EXAM (JAMES ALLEN) QUESTIONS
AND ANSWERS
1. The most likely single cause for the series of bankruptcies among larger nursing ho
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me chains around the year 2000 was ____.
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1. Too small increases in government reimbursement rates
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2. Paying too much for acquisitions in 1998 and 1999
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3. Not taking advantage of falling interest rates
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4. Thinking too small - ans-2
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2. In a chance conversation with the owner of an eight-
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facility chain, the newly hired administrator for the oldest facility in the chain indicates t
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hat, because the mortgage is fully retired, the administrator will concentrate more on be
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ing effec-sw
tive than efficient since the Quality Indicators are all at or above the state's aver-
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age. The owner would likely ____.
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1. Be pleased
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2. Be distressed
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3. Be content
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4. Praise the newly hired administrator - ans-2
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3.
Occupancy of Facility A has been a steady 70% since the Prospective Payment Syste
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m was introduced. Two weeks ago, a new 120-bed, equally equipped facil-
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ity opened several blocks away. The Facility A administrator tells the admissions coun
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selor to continue the usual recruitment approach. The chain owners ought to _____.
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1. Rest comfortably
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2. Seek a new administrator
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3. Appoint a new admissions counselor
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4. Take no action - ans-2
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4. sw Bankruptcies among larger nursing home chains prior to 2000 _____. sw sw sw sw sw sw sw sw sw
1. sw Were frequent sw
2. sw Were ubiquitous sw
3. sw Were highly unusual sw sw
4. sw Were routinely declared to avoid too much accumulated debt - ans-3
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5. sw Under the Prospective Payment System, nursing facilities' reimbursed costs _____.
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1. sw Were about the same as previously
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2. sw Were more bundled sw sw
3. sw Used an unbundled cost structure
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,4. Were reimbursement for actual costs - ans-2
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6. sw In recent years, Medicare has _____.
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1. sw Allowed facilities to make a modest profit sw sw sw sw sw sw
2. sw Shifted more costs onto nursing facilities
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3. sw Eased up on economic pressures previously placed on facilities
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4. sw Remained relatively unchanged in its reimbursement structure - ans-2
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7. The nurse newly promoted to director of nursing insists on giving four RN hours of p
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atient care each day on the Alzheimer's wing in the 175-
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bed facility. The administrator should _____.
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1. Praise the new director of nursing for her resident centeredness
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2. Appoint an assistant director of nursing
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3. Adapt the job description to fit her pattern
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4. Seek a new director of nursing - ans-4
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8. The applicant for the administrator position in a facility near a large teaching hospital
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insists that, as before in his rural facility, if hied he would not let the Medicare reimburs
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ement policies affect his case mix. This applicant _____.
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1. Should be hired
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2. Is likely to succeed if hired
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3. Can likely succeed in his goal
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4. Is out of touch - ans-4
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9. The newly hired assistant to the administrator insists that the organizational chart dot
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ted line between this position and the Department of Nursing be a solid line. The admin
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istrator should _____. sw sw
1. Agree in general
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2. Agree to this special case
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3. Ask the director of nursing for his or her opinion 4. Be forewarned - ans-4
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10. The medical supplies provider tells the administrator of a facility that has not paid bi
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lls for the past 3 months but is now operating under a bankruptcy judge's approved pla
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n for restructuring, that no more deliveries will be made until past bills are fully paid. Th
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e medical supplies provider _____.
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1. Is smart to cut losses at that point
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2. Does not understand how bankruptcy works 3. Will now likely get his past due bills p
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aid
4. Is farsighted - ans-2
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11. An administrator who adopts the leadership-by-walking-
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around (LBWA) approach by walking through the facility weekly and intently observing
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has _____. sw
1. Become an effective leader
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2. Chosen a good management style 3. Failed to understand LBWA
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4. Implemented a useful strategy - ans-3
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,12. The nursing facility administrator who, using the leadership-by-
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walking around (LBWA) technique, succeeds in actually making appropriate corrections
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on the spot during her rounds _____.
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1. Is effectively implementing the concept
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2. Gains additional power through the process 3. Exhibits appropriate leadership
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4. Does not understand LBWA - ans-4
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13. The rate of increase in the total number of nursing facilities in the United States dur
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ing the years 2008 to 2012 is _____.
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1. Likely to be about level
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2. Likely to double
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3. Likely to triple to accommodate the baby boomer generation 4. Likely to decrease m
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arkedly - ans-1 sw sw
14. The applicant for administrator of the facility insists that he has successfully used d
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emocratic leadership to the exclusion of all other leadership styles. The interviewer sho
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uld _____. sw
1. Recommend hiring this candidate
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2. Praise the candidate
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3. Be favorably impressed
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4. Continue to interview candidates - ans-4
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15. The candidate for administrator said that she used a variety of administrative styles,
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but could not say exactly which she would use in every circumstance. The interviewer
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should be _____. sw sw
1. Favorably impressed
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2. Unfavorably impressed
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3. Concerned about possible indecisiveness 4. Looking for one leadership style - ans-1
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16. The candidate for administrator indicated that he consistently chose the charis-
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matic style of leadership. This should _____ the interviewer.
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1. Reassure
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2. Alert
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3. Confirm the candidate's qualifications to 4. Please - ans-2
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17. The costs of providing subacute care to nursing home residents _____. 1. Is perha
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ps triple that of the more typical patient
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2. Covered by Medicare
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3. Absorbed by Medicaid if Medicare coverage is inadequate
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4. Mostly covered by private insurance - ans-1
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18. The nurse supervisor who had just been appointed director of nursing announced a
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t the first department head meeting that she had circulated a memo among the nurses t
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hat only formal communications were to be allowed in the nursing department. The ad
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ministrator should _____. sw sw
, 1. Be relieved
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2. Confirm the decision 3. Be supportive
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4. Anticipate problems - ans-4
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19. The department head was not surprised to learn that an employee had heard only t
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he positive comments to the employee and ignored the criticisms. The department hea
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d's grasp of the communication process is _____.
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1. Deficient
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2. Appropriate 3. Out of focus 4. Inadequate - ans-2
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20. The administrator routinely accepted as a nearly exclusive information source the di
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rector of nursing's positive reports that nursing was going well. The administrator is ___
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__.
1. Showing appropriate confidence in the director of nursing
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2. Utilizing the director of nursing properly
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3. Realizing a successful appointment has been made 4. Placing himself at risk - ans-4
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21. Periodic shortage of nurses available for nursing home employment _____. 1. Is be
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ing solved by community college programs
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2. Is decreasing
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3. Can be readily solved by hiring temporary nurses
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4. Is likely to remain for the foreseeable future - ans-4
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22. Congress and the federal rule makers behave as if the facility will run success-
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fully if Congress and the Centers for Medicare and Medicaid Services can write enoug
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h rules. They are _____.
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1. Incorrect
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2. Correct, according to behavior theory
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3. Pessimistic about the need for rules
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4. Correct, according to emerging management theory - ans-1
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23. When the administrator notices that the director of nursing seeks to turn as many d
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uties as possible over to housekeeping, the administrator should con-
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clude that the director of nursing is _____.
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1. Behaving normally
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2. Holding a grudge against housekeeping 3. Unwilling to be cooperative
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4. Wielding power desirably - ans-1
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24. The administrator insists that a timely copy of all reports generated within the facilit
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y come across her desk before anyone signs them. The administrator is _____.
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1. Not rationalizing her management information system
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2. Making appropriate and desirable requests
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3. Exercising good judgment
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4. Initiating an appropriate management information system - ans-1
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