NAB EXAM - CUSTOMER CARE,
SUPPORTS, AND SERVICES
Dementia education requirement - answer-all employees including volunteers must be
trained/educated in dementia and abuse prevention
Federal nursing staffing requirements - answer-the federal regulation does not give a
specific staffing ratio - instead the regulation states the facility must have sufficient
nursing staff to meet the needs of its residents. "the appropriate competencies and skills
sets to provide nursing and related services to assure practicable physical, mental, and
psychosocial well-being of each resident, as determined by resident assessments and
individual care plans and considering the number, acuity and diagnoses of the facility's
resident population must be provided.
According to leading age staffing should be considered based on 4 different
components - answer-facility census and its acuity levels
The range of the resident’s needs and diagnoses
The content of the individual plans of care
And the training, experience, and skill sets of the staff
Nursing facilities are mandated to use the services of an rn for ___ consecutive hours
per day and ___ days per week - answer-8; 7
Regulations pertaining to the charge nurse - answer-facility must have a designated
charge nurse on each tour of duty
Can the don serve as the charge nurse - answer-the don may serve as the charge
nurse only when the facility has an average of 60 or fewer residents/day
Don qualifications - answer-don must be an rn
Charge nurse qualifications - answer-rn or lpn
Cms waivers in charge nurse and don staffing - answer-Medicare waivers are granted
by cms; Medicaid waivers may be granted by the state
Obra definition of cna - answer-any individual providing nursing or nursing-related
services to residents in a facility and who is not a licensed health professional, a
registered nurse, a registered dietitian, or someone who volunteers to provide such
services w/o pay.
Federal employment standards for cnas - answer-certification and continuing education
requirements
,Paid feeding assistants (requirements and who do they work under) - answer-a cms
approved position
The aides must complete a state-approved training course
Work under an rn or lpn
Surveys and staffing: what they will observe for resident needs - answer-1) if staff are
responsive to resident needs and assistance
2) there is little delay in answering resident calls or needs for assistance
3) nursing staff are always nearby or responsible
4) residents seeking staff have little difficulty locating a staff member when the need
arises
5) residents do not have to call repeatedly for assistance
Surveys and staffing: what they will observe for daily staffing data - answer-surveyors
will check to ensure that the facility's daily staffing is posted in a prominent place that is
accessible to visitors as well as residents
Data needed:
Facility name
Date
Census
Total number and actual hours worked by the following categories of licenses and
unlicensed nursing staff directly responsible for resident care: rn; lpn; cnas
How long must daily staffing sheets be kept on file - answer-18 months or whichever is
required by the state whichever is greater
Quality of care - answer-resident care practices utilized by staff must reflect quality of
care which promotes the highest practicable physical, mental, and psychosocial well-
being
Resident care management should use ___ approach - answer-holistic
What are the most significant aspects of resident care practices - answer-staff attitudes
Late loss adls - which have the largest impact on a facility's quality measure
There is a direct relationship of these adl with the 5 start quality measure score and the
rug level - answer-bed mobility
Transfer
Eating
Toilet use
11 adls listed on mds - answer-bed mobility
,Transfers
Walk in room
Walk in hall
Locomotion on unit
Locomotion off unit
Dressing
Eating
Toilet use
Personal hygiene
Bathing
Bed mobility
Transfer
Eating toilet use
Average los for a short term rehab patient - answer-30 days or less
Iadls - answer-telephone use
Shopping
Food prep
Housekeeping
Laundry
Public transportation or driving their own car
Handle their own meds
Handle their own finances
Requirements when a resident changes physicians - answer-1) conduct a new history
and physical
2)write new orders
C) obtain a written release from the former physician
Action to take when death occurs - answer-1) contact resident's family members
2) follow facility protocol in pronouncing death
3) complete forms and documents for releasing the body
4) preparation of the body for the family to view should they desire and for release to the
mortuary
5) conferring with the family before release
Discharge summary - answer-1) recap of the resident's entire stay
2) final summary of the resident's status, including all items listed in the comprehensive
assessment
3) post-discharge plan of care, developed with the participation of the resident and
his/her family
Post-discharge plan - answer-applies to a resident who is discharged to a private
residence, another nursing facility, a residential facility, or other living arrangement
, Emergency drug kit - answer-nursing facilities must have an emergency drug kit
Crash cart - answer-materials to be used by the nurse or physician in case of an
emergency.
Should do regular audits on the crash cart
Infection prevention and control program - answer-must include systems for preventing,
reporting, investigating, and controlling infections and communicable diseases for all
residents, employees, volunteers, and anyone who visits the facility.
Cms standards for infection control mandates the facility must include: - answer-
investigate, control, and prevent infections
Develop procedures for the entire program
Document incidents and corrective actions
Prohibit employees with open lesions or communicable diseases from having direct
contact with residents or their food
Require all staff members to practice acceptable hand hygiene
Handle, process, store, and transport linens in a manner to prevent the spread of an
infection.
Two major causes of the spread of infections in the nh - answer-1) the employee who
does not follow proper hand hygiene
2) the mishandling of soiled linen
Cdc guidelines for hand hygiene - answer-all employees are to use the alcohol based
solution when cleaning their hands with two exceptions: first, if they are caring for a
resident with c-diff they must use soap and water, and second, all dietary department
must use soap and water
Federal regulations to employ an infection preventionist - answer-must have primary
professional training in nursing, medical technology, microbiology, epidemiology, or
other field
Be qualified by education, training, experience, or certification,
And have completed specialized training in infection prevention and control
Flu shots and pneumococcal - answer-it is a federal regulation that nursing homes offer
each resident an annual flu shot between October 1 and march 31
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