Telehealth and Beyond

Discussion Question:

As technology in healthcare continues a shift to homecare is inevitable, safety is of utmost importance. Review the most current Patient Safety Goals for homecare found under the NPSG Program Links( https://www.jointcommission.org/standards/national-patient-safety-goals/) . Review the 5 NPGS listed for the Home Care option and discuss each one related to how the nurse can ensure they are met. Finally, locate an article that discusses technology and home care and summarize the findings. How will this shift to home care impact your day-to-day nursing practice?

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length.

Assignment:

Telehealth and Beyond

Create a PowerPoint presentation that addresses each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with at least three (3) sources using APA citations throughout your presentation. Make sure to cite the sources using the APA writing style for the presentation. Include a slide for your references at the end. Follow best practices for PowerPoint presentations related to text size, color, images, effects, wordiness, and multimedia enhancements. Review the rubric criteria for this assignment.

  • Describe the need for Telehealth services. Explain the difference between Synchronous Telehealth and Asynchronous Telehealth. Finally, offer your personal opinions related to this new mechanism for health care (first person narration can be used for this final part).
  • Find an article that discusses another new or upcoming technology change. Discuss the main points of the article related to the technology (remember to cite the article). Then explain how nursing will be directly impacted by this new technology listing one positive and one possible downside.
    • Title Slide (1 slide)
    • Objective Slide (1 slide)
    • Need for Telehealth services. (2-3 slides)
    • Difference between Synchronous Telehealth and Asynchronous Telehealth. (1-2 slides)
    • Personal opinions of Telehealth. (1-2 slides)
    • Article on new or upcoming technology change, with main points regarding technology. (remember to cite the article) (2-4 slides)
    • How nursing is impacted by this new technology.  (2-3 slides)
    • References (1 slide)

Assignment Expectations:

Length: 11-17 slides

Structure: Include a title slide, objective slide, content slides, reference slide in APA format.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required for this assignment.

Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

Format: Save your assignment as a Microsoft PPT document (.pptx) or a PDF document (.pdf)

File name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”)

describe how the risk management program at the organization where you work (or at that of a typical health care organization) addresses social media and patient information privacy

Briefly describe how the risk management program at the organization where you work (or at that of a typical health care organization) addresses social media and patient information privacy. Provide three examples of risk management steps your health care organization (or another health care organization) could take to further protect patient information. Support your analysis with a minimum of one peer-reviewed reference.

Explain how soluble fiber lowers blood cholesterol,

Explain how soluble fiber lowers blood cholesterol, and list at least 3 foods high in soluble fiber:

Describe the health benefits of omega 3 fatty acids, and list at least 3 foods high in these.

Describe the health benefits of monounsaturated fats, and list at least 3 foods high in these.

# 38

Your roommate is in a hurry to lose 20 pounds, because her high school reunion is coming up in two weeks. She decides to go on a high protein (soy powder) very low calories vegan diet- she figures about 300 kcals a day would do the trick. She doesn’t know much about vegan diets but her friends are on one so she plans to focus on eating lettuce salads with fat free dressing, soy protein powder mixed water and celery. She asks for your advice on losing weight and vegan diets since she knows you are taking a nutrition class this quarter.

What are some health risks associated with her diet? What nutrition might she be low in?

What happened to the BMR ( Basal Metabolic Rate on a very low kcal( starvation) diet like this?

What kind of weight are your friends losing? Explain ( as the scale numbers fall, what is being lost, and why?)

How likely is your roommate to keep the weight she loses off?Explain. Do you have any good advice for her? Plan out a one day vegan diet ( so that all of her nutrient needs are met) and an activity plan for her that would help her out…

#39

1. Describe the difference between kwashiorkor and marasmus. 2 points

2. Your friend has cramping and diarrhea after drinking milk. Why? Explain. Which dairy foods could she potentially eat without getting these symptoms? explain why? 3 points

3. List four factors that that affect a person’s BMR rate: 2 points

4. List two health problems associated with obesity, and two associated with being underweight: 2 points

5. Design a vegan diet for one meal. Explain how you ensure all the essential amino acids that make up a complete protein will be included; and explain which of the essential amino acids are being complemented.  2 points

#40

our friend, who is obese, is at risk for diabetes Type 2, and has high triglycerides and cholesterol, with heart disease running in the family. He admits to being lazy, loves lying around and watching his favorite TV shows (while snacking), and likes to eat out at fast food places for meals (not a fan of cooking), but realizes that it might be time to change his diet and lifestyle. Come up with a plan that would work for him and help improve his health:

1. What are his two main risk factors for developing type 2 diabetes?

Suggestions to lower his risk? Explain (look at the science)….

2. What could he do to lower his triglycerides, cholesterol and risk of cardiovascular disease?

Explain how your suggestions will help (look at the science in your explanation).

3. Plan out a one day diet and activity plan for your friend that incorporates your suggestions- breakfast, lunch, dinner and snack.

#41

Ian is wanting to lose weight the healthy way. His physical data are the following:

Age: 25 years. Height: 6 feet, 0 inches Weight: 260 pounds

Activity Level: Sedentary, presently consumes about 3000 Calories/day

1. Calculate his body mass index (BMI) and indicate which zone he falls into (underweight, overweight, obese).

2. Calculate the number of Calories he should be consuming based on his ideal healthy weight.

3. If he follows this Calorie requirement based on his ideal healthy weight, calculate how many pounds will he lose in one month.

A Primer on Physical Therapy Assistant Education

(Use your own words, can be TYPED).

Chapter 4: A Primer on Physical Therapy Assistant Education

Read Pages 39-48

1)Summarize “PTA Education”(5pts)

2)Review Table 4-2;

What is accreditation & why is it important? (4pts)

a.Who is the accrediting body for Physical Therapy Education?

b.Is the FNU PTA Program Accredited?

3)What is the Goal of PTA Education?(1pt)

4)What are the principles of performance evaluation in PTA education? (5pts)

a.Why is competency-based education so important in this field?

b.How can “mastery” be obtained?

Chapter 6: Student Performance Evaluation

Read Pages 61-70

1)In the program, the exams are most often made up of multiple-choice questions. Provide at least three methods that can be helpful when answering a multiple choice question.

a.Review Table 6-1.

2)What are the most important concepts when answering a short answer question?

3)How can you effectively answer a prompted essay question?

4)What do you think is the most important factor once you have completed a writing assignment?

Practical Examinations or Performance Assessments; Lab Exams and Skills Checks. (5pts)

•The “How to Guide”!

oRead the example case provided on Pg. 65 in text box.

1)Summarize what you understand from this case and what you are being asked to complete in your “Rx” (treatment) plan by your PT.

•Read the sample case and rubric that your Professors provide you with PRIOR to exam day – you have these examples as study tools!

•Make a treatment plan, practice with a timer.

oTreatments are TIMED, so are exams!

•Practice makes perfect!

oCreate scenarios with classmates and mix it up!

Like a game of Truth or Dare except this would be “Question or Skill”. Make a set of flashcards, pull a flash card – do it or answer it.

Ex: Question; what primary muscles extend the knee? Where to they originate and insert?

Ex: Skill; correctly perform the manual muscle test to assess strength of the Quadriceps on B legs.

2)Provide an example & create your own; “question” card & “skills” card – one of each.

•Before the skills check or lab exam day, ASK questions for clarification. USE YOUR EMAIL.

Review Table 6-3 & 6-4. (1pt)

oWhat is a red flag? Why is it important to always meet these criteria with every practical examination?

consider how you might assess and treat adolescent clients presenting with disruptive behavior.

The adolescent population is often referred to as “young adults,” but in some ways, this is a misrepresentation. Adolescents are not children, but they are not yet adults either. This transition from childhood to adulthood often poses many unique challenges to working with adolescent clients, particularly in terms of disruptive behavior. In your role, you must overcome these behaviors to effectively counsel clients. For this Discussion, as you examine the Disruptive Behaviors media in this week’s Learning Resources, consider how you might assess and treat adolescent clients presenting with disruptive behavior.

Select an antidepressant or antipsychotic medication and apply the available evidence and treatment guidelines to determine appropriate therapeutic options for a patient.

Select an antidepressant or antipsychotic medication and apply the available evidence and treatment guidelines to determine appropriate therapeutic options for a patient. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions, including interactions with CAM. Identify an additional (possibly off-labeled) use of the medication not related to depression or psychosis.

Discuss the organization and the family role in every one of the heritages mentioned about and how they affect (positively or negatively) the delivery of health care.

Read chapter 23,33and 34of the class textbook and review the attached PowerPoint presentations. Read content chapter 33 and 34 in Davis Plus OnlineWebsite. Once done answer the following questions;

1. Discuss the organization and the family role in every one of the heritages mentioned about and how they affect (positively or negatively) the delivery of health care.

2. Identify sociocultural variables within the Irish, Italian and Puerto Rican heritage and mention some examples.

A minimum of 3 evidenced-based references must be used (excluding the class textbook). References must be no older than 5 years. A minimum of 700 words is required.

1What is the assessment reference date (ARD)? The beginning of the observation period for items on the MDS. The endpoint of the observation period for items on the MDS. Not related to the observation period for items on the MDS. The endpoint of a Medicare Part A stay, known as the last covered day. 2 What is the minimum number of assessments due in one year? One, as long as it is a comprehensive assessment. Two, a comprehensive and a Quarterly. Three, a comprehensive and two Quarterlies. Four, a comprehensive and three Quarterlies. 3 After completing the MDS, when must it be encoded? 7 days 14 days 21 days 31 days 4 The assessment reference date (ARD) for a Significant Change of Status Assessment (SCSA) is set for March 20. What is the date range for the 7-day “look-back” observation window? March 14 through March 20 March 14 through March 21 March 20 through March 27 March 27 through April 5 When signing at V0200B1 and entering the date at V0200B2, the registered nurse assessment coordinator is indicating which one of the following items? Verifying that the CAAs are complete. Attesting to the accuracy of the MDS. Certifying that the care planning is complete. Verifying that the MDS is complete. 6 The Activities Director completed the items assigned to her for a resident’s Admission assessment on February 25. She was off the next day when the assessment was printed and ready for signatures verifying accuracy at Z0400. When she returned to work on February 27, what was the appropriate course of action for her? Sign Z0400A and enter February 27 at Z0400B. Ask a staff member who was present the previous day to verify the accuracy of her work and sign and date Z0400 for her items. Sign Z0400A and enter February 25 at Z0400B. Review the work she did on February 25 and attest to the accuracy on February 27. 7 The Activities Director completed the items assigned to her for a resident’s Admission assessment on February 25. She was off the next day when the assessment was printed and ready for signatures verifying accuracy at Z0400. When she returned to work on February 27, what was the appropriate course of action for her? Sign Z0400A and enter February 27 at Z0400B. Ask a staff member who was present the previous day to verify the accuracy of her work and sign and date Z0400 for her items. Sign Z0400A and enter February 25 at Z0400B. Review the work she did on February 25 and attest to the accuracy on February 27. 8 The regulation indicates which of the following for when the look-back period extends into the preadmission period? Permits capturing the information for coding on the MDS as long as the preadmission period captured does not exceed 7 days. Permits capturing the information for coding on the MDS as long as the preadmission period captured does not exceed 14 days. Does not permit capturing the information for MDS coding. Does not permit capturing the information for MDS coding unless the RAI User’s Manual instructions state otherwise. 9 If you complete the MDS and CAAs for an Admission assessment on day 7 of the stay, by what day must the care plan be completed? Day 7 Day 12 Day 14 Day 21 10 According to the OBRA regulations, the Admission assessment must be completed (CAA completion, V0200B2) by the end of what day? Day 7 Day 12 Day 14 Day 21 11 Which of the following is true about scheduling an Annual assessment? There should be no more than 366 days from the assessment reference date of the previous comprehensive assessment to the assessment reference date of the Annual. There should be no more than 366 days from the completion date of the previous comprehensive assessment to the completion date of the Annual. The number of days since the ARD of the previous quarterly is irrelevant. If the resident meets criteria for a Significant Change in Status Assessment, it is acceptable to just complete the Annual instead since it is exactly the same assessment. 12 If the resident discharges return anticipated prior to completion of the initial Admission assessment, and the nurse assessment coordinator elected not to complete the Admission assessment that was in progress, what is the appropriate choice upon return? Schedule a Significant Change in Status Assessment, because this is required upon readmission following any hospitalization. Schedule a start of therapy OMRA. Schedule an Admission assessment that must be completed by day 7 of the current stay. Schedule an Admission assessment that must be completed by day 14 of the current stay. 13 Comprehensive assessment is distinguished from an assessment that is not comprehensive by what characteristics? A comprehensive assessment does not include section V. A comprehensive assessment requires care planning; all other assessment types do not. A comprehensive assessment always requires CAAs. A comprehensive assessment must be supported by chart documentation. 14 If the assessment reference date for an Admission assessment is September 12, when must the registered nurse assessment coordinator sign off that the assessment is complete at V0200B2? By September 12. No later than the 14th day after admission. No later than the 14th day after the assessment reference date (ARD). No later than the 21st day after Admission. 15 What do you do if a private pay resident is discharged within 14 days of admission, and you’ve completed only a portion of the Admission assessment? You must complete the assessment with the day of death or discharge as the ARD. Completion of the assessment is not required, but you must file the incomplete assessment in the discharge record. Completion of the OBRA discharge is not required. You complete the assessment, including CAAs, to the best of your ability. 16 Mr. J.’s Annual assessment is in progress. The assessment reference date (ARD) is October 10. Which option represents an acceptable sequence of events? Team members completed their sections, several attesting to their accuracy at Z0400 on October 11, others signed off on October 12. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 11 and V0200B2, (CAA completion), on October 14. Team members completed the behavior items in section E and signed them off, attesting to their accuracy at Z0400 on October 9. All other sections were signed off by October 12 at Z0400. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 12 and at V0200B2, (CAA Completion), on October 13. Several team members completed their sections and signed them off, attesting to their accuracy on October 11. All other sections were signed off at Z0400 by October 12. The registered nurse assessment coordinator signed at V0200B2, (CAA completion), on October 12 and at Z0500B, (MDS completion), on October 13. Team members completed the sections with interview items signed on October 10. Other non-interview items were signed off on either October 11 or October 12. The registered nurse assessment coordinator signed at Z0500B, (MDS completion) on October 12 and V0200B2 (CAA completion) 17 June 5 was the assessment reference date (ARD) for Mrs. K’s Admission assessment. Her first Quarterly assessment had an ARD of September 3. In October, she had a significant change in status, and the significant change of status assessment (SCSA) had an ARD of October 15. When is the next Quarterly due at A2300 and her next Annual assessment due at A2300? Quarterly due no later than December 1, Annual due no later than June 5 Quarterly due no later than December 1, Annual due no later than October 15 Quarterly due no later than January 15, Annual due no later than June 5 Quarterly due no later than January 15, Annual due no later than October 15 18 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step? Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA). Document that the resident has had significant change in status requiring an SCSA. Complete a Significant Change in Status Assessment. Schedule an Annual Assessment. 19 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step? Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA). Document that the resident has had significant change in status requiring an SCSA. Complete a Significant Change in Status Assessment. Schedule an Annual Assessment. 20 When is a comprehensive assessment not required? The resident is admitted to the facility for the first time and remains beyond 14 days. The resident has a significant change in status by MDS definition. The resident returns after a five-week hospital admission. A resident’s significant weight loss is her only change in health status. 21 Today is October 21. Mr. E., a private pay resident, was admitted on October 10. The assessment reference date (ARD) for his Admission assessment is October 20. It is clear today that he has suffered a significant change in status related to extension of his stroke. The physician does not want to admit him to the hospital because the nursing facility can provide the necessary care and services. From an MDS standpoint, what is the correct course of action? Complete the Admission assessment as planned. Complete a Significant Change in Status Assessment, because it will replace the Admission assessment. Dually code the assessment as both the Admission and PPS 5 Day. Dually code the assessment as both the Admission and SCSA. 22 On December 1, a long-term care resident was again readmitted from a six-day hospital stay. She is not Medicare eligible. The nurse assessment coordinator (NAC) completed a Significant Change assessment with an assessment reference date (ARD) of December 9. On December 30, the resident was readmitted to the hospital again and the NAC completed an OBRA Discharge return anticipated assessment. The resident returned to the skilled nursing facility on January 5. In this situation, which of the following is the most likely assessment to be completed next? A significant change assessment A quarterly assessment A care area assessment A care plan 23 After completing the Quarterly MDS, when must it be transmitted to the national QIES ASAP system? Within 7 days

1

1What is the assessment reference date (ARD)?

The beginning of the observation period for items on the MDS.

The endpoint of the observation period for items on the MDS.

Not related to the observation period for items on the MDS.

The endpoint of a Medicare Part A stay, known as the last covered day.

2 What is the minimum number of assessments due in one year?

One, as long as it is a comprehensive assessment.

Two, a comprehensive and a Quarterly.

Three, a comprehensive and two Quarterlies.

Four, a comprehensive and three Quarterlies.

3 After completing the MDS, when must it be encoded?

7 days

14 days

21 days

31 days

4 The assessment reference date (ARD) for a Significant Change of Status Assessment (SCSA) is set for March 20. What is the date range for the 7-day “look-back” observation window?

March 14 through March 20

March 14 through March 21

March 20 through March 27

March 27 through April

5 When signing at V0200B1 and entering the date at V0200B2, the registered nurse assessment coordinator is indicating which one of the following items?

Verifying that the CAAs are complete.

Attesting to the accuracy of the MDS.

Certifying that the care planning is complete.

Verifying that the MDS is complete.

6 The Activities Director completed the items assigned to her for a resident’s Admission assessment on February 25. She was off the next day when the assessment was printed and ready for signatures verifying accuracy at Z0400. When she returned to work on February 27, what was the appropriate course of action for her?

Sign Z0400A and enter February 27 at Z0400B.

Ask a staff member who was present the previous day to verify the accuracy of her work and sign and date Z0400 for her items.

Sign Z0400A and enter February 25 at Z0400B.

Review the work she did on February 25 and attest to the accuracy on February 27.

7 The Activities Director completed the items assigned to her for a resident’s Admission assessment on February 25. She was off the next day when the assessment was printed and ready for signatures verifying accuracy at Z0400. When she returned to work on February 27, what was the appropriate course of action for her?

Sign Z0400A and enter February 27 at Z0400B.

Ask a staff member who was present the previous day to verify the accuracy of her work and sign and date Z0400 for her items.

Sign Z0400A and enter February 25 at Z0400B.

Review the work she did on February 25 and attest to the accuracy on February 27.

8 The regulation indicates which of the following for when the look-back period extends into the preadmission period?

Permits capturing the information for coding on the MDS as long as the preadmission period captured does not exceed 7 days.

Permits capturing the information for coding on the MDS as long as the preadmission period captured does not exceed 14 days.

Does not permit capturing the information for MDS coding.

Does not permit capturing the information for MDS coding unless the RAI User’s Manual instructions state otherwise.

9 If you complete the MDS and CAAs for an Admission assessment on day 7 of the stay, by what day must the care plan be completed?

Day 7

Day 12

Day 14

Day 21

10 According to the OBRA regulations, the Admission assessment must be completed (CAA completion, V0200B2) by the end of what day?

Day 7

Day 12

Day 14

Day 21

11 Which of the following is true about scheduling an Annual assessment?

There should be no more than 366 days from the assessment reference date of the previous comprehensive assessment to the assessment reference date of the Annual.

There should be no more than 366 days from the completion date of the previous comprehensive assessment to the completion date of the Annual.

The number of days since the ARD of the previous quarterly is irrelevant.

If the resident meets criteria for a Significant Change in Status Assessment, it is acceptable to just complete the Annual instead since it is exactly the same assessment.

12 If the resident discharges return anticipated prior to completion of the initial Admission assessment, and the nurse assessment coordinator elected not to complete the Admission assessment that was in progress, what is the appropriate choice upon return?

Schedule a Significant Change in Status Assessment, because this is required upon readmission following any hospitalization.

Schedule a start of therapy OMRA.

Schedule an Admission assessment that must be completed by day 7 of the current stay.

Schedule an Admission assessment that must be completed by day 14 of the current stay.

13 Comprehensive assessment is distinguished from an assessment that is not comprehensive by what characteristics?

A comprehensive assessment does not include section V.

A comprehensive assessment requires care planning; all other assessment types do not.

A comprehensive assessment always requires CAAs.

A comprehensive assessment must be supported by chart documentation.

14 If the assessment reference date for an Admission assessment is September 12, when must the registered nurse assessment coordinator sign off that the assessment is complete at V0200B2?

By September 12.

No later than the 14th day after admission.

No later than the 14th day after the assessment reference date (ARD).

No later than the 21st day after Admission.

15 What do you do if a private pay resident is discharged within 14 days of admission, and you’ve completed only a portion of the Admission assessment?

You must complete the assessment with the day of death or discharge as the ARD.

Completion of the assessment is not required, but you must file the incomplete assessment in the discharge record.

Completion of the OBRA discharge is not required.

You complete the assessment, including CAAs, to the best of your ability.

16 Mr. J.’s Annual assessment is in progress. The assessment reference date (ARD) is October 10. Which option represents an acceptable sequence of events?

Team members completed their sections, several attesting to their accuracy at Z0400 on October 11, others signed off on October 12. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 11 and V0200B2, (CAA completion), on October 14.

Team members completed the behavior items in section E and signed them off, attesting to their accuracy at Z0400 on October 9. All other sections were signed off by October 12 at Z0400. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 12 and at V0200B2, (CAA Completion), on October 13.

Several team members completed their sections and signed them off, attesting to their accuracy on October 11. All other sections were signed off at Z0400 by October 12. The registered nurse assessment coordinator signed at V0200B2, (CAA completion), on October 12 and at Z0500B, (MDS completion), on October 13.

Team members completed the sections with interview items signed on October 10. Other non-interview items were signed off on either October 11 or October 12. The registered nurse assessment coordinator signed at Z0500B, (MDS completion) on October 12 and V0200B2 (CAA completion)

17 June 5 was the assessment reference date (ARD) for Mrs. K’s Admission assessment. Her first Quarterly assessment had an ARD of September 3. In October, she had a significant change in status, and the significant change of status assessment (SCSA) had an ARD of October 15. When is the next Quarterly due at A2300 and her next Annual assessment due at A2300?

Quarterly due no later than December 1, Annual due no later than June 5

Quarterly due no later than December 1, Annual due no later than October 15

Quarterly due no later than January 15, Annual due no later than June 5

Quarterly due no later than January 15, Annual due no later than October 15

18 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step?

Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA).

Document that the resident has had significant change in status requiring an SCSA.

Complete a Significant Change in Status Assessment.

Schedule an Annual Assessment.

19 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step?

Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA).

Document that the resident has had significant change in status requiring an SCSA.

Complete a Significant Change in Status Assessment.

Schedule an Annual Assessment.

20 When is a comprehensive assessment not required?

The resident is admitted to the facility for the first time and remains beyond 14 days.

The resident has a significant change in status by MDS definition.

The resident returns after a five-week hospital admission.

A resident’s significant weight loss is her only change in health status.

21 Today is October 21. Mr. E., a private pay resident, was admitted on October 10. The assessment reference date (ARD) for his Admission assessment is October 20. It is clear today that he has suffered a significant change in status related to extension of his stroke. The physician does not want to admit him to the hospital because the nursing facility can provide the necessary care and services. From an MDS standpoint, what is the correct course of action?

Complete the Admission assessment as planned.

Complete a Significant Change in Status Assessment, because it will replace the Admission assessment.

Dually code the assessment as both the Admission and PPS 5 Day.

Dually code the assessment as both the Admission and SCSA.

22 On December 1, a long-term care resident was again readmitted from a six-day hospital stay. She is not Medicare eligible. The nurse assessment coordinator (NAC) completed a Significant Change assessment with an assessment reference date (ARD) of December 9. On December 30, the resident was readmitted to the hospital again and the NAC completed an OBRA Discharge return anticipated assessment. The resident returned to the skilled nursing facility on January 5. In this situation, which of the following is the most likely assessment to be completed next?

A significant change assessment

A quarterly assessment

A care area assessment

A care plan

23 After completing the Quarterly MDS, when must it be transmitted to the national QIES ASAP system?

Within 7 days

The beginning of the observation period for items on the MDS.

The endpoint of the observation period for items on the MDS.

Not related to the observation period for items on the MDS.

The endpoint of a Medicare Part A stay, known as the last covered day.

2 What is the minimum number of assessments due in one year?

One, as long as it is a comprehensive assessment.

Two, a comprehensive and a Quarterly.

Three, a comprehensive and two Quarterlies.

Four, a comprehensive and three Quarterlies.

3 After completing the MDS, when must it be encoded?

7 days

14 days

21 days

31 days

4 The assessment reference date (ARD) for a Significant Change of Status Assessment (SCSA) is set for March 20. What is the date range for the 7-day “look-back” observation window?

March 14 through March 20

March 14 through March 21

March 20 through March 27

March 27 through April

5 When signing at V0200B1 and entering the date at V0200B2, the registered nurse assessment coordinator is indicating which one of the following items?

Verifying that the CAAs are complete.

Attesting to the accuracy of the MDS.

Certifying that the care planning is complete.

Verifying that the MDS is complete.

6 The Activities Director completed the items assigned to her for a resident’s Admission assessment on February 25. She was off the next day when the assessment was printed and ready for signatures verifying accuracy at Z0400. When she returned to work on February 27, what was the appropriate course of action for her?

Sign Z0400A and enter February 27 at Z0400B.

Ask a staff member who was present the previous day to verify the accuracy of her work and sign and date Z0400 for her items.

Sign Z0400A and enter February 25 at Z0400B.

Review the work she did on February 25 and attest to the accuracy on February 27.

7 The Activities Director completed the items assigned to her for a resident’s Admission assessment on February 25. She was off the next day when the assessment was printed and ready for signatures verifying accuracy at Z0400. When she returned to work on February 27, what was the appropriate course of action for her?

Sign Z0400A and enter February 27 at Z0400B.

Ask a staff member who was present the previous day to verify the accuracy of her work and sign and date Z0400 for her items.

Sign Z0400A and enter February 25 at Z0400B.

Review the work she did on February 25 and attest to the accuracy on February 27.

8 The regulation indicates which of the following for when the look-back period extends into the preadmission period?

Permits capturing the information for coding on the MDS as long as the preadmission period captured does not exceed 7 days.

Permits capturing the information for coding on the MDS as long as the preadmission period captured does not exceed 14 days.

Does not permit capturing the information for MDS coding.

Does not permit capturing the information for MDS coding unless the RAI User’s Manual instructions state otherwise.

9 If you complete the MDS and CAAs for an Admission assessment on day 7 of the stay, by what day must the care plan be completed?

Day 7

Day 12

Day 14

Day 21

10 According to the OBRA regulations, the Admission assessment must be completed (CAA completion, V0200B2) by the end of what day?

Day 7

Day 12

Day 14

Day 21

11 Which of the following is true about scheduling an Annual assessment?

There should be no more than 366 days from the assessment reference date of the previous comprehensive assessment to the assessment reference date of the Annual.

There should be no more than 366 days from the completion date of the previous comprehensive assessment to the completion date of the Annual.

The number of days since the ARD of the previous quarterly is irrelevant.

If the resident meets criteria for a Significant Change in Status Assessment, it is acceptable to just complete the Annual instead since it is exactly the same assessment.

12 If the resident discharges return anticipated prior to completion of the initial Admission assessment, and the nurse assessment coordinator elected not to complete the Admission assessment that was in progress, what is the appropriate choice upon return?

Schedule a Significant Change in Status Assessment, because this is required upon readmission following any hospitalization.

Schedule a start of therapy OMRA.

Schedule an Admission assessment that must be completed by day 7 of the current stay.

Schedule an Admission assessment that must be completed by day 14 of the current stay.

13 Comprehensive assessment is distinguished from an assessment that is not comprehensive by what characteristics?

A comprehensive assessment does not include section V.

A comprehensive assessment requires care planning; all other assessment types do not.

A comprehensive assessment always requires CAAs.

A comprehensive assessment must be supported by chart documentation.

14 If the assessment reference date for an Admission assessment is September 12, when must the registered nurse assessment coordinator sign off that the assessment is complete at V0200B2?

By September 12.

No later than the 14th day after admission.

No later than the 14th day after the assessment reference date (ARD).

No later than the 21st day after Admission.

15 What do you do if a private pay resident is discharged within 14 days of admission, and you’ve completed only a portion of the Admission assessment?

You must complete the assessment with the day of death or discharge as the ARD.

Completion of the assessment is not required, but you must file the incomplete assessment in the discharge record.

Completion of the OBRA discharge is not required.

You complete the assessment, including CAAs, to the best of your ability.

16 Mr. J.’s Annual assessment is in progress. The assessment reference date (ARD) is October 10. Which option represents an acceptable sequence of events?

Team members completed their sections, several attesting to their accuracy at Z0400 on October 11, others signed off on October 12. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 11 and V0200B2, (CAA completion), on October 14.

Team members completed the behavior items in section E and signed them off, attesting to their accuracy at Z0400 on October 9. All other sections were signed off by October 12 at Z0400. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 12 and at V0200B2, (CAA Completion), on October 13.

Several team members completed their sections and signed them off, attesting to their accuracy on October 11. All other sections were signed off at Z0400 by October 12. The registered nurse assessment coordinator signed at V0200B2, (CAA completion), on October 12 and at Z0500B, (MDS completion), on October 13.

Team members completed the sections with interview items signed on October 10. Other non-interview items were signed off on either October 11 or October 12. The registered nurse assessment coordinator signed at Z0500B, (MDS completion) on October 12 and V0200B2 (CAA completion)

17 June 5 was the assessment reference date (ARD) for Mrs. K’s Admission assessment. Her first Quarterly assessment had an ARD of September 3. In October, she had a significant change in status, and the significant change of status assessment (SCSA) had an ARD of October 15. When is the next Quarterly due at A2300 and her next Annual assessment due at A2300?

Quarterly due no later than December 1, Annual due no later than June 5

Quarterly due no later than December 1, Annual due no later than October 15

Quarterly due no later than January 15, Annual due no later than June 5

Quarterly due no later than January 15, Annual due no later than October 15

18 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step?

Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA).

Document that the resident has had significant change in status requiring an SCSA.

Complete a Significant Change in Status Assessment.

Schedule an Annual Assessment.

19 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step?

Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA).

Document that the resident has had significant change in status requiring an SCSA.

Complete a Significant Change in Status Assessment.

Schedule an Annual Assessment.

20 When is a comprehensive assessment not required?

The resident is admitted to the facility for the first time and remains beyond 14 days.

The resident has a significant change in status by MDS definition.

The resident returns after a five-week hospital admission.

A resident’s significant weight loss is her only change in health status.

21 Today is October 21. Mr. E., a private pay resident, was admitted on October 10. The assessment reference date (ARD) for his Admission assessment is October 20. It is clear today that he has suffered a significant change in status related to extension of his stroke. The physician does not want to admit him to the hospital because the nursing facility can provide the necessary care and services. From an MDS standpoint, what is the correct course of action?

Complete the Admission assessment as planned.

Complete a Significant Change in Status Assessment, because it will replace the Admission assessment.

Dually code the assessment as both the Admission and PPS 5 Day.

Dually code the assessment as both the Admission and SCSA.

22 On December 1, a long-term care resident was again readmitted from a six-day hospital stay. She is not Medicare eligible. The nurse assessment coordinator (NAC) completed a Significant Change assessment with an assessment reference date (ARD) of December 9. On December 30, the resident was readmitted to the hospital again and the NAC completed an OBRA Discharge return anticipated assessment. The resident returned to the skilled nursing facility on January 5. In this situation, which of the following is the most likely assessment to be completed next?

A significant change assessment

A quarterly assessment

A care area assessment

A care plan

23 After completing the Quarterly MDS, when must it be transmitted to the national QIES ASAP system?

Within 7 days

type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why.

Case Study:

A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago.

Write a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples

Betty, the chief nursing officer, had to make a decision about buying 120 new hospital beds for patient rooms. After she interviewed nurse mangers at the units where the beds were going to be placed, B

Betty, the chief nursing officer, had to make a decision about buying 120 new hospital beds for patient rooms. After she interviewed nurse mangers at the units where the beds were going to be placed, Betty compiled her findings and decided to contact a well-known equipment company to obtain prices and contracts. The equipment company’s executive salesperson, Jim, discussed options at length with her and invited her and her significant other to an upcoming all-expenses-paid lavish retreat at a five-star hotel in Hawaii to see demonstrations of the beds and to hear a comprehensive sales pitch. Betty thought to herself, “We badly need some relaxation and stress relief. Hawaii would be so much fun. Would it be wrong for us to go?”

  • If you were Betty, what would you do? Give your rationale. Justify your answer with an ethical framework—a theory, approach, or principle.
  • Do you consider this situation a conflict of interest? Why or why not? Give your rationale.
  • What policies, if any, should be in place regarding a scenario such as this one? Do you have any such policies in place at work for similar situations? Do such policies impact day-to-day activities in any way? Explain.