NCCAP Gerontology & Resident Needs Assessment 4 — Questions and Answers
Question 1: Polypharmacy in older adults, defined as taking five or more medications, most commonly affects activity participation by causing:
- Increased energy and motivation
- Sedation, dizziness, and cognitive changes (Correct answer)
- Improved mood and socialization
- Enhanced fine motor coordination
Correct answer: Sedation, dizziness, and cognitive changes
Polypharmacy frequently leads to sedation, dizziness, and cognitive side effects that directly impair an older adult's ability to engage in activities.
Question 2: The 'reminiscence therapy' technique is MOST grounded in which developmental theory?
- Maslow's hierarchy of needs
- Erikson's stage of ego integrity vs. despair (Correct answer)
- Piaget's theory of cognitive development
- Kohlberg's moral development theory
Correct answer: Erikson's stage of ego integrity vs. despair
Reminiscence therapy aligns with Erikson's final stage, helping older adults achieve ego integrity by reviewing and finding meaning in their life history.
Question 3: Which of the following is the MOST appropriate indicator of a successful activity program for a resident with advanced dementia?
- Completion of all scheduled activities without refusal
- Observable signs of positive affect during engagement (Correct answer)
- Improvement in MMSE scores over six months
- Increased verbal participation in group discussions
Correct answer: Observable signs of positive affect during engagement
For residents with advanced dementia, observable positive affect (smiling, calm engagement) is the most meaningful and realistic indicator of program success.
Question 4: Under the Americans with Disabilities Act (ADA), long-term care facilities are required to provide activity programming that:
- Offers identical activities to all residents regardless of ability
- Ensures equal access and reasonable accommodations for residents with disabilities (Correct answer)
- Prioritizes residents without disabilities in program scheduling
- Limits group activities to residents with similar functional levels
Correct answer: Ensures equal access and reasonable accommodations for residents with disabilities
The ADA requires equal access and reasonable accommodations, ensuring residents with disabilities can participate in programming to the fullest extent possible.
Question 5: A newly admitted resident expresses that religion and prayer are central to their daily life. According to the NCCAP standards, this information should be used to:
- Refer the resident exclusively to the chaplain for spiritual needs
- Incorporate spiritual activities and preferences into the individualized activity care plan (Correct answer)
- Document the preference but limit programming to secular activities
- Encourage the resident to adapt to the existing activity schedule
Correct answer: Incorporate spiritual activities and preferences into the individualized activity care plan
NCCAP standards require that spiritual preferences be documented and meaningfully incorporated into the individualized activity care plan.
Question 6: The geriatric syndrome known as 'sundowning' is characterized by:
- Increased sleepiness and withdrawal in the morning hours
- Increased confusion, agitation, and behavioral changes in the late afternoon or evening (Correct answer)
- A pattern of depression that worsens during winter months
- Sudden onset of delirium following a medical procedure
Correct answer: Increased confusion, agitation, and behavioral changes in the late afternoon or evening
Sundowning refers to the worsening of confusion, agitation, and behavioral symptoms in persons with dementia during the late afternoon and evening hours.
Question 7: Which documentation format is MOST commonly required for activity care plans in long-term care facilities regulated under OBRA?
- SOAP (Subjective, Objective, Assessment, Plan) notes
- DAP (Data, Assessment, Plan) or narrative format aligned with the interdisciplinary care plan (Correct answer)
- Free-form narrative without structured requirements
- Checklist-only format approved by CMS
Correct answer: DAP (Data, Assessment, Plan) or narrative format aligned with the interdisciplinary care plan
Activity care plan documentation in OBRA-regulated facilities typically follows DAP or narrative formats integrated into the interdisciplinary care plan process.
NCCAP Gerontology & Resident Needs Assessment 4
Polypharmacy in older adults, defined as taking five or more medications, most commonly affects activity participation by causing: