfully prepare for the future

Question 60

Nursing home administrators should anticipate and successfully prepare for 1. Increased reimbursement 2. New long-term care legislation 3. Increased longevity 4. Rapid change

Answer 60

Rapid change

Question 61

The long-term care industry has entered a period in which __ changes can be expected 1. Fewer 2. More dramatic 3. Rapid and far reaching 4. A more controlled rate of

Answer 61

Rapid and far reaching

Question 62

The ability to accurately predict the future implications for nursing facilties of new trends to which the present environment may offer small clues is the skill needed to successfully 1. Forecast 2. Review 3. Read the meaning of history 4. Learn from the past

Answer 62

Forecast

Question 63

Historically, during the 1970s and early 1980s (until the introduction of the diagnosis-related group method {DRG} of reimbursement) nursing facility administrators made long-range projections during a period of 1. Unlimited change 2. Intense social scrutiny of reimbursement mechanisms 3. relative stability in the health care field 4. Rapid social chane

Answer 63

relative stability in the health care field

Question 64

The rate of change in the health care field is believed to be 1. Slowing down 2. Coming under control 3. Increasing exponentially 4. Retrenching

Answer 64

Increasing exponentially

Question 65

Researching have predicted that every 10 years __ of all current knowledg and accepted practices in the health care and other industries will be __ 1. One fourth/ obsolete 2. One half/ obsolete 3. Three forths/ still usable 4. Four fifths/ still usable

Answer 65

One fourth / obsolete

Question 66

It is conceivable that the core business of the nursing home in this decade will __ the core business of the nursing home of the next decade 1. Be entirely different from 2. Remain relatively stable and closely resemble 3. Undergo change at a slower pace than 4. Be remarkably similar to

Answer 66

Be entirely different from

Question 67

One should expect that over the next few decades the rules governing the nursing home will be 1. Relatively stable 2. New, never experienced before 3. Even more formalized by Congressional legislation 4. Enforced less due to decreased personnel available to state ad federal agencies

Answer 67

New, never experienced before

Question 68

Nursing homes that stick to conventioal formulas for success are/ will 1. Be more likely to survive 2. Miss new markets and be in a backwash 3. Be more likely to produce a steady profit 4. Survive while those introducing constant change will lose needed focus

Answer 68

Miss new markets and be in a backwash

Question 69

In the text it is argued that, for the first time in human history, the capcity exists to provide 1. Complete health care for all citizens 2. A high level of health care for all citizens 3. More health care than any nation can afford 4. Affordable health care for all

Answer 69

More health care than any nation can afford

Question 70

The roles possible for hospitals, nursing homes, home health agnecies, and managed care organizations are 1. Predictable and likely , managable 2. Sorting themselves out 3. Being more and more successfully managed by government 4. Endless and will remain up for grabs

Answer 70

Endless and will remain up for grabs

Question 71

The staff in nursing facilities, over the next two decADES, WILL LIKELY 1. Experience culture shock 2. be reduced in staff/ patient ratios 3. Become accustomed to a predicatable cre business 4. Remain committed to the facility, lowering turnover

Answer 71

Remain committed to the facility, lowering turnover