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Flashcards in Mock National Exam Deck (165)
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1
Q

A resident was admitted to a facility on November 10. The comprehensive assessment was completed on November 27th. Per OBRA 1987 the comprehensive assessment was completed

A

Late

A comprehensive assessment is due 14 days after admission or by Nov 24th. It was late

2
Q

The ___ has ultimate legal responsibility for the operation of a nursing facility

A

Governing body

The governing body has ultimate responsibility for management of the facility

3
Q

Per OBRA 1987 air temperature is measured

A

Just above the floor

Air temperature is measured just off the floor

4
Q

The ___ requires employers to give worker time off for illness or to care for a sick family member

A

Family Medical Leave Act

5
Q

The ___ hires supervises and can fire the administrator

A

Governing body

6
Q

he administrator discovers the DON has been giving nursing aides 6 months to complete their state certification requirements. The administrator should

A

Reprimand the DON

120 days they can work after completing the course before getting their license

7
Q

The rights of an individual determined by a court to be incompetent would be exerciesd by a

A

A person appointed by a court or court guardian

8
Q

The maintenance director submitted a request for a family leave to care for his ailing mother. He has worked 1350 hours in the nine months he has worked for the facility. The administrator should

A

Inform the maintenance director he must have worked 12 months to be eligible for FMLA

Employee must work both 1250 hours and 12 months to use FML; and must continue to pay for insurance premiums while employee is on leave

9
Q

Per OBRA 1987 a resident has the right to review all their records within ___ of an oral or written request (excluding weekends and holidays)

A

24 hours

10
Q

The comprehensive assessment was completed on June 1. The care plan was completed on June 6th. The care plan was completed ___

A

Timely

Care plan must be done within 7 days of comprehensive assessment or by June 8th

11
Q

The comprehensive assessment must be signed by

A

Registered Nurse

12
Q

The ___ has legal responsibility or the day to day operation of a skilled nursing home

A

Administrator

The governing board has ultimate responsibility for resident are and managing the facility. The administrator is responsible for day to day operation

13
Q

The ___ is responsible for the day to day management of the facility’s nursing program

A

DON

The DON is a registered nurse is responsible to manage the nursing staff to follow physician order to adhere to professional standards

14
Q

CMS stands for

A

Centers for Medicaid and Medicare Services

15
Q

HHS stands for

A

Health and Human Services

16
Q

The new administrator starts December 1 2007 and reviews the minutes of the Quality Assurance Committee. The committee met the second Tuesday on January 7 2007., June 21 2007, and November 15 2007. The administrator should

A

Change the meeting dates to the first Tuesday of January, April, July, October to bring the facility into compliance with OBRA 1987

The quality assurance committee must meet at least quarterly per OBRA 1987

17
Q

A resident was only given lunch that day, was given the wrong medication in the morning, had her room changed without notification and was not given a bath as requested. Per OBRA 1987 how many resident rights were violated

A

3

A bath is not a resident right.

RULE OF THUMB. If they give two examples then the answer is one right was violated. If they give you three examples then 2 rights were violated. If they give you 4 examples then 3 rights were violated

18
Q

A resident was admitted on June 1. The attending physician charted a visit and physical examination on June 27 2007, July 29, and sept 4. With respect to required physician visits per OBRA 1987 the facility

A

Was in compliance and would not be cited

With the 10 day grace period, the physician has 40 days to visit and examine resident the first 3 months and they have 70 days to visit the resident from 4th month on. The facility will be cited if the physician visits are not timely

19
Q

The ___ has legal responsibly to adopt an implement facility policies

A

Governing body

20
Q

A resident was admitted on June 1. The addending physician charted a visit and physical examination of the resident on June 27, July 29, Sept 4, and November 17 2007. Per OBRA 1987 with respect to required physician visits, the facility

A

Would be cited for a late visit in November

Physician had 70 days to visit resident. The next visit after Sept 4 was due Nov 3 and with the 10 day grace period the last day was Nov 13. The visit occurred on Nov 17

21
Q

A state surveyor learns in interviews with residents that when residents are admitted they were provided with a written list of names of physicians who cared for residents in the facility in their admission packet. The facility assigned an attending physician to each resident prior to admission from a rotating list of physicians. Per OBRA 1987 the facility

A

Was out of compliance and would be cited

Facility must inform residents both orally and in writing that they have a right choose physician and must provide them with the names, addresses, and phone numbers of attending physicians. Their personal physician can see them if they agree to

22
Q

A housekeeper notices a resident is asleep in the room she needs to clean. She knocks on the residents door, identifies herself as a housekeeper, and seeing there is no response from the resident, decides to enter the room and begins cleaning. Te housekeeper should be

A

In-serviced

Although the housekeeper knocked an announced who she was, the resident had to acknowledge her presence and giver permission to enter the room and it did not happen

23
Q

____ is not n element of a Total Quality Management TQM program

A

Centralize decision making to improve customer service

The main focus of TQM is to train front line workers to make decisions

24
Q

The ___ is responsible to prepare and serve nutritious meals under sanitary conditions

A

Dietary Department

25
Q

All furniture, equipment, boxes and supplies must be elevated ___ inches above the floor to allow the floor directly underneath to be cleaned

A

6

26
Q

____ is the most comprehensive and effective improvement model

A

Total Quality Management

27
Q

The ___ coordinates all work activities in the facility and resolves conflict between departments

A

Administration department

28
Q

HCFA stands for

A

Health Care Financing Administration

29
Q

Telephone cords must be a minimum of

A

29 inches

30
Q

To safe money the administrator of a 100 bed facility reduced the hours of the dietary service manager to 20 hours per week. The governing body should

A

Reprimand the administrator

Must employ a dietary manager full time. The administrator should be reprimanded

31
Q

Adding baking soda to food will primarily

affect its

A

Nutritive value

Overcooking food in boiling water, adding baking soda and poorly storing food diminishes the vitamin and mineral content of food

32
Q

The residents quality of life and physical condition is the focus of

A

Outcomes are focused o actual results and not processes

33
Q

___ is not typical of a TQM program

A

Minimal training of staff

Extensive staff training so residents do need to wait for the NHA to come in for a bed pan

34
Q

A resident recently lost her husband and is tearful and depressed and is worried how she will pay for her stay. The administrator would ask the ___ to help her

A

Social Services director

Social services provides emotional support and interventions for psychosocial and financial problems

35
Q

Electrical switches must be located at a minimum of ___ inches above the floor

A

15

36
Q

Stooped posture, shuffling gait, garbled speech and tremors are symptoms of

A

Parkinsons Disease

37
Q

Nursing homes must have hearing aid compatible phones with volume between a minimum of ___ and a maximum of ___ decibels above normal

A

12,18

Any public telephones or other phones available to residents shoudl be hearing aid compatible with volume controls

38
Q

Grab bars and railings must support a minimum weight of ___ pounds

A

250

39
Q

The emergency generator must be visually inspected and checked

A

Weekly

40
Q

Federal resident care standards are now ___ and ___ and are not longer considered minimal standards

A

State of art, maximal

41
Q

The largest payor source for long term care is

A

Medicaid

42
Q

The average short term stay for a Medicare resident is

A

30 days, they leave after 21-20 days when their $124 a day copay kicks in or $3000 a month

43
Q

ANSI stands for

A

American National Standards Institute

44
Q

Non compliance affecting a limited number of residents and locations would be assigned a scope of

A

Isolated

45
Q

TQM is not characterized by

A

Minimal involvement of upper management

TQM involves engagement by upper management

46
Q

Administrators consult ___ to compare outcomes to expectatons

A

Policies and plans of actions

47
Q

A resident with Parkinsons would not benefit by

A

Bed rest

Parkinsons involves muscle rigidity and cognitive impairment resident benefit by exercise programs and reality orientation and memory exercised

48
Q

The states cannot ___ to compel facilities to correct class 1 deficiencies found during inspections

A

Impose civil or criminal penalties

49
Q

A___ violation is where the severity of negative outcomes that compromises a resident’s ability to maintain the highest physical, mental and psychosocial well being

A

Level 3

50
Q

Parking spaces must be at least ___ wide with an accessible handicap aisle at least ___ wide

A

96” 60”

51
Q

A broad statement of goals is a ___

A

Policy

52
Q

Long term residents should be surveyed regarding satisfaction with services

A

Annually

53
Q

Which is not true of the Joint Commission on Accreditation of Healthcare Organizations JCAHO

A

JCAHO can impose civil fines

54
Q

Communication occurs when

A

A message is transmitted by one person and received an decoded and understood by the other person

55
Q

NFPA stands for

A

National Fire Protection Association

56
Q

The emergency generator must run under full load for ___ every___

A

30 minutes, month

57
Q

The fire alarm can be silenced during a fire drill conducted between the hours of

A

10pm and 6am

58
Q

The ___ is responsible to assemble and analyze incident reports, infection rates, safety issues, medication errors and restraint use

A

Quality assurance committee

59
Q

___ publishes and promotes fire safety in nursing homes

A

NFPA

60
Q

Listening intently, acceptance, empathy and understanding the message descries

A

Active listening

61
Q

Patients and family look for ___ when selecting a nursing home

A

Variety and quality of food

62
Q

The Americans with Disabilities act construction standards are enforced by

A

Architecture and Transportation Barriers Compliance Board

63
Q

The Americans with Disabilities Act construction standards were developed by

A

ANSI

ANSI is a private organization that researches and publishes the ADA

64
Q

A mechanism to monitor consumer satisfaction and address other concerns is called the

A

Strucure

65
Q

The nursing home survey/inspection process focuses on

A

Outcomes

66
Q

All nursing facilities must be licensed by the

A

State

67
Q

Facilities that are licensed by the state and certified to receive Medicare and Medicaid reimbursement must submit to

A

State and federal inspection

68
Q

When the administrator writes a letter to the local state survey office to challenge the findings and citations issued during a survey the administrator is using the

A

Informal dispute resolution process

69
Q

Per OBRA 1987 a nursing home must maintain the highest ___ for residents

A

Physical, mental, and psychosocial well being

70
Q

When a facility requests a hearing before an administrative law judge to challenge the findings made during a state survey, the facility is using the

A

Formal dispute resolution process

71
Q

Federal inspection of resident care in nursing facilities is overseen by

A

CMS

72
Q

Quality Indicator QI reports for nursing homes available through the CMS would not include which of the following

A

Nursing home watch list

73
Q

Prior to entering a facility a state survey team would not review the

A

Resident council minutes

74
Q

The ___ is responsible to identify and address safety hazards that can injure residents and staff and is required by OSHA

A

Safety committee

75
Q

The federal nursing home certification survey program has a total of ___ different survey types

A

Off site preparation

76
Q

The phase of the state survey where the survey team gathers information from. OSCAR the ombudsman and other sources prior to entering a facility is called

A

Off site preparation

The online Survey and Certification Reports contains all MDS data is setup by the CMS

77
Q

The phase of the state survey where the survey team analyzes and compares observations and findings and determines if any violations were found and their severity is called

A

Information analytics

78
Q

Nursing homes must be inspected every

A

15 months

79
Q

An electronic medium that allows instantaneous communication internally and externally to thousands of people through a computer server is called

A

Email

80
Q

A finding of ‘substandard care’ requires the survey team to have evidence of

A

Immediate jeopardy to resident care that has or likely to cause serious injury or death

81
Q

A ___ tag would indicate substandard care was found

A

F377 J

A tag of G or above is indicative of substandard care

82
Q

The phase of the sate survey where they survey team sits down with the administrator ,the DON and department heads to discuss the finding of the survey team is called

A

Exit conference

83
Q

When services in a facility are not consistent from day to day and from sift to shift this is called

A

Inconsistency rule

84
Q

Communication between staff of equal rank or status is called

A

Horizontal comunication

85
Q

When consumers perceive a facility renders poor care because of the performance of one employee, this is called

A

Inseparability rule

86
Q

Upon completion of a survey, the surbey team sends the administrator which of the following if the facility was substantially in compliance, has only insoated or minor problems which caused no actual harm, and no plan of correction is required

A

Notice of isolated deficiencies

87
Q

The administrator has ___ days to prepare a plan of correction for all deficiencies cited in the survey

A

10 days

You only have 30 days from the time the survey team exits to achieve full compliance- your date certain for resurvey is 30 days, they have 10 days to submit the 2567 to you and you have 10 days to the plan of correction

88
Q

Communication from subordinates directed to upper management is called

A

Upward communication

89
Q

A violation or deficiency with the potential for no more than minor negative impact on a resident is a ___ deficiency

A

Level one

90
Q

____ has/have the least impact on influencing a resident or their family in choosing a facility

A

Media ads

91
Q

Short term residents should be surveyed ___ about satisfaction with services

A

Within 30 days from discharge

92
Q

A technology that connects cell phones, hand held devices and keyboards to a computer by high speed cable is called

A

Fire wire

93
Q

Implementation of a TQM program takes between

A

5-10 year

94
Q

The key consideration in determining the minimum level of staffing in a nursing facility is

A

Patient acuity levels

95
Q

Managing risks of negative outcomes is called

A

Risk management

96
Q

The key to a successful TQM program is

A

Training

97
Q

An organizational chart shows the reporting relationship between staff. A solid line on the chart denotes

A

Line authority

98
Q

A parking lot with 100 parking spaces would require ___ handicap accessible parking spots

A

4

1 handicap spot per 100 spots

99
Q

The most effective marking tool for a nursing home ot attract new residents is/are

A

A tour of the facility

100
Q

A violation with no more than minimal physical, mental or psychological discomfort is a ___ deficiency

A

Level 2

A level 1 would be no more than minor impact a level 2 involves actually discomfort

101
Q

Believing something that is not based in reality is caled

A

Delusion

102
Q

Communication directed from upper management to lower level managers and staff is called

A

Downward communication

103
Q

Non compliance affecting more than a limited number of residents and locations would be assigned a scope of ___

A

Patterned

104
Q

___ can provide nursing aide services and be included in calculated minimum staffing hours

A

A licensed practical nurse employed by the facility

105
Q

Managing risks of negative outcomes is called

A

Risk management

106
Q

The nosing on a stair. must project no more than

A

1 1/2

107
Q

Smoke detectors must be located no further than ___ feet apart and no more than ___ feet from any wall

A

30, 15

108
Q

Minimum wheelchair passing width for two wheelchairs is ___ inches

A

60”

109
Q

Minimum clear width for a single wheelchair is ___” continuously and ___” at any one point

A

36”, 32”

110
Q

There must be a passing space in an accessible route for wheelchairs every ___ feet

A

200

111
Q

A passenger loading zone must be at least ___” wide and ___” long

A

60”wide and 20” long

112
Q

The force required to open all doors, flush a toilet, operate faucet handles, and operate a water fountain cannot exceed ___ lbs of pressure

A

5

113
Q

Minimum wheelchair turning space is ___ inches

A

60”

114
Q

The high forward reach from a wheelchair is

A

48”

115
Q

The side reach from a wheelchair is between ___” and ___” off the floor

A

9”-54”

116
Q

A change in level surface over 1/2 inch

A

Requires ramp treatment

117
Q

A change between 1/4 and 1/2 inch in level surface

A

Requires a beveled edge

118
Q

A fire extinguisher is checked ___ and serviced ___

A

Quarterly, annualy

119
Q

Each level or story of a building that houses patient sleeping and treatment areas must be divided into ___ smoke compartments

A

2

120
Q

Vision panels are ___ in swinging doors

A

Required

121
Q

The maximum window sill height for a window in a resident’s room is ___ inches above the floor

A

36”

122
Q

Doors must be ___’ thick, solid bodied ___ core, or with ___ minutes of resistance fire rating

A

1 3/4, wood, 20 minutes

123
Q

The facility quality assessment and assurance committee. must meet at least

A

Quarterly

124
Q

The QA&A Committee does not need to include

A

The administrator

125
Q

Communicating though memos, meetings and follows lines of the organization chart is an example of ___

A

Formal communication

126
Q

Staff hatting informally in the break room is an example of ___

A

Informal communication

127
Q

ADA guidelines and standards are developed and approved by

A

ANSI

128
Q

Railings and grab bars must bear the weight of ___ lbs or more

A

250 lbs

129
Q

The maximum audible alarm decibel level is ___

A

120

130
Q

A nursing home must have a/n ___ operated fire alarm system that is ___ monitored

A

Manually, electronically

The fire alarm is manually operated because you need to ‘pull’ the alarm

131
Q

Activating or puling a fire alarm automatically activates all of the following except

A

Emergency generator

132
Q

Phones must be fitted with a cord no shorter than ___ inches

A

29”

133
Q

Landlings are required at teh bottom and top of each stairway run and must have a minimum width of

A

60 square inches

134
Q

Doors must have a clear width of ___” at openings and must be at a ___ “ angle to an accessible route

A

32”, 90degree

135
Q

The automatic smoke and fire detection systems must be connected to each other

A

Electronically

136
Q

The ___ specifies the number of directors, number of shares to be issued, and governs how the corporation is to be run

A

Bylaws

137
Q

A review of care provided patients for appropriateness and cost effectiveness is called

A

Utilization review

138
Q

A permit required before a nursing facility can begin construction is called a

A

Certificate of need

139
Q

A violation with a severity requiring immediate action due to risk of injury, harm, impairment, or death to a resident is a

A

Level 4

140
Q

The states and the CMS cannot impose

A

Civil and criminal penalties

141
Q

A leader who makes decisions based on staff consensus is using the

A

Democratic style

142
Q

A leader who delegates decision making to subordinates while setting larger objectives is using the

A

Laizze faire style

143
Q

An effective leader would not

A

Have one set response for every situation

A manager must adapt their style and response to different situations

144
Q

The fastes growing sector of the health care industry is

A

Home health care

145
Q

The current trend is to move individuals from institutional care to ___ which is less expensive

A

Home health care

146
Q

Management by Walking Around does not involve

A

Taking action on the spot

147
Q

An employee who has decision making authority with the same force and effect as if made by the administrator has

A

Line authority

148
Q

Upper managers do not

A

Usually write procedures

149
Q

Middle managers do not

A

Adopt policies

150
Q

Nursing aides are required to have a minimum of ___ hours of inservice trining per year under OBRA 1987

A

12 hours

151
Q

The ___ ultimately determines if a nurse aide is competent

A

State surveyors

152
Q

A charge nurse is __

A

Lower management

153
Q

A nurse aide enrolled in a state approved training program but has not completed the program at time of hire, has ___ to complete the program

A

4 months

154
Q

A nurse aide must be complete 16 hours of initial training in all of the following except

A

How to apply physical restraints

155
Q

A nurse aide must complete initial 16 hours of training in all of the following except

A

How to administer medication

156
Q

An intentional act or threat causing fear in another with reasonable expectation of harm is called a/an

A

Assault

157
Q

The ___ is the foundation that guides an organization

A

Philosophy

158
Q

The ___ communicates the purpose of the organization

A

Mission statement

159
Q

The ___ specifies the composition of the governing body, functions, timing of corporate meetings and the purpose of a corporation

A

Bylaws

160
Q

The ___ establishes the strategic plan

A

Governing body

161
Q

The overall style of governing how people relate to each other and that binds an organization is called

A

Corporate culture

162
Q

Authority granted to the governing body by state law is called

A

Express authority

163
Q

The ___ has ultimate responsibility for management and quality of care in a facility

A

Governing body

164
Q

The governing body of a facility is generally ___ for acts of employees

A

Not personally liable

165
Q

The mission statement and facility policies are created and implemented by the ___

A

Governing body