Download Federal Nursing Home Administrator Exam 2025 and more Exams Nursing in PDF only on Docsity!
1 / 14
Federal Nursing Home Administrator Exam
1. 1) OBRA asserts some separate committees can be folded into the quality improvement/assurance committee.
Safety, Pharmacy and which committee below can be added into QA/QI committee?: Infection Control
2. 2) Nursing homes are responsible for obtaining and providing dental care for residents. Who usually pays for
dental services?: The resident or a family member
3. 3) A facility is not allowed to charge a resident who is Medicaid and Medicare eligible except for:: Co-pays
4. 4) You calculate the average percent of occupancy by:: Dividing the total census (occupied bed days) by the
total number of days, then multiply by 100
5. 5) Resident's rights should be explained to the resident and or family member:: Prior to admission
6. 6) In case of an emergency, when no attending or back up physician is available, the decision as to who will
attend to the resident is to be made by the:: Administrator
7. 7) Federal law states that facilities must retain menus of food actually served for at least:: 30 days
8. 8) A resident with a living will and DPOA specified she wants to receive heroic measures if necessary. Six months
later the resident requires CPR, but is now incompetent and the son request CPR be withheld. What is the right thing to do?: Provide the CPR
9. 9) A resident asks to see his chart. The doctor tells the nurse not to allow the resident access to the chart. What
do you do?: Tell the doctor the law gives the resident the right to view the medical records
10. 10) Medical records belong to:: Facility
11. 11) When a resident passes away, the personal funds deposited with the facility must be given to the
resident's estate with a final accounting of the funds within:: 30 days
12. 12) The suffix "algia" refers to:: Pain
13. 13) Physical restraints must be removed:: Every two hours
14. 14) Depression is one of many psychological changes related to the aging process. Others include the following
except for:: Hearing loss
15. 15) "Nosocomal" refers to: Infection occurring inside the facility (institutional- ized)
16. 17) A capital budget is mostly about:: Equipment and real estate
17. 18) Current debts are debts that are:: Due within one year
18. 19) A ledger is a complete listing of:: Accounts payable and receivable
19. 20) Which resource usually provides the least revenue for a nursing home?: Insurance
2 / 14
20. 20) Past due accounts should not exceed:: 5%
21. 21) All of the following are a cash expense except:: Depreciation
22. 22) A pro forma is primarily: A financial statement or prediction
23. 23) A function of management is controlling, which means:: Measuring outcomes against benchmarks, then
responding
24. 24) OBRA requires every facility to have:: A governing body - The Omnibus Reconciliation Act
25. 25) Management by objectives means:: A system that determines goals and objectives
26. 26) Policies are:: General and flexible statements that guid thinking
27. 27) Procedures are:: Not flexable
28. 28) Short range (tactical) goals can be accomplished: In less than one year
29. 29) Policies should be developed by the:: Governing body
30. 30) The charge nurse is considered: Line level management
31. 31) McGregor's Theory X and Theory Y discuss individual's:: Employees's attitudes towards work
32. 32) Decision making requires all of the following except:: Controlling behav- ior
33. 33) Public relations has been defined as:: The management of communica- tions
34. 34) Strategic Planning is:: Long term plans based on the organizations overall business objectives
35. 35) Marketing should:: Increase and maintain census
36. 36) Keys to success in reducing turnover are all except:: Scheduling
37. 37) Which is not a recognized type of management?: Scalar Chain Manage- ment
38. 38) Unity of Command is:: Each person reports to one supervisor
39. 39) Speed is a communication barrier because, on average, a person speaks 180 words per minute, but
thinks at:: 300 words per minute
40. 40) The most overlooked aspect of communication in health facilities is:: Two way feedback loops
41. 41) Of the following, the task management performs that contribute most effectively and positively to morale
is:: Discipline consistentlyr and fairly
42. 42) In a bargaining unit, only need to sign a card to call a union election:: 30
percent
43. 44) During an interview or on a job application, you may ask for all except:-
: Place of Birth
44. 45) To be eligible for FMLA, an employee must first work: 1250 hours in the last 12 months
4 / 14 100 sq ft in private room window to outside
72. 72) OBRA requires housekeeping services necessary to: maintain a sani- tary, orderly, and clean interior
73. 73) Exposure Control Plan must be updated: Annually
74. HUMAN RESOURCES:
75. 74) Bargaining Unit: Workers identified by NlRB to form a group to unionize
76. 75) Construct Validity: Extent to which a tool measures a trait important to job performance
77. 76) Line management: Performs personnel functioned, delegated authority to make decisions
78. 77) Skill Analysis: identification of attributes required to
79. 78) Task Analysis: review of job description
80. 79) Employee Handbook: Policies related to work conditions
81. 80) Career Path: Avenues for upward mobility within organization
82. 81) Progressive Discipline: Use of specific number and type of warnings
83. 82) Job description: list of duties and responsibilities
84. 83) COLA: Group of temporary workers
85. 84) Election for unionization: Conducted by NLRB
86. 85) FLSA: minimum wage
87. 86) Halo Effect: One trait colors all performance
88. 87) In-Out migration: Movements of workers in and out of geographic area
89. 88) Pool: Group of temporary workers
90. 89) Labor Market: geographic area of recruitment
91. 90) Union election: NLRB conducts; 50% plus 1 potential bargaining unit mem- bers VOTING wins
92. LEADERSHIP AND MANAGEMENT (23% - 35 questions):
93. 91) Strategic Planning: setting long term goals
94. 92) Case mix: residents categorized by acuity
95. 93) Governing body: legally responsible for management
96. 94) Tactical planning: selecting goals for one year
97. 95) Management: achieve common goals thru organization
98. 96) Market segment: potential users of services
99. 97) Payor mix: residents categorized by payment type
100. 98) Rules: commands for action or non-action
101. 99) Procedures: required methods for handling activities
102. 100) Risk management: proactive means of anticipating problems
103. 101) Staff authority: advisory relationship with line management
5 / 14
104. 102) Forecasting: projects trends and needs which facility management must decide in future economic, social
and political environment expected and resources available.
105. 103) Bench Marking: improve business by comparing with best practice of others
(standards from which you measure)
106. 104) Upper-Level management: responsible for the overall functioning of the facility, normally interacting
directly with the Board of Directors and/or owners.
107. 105) Middle-Level management: report to upper-level while interacting with lower-level (DON)
108. 106) Lower-level management: directly supervise the staff who do the actual work
109. 107) Line Position (Authority):: empowered by administrator to make deci- sions for organization (DON can
fire, fire, give orders)
110. 108) Staff Position (Authority): not empowered to make decisions; duties are primarily to advise (consultants,
pharmacists, accountants, etc.)
111. 109) Functional Authority: action outside the normal lines of authority
1. Violates unity of command
2. Necessary due to principle of exception
The two often have edges of distinction blurred
112. 110) Actionable: conduct giving rise to legal action
113. 111) Aggrieved party: one whose rights invaded or who suffered injury
114. 112) Burden of proof: obligation of person bringing action
115. 113) Liable: written defamation
116. 114) Slander: verbal defamation
117. 115) Malice: intentional doing of wrongful act
118. 115) Tort: a wrong: legal duty owed, breached, and harm occured
119. 116) Worker Comp:: responsible for injuries occurring at work
120. 117) Scope of Employment:: range of employee activities (resident services by omission or commission)
121. 118) Governing:: excersis authority
122. 119) Advisory:: not binding
123. 120) Stewardship:: accumulation and use of assets
124. 121) Planning and monitoring:: goals and progress
125. 122) Determining Facility Objectives:: measurable, verifiable, and attainable
126. 123) Governing Body:: Approval of P & P Approval of budget
Selection and Appraisal of Administrator
127. FINANCE (14% - 21 questions):
7 / 14 place.
A. Advantage: Measure revenues earnings after expenses incurred; include depre- ciation, AP and AR
B. Disadvantage: Complexity
149. 145) Chart of accounts:: list of every account organized into: Assets, Liabilities, Capital,
Revenue, Expenses
150. 146) Assets:: things the facility OWN
151. 147) Liabilities:: things the facility OWES
152. 148) Capital:: Net worth or fund balance
153. 149) Revenues:: Earnings
154. 150) Expenses:: cost of personnel and supplies used in provision of service
155. 151) Journals:: books of original entry (the first place transactions are record- ed)
Cash receipts, billing, accounts payable (purchases), cash disbursements, payroll, general.
156. 152) General:: non-repetitive entries. Used to make adjustments to conform to accrual system.
157. 153) Double entry:: two entries for each transaction DEBIT and CREDIT
158. 154) General Ledger:: summary of all debits and credits contained in all the journals for the time period.
1. Continuous balance for each account monthly
2. Basis for "trail balance"
159. 156) Financial Statement:: summary of all transactions made in a particular time period and their effect on the
finances of the facility.
160. 157) Handling Cash: Two person procedure; one receives by opening mail or taking in person; the other
prepares bank deposit
161. 158) Collections: policy for deliquent bills. MUST BE CONSISTENT with all payment types; in not facility could
be charged with fraud.
162. 159) Payroll: largest expense (50-70% of operational) controlled by adminis- tration
separate bank account
163. 160) Residents' Accounts (Trust fund): Legally must provide Safe for cash and valuables
Separate accounting Interest Bearing - amounts over $50.
164. 161) Cost Per Patient Day =: Total cost/census days
165. RESIDENT CARE & QUALITY OF LIFE (35% - 52 questions):
8 / 14
166. 162) Nursing Assistant Training: 75 hour course and exams plus continuing in service
167. 164) Excess Disability: Avoidable Dysfunction
168. 165) PASAAR: Insures appropriate treatment for MR/MI population
169. 166) Function: Focus of Rehab
170. 167) Pharmacist: Monthly drug review/Audits
171. 168) Basis for Menu: Basic 4 plus recommended daily allowances
172. 168) Nursing Assistants: Provide most direct care
173. 169) OBRA ^87: Conditions to participate in Medicare and Medicaid
174. 170) MDS: Comprehensive Assessment within 14 days of admission
175. 171) Physician Extenders: Nurse Practitioner, Clinical Nurse Specialist or Physician Assistant
176. 172) Licensed Nurse: Charge Nurse on each tour of duty
177. 173) Time between Super and Breakfast: 14 hours
178. 174) RN Coverage: 8 consecutive hours, 7 days per week
179. 175) Frequency of Activities: 7 days per week during hours requested
180. 176) Frequency of Doctor Visits: Every 30 days for first 90 days, then every 60 days
181. 177) Access to records: 24 hours of request
182. 178) Care Plans: 21 days after admissions
183. 179) Required in service for CENA: 12 hours per year
184. 180) QA meetings: Quarterly
185. 181) Work before NA certified: 4 months
186. 182) Interest Bearing accounts: trust funds greater than $
187. 183) Involuntary Transfer Notice: 30 days
188. 184) CVA: Stroke
189. 185) COPD: Emphysema, Asthma, Bronchitis
190. 186) ac: before meals
191. 187) Meal service:: Key to high resident morale.
3-5 meals per day with no more than 14 hours btw evening meal and next breakfast (16 if HS snack)
192. 188) Dishwashing: wash at 150 to 1600 degrees F
193. 189) Hot food tray: leave tray line above 140 degrees F
194. 190) Cold food: leave tray line at less than 41*F
195. 191) Freezer: 0* - 20* F
196. 192) Refrigeration: 32* - 45*F
197. 193) Storage: room temperature
198. 194) RDA: Recommended Daily Allowance
Bread: 4 servings
10 / 14
206. In recent years Medicare has: shifted more cost onto nursing facilities
207. The nurse newly promoted to director of nurses (DON) insist on giving four RN hours of patient care each day
on the Alzheimer's wing in the 175-bed facility. The administrator should: Seek a new DON
208. The applicant for the administrator position in a facility near a larger teaching hospital who insists that, if
hired, as before with his rural facility, he would not let Medicare reimbursement policies affect his case mix: Is out of touch
209. The newly hired assistant to the administrator insists the organizational chart line btw his position and the
Department of Nursing be a solid line. The administrator should: Be forwarned
210. The medical supplies provider tells the administrator of the facility that has not paid bills the past 3 months,
but is now operating under bankruptcy juge's approved plan for restructuring, that no more deliveries will be made until past bills are fully paid. The medical supply provider: does not understand how bankruptsy works
211. An administrator who adopts the management-by-walking-around (MBWA) approach by walking through the
facility and intently observing week- ly has: Failed to understand MBWA
212. Management-by-walking-around (MBWA): style of business management which involves managers wandering
around, in an unstructured manner, through the workplace(s), at random, to check with employees, or equipment, about the staus of ongoing work
213. The nursing home administrator who, using the management-by-walk- ing-around (MBWA) technique,
succeeds in atually making appropriate cor- rections on the spot during his rounds: Doesnt understand (MBWA)
214. The applicant for administrator of the facility insist that he has succcess- fuly used democrate leadership to
the exclusion of all other leadership styles. The intervier should: continue to interview candidates
215. The candidate for administrator said she used a variety of administrative styles, but could't say exactly which
she would use in every circumstance. The interviewer should be: favorable impress
216. The candidate for administrator indicated that she consistently choose the charismatic style of leadership.
This should the interviewer.: - Alert
217. The cost of providing subacute care to nursing home residents
: Is perhaps triple that of more typical patient
218. The nurse supervisor who had just been appointed DON announced at the first department head meeting
that she had circulated a memo among the
11 / 14 nurses that only formal communications were to be allowed in the nursing department. The administrator should: Anticipate problems
219. The department head was not surprised to learn that the employee had only heard his positive comments to
the employee and ignored his criticism. The department head's grasp of the communicationn process is: Appropriate
220. The administrator routinely accepted as his nearly exclusive information source the director of nursing's
positive reports on how nursing was going well. The administrator is: Placing him at risk
221. Periodic shortage of nurses available for nursing home employment
: Is likely to remain for the foreseeable future
222. Congress and the Federal rule makers behave as if the facility will run successfully if congress and CMS can
write enough rules. They are: Incorrect
223. When the administrator notices the DON seeks to turn many duties as possible over to housekeeping, the
administrator should conclude that the DON is: Behaving normally
224. The administrator insist that a timely copy of all reports generated within the facility come across her desk
before anyone signs them. The administrator is : Not rationalizing her managemnt information system
225. The administrator notices that incident reports are being insufficiently filled out, but does nothing, believing
that the situation will likely correct itself. The administrator is : Failing to control effectively
226. Corporate sends a directive its flagship facility administrator, directing the administrator's attention more
towards outcome of resident care than cost of resident care during the coming 12 months. Corporate is more concerned with than with .: Effectiveness/efficiency
227. The long term care sector receiving increased funding and attention from the federal government is the .:
Home health care sector
228. The concept that nursing homes should be reimbursed by states for their actual costs was part of the :
Hatch Amendment
229. The intense health care cost-shifting efforts among providers such as Medicare, Medicaid and local
governments is : Likely to continue
230. Worried about the level of actual resident care being achieved in the facility, the administrator directs the
nurses to spend less time charting and more time focusing on the effeciveness of care being given to residents. The likely result will be : Better resident care, possible increase in deficiency citations
231. The new social worker informs the head of nursing that admissions is all she has time for and that nursing
must monitor and document each resident's socipsychological experience.: Responding appropriately to priorities
13 / 14
246. In the end, it can be said that the administrator's responsiblity to meet resident care needs and facility
needs ae : Both are equal
247. Superior performance depends on taking exceptional care of residents via superior service and :
Constant innovations
248. Superior performance for a nursing facility comes through : Innovation in
ways to serve residents
249. The supeb nursingb facility is supurb by virtue of its : Success in
serving the residents
250. Answering the phones and resident call bells with common courtesy and doing things that work are examples
of : A blind flash of the obvious
251. Giving every employee the space to innovate at least a little; listening to residents and acting on their ideas;
and wandering around with residents, staff, and suppliers are examples of the different-to-achieve : Com- mon sense, obvious
252. In a facility of 120 beds, the administrator personally performs each of the
management tasks.: Need not
253. To assure that all the management tasks are successfully accomplished, the administrator of a 120-bed facility
will typically divide management into : Three layers
254. A licensed person responsible for formulating and enforcing policies that will be applied to an entire facility is
thought of as a/an : Upper-level manager
255. The staff member responsible for reporting to upper-level management and at the same time interacting
significantly with several lower-level man- agers is the : Director of Nursing
256. The staff person for whom both upward and downward communication skills are most neccessary is the :
Director of nursing
257. When the director of nursing makes an effective policy decision without consulting the administrator, that
impacts all nursing personnel, the adminis- trator should : Be pleased
258. In the typical nursing facility, the decision-making process is
establishment of lower, middle, and upper levels of management.: Noticeably more complicated than the simple
259. Among the following positions the has no authority to make deci- sions for the
facility.: Assitant to the Administrator
260. Decisions made by persons on the staff to whom the administrator has deligated line authority are, in the
final analysis, regaurded as decisions by .: The administrator
14 / 14
261. When a nurse practitioner, who is more highly qualified than the director of nursing, gives orders in the
hallways, the director of nursing should feel : Undermined
262. In times of crisis, corporate representatives, who hold a staff or advisory relationship to their counterparts in
the local facility, may expect that their advice as staff be : Acted on as carrying line authority
263. As a generalization, it can be asserted that management success belongs to those who : success prepared
for the future
264. Nursing home administrators should anticipate and successfully prepare for : Rapid change
265. The long-term care industry entered a period in which chang(s) can be
expected.: Rapid and far reaching
