NAB CORE EXAM 2025: COMPREHENSIVE STUDY GUIDE WITH PRACTICE QUESTIONS & 100%
CORRECT ANSWERS] – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS
Domain 1: Resident Care and Quality of Life
Domain 2: Nursing and Clinical Services
Domain 3: Administration and Management
Domain 4: Regulatory Compliance and Survey Readiness
Domain 5: Financial Management and Reimbursement
Domain 6: Human Resources and Staffing
Domain 7: Environment, Safety, and Emergency Preparedness
Domain 8: Ethics, Professional Standards, and Resident Rights
Domain 9: Quality Assurance and Performance Improvement
Domain 10: Governance, Leadership, and Strategic Planning
INTRODUCTION
The NAB Core Exam assesses the knowledge, skills, and abilities required of licensed nursing home
administrators. It evaluates competency across foundational theory, applied professional practice,
technical concepts, regulatory and legal compliance, ethics, safety, and professional responsibility. The
examination employs multiple-choice and scenario-based questions designed to measure real-world
application, critical thinking, problem-solving, decision-making, interpretation, analysis, and
professional judgment. Candidates must demonstrate understanding of resident care, clinical services,
administration, finance, human resources, environment, quality improvement, and governance. This
comprehensive guide provides 200 practice questions with verified correct answers and detailed
rationales to prepare candidates for success on the NAB Core Exam.
SECTION ONE – QUESTIONS 1–100
Question 1
A nursing home administrator notices that resident satisfaction scores have declined over two
consecutive quarters. Which action should the administrator take FIRST?
A. Terminate the department head responsible for satisfaction
B. Conduct a root cause analysis to identify underlying issues
C. Implement a new satisfaction survey tool immediately
D. Report the decline to the governing board without analysis
🟢 Correct answer: B
🔴 Explanation: The first step in addressing declining satisfaction is to identify the root causes through
,systematic analysis. Terminating staff or changing tools without understanding the problem is
premature and may worsen the situation. Reporting without analysis provides no actionable
information.
Question 2
Under federal law, which of the following is a requirement for nursing home residents regarding their
personal funds?
A. The facility may commingle resident funds with facility operating funds
B. The facility must maintain resident funds separately and provide quarterly statements
C. The facility may charge residents for managing their funds without disclosure
D. The facility may use resident funds for facility expenses when cash flow is tight
🟢 Correct answer: B
🔴 Explanation: Federal regulations require facilities to maintain resident personal funds separately
from facility funds, provide quarterly statements, and not commingle funds. Using resident funds for
facility expenses or charging undisclosed fees is prohibited.
Question 3
A resident falls in the bathroom and sustains a fracture. The administrator's IMMEDIATE priority is to:
A. Notify the resident's family and the state survey agency
B. Ensure the resident receives appropriate medical attention
C. Review the fall prevention policy with staff
D. Document the incident in the facility log
🟢 Correct answer: B
🔴 Explanation: The immediate priority in any resident injury is ensuring the resident receives
appropriate medical care. Notification, policy review, and documentation follow after the resident's
health and safety are secured.
Question 4
Which financial statement reports a facility's revenues and expenses over a specific period?
A. Balance sheet
B. Statement of cash flows
C. Income statement
D. Statement of changes in equity
🟢 Correct answer: C
🔴 Explanation: The income statement, also called the profit and loss statement, reports revenues and
expenses over a specific period. The balance sheet shows assets, liabilities, and equity at a point in
time. The statement of cash flows tracks cash movements.
Question 5
A facility's census is 95 residents with 100 licensed beds. What is the occupancy rate?
A. 90%
B. 95%
C. 100%
D. 105%
,🟢 Correct answer: B
🔴 Explanation: Occupancy rate is calculated as (census ÷ licensed beds) × 100. Here, (95 ÷ 100) ×
100 = 95%. This is a fundamental operational metric.
Question 6
Which of the following best describes the purpose of a Minimum Data Set (MDS) assessment?
A. To determine facility staffing ratios
B. To establish a comprehensive, standardized assessment of each resident's functional capabilities
C. To calculate the facility's annual budget
D. To evaluate employee performance
🟢 Correct answer: B
🔴 Explanation: The MDS is a comprehensive, standardized assessment tool used to evaluate each
resident's functional capabilities, health status, and care needs. It drives care planning and Medicare
reimbursement under the RUGs/PDPM systems.
Question 7
An administrator discovers that a nurse aide has been verbally abusing a resident. The administrator
must:
A. Counsel the aide and return them to work
B. Immediately remove the aide from resident contact and report the incident per state and federal
requirements
C. Transfer the resident to another unit
D. Document the incident and address it at the next staff meeting
🟢 Correct answer: B
🔴 Explanation: Suspected abuse requires immediate action to protect residents, including removing
the alleged perpetrator from resident contact and reporting to appropriate authorities. Counseling or
delaying action is inadequate and potentially illegal.
Question 8
Which regulatory body is responsible for surveying nursing homes for compliance with Medicare and
Medicaid requirements?
A. OSHA
B. State Survey Agency acting on behalf of CMS
C. The Joint Commission
D. Local health department
🟢 Correct answer: B
🔴 Explanation: State Survey Agencies conduct surveys on behalf of CMS to determine compliance
with Medicare and Medicaid conditions of participation. OSHA regulates workplace safety, and The
Joint Commission is a private accrediting body.
Question 9
In the context of nursing home administration, what does the term "acuity" refer to?
A. The facility's financial stability
B. The severity and complexity of residents' health conditions
, C. The number of staff per shift
D. The age of the facility's physical plant
🟢 Correct answer: B
🔴 Explanation: Acuity refers to the severity and complexity of residents' health conditions, which
directly affects staffing needs, care planning, and resource allocation.
Question 10
A facility is preparing for its annual state survey. The administrator should ensure that:
A. Staff are instructed to hide deficiencies from surveyors
B. All records are accurate, current, and readily accessible
C. Only management speaks to surveyors
D. Residents are relocated during the survey
🟢 Correct answer: B
🔴 Explanation: Survey readiness requires accurate, current, and accessible records. Concealing
deficiencies, restricting communication, or relocating residents during a survey is inappropriate and
may constitute obstruction.
Question 11
Which of the following is a key component of a facility's Quality Assurance and Performance
Improvement (QAPI) program?
A. Increasing resident fees annually
B. Identifying and analyzing quality indicators and implementing corrective actions
C. Reducing staff training to save costs
D. Avoiding resident and family feedback
🟢 Correct answer: B
🔴 Explanation: QAPI programs systematically identify and analyze quality indicators, implement
corrective actions, and monitor outcomes. It is a data-driven, proactive approach to improving care
and services.
Question 12
A resident's care plan must be reviewed and revised:
A. Only upon admission
B. At least quarterly and whenever there is a significant change in condition
C. Once per year
D. Only when the physician requests it
🟢 Correct answer: B
🔴 Explanation: Federal regulations require care plans to be reviewed and revised at least quarterly
and whenever there is a significant change in the resident's condition. Annual or admission-only
reviews are insufficient.
Question 13
Which of the following is an example of a variable cost in a nursing home?
A. Mortgage payment
B. Property taxes
CORRECT ANSWERS] – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS
Domain 1: Resident Care and Quality of Life
Domain 2: Nursing and Clinical Services
Domain 3: Administration and Management
Domain 4: Regulatory Compliance and Survey Readiness
Domain 5: Financial Management and Reimbursement
Domain 6: Human Resources and Staffing
Domain 7: Environment, Safety, and Emergency Preparedness
Domain 8: Ethics, Professional Standards, and Resident Rights
Domain 9: Quality Assurance and Performance Improvement
Domain 10: Governance, Leadership, and Strategic Planning
INTRODUCTION
The NAB Core Exam assesses the knowledge, skills, and abilities required of licensed nursing home
administrators. It evaluates competency across foundational theory, applied professional practice,
technical concepts, regulatory and legal compliance, ethics, safety, and professional responsibility. The
examination employs multiple-choice and scenario-based questions designed to measure real-world
application, critical thinking, problem-solving, decision-making, interpretation, analysis, and
professional judgment. Candidates must demonstrate understanding of resident care, clinical services,
administration, finance, human resources, environment, quality improvement, and governance. This
comprehensive guide provides 200 practice questions with verified correct answers and detailed
rationales to prepare candidates for success on the NAB Core Exam.
SECTION ONE – QUESTIONS 1–100
Question 1
A nursing home administrator notices that resident satisfaction scores have declined over two
consecutive quarters. Which action should the administrator take FIRST?
A. Terminate the department head responsible for satisfaction
B. Conduct a root cause analysis to identify underlying issues
C. Implement a new satisfaction survey tool immediately
D. Report the decline to the governing board without analysis
🟢 Correct answer: B
🔴 Explanation: The first step in addressing declining satisfaction is to identify the root causes through
,systematic analysis. Terminating staff or changing tools without understanding the problem is
premature and may worsen the situation. Reporting without analysis provides no actionable
information.
Question 2
Under federal law, which of the following is a requirement for nursing home residents regarding their
personal funds?
A. The facility may commingle resident funds with facility operating funds
B. The facility must maintain resident funds separately and provide quarterly statements
C. The facility may charge residents for managing their funds without disclosure
D. The facility may use resident funds for facility expenses when cash flow is tight
🟢 Correct answer: B
🔴 Explanation: Federal regulations require facilities to maintain resident personal funds separately
from facility funds, provide quarterly statements, and not commingle funds. Using resident funds for
facility expenses or charging undisclosed fees is prohibited.
Question 3
A resident falls in the bathroom and sustains a fracture. The administrator's IMMEDIATE priority is to:
A. Notify the resident's family and the state survey agency
B. Ensure the resident receives appropriate medical attention
C. Review the fall prevention policy with staff
D. Document the incident in the facility log
🟢 Correct answer: B
🔴 Explanation: The immediate priority in any resident injury is ensuring the resident receives
appropriate medical care. Notification, policy review, and documentation follow after the resident's
health and safety are secured.
Question 4
Which financial statement reports a facility's revenues and expenses over a specific period?
A. Balance sheet
B. Statement of cash flows
C. Income statement
D. Statement of changes in equity
🟢 Correct answer: C
🔴 Explanation: The income statement, also called the profit and loss statement, reports revenues and
expenses over a specific period. The balance sheet shows assets, liabilities, and equity at a point in
time. The statement of cash flows tracks cash movements.
Question 5
A facility's census is 95 residents with 100 licensed beds. What is the occupancy rate?
A. 90%
B. 95%
C. 100%
D. 105%
,🟢 Correct answer: B
🔴 Explanation: Occupancy rate is calculated as (census ÷ licensed beds) × 100. Here, (95 ÷ 100) ×
100 = 95%. This is a fundamental operational metric.
Question 6
Which of the following best describes the purpose of a Minimum Data Set (MDS) assessment?
A. To determine facility staffing ratios
B. To establish a comprehensive, standardized assessment of each resident's functional capabilities
C. To calculate the facility's annual budget
D. To evaluate employee performance
🟢 Correct answer: B
🔴 Explanation: The MDS is a comprehensive, standardized assessment tool used to evaluate each
resident's functional capabilities, health status, and care needs. It drives care planning and Medicare
reimbursement under the RUGs/PDPM systems.
Question 7
An administrator discovers that a nurse aide has been verbally abusing a resident. The administrator
must:
A. Counsel the aide and return them to work
B. Immediately remove the aide from resident contact and report the incident per state and federal
requirements
C. Transfer the resident to another unit
D. Document the incident and address it at the next staff meeting
🟢 Correct answer: B
🔴 Explanation: Suspected abuse requires immediate action to protect residents, including removing
the alleged perpetrator from resident contact and reporting to appropriate authorities. Counseling or
delaying action is inadequate and potentially illegal.
Question 8
Which regulatory body is responsible for surveying nursing homes for compliance with Medicare and
Medicaid requirements?
A. OSHA
B. State Survey Agency acting on behalf of CMS
C. The Joint Commission
D. Local health department
🟢 Correct answer: B
🔴 Explanation: State Survey Agencies conduct surveys on behalf of CMS to determine compliance
with Medicare and Medicaid conditions of participation. OSHA regulates workplace safety, and The
Joint Commission is a private accrediting body.
Question 9
In the context of nursing home administration, what does the term "acuity" refer to?
A. The facility's financial stability
B. The severity and complexity of residents' health conditions
, C. The number of staff per shift
D. The age of the facility's physical plant
🟢 Correct answer: B
🔴 Explanation: Acuity refers to the severity and complexity of residents' health conditions, which
directly affects staffing needs, care planning, and resource allocation.
Question 10
A facility is preparing for its annual state survey. The administrator should ensure that:
A. Staff are instructed to hide deficiencies from surveyors
B. All records are accurate, current, and readily accessible
C. Only management speaks to surveyors
D. Residents are relocated during the survey
🟢 Correct answer: B
🔴 Explanation: Survey readiness requires accurate, current, and accessible records. Concealing
deficiencies, restricting communication, or relocating residents during a survey is inappropriate and
may constitute obstruction.
Question 11
Which of the following is a key component of a facility's Quality Assurance and Performance
Improvement (QAPI) program?
A. Increasing resident fees annually
B. Identifying and analyzing quality indicators and implementing corrective actions
C. Reducing staff training to save costs
D. Avoiding resident and family feedback
🟢 Correct answer: B
🔴 Explanation: QAPI programs systematically identify and analyze quality indicators, implement
corrective actions, and monitor outcomes. It is a data-driven, proactive approach to improving care
and services.
Question 12
A resident's care plan must be reviewed and revised:
A. Only upon admission
B. At least quarterly and whenever there is a significant change in condition
C. Once per year
D. Only when the physician requests it
🟢 Correct answer: B
🔴 Explanation: Federal regulations require care plans to be reviewed and revised at least quarterly
and whenever there is a significant change in the resident's condition. Annual or admission-only
reviews are insufficient.
Question 13
Which of the following is an example of a variable cost in a nursing home?
A. Mortgage payment
B. Property taxes
