Guidelines for Nursing Home Management and Operations, Exams of Nursing

Download Guidelines for Nursing Home Management and Operations and more Exams Nursing in PDF only on Docsity! Federal Nursing Home Ad ministrator Exam Questions with Verified Answers. 1) OBRA asserts some separate committees can be folded into the quality improvement/assurance committee. Safety, Pharmacy and which committee below can be added into QA/QI committee? - Correct answer Infection Control 2) Nursing homes are responsible for obtaining and providing dental care for residents. Who usually pays for dental services? - Correct answer the resident or a family member 3) A facility is not allowed to charge a resident who is Medicaid and Medicare eligible except for: - Correct answer Co-pays 4) You calculate the average percent of occupancy by: - Correct answer Dividing the total census (occupied bed days) by the total number of days, then multiply by 100 5) Resident's rights should be explained to the resident and or family member: - Correct answer prior to admission 6) In case of an emergency, when no attending or back up physician is available, the decision as to who will attend to the resident is to be made by the: - Correct answer Administrator 7) Federal law states that facilities must retain menus of food actually served for at least: - Correct answer 30 days 8) A resident with a living will and DPOA specified she wants to receive heroic measures if necessary. Six months later the resident requires CPR, but is now incompetent and the son request CPR be withheld. What is the right thing to do? - Correct answer Provide the CPR 9) A resident asks to see his chart. The doctor tells the nurse not to allow the resident access to the chart. What do you do? - Correct answer Tell the doctor the law gives the resident the right to view the medical records 10) Medical records belong to: - Correct answer Facility 11) When a resident passes away, the personal funds deposited with the facility must be given to the resident's estate with a final accounting of the funds within: - Correct answer 30 days 12) The suffix "alga" refers to: - Correct answer Pain 13) Physical restraints must be removed: - Correct answer every two hours Page 1 of 18 14) Depression is one of many psychological changes related to the aging process. Others include the following except for: - Correct answer Hearing loss 15) "Nosocomial" refers to - Correct answer Infection occurring inside the facility (institutionalized) 17) A capital budget is mostly about: - Correct answer Equipment and real estate 18) Current debts are debts that are: - Correct answer due within one year 19) A ledger is a complete listing of: - Correct answer Accounts payable and receivable 20) Which resource usually provides the least revenue for a nursing home? - Correct answer Insurance 20) Past due accounts should not exceed: - Correct answer 5% 21) All of the following are a cash expense except: - Correct answer Depreciation 22) A pro forma is primarily - Correct answer A financial statement or prediction 23) A function of management is controlling, which means: - Correct answer measuring outcomes against benchmarks, then responding 24) OBRA requires every facility to have: - Correct answer a governing body - The Omnibus Reconciliation Act 25) Management by objectives means: - Correct answer A system that determines goals and objectives 26) Policies are: - Correct answer General and flexible statements that guide thinking 27) Procedures are: - Correct answer not flexible 28) Short range (tactical) goals can be accomplished - Correct answer in less than one year 29) Policies should be developed by the: - Correct answer governing body 30) The charge nurse is considered - Correct answer Line level management 31) McGregor's Theory X and Theory Y discuss individuals: - Correct answer Employees’ attitudes towards work 32) Decision making requires all of the following except: - Correct answer controlling behavior Page 2 of 18 68) Handrails at bottom of stairs must be: - Correct answer extended parallel to floor for 12 inches 69) Windows must have opening force requirement: - Correct answer of no more than 5 lbs. 70) Generator should provide for full load for - Correct answer 4 hours, under emergency power need 71) Resident rooms - Correct answer No more than 4 residents per room 80 sq. ft. per resident in multi-bed rooms 100 sq. ft. in private room Window to outside 72) OBRA requires housekeeping services necessary to - Correct answer maintain a sanitary, orderly, and clean interior 73) Exposure Control Plan must be updated - Correct answer annually HUMAN RESOURCES - Correct answer 74) Bargaining Unit - Correct answer Workers identified by nor to form a group to unionize 75) Construct Validity - Correct answer Extent to which a tool measures a trait important to job performance 76) Line management - Correct answer Performs personnel functioned, delegated authority to make decisions 77) Skill Analysis - Correct answer identification of attributes required to 78) Task Analysis - Correct answer review of job description 79) Employee Handbook - Correct answer Policies related to work conditions 80) Career Path - Correct answer Avenues for upward mobility within organization 81) Progressive Discipline - Correct answer Use of specific number and type of warnings 82) Job description - Correct answer list of duties and responsibilities 83) COLA - Correct answer Group of temporary workers Page 5 of 18 84) Election for unionization - Correct answer Conducted by NLRB 85) FLSA - Correct answer minimum wage 86) Halo Effect - Correct answer one trait colors all performance 87) In-Out migration - Correct answer Movements of workers in and out of geographic area 88) Pool - Correct answer Group of temporary workers 89) Labor Market - Correct answer geographic area of recruitment 90) Union election - Correct answer NLRB conducts; 50% plus 1 potential bargaining unit members VOTING wins LEADERSHIP AND MANAGEMENT (23% - 35 questions) - Correct answer 91) Strategic Planning - Correct answer setting long term goals 92) Case mix - Correct answer residents categorized by acuity 93) Governing body - Correct answer legally responsible for management 94) Tactical planning - Correct answer selecting goals for one year 95) Management - Correct answer achieve common goals thru organization 96) Market segment - Correct answer potential users of services 97) Payer mix - Correct answer residents categorized by payment type 98) Rules - Correct answer commands for action or non-action 99) Procedures - Correct answer required methods for handling activities 100) Risk management - Correct answer proactive means of anticipating problems 101) Staff authority - Correct answer advisory relationship with line management 102) Forecasting - Correct answer projects trends and needs which facility management must decide in future economic, social and political environment expected and resources available. 103) Bench Marking - Correct answer improve business by comparing with best practice of others Page 6 of 18 (Standards from which you measure) 104) Upper-Level management - Correct answer responsible for the overall functioning of the facility, normally interacting directly with the Board of Directors and/or owners. 105) Middle-Level management - Correct answer report to upper-level while interacting with lower-level (DON) 106) Lower-level management - Correct answer directly supervise the staff who do the actual work 107) Line Position (Authority): - Correct answer empowered by administrator to make decisions for organization (DON can fire, fire, and give orders) 108) Staff Position (Authority) - Correct answer not empowered to make decisions; duties are primarily to advise (consultants, pharmacists, accountants, etc.) 109) Functional Authority - Correct answer action outside the normal lines of authority 1. Violates unity of command 2. Necessary due to principle of exception The two often have edges of distinction blurred 110) Actionable - Correct answer conduct giving rise to legal action 111) Aggrieved party - Correct answer one whose rights invaded or who suffered injury 112) Burden of proof - Correct answer obligation of person bringing action 113) Liable - Correct answer written defamation 114) Slander - Correct answer verbal defamation 115) Malice - Correct answer intentional doing of wrongful act 115) Tort - Correct answer a wrong: legal duty owed, breached, and harm occurred 116) Worker Comp: - Correct answer responsible for injuries occurring at work 117) Scope of Employment: - Correct answer range of employee activities (resident services by omission or commission) 118) Governing: - Correct answer excesses authority 119) Advisory: - Correct answer not binding 120) Stewardship: - Correct answer accumulation and use of assets Page 7 of 18 150) Expenses: - Correct answer cost of personnel and supplies used in provision of service 151) Journals: - Correct answer books of original entry (the first place transactions are recorded) Cash receipts, billing, accounts payable (purchases), cash disbursements, Payroll, general. 152) General: - Correct answer non-repetitive entries. Used to make adjustments to conform to accrual system. 153) Double entry: - Correct answer two entries for each transaction DEBIT and CREDIT 154) General Ledger: - Correct answer summary of all debits and credits contained in all the journals for the time period. 1. Continuous balance for each account monthly 2. Basis for "trail balance" 156) Financial Statement: - Correct answer summary of all transactions made in a particular time period and their effect on the finances of the facility. 157) Handling Cash - Correct answer Two person procedure; one receives by opening mail or taking in person; the other prepares bank deposit 158) Collections - Correct answer policy for delinquent bills. MUST BE CONSISTENT with all payment types; in not facility could be charged with fraud. 159) Payroll - Correct answer largest expense (50-70% of operational) controlled by administration Separate bank account 160) Residents' Accounts (Trust fund) - Correct answer legally must provide Safe for cash and valuables Separate accounting Interest Bearing - amounts over $50.00 161) Cost Per Patient Day = - Correct answer Total cost/census days RESIDENT CARE & QUALITY OF LIFE (35% - 52 questions) - Correct answer 162) Nursing Assistant Training - Correct answer 75 hour course and exams plus continuing in service 164) Excess Disability - Correct answer Avoidable Dysfunction Page 10 of 18 165) PASAAR - Correct answer Insures appropriate treatment for MR/MI population 166) Function - Correct answer Focus of Rehab 167) Pharmacist - Correct answer Monthly drug review/Audits 168) Basis for Menu - Correct answer Basic 4 plus recommended daily allowances 168) Nursing Assistants - Correct answer Provide most direct care 169) OBRA ^87 - Correct answer Conditions to participate in Medicare and Medicaid 170) MDS - Correct answer Comprehensive Assessment within 14 days of admission 171) Physician Extenders - Correct answer Nurse Practitioner, Clinical Nurse Specialist or Physician Assistant 172) Licensed Nurse - Correct answer Charge Nurse on each tour of duty 173) Time between Super and Breakfast - Correct answer 14 hours 174) RN Coverage - Correct answer 8 consecutive hours, 7 days per week 175) Frequency of Activities - Correct answer 7 days per week during hours requested 176) Frequency of Doctor Visits - Correct answer Every 30 days for first 90 days, then every 60 days 177) Access to records - Correct answer 24 hours of request 178) Care Plans - Correct answer 21 days after admissions 179) required in service for CENA - Correct answer 12 hours per year 180) QA meetings - Correct answer Quarterly 181) Work before NA certified - Correct answer 4 months 182) Interest Bearing accounts - Correct answer trust funds greater than $50 183) Involuntary Transfer Notice - Correct answer 30 days 184) CVA - Correct answer Stroke 185) COPD - Correct answer Emphysema, Asthma, Bronchitis Page 11 of 18 186) ac - Correct answer before meals 187) Meal service: - Correct answer Key to high resident morale. 3-5 meals per day with no more than 14 hours btw evening meal and next breakfast (16 if HS snack) 188) Dishwashing - Correct answer wash at 150 to 1600 degrees F 189) Hot food tray - Correct answer leave tray line above 140 degrees F 190) Cold food - Correct answer leave tray line at less than 41*F 191) Freezer - Correct answer 0* - 20* F 192) Refrigeration - Correct answer 32* - 45*F 193) Storage - Correct answer room temperature 194) RDA - Correct answer Recommended Daily Allowance Bread: 4 servings Fruit/veggies 2 cups Meat: 4 oz. Milk: 2 cups 195) Quality Assurance Committee - Correct answer DON, a physician, and 3 other staff members A. Care plan B. Infection Control C. Pharmacy Committee D. Safety Committee 196) Administration - Correct answer A. License B. Compliance with standards and regulations C. Governing body D. Nurse Aide Training E. Medical Director F. Laboratory Services G. Radiology Service H. Clinical Services I. Disaster Plan J. Transfer Agreement K. Quality assurance L. Disclosure Page 12 of 18 The administrator insist that a timely copy of all reports generated within the facility come across her desk before anyone signs them. The administrator is _______ - Correct answer not rationalizing her management information system 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 ______ - Correct answer failing to control effectively Corporate sends a directive its flagship facility administrator, directing the administrator's attention more towards outcome of resident care than cost of resident care during the coming 12 months. Corporate is more concerned with __________than with _________. - Correct answer Effectiveness/efficiency The long term care sector receiving increased funding and attention from the federal government is the ________________. - Correct answer Home health care sector The concept that nursing homes should be reimbursed by states for their actual costs was part of the _______ - Correct answer Hatch Amendment The intense health care cost-shifting efforts among providers such as Medicare, Medicaid and local governments is _____________ - Correct answer Likely to continue 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 ________ - Correct answer Better resident care, possible increase in deficiency citations The new social worker informs the head of nursing that admissions is all she has time for and that nursing must monitor and document each resident's socipsychological experience. - Correct answer responding appropriately to priorities Attempting to find the right person for each well-defined job is known as the management function of __________ - Correct answer The administrator who takes steps that insure the goals are accomplished and that each job is done as planned is successfully ______________ - Correct answer Controlling quality The administrators' job is to assure that the ________employees do the tasks of the organization at an acceptable quality level. - Correct answer Appropriate The administrator who conducts a national search for a director of nursing position and interviews 20 candidates from 7 different surrounding states by phone is engaged in the managerial function of ______ - Correct answer Staffing Page 15 of 18 Corporate sends a directive to its flagship facility administrator, directing the administrator's attention more towards outcome of resident care than cost of resident care during the coming 12 months. Corporate is more concerned with ______than with _____. - Correct answer Effectiveness/efficiency The long-term care receiving increased funding and attention from the federal government is the _______. - Correct answer Home health care sector The concept that nursing homes should be reimbursed by states for their actual cost was part of the _____. - Correct answer Hatch Amendment The intense health care cost shifting efforts among providers such as Medicare, Medicaid, and local governments is ____. - Correct answer Likely to continue Worried about the level of actual resident care achieved in the facility, the administrator directs the nurse to spend less time charting and more time focusing on the effectiveness of care being given to the residents. The likely result will be___ - Correct answer Better resident care, but increased deficiency citations The new social worker informs the head of nursing that the admissions is all she has time for and that nursing must monitor and document each resident's socipsychological experiences. The new social worker is _____ - Correct answer responding appropriately to priorities Attempting to find the right person for each well-defined job is known as the management function ______ - Correct answer Staffing The administrator who takes steps that assures the goals are accomplished and that each job as planned is successful __ - Correct answer controlling quality The administrator's job is to assure that the ____employees do the task of the organization at an acceptable quality level. - Correct answer Appropriate The administrator who conducts a national search for a director of nursing position and interviews 20 candidates from 7 different surrounding states by phone is engaged in the managerial function of ______ - Correct answer Staffing In the end, it can be said that the administrator's responsibility to meet resident care needs and facility needs are ______ - Correct answer both are equal Superior performance depends on taking exceptional care of residents via superior service and _____ - Correct answer Constant innovations Superior performance for a nursing facility comes through __ - Correct answer Innovation in ways to serve residents Page 16 of 18 The superb nursing facility is superb by virtue of its ____ - Correct answer Success in serving the residents Answering the phones and resident call bells with common courtesy and doing things that work are examples of ______ - Correct answer a blind flash of the obvious Giving every employee the space to innovate at least a little; listening to residents and acting on their ideas; and wandering around with residents, staff, and suppliers are examples of the different-to-achieve ________ - Correct answer Common sense, obvious In a facility of 120 beds, the administrator ____personally performs each of the management tasks. - Correct answer Need not To assure that all the management tasks are successfully accomplished, the administrator of a 120-bed facility will typically divide management into _____ - Correct answer three layers A licensed person responsible for formulating and enforcing policies that will be applied to an entire facility is thought of as a/an ____ - Correct answer Upper-level manager The staff member responsible for reporting to upper-level management and at the same time interacting significantly with several lower-level managers is the ______ - Correct answer Director of Nursing The staff person for whom both upward and downward communication skills are most necessary is the ____ - Correct answer Director of nursing When the director of nursing makes an effective policy decision without consulting the administrator that impacts all nursing personnel, the administrator should ______ - Correct answer be pleased In the typical nursing facility, the decision-making process is _______ establishment of lower, middle, and upper levels of management. - Correct answer noticeably more complicated than the simple Among the following positions the _____has no authority to make decisions for the facility. - Correct answer Assistant to the Administrator Decisions made by persons on the staff to whom the administrator has delegated line authority are, in the final analysis, regarded as decisions by ______. - Correct answer the administrator Page 17 of 18