ACTIVITY DIRECTOR EXAMINATION SET TEST 2025/2026
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔Minimum Data Set 3.0 - ✔✔Active diagnoses are diagnoses that have a direct.
relationship to the resident's current functional, cognitive, or mood or behavior status,
medical treatments, nursing monitoring, or risk of death during the 7-day look-back
period. This list of all health issues affecting functioning and potentially will require close
monitoring. Active problems include chronic problems such as scoliosis, as well as
acute problems.
✔✔Five stages of the grieving process - ✔✔Denial
Anger
Bargaining
Depression
Acceptance
✔✔Weeks before end of life - ✔✔Several weeks before the ending of life, the individual
may experience changes in their sleeping, eating, and social habits. These can include
more hours spent sleeping, a decreased appetite and lower desire to eat solid foods,
and little desire to communicate or interact with others. Other symptoms can include
increased infections, weight loss, nausea, and general pain.During this stage, simple
attention to comfort is most needed. Allow them to sleep for as long as they need, and
do not force them to eat. Liquids and ice may be all they are able to stomach at this
time. Speak in a calm reassuring voice. The transitioning individual may need help
eating, dressing, bathing, and taking medications during these weeks.From a
therapeutic perspective - appropriate massage treatments are beneficial to provide
much needed sensory related relief.
✔✔Days before end of life - ✔✔The individual will undergo several more physiological
changes in the days before their death. Their pulmonary system will start to degrade,
and their breathing patterns will change. They may also begin to cough more frequently.
While these sound alarming, the changes are generally painless. They may experience
hallucinations and talk to people or objects that are not there. Other symptoms in the
days before death can include a drop in blood pressure, frequent temperature changes,
blotchy skin, erratic sleeping patterns, and changes in bowel movements and
urination.At this point, care is about managing their eating, sleeping, bathing, and other
activities of daily living and monitor them more closely. Changes in medication dosages
may be necessary to ensure that they remain as comfortable as possible.
✔✔One day before end of life - ✔✔About one day before, the physical changes
experienced over the last few months will become more pronounced. Sleep takes up
most of the day and interactions with others will greatly decline. Other symptoms can
consist of increased difficulty breathing and congestion with a drop in blood
pressure.NOTE: It is important to understand that hearing may remain unchanged from
their normal abilities - which is why experts highly recommend that caregivers must
never say anything that would cause the resident undue anxiety, stress or worry.Sleep
,patterns should not be disrupted and allowed to occur as much as necessary, and
caregivers should continue to speak to them in a normal voice. They may be unable to
swallow, and small amounts of water or ice may be the only thing they are able to
tolerate. They may experience a sudden burst of energy and restlessness, so be patient
and reassure them that everything is okay.
✔✔Hours before end of life - ✔✔When end of life nears, their body will begin to finally
shut down. This can lead to sudden outbursts and unresponsiveness when you try to
communicate, once again note that their hearing may still be functioning. They may
experience more hallucinations, glassy eyes, cold hands, and a weak pulse. Continue to
provide a calm and loving presence for them as they move through this transition.
✔✔How to offer support - ✔✔Spiritual support is typically the work of chaplains, who
work with local religious and spiritual leaders to help provide spiritual support for those
nearing the end of their lives. The goal is to help those in transition find peace and
comfort.
-Giving away belongings and making plans. Some people want to maintain control over
their life, so they want to participate in making final decisions about their belongings or
their person. Although it is emotionally hard to talk about final arrangements, it is often
important, especially for the dying, to honor the choices they may desire to express.
-Withdrawal. The person may seem unresponsive, withdrawn, or in a comatose-like
state. They are detaching. It is a typical end-of-life symptom. It is important to know that
hearing remains. Speak in a normal voice. Identify yourself. Offer to hold their hand.
-Vision-like experiences. The person may say they have spoken to people who are
already deceased. They may say they have been places or seen things not visible to
you. This is not a hallucination or a drug reaction. It is a common symptom of the end-
of-life process. How you can help: Do not contradict, explain away, or discount this
experience. Affirm them. If the experience is frightening, reassure them it is common
and natural: "Yes, these things happen."
-Restlessness. Repetitive and restless tasks may indicate something unsolved or
unfinished is preventing them from letting go. Help the individual recall a favorite place
or good experience. Read to them. Play soothing music. Give reassurance that it is
okay to let go.
✔✔How to offer support - ✔✔-Communication and permission. Statements and/or
requests may be made that seem out of character. They may be testing you to see if
you are ready to let go. They may want to be with a few select people. The individual
may need your affirmation, support, and permission to let go. Let them know that they
are loved and that their loved ones know that they will be alright. Say whatever words of
love and support you need to say. - Give them permission.
-Saying goodbye. This is their final gift. Listen. Hold them. Say whatever you need to
say. It may be just, "I love you," or recounting favorite memories you have shared. It
may be an apology, or just saying, "Thank you.
✔✔pallative care - ✔✔Palliative care is a resource for anyone living with a serious
illness, such as heart failure, chronic obstructive pulmonary disease, cancer, dementia,
, dementia, Parkinson's disease, and many others. Palliative care can be helpful at any
stage of illness and is best provided from the point of diagnosis.
In addition to improving quality of life and helping with symptoms, palliative care can
help residents understand their choices for medical treatment. The organized services
available through palliative care may be helpful to any older person having a lot of
general discomfort and disability very late in life. Palliative care can be provided along
with curative treatment and does not depend on prognosis.
In palliative care, the resident does not have to give up treatment that might cure a
serious illness. Palliative care can be provided along with curative treatment and may
begin at the time of diagnosis. Over time, if the physician or the palliative care team
believes ongoing treatment is no longer helping, there are two possibilities.
Palliative care could transition to hospice care if it has been determined that the resident
is likely to die within 6 months. Or the palliative care team could continue to help with
increasing emphasis on comfort care.
✔✔hospice care - ✔✔Increasingly, people are choosing hospice care at the end of life.
Hospice can be provided in any setting—home, nursing home, assisted living facility, or
inpatient hospital.
At some point, it may not be possible to cure a serious illness, or a patient may choose
not to undergo certain treatments. Hospice is designed for this situation. The patient
beginning hospice care understands that his or her illness is not responding to medical
attempts to cure it or to slow the disease's progress.
Like palliative care, hospice provides comprehensive comfort care as well as support for
the family, but, in hospice, attempts to cure the person's illness are stopped. Hospice is
provided for a person with a terminal illness whose doctor believes he or she has 6
months or less to live if the illness runs its natural course.
Hospice is an approach to care, so it is not tied to a specific place. It can be offered in
two types of settings—at home or in a facility such as a nursing home, hospital, or even
in a separate hospice center.
✔✔Pioneer Network - ✔✔Over the years, organizations such as The Live Oak Institute,
The Eden Alternative and Pioneer Network have been created by forward thinking
individuals whose purpose is to address issues related to hyper focused regulatory
practices which often shifted attention away from the residents' to some degree which
may have unintentionally attributed to resident decline in many areas. Although
regulations are solidly based on safety - a balance was sought to provide a more home
like environment for those we serve.
Culture change in long-term care setting is about meaningful relationships and person
centered service focused on the individuality of the resident receiving care, so that each
unique individual can continue to live a meaningful life and feel "at home" in whatever
facility they come to live in. Part of feeling at home is creating living spaces that are
more private, comfortable, and personalized.
✔✔Culture Change - ✔✔the common name given to the national movement for the
transformation of older adult services, based on person-directed values and practices
where the voice of elders and those working most closely with them are solicited,
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔Minimum Data Set 3.0 - ✔✔Active diagnoses are diagnoses that have a direct.
relationship to the resident's current functional, cognitive, or mood or behavior status,
medical treatments, nursing monitoring, or risk of death during the 7-day look-back
period. This list of all health issues affecting functioning and potentially will require close
monitoring. Active problems include chronic problems such as scoliosis, as well as
acute problems.
✔✔Five stages of the grieving process - ✔✔Denial
Anger
Bargaining
Depression
Acceptance
✔✔Weeks before end of life - ✔✔Several weeks before the ending of life, the individual
may experience changes in their sleeping, eating, and social habits. These can include
more hours spent sleeping, a decreased appetite and lower desire to eat solid foods,
and little desire to communicate or interact with others. Other symptoms can include
increased infections, weight loss, nausea, and general pain.During this stage, simple
attention to comfort is most needed. Allow them to sleep for as long as they need, and
do not force them to eat. Liquids and ice may be all they are able to stomach at this
time. Speak in a calm reassuring voice. The transitioning individual may need help
eating, dressing, bathing, and taking medications during these weeks.From a
therapeutic perspective - appropriate massage treatments are beneficial to provide
much needed sensory related relief.
✔✔Days before end of life - ✔✔The individual will undergo several more physiological
changes in the days before their death. Their pulmonary system will start to degrade,
and their breathing patterns will change. They may also begin to cough more frequently.
While these sound alarming, the changes are generally painless. They may experience
hallucinations and talk to people or objects that are not there. Other symptoms in the
days before death can include a drop in blood pressure, frequent temperature changes,
blotchy skin, erratic sleeping patterns, and changes in bowel movements and
urination.At this point, care is about managing their eating, sleeping, bathing, and other
activities of daily living and monitor them more closely. Changes in medication dosages
may be necessary to ensure that they remain as comfortable as possible.
✔✔One day before end of life - ✔✔About one day before, the physical changes
experienced over the last few months will become more pronounced. Sleep takes up
most of the day and interactions with others will greatly decline. Other symptoms can
consist of increased difficulty breathing and congestion with a drop in blood
pressure.NOTE: It is important to understand that hearing may remain unchanged from
their normal abilities - which is why experts highly recommend that caregivers must
never say anything that would cause the resident undue anxiety, stress or worry.Sleep
,patterns should not be disrupted and allowed to occur as much as necessary, and
caregivers should continue to speak to them in a normal voice. They may be unable to
swallow, and small amounts of water or ice may be the only thing they are able to
tolerate. They may experience a sudden burst of energy and restlessness, so be patient
and reassure them that everything is okay.
✔✔Hours before end of life - ✔✔When end of life nears, their body will begin to finally
shut down. This can lead to sudden outbursts and unresponsiveness when you try to
communicate, once again note that their hearing may still be functioning. They may
experience more hallucinations, glassy eyes, cold hands, and a weak pulse. Continue to
provide a calm and loving presence for them as they move through this transition.
✔✔How to offer support - ✔✔Spiritual support is typically the work of chaplains, who
work with local religious and spiritual leaders to help provide spiritual support for those
nearing the end of their lives. The goal is to help those in transition find peace and
comfort.
-Giving away belongings and making plans. Some people want to maintain control over
their life, so they want to participate in making final decisions about their belongings or
their person. Although it is emotionally hard to talk about final arrangements, it is often
important, especially for the dying, to honor the choices they may desire to express.
-Withdrawal. The person may seem unresponsive, withdrawn, or in a comatose-like
state. They are detaching. It is a typical end-of-life symptom. It is important to know that
hearing remains. Speak in a normal voice. Identify yourself. Offer to hold their hand.
-Vision-like experiences. The person may say they have spoken to people who are
already deceased. They may say they have been places or seen things not visible to
you. This is not a hallucination or a drug reaction. It is a common symptom of the end-
of-life process. How you can help: Do not contradict, explain away, or discount this
experience. Affirm them. If the experience is frightening, reassure them it is common
and natural: "Yes, these things happen."
-Restlessness. Repetitive and restless tasks may indicate something unsolved or
unfinished is preventing them from letting go. Help the individual recall a favorite place
or good experience. Read to them. Play soothing music. Give reassurance that it is
okay to let go.
✔✔How to offer support - ✔✔-Communication and permission. Statements and/or
requests may be made that seem out of character. They may be testing you to see if
you are ready to let go. They may want to be with a few select people. The individual
may need your affirmation, support, and permission to let go. Let them know that they
are loved and that their loved ones know that they will be alright. Say whatever words of
love and support you need to say. - Give them permission.
-Saying goodbye. This is their final gift. Listen. Hold them. Say whatever you need to
say. It may be just, "I love you," or recounting favorite memories you have shared. It
may be an apology, or just saying, "Thank you.
✔✔pallative care - ✔✔Palliative care is a resource for anyone living with a serious
illness, such as heart failure, chronic obstructive pulmonary disease, cancer, dementia,
, dementia, Parkinson's disease, and many others. Palliative care can be helpful at any
stage of illness and is best provided from the point of diagnosis.
In addition to improving quality of life and helping with symptoms, palliative care can
help residents understand their choices for medical treatment. The organized services
available through palliative care may be helpful to any older person having a lot of
general discomfort and disability very late in life. Palliative care can be provided along
with curative treatment and does not depend on prognosis.
In palliative care, the resident does not have to give up treatment that might cure a
serious illness. Palliative care can be provided along with curative treatment and may
begin at the time of diagnosis. Over time, if the physician or the palliative care team
believes ongoing treatment is no longer helping, there are two possibilities.
Palliative care could transition to hospice care if it has been determined that the resident
is likely to die within 6 months. Or the palliative care team could continue to help with
increasing emphasis on comfort care.
✔✔hospice care - ✔✔Increasingly, people are choosing hospice care at the end of life.
Hospice can be provided in any setting—home, nursing home, assisted living facility, or
inpatient hospital.
At some point, it may not be possible to cure a serious illness, or a patient may choose
not to undergo certain treatments. Hospice is designed for this situation. The patient
beginning hospice care understands that his or her illness is not responding to medical
attempts to cure it or to slow the disease's progress.
Like palliative care, hospice provides comprehensive comfort care as well as support for
the family, but, in hospice, attempts to cure the person's illness are stopped. Hospice is
provided for a person with a terminal illness whose doctor believes he or she has 6
months or less to live if the illness runs its natural course.
Hospice is an approach to care, so it is not tied to a specific place. It can be offered in
two types of settings—at home or in a facility such as a nursing home, hospital, or even
in a separate hospice center.
✔✔Pioneer Network - ✔✔Over the years, organizations such as The Live Oak Institute,
The Eden Alternative and Pioneer Network have been created by forward thinking
individuals whose purpose is to address issues related to hyper focused regulatory
practices which often shifted attention away from the residents' to some degree which
may have unintentionally attributed to resident decline in many areas. Although
regulations are solidly based on safety - a balance was sought to provide a more home
like environment for those we serve.
Culture change in long-term care setting is about meaningful relationships and person
centered service focused on the individuality of the resident receiving care, so that each
unique individual can continue to live a meaningful life and feel "at home" in whatever
facility they come to live in. Part of feeling at home is creating living spaces that are
more private, comfortable, and personalized.
✔✔Culture Change - ✔✔the common name given to the national movement for the
transformation of older adult services, based on person-directed values and practices
where the voice of elders and those working most closely with them are solicited,
