NAB Core Examination Study Set |
2026/2027 Verified Edition
National Association of Long Term Care Administrator Boards – Core
Examination (Long-Term Care Administrator Licensure)
Exam Structure
Feature Details
Exam Title NAB Core Examination (Long-Term Care
Administrator Licensure)
Curriculum Year 2026/2027
Total Official Questions 100 Scored Questions
Format Multiple Choice (4 Options)
Time Limit 2.5 Hours (150 Minutes)
Introduction
This comprehensive study guide is tailored for the 2026/2027 National Association of Long Term
Care Administrator Boards (NAB) Core Examination. While sharing actual live exam questions
violates NAB test security and copyright policies, this resource provides highly accurate, verified
simulated questions that perfectly mirror the official 100-question blueprint. These practice items
are designed to test your administrative judgment, regulatory knowledge, and operational
expertise to ensure you pass the licensure test with confidence.
Answer Format: All correct answers are clearly marked in bold to support efficient study and
mastery of Long-Term Care Administration content.
Examination Overview – NAB Core Blueprint
Domain Percentage Approx. Questions
1. Resident Care and Quality 25% 25
of Life
2. Human Resources 20% 20
Management
3. Finance and 20% 20
Administration
4. Environment and Physical 15% 15
Plant Management
5. Leadership and Regulatory 20% 20
Compliance
,Examination – 100 Questions
Questions 1-5 are the original verified sample questions. Questions 6-100 complete the
2026/2027 blueprint.
1. A resident with advanced dementia has stopped eating orally. The family is highly
distressed and insists on the placement of a percutaneous endoscopic gastrostomy
(PEG) feeding tube. What is the most appropriate initial action for the nursing
home administrator?
Domain: Resident Care and Quality of Life
A) Immediately schedule the resident for the PEG tube placement to honor the family's
wishes.
B) Convene an interdisciplinary care conference with the family to discuss goals
of care, palliative options, and the clinical risks of tube feeding in advanced
dementia.
C) Inform the family that state law prohibits feeding tubes in patients with dementia.
D) Transfer the resident to an acute care hospital for a psychiatric evaluation.
Correct Answer: B — In cases of advanced dementia and declining oral intake, the standard
of care and regulatory best practice is to hold a family care conference. The interdisciplinary
team should educate the family on the lack of clinical benefit and potential harms of artificial
nutrition in advanced dementia, while exploring palliative care and comfort feeding options.
2. A certified nursing assistant (CNA) calls in sick for the third time this week,
resulting in short staffing on the unit. The CNA claims they have a chronic illness.
What is the most appropriate administrative action regarding this employee?
Domain: Human Resources Management
A) Immediately terminate the CNA for violating the facility's attendance policy.
B) Assign the CNA to a non-resident care administrative role to prevent future short staffing.
C) Review the attendance record, conduct a formal counseling session, and
initiate an attendance improvement plan while exploring FMLA or ADA
accommodations if applicable.
D) Ignore the absences since the CNA has a chronic illness to avoid a discrimination lawsuit.
Correct Answer: C — The administrator must balance operational needs with legal
compliance. Immediate termination without documentation or exploring accommodations (like
ADA or FMLA) poses a legal risk. Document, counsel, implement an improvement plan, and
evaluate for protected leave.
3. The facility's average daily census has dropped by 10% over the last quarter,
negatively impacting the operating budget. Which financial strategy should the
administrator prioritize first to stabilize the budget without compromising resident
care?
Domain: Finance and Administration
A) Reduce the quality and quantity of food services to lower dietary costs.
B) Conduct a variance analysis to identify and reduce controllable variable
costs, such as agency labor and overtime, while maintaining core staffing ratios.
C) Immediately lay off 20% of the full-time nursing staff.
D) Increase the daily rate for all new admissions by 30%.
, Correct Answer: B — When census drops, control variable expenses like agency staff and
overtime that are no longer justified. Cutting food quality or core nursing staff violates care
standards, and arbitrarily raising rates is not market-viable.
4. During a routine safety walk-through, the administrator notices that the water
temperature at a resident's showerhead is 130°F (54°C). What is the correct
immediate action?
Domain: Environment and Physical Plant Management
A) Post a warning sign near the showerhead indicating the water is hot.
B) Immediately adjust the anti-scald valve to bring the temperature to the
regulatory standard (typically 105°F-110°F) and document the correction.
C) Wait for the maintenance director to return the next day to fix the boiler.
D) Instruct the nursing staff to mix cold water manually before every shower.
Correct Answer: B — Life Safety Code and CMS regulations mandate water temperatures in
resident bathing areas be regulated to prevent scalding, typically max 110°F. 130°F is a severe
burn risk and must be corrected immediately with documentation.
5. A state surveyor arrives unannounced at the facility at 8:00 AM and requests the
facility's emergency preparedness drill logs and staff orientation records from the
past year. What should the administrator do?
Domain: Leadership and Regulatory Compliance
A) Refuse to provide the records until the surveyor presents a federal subpoena.
B) Tell the surveyor they must schedule an appointment and return next week.
C) Provide the requested logs immediately, ensure the surveyor has a
designated workspace, and notify the respective department heads to prepare
for the survey.
D) Only provide the emergency preparedness logs and hide the orientation records until
legal counsel arrives.
Correct Answer: C — State and federal surveyors have legal authority to conduct
unannounced inspections and request immediate access to records. Cooperate fully, provide
documents promptly, and activate the facility's survey protocol.
6. Under CMS Requirements of Participation, how frequently must a
comprehensive care plan be reviewed and revised for a long-term care resident?
Domain: Resident Care and Quality of Life
A) Monthly
B) Quarterly, and with any significant change in condition
C) Semiannually only
D) Annually unless the family requests a review
Correct Answer: B — F-tag 657 requires the interdisciplinary team to review and revise the
comprehensive care plan at least quarterly, and after each assessment, including with any
significant change.
7. A resident with a history of falls has a new order for a physical restraint vest for
'safety'. What is the administrator's first compliance priority?
2026/2027 Verified Edition
National Association of Long Term Care Administrator Boards – Core
Examination (Long-Term Care Administrator Licensure)
Exam Structure
Feature Details
Exam Title NAB Core Examination (Long-Term Care
Administrator Licensure)
Curriculum Year 2026/2027
Total Official Questions 100 Scored Questions
Format Multiple Choice (4 Options)
Time Limit 2.5 Hours (150 Minutes)
Introduction
This comprehensive study guide is tailored for the 2026/2027 National Association of Long Term
Care Administrator Boards (NAB) Core Examination. While sharing actual live exam questions
violates NAB test security and copyright policies, this resource provides highly accurate, verified
simulated questions that perfectly mirror the official 100-question blueprint. These practice items
are designed to test your administrative judgment, regulatory knowledge, and operational
expertise to ensure you pass the licensure test with confidence.
Answer Format: All correct answers are clearly marked in bold to support efficient study and
mastery of Long-Term Care Administration content.
Examination Overview – NAB Core Blueprint
Domain Percentage Approx. Questions
1. Resident Care and Quality 25% 25
of Life
2. Human Resources 20% 20
Management
3. Finance and 20% 20
Administration
4. Environment and Physical 15% 15
Plant Management
5. Leadership and Regulatory 20% 20
Compliance
,Examination – 100 Questions
Questions 1-5 are the original verified sample questions. Questions 6-100 complete the
2026/2027 blueprint.
1. A resident with advanced dementia has stopped eating orally. The family is highly
distressed and insists on the placement of a percutaneous endoscopic gastrostomy
(PEG) feeding tube. What is the most appropriate initial action for the nursing
home administrator?
Domain: Resident Care and Quality of Life
A) Immediately schedule the resident for the PEG tube placement to honor the family's
wishes.
B) Convene an interdisciplinary care conference with the family to discuss goals
of care, palliative options, and the clinical risks of tube feeding in advanced
dementia.
C) Inform the family that state law prohibits feeding tubes in patients with dementia.
D) Transfer the resident to an acute care hospital for a psychiatric evaluation.
Correct Answer: B — In cases of advanced dementia and declining oral intake, the standard
of care and regulatory best practice is to hold a family care conference. The interdisciplinary
team should educate the family on the lack of clinical benefit and potential harms of artificial
nutrition in advanced dementia, while exploring palliative care and comfort feeding options.
2. A certified nursing assistant (CNA) calls in sick for the third time this week,
resulting in short staffing on the unit. The CNA claims they have a chronic illness.
What is the most appropriate administrative action regarding this employee?
Domain: Human Resources Management
A) Immediately terminate the CNA for violating the facility's attendance policy.
B) Assign the CNA to a non-resident care administrative role to prevent future short staffing.
C) Review the attendance record, conduct a formal counseling session, and
initiate an attendance improvement plan while exploring FMLA or ADA
accommodations if applicable.
D) Ignore the absences since the CNA has a chronic illness to avoid a discrimination lawsuit.
Correct Answer: C — The administrator must balance operational needs with legal
compliance. Immediate termination without documentation or exploring accommodations (like
ADA or FMLA) poses a legal risk. Document, counsel, implement an improvement plan, and
evaluate for protected leave.
3. The facility's average daily census has dropped by 10% over the last quarter,
negatively impacting the operating budget. Which financial strategy should the
administrator prioritize first to stabilize the budget without compromising resident
care?
Domain: Finance and Administration
A) Reduce the quality and quantity of food services to lower dietary costs.
B) Conduct a variance analysis to identify and reduce controllable variable
costs, such as agency labor and overtime, while maintaining core staffing ratios.
C) Immediately lay off 20% of the full-time nursing staff.
D) Increase the daily rate for all new admissions by 30%.
, Correct Answer: B — When census drops, control variable expenses like agency staff and
overtime that are no longer justified. Cutting food quality or core nursing staff violates care
standards, and arbitrarily raising rates is not market-viable.
4. During a routine safety walk-through, the administrator notices that the water
temperature at a resident's showerhead is 130°F (54°C). What is the correct
immediate action?
Domain: Environment and Physical Plant Management
A) Post a warning sign near the showerhead indicating the water is hot.
B) Immediately adjust the anti-scald valve to bring the temperature to the
regulatory standard (typically 105°F-110°F) and document the correction.
C) Wait for the maintenance director to return the next day to fix the boiler.
D) Instruct the nursing staff to mix cold water manually before every shower.
Correct Answer: B — Life Safety Code and CMS regulations mandate water temperatures in
resident bathing areas be regulated to prevent scalding, typically max 110°F. 130°F is a severe
burn risk and must be corrected immediately with documentation.
5. A state surveyor arrives unannounced at the facility at 8:00 AM and requests the
facility's emergency preparedness drill logs and staff orientation records from the
past year. What should the administrator do?
Domain: Leadership and Regulatory Compliance
A) Refuse to provide the records until the surveyor presents a federal subpoena.
B) Tell the surveyor they must schedule an appointment and return next week.
C) Provide the requested logs immediately, ensure the surveyor has a
designated workspace, and notify the respective department heads to prepare
for the survey.
D) Only provide the emergency preparedness logs and hide the orientation records until
legal counsel arrives.
Correct Answer: C — State and federal surveyors have legal authority to conduct
unannounced inspections and request immediate access to records. Cooperate fully, provide
documents promptly, and activate the facility's survey protocol.
6. Under CMS Requirements of Participation, how frequently must a
comprehensive care plan be reviewed and revised for a long-term care resident?
Domain: Resident Care and Quality of Life
A) Monthly
B) Quarterly, and with any significant change in condition
C) Semiannually only
D) Annually unless the family requests a review
Correct Answer: B — F-tag 657 requires the interdisciplinary team to review and revise the
comprehensive care plan at least quarterly, and after each assessment, including with any
significant change.
7. A resident with a history of falls has a new order for a physical restraint vest for
'safety'. What is the administrator's first compliance priority?
