Advanced Professional Practice Flashcards

A CMD is updating the facility's advance directive policy. Which statement about POLST (Physician Orders for Life-Sustaining Treatment) is MOST accurate?

Answer: POLST translates advance directive wishes into actionable medical orders and is honored across care settings

POLST converts patient wishes into portable, immediately actionable medical orders that are recognized and honored across different care settings including LTC, home, and acute care.

In a skilled nursing facility, which of the following is the CMD's MOST important role during a state survey?

Answer: Being available as a resource, ensuring clinical policies are defensible, and supporting staff in providing clinical rationale for care decisions

During surveys, the CMD serves as a clinical resource and ensures that care decisions have documented clinical rationale consistent with established policies and standards.

A CMD receives a report that a nurse aide has been witnessed providing rough physical care to a resident. What is the IMMEDIATE required action?

Answer: Remove the aide from resident contact, ensure resident safety, and initiate mandatory abuse reporting per state law and facility policy

Suspected abuse requires immediate removal of the alleged perpetrator from resident contact, medical evaluation of the resident, and mandatory reporting to the state agency per OBRA requirements.

A resident with end-stage COPD is increasingly dyspneic despite maximum bronchodilator therapy. The resident has an advance directive requesting comfort care. What is the MOST appropriate CMD guidance?

Answer: Transition to a palliative comfort-focused regimen including opioids for dyspnea relief, consistent with the resident's expressed wishes

Evidence supports opioids as effective and ethical treatment for refractory dyspnea in terminal illness, and honoring the resident's comfort care directive is the standard of care.

Which data element is MOST useful to the CMD when monitoring the effectiveness of a facility's infection prevention program?

Answer: Infection rates stratified by infection type compared to baseline and national benchmarks

Infection rates stratified by type and compared against baseline trends and national benchmarks provide the most meaningful outcome data for evaluating infection prevention program effectiveness.

A CMD is developing a delirium identification and management protocol. Which tool is MOST validated for delirium screening in long-term care residents?

Answer: Confusion Assessment Method (CAM)

The Confusion Assessment Method (CAM) is the most widely validated and used tool for detecting delirium across care settings including long-term care.

A CMD is asked to participate in developing the facility's emergency preparedness plan. What is the CMD's MOST critical contribution?

Answer: Providing clinical guidance on managing medically complex residents during evacuation, shelter-in-place, and resource-limited scenarios

The CMD's primary value in emergency preparedness is ensuring the plan addresses the clinical needs of medically complex residents across all hazard scenarios.