Illinois Nursing Home Administrators
NHA Ultimate Exam
**Question 1.** Which federal regulation primarily governs the provision of
nursing services in a skilled nursing facility?
A) The Health Insurance Portability and Accountability Act (HIPAA)
B) The Nursing Home Reform Act of 1987 (OBRA-87)
C) The Occupational Safety and Health Act (OSHA)
D) The Fair Labor Standards Act (FLSA)
Answer: B
Explanation: OBRA-87 establishes minimum standards for nursing care, resident
rights, and quality of life in nursing homes.
**Question 2.** In Illinois, a Type AA violation is defined as a deficiency that:
A) May cause minimal harm to a resident
B) Is likely to cause serious physical harm
C) Proximately causes the death of a resident
D) Results in a substantial probability of less than minimal harm
Answer: C
Explanation: Type AA violations are the most serious; they directly lead to a
resident’s death.
**Question 3.** The “Scope and Severity” grid used in federal surveys assesses
deficiencies based on:
A) The cost of corrective action
B) The impact on resident health and safety and the immediacy of the problem
C) The number of staff involved in the violation
, Illinois Nursing Home Administrators
NHA Ultimate Exam
D) The length of time the deficiency has existed
Answer: B
Explanation: Scope evaluates the breadth of impact, while Severity evaluates the
seriousness of the impact on resident health and safety.
**Question 4.** Which of the following is a required component of the resident’s
right to privacy under federal regulations?
A) Mandatory weekly family meetings
B) Confidential handling of medical records
C) Public posting of medication administration records
D) Open-door policy for all resident rooms
Answer: B
Explanation: HIPAA and resident-rights provisions require that personal health
information be kept confidential.
**Question 5.** The Illinois Nursing Home Care Act requires a notice period of at
least how many days for an involuntary transfer?
A) 7 days
B) 14 days
C) 21 days
D) 30 days
Answer: C
Explanation: Illinois law mandates a minimum 21-day notice for involuntary
transfers, giving residents time to contest the decision.
, Illinois Nursing Home Administrators
NHA Ultimate Exam
**Question 6.** Which of the following best describes the purpose of a Quality
Assurance and Performance Improvement (QAPI) program?
A) To increase profit margins by reducing staff hours
B) To systematically identify, analyze, and improve care processes
C) To enforce disciplinary actions against staff
D) To develop marketing strategies for census growth
Answer: B
Explanation: QAPI is a data-driven framework that continuously improves resident
outcomes and compliance.
**Question 7.** In Illinois, the required nurse staffing ratio is expressed as:
A) Minimum nursing hours per resident day (NHPRD)
B) Number of nurses per 100 beds
C) Ratio of RN to LPN per shift
D) Percentage of total staff that must be licensed nurses
Answer: A
Explanation: Illinois specifies a minimum number of nursing hours per resident
day to ensure adequate care.
**Question 8.** Which of the following is NOT a function of the facility’s
Electronic Health Record (EHR) system?
A) Storing resident medication orders
B) Generating marketing brochures
C) Documenting progress notes
, Illinois Nursing Home Administrators
NHA Ultimate Exam
D) Facilitating secure data exchange with hospitals
Answer: B
Explanation: EHR systems are clinical tools; creating marketing materials is
outside their scope.
**Question 9.** A resident files a grievance about inadequate pain management.
Under federal regulations, the facility must:
A) Resolve the grievance within 24 hours
B) Document the grievance and provide a written response within 5 business days
C) Forward the grievance to the state health department immediately
D) Ignore the grievance if the resident is not a Medicare beneficiary
Answer: B
Explanation: OBRA-87 requires timely documentation and a written response
(typically within 5 business days) to resident grievances.
**Question 10.** Which of the following best defines “palliative care” in a
nursing home setting?
A) Curative treatment aimed at disease eradication
B) End-of-life care limited to hospice enrollment only
C) Relief of suffering while supporting quality of life regardless of prognosis
D) Physical therapy focused on restoring full independence
Answer: C
Explanation: Palliative care focuses on symptom relief and quality of life,
independent of curative intent.
NHA Ultimate Exam
**Question 1.** Which federal regulation primarily governs the provision of
nursing services in a skilled nursing facility?
A) The Health Insurance Portability and Accountability Act (HIPAA)
B) The Nursing Home Reform Act of 1987 (OBRA-87)
C) The Occupational Safety and Health Act (OSHA)
D) The Fair Labor Standards Act (FLSA)
Answer: B
Explanation: OBRA-87 establishes minimum standards for nursing care, resident
rights, and quality of life in nursing homes.
**Question 2.** In Illinois, a Type AA violation is defined as a deficiency that:
A) May cause minimal harm to a resident
B) Is likely to cause serious physical harm
C) Proximately causes the death of a resident
D) Results in a substantial probability of less than minimal harm
Answer: C
Explanation: Type AA violations are the most serious; they directly lead to a
resident’s death.
**Question 3.** The “Scope and Severity” grid used in federal surveys assesses
deficiencies based on:
A) The cost of corrective action
B) The impact on resident health and safety and the immediacy of the problem
C) The number of staff involved in the violation
, Illinois Nursing Home Administrators
NHA Ultimate Exam
D) The length of time the deficiency has existed
Answer: B
Explanation: Scope evaluates the breadth of impact, while Severity evaluates the
seriousness of the impact on resident health and safety.
**Question 4.** Which of the following is a required component of the resident’s
right to privacy under federal regulations?
A) Mandatory weekly family meetings
B) Confidential handling of medical records
C) Public posting of medication administration records
D) Open-door policy for all resident rooms
Answer: B
Explanation: HIPAA and resident-rights provisions require that personal health
information be kept confidential.
**Question 5.** The Illinois Nursing Home Care Act requires a notice period of at
least how many days for an involuntary transfer?
A) 7 days
B) 14 days
C) 21 days
D) 30 days
Answer: C
Explanation: Illinois law mandates a minimum 21-day notice for involuntary
transfers, giving residents time to contest the decision.
, Illinois Nursing Home Administrators
NHA Ultimate Exam
**Question 6.** Which of the following best describes the purpose of a Quality
Assurance and Performance Improvement (QAPI) program?
A) To increase profit margins by reducing staff hours
B) To systematically identify, analyze, and improve care processes
C) To enforce disciplinary actions against staff
D) To develop marketing strategies for census growth
Answer: B
Explanation: QAPI is a data-driven framework that continuously improves resident
outcomes and compliance.
**Question 7.** In Illinois, the required nurse staffing ratio is expressed as:
A) Minimum nursing hours per resident day (NHPRD)
B) Number of nurses per 100 beds
C) Ratio of RN to LPN per shift
D) Percentage of total staff that must be licensed nurses
Answer: A
Explanation: Illinois specifies a minimum number of nursing hours per resident
day to ensure adequate care.
**Question 8.** Which of the following is NOT a function of the facility’s
Electronic Health Record (EHR) system?
A) Storing resident medication orders
B) Generating marketing brochures
C) Documenting progress notes
, Illinois Nursing Home Administrators
NHA Ultimate Exam
D) Facilitating secure data exchange with hospitals
Answer: B
Explanation: EHR systems are clinical tools; creating marketing materials is
outside their scope.
**Question 9.** A resident files a grievance about inadequate pain management.
Under federal regulations, the facility must:
A) Resolve the grievance within 24 hours
B) Document the grievance and provide a written response within 5 business days
C) Forward the grievance to the state health department immediately
D) Ignore the grievance if the resident is not a Medicare beneficiary
Answer: B
Explanation: OBRA-87 requires timely documentation and a written response
(typically within 5 business days) to resident grievances.
**Question 10.** Which of the following best defines “palliative care” in a
nursing home setting?
A) Curative treatment aimed at disease eradication
B) End-of-life care limited to hospice enrollment only
C) Relief of suffering while supporting quality of life regardless of prognosis
D) Physical therapy focused on restoring full independence
Answer: C
Explanation: Palliative care focuses on symptom relief and quality of life,
independent of curative intent.
