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1. Which term describes a person whose gender identity differs from the sex they were assigned at birth?
A. Intersex
B. Transgender
C. Non-binary
D. Gender fluid
2. Which statement about being intersex is consistent with the course?
A. It refers to variations in reproductive or sexual anatomy and is distinct from sexual orientation and gender identity
B. It describes a gender identity that exists outside the male/female binary
C. It describes attraction to people regardless of their gender identity
D. It is a subset of transgender identity
3. Approximately how many adults aged 50 and older in the United States currently identify as LGBTQ+?
A. 1.2 million
B. 5.5 million
C. 2.7 million
D. 14 million
4. In what year did the American Psychiatric Association remove homosexuality from its classification of mental disorders?
A. 1973
B. 1953
C. 1993
D. 2003
5. Why may some older LGBTQ+ adults be hesitant to enter a nursing home?
A. Most nursing homes are not permitted to admit same-sex couples to shared rooms
B. Federal rules require facilities to record a resident’s sexual orientation at admission
C. LGBTQ+ adults are generally ineligible for Medicaid-funded long-term care
D. Many have lived through decades of institutional discrimination and fear being vulnerable when dependent on others for care
6. A staff member assumes that an older resident’s longtime partner is the resident’s sibling. How does the course classify this behavior?
A. A systemic barrier embedded in facility policy
B. A microaggression rooted in heteronormative assumptions
C. Overt harassment that requires immediate termination
D. A violation of the resident’s right to visitation
7. Research cited in the course links repeated exposure to microaggressions with which outcomes?
A. Short-term embarrassment with no lasting health effects
B. Anxiety but no physical health effects
C. Depression, prolonged stress, high blood pressure, and sleep difficulties
D. Higher rates of dementia and falls
8. What does the course state about discrimination based on sexual orientation and gender identity following the Bostock v. Clayton County Supreme Court decision?
A. It is prohibited under federal law
B. It is prohibited only in states that have their own protections
C. It is prohibited for residents but not for employees
D. It is prohibited only in federally operated facilities
9. A resident’s family objects to an LGBTQ+ nurse caring for their mother. According to the course, how should the facility respond?
A. Reassign the nurse to honor the resident’s and family’s preferences
B. Allow the nurse to continue only if the resident consents in writing
C. Document the objection and reassign the nurse until the family is more comfortable
D. Recognize that resident or family objections cannot justify discriminatory treatment of LGBTQ+ staff
10. Which approach does the course recommend for making cultural competency training engaging and impactful?
A. Providing a single annual lecture followed by a written test
B. Using real-life scenarios and role-playing, and creating opportunities for ongoing dialogue and feedback
C. Assigning self-paced reading to new staff at the time of hire
D. Limiting training to supervisors, who then relay key points to staff
11. Beyond listing protected characteristics, what should a robust non-discrimination policy include?
A. Clear consequences for discriminatory behavior, including disciplinary action up to termination, and measures to address resident-on-resident harassment
B. A requirement that residents disclose their sexual orientation at admission
C. Exemptions for staff members who have personal objections
D. A list of approved family members who may visit each resident
12. How does the course recommend revising traditional visitation policies?
A. Limit visitation to legal spouses and blood relatives to simplify enforcement
B. Require family approval before nonrelatives may visit
C. Use inclusive terms such as “partner” or “designated support person,” and make visitation decisions in collaboration with the resident
D. Allow staff to determine appropriate visitors based on the resident’s family structure
13. What role does the course assign to the nursing home administrator in cultivating a culture of inclusion?
A. Delegating inclusion efforts to human resources to ensure objectivity
B. Focusing on policy compliance rather than day-to-day culture
C. Limiting involvement to approving the annual training calendar
D. Setting the tone by consistently modeling inclusive behavior and using respectful language
14. Under the federal requirements described in the course, how long must grievance records be maintained?
A. At least one year from the date the grievance was filed
B. At least three years from the date of resolution
C. At least five years from the date the grievance was filed
D. Until the resident is discharged from the facility
15. Which element must be included in the written grievance decision provided to a resident?
A. The name of the staff member involved in the complaint
B. A copy of the resident’s current care plan
C. Whether the grievance was confirmed
D. A signed statement that the resident will not file further complaints
16. Why does the course emphasize having clear grievance procedures for staff as well as residents?
A. Neglecting staff concerns can lead to turnover, burnout, and a decline in the quality of resident care
B. Federal regulations require the Grievance Official to resolve all staff complaints
C. Staff grievances must be reported to the Long-Term Care Ombudsman
D. Staff grievances are exempt from documentation requirements
17. Which statement about the Long-Term Care Ombudsman is consistent with the course?
A. Ombudsmen are facility employees who report directly to the administrator
B. Ombudsmen must be contacted for every grievance a resident files
C. Ombudsmen may review resident records without the resident’s permission
D. Ombudsmen can meet privately with residents, but they are not intended to serve as regular trainers or mediators
18. Under 42 CFR §483.21, within what timeframe must a facility develop a baseline care plan for a new resident?
A. Within 24 hours of admission
B. Within 48 hours of admission
C. Within 7 days of admission
D. Within 14 days of admission
19. When auditing the care plan of a resident who identifies as LGBTQ+, what does the course recommend reviewing?
A. Documentation of when and how the resident came out to family
B. Whether the resident’s family has approved the resident’s identity
C. Pronoun preferences, spouse or partner information, and any needed support services, including mental health services
D. Whether a separate confidential care plan has been created for the resident’s identity
20. In the case study “Living Two Lives,” who does the course say should ultimately decide whether Eleanor discloses her relationship with Ruth to her family?
A. Her primary nurse, Maria
B. Her counselor
C. The care team, together with her son during a care planning meeting
D. Eleanor
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