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NURSING HOME ADMINISTRATOR LICENSURE EXAM REVIEW COURSE

National Exam Module 7

MOCK NATIONAL EXAM 9

This is a timed exam. You have exactly 3 hours to complete the exam

Stan Mucinic, LNHA EXAMprofessional.com

[email protected] 561-255-8213

mailto:[email protected]


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MOCK EXAM 9

1. Which is not true of advanced directives?

1. All residents must be informed of their rights to make advanced directives upon admission

2. A facility must have written policies and procedures regarding advanced directives

3. Residents must execute a signed directive before or upon admission

4. A facility cannot be required to provide care that conflicts with an advanced directive

2. The primary reason residents should be encouraged to eat in the main dining room is to _____.

1. Encourage socialization

2. Allow housekeepers time to clean their rooms

3. Reduce travel time and costs to serve meals to residents

4. Allow the food service director to observe the amount of food each resident consumes

3. ________ is associated with involuntary movements of the head, lips, tongue, face and extremities,

including lip smacking movement.

1. Parkinson’s disease

2. Alzheimer’s

3. Aphasia

4. Tardives Dyskinesia

4. _______is the primary reason you would invite the fire department to provide staff training in fire

emergency measures at your facility.

1. Establishing a good public image

2. Augmenting training resources for staff

3. Providing an opportunity for the firefighters to become acquainted with your facility layout and

Emergency cutoff switches

4. Assuring quick approval of the fire plan each year

5. Where a facility has an outside provider provide in-house dialysis, the facility must ______ to protect

resident rights.

1. Require the company to sign a provider transfer agreement

2. Require the provider to maintain malpractice insurance

3. Award the contract based on competitive bidding

4. Seek approval from the resident council


6. The administrator’s main role in the facility activity program is to _____. 1. Visit, observe and support

2. Organize a volunteer program

3. Insure residents participate in program activities

4. Encourage family members support the activity department

7. The main reason for informing a resident and any roommate(s) of a room change in advance is

because ___________.

1. Residents need time to pack

2. A room change could result in an avoidable decline in physical, mental and psychosocial well

being

3. Residents have the right to appeal room changes to the ombudsman

4. The resident’s attending physician must be notified in advance

8. The main challenge with on-the-job training in nursing homes is _______.

1 Finding experienced employees to train new employees

2. There is too little time for trainers to train new people

3. That employees cannot learn new skills from coworkers

4. That on the job training is not as effective as other means

9. _______ is required by the FLSA.

1. Holiday pay

2. Sick Pay

3. Vacation pay

4. Overtime

10. Assets appear on the ________.

1. Income statement

2. Balance sheet

3. Profit and loss statement

4. General Ledger

11. _____does not relate to inventory.

1. LIFO

2. Periodic

3. Perpetual

4. Posting

.


12. The current ratio is calculated by dividing current _________.

1. Assets by total assets

2. Liabilities by total liabilities

3. Assets by current liabilities

4. Liabilities by current assets

13, The Safe Harbor regulations do not prohibit _______.

1. A facility from purchasing from a supplier with common ownership

2. Ownership in excess of 40 percent of a hospital by a physician

3. Extra payments for services or items reimbursed under Medicare or Medicaid

4. Nursing facility providers from investing only in publicly traded companies with an asset value of at

least $50 million dollars

14. A current trial balance usually does not include __________.

1. Debits

2. Credits

3. Zero balances

4. Names of accounts

15. To determine the capability of a facility to meet short term cash needs, you would look at the ______.

1. Cash flow statement

2. Balance sheet

3. Trial balance


16 Annual audits are necessary to ____________.

1. Reduce cost

2. Verify the accuracy of financial records

3. Establish depreciation schedules

4. Verify budgets

17. Cash flow is the cash receipts ________.

1. Less liabilities

2. Plus assets minus liabilities

3. Less the cash disbursements

4. Plus the assets minus expenditures


18. Waste management is monitored by ______.

1. CMS

2. ANSI

3. NFPA

4. OSHA

19. Universal precautions were developed by the _______.

1. CDC

2. ANSI

3. OBRA

4. .OSHA

20. A totally private pay facility is ______.

1. Certified

2. Licensed

3. Accredited

4. Medicare and or Medicaid approved

21. The number of disaster drills is determined by_____.

1. OSHA

2. NIOSH

3. OBRA

4. Life Safety Code

22. Under Respondeat Superior, when a worker commits a tort within the scope of their job

_______________.

1. Only the facility may be held liable

2. Only the employee may be held liable

3. Both the employer and the employee are liable

4. Neither the facility nor the employee may be held liable

23. A facility is not required to notify the state licensing agency when there is a change in the _____.

1. Facility Ownership (governing body)

2. Administrator

3. Director of nursing

4. Social Services Director


24. The Ombudsman program is funded by ______.

1, Medicare

2. Medicaid

3. Administration on Aging

4. CMS

25. In a nursing home, total quality management is an approach that ____________.

1. Builds strong leadership skills for managers

2. Discourages employees to question rules

3. Builds employee team work

4. Creates a direct line of communication with executive managers

26. ________ is a major need of the elderly.

1. A reason for being

2. Independence

3. Privacy

4. Good nutrition

27. The corporate compliance officer for the nursing facility is the _____.

1. Nursing home administrator

2. The Medical Director

3. The Director of Nursing

4. The MDS Coordinator

28. ________ is not a chronic condition.

1. CHF

2. Diabetes

3. Pneumonia

4. COPD

29. Which is not true with respect to advanced directives?

1. Residents have the right to make an advanced directive

2. A living will is an advanced directive

3. Each resident must have a signed advanced directive in their chart

4. A facility cannot require a resident to sign an advanced directive prepared by the facility


30. The best way to assess a resident with complicated medical conditions is to do a _____.

1. 7 day comprehensive assessment

2. 14 day comprehensive assessment

3. RAPS

4. RAI

31. What should a member of the governing body do if he or she has a family contact them directly

regarding a concern they have with the care provided by the facility?

1. Request to meet with the resident council to discuss the issue

2. Resolve the issue on their own

3. Call the long term care ombudsman

4. Refer the matter to the nursing home administrator for resolution

32. If each resident requires 3 hours of nursing aide care per day, and the facility has 120 beds and is at

90% occupancy, approximately how many nursing aides would be required for the day, if each

nursing aide worked 8 hours per shift?

1. 36

2. 40

3. 47

4. 50

33. What is the cost per day for food for a facility that spent $12,000 in October, $10,000 in November

and $14,000 in December. The facility had a total of $9,000 resident days for October through

December. What was the approximate average daily cost per resident?

1. $3.70

2. $4.00

3. $4.30

4. $4.90

34. Lighting, temperature and sound levels relate primarily to __________.

1. Comfort

2. Safety

3. Treatment

4. Sanitation


35. Work orders would not include _____________.

1. The location of the problem

2. A description of the problem

3. An authorized signature

4. The equipment needed to do the job

36. The cost to maintain capital equipment in a nursing home will justify replacement within _____.

1. 2 Years

2. 5 years

3. 10 years

4. 15 years

37. Safety training programs for employees must be done _____.

1. Weekly

2. Monthly

3. Quarterly

4. Immediately after hire

38. The concept of community relations is to ______.

1. Involve the facility and the community in an interrelationship

2. Inform the public

3. Insure high occupancy rates

4. Replace public relations and marketing programs

39. Public relations is __________.

1. Advertising

2. A program designed to meet consumer needs

3. Managing communication between the facility and the public

4. The process of selling services to meet the needs of the public

40. One of the best ways for a facility to develop an effective public relations program is to _____.

1. Avoid making statements to the media

2. Support community interests that support the facility

3. Print a monthly newsletter and distribute the letter to the community

4. Get the facility and the community involved in projects of mutual interest that strengthen the

bonds between them


41. Gerontology is the study of _____.

1. The aging process

2. ADL levels of the aged

3. Illnesses of the aged

4. Psychology of aging

42. When counseling family members, it is best to ______.

1. Explain the facility policies

2. Involve the medical director

3. Let the family express their feelings

4. Engage the family in problem solving

43. If a physician reports a med error to the administrator, the administrator should _______.

1. Consult the facility attorney

2. Redesign the drug control system

3. Decide whether to take disciplinary action

4. Allow the physician to take any necessary action

44. Individuals over 65 take an average of ____ medications.

1. 2.9

2. 3.5

3. 7.2

4. 9.9

45. _________ makes it possible for organizations to expand and grow.

1. Decentralization

2. Centralization

3. Horizontal Integration

4. Market segmentation

46. Turnover is highest for ______.

1. Administrators

2. Dietary staff

3. Social workers

4. Nursing aides


47. Fringe benefits or employee benefits are ______.

1. Required by Fair Labor Standards Act

2. Considered to be a right by employees

3. Required by the Taft Hartley Act

4. Primarily provided by employers to discourage unionization

48. The best source for new employees is _____.

1. Employment agencies

2. Help wanted ads

3. Current employee referrals

4. State employment offices

49. An employment application can request a job applicant’s _____________.

1. Birthplace

2. Citizenship

3. Marital status

4. Religion

50. _________ is a subjective measurement of performance on an employee evaluation.

1. Personality

2. Quality of work

3. Employee cooperation

4. Employee attitudes

51. Accounts payable past 60 days should not exceed _______ as a total percentage of all accounts

payables.

1. 5 %

2. 10%

3. 15 %

4. 20%

52. An earnings statement that compares revenues to expenses is also referred to as a ____________.

1. Balance sheet


3. Bank statement

4. Statement of changes in financial condition


53. Most facilities prepare a budget _________:

1. Daily

2. Weekly

3. Quarterly

4. Annually

54 The _____________ investigates Medicare and Medicaid fraud

1. Office of Inspector General

2. Long term care ombudsman

3. CMS

4. DHHS

55. Accounts receivables that are uncollected after ____ days should be written off as bad debt.

1. 30 days

2. 60 days

3. 90 days

4. 120 days

56. The heart of the blood borne pathogen program is _________.

1. Recording employee injuries

2. Posting the MSDS

3. Providing a safe workplace

4. A written plan in case of exposure

57. ___________ requires employer health insurers to limit the exclusionary period for pre-existing

conditions to 12 months.

1 COBRA

2. OBRA

3. HIPAA

4. PSDA

58. ________enforces the Equal Pay Act.

1. Dept of Labor

2. OIG

3. OSHA

4. EEOC


59. ________ enforces the provisions of the ADA relating to discrimination in employment for applicants

with a disability.

1. EEOC

2. OSHA

3. Architectural and Barriers Compliance Board

4. CMS

60. _____ requires employers to provide terminated employees a certificate of coverage upon

termination or separation.

1 HIPAA

2. OBRA

3. COBRA

4. PSDA

61. If an employee provides their new employer a certificate of coverage, the employer’s health insurance

provider can limit coverage for pre-existing conditions for a period of _______ months.

1. 0

2. 3

3. 6

4. 12

62. A facility that receives a citation during a survey for a tag that does not require a plan of correction or

re-survey would receive the ___________.

1. Form 2567

2. Form 101

3. Letter of Isolated Deficiencies

4. Form 2570

63. The _______ enforces the Civil Rights Act.

1. Dept of Labor

2. OIG

3. OSHA

4. EEOC

64. The __________ prohibits paying for Medicare referrals.

1. Robinson Patman Act

2. Ethics in Patient Referrals Act

3. Taft Hartley Act

4. Wagner Act


65. _________ does not need to be connected to the emergency electrical power source.

1. Emergency lighting

2. Life support systems

3. Fire alarm

4. Telephone system

66. High forward reach is ______.

1. 12 inches

2. 24 inches

3. 36 inches

4. 48 inches

67. _________ is filed with the state Department of Corporations to form a duly organized corporation.

1. Certificate of incorporation

2. Bylaws

3. Form 2567

4. Certificate of Dissolution

68. An employer is required to provide workers ____________.

1. Health insurance

2. Pension Plan

3. Unemployment insurance

4. Life insurance

69. The governing body of a non profit facility would be required to __________.

1. Appoint a long term care ombudsman

2. Hire and supervise a CEO

3. Issue shares of stock

4. Hire a charge nurse

70. _________ would be issued if surveyors determined that residents were harmed by the facility.

1. A scope of severity of Class H

2. A scope of severity of Class E

3. A scope of severity of Class F

4. A scope of severity of Class D


71. The best way to increase a facility’s cash position is to _______.

1. Issue shares of stock

2. Increase census

3. Admit more Medicare residents

4. Collect AR

72. A facility must submit a request for a formal administrative hearing within ___ days.

1. 10 days

2. 20 days

3. 30 Days

4. 40 days

73. Fire protection standards are developed and published by _________.

1. ANSI-CABO

2. OSHA – NIOSH

3. NFPA – Life Safety

4. DHHS – CMS

74. Psychological aging begins ______.

1. At Birth

2. Early teens

3. Twenty years and older

4. Sixty years and older

75. If a resident elopes from a facility and is later found by staff, staff should __________ when asked for

comment by the media.

1. Refuse to answer any questions

2. Provide as much detail as possible about the resident

3. Refer all questions to the administrator

4. Refer all questions to the marketing director

76. If a resident develops a communicable disease, the facility should _______.

1. Discharge the resident

2. Transfer the resident to the hospital

3. Set up specific and appropriate isolation and containment procedures

4. Restrict all resident activities


77. Equity theory says that workers should be given equity increases when ___________.

1. Employees perform above and beyond expectations

2. When employees do the same amount and type of work

3. When inflation significantly increases

4. When long time employees are paid significantly less then new employees being hired at current

market rates

78. Reaching out to the community and strengthening your relationship with community organizations is

called ____________.

1. Marketing 2. Public Relations 3. Market audit 4. Market Analysis

79. Employers with ______ employees are subject to FMLA.

1. 15

2. 20

3. 50

4. 100

80. OSHA requires you to keep workers medical records for _________.

1. 30 years from date of hire 2. 30 years from date of discharge 3. 30 years from the date the employee was injured 4. During employment plus 30 years after termination

81. Which is the basis for a tort?

1. A facility fraudulently submits a Medicare bill 2. Judge acquits you of a crime 3. The legislature passes a law 4. The facility negligently harms a resident

82. You just admitted a resident with a history of wandering. What would be the first step in protecting the resident?

1. Install locks and alarms on doors 2. Call the physician for medication to manage the resident 3. Put the resident in physical restraints for their safety 4. Have the nursing team evaluate the resident for possible interventions to address their need to

wander

83. _______ would most likely cause a decubitis sore to develop. 1. Too much pressure on one area of the body 2. Poor nutrition 3. Tight fitting clothing 4. A fall


84. A resident on a low salt diet wants to come into the dining room. What should the facility do?

1. Let them sit anywhere they want 2. Require the resident to eat in their room 3. Require the resident to sit with other residents on a similar diet so staff can track what they eat 4. Ensure that salt is removed from all the tables first

85. The daughter of a resident who lacks capacity to make decisions asks to see the resident’s chart. What should the facility do?

1. Give the daughter access to the chart 2. Refuse to allow the daughter access to the chart 3. Get permission from the resident 4. Require the daughter to get a court order

86. The reason why the maintenance staff need to have work order requests filled out is to ______. 1, Operate cost effectively 2, Avoid duplication 3. Develop a maintenance schedule 4. Prioritize repairs 87. What does the suffix “plegia” mean?

1. Loss of control of bowel and bladder 2. Paralysis 3. Infection 4. Renal failure

88. The _______ is permitted to dispense medications.

1. LPN 2. DON 3. Med tech 4. Pharmacist

89. The attending physician must be notified _____ a medication with a stop order is to be refilled. 1. Before 2. After 3. When requested by the licensed nurse 4. None of the above

90. A facility needs to keep _____ months of assessments in the resident charts. 1. 3 months 2. 6 months 3. 12 months 4. 15 months

91. The _______ have the power to make health care decisions. 1. Health care surrogate, Durable power of Attorney, Proxy 2. Ombudsman, power of attorney, proxy 3. Guardian, power of attorney, health care surrogate 4. Administrator, Durable power of attorney, Health care surrogate


92. The ________ decides whether a resident can self administer drugs. 1. DON 2. Medical director 3. Interdisciplinary team 4. Attending physician

93. ___________ makes the employer responsible for injuries to third parties caused by employees in the course of their job.

1. Respondeat Superior 2. Federal Employer Liability Act 3. Unemployment compensation 4. OSHA

94 A resident who was approved to self administer drugs, overdoses by mistake and is hospitalized. When the resident is ready to be released and return to the facility, the facility should?

1. Refuse to admit the resident 2. Revoke any future request from the resident for approval to self administer drugs 3. Discharge the resident upon re-admission 4. Evaluate the resident for appropriateness to allow them to self administer drugs once more.

95. The consultant dietician must _______________. 1. Observe and log what the resident does not like to eat 2. Observe and record everything the resident eats on a daily basis 3. Write down food likes and dislikes and document their progress in their chart 4. Write orders for therapeutic diets

96. Occupational therapy is concerned with ____________. 1. Weight bearing muscles of the lower body 2. The muscles of the upper body 3. Speech 4. Ability to properly swallow

97. The facility needs to provide adequate space in the dining room and spacing between tables to ______.

1. Allow to people to sit together at the same table 2. Provide sufficient room to allow residents privacy in private conversations 3. Allow sufficient space to wheel the food cart from table to table 4. Allow sufficient space for an independently functioning resident to get up and independently move around

98. How do you calculate adequate required living space in a resident room?

1. Living space less the bathroom, vestibule or hallway 2. Total living space less the furniture in the room 3. Total Living space less the radius of the space needed to open the door 4. Living space plus the bathroom or toilet


99. A specialist who treats cancer is called a(n) ______.

1. Podiatrist 2. Hearing specialist 3. Ophthalmologist 4. Oncologist

100. A colostomy bag is connected to the _____.

1. Stomach wall 2. Rectum 3. Colon 4. Esophagus

101. When a resident is given a drug to calm them down, this is an example of a _______.

1. Chemical restraint 2. Physical restraint 3. Drug holiday 4. Diuretic

102. Per OBRA 1987, a ______ would have the least priority on the repair schedule. 1. Water fountain 2. Kitchen freezer 3. Medication refrigerator 4. Emergency generator

103 ___________is the best indicator of low employee morale. 1. Employees expressing displeasure with a supervisor 2. Employees demanding a pay increase 3. High employee turnover 4. High absenteeism

104. _______is a major reason for increased stress nurses are experiencing in long term care.

1. Shortage of nurses 2. Higher staffing levels 3. Shorter resident stays but higher acuity 4. Retrospective payment system

105. _______ is best for a resident who suffered a cerebrovascular accident.

1. Lower extremity therapy 2. Upper extremity therapy 3. Stroke recovery program 4. Dialysis

106. ________ would cover a facility where a nurse administered the wrong medication to a resident causing hospitalization.

1. General liability insurance 2. Professional liability insurance 3. Business interruption insurance 4. Property insurance


107. An interviewer cannot ask a job applicant _______.

1. For their alien card 2. Whether they know anyone who works at the company 3. Their age 4. Whether they can perform the tasks of the job

108. Hot food must be served is at a minimum temperature of ____ and above. 1. 125 degrees 2. 130 degrees 3. 135 degrees 4. 140 degrees

109. A resident with audiological problems would be referred to a __________________. 1. Podiatrist 2. Hearing specialist 3. Ophthalmologist 4. Oncologist

110. ________ would insure a facility where a visitor slips and falls in the facility.

1. General liability 2. Professional liability 3. Business interruption insurance 4. Property insurance

111. An interviewer cannot ask a job applicant if they _________.

1. Were ever convicted of a crime 2. Are a U.S. citizen 3. Possess any professional licenses or certifications 4. Have ever filed a workers’ compensation claim

112. Cold food must be served no warmer than ____ degrees F. 1. 40 2. 41 3. 45 4. 47

113. If a resident suffered a myocardial infarction, which therapy would be best for them?

1 Stroke recovery program 2 Dialysis 3 Cardiac recovery Program 4 Cognitive Training


MOCK EXAM 9 – ANSWER KEY

Item # Answer Description 1 3 Cannot require a resident to execute an advanced directive

2 1 3 4 4 3 5 1 6 1 7 2 8 2 9 4 10 2 11 4 12 3 13 4 The other choices are specially prohibited Choice 4 is a safe harbor exemption 14 4 15 1 The cash flow statement pinpoints when cash is coming in and allows you to schedule

payment of bills 16 2 17 3

18 4 19 1 Universal precautions were developed by the CDC and are required by OSHA 20 2 All nursing homes must be licensed by the state. A facility would need to be certified

by the CMS to participate in the Medicare and Medicaid program 21 4 22 3 23 4 24 3 The local agency on agency receives funding under the Older American’s Act to fund

daycare centers, senior centers, meals on meals and the long term care ombudsman program

25 3 26 1 27 1 28 3

29 3 30 4 The Resident Assessment Instrument (RAI) is a comprehensive assessment instrument

comprised of the MDS, RAPS and instructions to use the RAI. The RAPs or Resident Assessment Protocols is a tool for further investigation and assessment in specific resident problems. The RAPs can trigger further intervention and assessments

31 4 32 2 33 2 34 1 35 4

36 3 37 4 38 1 39 3 40 4

41 1

42 3

43 4

44 3 7.2 45 1

46 4


Quest # Answer Explanation 47 2

48 3

49 2

50 1

51 1

52 2

53 4 The budget is prepared annually and reviewed monthly

54 1 55 3 56 4 57 3 58 4 59 1 60 3 61 1 62 3 63 4 64 2

65 4 66 4 67 1 68 3 The other choices are fringe benefits unlike overtime, unemployment and workers

compensation insurance which are mandated by federal law 69 2 70 1 71 4 72 2 73 3 74 1 75 3 76 3 77 4 78 2 79 3 80 4 81 4 82 4 83 1 84 1 85 1 86 4 87 2 88 4 Nurses administer meds. Pharmacists mix and dispense meds 89 1 90 4 91 1 A power of attorney does not have the power to

make health care decisions 92 3 93 1 94 4 95 3 96 2 97 4 98 1 99 4


100 1 101 1 102 1 103 3 104 3 105 3 106 2 107 3 108 3 109 2 110 1 111 4 112 2 113 3 A myocardial infarction is a heart attack


Answer Sheet – Mock National Exam 9

36 73 110 147

1 37 74 111 148

2 38 75 112 149

3 39 76 113 150

4 40 77 114 151

5 41 78 115 152

6 42 79 116 153

7 43 80 117 154

8 44 81 118 155

9 45 82 119 156

10 46 83 120 157

11 47 84 121 158

12 48 85 122 159

13 49 86 123 160

14 50 87 124 161

15 51 88 125 162

16 52 89 126 163

17 53 90 127 164

18 54 91 128 165

19 55 92 129

20 56 93 130

21 57 94 131

22 58 95 132

23 59 96 133

24 60 97 134

25 61 98 135

26 62 99 136

27 63 100 137

28 64 101 138

29 65 102 139

30 66 103 140

31 67 104 141

32 68 105 142

33 69 106 143

34 70 107 144

35 71 108 145

72 109 146

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