SMQT Abuse, Neglect, and Exploitation Prevention 2 — Questions and Answers
Question 1: Which of the following staff behaviors would be classified as 'psychological abuse' of a nursing home resident?
- Failing to reposition a bedridden resident on the schedule documented in the care plan
- Repeatedly threatening a resident with punishment if they do not cooperate with personal care (Correct answer)
- Removing money from a resident's personal funds account without authorization
- Administering an incorrect medication dosage that causes the resident discomfort
Correct answer: Repeatedly threatening a resident with punishment if they do not cooperate with personal care
Psychological abuse includes verbal threats, humiliation, intimidation, and other conduct that causes mental anguish or emotional distress to a resident.
Question 2: During a survey, which finding would most strongly indicate the possible presence of physical abuse of a resident?
- A resident who consistently refuses to participate in scheduled recreational activities
- Multiple unexplained bruises in various stages of healing located on a resident's body (Correct answer)
- A resident who repeatedly requests extra servings of food at mealtimes
- Documentation of a single resident fall with a corresponding bruise at the site of impact
Correct answer: Multiple unexplained bruises in various stages of healing located on a resident's body
Multiple unexplained bruises in various stages of healing indicate a pattern of repeated injury without adequate explanation, which is a classic indicator of possible physical abuse.
Question 3: What is the primary regulatory purpose of conducting background checks on prospective nursing facility employees?
- To verify the applicant's educational credentials and professional licensure status
- To identify individuals with a prior history of abuse, neglect, or financial exploitation of vulnerable adults (Correct answer)
- To assess the applicant's credit history and overall financial reliability
- To confirm the accuracy of the applicant's stated employment history and professional references
Correct answer: To identify individuals with a prior history of abuse, neglect, or financial exploitation of vulnerable adults
Background checks are primarily required to screen out individuals with a documented history of abuse, neglect, or exploitation, protecting residents from known risk factors.
Question 4: A resident tells a surveyor that a nurse aide 'grabbed my arm and twisted it hard' when they refused to take a shower. Which type of regulatory violation does this describe?
- Psychological abuse because it was done to force compliance
- Sexual abuse because it involved unauthorized physical contact
- Physical abuse because it involved the use of physical force causing or risking bodily injury (Correct answer)
- Neglect because the resident's right to refuse care was not respected
Correct answer: Physical abuse because it involved the use of physical force causing or risking bodily injury
Physical abuse is the use of physical force that may result in bodily injury, physical pain, or impairment, including grabbing and twisting a resident's limb.
Question 5: Which scenario constitutes 'neglect' rather than 'abuse' under long-term care regulations?
- A staff member yells obscenities and makes degrading remarks to a confused resident
- A resident with a documented skin care protocol develops a deep pressure ulcer because staff consistently failed to follow the protocol (Correct answer)
- A staff member touches a resident in their genital area without care justification during morning care
- A staff member removes cash from a resident's wallet while assisting with personal care
Correct answer: A resident with a documented skin care protocol develops a deep pressure ulcer because staff consistently failed to follow the protocol
Neglect occurs when staff fail to provide required care — such as not following a skin care protocol — resulting in preventable harm, rather than through a willful harmful act.
Question 6: Under federal regulations, what must a facility do regarding an employee for whom abuse has been substantiated?
- Place the employee on permanent probation within the facility with enhanced supervision
- Prohibit future employment and report to the appropriate nurse aide registry or applicable licensing authority (Correct answer)
- Reassign the employee exclusively to administrative or non-resident-contact positions
- Allow continued employment contingent upon successful completion of mandatory retraining
Correct answer: Prohibit future employment and report to the appropriate nurse aide registry or applicable licensing authority
Facilities must terminate employees with substantiated abuse findings and report them to the State nurse aide registry or licensing authority to prevent employment in other care settings.
Question 7: A surveyor observes a staff member repeatedly mocking and ridiculing a cognitively impaired resident in front of other residents. This should be documented as:
- Neglect because the staff member is failing to provide appropriate emotional support to the resident
- Physical abuse because the public humiliation may cause the resident to experience physical symptoms of distress
- Verbal or psychological abuse because it constitutes humiliation and ridicule causing mental anguish (Correct answer)
- An isolated behavioral incident requiring only an informal counseling conversation with the staff member
Correct answer: Verbal or psychological abuse because it constitutes humiliation and ridicule causing mental anguish
Mocking and ridiculing a resident constitutes verbal or psychological abuse, which includes humiliation, harassment, and conduct that causes mental anguish or emotional distress.
SMQT Abuse, Neglect, and Exploitation Prevention 2
Which of the following staff behaviors would be classified as 'psychological abuse' of a nursing home resident?