CNHA Resident Care and Services 2 — Questions and Answers
Question 1: Under federal regulations, how quickly must a nursing facility notify a resident's family of a significant change in the resident's condition?
- As soon as practicable (Correct answer)
- Within 72 hours
- Within 7 days
- At the next scheduled care conference
Correct answer: As soon as practicable
CMS regulations require nursing facilities to notify the resident's physician and legal representative or family member as soon as practicable when there is a significant change in the resident's condition.
Question 2: Which of the following best describes 'person-centered care' as applied in nursing home administration?
- Care that reflects the resident's preferences, values, and goals (Correct answer)
- Care that maximizes clinical efficiency
- Care dictated solely by physician orders
- Care based on the facility's standardized protocols
Correct answer: Care that reflects the resident's preferences, values, and goals
Person-centered care in nursing homes means tailoring all services and interventions to align with each resident's individual preferences, values, history, and goals.
Question 3: A resident is at high risk for pressure ulcers. Which of the following is the administrator's primary responsibility in this situation?
- Ensure the care plan includes evidence-based prevention interventions (Correct answer)
- Personally reposition the resident every two hours
- Transfer the resident to a hospital
- Reduce the resident's caloric intake
Correct answer: Ensure the care plan includes evidence-based prevention interventions
The administrator's role is to ensure systems and care plans are in place with evidence-based interventions to prevent pressure ulcers, not to provide direct clinical care.
Question 4: What does the term 'restraint-free environment' mean in a certified nursing facility?
- Physical and chemical restraints are used only when clinically justified with informed consent (Correct answer)
- No restraints of any kind are ever used under any circumstances
- Restraints are used based on staff convenience
- Restraints require only physician approval without resident consent
Correct answer: Physical and chemical restraints are used only when clinically justified with informed consent
A restraint-free environment means physical and chemical restraints are minimized and used only when clinically necessary, with proper informed consent and documentation.
Question 5: Which act specifically strengthened resident rights in nursing homes by establishing the Long-Term Care Ombudsman Program?
- Older Americans Act (Correct answer)
- Social Security Act
- Americans with Disabilities Act
- Medicare Prescription Drug Improvement Act
Correct answer: Older Americans Act
The Older Americans Act established and funds the Long-Term Care Ombudsman Program, which advocates for the rights and well-being of nursing home residents.
Question 6: A resident with dementia is unable to make informed decisions. Who is authorized to make care decisions on their behalf?
- The legally designated surrogate decision-maker or healthcare proxy (Correct answer)
- The attending physician exclusively
- The Director of Nursing
- The nursing home administrator
Correct answer: The legally designated surrogate decision-maker or healthcare proxy
When a resident lacks decision-making capacity, a legally designated surrogate such as a healthcare proxy, power of attorney, or court-appointed guardian assumes decision-making authority.
CNHA Resident Care and Services 2
Under federal regulations, how quickly must a nursing facility notify a resident's family of a significant change in the resident's condition?