NHA Practice Exam 1

NHA Practice Exam 1 Normal psychological aging in the elderly includes all of the following except: Ans- loss of memory Normal physiological aging of the elderly does not include: Ans- dementia Which of the following disorders is more likely to go unnoticed by the staff? Ans- depression What procedures have been found to be most effective for a resident with depression? Ans- counseling, activities, and medications Which of the following is not a symptom of depression? Ans- hallucinations A most effective way to plan for setting up a program for residents who tend to wander is to: Ansdetermine at or before admission if the resident tends to wander HIPAA requires that resident records meet all of the following standards except be: Ans- maintained by a professionally qualified Registered Health Information Technician (RHIT) Which two classes of food are most likely to cause allergic reactions in residents? Ans- dairy products and seafood A facility had an average daily census of 110 residents during the month of June. Total food costs for the average month was $30,000. What was the food cost per resident day? Ans- $9.09 What type of activity seems to be most effective for persons afflicted with Alzheimer's Disease? Ans- an activity that utilizes music In planning a resident activities, a primary goal should be to: Ans- provide participation and enjoyment Mrs. Jones complains that her physician will not listen or answer her questions. What should the facility staff tell her to do? Ans- coach Mrs. Jones on how to relate to her physician What is the first thing a nurse should do when a resident refuses to take his medicine? Ans- explain the consequences to the resident A resident's activity program should be designed to stimulate the resident's cognition, motor skills, ad affective needs. Which of the following activities will accomplish all three goals? Ans- organizing a handbell choir The essential difference between verbal abuse and mental abuse of a resident is: Ans- verbal abuse is any use of disparaging remarks; mental abuse is the use of actions that humiliate, harass, or threaten Robert Hornbeck is only 65 years old and suffers from dementia. His family struggles with his condition, but is determined to do whatever they can to ensure that he has the highest quality of life possible. They have consulted with the local Alzheimer's Association and learned that there are care areas that can "make a significant difference in his quality of life." Which of the following is not one of these recommended areas? Ans- physical exercises Warren Cruz suffers from Alzheimer's Disease. Due to his disease, his behavior has become such that his wife and adult children can no longer care for him at home. Thus, they make the decision to place him in a post-acute, long-term care facility. The staff notices at once that Mr Cruz is very agitated and will not stay situated in one place for any length of time. He is in and out of other resident's rooms He picks up objects from tables and walks around almost constantly. Which of the following should the facility do? Ans- The social worker learns that Mr. Cruz had been a carpenter during his professional life. Along with activities, the social worker sets up a work station with Lincoln Logs and Legos for Mr. Cruz. Sharon Willis's mother is a resident in a long-term care facility. Ms. Willis receives complaints from her mother that each morning her breakfast arrives late, is always cold, and is never what she ordered. On a Sunday morning she arrives at the facility in time to observe her mother's breakfast. The following morning the administrator receives a call from the daughter who is complaining loudly about the lack of service her mother is receiving and the fact that her mother received a cold biscuit, scrambled eggs, and sausage for breakfast when she ordered raisin toast, a poached egg, and bacon. How should the administrator handle this issue? Ans- Listen intently to Ms. Willis' concerns, take notes, investigate the concerns, and report findings to Ms. Willis. Next, implement corrections if necessary, and evaluate the processes to help ensure an efficient and effective program. Which of the following is the leading cause of vision loss in people over the age of 65? Ans- age-related macular degeneration The potentially blinding effect of which the following can be drastically reduced int he United States through an effective and safe surgery? Ans- cataracts Which of the following is not defined as a fall in a long-term care facility? Ans- when the staff witnesses one resident push another to the ground A resident in a long-term care facility is very confused. She is in her 80's but insists on finding her elderly grandfather as it is her responsibility to care for him. Which of the following treatment programs would a facility most likely use with this resident? Ans- staff members will reassure and reaffirm her feelings and thoughts through validation therapy The administrator is responsible for ensuring a safe environment for the persons residing in the longterm care facility. Dietary staff must have a system in place to ensure the proper cooking temperatures of the food in order to prevent food borne illnesses. Which of the following cooking temperatures is not correct? Ans- fin fish must be cooked to 135 degrees F Bladder incontinence is common place among elders. In many cases a resident can regain control of his/her bladder functions through various treatment programs. Which of the following is not an effective means of treatment? Ans- cathetrization Which of the following medications is considered a Scheduled II drug? Ans- percoset A staff member is accused of abusing a resident in a long-term care facility. What must the administrator do? Ans- Report the alleged violation to the state agency and to all other agencies as required, and take all necessary corrective actions depending on the results of the investigation A resident's medical records belong to which of the following? Ans- the facility Social workers in a long-term care facility can perform all of the following services except: Anspsychiatric treatment Falls are a major cause of injuries among residents in long-term care facilities; therefore it is imperative that Falls Preventions Programs are in place. Which of the following is LEAST likely to be considered a common cause of falls within a facility? Ans- extensive physical therapy causing the resident to tire more easily, thus increasing the probability of falls Who is the key person(s) to handle an employee problem or grievance? Ans- the immediate supervisor Which of the following is not normally associated with infections in long-term care facilities AnsLegionnaires Disease Under its Ergonomics Guidelines, OSHA lists three factors that long-term care employees encounter. Which one of the following is NOT a factor? Ans- walking and standing- too much time without sitting and relaxing thus causing undue hardship on knees and ankles What is the first step in counseling an employee who has a problem? Ans- let the employee express her feelings about the problem Shady Grove Retirement Center spends an average of $1500 to recruit, hire, and train a new employee. Shady Grove employs 100 staff members. During the past 12 months, 25 of its employees were either terminated or resigned voluntarily. How much money did the turnover cost the facility? Ans- $37,500 What are the recommended steps in correcting an employee's work error? Ans- Check their understanding of how the task is supposed to be done, point out the error, and discuss the consequences of the error Communication between staff and management is often a major problem. Why is face-to-face communication considered the most effective method of communication? Ans- Management can more readily obtain feedback to determine the employee's level of understanding The key to a good pay scale is: Ans- starting at the fair wage standard of the community What is generally considered the first priority in an employee training program? Ans- fire prevention and control What is meant by respondeat superior? Ans- the employer is responsible for actions of employees performed within the course of their employment What is the primary purpose of developing policies, procedures, and rules? Ans- to provide employees with information concerning what is expected of them and what they can expect from the employer A job description should include all of the following except: Ans- the specific work assignments of an employee in their department level Which of the following is not a governmentally mandated employee benefit? Ans- vacation and sick leave The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provides for the following: Ansto allow a former employee to maintain group health insurance for medical benefits for a period up to 18 months after separation Which one of the following would the EEOC probably approve as an advertisement for employees? Ansmale or female who can read and write and who likes to work with the elderly All of the following qualify an employee for Family and Medical Leave except: Ans- to care for a sick brother What is the essential difference between bookkeeping and accounting? Ans- bookkeeping is making original entries and transactions and can be done by a clerk; accounting includes bookkeeping, financial reports, auditing, and more Working capital, as distinguished from other types of capital, means the: Ans- excess of current assets over current liabilities What is the difference between fixed and variable expenses? Ans- fixed expenses remain constant without regard to the number of residents; variable expenses change with the volume of business There are several types of budgets. Which budget outlines the facility's projected income and anticipated revenues for the upcoming fiscal year? Ans- operating The long-term care administrator receives a $45,000 order for raw food in the month of June. The accounting department records that purchase in June even though the invoice is not paid until July. This type of accounting is known as: Ans- accrual basis accounting During the year for a long-term care entity provided 30,000 days of care. The operational costs were $6,390,000 and the reimbursement rate was $220 per day. What was the profit per resident day? Ans- $7. 6,390,000/30,000=213... 220-213=7 A van is purchased for your facility at a cost of $40,000. You depreciate the cost in 5 years at the end of which time there will be a salvage value of $5000. Using straight-line depreciation, what will be the accumulated depreciation taken after three years? Ans- $21,000. 40,000-5,000=35,000... 35,000/5=7,000... 7,000x3=21,000 The owner of a single post acute care entity notices that her expenses continue to increase. Since her profit margins are very slim, she asks the administrator to come up with a plan on how to better keep the cost of purchases down. Which of the following should NOT be included in the administrator's recommendations? Ans- always buy the least expensive products What is the major purpose of having a good risk management program? Ans- to reduce occurrences that result in legal action against the facility or damage to its reputation The first step in developing a risk management program is: Ans- identifying and enumerating the risk factors in each department Your post-acute operation has the capacity to provide care to 120 participants per day. in June, the operations provided care to 3,060 clients. The operations provided care to what percentage of possible clients? Ans- 85%. 3,060/30=102 102/120=.85 There are three principal values in maintaining a petty cash fund. Which of the following is not one of those values? Ans- the reduction of the number of entries to small accounts that clutter accounting records Cost management may involve having an accountant complete a sensitivity analysis. What does the sensitivity analysis accomplish? Ans- analyzes various costs and helps to plan cost controls The owners of a new long-term care operation are concerned that they are not realizing a profit as quickly as they had projected. This is causing a severe financial strain as the owners are being forced to use the line of credit they have with a local lender. As an administrator, there are three things you can recommend be done to lower the operation's break-even point and help the owner realize a profit. Which one of the following should NOT be included? Ans- sell off excess supplies and unused equipment As the administrator of a long-term care operation, you are negotiating terms with a new vendor. The vendor wants to see your financial ratio that will indicate the facility's ability to pay on a timely basis. Which of the following ratios would the vendor be most interested in reviewing? Ans- acid test ratio What is the best way to ensure that your landscape adds to the attractiveness of the physical plant? Ans- at least initially, employ an expert in horticulture to plan the landscaping All employees, with some exceptions, are required to use the alcohol-based rubs for hand hygiene. The strategic placement of the dispensers is important. Which of the following is not a requirement? Ansdispensers must display safety data which informs the user of the chemical contents of the rub The Americans with Disability Act Accessibility Guidelines (ADAAG) are regulations that ensure buildings are available to and usable by the physically handicapped. Which of the following is true of ADAAG regulations? Ans- handicapped parking spaces must be at least eight feet wide with a five foot aisle that may be utilized for two parking spaces Which of OSHA's programs require preparation and distribution of Safety Data sheets (SDS)? Ans- hazard communication What is the purpose of the lockout/tagout program? Ans- to protect employees from hazardous energy How should staff react to the clutter they feel a resident brings into his room or apartment? Ansrecognize that each item reflects a pleasant memory and that it is of value to the resident An easy way to promote a real change in the social environment is to: Ans- teach every staff member to make eye contact, smile, ad speak every time they meet one of their clients Which of the following is not a true value of a preventative maintenance program? Ans- reduces the number of full time maintenance personnel A person walks into a facility carrying a machete. According to Homeland Security which of the following is not recommended? Ans- negotiate with the person to deescalate the situation Which of the following would not be considered a recordable event by OSHA? Ans- an injury that requires drilling into a fingernail or toenail to relieve pressure Leadership has many, varied meanings, but what are the basic things a leader does? Ans- establishes goals and then initiates and monitors actions that will attain desired results Leaders are managers. What are the two types of management that leaders frequently use to make management effective? Ans- total quality management and management by walking around Leaders/managers carry out five functions to a greater or lesser degree depending on where they are in the administrative hierarchy. Which of the following is not identified as a function? Ans- coordinating Which one of the following is considered the central function of management as it is a part of all management functions and actions in the organization? Ans- planning When a plan is developed indicating the task to be accomplished, when, and by whom, what must a leader/manager do? Ans- determine what activities will be needed, group them, and set up the organization's structure What is the essential difference in marketing and public relations? Ans- marketing focuses on selling services to the potential user; public relations focuses on developing a good image with the entire public Your professional organization is sponsoring a bill in the legislature that will have a strong impact on the entire industry. Every administrator is asked to help get the legislation enacted. What is the most effective action you can take? Ans- contact your local legislators and ensure they understand the bill and will support it What is the essential difference in bylaws and policies and procedures? Ans- bylaws are rules and regulations that govern the corporation; policies govern the day-to-day operations of the organization A primary value to the administrator of a good set of policies, procedures, and rules is that the administrator will: Ans- be in charge of the operations whether she is present or not How can you tell when authority is properly delegated? Ans- decisions are made by the lowest, authorized person in the echelon You have a very strict supervisor who says, "I don't care if my employees like me or not. I just want them to get their work done." What leadership style is the supervisor using? Ans- dictatorial In traditional organizations who uses line authority and who uses staff authority? Ans- the administrator and director of nursing uses line authority; consultants use staff authority Why must the administrator carefully monitor the informal organizations in his long-term care facility? Ans- they have undue influence on decision-making in the facility Two of your key employees do not like each other. They do not always work well together and will hardly speak to one another. How can you best resolve this conflict? Ans- call them together, let each tell his/her side of the story without interruption, then the other repeats what was said What is considered the key to good communications in any long-term care or post acute care setting? Ans- listening, which should take up almost 40% of one's time One of your key administrative team members talks to you about a problem. She is upset and asks you to do something about her problem. How should you proceed? Ans- allow her to express her feelings, without a comment from you, and let her get it off her chest Upward communication in health care organizations is often a problem. What do supervisors tend to do when they report to the administrator? Ans- filter out information that might adversely reflect them or someone they are trying to protect In order to promote good relationships among all departments, which approach has proven very successful? Ans- allowing no change in any department until all other departments know about the change and have time to prepare for any impact the change may have on them A laissez-faire type of leadership that involves telling employees what they are to do and leaving them alone to do it, may work with what type of employee? Ans- professional staff such as social workers and pharmacists Which of the following is not a primary duty of an organization's governing board? Ans- overseeing the day-to-day operations of the post-acute care facility Your organization has a very strict dress code policy that requires the nurse aide to wear blue scrubs and closed-toed shoes. One Saturday morning you receive a call from the third shift charge nurse who informs you that the facility has experienced multiple call-offs, causing a severe staffing shortage. The charge nurse has called PRN staff as well as staff members who are not scheduled in an attempt to rectify the staffing problem. No one she has called is willing to co