2026 NAB NHA Board Exam Prep: 200
Practice Questions with Rationales &
Solutions | HPPD, Depreciation & Financial
Formulas | CMS Regulations, Life Safety
Code NFPA 101, OSHA, Title VII, ADA & PDPM
Compliance Guide
Intro Coverage:
Master the NAB Exam on Your First Try!
This comprehensive 200-question practice test set covers all four core administrative
domains: Customer Care, Human Resources, Finance, and Environment/Quality. Every
question features a realistic 14+ word stem modeled directly after the official NHA/NAB
exam pattern, complete with step-by-step math breakdowns and detailed answer rationales.
Domains Covered: Customer Care (Q1–55), Human Resources (Q56–110),
Finance & Accounting (Q111–155), Environment & Life Safety (Q156–200).
Includes: Clear solutions for HPPD, Depreciation, Working Capital,
Occupancy, and Debt Ratios + key legal regulations (OBRA, Life Safety
Code, OSHA, FLSA, ADA).
Coverage Overview:
Customer Care & Supports: Resident rights, care planning, MDS/PHQ-
9/BIMS, palliative care, and social service thresholds.
Human Resource Management: Wage/hour compliance (FLSA),
employment discrimination law (ADA/ADEA/Title VII), and retention
strategies.
Financial Management: Solvency ratios, A/R management, cost behaviors,
and accounting formulas.
, Environment & Quality: Life Safety Code (NFPA 101), emergency power
load testing, water temperatures, HazCom, and QAPI root-cause analysis.
Domain 1: Customer Care, Supports, and Services
Q1. A 78-year-old resident with mid-stage Alzheimer’s disease has been observed
wandering into other residents' rooms during late evening hours, causing distress
among neighbors. What is the most appropriate first line of intervention for the
interdisciplinary team to implement?
A. Request an order for a low-dose psychotropic medication from the attending physician.
B. Install wander-prevention alarms on the resident’s personal room door immediately.
C. Conduct a comprehensive assessment to identify underlying triggers such as unmet
physical needs or environmental factors.
D. Assign a 1-on-1 dedicated nurse aide to shadow the resident during all evening hours.
Answer: C
Rationale: CMS guidelines and NAB standards require non-pharmacological
interventions and root-cause assessment prior to chemical or physical restraints or
restrictive measures.
Q2. During a routine care plan conference, a competent long-term care resident
explicitly refuses a medically necessary low-sodium diet prescribed by their
cardiologist. How should the administrator ensure the resident's rights and safety are
properly balanced?
A. Enforce the physician's dietary order strictly to prevent facility liability and health
complications.
B. Document the resident’s informed refusal, discuss potential risks, and adapt the care
plan to accommodate their preferences safely.
C. Discharge the resident for non-compliance with the established medical treatment plan.
D. Require the family to sign a waiver absolving the facility of all health-related outcomes.
Answer: B
, Rationale: Resident rights under federal regulations preserve autonomy, including
the right to refuse treatment after being fully informed of clinical risks.
Q3. A skilled nursing facility receives a new resident directly from an acute care
hospital following a total hip replacement. Within what specific timeframe must the
initial comprehensive MDS assessment be completed?
A. Within 7 calendar days of admission.
B. Within 14 calendar days of admission.
C. Within 21 calendar days of admission.
D. Within 30 calendar days of admission.
Answer: B
Rationale: Under OBRA '87 regulations, the initial Minimum Data Set (MDS)
comprehensive assessment must be completed no later than 14 calendar days after
admission.
Q4. An interdisciplinary team is reviewing the dining preferences of newly admitted
residents in an assisted living community. Which approach best demonstrates
person-centered care principles?
A. Serving all meals at set fixed hours to ensure dietary staff efficiency and routine.
B. Offering flexible dining hours with a menu choice that accommodates individual cultural
and personal preferences.
C. Providing standardized pre-plated meals delivered directly to resident rooms.
D. Requiring residents to eat in the main dining room unless medically bedridden.
Answer: B
Rationale: Person-centered care emphasizes individual choice, flexibility, and
cultural sensitivity over institutional routines.
Q5. A resident's family member reports that personal clothing items have gone
missing repeatedly over the past month. What administrative action best addresses
this system issue?
A. Tell the family that personal laundry is handled at the resident’s own risk.
, B. Review facility labeling and laundry handling policies, audit the inventory tracking system,
and resolve the missing items.
C. Advise the family to take all personal clothing items home and wash them independently.
D. Reimburse the family immediately without investigating internal laundry operations.
Answer: B
Rationale: The administrator is responsible for maintaining effective operational
control and safeguarding resident personal property.
Domain 2: Human Resources
Q6. A certified nursing assistant (CNA) reports to work smelling strongly of alcohol
and exhibiting slurred speech during morning report. What is the immediate duty of
the charge nurse and facility administrator?
A. Allow the CNA to work light duties away from direct resident contact for the shift.
B. Remove the employee from resident care immediately, initiate drug/alcohol testing per
policy, and arrange safe transportation home.
C. Issue a written reprimand at the end of the shift and schedule a meeting for the following
week.
D. Terminate the employee on the spot without conducting an investigation or
documentation process.
Answer: B
Rationale: Resident safety demands immediate removal from duty when impairment
is suspected, followed by established chain-of-custody policy protocols.
Q7. During an annual performance review, a departmental manager asks the
administrator how to avoid subjective bias when evaluating staff members. Which
performance appraisal tool provides the highest level of objectivity?
A. Graphic rating scale based on general personality traits.
B. Behaviorally Anchored Rating Scale (BARS) tied to specific job descriptions and
measurable duties.
C. Essay evaluation written entirely from the manager's memory.
Practice Questions with Rationales &
Solutions | HPPD, Depreciation & Financial
Formulas | CMS Regulations, Life Safety
Code NFPA 101, OSHA, Title VII, ADA & PDPM
Compliance Guide
Intro Coverage:
Master the NAB Exam on Your First Try!
This comprehensive 200-question practice test set covers all four core administrative
domains: Customer Care, Human Resources, Finance, and Environment/Quality. Every
question features a realistic 14+ word stem modeled directly after the official NHA/NAB
exam pattern, complete with step-by-step math breakdowns and detailed answer rationales.
Domains Covered: Customer Care (Q1–55), Human Resources (Q56–110),
Finance & Accounting (Q111–155), Environment & Life Safety (Q156–200).
Includes: Clear solutions for HPPD, Depreciation, Working Capital,
Occupancy, and Debt Ratios + key legal regulations (OBRA, Life Safety
Code, OSHA, FLSA, ADA).
Coverage Overview:
Customer Care & Supports: Resident rights, care planning, MDS/PHQ-
9/BIMS, palliative care, and social service thresholds.
Human Resource Management: Wage/hour compliance (FLSA),
employment discrimination law (ADA/ADEA/Title VII), and retention
strategies.
Financial Management: Solvency ratios, A/R management, cost behaviors,
and accounting formulas.
, Environment & Quality: Life Safety Code (NFPA 101), emergency power
load testing, water temperatures, HazCom, and QAPI root-cause analysis.
Domain 1: Customer Care, Supports, and Services
Q1. A 78-year-old resident with mid-stage Alzheimer’s disease has been observed
wandering into other residents' rooms during late evening hours, causing distress
among neighbors. What is the most appropriate first line of intervention for the
interdisciplinary team to implement?
A. Request an order for a low-dose psychotropic medication from the attending physician.
B. Install wander-prevention alarms on the resident’s personal room door immediately.
C. Conduct a comprehensive assessment to identify underlying triggers such as unmet
physical needs or environmental factors.
D. Assign a 1-on-1 dedicated nurse aide to shadow the resident during all evening hours.
Answer: C
Rationale: CMS guidelines and NAB standards require non-pharmacological
interventions and root-cause assessment prior to chemical or physical restraints or
restrictive measures.
Q2. During a routine care plan conference, a competent long-term care resident
explicitly refuses a medically necessary low-sodium diet prescribed by their
cardiologist. How should the administrator ensure the resident's rights and safety are
properly balanced?
A. Enforce the physician's dietary order strictly to prevent facility liability and health
complications.
B. Document the resident’s informed refusal, discuss potential risks, and adapt the care
plan to accommodate their preferences safely.
C. Discharge the resident for non-compliance with the established medical treatment plan.
D. Require the family to sign a waiver absolving the facility of all health-related outcomes.
Answer: B
, Rationale: Resident rights under federal regulations preserve autonomy, including
the right to refuse treatment after being fully informed of clinical risks.
Q3. A skilled nursing facility receives a new resident directly from an acute care
hospital following a total hip replacement. Within what specific timeframe must the
initial comprehensive MDS assessment be completed?
A. Within 7 calendar days of admission.
B. Within 14 calendar days of admission.
C. Within 21 calendar days of admission.
D. Within 30 calendar days of admission.
Answer: B
Rationale: Under OBRA '87 regulations, the initial Minimum Data Set (MDS)
comprehensive assessment must be completed no later than 14 calendar days after
admission.
Q4. An interdisciplinary team is reviewing the dining preferences of newly admitted
residents in an assisted living community. Which approach best demonstrates
person-centered care principles?
A. Serving all meals at set fixed hours to ensure dietary staff efficiency and routine.
B. Offering flexible dining hours with a menu choice that accommodates individual cultural
and personal preferences.
C. Providing standardized pre-plated meals delivered directly to resident rooms.
D. Requiring residents to eat in the main dining room unless medically bedridden.
Answer: B
Rationale: Person-centered care emphasizes individual choice, flexibility, and
cultural sensitivity over institutional routines.
Q5. A resident's family member reports that personal clothing items have gone
missing repeatedly over the past month. What administrative action best addresses
this system issue?
A. Tell the family that personal laundry is handled at the resident’s own risk.
, B. Review facility labeling and laundry handling policies, audit the inventory tracking system,
and resolve the missing items.
C. Advise the family to take all personal clothing items home and wash them independently.
D. Reimburse the family immediately without investigating internal laundry operations.
Answer: B
Rationale: The administrator is responsible for maintaining effective operational
control and safeguarding resident personal property.
Domain 2: Human Resources
Q6. A certified nursing assistant (CNA) reports to work smelling strongly of alcohol
and exhibiting slurred speech during morning report. What is the immediate duty of
the charge nurse and facility administrator?
A. Allow the CNA to work light duties away from direct resident contact for the shift.
B. Remove the employee from resident care immediately, initiate drug/alcohol testing per
policy, and arrange safe transportation home.
C. Issue a written reprimand at the end of the shift and schedule a meeting for the following
week.
D. Terminate the employee on the spot without conducting an investigation or
documentation process.
Answer: B
Rationale: Resident safety demands immediate removal from duty when impairment
is suspected, followed by established chain-of-custody policy protocols.
Q7. During an annual performance review, a departmental manager asks the
administrator how to avoid subjective bias when evaluating staff members. Which
performance appraisal tool provides the highest level of objectivity?
A. Graphic rating scale based on general personality traits.
B. Behaviorally Anchored Rating Scale (BARS) tied to specific job descriptions and
measurable duties.
C. Essay evaluation written entirely from the manager's memory.
