Chapter 11: Long-Term Care: Black & Hawks: Medical-Surgical Nursing: Clinical Management For Positive Outcomes, 7 Edition

Black & Hawks: Medical-Surgical Nursing: Clinical Management for
Positive Outcomes, 7th Edition
Chapter 11: Long-Term Care
MULTIPLE CHOICE
1. Historically, European countries in the 1700s housed older persons in institutions with
a. older people of the same gender.
b. those of the same socioeconomic class.
c. mentally ill persons.
d. farmers, who could use them as labor.
ANS: c
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: Cognitive Level: Knowledge REF: Text Reference: 179

TOP: Nursing Process Step: N/A MSC: NCLEX: 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. stay in hospitals until completely well.
d. receive care by a physician in the home.
ANS: b
The Social Security Act in 1935 allowed older the means to purchase care privately and
not to rely on charitable or public institutions.

3. The Hill-Burton Hospital Survey and Construction Act of 1946 provided building
funds and resulted in nursing homes that
a. resembled hospitals.
b. were located only in rural settings.
c. were to have at least 100 beds.
d. allowed for flexible visiting hours.
ANS: a
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.

Elsevier items and derived items 2005 by Elsevier Inc.

Chapter 11: Long-Term Care 2
4. In 1965 the enactment of Medicare and Medicaid provided older adults and poor
persons with the assurance of
a. a reasonable standard of living.
b. guaranteed housing.
c. increased food allowance funding.
d. a minimal level of health care.
ANS: d
The Medicare and Medicaid laws assured the aged and poor populations of a minimal
level of health care.

5. The Omnibus Budget Reconciliation Act of 1987 (OBRA) affected nursing homes by
a. producing profound reforms in nursing home care.
b. providing for better funding to meet the needs of the residents.
c. allowing residents more choice in the selection of a nursing home.
d. mandating that each resident have a private room and bath.
ANS: a
OBRA caused profound reforms in long-term care facilities.

6. The defining impairment that affects almost all residents in a nursing home is
a. visual deficit.
b. profound hearing loss.
c. Alzheimer’s disease.
d. performance of activities of daily living (ADL).
ANS: d
Most residents have conditions that impair their self-help capacity or require
interventions pertinent to their ADL that they cannot perform independently.

7. Among the Resident Rights outlined by OBRA is the right to

a. have clean, safe, home-like environment.
b. organize and participate in resident groups.
c. choose activities and care.
d. be informed of rights, rules, and responsibilities.
ANS: d

OBRA Resident Rights include being informed of rights, rules, and responsibilities. The
other options are quality of life protections.
DIF: Cognitive Level: Knowledge REF: Text Reference: 181, Box 11-1;
8. In regard to nursing services in a long-term care facility, OBRA regulations include

a. availability of vocational nurses on each unit 24 hours a day, 7 days a week.
b. provision of nursing personnel consistent with the level of care and needs of
residents.
c. presence of at least four direct caregivers on duty per unit for each shift, regardless
of census.
d. a director of nursing that holds at least a master’s degree in health administration.
ANS: b
OBRA mandated that long-term care facilities provide nursing personnel consistent with
the residents’ level of care and needs.
DIF: Cognitive Level: Knowledge REF: Text Reference: 182, Box 11-1;
9. The OBRA regulation that specifically addresses registered nurse (RN) staffing is that
the RN must be on duty at least
a. 8 consecutive hours per day, 7 days a week.
b. 16 consecutive hours per day, 7 days a week.
c. 8 consecutive hours per day, 5 days a week.
d. 16 consecutive hours per day, 5 days a week.
ANS: a
Regulatory standards are basic. The only specific staffing requirement in federal
regulations is that an RN must be on duty at least 8 consecutive hours, 7 days a week, and
that a full-time director of nursing must be on staff if the facility has more than 60 beds.
DIF: Cognitive Level: Knowledge REF: Text Reference: 182, 183;

10. 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.

11. The person responsible for coordinating the completion of the Minimum Data Set
(MDS) for a long-term care resident is the
a. physician.
b. RN.
c. LVN/LPN.
d. director of nursing.
ANS: b
An RN coordinates completion of the MDS, the tool on which assessment is documented.

12. After a long-term care facility nurse receives a phone order from the physician, she
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.

13. Categories addressed in the Minimum Data Set assessment tool include
a. spirituality.
b. knowledge of health condition.
c. attitudes regarding health status.
d. cognitive pattern.
ANS: d
The MDS categories include background data, cognitive patterns, communication hearing
patterns, vision patterns, mood and behavior patterns, psychosocial well being, physical
functioning, and structural problems and continence.
DIF: Cognitive Level: Knowledge REF: Text Reference: 184, Figure 11-1;
14. 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. transitional care setting.
c. nursing home.
d. assisted living center.

ANS: d
The assisted living center allows the greatest amount of personal freedom while
supplying supervision, meals, and social activities.

15. Transfer from a long-term care facility is being considered for a combative resident.
OBRA Resident Rights that impact this decision include
a. there must be a legitimate and documented reason for the transfer.
b. the family can prevent the discharge through litigation.
c. the care plan must have addressed the problem behavior.
d. the resident may delay the transfer for 20 days by simply requesting it.
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: Cognitive Level: Application REF: Text Reference: 182, Box 11-1;

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Black & Hawks: Medical-Surgical Nursing: Clinical Management for

Positive Outcomes, 7th Edition

Chapter 11: Long-Term Care

DIF: Cognitive Level: Knowledge REF: Text Reference: 179

DIF: Cognitive Level: Knowledge REF: Text Reference: 180

DIF: Cognitive Level: Knowledge REF: Text Reference: 180

Elsevier items and derived items 2005 by Elsevier Inc.

DIF: Cognitive Level: Knowledge REF: Text Reference: 180

DIF: Cognitive Level: Knowledge REF: Text Reference: 181

DIF: Cognitive Level: Knowledge REF: Text Reference: 181

7. Among the Resident Rights outlined by OBRA is the right to

Elsevier items and derived items 2005 by Elsevier Inc.

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

DIF: Cognitive Level: Knowledge REF: Text Reference: 182, 183;

DIF: Cognitive Level: Knowledge REF: Text Reference: 183

Elsevier items and derived items 2005 by Elsevier Inc.

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

DIF: Cognitive Level: Knowledge REF: Text Reference: 183

DIF: Cognitive Level: Knowledge REF: Text Reference: 185

Elsevier items and derived items 2005 by Elsevier Inc.

DIF: Cognitive Level: Knowledge REF: Text Reference: 187

Elsevier items and derived items 2005 by Elsevier Inc.

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