,Instructor’s Guide for
Hartman’s Nursing Assistant Care
Long-Term Care
fifth edition
by Hartman Publishing, Inc.
,ii
Credits
Managing Editor
Susan Alvare Hedman
Copy Editor
Angela Storey
Cover Illustrator
Iveta Vaicule
Production
Tracy Kopsachilis
Proofreader
Kristin Calderon
Copyright Information
© 2022 by Hartman Publishing, Inc.
1313 Iron Avenue SW
Albuquerque, New Mexico 87102
(505) 291-1274
web: hartmanonline.com
email:
Twitter: @HartmanPub
All rights reserved. No part of this book may be reproduced, in any form or by any means, without permission in writing
from the publisher.
ISBN 978-1-60425-139-5
PRINTED IN THE USA
Notice to Readers
Though the guidelines and procedures contained in this text are based on consultations with healthcare professionals, they
should not be considered absolute recommendations. The instructor and readers should follow employer, local, state, and
federal guidelines concerning healthcare practices. These guidelines change, and it is the reader’s responsibility to be aware
of these changes and of the policies and procedures of her or his healthcare facility.
The publisher, authors, editors, and reviewers cannot accept any responsibility for errors or omissions or for any conse-
quences from application of the information in this book and make no warranty, express or implied, with respect to the
contents of the book. The publisher does not warrant or guarantee any of the products described herein or perform any
analysis in connection with any of the product information contained herein.
, iii
Table of Contents
Preface v Appendix G Final Exam 485
Appendix H Answer Key for Final Exam 495
Lesson Plans Appendix I Final Exam 2 499
1 Understanding Healthcare Settings 1 Appendix J Answer Key for Final Exam 2 505
2 The Nursing Assistant and the Care Team 6 Appendix K Workbook Answer Key and Practice Exam
Answer Key 507
3 Legal and Ethical Issues 12
Appendix L Answer Key for Chapter Review Questions 548
4 Communication and Cultural Diversity 19
5 Infection Prevention and Control 28
6 Safety and Body Mechanics 39
7 Emergency Care and Disaster Preparation 46
8 Human Needs and Human Development 52
9 The Healthy Human Body 63
10 Positioning, Transfers, and Ambulation 71
11 Admitting, Transferring, and Discharging 76
12 The Resident’s Unit 81
13 Personal Care Skills 85
14 Basic Nursing Skills 93
15 Nutrition and Hydration 102
16 Urinary Elimination 113
17 Bowel Elimination 119
18 Common Chronic and Acute Conditions 125
19 Confusion, Dementia, and Alzheimer’s Disease 142
20 Mental Health and Mental Health Disorders 151
21 Rehabilitation and Restorative Care 156
22 Special Care Skills 161
23 Dying, Death, and Hospice 169
24 Caring for Your Career and Yourself 175
Appendices
Appendix A Key Material 184
Appendix B Handouts 279
Appendix C Chapter Exams 329
Appendix D Answer Key for Chapter Exams 387
Appendix E 2nd Set of Chapter Exams 397
Appendix F Answer Key for 2nd Set of Chapter Exams 473
,iv
, v
Preface
Welcome to the instructor’s guide for Hartman’s Nursing Assistant Care: Long-Term Care 5e! We want
to be your teaching partner, and we have tried to make this the most useful instructor’s guide we
have ever written. If you have suggestions for improving it, please let us know. If you teach topics
not covered in the book, call us and we will do something about it!
Like the textbook and the workbook, the instructor’s guide is organized around learning objectives,
which should make teaching the material much simpler. We have included the textbook and work-
book page numbers to make it easier for you to assign readings and exercises to your students.
Appendix A contains all of the key material that we have created for this course, and Appendix B
contains the handouts. There are exams for all chapters located in Appendix C. Appendix D contains
the answers for each chapter’s exams. Appendix E contains a second set of exams for each chapter,
and Appendix F has the answers to those exams. Appendix G contains a final exam and Appendix
H has the answers to that exam. Appendix I contains a shorter, additional final exam, and Appendix
J contains the answers to that exam. Appendix K contains the workbook answer key and the answer
key for the chapter exam. Appendix L contains the answers to the chapter review questions.
Hartman Publishing’s complete instructor’s guides (lesson plans, transparency masters, key mate-
rial, handouts, exams, PowerPoint slides, key terms, and procedure checklists) are legally protected
by United States copyright law. Each instructor’s guide is licensed for use as part of an adoption and
purchase of textbooks. If every student in your course has a purchased textbook, and we are able to
verify your purchases of Hartman books, you are free to make as many copies as you need of the
instructor’s guide for use at your facility, school, or agency, as well as to modify items to suit your
teaching needs. Electronic or online use is limited and conditional: permission is conveyed only to
purchasing institutions, and the material can only be accessed by students and instructors via a pri-
vate, password-protected, nonpublic portal. Posting or uploading of Hartman Publishing’s material
to a public website is expressly prohibited.
This instructor’s guide, along with additional exams, critical thinking questions, and other teaching
material, is available at no charge for registered users at Hartman Publishing’s instructor’s website:
instructors.hartmanonline.com.
We hope you find this guide helpful, thorough, and engaging. Call us with your feedback and sug-
gestions! We would love to hear from you.
Happy teaching!
,vi
, 1
1
Understanding Healthcare Settings
1. Discuss the structure of the healthcare system and describe ways it is changing
2. Describe a typical long-term care facility
3. Describe residents who live in long-term care facilities
4. Explain policies and procedures
5. Describe the long-term care survey process
6. Explain Medicare and Medicaid
7. Discuss the terms culture change, person-centered care, and trauma-informed care
Supplemental Tools
key material 1-1 traditional healthcare • Skilled care
system • Length of stay
key material 1-2 residents in ltc facilities • Terminal illness
key material 1-3 facts about medicare • Chronic illness
and medicaid
• Home health care
chapter 1: exam
• Diagnoses
Assignments • Assisted living
textbook reading: pp. 1–8 • Dementia
workbook exercises: pp. 1–4 • Adult day services
Overview of Teaching Strategies • Acute care
The purpose of the teaching strategy for this chap- • Subacute care
ter is to describe various healthcare settings, with • Outpatient care
an emphasis on long-term care. Students will learn
how LTC is paid for and will be introduced to the • Rehabilitation
types of residents for whom they will care. • Hospice care
• Managed care
1. Discuss the structure of the healthcare • Health maintenance organizations (HMOs)
system and describe ways it is changing • Preferred provider organizations (PPOs)
Meeting the Learning Objective Display Key Material
textbook pp. 1–4 1-1 traditional healthcare system
workbook pp. 1–2
Discuss the evolution of health care, using the
Lecture slide or creating one of your own as part of
Define the following terms: the lecture. Emphasize major changes in the
healthcare system:
• Providers
• Increased use of expensive technology
• Facilities
• Rising costs of health care
• Payers
• New ways to control costs of care
• Long-term care (LTC)
,2
2. Describe a typical long-term care facility Residents with a length of stay of less than six
months
Meeting the Learning Objective • May be admitted for terminal care (will die in
textbook p. 4 facility)
workbook p. 2 • May be admitted for rehabilitation or temporary
illness (will recover and return to community)
Lecture
Stress that different reasons for being in a facility
Define the following terms:
will require different kinds of care.
• Activities of daily living (ADLs)
• Catheters Note that many residents in LTC lack outside sup-
port, and stress the importance of caring for the
Discuss different models of LTC facilities, includ- whole person.
ing those for residents with dementia and those
with assisted living wings. Review services that
4. Explain policies and procedures
facilities offer.
Meeting the Learning Objective
3. Describe residents who live in long-term textbook pp. 5–6
care facilities workbook p. 3
Meeting the Learning Objective Lecture
textbook pp. 4–5 Define the following terms:
workbook pp. 2–3 • Policy
• Procedure
Display Key Material
1-2 residents in ltc facilities Discuss common policies and procedures in
facilities:
Discuss these facts about residents in long-term • All resident information is confidential.
care facilities in the US:
• Resident’s care plan must be followed.
• 83.5% are over age 65 • Nursing assistants (NAs) only perform tasks in
• 68% are female job descriptions.
• More than 75% are white and non-Hispanic • NAs report to nurse.
• About 1/3 come from a private residence • NAs should not discuss personal problems with
residents or families.
• Over 50% come from a hospital or other facility
• NAs should not take money or gifts from resi-
• As many as 48% have dementia dents or families.
• NAs must be on time and dependable.
Discuss length of stay and reasons that residents
with different lengths of stay might be in an LTC Encourage students to ask questions about poli-
facility. cies and procedures and to review the procedure
manual when they are unsure about care.
Residents with a length of stay of six months or
more
• Make up over 2/3 of residents 5. Describe the long-term care survey
process
• Require 24-hour care
• Did not have caregivers available to give enough Meeting the Learning Objective
care at home textbook p. 6
• May have developmental disabilities (this is the workbook p. 3
group with the longest average stay)
, 3
Lecture • Part C allows private health insurance companies
Define the following terms: to provide Medicare benefits.
• Cite • Part D helps pay for medications prescribed for
• Joint Commission treatment.
Discuss how surveyors study residents’ care and Describe facts about Medicaid:
how well their needs are being met: • Funded by both federal government and each
• Interview residents and their families state
• Observe staff interactions with residents and • Eligibility determined by income and special
care given circumstances
• Review residents’ charts • People must qualify for Medicaid.
• Observe residents’ meals Describe long-term care coverage under Medicare
and Medicaid:
Emphasize that NAs should tell the truth when
asked questions by surveyors. They should not • Pays LTC facilities a fixed amount for services
guess if they do not know the answer. • Services are based on the resident’s needs upon
admission and throughout facility stay.
Point out to students that surveys conducted by
the Joint Commission are not affiliated with state
inspections and that facilities participate in Joint 7. Discuss the terms culture change,
Commission surveys on a voluntary basis. person-centered care, and
trauma-informed care
Optional Activity
If teaching in a facility, show students the last sur- Meeting the Learning Objective
vey and discuss the areas listed on the survey. textbook pp. 7–8
workbook p. 4
6. Explain Medicare and Medicaid
Lecture
Meeting the Learning Objective Define the following terms:
textbook pp. 6–7 • Culture change
workbook p. 3 • Person-centered care
• Trauma-informed care
Lecture
Define the following terms: Discuss the core values of culture change:
• Centers for Medicare & Medicaid Services (CMS) • Choice
• Dignity
• Medicare
• Respect
• Medicaid
• Self-determination
Display Key Material • Purposeful living
1-3 facts about medicare and medicaid Describe person-centered care:
Describe Medicare coverage: • Emphasizes individuality of person who needs
care.
• For those 65 or older or anyone who has perma-
nent kidney failure and/or certain disabilities • Each person’s background, culture, language,
beliefs, and traditions are respected.
• Part A helps pay for care in a hospital or skilled
nursing facility or for care from a home health • Improving each resident’s quality of life is an
agency or hospice. important goal.
• Part B helps pay for doctor services and other Discuss the types of past trauma a person may
medical services and equipment. have experienced and how involving the person in
Hartman’s Nursing Assistant Care
Long-Term Care
fifth edition
by Hartman Publishing, Inc.
,ii
Credits
Managing Editor
Susan Alvare Hedman
Copy Editor
Angela Storey
Cover Illustrator
Iveta Vaicule
Production
Tracy Kopsachilis
Proofreader
Kristin Calderon
Copyright Information
© 2022 by Hartman Publishing, Inc.
1313 Iron Avenue SW
Albuquerque, New Mexico 87102
(505) 291-1274
web: hartmanonline.com
email:
Twitter: @HartmanPub
All rights reserved. No part of this book may be reproduced, in any form or by any means, without permission in writing
from the publisher.
ISBN 978-1-60425-139-5
PRINTED IN THE USA
Notice to Readers
Though the guidelines and procedures contained in this text are based on consultations with healthcare professionals, they
should not be considered absolute recommendations. The instructor and readers should follow employer, local, state, and
federal guidelines concerning healthcare practices. These guidelines change, and it is the reader’s responsibility to be aware
of these changes and of the policies and procedures of her or his healthcare facility.
The publisher, authors, editors, and reviewers cannot accept any responsibility for errors or omissions or for any conse-
quences from application of the information in this book and make no warranty, express or implied, with respect to the
contents of the book. The publisher does not warrant or guarantee any of the products described herein or perform any
analysis in connection with any of the product information contained herein.
, iii
Table of Contents
Preface v Appendix G Final Exam 485
Appendix H Answer Key for Final Exam 495
Lesson Plans Appendix I Final Exam 2 499
1 Understanding Healthcare Settings 1 Appendix J Answer Key for Final Exam 2 505
2 The Nursing Assistant and the Care Team 6 Appendix K Workbook Answer Key and Practice Exam
Answer Key 507
3 Legal and Ethical Issues 12
Appendix L Answer Key for Chapter Review Questions 548
4 Communication and Cultural Diversity 19
5 Infection Prevention and Control 28
6 Safety and Body Mechanics 39
7 Emergency Care and Disaster Preparation 46
8 Human Needs and Human Development 52
9 The Healthy Human Body 63
10 Positioning, Transfers, and Ambulation 71
11 Admitting, Transferring, and Discharging 76
12 The Resident’s Unit 81
13 Personal Care Skills 85
14 Basic Nursing Skills 93
15 Nutrition and Hydration 102
16 Urinary Elimination 113
17 Bowel Elimination 119
18 Common Chronic and Acute Conditions 125
19 Confusion, Dementia, and Alzheimer’s Disease 142
20 Mental Health and Mental Health Disorders 151
21 Rehabilitation and Restorative Care 156
22 Special Care Skills 161
23 Dying, Death, and Hospice 169
24 Caring for Your Career and Yourself 175
Appendices
Appendix A Key Material 184
Appendix B Handouts 279
Appendix C Chapter Exams 329
Appendix D Answer Key for Chapter Exams 387
Appendix E 2nd Set of Chapter Exams 397
Appendix F Answer Key for 2nd Set of Chapter Exams 473
,iv
, v
Preface
Welcome to the instructor’s guide for Hartman’s Nursing Assistant Care: Long-Term Care 5e! We want
to be your teaching partner, and we have tried to make this the most useful instructor’s guide we
have ever written. If you have suggestions for improving it, please let us know. If you teach topics
not covered in the book, call us and we will do something about it!
Like the textbook and the workbook, the instructor’s guide is organized around learning objectives,
which should make teaching the material much simpler. We have included the textbook and work-
book page numbers to make it easier for you to assign readings and exercises to your students.
Appendix A contains all of the key material that we have created for this course, and Appendix B
contains the handouts. There are exams for all chapters located in Appendix C. Appendix D contains
the answers for each chapter’s exams. Appendix E contains a second set of exams for each chapter,
and Appendix F has the answers to those exams. Appendix G contains a final exam and Appendix
H has the answers to that exam. Appendix I contains a shorter, additional final exam, and Appendix
J contains the answers to that exam. Appendix K contains the workbook answer key and the answer
key for the chapter exam. Appendix L contains the answers to the chapter review questions.
Hartman Publishing’s complete instructor’s guides (lesson plans, transparency masters, key mate-
rial, handouts, exams, PowerPoint slides, key terms, and procedure checklists) are legally protected
by United States copyright law. Each instructor’s guide is licensed for use as part of an adoption and
purchase of textbooks. If every student in your course has a purchased textbook, and we are able to
verify your purchases of Hartman books, you are free to make as many copies as you need of the
instructor’s guide for use at your facility, school, or agency, as well as to modify items to suit your
teaching needs. Electronic or online use is limited and conditional: permission is conveyed only to
purchasing institutions, and the material can only be accessed by students and instructors via a pri-
vate, password-protected, nonpublic portal. Posting or uploading of Hartman Publishing’s material
to a public website is expressly prohibited.
This instructor’s guide, along with additional exams, critical thinking questions, and other teaching
material, is available at no charge for registered users at Hartman Publishing’s instructor’s website:
instructors.hartmanonline.com.
We hope you find this guide helpful, thorough, and engaging. Call us with your feedback and sug-
gestions! We would love to hear from you.
Happy teaching!
,vi
, 1
1
Understanding Healthcare Settings
1. Discuss the structure of the healthcare system and describe ways it is changing
2. Describe a typical long-term care facility
3. Describe residents who live in long-term care facilities
4. Explain policies and procedures
5. Describe the long-term care survey process
6. Explain Medicare and Medicaid
7. Discuss the terms culture change, person-centered care, and trauma-informed care
Supplemental Tools
key material 1-1 traditional healthcare • Skilled care
system • Length of stay
key material 1-2 residents in ltc facilities • Terminal illness
key material 1-3 facts about medicare • Chronic illness
and medicaid
• Home health care
chapter 1: exam
• Diagnoses
Assignments • Assisted living
textbook reading: pp. 1–8 • Dementia
workbook exercises: pp. 1–4 • Adult day services
Overview of Teaching Strategies • Acute care
The purpose of the teaching strategy for this chap- • Subacute care
ter is to describe various healthcare settings, with • Outpatient care
an emphasis on long-term care. Students will learn
how LTC is paid for and will be introduced to the • Rehabilitation
types of residents for whom they will care. • Hospice care
• Managed care
1. Discuss the structure of the healthcare • Health maintenance organizations (HMOs)
system and describe ways it is changing • Preferred provider organizations (PPOs)
Meeting the Learning Objective Display Key Material
textbook pp. 1–4 1-1 traditional healthcare system
workbook pp. 1–2
Discuss the evolution of health care, using the
Lecture slide or creating one of your own as part of
Define the following terms: the lecture. Emphasize major changes in the
healthcare system:
• Providers
• Increased use of expensive technology
• Facilities
• Rising costs of health care
• Payers
• New ways to control costs of care
• Long-term care (LTC)
,2
2. Describe a typical long-term care facility Residents with a length of stay of less than six
months
Meeting the Learning Objective • May be admitted for terminal care (will die in
textbook p. 4 facility)
workbook p. 2 • May be admitted for rehabilitation or temporary
illness (will recover and return to community)
Lecture
Stress that different reasons for being in a facility
Define the following terms:
will require different kinds of care.
• Activities of daily living (ADLs)
• Catheters Note that many residents in LTC lack outside sup-
port, and stress the importance of caring for the
Discuss different models of LTC facilities, includ- whole person.
ing those for residents with dementia and those
with assisted living wings. Review services that
4. Explain policies and procedures
facilities offer.
Meeting the Learning Objective
3. Describe residents who live in long-term textbook pp. 5–6
care facilities workbook p. 3
Meeting the Learning Objective Lecture
textbook pp. 4–5 Define the following terms:
workbook pp. 2–3 • Policy
• Procedure
Display Key Material
1-2 residents in ltc facilities Discuss common policies and procedures in
facilities:
Discuss these facts about residents in long-term • All resident information is confidential.
care facilities in the US:
• Resident’s care plan must be followed.
• 83.5% are over age 65 • Nursing assistants (NAs) only perform tasks in
• 68% are female job descriptions.
• More than 75% are white and non-Hispanic • NAs report to nurse.
• About 1/3 come from a private residence • NAs should not discuss personal problems with
residents or families.
• Over 50% come from a hospital or other facility
• NAs should not take money or gifts from resi-
• As many as 48% have dementia dents or families.
• NAs must be on time and dependable.
Discuss length of stay and reasons that residents
with different lengths of stay might be in an LTC Encourage students to ask questions about poli-
facility. cies and procedures and to review the procedure
manual when they are unsure about care.
Residents with a length of stay of six months or
more
• Make up over 2/3 of residents 5. Describe the long-term care survey
process
• Require 24-hour care
• Did not have caregivers available to give enough Meeting the Learning Objective
care at home textbook p. 6
• May have developmental disabilities (this is the workbook p. 3
group with the longest average stay)
, 3
Lecture • Part C allows private health insurance companies
Define the following terms: to provide Medicare benefits.
• Cite • Part D helps pay for medications prescribed for
• Joint Commission treatment.
Discuss how surveyors study residents’ care and Describe facts about Medicaid:
how well their needs are being met: • Funded by both federal government and each
• Interview residents and their families state
• Observe staff interactions with residents and • Eligibility determined by income and special
care given circumstances
• Review residents’ charts • People must qualify for Medicaid.
• Observe residents’ meals Describe long-term care coverage under Medicare
and Medicaid:
Emphasize that NAs should tell the truth when
asked questions by surveyors. They should not • Pays LTC facilities a fixed amount for services
guess if they do not know the answer. • Services are based on the resident’s needs upon
admission and throughout facility stay.
Point out to students that surveys conducted by
the Joint Commission are not affiliated with state
inspections and that facilities participate in Joint 7. Discuss the terms culture change,
Commission surveys on a voluntary basis. person-centered care, and
trauma-informed care
Optional Activity
If teaching in a facility, show students the last sur- Meeting the Learning Objective
vey and discuss the areas listed on the survey. textbook pp. 7–8
workbook p. 4
6. Explain Medicare and Medicaid
Lecture
Meeting the Learning Objective Define the following terms:
textbook pp. 6–7 • Culture change
workbook p. 3 • Person-centered care
• Trauma-informed care
Lecture
Define the following terms: Discuss the core values of culture change:
• Centers for Medicare & Medicaid Services (CMS) • Choice
• Dignity
• Medicare
• Respect
• Medicaid
• Self-determination
Display Key Material • Purposeful living
1-3 facts about medicare and medicaid Describe person-centered care:
Describe Medicare coverage: • Emphasizes individuality of person who needs
care.
• For those 65 or older or anyone who has perma-
nent kidney failure and/or certain disabilities • Each person’s background, culture, language,
beliefs, and traditions are respected.
• Part A helps pay for care in a hospital or skilled
nursing facility or for care from a home health • Improving each resident’s quality of life is an
agency or hospice. important goal.
• Part B helps pay for doctor services and other Discuss the types of past trauma a person may
medical services and equipment. have experienced and how involving the person in
