Chapter 9: Long-Term Care Nursing School Test Banks

Black & Hawks: Medical-Surgical Nursing, 8th Edition

Test Bank

Chapter 9: Long-Term Care

MULTIPLE CHOICE

1. Historically, European countries in the 1700s housed older persons in institutions with

a.

farmers, who could use them as labor.

b.

mentally ill persons.

c.

older people of the same gender.

d.

those of the same socioeconomic class.

ANS: B

European countries created institutions to house mentally ill persons, orphans, old people, criminals, and persons with contagious diseases in order to separate them from the general population rather than care for them.

DIF: Knowledge/Remembering REF: p. 103 OBJ: N/A

MSC: N/A

2. The enactment of Social Security in 1935 afforded older adults the ability to

a.

enter a city-sponsored nursing home.

b.

purchase care privately.

c.

receive care by a physician in the home.

d.

stay in hospitals until completely well.

ANS: B

The Social Security Act in 1935 allowed older people the means to purchase care privately and not to rely on charitable or public institutions.

DIF: Knowledge/Remembering REF: p. 104 OBJ: N/A

MSC: N/A

3. The Hill-Burton Hospital Survey and Construction Act of 1946 provided building funds and resulted in nursing homes that

a.

allowed for flexible visiting hours.

b.

resembled hospitals.

c.

were located only in rural settings.

d.

were to have at least 100 beds.

ANS: B

The Hill-Burton Act provided funds for building nursing homes, but the new facilities had to meet the criteria for hospitals and were built and organized similarly.

DIF: Knowledge/Remembering REF: p. 104 OBJ: N/A

MSC: N/A

4. In 1965 the enactment of Medicare and Medicaid provided older adults and poor persons with the assurance of

a.

a minimal level of health care.

b.

a reasonable standard of living.

c.

guaranteed housing.

d.

increased food allowance funding.

ANS: A

The Medicare and Medicaid laws assured the aged and poor populations of a minimal level of health care.

DIF: Knowledge/Remembering REF: p. 104 OBJ: N/A

MSC: N/A

5. The Omnibus Budget Reconciliation Act of 1987 (OBRA) affected nursing homes by

a.

allowing residents more choice in the selection of a nursing home.

b.

mandating that each resident have a private room and bath.

c.

producing profound reforms in nursing home care.

d.

providing for better funding to meet the needs of the residents.

ANS: C

OBRA caused profound reforms in long-term care facilities.

DIF: Knowledge/Remembering REF: pp. 104-105 OBJ: N/A

MSC: N/A

6. The nurse plans programming at a nursing home understanding that the defining impairment that affects almost all residents in a nursing home is

a.

Alzheimers disease or other cognitive deficit.

b.

impairment in ability to perform activities of daily living (ADL).

c.

profound hearing loss or other unspecified sensory deficit.

d.

severe, progressive visual deficit.

ANS: B

Most residents have conditions that impair their self-help capacity or require interventions pertinent to their ADL that they cannot perform independently. About one half have cognitive impairment. About 4 of 10 residents have visual problems and about one third have hearing loss.

DIF: Comprehension/Understanding REF: p. 105 OBJ: Planning

MSC: Health Promotion and Maintenance Aging Process

7. A nurse teaching a new resident and family about the Resident Rights outlined by OBRA would include which information? A resident has the right to

a.

be informed of rights, rules, and responsibilities.

b.

choose activities and care.

c.

have clean, safe, home-like environment.

d.

organize and participate in resident groups.

ANS: A

OBRA Resident Rights include being informed of rights, rules, and responsibilities. The other options are quality of life protections and are certainly important in themselves.

DIF: Comprehension/Understanding REF: p. 107 OBJ: Intervention

MSC: Safe, Effective Care Environment Management of Care-Legal Rights and Responsibilities

8. In regard to nursing services in a long-term care facility, OBRA regulations include

a.

a director of nursing that holds at least a masters degree in health administration.

b.

availability of vocational nurses on each unit 24 hours a day, 7 days a week.

c.

the presence of at least four direct caregivers on duty per unit for each shift, regardless of census.

d.

the provision of nursing personnel consistent with the level of care and needs of residents.

ANS: D

OBRA mandated that long-term care facilities provide nursing personnel consistent with the residents level of care and needs. The requirement for a director of nursing is that there is a full-time director if the facility has more than 60 beds. There are no specific staffing guidelines other than a registered nurse on duty for at least 8 consecutive hours a day, 7 days a week.

DIF: Knowledge/Remembering REF: pp. 105, 107 OBJ: N/A

MSC: Safe, Effective Care Environment Management of Care-Legal Rights and Responsibilities

9. The nurse admitting a new resident to a long-term care facility is mindful that after the resident is assessed, a care plan must be written within

a.

1 day.

b.

3 days.

c.

5 days.

d.

7 days.

ANS: D

The guidelines mandate that a nursing care plan be on record 7 days after the initial assessment.

DIF: Knowledge/Remembering REF: p. 107 OBJ: Intervention

MSC: Safe, Effective Care Environment Management of Care-Legal Rights and Responsibilities

10. After a long-term care facility nurse receives a phone order from the physician, the nurse must ensure that the order is countersigned in

a.

8 hours.

b.

12 hours.

c.

24 hours.

d.

48 hours.

ANS: C

The telephone order should be countersigned within 24 hours.

DIF: Knowledge/Remembering REF: p. 109 OBJ: Intervention

MSC: Safe, Effective Care Environment Management of Care-Legal Rights and Responsibilities

11. The form of residential long-term care facility that offers the most personal freedom, as well as provision of meals, medication supervision, and personal care assistance, is

a.

adult day care center.

b.

assisted living center.

c.

nursing home.

d.

transitional care setting.

ANS: B

The assisted living center allows the greatest amount of personal freedom while supplying supervision, meals, and social activities. An adult day care center functions during daytime hours for activities, meals, assistance with personal care, and health care supervision. A nursing home has many regulations to which residents must adhere.

DIF: Comprehension/Understanding REF: pp. 109-110 OBJ: N/A

MSC: Health Promotion and Maintenance Health and Wellness

12. Transfer from a long-term care facility is being considered for a combative resident.OBRA Resident Rights that impact this decision include

a.

a legitimate and documented reason for the transfer.

b.

addressing the problem behavior in the care plan.

c.

the family preventing the discharge through litigation.

d.

the resident has the right to delay the transfer for 20 days.

ANS: A

OBRA Resident Rights include the provision of a legitimate reason for the transfer. The other options are not included in the rights as published.

DIF: Comprehension/Understanding REF: p. 107 OBJ: Intervention

MSC: Safe, Effective Care Environment Management of Care-Legal Rights and Responsibilities

Elsevier items and derived items 2009 by Saunders, an imprint of Elsevier Inc.

Some material was previously published.

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