DQA SMQT EXAM-with 100% verified solutions 2024-2025-tutor verified.docx, Exams of Nursing

Download DQA SMQT EXAM-with 100% verified solutions 2024-2025-tutor verified.docx and more Exams Nursing in PDF only on Docsity! DQA SMQT EXAM-with 100% verified solutions 2024-2025-tutor verified 150Q%A What is severity level 2 Noncompliance that has potential to cause more than minimal harm that is not IJ resident has no more than minimal discomfort, their is a potential to compromise residents ability to reach highest practicable level, shame/embarassment without loss of interest minimal episodic pain, facility has no system to prevent problems The TC must complete which tasks during offsite prep? Create/export shell from ACO Import shell into ASE-q Add team members Complete offsite prep screen Make unit assignments Make mandatory task assignments print documents Share offsite prep with team What documents are printed by the TC during offsite prep? 1 matrix with instructions 1 entrance conference worksheet 3 beneficiary worksheets What is the purpose of the initial pool process? To briefly screen all residents and observe, interview and complete initial record review. When should you share data? At the end of each day and when the team composition changes. What must be done prior to Sample Selection The completed I.P data is shared and the TC confirms that the data is complete. What are the 7 LTSCP steps? 1. Offsite prep 2. Facility entrance 3. Initial Pool Process 4. Sample Selction 5.Investigation 6. Ongoing and other survey activities 7. Potential Citations Name 3 antipsychotics Thorazine (chlorpromazine) Haldol (haloperidol) Abilify (aripiprazole) Clozaril (clozapine) Zyprexa (olanzapine) Latuda (lurasidone) Seroquel (quetiapine) Risperdal (risperidone) Indications of unnecessary medication include? Excessive dose excessive duration Severe weight loss in 1 month? greater than 5% weight loss Significant weight loss in 3 months? 7.5% weight loss Severe weight loss is 3 months? greater than 7.5% weight loss Significant weight loss in 6 months? 10% weight loss What are signs and symptoms of digoxin toxicity? anorexia, nausea ,vomiting, visual changes, cardia arrhythmia, low heart rate When must a Gradual Dose reduction (GDR) occur? Within the first year in which a resident is admitted or med is prescribed the facility must attempt a GDR in two separate quarters (with at least one month in between the attempts) unless clinically contraindicated. Severe weight loss in 6 months greater than 10% weight loss When finalizing the sample what do you do if other residents are marked FI for the complaint allegation care area?,sample 3 residents for the care area. What residents are system selected? any offsite selected with at least one care area marked FI, any resident a surveyor marked as include in sample, any identified abuse concern from IP or history of abuse citation or allegation since last survey. What areas are reviewed for non-interviewable residents ? Pressure ulcers, dialysis, infections, nutrition, falls in last 120 days, ADL decline, low risk B&B, unplanned hospitalization, elopement, change of condition in last 120 days. All residents are reviewed for which areas? Advanced directives, confirm specific information based on RI/RO, other concerns . What act established Medicare and Medicaid Social Security Act of 1965 signed by Johnson established Medicare for aged over 65 and Medicaid health insurance for low income. What is the survey process based on? Person centered care, resident centered outcomes, QOC and QOL. What are the components of a deficiency statement? 1. regulatory reference 2. deficient practice statement 3.relevance facts and findings When should you export the survey shell from ACO? Export the shell as close to the survey as possible but no more than 5 business days before. When should you contact the RAI coordinator? If the number of residents is unreasonable after exporting the survey shell Which residents are included in the survey shell? 1. Offsite selected who make up 70% of the sample 2. Residents with at least 1 MDS in the last 120 days 3. Residents for closed record review What is the CASPER report? Certification and Survey Provider Enhanced Reporting What items are required upon entrance 1. Census excluding bed holds 2. Matrix for new admits in the last 30 days What should you ask for if Abuse is being investigated based on a history of abuse as noted on offsite prep screen? Ask facility for all allegations of abuse since the last survey. What should you consider when adding residents when the sample size is not met? Residents with the most concerns Residents with concerns R/T QOL and RR Residents selected for unnecessary med review prior survey and complaint results underrepresented areas of facility. What is investigated when more than 5 complaint/fri residents are added to the sample? You will only investigate for the allegation When finalizing the sample you must ensure that a surveyor is assigned to which residents? every resident in the sample, additional complaint/fri residents, non sampled unnecessary medication review residents What are the 9 mandatory facility tasks 1. Beneficiary Protection Notification review 2.Dining observation 3. Infection control 4. Kitchen 5. Medication Administration 6. Medication Storage 7. QAA/QAPI 8. Resident Council Meeting 9. Sufficient and Competent Nurse Staff What 3 task are assigned to all surveyors? Dining observation, infection control, sufficient and competent nurse staff. (One surveyor is assigned primary responsibility for completion of each task) Which facility tasks are triggered tasks? Environment, Personal Funds, Resident Assessment 483.24 Quality of Life- pertains to all care and services provided. Facilities must provide necessary care and services to attain or maintain highest practicable physical, mental, and psychosocial well being. 483.25 Quality of Care-facility must ensure residents receive care and treatment in accordance with professional standards of practice, person centered care and resident choice What is included on a baseline care plan? Initial goals based on admission orders MD orders and dietary orders Therapy and social Services PASARR What is a PASARR Pre-Admission Screening and Resident review -screening to ensure that the facility coordinates with the appropriate, State designated authority, to ensure that individuals with a mental disorder, intellectual disability or a related condition receive care and services in the most integrated setting appropriate to their needs. What pathway is used to investigate QOC concerns that have no pathway? General CE pathway When should you use "Investigation Notes"? used for information specific to the care area being reviewed When should you use "Resident Notes" when you have information about the resident you would like to have for all care areas What must you do prior to observing resident care? Have consent from the resident or resident rep., and facility nurse staff must be available during the observation. How should you determine who to interview? What factors should you consider in determining severity when the is no actual harm? how likely is it that a resident could suffer harm, impairment, death or compromise/deterioration? Does the deficient practice require immediate correction? Could the noncompliance have an impact on many residents? Use the psychosocial outcome grid and the reasonable person concept What is the psychosocial outcome grid? guide designed to identify each residents psychosocial response to noncompliance as the basis for determining psychosocial severity of a deficiency What is reasonable person concept? Used when a resident's psychosocial outcome may not be readily determined through the investigative process. The team should determine the severity of the psychosocial outcome that the deficient practice would have had on a reasonable person in a similar situation. What factors drive decisions on severity? residents condition whether staff followed P&P duration of event facility and staff response to the problem impact on the resident (condition after the event) What does Widespread scope refer to? The entire population, not a subset, not a hall, but ALL How do you classify the severity when the evidence includes incidents of varying severity and cope? Classify the deficiency at the highest level of severity.Ex. 1 resident severity level 3, there were widespread finding of same deficiency at severity level 2-classify as severity level 3-scope isolated How do you determine SQC Deficiency designated under CoP 1 or more def. that poses IJ A pattern of, or widespread def. at severity level 3 A widespread deficiency a severity level 2 (F,H,I,J,K, or L) What does the Beneficiary Protection Notice Review verify? verify notification to resident when Med A ends- SNF-ABN and NOMNC verify the facility billed medicare within the required time frame after the resident requested a demand bill verify that the facility did not bill the resident while a decision was pending. What is the danger zone? above 41degress or below 135 degrees What are the 3 types of contamination Biological, chemical, physical What is Critical Control Point (CCP) a specific point, procedure, or a step in food preparation and serving at which control can be exercised to reduce, eliminate, or prevent the possibility of a food safety hazard. Cooking ,cooling, holding, reheating What temperature should hot foods be held at? 135 degrees or higher What temperature should cold foods be held at? 41 degrees or lower What temperature should food be re-heated to? 165 degrees for 15 seconds within 2 hours Should ABHS be used in food Service ? No What is the purpose of medication administration observation? Physician services (483.30) Nursing Services (483.35) Administration (483.70) QAPI (483.75) Infection Control (483.80) if applicable Training (483.95) if applicable Resident Assessment (483.20) if def. in QOC triggered What is universe total number affected or at risk from deficient practice What area trigger an extended survey? Residents rights 483.10 Abuse 483.12 QOL 483.24 QOC 483.25 Behavioral Health 483.40 Pharmacy 483.45 Administration 483.7 Infection Control 483.80 How many hours upon Oral or Written request does a facility have to provide clinical records excluding weekends and holidays 24 How many days should a request for medical records take 2 working days with advance notice Funds in excess of how much should be in an interest bearing account $50 A provider must notify a resident when the amount of money in anaccount is $200 less the SSI limit A resident must receive mail within how many hours of its arrival in the home 24 hours The facility has how many days to convey funds after the death of a resident 30 days A provider must give how many days day advance notice before transfer or discharge 30 days How many beds does a facility have to have for a full time social worker 120 beds The MDS assessment must be conducted no later than how many days after admission 14 days after admission Annual assessments must be done every 12 months Review of assessments occur every 3 months or quarterly Comprehensive care plan must be developed within how many days after completion of what Within 7 days after completion of the MDS Assessment How often should a physician visit? Every 30 days for 90 days and then every 60 days Timely MD visits occur within 10 days after the visit was required MD services are required 24/7 What is hemoglobin 1 ac? This is a measurement of the variability of the blood sugar over time. What is a lab draw for iron, hemoglobin and hematocrit going to tell you This measures if someone has anemia. What drugs would you measure iron or hemoglobin for? These are measured when someone may be taking iron. Many people on dialysis have low iron and need replacement What are electrolytes? This is potassium or magnesium for example. People with cardiac issues what electrolyte is commonly measured? potassium or K+ What is BUN? blood urea nitrogen. This can measure function of kidneys. An elevated BUN can mean person is dehydrated, kidneys are not working, person is having congestive heart failure What is albumin Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn't leak into other tissues. It is also carries various substances throughout your body, including hormones, vitamins, and enzymes. Low albumin levels can indicate a problem with your liver or kidneys. Why is albumin important for medications? Medications can attach to albumin. so if you have have low or high albumin levels you may have more or less drug available in a persons system. Too much drug can cause more side effects. Too little of the drug and it can't work What is a corticosteroid? These are drugs like prednisone or hydrocoritsone. What do corticosteroids do? reduce inflammation What is anticholinergic symptoms? Anticholinergic symptoms dry people out. So dry eyes, consitpation, dry brain so confusion, less urine so infections or retention, dry mouth so swallowing difficulties, dry skin Anticholinergic drugs Oxybutynin (Ditropan, Gelnique), tolterodine (Detrol), Darifenacin (Enablex), Solifenacin (Vesicare), Trospium (Sanctura), Fesoterodine (Toviaz) What is digoxin used for? increase heart contractility what are symptoms of digoxin toxicity? -GI upset, anorexia, ectopic heart beats, A. fib, heart blocks, VISUAL DISTURBANCES and disorientation. What is a common side effect from corticosteroid? GI bleeds What are some common electrolytes? magnesium, sodium, magnesium, potassium