NAB Core Exam Practice Questions with
Verified Answers for Nursing Home
Administrator Licensing Updated.
Question 1
In order to be in compliance with the Immigration Reform and Control Act of 1986, an
I-9 Form must be completed within what time period after the first date of
employment?
1. 24 hours
2. 72 hours
3. 5 days
4. 90 days
Correct Answer
2. 72 hours
Question 2
Which of these is not a legal question that employers may ask of job applicants?
A. Are you able to perform the essential functions of this job with or without a
reasonable accommodation?
B. Would you demonstrate how you would perform a job function?
C. Are you able to meet the attendance requirements of this job?
D. Do you have a disability that would interfere with your ability to perform
Correct Answer
D. Do you have a disability that would interfere with your ability to perform
Question 1: According to the Omnibus Budget Reconciliation Act (OBRA)
of 1987, which of the following best describes the fundamental philosophy
of care that nursing facilities must adopt to ensure regulatory compliance
and promote resident well-being?
A. Facilities must prioritize operational efficiency and cost containment above
all other considerations to ensure financial viability.
B. Facilities must provide services and activities to attain or maintain the
highest practicable physical, mental, and psychosocial well-being of each
resident.
C. Facilities must strictly adhere to a medical model of care, focusing
primarily on the treatment of acute illnesses and injuries.
D. Facilities must delegate all care planning decisions to the attending
physician to ensure medical accuracy and liability protection.
CORRECT ANSWER: B. Facilities must provide services and activities to
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,attain or maintain the highest practicable physical, mental, and
psychosocial well-being of each resident.
Rationale: OBRA '87 mandates that nursing facilities must provide care that
helps each resident attain or maintain their highest practicable level of
physical, mental, and psychosocial well-being, forming the foundation of
resident-centered care and federal regulatory compliance.
Question 2: A nursing home administrator is reviewing the facility's
grievance procedure. To comply with federal regulations, the grievance
policy must ensure that:
A. All grievances are investigated by the facility's legal counsel before any
administrative action is taken.
B. Residents can voice grievances without fear of reprisal, and the facility
must document the investigation and resolution.
C. Grievances must be submitted in writing and signed by the resident or
their legal representative to be considered valid.
D. The administrator must personally resolve every grievance within 24 hours
of it being reported by the resident.
CORRECT ANSWER: B. Residents can voice grievances without fear of
reprisal, and the facility must document the investigation and resolution.
Rationale: Federal regulations require facilities to have a grievance policy
that allows residents to voice complaints without fear of reprisal. The facility
must investigate and document the resolution, but it does not require legal
counsel involvement, written submission only, or a strict 24-hour resolution
by the administrator.
Question 3: A competent resident with decision-making capacity refuses a
prescribed course of antibiotics for a urinary tract infection. What is the
most appropriate action for the nursing home administrator and care team
to take?
A. Administer the medication covertly in the resident's food to ensure the
infection is treated.
B. Respect the resident's right to refuse treatment, document the refusal, and
educate the resident on the potential consequences.
C. Contact the resident's family to obtain consent for the medication against
the resident's stated wishes.
D. Petition the local court for an emergency order to force the administration
of the medication.
CORRECT ANSWER: B. Respect the resident's right to refuse treatment,
document the refusal, and educate the resident on the potential
consequences.
Rationale: Competent residents have the fundamental right to refuse any
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,medical treatment. The care team must respect this right, thoroughly
document the refusal and the education provided regarding potential risks,
and continue to monitor the resident's condition.
Question 4: Under the Patient Self-Determination Act (PSDA), what is the
nursing facility's primary responsibility regarding advance directives upon
a resident's admission?
A. To require every resident to execute a living will before admission is
finalized.
B. To provide written information to residents about their rights under state
law to make decisions concerning medical care, including the right to accept
or refuse treatment and to formulate advance directives.
C. To automatically appoint a family member as the healthcare proxy if the
resident does not have a designated power of attorney.
D. To store the resident's advance directive in a secure location and not share
it with the care team to protect privacy.
CORRECT ANSWER: B. To provide written information to residents about
heir rights under state law to make decisions concerning medical care,
including the right to accept or refuse treatment and to formulate advance
directives.
Rationale: The PSDA requires healthcare facilities to provide written
information to all adult patients/residents about their rights under state law
to make healthcare decisions and formulate advance directives. It does not
mandate that residents create them, nor does it allow the facility to appoint
a proxy.
Question 5: Which of the following scenarios constitutes the inappropriate
use of a physical restraint in a nursing facility?
A. Using a lap buddy with a resident's consent to prevent them from sliding
out of a wheelchair.
B. Applying a vest restraint to a confused resident who is repeatedly
attempting to stand unassisted and has a history of falls, without a
physician's order or less restrictive alternatives being tried.
C. Temporarily holding a resident's hand during a transfer to provide stability
and prevent a fall.
D. Using a bed alarm to alert staff when a high-risk fall resident attempts to
get out of bed unassisted.
CORRECT ANSWER: B. Applying a vest restraint to a confused resident who
is repeatedly attempting to stand unassisted and has a history of falls,
without a physician's order or less restrictive alternatives being tried.
Rationale: Physical restraints can only be used to ensure the immediate
physical safety of the resident or others, and only when less restrictive
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, interventions have been determined to be ineffective. They require a
physician's order and cannot be used for discipline or convenience.
Question 6: The interdisciplinary care planning team is mandated by
federal regulations. Which of the following individuals must be included as
a core member of this team?
A. The facility's governing body chairperson
B. The resident's primary care physician, a registered nurse, and the resident
or their legal representative
C. The facility's dietary manager and housekeeping supervisor
D. The state surveyor and the long-term care ombudsman
CORRECT ANSWER: B. The resident's primary care physician, a registered
nurse, and the resident or their legal representative
Rationale: Federal regulations mandate that the interdisciplinary care
planning team must include the attending physician, a registered nurse with
responsibility for the resident, and the resident or their legal representative.
Other staff may be included as appropriate, but these are core required
members.
Question 7: According to the Resident Assessment Instrument (RAI)
guidelines, within how many days of a resident's admission must the
comprehensive MDS 3.0 assessment be completed?
A. 5 days
B. 14 days
C. 30 days
D. 60 days
CORRECT ANSWER: B. 14 days
Rationale: The comprehensive MDS 3.0 assessment must be completed
within 14 days of a resident's admission to the facility. This assessment forms
the basis for the individualized care plan and, under PDPM, drives Medicare
reimbursement.
Question 8: The Patient Driven Payment Model (PDPM) replaced the RUG-
IV system for Medicare Part A reimbursement. What is the primary focus
of the PDPM case-mix classification?
A. The total number of therapy minutes provided to the resident.
B. The resident's clinical characteristics, including medical complexity,
functional status, and nursing needs.
C. The facility's overall staffing ratios and wage index.
D. The length of stay of the resident in the skilled nursing facility.
CORRECT ANSWER: B. The resident's clinical characteristics, including
medical complexity, functional status, and nursing needs.
Rationale: PDPM shifts the focus from therapy volume (minutes) to the
Page 4 of 168
Verified Answers for Nursing Home
Administrator Licensing Updated.
Question 1
In order to be in compliance with the Immigration Reform and Control Act of 1986, an
I-9 Form must be completed within what time period after the first date of
employment?
1. 24 hours
2. 72 hours
3. 5 days
4. 90 days
Correct Answer
2. 72 hours
Question 2
Which of these is not a legal question that employers may ask of job applicants?
A. Are you able to perform the essential functions of this job with or without a
reasonable accommodation?
B. Would you demonstrate how you would perform a job function?
C. Are you able to meet the attendance requirements of this job?
D. Do you have a disability that would interfere with your ability to perform
Correct Answer
D. Do you have a disability that would interfere with your ability to perform
Question 1: According to the Omnibus Budget Reconciliation Act (OBRA)
of 1987, which of the following best describes the fundamental philosophy
of care that nursing facilities must adopt to ensure regulatory compliance
and promote resident well-being?
A. Facilities must prioritize operational efficiency and cost containment above
all other considerations to ensure financial viability.
B. Facilities must provide services and activities to attain or maintain the
highest practicable physical, mental, and psychosocial well-being of each
resident.
C. Facilities must strictly adhere to a medical model of care, focusing
primarily on the treatment of acute illnesses and injuries.
D. Facilities must delegate all care planning decisions to the attending
physician to ensure medical accuracy and liability protection.
CORRECT ANSWER: B. Facilities must provide services and activities to
Page 1 of 168
,attain or maintain the highest practicable physical, mental, and
psychosocial well-being of each resident.
Rationale: OBRA '87 mandates that nursing facilities must provide care that
helps each resident attain or maintain their highest practicable level of
physical, mental, and psychosocial well-being, forming the foundation of
resident-centered care and federal regulatory compliance.
Question 2: A nursing home administrator is reviewing the facility's
grievance procedure. To comply with federal regulations, the grievance
policy must ensure that:
A. All grievances are investigated by the facility's legal counsel before any
administrative action is taken.
B. Residents can voice grievances without fear of reprisal, and the facility
must document the investigation and resolution.
C. Grievances must be submitted in writing and signed by the resident or
their legal representative to be considered valid.
D. The administrator must personally resolve every grievance within 24 hours
of it being reported by the resident.
CORRECT ANSWER: B. Residents can voice grievances without fear of
reprisal, and the facility must document the investigation and resolution.
Rationale: Federal regulations require facilities to have a grievance policy
that allows residents to voice complaints without fear of reprisal. The facility
must investigate and document the resolution, but it does not require legal
counsel involvement, written submission only, or a strict 24-hour resolution
by the administrator.
Question 3: A competent resident with decision-making capacity refuses a
prescribed course of antibiotics for a urinary tract infection. What is the
most appropriate action for the nursing home administrator and care team
to take?
A. Administer the medication covertly in the resident's food to ensure the
infection is treated.
B. Respect the resident's right to refuse treatment, document the refusal, and
educate the resident on the potential consequences.
C. Contact the resident's family to obtain consent for the medication against
the resident's stated wishes.
D. Petition the local court for an emergency order to force the administration
of the medication.
CORRECT ANSWER: B. Respect the resident's right to refuse treatment,
document the refusal, and educate the resident on the potential
consequences.
Rationale: Competent residents have the fundamental right to refuse any
Page 2 of 168
,medical treatment. The care team must respect this right, thoroughly
document the refusal and the education provided regarding potential risks,
and continue to monitor the resident's condition.
Question 4: Under the Patient Self-Determination Act (PSDA), what is the
nursing facility's primary responsibility regarding advance directives upon
a resident's admission?
A. To require every resident to execute a living will before admission is
finalized.
B. To provide written information to residents about their rights under state
law to make decisions concerning medical care, including the right to accept
or refuse treatment and to formulate advance directives.
C. To automatically appoint a family member as the healthcare proxy if the
resident does not have a designated power of attorney.
D. To store the resident's advance directive in a secure location and not share
it with the care team to protect privacy.
CORRECT ANSWER: B. To provide written information to residents about
heir rights under state law to make decisions concerning medical care,
including the right to accept or refuse treatment and to formulate advance
directives.
Rationale: The PSDA requires healthcare facilities to provide written
information to all adult patients/residents about their rights under state law
to make healthcare decisions and formulate advance directives. It does not
mandate that residents create them, nor does it allow the facility to appoint
a proxy.
Question 5: Which of the following scenarios constitutes the inappropriate
use of a physical restraint in a nursing facility?
A. Using a lap buddy with a resident's consent to prevent them from sliding
out of a wheelchair.
B. Applying a vest restraint to a confused resident who is repeatedly
attempting to stand unassisted and has a history of falls, without a
physician's order or less restrictive alternatives being tried.
C. Temporarily holding a resident's hand during a transfer to provide stability
and prevent a fall.
D. Using a bed alarm to alert staff when a high-risk fall resident attempts to
get out of bed unassisted.
CORRECT ANSWER: B. Applying a vest restraint to a confused resident who
is repeatedly attempting to stand unassisted and has a history of falls,
without a physician's order or less restrictive alternatives being tried.
Rationale: Physical restraints can only be used to ensure the immediate
physical safety of the resident or others, and only when less restrictive
Page 3 of 168
, interventions have been determined to be ineffective. They require a
physician's order and cannot be used for discipline or convenience.
Question 6: The interdisciplinary care planning team is mandated by
federal regulations. Which of the following individuals must be included as
a core member of this team?
A. The facility's governing body chairperson
B. The resident's primary care physician, a registered nurse, and the resident
or their legal representative
C. The facility's dietary manager and housekeeping supervisor
D. The state surveyor and the long-term care ombudsman
CORRECT ANSWER: B. The resident's primary care physician, a registered
nurse, and the resident or their legal representative
Rationale: Federal regulations mandate that the interdisciplinary care
planning team must include the attending physician, a registered nurse with
responsibility for the resident, and the resident or their legal representative.
Other staff may be included as appropriate, but these are core required
members.
Question 7: According to the Resident Assessment Instrument (RAI)
guidelines, within how many days of a resident's admission must the
comprehensive MDS 3.0 assessment be completed?
A. 5 days
B. 14 days
C. 30 days
D. 60 days
CORRECT ANSWER: B. 14 days
Rationale: The comprehensive MDS 3.0 assessment must be completed
within 14 days of a resident's admission to the facility. This assessment forms
the basis for the individualized care plan and, under PDPM, drives Medicare
reimbursement.
Question 8: The Patient Driven Payment Model (PDPM) replaced the RUG-
IV system for Medicare Part A reimbursement. What is the primary focus
of the PDPM case-mix classification?
A. The total number of therapy minutes provided to the resident.
B. The resident's clinical characteristics, including medical complexity,
functional status, and nursing needs.
C. The facility's overall staffing ratios and wage index.
D. The length of stay of the resident in the skilled nursing facility.
CORRECT ANSWER: B. The resident's clinical characteristics, including
medical complexity, functional status, and nursing needs.
Rationale: PDPM shifts the focus from therapy volume (minutes) to the
Page 4 of 168
