Nursing Home Operations and Regulations, Exams of Service Management

Download Nursing Home Operations and Regulations and more Exams Service Management in PDF only on Docsity! NHA Line of Service Exam Prep Questions and Answers. 1. Which of the following is part of standard precautions for infection control? A. Wearing a gown each time there is a clothing change for an incontinent resident. B. Placing soiled linens on the floor rather than on the bed or other furniture. C. Washing hands after touching a resident's blood or urine, if gloves were worn at the time of contact. D. Using an antimicrobial soap for routine hand washing. - Correct answer C. Washing hands after touching a resident's blood or urine, if gloves were worn at the time of contact. 2. If a facility must notify a resident's physician about a significant change in the resident's status but the resident's attending physician cannot be reached, which of these steps should the facility take first A. Call the Medical Director. B. Transfer the resident to a hospital. C. Assign another physician to the case. D. Call the physician designated by the attending physician to cover for him or her in his or her absence. - Correct answer D. Call the physician designated by the attending physician to cover for him or her in his or her absence. 3. A certified nursing facility must complete a performance evaluation of every nurse aide at least once every A. month B. quarter C. 12 months D. two years - Correct answer C. 12 months 4. One necessary occasion for a comprehensive reassessment is when a resident undergoes an unplanned weight loss that exceeds A. 5 percent in one month. B. 5 percent in one month, or 10 percent in 6 months. C. 5 percent in 3 months, or 10 percent in 6 months. D. 10 percent in one month. - Correct answer B. 5 percent in one month, or 10 percent in 6 months. 5. Medicare-certified facilities must use which one of the following? A. accrual basis of accounting B. perpetual inventory P a g e 1 | 12 C. centralized meal service D. paid feeding assistants - Correct answer A. accrual basis of accounting 6. To meet Life Safety Code requirements, the facility emergency power source must be capable of providing illumination for all the means of egress how soon after loss of regular electric power? A. immediately B. within five seconds C. within 10 seconds D. within 30 seconds - Correct answer C. within 10 seconds 7. A Stage III pressure ulcer is characterized by A. dark red skin areas with blue discoloration in the center B. damage to muscle and bone C. break in skin down to and including underlying fatty tissues D. blisters - Correct answer C. break in skin down to and including underlying fatty tissues 8. The administrator's role in the survey process includes all except which one of the following? A. Responding promptly to surveyors' requests for records and information. B. Providing input into, and Insuring timely completion of, plans of correction. C. Year-round training and directing of staff in compliance with regulatory requirements. D. Insulating the governing body from involvement. - Correct answer D. insulating the governing body from involvement. 9. A chemical restraint is defined as a psychoactive drug that A. produces adverse reactions and side effects requiring the attention of the interdisciplinary team. B. is useful in managing agitation in persons with dementia. C. may serve as an appropriate substitute for a physical restraint. D. is impermissibly used for discipline or convenience and is not required to treat medical symptoms. - Correct answer D. is impermissibly used for discipline or convenience and is not required to treat medical symptoms. 10. A resident repeatedly reports seeing birds flying in his room. No one else can see these birds. This resident may be having which one of the following? P a g e 2 | 12 C. supplying more air to the room from the outside than is being exhausted from it by the ventilation system. D. having a minimum number of air changes per hour. - Correct answer A. exhausting more air from the room to the outside than is being supplied to it by the ventilation system. 21. Where a conflict exists between state licensing rules and federal certification standards, which one takes priority in the case of a certified facility? A. the federal standard B. the state rule C. the more stringent of the two D. The choice is at the discretion of the survey team. - Correct answer C. the more stringent of the two 22. According to the federal certification standards, if the facility has a resident service furnished by an outside person or agency, there must be a written agreement that the facility assumes responsibility for "obtaining services that meet professional standards" and for which one of the following? A. On-going training of the person furnishing the services. B. Income tax withholding and payment of FICA taxes for the person C. The timeliness of the services. D. Representation of the person or agency at the resident care-plan conference. - Correct answer C. The timeliness of the services. 23. Which one of the following statements is the primary reason why nurse's aides should receive training in communication skills? A. They are the staff who most frequently come into contact with residents and family. B. They must develop plans of correction when the facility is cited for deficiencies by surveyors. C. It is important that they clearly express their job dissatisfaction to the facility administrator. D. Such training is required by federal certification standards and sometimes also by state licensure regulations. - Correct answer A. They are the staff who most frequently come into contact with residents and family. P a g e 5 | 12 24. The facility employee most likely to assist a resident who is about to be discharged in contacting an outside resource agency is the A. occupational therapist B. social worker C. nurse's aide D. Director of Nursing - Correct answer B. social worker 25. For a long-term care organization to be successful under a case-mix based system of reimbursement, it should engage in which one of the following? A. double-entry bookkeeping B. group purchasing C. accelerated method of depreciation D. integration of clinical and financial data systems. - Correct answer D. integration of clinical and financial data systems. 26. The facility must notify each resident that receives Medicaid benefits when the personal funds in the resident's account reaches _______________ the limit at which the resident may lose Medicaid eligibility. A. $200 less than B. exactly C. $200 greater than D. anywhere between $200 less than and $200 greater than - Correct answer A. $200 less than 27. The Life Safety Code permits skilled nursing facilities to have which one of the following? A. bedroom doors with ventilation louvers B. non-fire-retardant Christmas trees as long as they are located near a fire extinguisher C. handrails with a one-inch clearance from the wall D. self-closing stairwell doors - Correct answer D. self-closing stairwell doors 28. At least how often must a pharmacist review the drug regimen of each resident? A. weekly C. quarterly B. monthly D. annually - Correct answer B. monthly 29. Which of the following is not an example of rehabilitation nursing? A. using a Foley catheter to heal bedsores P a g e 6 | 12 B. providing ROM exercises for residents with a limited range of motion C. using prompted voiding for residents with urinary incontinence D. using task segmentation in assisting a resident to perform grooming tasks - Correct answer A. using a Foley catheter to heal bedsores 30. A 125-bed facility has 100 residents. What is its occupancy rate? A. 80 percent C. 100 B. 1.25 D. Not possible to determine with these data. - Correct answer A. 80 percent 31. An administrator notices a resident sitting in the same position in her wheel chair for a long while, and there is a planned activity going on in the next room. The administrator should A. greet the resident, then push her into the activity room. B. have a CNA reposition the resident. C. ask the resident what activity she would like to engage in, and suggest some options she might enjoy. D. take the resident back to her room. - Correct answer C. ask the resident what activity she would like to engage in, and suggest some options she might enjoy. 32. When a nurse's aide moves a resident, it is important that safe lifting practices be used. The aide should A. keep the resident at arm's length. B. bend at the knees and keep ones back straight. C. twist at the waist. D. move the resident rapidly. - Correct answer B. bend at the knees and keep ones back straight. 33. Which of the following is part of the information on a CASPER Report 3 (formerly called an OSCAR report 3)? A. the facility's ranking among all the state's facilities in terms of percentage of residents who have certain condition or are receiving certain services B. deficiencies cited in past surveys C. errors on Medicare bills that have been electronically submitted D. the names of all persons and corporations who have a percentage of direct or indirect ownership in the facility of 5 percent or more. - Correct answer B. deficiencies cited in past surveys P a g e 7 | 12 43. The OSHA Hazardous Communication Standard includes the requirement that employees be informed about A. blood borne diseases and ways to reduce one's risk of exposure to them B. the significance of lockout and tag out devices C. the importance of protecting the confidentiality of patient information D. health hazards of chemicals in the workplace - Correct answer D. health hazards of chemicals in the workplace 44. The warm dampness of washing machines could make them breeding grounds for mold. What should be done to prevent this? A. Use a 1:3 bleach solution once every three loads. B. Swab the inside with a germicide once a day. C. Leave the washing machine open to air when not in use so that it dries completely. D. Keep the cover of the machine tightly closed when not in use. - Correct answer C. Leave the washing machine open to air when not in use so that it dries completely. 45. An alert and oriented resident tells staff that she does not want to see a person who has come to the facility to visit her. What would be the most appropriate response by staff? A. Tell the visitor how to contact the resident's immediate family. B. Tell the visitor that the resident is not available and to come back at a later time. C. Tell the visitor that the resident refuses to see him and has the right to refuse to see visitors. D. Arrange for the resident and visitor to meet only when a staff member is present throughout the visit. - Correct answer C. Tell the visitor that the resident refuses to see him and has the right to refuse to see visitors. 46. A certified facility with more than 120 beds must employ a full-time A. social worker B. medical director C. dietician D. MDS coordinator - Correct answer A. social worker 47. the most important step in preventing transmission of infectious diseases in a nursing facility is... P a g e 10 | 12 A. comprehensive physical examination of residents at the time of admission, and of employees at start of employment. B. timely and thorough hand hygiene by staff. C. routine culturing of floors, table tops, and other environmental surfaces D. walking rounds through resident-care areas. - Correct answer B. timely and thorough hand hygiene by staff. 48. How soon after delivery of mail to the facility by the postal service must the facility deliver residents' mail to the residents? A. Immediately B. within 4 hours C. within 24 hours D. within 48 hours - Correct answer C. Within 24 hours 49. Which of the following interventions is least acceptable in the effort to prevent resident falls? A. exercises to improve gait and balance B. making staff assistance for trips to the toilet available on a scheduled basis C. adjusting bed heights D. having residents use chairs that prevent rising - Correct answer D. having residents use chairs that prevent rising 50. Which of the following types of medications must be separately locked (i.e., the key to gain access to them must be different from the key that gives access to all other types of medications)? A. Title II B. Schedule II C. antipsychotics D. psychotropic - Correct answer B. Schedule II 51. A resident who is a Medicaid recipient is hospitalized, and the hospital stay exceeds the bed-hold period under the state's Medicaid plan. Which one of the following statements describes the Medicaid-certified facility's duty in readmitting this resident, if the resident still requires services provided by the facility? A. Readmit the person immediately to the bed that he or she had prior to the hospital transfer. B. The facility is under no obligation to readmit this person. P a g e 11 | 12 C. Readmit the person as soon as a bed becomes available in a semi-private room shared with another resident of the same sex. D. Place the person on the facility's waiting list, and readmit as soon as possible after all the other persons already on the waiting list have been admitted. - Correct answer C. Readmit the person as soon as a bed becomes available in a semi-private room shared with another resident of the same sex. 52. Which of the following is a type of skin ulcer that is not caused by pressure over a bony prominence? A. vascular insufficiency B. epidermal dystrophy C. unsaleable D. necrotic - Correct answer A. vascular insufficiency 53. The facility submits a request for an IDR when it wishes to A. refute survey findings that have resulted in a statement of deficiencies. B. expand its number of Medicare-certified beds. C. challenge the reimbursement it has received under the Medicare Prospective Payment System. D. obtain a determination as to whether a Medicare beneficiary meets the "need for skilled services" criterion for a Part A covered stay. - Correct answer A. refute survey findings that have resulted in a statement of deficiencies. 54. When a health insurer pays a predetermined fixed monthly amount per plan member to cover all covered services, it is making what kind of payment? A. formulary B. deductible C. extramural D. capitation - Correct answer D. capitation 55. Care Area Assessments (CAAs) are key steps in A. budgeting B. strategic planning C. developing plans of care D. reimbursement maximizing - Correct answer C. developing plans of care P a g e 12 | 12