CALA Study Guide Questions and Answers with Complete Solutions, Exams of Advanced Education

Download CALA Study Guide Questions and Answers with Complete Solutions and more Exams Advanced Education in PDF only on Docsity!

CALA Study Guide Questions and

Answers with Complete Solutions

Aging in Place - Correct Answer-process which allows individuals to remain in their living environment despite cognitive or physical decline occurred in aging AL census must be Medicaid - Correct Answer-10% AL census must be Long Term Care (LTC) - Correct Answer- 20%. 3 years after opening Assisted Living Principles - Correct Answer-Promotes maximum independence Promotes dignity Promotes self-direction & participation Allows aging in place AL Values - Correct Answer-DIPCI Dignity Individuality

Privacy Choice Indepence Resident's Rights - Correct Answer-1. The right to receive personalized services and care in accordance with the resident's individualized general service and/or health service plan;

2. The right to receive a level of care and services that addresses the resident's changing physical and psychosocial status;
3. The right to have his or her independence and individuality;
4. The right to be treated with respect, courtesy, consideration and dignity;
5. The right to make choices with respect to services and lifestyle;

6. The right to privacy;
7. The right to have or not to have families' and friends' participation in resident service planning and implementation;
8. The right to receive pain management as needed, in accordance with N.J.A.C. 8:43E-6;
9. The right to choose a physician, advanced practice nurse, or physician assistant;
10. The right to appeal an involuntary discharge as specified at N.J.A.C. 8:36-5.14(b);
11. The right to receive written documentation that fee increases based on a higher level of care are based on reassessment of the resident and in

accordance with N.J.A.C. 8:36-6.2;

12. The right to receive a written explanation of fee increases that are not related to increased services, upon request by the resident;
13. The right to participate, to the fullest extent that the resident is able, in planning his or her own medical treatment and care;
    14. The right to refuse medication and treatment after the resident has been informed, in language that the resident understands, of the possible consequences of this decision;
14. The right to refuse to participate in experimental research, including the investigations of new drugs and medical devices. The resident shall be included in experimental research only when he or she gives informed, written

consent to such participation;

16. The right to be free from physical and mental High Blood pressure - Correct Answer-Result of Hypertension Cellular Theory - Correct Answer-Senescent changes are result of genetic program. leads to diminished function and result in death of organ Stress & Viral Theory - Correct Answer-Organs have fixed amount of energy available and they wear out. Residual damage resulting from stress, body no longer is able to resist stress & dies off Activity Theory - Correct Answer-Stay active, body will last at optimal age Human Needs Theory - Correct Answer-Hierarchy of physiologic needs, safety and security, love and belonging, self-esteem, self-actualization. Meaning fulfilled in self- creativity relationships w/ friends, family, and society

Skin Changes in aging - Correct Answer-Decrease in subcutaneous tissue Loss of insulation Increase chance of hypothermia Genito-urinary Changes in aging - Correct Answer-Decrease bladder capacity Frequent bathroom trips Nocturia - peeing at night, increase in falls Decrease fluid intake to compensate Dehydration, infection (UTI) Respiratory Changes in aging - Correct Answer-Decrease in strength & stiffening of chest wall Decrease O2 intake = fatigue Decrease ability to cough eliminate secretions High risk of Pneumonia Parkinson's Disease - Correct Answer-Shuffling, mask-like face

Stroke/TIA's - Correct Answer-Gradual decline CVA - cerebrovascular accident Numbness/paralysis of one side of body Osteoporosis - Correct Answer-Hump back Ophthalmology - Correct Answer-Macular degeneration Common Mental Disease/Disorders in Elderly population - Correct Answer-Depression Alcohol Abuse Suicide Drug Problem Dementia Alzheimer's Disease - Correct Answer-Abnormal loss of brain cells Accounts for 50% - 60% of dementia in elderly Loss of memory, mental functions, loss of ability to do ADLs Gradual decline over time

Multi-infarct Dementia - Correct Answer-Cause in repeated brain damage due to loss of blood supply from CVA Accounts for 20% in elderly Sudden loss/decline Withdrawal from society - Correct Answer-When unable to perform functions that are important to them Types of Supportive Services - Correct Answer-Preventive care Supervision of self-administration of medication Administration of medication Assistance in performing Daily Activities of Living (ADLs) Access to therapeutic care (OT, PT, etc.) Food Service - community dining Transportation Services Dignity - Correct Answer-Residents have varied lifestyles. Self- worth Individuality - Correct Answer-Recognize residents as individuals

Privacy - Correct Answer-Residents must be provided w/ a lockable entrance door Choice - Correct Answer-Encourage personalization to their rooms Independence - Correct Answer-Feeling of control over his/her own environment Resident environment housekeeping & sanitation conditions - Correct Answer-Facility shall be clean to sight/touch and free of dirt & debris All rooms shall be ventilated to prevent mold growth & noxious odors Central kitchen thermometers shall be within 3 degrees Articles of storage shall be 6" elevated from floor, 18" from ceiling, and away from wall to prevent moisture Non-carpet floors in public areas shall be coated with - Correct Answer-Slip-resistant floor finish

All poisonous/toxic materials shall be - Correct Answer- Identified, labeled, and stored in locked cabinet Combustible materials shall not be - Correct Answer-Stored in heater rooms or within 18 ft of any heater Electrical inspections conducted - Correct Answer-Annually Storage & Transportation of Laundry - Correct Answer-Clean or dirty must be covered to protect from contamination and vermin-proof No co-mingling of residents laundry Required Laundry Equipment - Correct Answer-1 non- commercial washer/dryer shall be provided for residents personal use Commercial laundry equipment shall be installed in separate rooms with fire separation assemblies of at least 1 hour rated construction Dietary Department shall provide - Correct Answer-Station for receiving food supplies

Minimum storage facilities of 3 days food supply Food prep facilities Hand-washing facilities Requirements of public areas - Correct Answer-Entrance shall be grade level - sheltered from weather and able to accommodate wheelchairs Space for private interviews Individual mailboxes Room for examination Room for examination - Correct Answer-Accommodate overnight stay including toilet Minimum of 100 sq. ft. (10X10) Requirements of Administration - Correct Answer-Medical, administration and professional records Places for storage Space for staff's personal possessions

Waste Removal - Correct Answer-All waste must be collected, stored and disposed of in accordance w/ rules of NJ State Dept. of Environmental Protections & NJDOH Heating Season (day) - Correct Answer-72 degrees Heating Season (night) - Correct Answer-68 degrees Warm Weather conditions - Correct Answer-shall not exceed 82 degrees Water supply temperature - Correct Answer-at least 105 degrees, shall not exceed 120 degrees Pork temperature - Correct Answer-145 degrees Beef temperature - Correct Answer-155 degrees Chicken - Correct Answer-165 degrees

Personal Cleanliness - Correct Answer-Hand washing at total of 20 seconds 10 seconds of vigorous rubbing Refrigeration Temperature - Correct Answer-41 degrees or less Fire extinguisher - Correct Answer-Minimum of 2 in basement, at least one on each floor, as required in the kitchen Visually checked monthly and recorded Fire sprinkler system - Correct Answer-inspected based on manufacturers recommendations Emergency Plans - Correct Answer-shall be filed w/ Dept. of Health. shall be notified of any changes in plans Fire drills - Correct Answer-once per shift, quarterly one joint fire drill w local fire department one manual pull each month

The occupational safety and health act of 1970 (OSHA) - Correct Answer-requires employers to record only employee injuries/illnesses that are work-related and when medical attention is required OSHA standards - Correct Answer-Hepatitis B vaccinations must be made available to all employees who have reasonably anticipated occupational blood exposure within 10 working days of assignment OSHA record keeping requirements - Correct Answer-establish medical records for any employee who has be determined at risk to blood born pathogens medical records must be retained for the length of employment plus 30 years training records kept for 3 years from training date OSHA log 300 - Correct Answer-used to track employee work related injuries or illnesses from the current year OSHA log 300A - Correct Answer-summary of incidents from the previous year (using OHSA log 300) posted 2/1 - 4/30 each year

Hazard communication program - Correct Answer-written; provide employees w/ info on labeling system used to warn employees of hazardous chemicals in the workplace Material safety data sheet (MSDS) - Correct Answer-purpose, use and location of hazardous chemicals within the facility Initial interview - Correct Answer-usually done by the marketer. documentation shall be included in the resident's record If applicant is denied admission, applicant and/or family is entitled to a reason, in writing - Correct Answer-15 days of written request Initial assessment - Correct Answer-conducted by RN within 30 days prior admission Health Service plan (HSP) - Correct Answer-completed within 14 days of admission

reviewed quarterly unless change of status skilled professionals (PT, Hospice, OT) plan must be 14 days or longer to be considered General Service plan (GSP) - Correct Answer-developed within 14 days of admission reviewed semi-annually custodial needs - ADLs can be delegated to non-nurse medication is considered custodial needs Quality assurance - Correct Answer-facility shall have a written program to monitor the quality of care delivered to the residents, to be done quarterly 7 mandatory in-services - Correct Answer-concepts of AL resident rights elder abuse general safety fire pain

infection control & blood borne pathogens Evaluation of quality assurance - Correct Answer-resident care staffing infection prevention/control safety resdient care discharge planning service housekeeping sanitation maintenance of physical plant and equipment Required personal care staffing - Correct Answer-one awake personal care assistant (PCA) and at least 1 additional employee must be present at all times Activities of Daily Living (ADLs) - Correct Answer-bathing dressing ambulating toiletting transferring

eating Personal care assistant (PCA) - Correct Answer-certified home health aide (CHHA) certified nursing aide (CNA) Pharmacy services - Correct Answer-pharmaceutical services provided by registered pharmacists contract separate pharmaceutical provider for consultant that audits (MAR & TAR audits) Self administration of medication - Correct Answer- supervision and/or assistance during self-administration of medication Administration of medication - Correct Answer-not considered a HSP administered w/ accordance to prescribed order responsibility of RN Resident transportation - Correct Answer-providing either directly or by arrangement

Dietician - Correct Answer-on-going basis provides nutritional counseling & education to residents sign off and reviews menus Requirement for dining services - Correct Answer-comply w/ sanitary code must have current diet manual available to the dining services staff and to nursing staff 3 meals a day, 24/ written, dated menus planned 14 days in advance substitutes w/ same nutritional value should be available ill meals will be served in rooms Housekeeping services - Correct Answer-written work plan for operations shall be established & implemented for each area of the facility personnel shall be trained in all cleaning procedures including the use and care of equipment must meet OSHA standards Laundry services - Correct Answer-written policies & procedures shall be established and implemented

storage & transportation of laundry collection & storage of soiled laundry in ventilated area protection of clean laundry contamination no co-mingle resident's personal laundry residents may be moved (but its not required) if higher level of is required as demonstrated by the following: - Correct Answer-required 24/7 nursing supervision bedridden for more than 14 consecutive days consistently & totally dependent in 4 or more ADLs cognitive decline severe enough to prevent the making of simple decisions regarding ADLs require treatment of stage 3 or stage 4 pressure sores or multiple stage 2 requires more than assistance w/ transferring medically unstable - facility unable to care for managed risk - Correct Answer-balancing resident's choice and independence against the health & safety of the resident and other persons in the facility

managed risk agreement - Correct Answer-formal written plan negotiated between resident and facility to avoid or reduce adverse outcomes shared responsibility - Correct Answer-both agreed parties share responsibility for planning and decision making affecting residents bounded choice - Correct Answer-residents are able to express and act upon their choices within certain limits Limitation - Correct Answer-set to prevent imminent danger or harm to maintain the respect & dignity of others low risk choice - Correct Answer-risk is tolerable sweater in warm weather high risk choice - Correct Answer-result in harm small fire in microwave managed risk agreement components - Correct Answer-cause of concern

probable consequences of the choice residents desires in situation possible options available final agreements reached by all parties importance of documentation - Correct Answer-legal records and can be subpoenaed in court and must be made available to surveyors at all times purpose of progress notes charting - Correct Answer-primary communication source core for planning care basis for planning care (HSP, GSP) charting standards - Correct Answer-pen only - no erase or white-out write on every line SOAP - subjective objective assessment plan SOAP - Correct Answer-subjective objective assessment plan

confidentiality - Correct Answer-all records considered records owned by facility written consent for release of records register - Correct Answer-required to have most accurate and current to census core requirement - admission date, discharge date, discharge destination recorded within 48 hours personal interview - Correct Answer-initial should be face to face, open ended questions recruitment - Correct Answer-goal of facility ti hire best candidate for job references made before job offer orientation - Correct Answer-resident rights covered immediately

in-service training - Correct Answer-begins at orientation and continues throughout employment through regularly scheduled programs key points in creative scheduling - Correct Answer-flexibility, creativity, cross-training cross-training - Correct Answer-expand capacity and increase flexibility and reducing task segmentation Family Medical Leave Act (FMLA 1993) - Correct Answer- requires employers of 50 or more employees to provided up to 12 weeks of unpaid job-protected leave to eligible employees must have worked at least the past 12 months, and must have work the last 1250 hours during a 12 month period job description - Correct Answer-develop for each position within facility. required to read and sign. signed copy on file and copy for employee appropriate nurse delegation - Correct Answer-RN is responsible for quality of al nursing care including assessment

of nursing needs, nursing care plan, implementation, monitoring and evaluation of plan may delegate LPN, ancillary staff (aides, techs, etc.) tasks which may not be delegated - Correct Answer-that require understanding of nursing principles necessary to recognize and manage complications, judgement and knowledge of RN drug distribution system - Correct Answer-individual/multiple drugs (bubbles, bingo cards) color code on packaging for different time periods prescription drugs - Correct Answer-must be stored in original container, labels must be intact and readable discontinued or expired med. - Correct Answer-shall be destroyed within 30 days in facility witnessed and documented by 2 persons hand washing - Correct Answer-#1 infection prevention gloves don't replace