Care Facility Regulations Quiz

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Questions and Answers

What defines a resident who is considered 'alert and oriented'?

They know who they are and where they are. (correct)

They require total care for daily activities.

They suffer from a severe mental health disorder.

They can meet their own daily care needs.

Which group of residents requires complete assistance and cannot understand their own needs?

Persons needing respite care

Persons needing complete care (correct)

Life long residents

Short term residents

What is the primary goal for short term residents recovering from injuries?

To receive end of life care.

To achieve optimal function and return home. (correct)

To maintain lifelong assistance.

To provide respite for caregivers.

What do OBRA standards primarily focus on regarding resident rights?

Protecting and promoting the resident's rights. (B) Signup and view all the answers

What behavior is expected from staff during the survey process?

Promoting quality of life and health through observation. (A) Signup and view all the answers

What is the role of an ombudsman in a care facility?

To support or promote the needs and interests of another person (D) Signup and view all the answers

Which of the following is a requirement of OBRA regarding nursing assistants?

Completion of 75 hours of instruction (D) Signup and view all the answers

What does the term 'involuntary seclusion' refer to?

Separating a person from others against their will (C) Signup and view all the answers

What is required for a nursing assistant to maintain their registry status according to OBRA?

Complete 12 hours of education every year (A) Signup and view all the answers

Which of the following accurately describes the 'representative' in a care context?

A person with the legal right to act on behalf of a patient or resident (D) Signup and view all the answers

Which nursing pattern is focused on the individual's total care?

Primary nursing (B) Signup and view all the answers

What is the main focus of functional nursing?

Task completion (B) Signup and view all the answers

Which program provides health insurance for people aged 65 and older?

Medicare (D) Signup and view all the answers

What type of care does a memory care unit provide?

Safe environment for dementia patients (A) Signup and view all the answers

Which additional service does Part B of Medicare cover?

Preventive care (C) Signup and view all the answers

What is the purpose of the Health Insurance Marketplace?

Allow individuals to shop for affordable health insurance (D) Signup and view all the answers

Which care is typically not covered by health insurance?

All costs related to experimental treatments (A) Signup and view all the answers

What is a characteristic of long-term care centers?

Care for patients recovering from acute illness or surgery (D) Signup and view all the answers

What characterizes an acute illness?

It has a rapid onset and is expected to recover in a short duration. (A) Signup and view all the answers

Which of the following accurately describes a chronic illness?

An illness that has no cure but can be managed or prevented. (A) Signup and view all the answers

What must an individual do if they have not worked for 24 months?

Both retraining and a new competency evaluation are required (A) Signup and view all the answers

In which settings is a 'resident' typically found?

In a long-term care center. (B) Signup and view all the answers

Which of the following is NOT one of the five rights of delegation?

Right behavior (D) Signup and view all the answers

What is the primary responsibility when accepting a task?

Complete the task safely and responsibly (D) Signup and view all the answers

Which tasks are included in personal care in assisted living residences (ALR)?

Bathing, dressing, and grooming. (A) Signup and view all the answers

Which action is an example of battery?

Physically touching a person without consent (D) Signup and view all the answers

What does the 'delegation process' entail?

It is a formal process that requires the nurse's judgement and knowledge. (D) Signup and view all the answers

What is the role of a certified nursing assistant (CNA) in delegation?

They can accept or refuse tasks within their job description. (D) Signup and view all the answers

What defines a boundary violation in a professional setting?

Engaging in behavior that satisfies personal needs instead of the person's (D) Signup and view all the answers

Who can a registered nurse (RN) delegate tasks to?

Licensed practical nurses, certified nursing assistants, or unlicensed personnel. (B) Signup and view all the answers

What is categorized as an unintentional tort?

Neglecting the standard of care (A) Signup and view all the answers

Which legal term describes the unlawful restraint of a person's freedom of movement?

False imprisonment (B) Signup and view all the answers

What right does a healthcare worker have if they believe a task exceeds their qualifications?

To refuse the task based on safety concerns or lack of training (B) Signup and view all the answers

What steps should be followed in resolving a problem?

Define, collect information, identify solutions, carry out solution, evaluate results (A) Signup and view all the answers

Which of the following is NOT considered a courtesy in communication?

Interrupting during discussions (C) Signup and view all the answers

What is the proper way to resign from a job?

Give a 2-week notice and state the reason for leaving (C) Signup and view all the answers

What does choking indicate during an emergency?

An obstruction in the airway (A) Signup and view all the answers

Which of the following best describes 'job safety'?

Following agency rules and understanding your responsibilities (D) Signup and view all the answers

Which identifiers should be used when identifying nursing center residents?

Name and date of birth (C) Signup and view all the answers

What is a common cause of burns that must be prevented?

Electrical items (C) Signup and view all the answers

Which of these correctly defines dementia?

A gradual loss of cognitive and social function (B) Signup and view all the answers

What characterizes a terminal illness?

It is an illness from which a person will most likely not recover. (A) Signup and view all the answers

Which of the following accurately reflects the delegation process in healthcare?

The process includes assessment, communication, guidance, and follow-up. (C) Signup and view all the answers

What is one responsibility that a certified nursing assistant (CNA) has when accepting a delegated task?

To ensure they can perform the task safely and responsibly. (A) Signup and view all the answers

Which type of care is typically provided in an assisted living residence (ALR)?

Personal care along with support for independent living. (D) Signup and view all the answers

Who can a licensed practical nurse (LPN) delegate tasks to?

Certified nursing assistants (CNAs) only. (B) Signup and view all the answers

Which item should be put on first when donning personal protective equipment (PPE)?

Gown (B) Signup and view all the answers

What is a common emotional response from patients when isolated due to infection control measures?

Sadness (B) Signup and view all the answers

What is the primary role of a 'reservoir' in the chain of infection?

To provide a place for pathogen growth (A) Signup and view all the answers

In applying PPE, which item is put on last?

Gloves (C) Signup and view all the answers

Which of the following best describes the term 'susceptible host'?

A person who may develop an infection due to weakened immunity (A) Signup and view all the answers

What is the correct order for removing PPE?

Gloves, Goggles, Gown, Mask (D) Signup and view all the answers

Which of the following methods of transmission involves the spread of pathogens through the air?

Airborne transmission (A) Signup and view all the answers

What is a common misconception about the role of a caregiver in infection control?

Infection control is solely the responsibility of medical staff. (C) Signup and view all the answers

What is the correct procedure for resigning from a job?

Give a 2 week notice along with a reason for leaving (C) Signup and view all the answers

Which action is appropriate when dealing with personal matters at work?

Ensure that personal matters do not interfere with your job (A) Signup and view all the answers

Which of the following is classified as a form of workplace violence?

Physical assault directed towards staff (C) Signup and view all the answers

What is the primary method to identify nursing center residents?

Use ID bracelets and compare them with name and DOB (C) Signup and view all the answers

What is the best way to prevent burns in a healthcare setting?

Monitor smoking and hot liquids carefully (A) Signup and view all the answers

What is the first step in the RACE protocol for fire safety?

Rescue individuals in danger from the fire (B) Signup and view all the answers

Which statement is true regarding choking emergencies?

Clutching at the throat is a universal sign of choking (B) Signup and view all the answers

How should hazardous substances be handled in the workplace?

Label with pictograms to indicate risks (A) Signup and view all the answers

In what situation are transmission-based precautions necessary?

When a patient has or may have certain infections (D) Signup and view all the answers

What is the main focus of standard precautions in healthcare?

To apply protective measures universally (B) Signup and view all the answers

Which statement correctly describes disinfection procedures?

Using utility gloves can prevent skin irritation during disinfection (D) Signup and view all the answers

What must be done when using a sterilized piece of equipment?

Inspect for any visible damage or defects (A) Signup and view all the answers

Which term refers to the health care-associated infection developed from inadequate cleanliness?

Contamination (B) Signup and view all the answers

What identifies the yellow wristband in a healthcare setting?

Signifies a fall risk (D) Signup and view all the answers

What information is NOT typically included in a nursing assistant's record?

Previous work experience (D) Signup and view all the answers

Which of the following accurately describes the concept of scope of practice?

The legal limits of a healthcare worker's role (B) Signup and view all the answers

Which of the following is NOT a type of elder abuse?

Social neglect (C) Signup and view all the answers

What is the primary responsibility of a nursing assistant when a task is accepted?

To complete the task safely (C) Signup and view all the answers

What action is considered a boundary violation?

Taking personal information for your own benefit (B) Signup and view all the answers

Which of the following acts is categorized as a tort?

Failing to provide necessary medical treatment (D) Signup and view all the answers

Which statement accurately defines informed consent?

The process where a person receives and understands information about a treatment (B) Signup and view all the answers

What constitutes abuse in a healthcare setting?

Willingful infliction of pain or suffering (A) Signup and view all the answers

Which of the following actions should a nursing assistant take if a task exceeds their qualifications?

Refuse the task and report the situation (B) Signup and view all the answers

What does the right to refuse a task entail for a nursing assistant?

Refusal must be based on lack of training or safety concerns (D) Signup and view all the answers

Which of these is a key component of ethical behavior in a healthcare environment?

Knowing what constitutes right and wrong conduct (C) Signup and view all the answers

What type of abuse is characterized by the intentional use of force that results in injury?

Physical abuse (B) Signup and view all the answers

Which of the following best describes the responsibility of a nurse with respect to consent?

Providing patients with information to make informed decisions (D) Signup and view all the answers

What is considered a primary factor in resolving workplace conflicts?

Collecting information about the problem and discussing it (C) Signup and view all the answers

Which of the following best describes the purpose of case management in nursing care?

Coordinating care during discharge and transition into home or long-term care (A) Signup and view all the answers

In a nursing center, which category of residents would require lifelong assistance due to disabilities from birth?

Life long residents (C) Signup and view all the answers

What is a key feature of the Patient Protection and Affordable Care Act (ACA)?

It helps people shop for and enroll in affordable health insurance (D) Signup and view all the answers

Which of the following roles is primarily responsible for advocating for the rights and needs of residents in care facilities?

Ombudsman (D) Signup and view all the answers

What is true regarding the coverage provided by Medicare Part A?

Includes hospital stays and hospice care (B) Signup and view all the answers

Which type of nursing pattern is characterized by a focus on specific tasks and jobs rather than overall patient care?

Functional nursing (A) Signup and view all the answers

What is the primary goal for residents receiving hospice care?

To promote comfort and quality of life in their final days (B) Signup and view all the answers

Which of the following rights ensures that a resident's movements are not restricted without proper medical justification?

Freedom from restraints (D) Signup and view all the answers

In which situation would a resident typically require respite care?

When a caregiver needs temporary relief (D) Signup and view all the answers

Which program offers health insurance to individuals and families purchasing it independently?

Private insurance (C) Signup and view all the answers

What defines the role of a representative in a healthcare context?

An individual with legal authority to act on behalf of a patient (D) Signup and view all the answers

What is a primary responsibility of healthcare workers during the survey process?

To ensure adherence to agency policies and procedures (A) Signup and view all the answers

Which aspect of care does the nursing care pattern of primary nursing focus on?

Comprehensive and personalized care for individuals (D) Signup and view all the answers

Which of the following best describes how Medicaid operates?

It provides assistance based on income and is jointly funded by federal and state governments (A) Signup and view all the answers

Study Notes

Quiz 1

Acute illness: rapid onset, short duration, expected recovery
Chronic illness: no cure, preventable
Terminal illness: illness where recovery is unlikely
Functional nursing: focus on tasks and jobs
Hospital patient: person receiving care in a hospital
Long-term care resident: person residing in a long-term care center
Assist living residence (ALR): provides housing, personal care, home-like setting; includes personal care (bathing, dressing, grooming), meals (cooking, eating), housekeeping, personal safety, and transportation
Delegation: nurse directs nursing assistant to perform a task; requires nurse's knowledge and judgment; process includes assessment of needs, communication, guidance & assistance, and follow-up & feedback (remember ANCGAFF)
Registered Nurse (RN): completed 2-4 year program, passed license test, delegates to LPN, CNA
Licensed Practical Nurse (LPN): completed practical nursing program, passed license test, can delegate to CNA; used in California and Texas
Licensed Vocational Nurse (LVN): used in California and Texas, can delegate to CNA
Certified Nursing Assistant (CNA): passed nursing assistant training and competency evaluation program (NATCEP), performs tasks under supervision of a licensed nurse, cannot delegate

Nursing Team and Care Patterns

Health team: includes many health care workers with skills and knowledge focusing on total person care (interdisciplinary team)
Nursing team: RN, LPN/LVN, CNA; part of interdisciplinary team
Nursing care patterns: depend on number of persons needing care, staff, and cost; include functional nursing, team nursing, primary nursing, case management, and patient-focused care. (remember FTPCP)

Long-Term Care Centers and Hospices

Long-term care centers: patients usually recovering from illness or surgery, some need home care, others need care until able to go home, some need care until death
Memory care unit: designed for people with Alzheimer's and dementia, unit is usually separate for safety
Hospices: health care agency promoting comfort and quality life for the dying person and family (less than 6 months to live)

Paying for Healthcare

Private insurance: bought by individuals and families
Group insurance: bought by groups and organizations
Medicare: federal program for those 65+ and younger with certain disabilities; Part A (hospital, SNF, hospice, and home care), Part B (doctor services, preventive care, ambulance services, medical supplies, mental health care, and some drugs) - voluntary, monthly premium
Medicaid: jointly funded by federal and state, for low-income people
Health insurance marketplace: service helps people shop for and enroll in affordable insurance (ACA/Affordable Care Act of 2010)

Resident Rights

OBRA (Omnibus Budget Reconciliation Act of 1987): sets minimum standards for care quality in nursing centers
Surveys: surveyors observe staff behavior and actions to ensure standards are met and promote quality of life, health, and safety
Residents rights: to be treated with dignity and respect, exercise rights, be informed of rights and rules, access their records, refuse treatment, make advance directives, know their health status, manage personal and financial affairs, and have privacy rights

Competency Evaluation and Certification

Competency evaluation: written and skills test (3 attempts after training)
Nursing assistant registry: official record of completed NATCEP in each state
Registry information: full name, identifying information, date NATCEP was passed, and information about findings of abuse, neglect, or dishonest use of property
Certification: official recognition by a state that standards have been met; recertification required after 24 months without work
Maintaining competence: nursing assistants require 12 hours of education every year. Those not working for 24 months need a new competency evaluation

Rules for Nursing Assistants

Role of nursing assistant: assistant to nurse; reports observations and changes; performs only trained tasks, asks nurse for guidance if unsure; performs tasks within job description and state regulations
Delegation rights: (Right person, Right task, Right circumstance, Right directions, Right supervision, and Right evaluation - remember TCPDCSE)

Role Limits

Never give drugs: nurses provide medication/ state-approved programs may allow exceptions
Never insert tubes or objects: exceptions exist for training procedures
Never take oral or phone orders: have the doctor wait for a nurse (politely)
Never diagnose or prescribe: nurses clarify information from the doctor; doctors and advanced practice nurses diagnose and prescribe
Never supervise others: nurses are responsible for supervising; severe legal problems result if not followed
Never ignore an order or request: politely explain limitations; cannot neglect the person's care

Safety Needs /Safety Measures

Safety in health care: following center policy and care plan
Patient identification: includes name, date of birth, ID number, room, and bed number
Prevent burns: common causes include smoking, spilled hot liquids, electrical items, very hot water
Poisoning: keep harmful substances away from containers, read labels carefully
Choking: foreign body airway obstruction (FBAO); common cause is poorly chewed food
Safety measures include wiping up spills, preventing unsafe situations (ex. a person sliding out of a wheelchair), offering help, following agency protocol, addressing electrical outlets or switches that don't work, water leaks, broken windows/doors/fixtures, odours or smells in patient areas, and more.

Other Important Terms

Informed consent: process where the person receives information about a treatment or procedure and can decide whether to receive it or not
Communication: different ways of giving consent: written, verbal, or implied; explained to the person; allowing person to refuse any procedure at any time
Abuse: assault (attempting to touch without consent) or battery (touching without consent), boundary crossing, boundary violation (meets your needs, not the person's), defamation (false statement to a third person), libel (false statement in writing), slander (false statement verbally), false imprisonment (unlawful restraint of movement), ethics (knowing right vs wrong conduct), medical battery (giving treatment to someone who refused), malpractice (giving wrong care), unintentional torts, and intentional torts
Criminal laws: acts violating rules like murder, rape, and robbery (harm was intended)
Civil laws (family, relationships): concerned with relationships between people (tort); elder abuse (negligent act by a caregiver causing harm or risk of harm to an older adult) - types: physical, neglect, financial, emotional/psychological, sexual, and abandonment
Workplace violence: actions towards persons at work, when on duty
Cleaning procedures: including wiping spills, using paper towels, cleaning floors with a mop and disinfectant/ sanitizing agents
Disinfection: methods of cleaning/ removing pathogenic substances (chemical disinfectants)

Professional Appearance

Uniforms: must follow agency dress codes
Jewelry: limited to simple, allowed jewelry
Hair: simple style away from the face
Nails: clean, short, and neatly shaped; no non-natural nails; light-colored polish is sometimes allowed
Makeup: moderate in color and amount
Fragrances: never allowed; perfumes, colognes, or aftershave are not permitted

Work Ethics

Caring: showing concern for the person
Cheerful: greeting others pleasantly
Conscientious: following instructions carefully and protecting the person's property, belongings
Considerate: respecting the person's feelings
Cooperative: helping others willingly during busy times
Courteous: being polite
Dependable: arriving on time and completing tasks
Empathy: put self in the other person's place
Enthusiastic: being excited about the work performed
Honest: accurately reporting care, observations, and errors
Patient: coping calmly with problems or delays
Respectful: treating others with dignity

Planning and Prioritization

Planning work: deciding what to do and when; prioritizing most important tasks
Meals and breaks: usually 30 minutes or 15 minutes, nurse should be on time when leaving or returning from breaks.
Conflict resolution: dealing with problems or opposing ideas or conflicting interest to resolve and find solutions to problems.

Job Safety and Responsibility; Resigning

Job safety: always prioritizing protection from harm, follow agency procedures, and know your capabilities and limitations
Resigning from a job: providing 2 weeks’ of notice, explaining reasons behind leaving the job
Personal matters: personal issues like making phone calls or visitors must be managed during breaktimes with no interference to training.

Other

Chapter 5 key terms: gossip, stress, harassment (causes harm, trouble, and offense)
Chapter 11 key terms: severe and life-threatening issues and states that have occurred such as coma, dementia, suffocation, elopement, paralysis, disaster, and others
RACE (Rescue, Alarm, Contain, Extinguish) and PASS (Pull, Aim, Squeeze, Sweep).

Communication

Informed consent: different ways of giving consent: written, verbal, or implied; explained to the person; allowing person to refuse any procedure at any time
Other communication issues: (not allowed) (gossip, stress, and harassment)

Transmission-Based Precautions

Contact: single room preferred or 3 ft separation
Droplet: mask upon entry, other PPE as needed
Airborne: special room (or transfer to agency with one), and respirator upon entry, other PPE as needed.

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Description

Test your knowledge on resident care standards, including OBRA regulations and the roles of staff and ombudsmen in care facilities. This quiz covers essential definitions and goals related to the care of residents, particularly those with varying levels of alertness and independence. Enhance your understanding of resident rights and the responsibilities of nursing assistants.