NC MEDICARE SUPPLEMENT AND
LONG-TERM CARE CERTIFICATION
2025/2026 EXAM QUESTIONS AND
VERIFIED ANSWERS (96 Questions)
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*QUESTION 1:*
A Medicare beneficiary is enrolled in a Medicare Supplement (Medigap) plan and also has a Medicare
Advantage (Part C) plan. Which statement is correct regarding their coverage?
A) They can keep both plans and use them interchangeably for all services.
B) The Medigap plan will pay the Medicare Advantage plan's copayments.
C) It is illegal for a beneficiary to have both a Medigap and a Medicare Advantage plan simultaneously.
D) The Medicare Advantage plan will coordinate benefits with the Medigap plan.
> 🎯 *CORRECT ANSWER:* C) It is illegal for a beneficiary to have both a Medigap and a Medicare
Advantage plan simultaneously.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Federal law prohibits dual enrollment to prevent duplicate payments.
> * *Why Distractors Fail:* Coordination doesn't occur; selling both is unlawful.
> * *Core Takeaway:* Beneficiaries must choose Part C OR Medigap, not both.
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*QUESTION 2:*
,A long-term care resident with a history of falls is prescribed a new sedative-hypnotic. Which action is
most important to include in their care plan?
A) Restrict fluids after 6 PM to prevent nocturia.
B) Place the bed in the lowest position with floor mats.
C) Administer the medication only upon request.
D) Increase the dose if the resident is agitated.
> 🎯 *CORRECT ANSWER:* B) Place the bed in the lowest position with floor mats.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Low beds with mats reduce injury from falls.
> * *Why Distractors Fail:* Restricting fluids doesn't prevent fall-related injury.
> * *Core Takeaway:* Fall prevention includes bed lowering and protective mats.
---
*QUESTION 3:*
A resident with dementia is wandering and attempting to leave the secured unit. The nurse's initial
intervention should be to:
A) Apply a physical restraint to prevent elopement.
B) Administer a PRN antipsychotic to calm the resident.
C) Redirect the resident to a safe, engaging activity.
D) Call the family to come and pick up the resident.
> 🎯 *CORRECT ANSWER:* C) Redirect the resident to a safe, engaging activity.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Redirection is a least-restrictive, therapeutic intervention.
> * *Why Distractors Fail:* Restraints and medications are last-resort interventions.
> * *Core Takeaway:* Use non-pharmacological approaches first for wandering.
,---
*QUESTION 4:*
Medicare Part A covers which of the following services for a beneficiary in a skilled nursing facility (SNF)?
A) Custodial care and assistance with ADLs for chronic conditions.
B) A semi-private room, meals, and skilled nursing care up to 100 days per benefit period.
C) Physician visits and outpatient laboratory tests.
D) Long-term care for Alzheimer's disease in a memory care unit.
> 🎯 *CORRECT ANSWER:* B) A semi-private room, meals, and skilled nursing care up to 100 days per
benefit period.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Part A covers SNF care following a qualifying hospital stay.
> * *Why Distractors Fail:* Custodial care is excluded; Part B covers physician visits.
> * *Core Takeaway:* Part A covers short-term skilled nursing care, not long-term custody.
---
*QUESTION 5:*
A resident who is NPO is receiving IV fluids and has a urine output of 300 mL over 12 hours. The nurse
should first:
A) Increase the IV fluid rate.
B) Notify the healthcare provider.
C) Assess the resident for signs of dehydration.
D) Check the patency of the urinary catheter.
> 🎯 *CORRECT ANSWER:* D) Check the patency of the urinary catheter.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Low output may be due to catheter obstruction or kinking.
> * *Why Distractors Fail:* Assessment of catheter patency precedes notification.
, > * *Core Takeaway:* Check for mechanical issues before assuming renal cause.
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*QUESTION 6:*
A Medicare beneficiary is comparing Medigap plans. Which plan offers the most comprehensive
coverage, including coverage for Medicare Part B excess charges and foreign travel?
A) Plan K
B) Plan F
C) Plan N
D) Plan G
> 🎯 *CORRECT ANSWER:* B) Plan F
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Plan F covers all Medicare deductibles, copays, and excess charges.
> * *Why Distractors Fail:* Plan G covers most, except Part B deductible.
> * *Core Takeaway:* Plan F provides the broadest coverage of any Medigap plan.
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*QUESTION 7:*
A resident in a long-term care facility has a stage 3 pressure injury on the sacrum. The wound care nurse
notes undermining and tunneling. Which intervention is a priority?
A) Apply a dry sterile gauze dressing.
B) Pack the wound with a sterile saline-moistened dressing.
C) Obtain a wound culture and sensitivity.
D) Initiate pressure-relieving devices and frequent repositioning.
> 🎯 *CORRECT ANSWER:* D) Initiate pressure-relieving devices and frequent repositioning.
> 💡 *CLINICAL RATIONALE:*
LONG-TERM CARE CERTIFICATION
2025/2026 EXAM QUESTIONS AND
VERIFIED ANSWERS (96 Questions)
---
*QUESTION 1:*
A Medicare beneficiary is enrolled in a Medicare Supplement (Medigap) plan and also has a Medicare
Advantage (Part C) plan. Which statement is correct regarding their coverage?
A) They can keep both plans and use them interchangeably for all services.
B) The Medigap plan will pay the Medicare Advantage plan's copayments.
C) It is illegal for a beneficiary to have both a Medigap and a Medicare Advantage plan simultaneously.
D) The Medicare Advantage plan will coordinate benefits with the Medigap plan.
> 🎯 *CORRECT ANSWER:* C) It is illegal for a beneficiary to have both a Medigap and a Medicare
Advantage plan simultaneously.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Federal law prohibits dual enrollment to prevent duplicate payments.
> * *Why Distractors Fail:* Coordination doesn't occur; selling both is unlawful.
> * *Core Takeaway:* Beneficiaries must choose Part C OR Medigap, not both.
---
*QUESTION 2:*
,A long-term care resident with a history of falls is prescribed a new sedative-hypnotic. Which action is
most important to include in their care plan?
A) Restrict fluids after 6 PM to prevent nocturia.
B) Place the bed in the lowest position with floor mats.
C) Administer the medication only upon request.
D) Increase the dose if the resident is agitated.
> 🎯 *CORRECT ANSWER:* B) Place the bed in the lowest position with floor mats.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Low beds with mats reduce injury from falls.
> * *Why Distractors Fail:* Restricting fluids doesn't prevent fall-related injury.
> * *Core Takeaway:* Fall prevention includes bed lowering and protective mats.
---
*QUESTION 3:*
A resident with dementia is wandering and attempting to leave the secured unit. The nurse's initial
intervention should be to:
A) Apply a physical restraint to prevent elopement.
B) Administer a PRN antipsychotic to calm the resident.
C) Redirect the resident to a safe, engaging activity.
D) Call the family to come and pick up the resident.
> 🎯 *CORRECT ANSWER:* C) Redirect the resident to a safe, engaging activity.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Redirection is a least-restrictive, therapeutic intervention.
> * *Why Distractors Fail:* Restraints and medications are last-resort interventions.
> * *Core Takeaway:* Use non-pharmacological approaches first for wandering.
,---
*QUESTION 4:*
Medicare Part A covers which of the following services for a beneficiary in a skilled nursing facility (SNF)?
A) Custodial care and assistance with ADLs for chronic conditions.
B) A semi-private room, meals, and skilled nursing care up to 100 days per benefit period.
C) Physician visits and outpatient laboratory tests.
D) Long-term care for Alzheimer's disease in a memory care unit.
> 🎯 *CORRECT ANSWER:* B) A semi-private room, meals, and skilled nursing care up to 100 days per
benefit period.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Part A covers SNF care following a qualifying hospital stay.
> * *Why Distractors Fail:* Custodial care is excluded; Part B covers physician visits.
> * *Core Takeaway:* Part A covers short-term skilled nursing care, not long-term custody.
---
*QUESTION 5:*
A resident who is NPO is receiving IV fluids and has a urine output of 300 mL over 12 hours. The nurse
should first:
A) Increase the IV fluid rate.
B) Notify the healthcare provider.
C) Assess the resident for signs of dehydration.
D) Check the patency of the urinary catheter.
> 🎯 *CORRECT ANSWER:* D) Check the patency of the urinary catheter.
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Low output may be due to catheter obstruction or kinking.
> * *Why Distractors Fail:* Assessment of catheter patency precedes notification.
, > * *Core Takeaway:* Check for mechanical issues before assuming renal cause.
---
*QUESTION 6:*
A Medicare beneficiary is comparing Medigap plans. Which plan offers the most comprehensive
coverage, including coverage for Medicare Part B excess charges and foreign travel?
A) Plan K
B) Plan F
C) Plan N
D) Plan G
> 🎯 *CORRECT ANSWER:* B) Plan F
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Plan F covers all Medicare deductibles, copays, and excess charges.
> * *Why Distractors Fail:* Plan G covers most, except Part B deductible.
> * *Core Takeaway:* Plan F provides the broadest coverage of any Medigap plan.
---
*QUESTION 7:*
A resident in a long-term care facility has a stage 3 pressure injury on the sacrum. The wound care nurse
notes undermining and tunneling. Which intervention is a priority?
A) Apply a dry sterile gauze dressing.
B) Pack the wound with a sterile saline-moistened dressing.
C) Obtain a wound culture and sensitivity.
D) Initiate pressure-relieving devices and frequent repositioning.
> 🎯 *CORRECT ANSWER:* D) Initiate pressure-relieving devices and frequent repositioning.
> 💡 *CLINICAL RATIONALE:*
