Continuing education test #89 * based on nursing homes September 2004.

How to use this self-study program

* Take the Pre-Test before you begin to read this issue of Nursing Homes/Long Term Care Management.

* After reading the articles, complete the Test and Evaluation Section.

* If your score is 70% or above, we will send you a certificate of completion and notify the state(s) that you indicate. If your score is less than 70%, you may retake the test.

* Please include your license numbers for each state (NHA licenses only).

* Tests will be graded and state boards notified within three (3) weeks of receipt.

* According to the ACHCA Code of Ethics, "Preservation of the highest standards of integrity and ethical principles is vital to the successful discharge of the professional responsibilities of all long-term care administrators." You are expected to complete this program according to these guidelines.

* Each Post-Test is approved for 2 CE Credits for nursing home administrators and 2.4 Contact Hours for nurses.

* Not all states accept self-study programs for credit. Check with your state to confirm restrictions. If you feel that you have benefited from this program, please encourage your state to change its policy.

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PRE-TEST

1. According to national data, how many falls per year are the underlying cause of death for patients over age 65?

a. 2,500

b. 5,000

c. 10,000

d. 15,000

2. Recent data suggest that the leading causes of nursing home fires occur in:

a. HVAC systems and laundry areas.

b. cooking and laundry areas.

c. wiring and HVAC systems.

d. resident rooms.

POST-TEST

1. In the article "An All-Out Attack on Falls," the most recent addition to the Kings Harbor risk management team was the:

a. Director of Rehabilitation.

b. Engineering Department representative.

c. Medical Director.

d. Activities Director.

2. According to Braun ("Fire Safety: Is Your Facility Legal?"), how often must nursing homes receiving Medicare and Medicaid payment be surveyed for compliance with the NFPA Life Safety Code?:

a. at least every 6 months

b. at least every 15 months

c. at least every 12 months

d. at least every 18 months

3. Nursing homes, says Braun, can address cited deficiencies in all of the following ways except:

a. submit a plan of correction.

b. obtain a waiver from CMS.

c. have a reinspection by local fire officials.

d. undergo a Fire Safety Evaluation System inspection.

4. Which of the following is not a factor in scalding risk, as stated by Fathers ("Bathing Safety for the Elderly and Disabled")?

a. residents' slower reflexes

b. inability of some residents to control temperature

c. bathwater additives

d. leaving resident unattended for a long time

5. According to Fathers, to effectively eliminate biofilms in the water system:

a. combine 140[degrees]F heated water with constant circulation and thermostatic/pressure balancing valve technology.

b. distribute water heated to 120[degrees]F.

c. superheat and flush water lines and fittings.

d. use high concentrations of chlorine in plumbing system.

6. As stated by Boczko ("Managing Dysphagia in Dementia: A Timed Snack Protocol"), handheld, highly spiced or sweetened snacks should be given to the resident:

a. upon request.

b. four times a day at sporadic intervals.

c. when available throughout the day.

d. at regular predetermined intervals.

7. Physiologic and sensory changes in the elderly that affect food intake include which of the following?

a. decreased taste and smell

b. decrease in flexibility of swallowing structures

c. decreased cognition

d. all of the above

8. With which statement would Gross ("Missing: Death Education for Nursing Facilities") disagree?

a. Everyone in contact with a dying resident should be educated on death.

b. Harp music may cause anxiety to a dying resident.

c. A remembrance service provides closure to those who knew the deceased.

d. Some nursing homes have on-staff chaplains.

9. According to Clay ("Preventing Pressure Ulcers in Your Facility"), where is the second most common site of pressure ulcers?

a. the sacrum

b. the elbow area

c. the heel area

d. the buttocks

10. Willging ("Decide What You Want From Satisfaction Surveys") suggests the following ways to measure satisfaction except:

a. make use of focus groups.

b. measure other attributes, such as affordability.

c. pay more attention to the dissatisfied minority of clients than the satisfied majority.

d. generate useful data.

11. For complete and timely MDS documentation of therapy services, Underwood (Survey Survival) does not recommend:

a. one-person responsibility.

b. establish clear expectations.

c. regular education.

d. updating resource tools.

12. According to Oatway (Computer Technology), all of the following conditions must be met before the widespread adoption of electronic health records except:

a. the records must be guaranteed to be authentic.

b. the records process must obtain OIG approval.

c. the records process must meet HIPAA privacy requirements.

d. the records must be readily available.

POST-TEST EVALUATION

The material in this issue on fall-improvement initiatives was:

___ informative

___ very interesting

___ not interesting

My knowledge of fire safety regulations was:

___ increased considerably

___ increased somewhat

___ unchanged

The article on the timed snack program was:

___ very helpful

___ somewhat helpful

___ not much help

In understanding the material covered in this issue of Nursing Homes/Long Term Care Management, the ACHCA testing process was:

___ very helpful

___ somewhat helpful

___ not much help

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PRE-TEST ANSWERS

 1.  c.
 2.  b.

POST-TEST
(Circle the most appropriate answer)

 1.  a   b   c   d
 2.  a   b   c   d
 3.  a   b   c   d
 4.  a   b   c   d
 5.  a   b   c   d
 6.  a   b   c   d
 7.  a   b   c   d
 8.  a   b   c   d
 9.  a   b   c   d
10.  a   b   c   d
11.  a   b   c   d
12.  a   b   c   d