, Question 1
A resident with a documented history of wandering exits the assisted living
facility unnoticed. The director discovers that the facility's egress system was
disabled for maintenance. Under Minnesota Statutes 144G, which action best
demonstrates the director's legal and ethical responsibility?
A. Immediately report the incident to the state licensing agency and
conduct a root-cause analysis.
B. Document the incident internally and review the maintenance policy
with staff.
C. Inform the resident's family and increase supervision without notifying
authorities.
D. Wait for the next scheduled licensing inspection to disclose the
incident.
Correct Answer: A - Immediately report the incident to the state
licensing agency and conduct a root-cause analysis.
RATIONALE
Minnesota law mandates reporting incidents that compromise resident
safety, especially those involving elopement and disabled safety
systems. Immediate reporting and root-cause analysis are required to
ensure accountability and prevent recurrence. Options B, C, and D fail
to meet legal reporting obligations and risk further harm.
Question 2
An ALD is reviewing a new medication order for a resident with dysphagia.
The order is for a crushed extended-release tablet. Which principle should
guide the director's response?
A. Crushing extended-release medications is generally contraindicated
due to altered pharmacokinetics.
B. Crushing is acceptable if mixed with applesauce and administered
immediately.
Page 2
, C. The director should defer to the prescriber's order without question.
D. Crushing is allowed if the resident has a feeding tube.
Correct Answer: A - Crushing extended-release medications is
generally contraindicated due to altered pharmacokinetics.
RATIONALE
Extended-release formulations are designed to release medication
slowly; crushing can cause dose dumping and toxicity. The director
must advocate for a safer alternative, such as a liquid or
immediate-release form. Options B, C, and D are unsafe practices that
could lead to adverse events.
Question 3
A facility's emergency preparedness plan lacks provisions for a prolonged
power outage. Which element is most critical to add to ensure resident safety
during such an event?
A. A backup generator sufficient to power all life-support and
refrigeration equipment.
B. A stockpile of flashlights and batteries for each resident room.
C. A communication plan to notify families within 24 hours.
D. An agreement with a nearby hotel for temporary relocation.
Correct Answer: A - A backup generator sufficient to power all
life-support and refrigeration equipment.
RATIONALE
Life-support equipment and medication refrigeration are essential
during power outages; a generator ensures continuity of care.
Flashlights, family notification, and relocation plans are secondary to
maintaining critical equipment. Minnesota rules require adequate
emergency power for essential functions.
Page 3
, Question 4
During a compliance audit, the director finds that staff are not consistently
documenting resident refusals of care. Which strategy best addresses this
systemic issue?
A. Implement a standardized refusal documentation form and provide
staff training on its use.
B. Terminate staff who fail to document refusals.
C. Ignore minor refusals to reduce paperwork burden.
D. Delegate documentation to family members.
Correct Answer: A - Implement a standardized refusal
documentation form and provide staff training on its use.
RATIONALE
Standardized forms and training ensure consistent, legally defensible
documentation of refusals, which is required to demonstrate respect
for resident rights and to mitigate liability. Punitive measures or
ignoring refusals can lead to regulatory citations. Family delegation is
inappropriate for clinical documentation.
Question 5
A resident's care plan includes a restrictive intervention. Which criterion must
be met for this intervention to be permissible under Minnesota law?
A. It must be ordered by a physician and reviewed quarterly.
B. It must be the least restrictive alternative and based on a
comprehensive assessment.
C. It must be approved by the resident's family.
D. It must be implemented only during nighttime hours.
Correct Answer: B - It must be the least restrictive alternative
and based on a comprehensive assessment.
Page 4
A resident with a documented history of wandering exits the assisted living
facility unnoticed. The director discovers that the facility's egress system was
disabled for maintenance. Under Minnesota Statutes 144G, which action best
demonstrates the director's legal and ethical responsibility?
A. Immediately report the incident to the state licensing agency and
conduct a root-cause analysis.
B. Document the incident internally and review the maintenance policy
with staff.
C. Inform the resident's family and increase supervision without notifying
authorities.
D. Wait for the next scheduled licensing inspection to disclose the
incident.
Correct Answer: A - Immediately report the incident to the state
licensing agency and conduct a root-cause analysis.
RATIONALE
Minnesota law mandates reporting incidents that compromise resident
safety, especially those involving elopement and disabled safety
systems. Immediate reporting and root-cause analysis are required to
ensure accountability and prevent recurrence. Options B, C, and D fail
to meet legal reporting obligations and risk further harm.
Question 2
An ALD is reviewing a new medication order for a resident with dysphagia.
The order is for a crushed extended-release tablet. Which principle should
guide the director's response?
A. Crushing extended-release medications is generally contraindicated
due to altered pharmacokinetics.
B. Crushing is acceptable if mixed with applesauce and administered
immediately.
Page 2
, C. The director should defer to the prescriber's order without question.
D. Crushing is allowed if the resident has a feeding tube.
Correct Answer: A - Crushing extended-release medications is
generally contraindicated due to altered pharmacokinetics.
RATIONALE
Extended-release formulations are designed to release medication
slowly; crushing can cause dose dumping and toxicity. The director
must advocate for a safer alternative, such as a liquid or
immediate-release form. Options B, C, and D are unsafe practices that
could lead to adverse events.
Question 3
A facility's emergency preparedness plan lacks provisions for a prolonged
power outage. Which element is most critical to add to ensure resident safety
during such an event?
A. A backup generator sufficient to power all life-support and
refrigeration equipment.
B. A stockpile of flashlights and batteries for each resident room.
C. A communication plan to notify families within 24 hours.
D. An agreement with a nearby hotel for temporary relocation.
Correct Answer: A - A backup generator sufficient to power all
life-support and refrigeration equipment.
RATIONALE
Life-support equipment and medication refrigeration are essential
during power outages; a generator ensures continuity of care.
Flashlights, family notification, and relocation plans are secondary to
maintaining critical equipment. Minnesota rules require adequate
emergency power for essential functions.
Page 3
, Question 4
During a compliance audit, the director finds that staff are not consistently
documenting resident refusals of care. Which strategy best addresses this
systemic issue?
A. Implement a standardized refusal documentation form and provide
staff training on its use.
B. Terminate staff who fail to document refusals.
C. Ignore minor refusals to reduce paperwork burden.
D. Delegate documentation to family members.
Correct Answer: A - Implement a standardized refusal
documentation form and provide staff training on its use.
RATIONALE
Standardized forms and training ensure consistent, legally defensible
documentation of refusals, which is required to demonstrate respect
for resident rights and to mitigate liability. Punitive measures or
ignoring refusals can lead to regulatory citations. Family delegation is
inappropriate for clinical documentation.
Question 5
A resident's care plan includes a restrictive intervention. Which criterion must
be met for this intervention to be permissible under Minnesota law?
A. It must be ordered by a physician and reviewed quarterly.
B. It must be the least restrictive alternative and based on a
comprehensive assessment.
C. It must be approved by the resident's family.
D. It must be implemented only during nighttime hours.
Correct Answer: B - It must be the least restrictive alternative
and based on a comprehensive assessment.
Page 4
