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Medicaid
LOC, Scenario based questions
| Question | Answer |
|---|---|
| A client with schizophrenia has not shown delusions in the last 3 days because staff ensure medication compliance. Without medication the delusions would likely return. How should the behavior be coded? | Code the behavior as present but not exhibited in the last 3 days. |
| A client repeatedly walks out the front door and cannot explain where they are going or how to get home. What behavior is this? | Wandering. |
| A client refuses insulin because they believe staff are poisoning them. How should this be coded? | Resisting care. |
| A client declines a medication after discussing side effects with their physician and understanding the risks. Is this resisting care? | No; it is an informed medical decision. |
| During the assessment, a client repeats the same question four times. What deficit is most likely present? | Short-term memory deficit. |
| A client cannot explain how to make a sandwich or coffee. Which memory area may be impaired? | Procedural memory. |
| A client does not recognize a caregiver they see every day. Which memory area may be impaired? | Situational memory. |
| A client is alert and oriented in the morning but confused and agitated every evening. How should this be coded? | Mental function varies over the course of the day. |
| A daughter is visiting and currently performs all bathing tasks for her mother. When coding capacity, what should you assess? | The mother's ability if the daughter were not there. |
| A client needs their walker placed beside the bed but then walks independently. What ADL code is most appropriate? | Code 1; setup only. |
| A client needs reminders throughout bathing but no physical help. What ADL code is most appropriate? | Code 2; supervision. |
| A caregiver guides a client's arm into a shirt sleeve but does not support the arm's weight. What code fits best? | Code 3; limited assistance. |
| A caregiver must lift a client's leg into the bathtub, but the client performs most other transfer tasks. What code fits best? | Code 4; extensive assistance. |
| A caregiver provides weight-bearing support for most of the transfer process into the bathtub. What code fits best? | Code 5; maximal assistance. |
| A client cannot participate in any part of dressing. What code fits best? | Code 6; total dependence. |
| A wheelchair user independently moves around the home once seated in the chair. How should locomotion be coded? | Independent locomotion. |
| A client spends most of the day in bed but transfers to a wheelchair for meals. Are they bedbound? | No. |
| A client requires total assistance with eating every meal. What important eligibility implication exists? | This may trigger level of care. |
| A client receives nutrition through a feeding tube but independently manages the feeding equipment. How should eating be coded? | Based on support needed; not automatically dependent. |
| A doctor advises a client to eat fewer carbohydrates. No measured diet is ordered. Does this count as a physician-ordered diet? | No. |
| A client can get to the bathroom alone but needs help pulling clothing up and cleaning after incontinence. Which item should receive assistance coding? | Toilet use. |
| A client can wash their body independently but needs help stepping over the tub edge. How should bathing be coded? | Bathing independent; bath transfer needs assistance. |
| A client can wash their body but needs help washing their hair. Is bathing assistance required? | No; hair care is coded under personal hygiene. |
| A client can put on clothing but cannot manage buttons or zippers. What dressing factor should be considered? | Fasteners are part of dressing. |
| A client forgets medication doses and needs weekly nurse setup. What is the minimum medication-management code? | Code 4. |
| A client only needs reminders to take medications and no hands-on assistance. What medication-management code fits best? | Code 2. |
| A client can plan meals, gather ingredients, and set the table but cannot safely prepare food. What meal-prep code range is likely? | Extensive assistance because they still perform most subtasks. |
| A client needs help planning, gathering ingredients, and preparing food but can set the table independently. What meal-prep code range is likely? | Maximal assistance because help is needed with more than 50% of subtasks. |
| A client prepares meals independently but has fallen several times in the kitchen. What should be considered when coding? | Safety and presumed ability, not just what they currently do. |
| While coding cognition, you identify a procedural memory deficit. What additional area should you review carefully? | Daily decision-making and related cognitive items because deficits often affect multiple areas. |
Created by:
research11