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NORTH CAROLINA NURSING HOME ADMINISTRATOR STATE EXAM
100% CORRECTLY ANSWERED QUESTIONS
""Brain injury long term care" definition - CORRECT ANSWER an interdisciplinary, intensive
maintenance program for patients who have incurred brain damage caused by external physical trauma and who have completed a primary course of rehabilitative treatment and have reached a point of no gain or progress for more than three consecutive months. Provided through a medically supervised interdisciplinary process and is directed toward maintaining the individual at the optimal level of physical, cognitive, and behavioral functions"
"Capacity definition - CORRECT ANSWER the maximum number of patient or resident beds for
which the facility is licensed to maintain at any given time"
""Comprehensive, inpatient rehabilitation program" definition - CORRECT ANSWER program
for the treatment of persons with functional limitations or chronic disabling conditions who have the potential to achieve a significant improvement in activities of daily living, including bathing, dressing, grooming, transferring, eating, and using speech, language, or other communication systems. Utilizes a coordinated and integrated, interdisciplinary approach, directed by a physician, to assess patient needs and to provide treatment and evaluation of physical, psychosocial, and cognitive deficits."
of errors / # of opportunities for error x 100
ex: 5 errors / 60 opportunities = 0.083 x 100 = 8.3%"
""Misappropriation of property" definition - CORRECT ANSWER the deliberate misplacement,
exploitation, or wrongful, temporary or permanent use of a patient's belongings or money without the patient's consent"
"Neglect definition - CORRECT ANSWER a failure to provide goods and services necessary to
avoid physical harm, mental anguish, or mental illness"
""New facility" meaning - CORRECT ANSWER a facility for which an initial license is sought, a
proposed addition to an existing facility, or a proposed remodeled portion of an existing facility that will be built according to construction documents and specifications approved by the Department of Health and Human Services for compliance which standards established in this Subchapter [13D]"
""Nurse aide" definition - CORRECT ANSWER a person who is listed on the NC Nurse Aide
Registry and provides nursing or nursing-related services to patients in a nursing home. A nurse aide is not a licensed health professional."
"Patient definition - CORRECT ANSWER any person admitted for nursing care"
"Resident definition - CORRECT ANSWER any person admitted for care to an adult care home
part of a combination facility"
""Respite care" definition - CORRECT ANSWER services provided for a patient on a temporary
basis, not to exceed 30 days"
"New facility licensure application requirements - CORRECT ANSWER A legal entity shall
submit an application for licensure for a new facility to the Nursing Home Licensure and Certification Section of the DHSR at least 30 days prior to a license being issued or patients admitted. Application must include:
- legal identity of applicant (licensee) and mailing address
- name(s) under which the facility is presented to the public
- location and mailing address of the facility
- ownership disclosure
- bed complement
- magnitude and scope of services offered
- name and current license number of the administrator
- name and current license number of the DON
- name and current license number of the medical director"
"(T/F) Only one license shall be issued to each facility. - CORRECT ANSWER True"
**the Department shall issue a new license following notification and verification of data
submitted - CORRECT ANSWER at least 30 days"
"The facility shall notify the Nursing Home Licensure and Certification Section of the DHSR within _______ following the occurrence of:
- change in administration
- change in the DON
- change in facility mailing address or telephone number
- changes in the magnitude or scope of services
- emergencies or situations requiring relocation of patients to a temporary location away from
the facility - CORRECT ANSWER one working day"
"The Division shall authorize, in writing, a temporary increase in licensed bed in accordance with rules, if it is determined that: (1) the increase is not associated with _____; and
(2) the increase would not _____ - CORRECT ANSWER capital expenditure
jeopardize the health, safety, and welfare of the patients" "The Department may amend a license by reducing it from a full license to a provisional license whenever the Department finds that:
- the licensee has substantially failed to comply with the provisions of G.S. 131E, Article 6 and the rules promulgated under that article; and
2) there is continued non-compliance after ______ - CORRECT ANSWER the third revisit"
"The Department shall give the licensee written notice of the amendment to the license. This shall be given personally or by certified mail and shall set forth:
- the length of the ____ license
- a reference to the ____ that contains the facts
- the ____ alleged to be violated; and
4) notice of the facility's right to a ____ on the amendment of the license - CORRECT ANSWER
- provisional
- statement of deficiencies
- statutes or rules
- contested case hearing" "The issuance of a provisional license (IS / IS NOT) a procedural prerequisite to the revocation of a
license pursuant to Paragraph (e) of this Rule. - CORRECT ANSWER is not"
"The Department may, in accordance with G.S. 131E-232, petition to have a _____ appointed to
operate a facility - CORRECT ANSWER temporary manager"
"The Department shall notify the facility personally or by certified mail of the decision to suspend admissions. Such notice shall include:
- a reference to the ____ that contains the facts;
- citation of ____ alleged to be violated; and
3) notice of the facility's right to ____ on the suspension - CORRECT ANSWER 1) statement of
deficiencies
- statutes and rules
- a contested case hearing"
"(T/F) The facility shall admit new patients during the effective period of the suspension -
CORRECT ANSWER False - the facility shall not admit new patients"
"The suspension is effective on the date specified in the _____ - CORRECT ANSWER notice of
suspension"
"The suspension shall remain effective until the facility demonstrated to the Department: -
CORRECT ANSWER that conditions are no longer detrimental to the health and safety of the
patients"
"(T/F) The administrator shall be responsible for developing and implementing policies for the
management and operation of the facility - CORRECT ANSWER True
- as set forth in 21 NCAC 37B .0204, which is incorporated herein by reference including subsequent amendments and editions. These rules may be accessed free of charge at http://reports.oah.state.nc.us/ncac.asp." "In the physical absence of the administrator, a person shall be ____ who is designated to be in
charge of the facility operation. - CORRECT ANSWER on-site"
"No patient shall be admitted except by a ____ - CORRECT ANSWER physician"
"Admission shall be in accordance with ____ policies and procedures - CORRECT ANSWER
facility" "When shall the facility acquire orders for immediate care of the patient from the admitting
physician? - CORRECT ANSWER prior to or at the time of admission"
"When shall the facility shall acquire medical information which shall include current medical information (e.g., medical findings, diagnoses, and other information necessary to formalize the
initial plan of care)? - CORRECT ANSWER within 48 hours of admission"
"Only persons who are ____ years or older shall be admitted to the adult care home portion of a
combination facility. - CORRECT ANSWER 18"
"(T/F) Patients who require health, habilitative or rehabilitative care beyond those for which the
facility is licensed and capable of providing shall not be admitted to the licensed nursing home. -
CORRECT ANSWER True"
"(T/F) Persons requiring continuous nursing care shall be admitted into an adult care home bed in
a combination facility. - CORRECT ANSWER False
No person requiring continuous nursing care shall be admitted to an adult care home bed in a combination facility, except under emergency situations as described in Rule .2105 of this Subchapter. Should an existing resident of an adult care home bed require continuous nursing care, the facility shall either discharge the resident or provide the next available nursing facility bed (that is not needed to comply with G.S. 131E-130) to the resident to ensure continuity of care and to prevent unnecessary discharge from the facility"
"(T/F) Respite care is required as a condition of licensure. - CORRECT ANSWER False
Respite care is not required as a condition of licensure. Facilities providing respite care, however, shall meet the requirements of this Subchapter [13D] with the following exceptions: Rules .2205, .2301, and .2501(b) and (c) of this Subchapter."
"A respite patient's descriptive record shall include: - CORRECT ANSWER 1) preadmission or
admission assessment
- IDT notes as warranted by episodic events
- medication administration records
- a summary of the stay upon discharge" "(T/F) The facility shall complete a preadmission or admission assessment which allows for the
development of a short-term plan of care and is based on the respite patient's customary care. -
CORRECT ANSWER True
The assessment shall address needs, including but not limited to identifying information, customary routines, hearing, vision, cognitive ability, functional limitations, continence, special procedures and treatments, skin conditions, behavior and mood, oral and nutritional status and medication regimen. The plan shall be developed to meet the respite care patient's needs." "(T/F) The facility must ensure a medical order for discharge (except when a patient leaves
against medical advice or is discharged for non-payment). - CORRECT ANSWER True"
"(T/F) The patient or the legal representative must be informed and included in the discharge
planning process. - CORRECT ANSWER True"
"Who is responsible for the implementation of patient care policies and coordination of medical care in the facility? A) administrator B) director of nursing C) medical director
"(T/F) Tuberculosis screening shall be done upon admission of ALL patients being admitted from
settings other than hospitals, nursing facilities, or combination facilities. - CORRECT ANSWER
True"
"Staff should be screened for tuberculosis within ____ of the hire date. - CORRECT ANSWER 7
days" "Following initial admission/hire tuberculosis screening, the facility shall ensure screening ____
for patients and staff. - CORRECT ANSWER annually"
"(T/F) An employee with a communicable disease or infected skin lesion, in which direct contact is the mode of transmission of disease, may engage in direct contact with patients or their food as
long as they wear PPE. - CORRECT ANSWER False
The facility shall prohibit any employee with a communicable disease or infected skin lesion from direct contact with patients or their food, if direct contact is the mode of transmission of the disease."
"All linen shall be handled, stored, processed, and transported so as to prevent ____. - CORRECT
ANSWER the spread of infection"
"Two measures to prevent patient abuse, patient neglect, or misappropriation of patient property:
2) - CORRECT ANSWER 1) orientation and instruction of facility staff on patients' rights
- the screening of and requesting of references for all prospective employees" "A facility shall ensure that the Division of Health Service Regulation (DHSR) is notified within ____ of the facility's becoming aware of any allegation against health care personnel of any act
listed in G.S. 131E-256(a)(1). - CORRECT ANSWER 24 hours"
"Three things the facility shall do while an allegation investigation is in progress:
3) - CORRECT ANSWER 1) investigate allegation
- document all information pertaining to such investigation
- take the necessary steps to prevent further incidents" "A facility shall ensure that the report of investigation is printed or typed and sent to DHSR within
____ of the allegation. - CORRECT ANSWER 5 working days"
"5-working day report of allegation investigation includes:
7) - CORRECT ANSWER 1) the date and time of the alleged incident
- the patient's full name and room number
- details of the allegation and any injury
- names of the accused and any witnesses
- names of the facility staff who investigated the allegation
- results of the investigation
- any corrective action that was taken by the facility" "Professional staff shall be licensed, certified, or registered in accordance with applicable ____
laws. - CORRECT ANSWER state"
"The facility shall provide orientation regarding facility ____ and ____ for all staff upon
employment. - CORRECT ANSWER policies and procedures"
"The facility shall train all staff ____ in accordance with their job duties. - CORRECT ANSWER
periodically" "(T/F) Verification of credentials shall be maintained in each employee's individual personnel
record. - CORRECT ANSWER True"
- presence of visual, hearing, or other sensory deficits
- drug therapy" "(T/F) The physician may participate in the preparation of the comprehensive plan of care via
telephone or written notice. - CORRECT ANSWER True"
"The facility shall review the comprehensive assessments and plans of care no less frequently
than ____ and make necessary revisions to ensure accuracy. - CORRECT ANSWER once every
90 days"
"(T/F) The DON must serve on a full-time basis. - CORRECT ANSWER True"
"(T/F) The DON must be an RN. - CORRECT ANSWER True"
"The facility shall provide licensed nursing staff sufficient to accomplish the following 3
components: - CORRECT ANSWER 1) patient needs assessments
- patient care planning
- supervisory functions in accordance with the levels of patient care advertised/offered by the facility" "The facility must have sufficient nursing and related services to attain/maintain the ____, ____, and ____ well-being of each patient, as determined by patient assessments and individual plans
of care. - CORRECT ANSWER physical, mental, and psychosocial"
"A multi-storied facility shall have at least ___ nurse aide(s) on duty on each patient floor at all
times. - CORRECT ANSWER 1"
"(Except for designated units with higher staffing requirements noted elsewhere in this Subchapter), Daily direct patient care nursing staff, licensed and unlicensed, must include at least
___ licensed nurse(s) for direct patient care at all times. - CORRECT ANSWER 1"
"(Except for designated units with higher staffing requirements noted elsewhere in this Subchapter), Daily direct patient care nursing staff, licensed and unlicensed, must include a
registered nurse at least ____ consecutive hours a day, ____ days a week. - CORRECT ANSWER
8 consecutive hours, seven days a week. This coverage may be spread over more than one shift if such need exits."
"The DON may be counted as meeting the requirements for both the DON and patient staffing for
facilities with a total census of ____ nursing beds or less. - CORRECT ANSWER 60"
"The facility shall provide to the Department, upon request, verification of ____ and of past or
present ___ of any nurse aide employed by the facility. - CORRECT ANSWER in-service
training; employment" "The facility shall provide necessary care and services in accordance with ____, the patient's
comprehensive assessment, and on-going plan of care. - CORRECT ANSWER medical orders"
"(T/F) Acute changes in the patient's physical, mental, or psychosocial status shall be evaluated
and reported to the physician or other persons legally authorized to perform medical acts. -
CORRECT ANSWER True"
"The facility shall not utilize any ____ for the purpose of discipline or convenience, and that are
not required to treat the patient's medical condition. - CORRECT ANSWER chemical or
physical restraints" "(T/F) An evaluation must be done to ensure that the least restrictive means of restraint have
been initiated on patients requiring restraints. - CORRECT ANSWER True"
"The facility shall ensure that all patients who are unable to perform ADLs receive the necessary
assistance to maintain good ____, ____, and ____ hygiene. - CORRECT ANSWER grooming;
oral; personal" "The facility shall ensure appropriate measures are taken to restore the patient's ability to:
6) - CORRECT ANSWER 1) bathe
- dress
- groom
- transfer and ambulate
- toilet
- eat"
"(T/F) Gradual dose reductions and behavioral interventions, unless clinically contraindicated, are
required to be employed in antipsychotic therapy. - CORRECT ANSWER True"
""Gradual dose reduction" meaning - CORRECT ANSWER The stepwise tapering of a dose to
determine if symptoms, conditions, or risks can be managed by a lower dose or if the dose or the medication can be discontinued" "Signed medical orders for medications and drug treatments must include the following six items:
- CORRECT ANSWER 1) drug name
- strength
- quantity to be administered
- route of administration
- frequency
- if PRN, a stated indication for use" "(T/F) A patient may self-administer medication if the DON determines that this practice is safe.
CORRECT ANSWER False"
"The four requirements for self-administration of medication include: - CORRECT ANSWER 1)
determination by the IDT that this practice is safe
- administration ordered by the physician or other person legally authorized to prescribe medications
- instructions for administration printed on the medication label; and
- administration of medication monitored by the nursing staff and consultant pharmacist." "(T/F) The administration of one patient's medications to another patient is prohibited under all
circumstances. - CORRECT ANSWER False
The administration of one patient's medications to another patient is prohibited except in the case of an emergency - in the event of such emergency, the facility shall ensure that the borrowed medications are replaced and so documented" "(T/F) Omission of medication and the reason for omission shall be indicated in the patient's
medical record. - CORRECT ANSWER True"
"Information included in medication administration records - CORRECT ANSWER 1) time of
administration
- identification of the drug
- strength of drug
- quantity of drug administered
- route of administration
- frequency
- documentation sufficient to determine the staff who administered the drug
- documentation of injection sites and topical medical sites requiring rotation of transdermal medication" "The ____ shall receive an exact copy of each physician's order for medications and treatments.
CORRECT ANSWER pharmacy"
"When medication orders do not state the number of doses or days to administer the medication,
the facility shall implement ____ according to the manufacturer's recommendations. -
CORRECT ANSWER automatic stop orders"
"The facility shall maintain a(n) ____ of controlled substances as defined by the NC Controlled
Substances Act, G.S. 90, Article 5. - CORRECT ANSWER accountability"
"The facility shall ensure that ____ and ____ dental services are available for all patients. -
CORRECT ANSWER routine and emergency"
"(T/F) The facility shall, if necessary, assist the patient in making appointments and transportation
to the dentist's office. - CORRECT ANSWER True"
"(T/F) In a combination home, the nurse-in-charge shall not also serve as supervisor-in-charge of
the domiciliary beds. - CORRECT ANSWER False
The nurse-in-charge of the nursing facility may also serve as supervisor-in-charge of the domiciliary beds" "(T/F) If adult care homes are located in a separate building or a separate level of the same building, there shall be a person on duty in the adult care home portion of the facility at all times.
CORRECT ANSWER True"
"(T/F) Each state shall develop and implement a Cardio-Pulmonary Resuscitation (CPR) policy. -
CORRECT ANSWER False
"(T/F) The facility shall provide orientation, on-the-job training, and in-service programs for ALL
medical records personnel. - CORRECT ANSWER True"
"A facility shall keep medical records on file for ____ following the discharge of an adult patient.
CORRECT ANSWER 5 years"
"Excluding the scenario of a facility discontinuing operation, if a patient is a minor when discharged from the nursing facility, the records shall be kept on file ____ and for the additional
time specified in G.S. 1-17(b) for commencement of an action on behalf of a minor. - CORRECT
ANSWER until his or her 19th birthday"
"If a facility discontinues operation, the licensee shall inform ____ where its records are stored. -
CORRECT ANSWER DHSR"
"For ____ after a facility discontinues operations, records shall be stored with a business offering
medical record storage and retrieval services. - CORRECT ANSWER 5 years"
"All medical records are confidential. A facility shall comply with 42 CFR Parts 160, 162, and 164 of
the ____. - CORRECT ANSWER Health Insurance Portability and Accountability Act (HIPAA)"
"(T/F) A patient may deny DHSR access to his or her medical record. - CORRECT ANSWER True
At the time of the inspection, a facility shall inform the surveyor of the name of any patient who has denied the Department access to his or her medical record pursuant to G.S. 131E-105"
"The names and telephone numbers of the designated physicians shall be posted ____. -
CORRECT ANSWER at each nurse's station"
"(T/F) The facility shall ensure each patient's care is supervised by a physician and that provisions
are made for emergency physicians when medical directors are unavailable. - CORRECT
ANSWER False
The facility shall ensure each patient's care is supervised by a physician and that provisions are made for emergency physicians when attending physicians are unavailable" "Patients shall be seen by a physician at least once every ____ for the first ____ and at least every
___ thereafter. - CORRECT ANSWER 30 days; 90 days; 60 days"
"(T/F) Following the initial visit, the physician may delegate this responsibility to a physician
assistant or nurse practitioner every other visit. - CORRECT ANSWER True"
"A physician's visit is considered timely if it occurs not later than ____ after the visit was required.
- CORRECT ANSWER 10 days" "(T/F) Medical orders may be given orally by the physician, nurse practitioner, or physician
assistant. - CORRECT ANSWER True"
"Medical orders, given orally by the physician, nurse practitioner, or physician assistant, shall be given only to a(n) ____ or other licensed professional who by law is allowed to accept physician
orders, except for orders for therapeutic diets, which shall be given to either a(n) ____ or ____. -
CORRECT ANSWER licensed nurse; dietician; licensed nurse"
"The record of each telephone order shall include:
4) - CORRECT ANSWER 1) the name of the physician giving the order, of other personal legally
authorized to prescribe
- date and time of the order
- content of the order
- name of person receiving the order" "The physician, or other personal legally authorized to prescribe, who gives oral orders shall sign
the orders within ____. - CORRECT ANSWER 5 days"
"(T/F) Each patient or legal representative shall be allowed to select his or her private physician except in those facilities affiliated with medical teaching programs and having written policies
requiring all patients to participate in the medical teaching program. - CORRECT ANSWER
True" "(T/F) The private physician shall fulfill given requirements as determined by applicable state and
federal regulations, and the facility's policies and procedures pertaining to physician services. -
CORRECT ANSWER True"
