1. Which federal law provided funds for the medical care of the aged poor?

1. Social Security Act of 1935

2. Kerr-Mills Act of 1960
3. Hill-Burton Act of 1960
4. Rehabilitation Act of 1973

2. The minimum staffing level required by CMS is:

1. 2.0 PPD
2. 2.5 PPD
3. 3.0 PPD
4. Determined by the individual states

3. Under which circumstance may the DON serve as charge nurse:

1. The average census is less than 60
2. A waiver has been obtained from the state health department
3. No other licensed nurses are willing to serve as charge nurse
4. The DON may never serve as charge nurse

4. Which of the following is NOT an indicator of inadequate nurse staffing?

1. Staff responding slowly to resident requests for help
2. Residents cannot locate staff quickly
3. Nurse staffing information is not posted as required
4. Residents have to make repetative calls for help

5. The most important aspect of resident care is:

1. Staff attitudes towards residents
2. Prevention and treatment of pressure ulcers
3. A well-rounded activities program
4. Prompt attention to incontinence episodes

6. Which of the following is NOT recommended as part of an infection control program:

1. Infection log
2. Antibiotic log
3. Infection record individualized for each resident
4. Facility floor plans used to track outbreaks

7. Which type of incontinence is characterized by urine leakage with coughing or laughing?

1. Stress
2. Urge
3. Overflow
4. Functional

8. Which type of vision problem is characterized by seeing straight lines as crooked?

1. Glaucoma
2. Legal blindness
3. Macular degeneration
4. Cataracts

9. Which type of behavioral intervention may not be appropriate for demented individuals?
1. Remotivation
2. Reality orientation
3. Validation therapy
4. Sensory training

10. Door locks that are engaged by wandering residents can only work for how long?
1. 15 seconds
2. 30 seconds
3. 1 minute
4. Doors are never allowed to be locked
11. The single best preventative measure for pressure ulcers is:
1. Prompt incontinence care
2. Adequate hydration
3. Use of "donut" cushions when in a wheelchair
4. Frequent turning and repositioning

12. Which model of care attempts to use the presence of plants, pets, and children to combat boredom,
lonliness, and helplessness in nursing facility residents?
1. Eden Alternative
2. Pioneer Network
3. Greenhouse Model
4. Gentlecare

13. PASSAR is a process for:

1. Assessing pressure ulcer risk
2. Screening for fall risk
3. Classifying level of protein deficiency
4. Screening for mental illness or developmental disabilities

14. Which of the following is permissable as part of an admission contract?

1. Third party guarantee of payment
2. Waiver of the right to receive Medicaid
3. Mandatory charitable contributions
4. Requirement of arbitration to resolve legal conflicts

15. Under which situation would a MDS not need to be completed?

1. A resident's payor source is private pay
2. A resident on insurance only stays for 21 days
3. A resident on Medicare stays for 12 days
4. A resident on Medicaid stays for 12 days

16. Which of following does not consitute a significant change for MDS purposes?
1. A resident has a stroke that causes dysphagia and aphasia
2. A resident requires IV therapy but has run out of available skilled days
3. A resident has fallen and broken her hip
4. A resident has a mild case of pneumonia but is expected to recover within a week

17. Who is required to coordinate the RAI process?

1. A licensed nursing home administrator
2. An individual who has a MDS certification
3. Any registered nurse
4. Any member of the interdisiciplinary team

18. How soon after the MDS is completed must the care plan be developed?
1. 7 days
2. 14 days
3. 21 days
4. 30 days

19. If state law does not say otherwise, how long should clinical records be retained after the resident has been
discharged?
1. 3 years
2. 5 years
3. 20 years
4. Indefintely

20. Which of the following is universally regarded as the best way to reduce food wastage?
1. Utilize buffet lines in the dining room
2. Reduce meal portions to the smallest feasible amount
3. Provide more snacks in between meals
 4. Prepare and serve attractive, tasty food

21. OBRA 87 requires what of dietary managers?

1. Licensure as a registered dietician
2. Certification as a certified dietary manager
3. Completion of a state approved course
4. The ability to communicate with a qualified dietician

22. Which of the following indicates a significant weight loss?

1. 5% over three months
2. 7.5% over three months
3. 7.5% over six months
4. 10% over twelve months

23. At what temperature must be hot foods leave the kitchen?

1. 90 degrees
2. 100 degrees
3. 120 degrees
4. 140 degrees

24. After a resident has been in the facility for 3 months, how often must they see a physician?
1. Every 30 days
2. Every 60 days
3. Every 90 days
4. Only when medically necessary

25. How often must a pharmacist conduct a drug regimen review?

1. Monthly
2. Bi-monthly
3. Quarterly
4. Annually

26. Which of the following would not constitute a significant medication error?
1. Two multivitamin tablets were administered when only one was ordered
2. Three ounces of water were given with a laxative
3. Twelve units of insulin were ordered and fifteen units were administered
4. The licensed nurse failed to obtain a apical pulse before adminstering digoxin

27. Which is not an OBRA approved indication for antipsychotic usage?

1. Hiccups
2. Itching
3. Schizophrenia
4. Wandering

28. Which therapist would be able to best help a post-stroke resident with aphasia who needs to improve her
ability to use her hands (for buttoning and fastening clothing, turning on/off water faucets, etc.)?
1. Recreation therapist
2. Physical therapist
3. Occupational therapist
4. Speech-language pathologist

29. Which individual is required to serve on the facility's QAA committee?

1. Medical director
2. Nursing home administrator
3. Director of nursing
4. Certified nursing assistant

30. Residents do NOT have which of the following rights?

1. Immediate access to the secretary of the US department of Health and Human Services
2. Refuse to participate in research which consists only of aggregated statistics
 3. Self-administration of medication if it has been deemed safe
4. To read a CMS form 2567 which includes the facility's plan of correction

31. Consentual sex with a nursing home resident is prohibited in which case?
1. The sexual act involves two individuals of the same gender
2. One of the individuals is married to someone else
3. The two indviduals were married but are now divorced
4. One of the individuals has been judged incompetent

32. The F223 tag does not explicity prohibit which type of abuse?
1. Physical abuse
2. Verbal abuse
3. Neglect
4. Financial exploitation

33. Which statement best describes a policy?

1. A document guiding the staff's decision making
2. A document guiding the staff's actions
3. Specific actions that must or must not be taken
4. A document containing all information pertinant to employees

34. Which statement best describes a personnel manual?

1. A document guiding the staff's decision making
2. A document guiding the staff's actions
3. Specific actions that must or must not be taken
4. A document containing all information pertinant to employees

35. Why are essential functions included as part of a job description?

1. To avoid lawsuits
2. To prevent workers compensation claims
3. To meet the requirements of the Americans with Disabilities Act
4. To prevent employees from quitting by letting them know expectations

36. Which of the following individuals is not allowed to feed a resident?

1. A nurse aide trainee who has only completed 12 hours of training so far
2. A volunteer
3. An occupational therapist
4. An activities assistant

37. How does a CNA ordinarily renew their certification at the end of a two year period?
1. Complete 24 hours of inservice training within the past 24 months
2. Retake the CNA course offered by the nursing facility
3. Have at least one satisfactory performance evaluation
4. Submit evidence of having worked at least one shift of at least eight hours

38. Which of the following personal goals would be viewed as constructive?

1. To get out the house, away from the children
2. To tell other people what to do
3. To help old people
4. To find out gossip

39. Which of the following personal goals would be viewed as destructive?

1. To get out the house, away from the children
2. To tell other people what to do
3. To help old people
4. To find out gossip

40. Which of these would be considered a social reward?

1. Feelings of satisfaction from the work being performed
2. Praise and recogntion from supervisors
 3. Pay increases
4. Reserved parking space for the employee of the month

41. The primary reason that people quit their jobs is:
1. Poor relationships with supervisors
2. Inadequate interpersonal skills
3. Low wages
4. Lack of health insurance

42. The best forum for communicating messages in a timely manner is:
1. Daily department head meeting
2. Weekly care plan meeting
3. Quarterly QAA meeting
4. Via memos and emails

43. The least acceptable method of recruiting additional employees is:

1. Newspaper advertising
2. Outsourcing the work through an employment agency
3. Using agency nurses through a temp agency
4. Visiting nursing schools to recruit new graduates

44. Which of the following items can be included on an application?

1. Religion
2. Felony conviction
3. Length of residence
4. If the individual is receiving welfare benefits

45. Which of the following interview questions will yield the most accurate information?
1. "What were your job duties as a CNA at Shady Pines Manor?"
2. "Tell me about a time you had to deal with a difficult family member"
3. "Why did you quit your last job at Shelbyville Nursing Home?"
4. "Who do you know that works here that could vouch for you?"

46. The most valuable information on a prospective employee is:

1. Length of time at a particular job
2. Level of education
3. Quality of references
4. Types of outside hobbies

47. The number one priority for staff training is:

1. Attitude training
2. Resident rights
3. Fire prevention
4. Accident prevention

48. The term "respondeat superior" means that:

1. Employers are responsible for their employees actions
2. Employees are responsible for their employers actions
3. A CNA can never be held responsible for her actions
4. A NHA can not be held responsible; only the governing body can

49. Which employee is not exempt from minimum wage requirements?

1. Students
2. Externs
3. Salaried employees
4. Residents who work

50. Which system gives a raise based soley on the basis of length of service?
1. Senority
2. Merit
 3. Mixed
4. Job-based

51. Getting input from employees is characteristic of:

1. Management by walking around
2. Total quality management
3. Learning organizations
4. Six sigma

52. Allowing an employee to vent while the supervisior listens without talking is an example of:
1. Crisis intervention
2. Coaching supervision
3. Creative problem solving
4. Nondirective techniques

53. Corporate compliance programs were originally designed to address:

1. Compliance with Medicare conditions of participation
2. High rates of worker compensation claims
3. Medicare and Medicaid fraud, especially in billing
4. Employee theft

54. Which of the following can be done during union campaigns?

1. Fire an employee who discusses the union while on the job
2. Interrogation of an employee who talks with a union representative
3. Spying on individuals who speak with union representatives
4. Ask an employee if they attended a union meeting

55. A building would not be considered a _________ asset.

1. Fixed
2. Capital
3. Tangible
4. Intangible

56. The excess of current assets over current liabilities is:

1. Investment capital
2. Working capital
3. Capital expenditures
4. Revenue expenditures

57. Which type of corporation can be double taxed?

1. C corporation
2. S corporation
3. LLC
4. Nonprofit corporation

58. Budgeting by prioritizing potential items is called:

1. Operating budget
2. Capital budget
3. Cash budget
4. Zero-based budget

59. Recording revenues when they are realized instead of received is also known as:
1. Cash basis accounting
2. Accrual basis accounting
3. Cost reporting
4. A very bad idea

60. A summary of assets, liabilities, and equity is called a:

1. Trial balance
2. Balance sheet
 3. Income statement
4. Retained earnings statement

61. Total current assets divided by total current liabilities is:

1. Current ratio
2. Acid-test ratio
3. Equity ratio
4. Cash flow ratio

62. Which law mandated prospective payment for nursing homes?

1. Social Security Act of 1965
2. Omnibus Budget Reconciliation Act of 1987
3. Balanced Budget Act of 1997
4. Medicare Modernization Act of 2004

63. Medicare Part B wound care is billed to the:

1. Regional carrier
2. Fiscal intermediary
3. Supplier of wound care supplies
4. CMS regional office

64. Which depreciation method is required by Medicare?

1. Straight-line
2. Accelerated
3. Double-declining
4. Accumulated

65. The #1 and #2 costs in a nursing home are typically:

1. Payroll, food costs
2. Payroll, cost of nursing supplies
3. Mortgage payments, payroll
4. Payroll, mortgage payments

66. Which of the following can not be included in the bundled Medicare rate?
1. Physician services
2. Cost of activities program
3. Personal laundry
4. Adult diapers

67. Life Safety Code guidelines are issued by the:

1. National Fire Protection Association
2. American National Standards Institute
3. Occupational Safety and Health Administration
4. Centers for Medicare and Medicaid Services

68. How many residents may occupy a bedroom without a waiver?

1. 2
2. 3
3. 4
4. 5

69. Which laundry practice will promote cost containment?

1. Use of bulk soap
2. Overloading machines
3. Underloading machines
4. Cleaning filters

70. Which type of extinguisher would be best for a grease fire?

1. Class A
2. Class B
 3. Class C
4. Class D

71. What type of authority does an administrator have by virtue of her position?
1. Line
2. Staff
3. Functional
4. Decentralized

72. The "tell and see" method of management is also known as:
1. Laissez-faire
2. Democratic
3. Paternal
4. Autocratic

73. Suggesting to someone what to do is an example of a _________ instruction.

1. Specific
2. General
3. Formal
4. Informal

74. Which process is used to challenge deficiencies cited on a survey?

1. Informal dispute resolution
2. Survey appeal
3. Remedy process
4. Plan of correction

75. Which of the following is considered improper practice for an administrator's first day?
1. Meet all department heads
2. Review the risk management program
3. Discuss the prevoius administrator
4. Avoid chronic complainers