NAB CORE Act ual Exam Association of Long– National Term Care Administrator Boards (NAB) – Edition – 2026/2027 Verified Questions and Answers

NAB CORE Act ual Exam Association of Long– National Term Care Administrator Boards (NAB) – Edition – 2026/2027 Verified Questions and Answers 1. Which of the following best defines "quality of care" in a long-term care facility? A. Providing the most expensive services available B. Ensuring services meet professional standards and improve residents' outcomes C. Allowing residents to make all their medical decisions without consultation D. Reducing staffing to cut costs B. Ensuring services meet professional standards and improve residents' outcomes True or False: The Quality Assurance and Performance Improvement (QAPI) program is a voluntary federal initiative for long-term care facilities. False (QAPI is federally required under the Affordable Care Act for certified facilities) 3. A facility’s fall prevention program should include all of the following EXCEPT: A. Individualized risk assessments B. Staff training C. Routine use of restraints D. Environmental modifications C. Routine use of restraints 4. What is the minimum frequency a facility must complete a comprehensive assessment using the Resident Assessment Instrument (RAI)? A. Monthly B. Every 6 months C. Annually and upon significant change D. Every 90 days C. Annually and upon significant change Which federal regulation requires that each resident receives and the facility provides the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being? A. CMS Condition of Participation B. OBRA 1987 C. HIPAA D. OSHA Long-Term Care Standard B. OBRA 1987 6. Which tool is used by CMS to monitor quality measures in nursing homes? A. ADL Charting Form B. MDS 3.0 C. Facility Quality Dashboard D. OSHA 300 Log B. MDS 3.0 8. A resident with dementia frequently wanders into other residents’ rooms. What is the best quality care response? A. Lock the resident in their room B. Increase use of sedating medications C. Develop a person-centered care plan with staff interventions to redirect D. Move the resident to a different floor C. Develop a person-centered care plan with staff interventions to redirect 9. In providing culturally competent care, a facility should: A. Only acknowledge religious differences B. Train staff in cultural sensitivity and adapt care plans accordingly C. Avoid cultural discussions with residents D. Assign residents to caregivers from the same background B. Train staff in cultural sensitivity and adapt care plans accordingly 10. Which of the following is an example of a quality measure tracked by CMS? A. Staff turnover rates B. Number of resident complaints C. Percentage of residents with new or worsening pressure ulcers D. Number of meals served daily C. Percentage of residents with new or worsening pressure ulcers 1A1 – Medical and Nursing Care Practices 1. Which of the following best supports high-quality nursing care in a long-term care setting? A. Standardized staffing schedules B. Evidence-based care protocols C. Monthly resident satisfaction surveys D. Frequent family social events B. Evidence-based care protocols 1A2 – Medication Management and Administration 2. A common cause of medication errors in long-term care is: A. Overhydration of residents B. Use of electronic medical records C. Inadequate staff training on medication administration D. Frequent physical therapy sessions C. Inadequate staff training on medication administration 1A3 – Disease Management 3. Which of the following best describes the key difference between chronic and acute conditions? A. Chronic conditions are more painful B. Acute conditions are long-lasting C. Chronic conditions require ongoing care management D. Acute conditions are untreatable C. Chronic conditions require ongoing care management 1A4 – Nutrition and Hydration 4. A resident on a mechanical soft diet should avoid: A. Cooked vegetables B. Mashed potatoes C. Raw celery D. Scrambled eggs C. Raw celery 1A5 – Activities of Daily Living (ADLs) and Independent Activities of Daily Living (IADLs) 5. Which of the following is considered an Instrumental Activity of Daily Living (IADL)? A. Dressing B. Toileting C. Cooking meals D. Bathing C. Cooking meals 1A6 – Rehabilitation and Restorative Programs 6. The goal of restorative nursing programs is to: A. Cure all chronic illnesses B. Increase resident independence and function C. Provide acute care within the facility D. Eliminate the need for therapists B. Increase resident independence and function 1A7 – Care Recipient Assessment and Interdisciplinary Care Planning 7. An interdisciplinary care plan meeting should involve: A. Only nursing staff and administration B. The resident, family, and professionals from multiple disciplines C. Just the physician and charge nurse D. Only the dietary and recreation staff B. The resident, family, and professionals from multiple disciplines 1A8 – Clinical and Medical Records and Documentation Requirements 8. HIPAA requires that resident medical records be retained for: A. 3 years B. 6 years from the date of creation or last use C. 1 year after discharge D. Indefinitely B. 6 years from the date of creation or last use 1A9 – Medical Director 9. The primary role of a facility’s Medical Director is to: A. Perform all direct medical care B. Serve as the administrator’s assistant C. Oversee clinical policies and ensure quality medical care D. Hire nursing staff C. Oversee clinical policies and ensure quality medical care 1A10 – Emergency Medical Services 10. Which of the following is an appropriate staff response to a choking resident? A. Call 911 and wait for EMS B. Offer water immediately C. Begin abdominal thrusts (Heimlich maneuver) D. Use an oxygen mask C. Begin abdominal thrusts (Heimlich maneuver) 1A11 – Transition of Care 11. Which of the following is the best way to support a safe discharge process? A. Provide a gift to the resident B. Include discharge planning at admission and involve all relevant care team members C. Schedule discharge without notifying the resident's family D. Allow the resident to arrange their own medications B. Include discharge planning at admission and involve all relevant care team members 1A12 – Basic Healthcare Terminology 12. What does the medical term "PRN" mean? A. Daily B. As needed C. Before meals D. Once a week B. As needed Define OBRA 1987 OBRA 1987 stands for the Omnibus Budget Reconciliation Act of 1987. It is a landmark federal law in the United States that significantly reformed nursing home care standards and protections for residents. Power of Attorney (POA) - Definition A Power of Attorney (POA) is a legal document that gives one person (the agent or attorney-in fact) the authority to act on behalf of another person (the principal) in legal, financial, or healthcare matters. Yes — a Power of Attorney (POA) can make healthcare decisions, but only if it is a Healthcare Power of Attorney (also called a Medical Power of Attorney). Guardianship define A legal arrangement in which a court appoints a person (guardian) to make decisions for someone who is legally incapacitated. Guardians typically make personal and healthcare decisions. Conservatorship define Similar to guardianship, but typically refers to financial and legal decisions. A conservator is appointed by a court to manage the individual’s estate or finances when they are unable to do so. Define Code Status: Code Status A medical order indicating the level of medical interventions a care recipient wants if they experience cardiac or respiratory arrest. Common options include: Full Code: All life-saving measures. DNR (Do Not Resuscitate): No CPR if breathing or heartbeat stops. DNI (Do Not Intubate): No intubation or mechanical ventilation. Define Advance Directives Legal documents that specify a person's healthcare preferences in case they become unable to communicate them. Types include: Living Will (treatment preferences) Durable Power of Attorney for Healthcare POLST/MOLST forms (physician orders for life-sustaining treatment) Define Ethical Decision-Making A framework for making care decisions that consider the care recipient’s values, autonomy, and best interests, often used when legal documents are unclear or absent. It involves principles like: Autonomy (respecting the person’s wishes) Beneficence (acting in the person’s best interest) Non-maleficence (do no harm) Justice (fair treatment) Define Care Recipient (and Representative) Satisfaction Refers to the perceptions, experiences, and overall level of contentment that individuals receiving care — and their representatives (such as family members, legal guardians, or health care agents) — have with the quality, delivery, and outcomes of care and services provided. This concept is a key indicator of quality in healthcare and long-term care settings. Define Meals on Wheels A nationwide program that delivers nutritious meals to homebound seniors or individuals with limited mobility. Helps prevent malnutrition and social isolation. Often operated by local nonprofits or community centers. Define Housing Vouchers Also known as Section 8 vouchers, these are federally funded subsidies that help low-income individuals and families afford safe and decent housing in the private market. Participants typically pay 30% of their income toward rent. Administered by local public housing authorities. Define Area Agencies on Aging (AAA) Regional organizations that coordinate services for older adults and their caregivers under the Older Americans Act. Services may include case management, transportation, caregiver support, legal aid, and home delivered meals. AAAs help individuals navigate and access local aging services. Define Veterans Affairs (VA) The U.S. Department of Veterans Affairs provides a wide range of healthcare, housing, and financial benefits to eligible veterans and their families. Services include VA medical centers, long-term care, mental health services, and VA pensions. VA also partners with community programs to expand veteran support. Define chronic conditions Chronic Conditions are health conditions or diseases that are long-lasting (typically lasting three months or more) and generally cannot be cured completely, but can be managed or controlled over time. They often require ongoing medical attention, lifestyle adjustments, and sometimes long-term treatment to prevent complications. Common Examples: Diabetes Hypertension (high blood pressure) Arthritis Chronic obstructive pulmonary disease (COPD) Heart disease Asthma Chronic kidney disease Define Acute Conditions health problems or illnesses that have a rapid onset and a short duration, usually lasting a few days to a few weeks. They often require immediate or urgent medical attention and typically resolve completely with treatment, although some may lead to complications. Influenza (flu) Pneumonia Appendicitis Broken bones (fractures) Acute infections (e.g., urinary tract infections, strep throat) Heart attack (myocardial infarction) What does Medicare cover? Medicare has four parts: • Part A (Hospital Insurance): Covers hospital stays, skilled nursing facility care, hospice, and some home health care. Most people don't pay a premium for Part A. • Part B (Medical Insurance): Covers doctor visits, outpatient care, medical supplies, and preventive services. People pay a monthly premium for Part B. • Part C (Medicare Advantage Plans): Private insurance plans approved by Medicare that bundle Parts A, B, and usually D. May offer extra benefits like dental or vision. • Part D (Prescription Drug Coverage): Helps cover the cost of prescription drugs. Offered through private insurance companies. MOLST stands for? Medical Orders for Life-Sustaining Treatment. It's a medical order form used to document a seriously ill patient's preferences about life sustaining treatments. Unlike an advance directive, which is more of a legal document expressing wishes, a MOLST form is a physician's medical order that healthcare providers must follow across different care settings (hospital, nursing home, home care, etc.). A POLST stands for? Physician Orders for Life-Sustaining Treatment. It's a medical order form that documents a seriously ill or frail person's wishes about the types of medical care they want — or don't want — in a medical emergency, especially near the end of life. Like a MOLST, it must be signed by a healthcare professional to be legally valid. Key Points about a POLST ? Designed for people with serious, life-limiting illness or advanced frailty. • Specifies preferences about treatments like: • CPR (Do Not Resuscitate — DNR) • Mechanical ventilation • Hospital transfer • Tube feeding • Use of antibiotics • Is an actionable medical order — meaning emergency personnel and healthcare providers must follow it. • Travels with the patient across all care settings: hospital, nursing home, home, and during EMS transport. • Typically printed on brightly colored paper (varies by state) for visibility. POLST vs Advance Directive? POLST is a doctor's order for seriously ill patients — meant for near-term medical decision making. • Advance Directives are legal documents where any adult can outline future healthcare preferences and name a healthcare proxy — often for use if the person later becomes unable to communicate. Give an example of a POLST: If an elderly patient with advanced cancer has a POLST indicating DNR and no mechanical ventilation, EMS and hospital staff are legally bound to honor those wishes during a medical crisis.