FEDERAL NURSING HOME ADMINISTRATOR EXAM PREP DOCUMENT 2026/2027 |
NATIONAL ASSOCIATION OF LONG TERM CARE ADMINISTRATOR BOARDS (NAB)
CORE OF KNOWLEDGE COMPLETE PRACTICE EXAM | LONG-TERM CARE
MANAGEMENT, CMS REGULATIONS, LEADERSHIP & COMPLIANCE | 160 VERIFIED
PRACTICE QUESTIONS WITH DETAILED RATIONALES | UPDATED 2026/2027 STUDY
GUIDE
Examiner/Administrator: National Association of Long Term Care Administrator
Boards (NAB)
FEDERAL NURSING HOME ADMINISTRATOR EXAM
2026/2027 PRACTICE EDITION
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
COMPLETE PRACTICE EXAM
160 MULTIPLE-CHOICE QUESTIONS
PASSING SCORE: 70%
TESTING TIME: 180 MINUTES
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
TABLE OF CONTENTS
1. Resident-Centered Care & Quality of Life
2. Human Resources & Leadership
3. Finance & Business Operations
4. Environmental Services & Life Safety
5. Federal CMS Regulations & Survey Compliance
6. Ethics, Resident Rights & Legal Responsibilities
7. Quality Assurance & Performance Improvement (QAPI)
8. Infection Prevention & Emergency Preparedness
,9. Risk Management & Clinical Operations
10. Long-Term Care Administration & NAB Core of Knowledge
FEDERAL LONG-TERM CARE REGULATORY STANDARDS || NATIONAL ASSOCIATION
OF LONG TERM CARE ADMINISTRATOR BOARDS (NAB) || ALIGNED WITH CURRENT
NAB CORE OF KNOWLEDGE AND CMS REQUIREMENTS || PROFESSIONAL
EXAMINATION STUDY GUIDE || 100% ORIGINAL PRACTICE QUESTIONS WITH
VERIFIED RATIONALES || COMPREHENSIVE LICENSURE PREPARATION || DESIGNED
FOR PROFESSIONAL CERTIFICATION EXAMINATION USE || 2026/2027 EDITION
Resident-Centered Care, Quality of Life & Resident Rights
(Questions 1–10)
QUESTION 1
A nursing home administrator is reviewing resident satisfaction surveys and discovers
that residents consistently report limited opportunities to participate in meaningful
daily activities. Which action best aligns with federal expectations for person-
centered care?
A. Require all residents to attend a standardized recreation schedule.
B. Develop individualized activity programs based on each resident's interests,
abilities, and preferences.
C. Increase television programming in common areas.
D. Schedule activities according to staff availability.
Correct Answer: B. Develop individualized activity programs based on each
resident's interests, abilities, and preferences.
Explanation: Federal long-term care regulations emphasize resident-centered care,
requiring facilities to provide activities that meet each resident's interests and
psychosocial needs. Individualized programming promotes dignity, autonomy, and
quality of life. Standardized activities (A), passive entertainment (C), or staff-centered
scheduling (D) fail to meet regulatory expectations.
,QUESTION 2
A cognitively intact resident refuses a prescribed medication after receiving
appropriate education. What is the administrator's most appropriate response?
A. Require administration because it was physician ordered.
B. Support the resident's right to refuse treatment while ensuring documentation and
notification procedures are followed.
C. Ask staff to disguise the medication in food.
D. Transfer the resident to another facility.
Correct Answer: B. Support the resident's right to refuse treatment while ensuring
documentation and notification procedures are followed.
Explanation: Competent residents maintain the right to refuse treatment. Staff should
educate the resident, document the refusal, notify the prescribing practitioner when
appropriate, and continue monitoring. Options A, C, and D violate resident rights and
ethical practice.
QUESTION 3
A resident complains that staff frequently discuss medical information in the hallway
where visitors can overhear. Which federal principle is most directly affected?
A. Infection prevention
B. Privacy and confidentiality
C. Fire safety
D. Dietary services
Correct Answer: B. Privacy and confidentiality.
, Explanation: Residents have the right to privacy regarding personal and medical
information. Discussing protected information in public areas risks unauthorized
disclosure. The remaining options are unrelated to the scenario.
QUESTION 4
Which leadership strategy most effectively promotes a culture of resident-centered
care throughout a nursing facility?
A. Reward departments solely for reducing expenses.
B. Focus quality improvement exclusively on survey deficiencies.
C. Encourage interdisciplinary collaboration and resident participation in care
planning.
D. Delegate all resident concerns to the social services department.
Correct Answer: C. Encourage interdisciplinary collaboration and resident
participation in care planning.
Explanation: Resident-centered care depends on interdisciplinary teamwork and active
resident involvement in decision-making. Cost reduction alone (A), reactive compliance
(B), or isolated responsibility (D) does not foster a sustainable quality culture.
QUESTION 5
Which situation most likely represents an infringement of resident dignity?
A. Calling residents by preferred names.
B. Explaining procedures before providing care.
C. Discussing care needs loudly in a shared dining room.
D. Encouraging resident participation during care conferences.
Correct Answer: C. Discussing care needs loudly in a shared dining room.
NATIONAL ASSOCIATION OF LONG TERM CARE ADMINISTRATOR BOARDS (NAB)
CORE OF KNOWLEDGE COMPLETE PRACTICE EXAM | LONG-TERM CARE
MANAGEMENT, CMS REGULATIONS, LEADERSHIP & COMPLIANCE | 160 VERIFIED
PRACTICE QUESTIONS WITH DETAILED RATIONALES | UPDATED 2026/2027 STUDY
GUIDE
Examiner/Administrator: National Association of Long Term Care Administrator
Boards (NAB)
FEDERAL NURSING HOME ADMINISTRATOR EXAM
2026/2027 PRACTICE EDITION
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
COMPLETE PRACTICE EXAM
160 MULTIPLE-CHOICE QUESTIONS
PASSING SCORE: 70%
TESTING TIME: 180 MINUTES
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
TABLE OF CONTENTS
1. Resident-Centered Care & Quality of Life
2. Human Resources & Leadership
3. Finance & Business Operations
4. Environmental Services & Life Safety
5. Federal CMS Regulations & Survey Compliance
6. Ethics, Resident Rights & Legal Responsibilities
7. Quality Assurance & Performance Improvement (QAPI)
8. Infection Prevention & Emergency Preparedness
,9. Risk Management & Clinical Operations
10. Long-Term Care Administration & NAB Core of Knowledge
FEDERAL LONG-TERM CARE REGULATORY STANDARDS || NATIONAL ASSOCIATION
OF LONG TERM CARE ADMINISTRATOR BOARDS (NAB) || ALIGNED WITH CURRENT
NAB CORE OF KNOWLEDGE AND CMS REQUIREMENTS || PROFESSIONAL
EXAMINATION STUDY GUIDE || 100% ORIGINAL PRACTICE QUESTIONS WITH
VERIFIED RATIONALES || COMPREHENSIVE LICENSURE PREPARATION || DESIGNED
FOR PROFESSIONAL CERTIFICATION EXAMINATION USE || 2026/2027 EDITION
Resident-Centered Care, Quality of Life & Resident Rights
(Questions 1–10)
QUESTION 1
A nursing home administrator is reviewing resident satisfaction surveys and discovers
that residents consistently report limited opportunities to participate in meaningful
daily activities. Which action best aligns with federal expectations for person-
centered care?
A. Require all residents to attend a standardized recreation schedule.
B. Develop individualized activity programs based on each resident's interests,
abilities, and preferences.
C. Increase television programming in common areas.
D. Schedule activities according to staff availability.
Correct Answer: B. Develop individualized activity programs based on each
resident's interests, abilities, and preferences.
Explanation: Federal long-term care regulations emphasize resident-centered care,
requiring facilities to provide activities that meet each resident's interests and
psychosocial needs. Individualized programming promotes dignity, autonomy, and
quality of life. Standardized activities (A), passive entertainment (C), or staff-centered
scheduling (D) fail to meet regulatory expectations.
,QUESTION 2
A cognitively intact resident refuses a prescribed medication after receiving
appropriate education. What is the administrator's most appropriate response?
A. Require administration because it was physician ordered.
B. Support the resident's right to refuse treatment while ensuring documentation and
notification procedures are followed.
C. Ask staff to disguise the medication in food.
D. Transfer the resident to another facility.
Correct Answer: B. Support the resident's right to refuse treatment while ensuring
documentation and notification procedures are followed.
Explanation: Competent residents maintain the right to refuse treatment. Staff should
educate the resident, document the refusal, notify the prescribing practitioner when
appropriate, and continue monitoring. Options A, C, and D violate resident rights and
ethical practice.
QUESTION 3
A resident complains that staff frequently discuss medical information in the hallway
where visitors can overhear. Which federal principle is most directly affected?
A. Infection prevention
B. Privacy and confidentiality
C. Fire safety
D. Dietary services
Correct Answer: B. Privacy and confidentiality.
, Explanation: Residents have the right to privacy regarding personal and medical
information. Discussing protected information in public areas risks unauthorized
disclosure. The remaining options are unrelated to the scenario.
QUESTION 4
Which leadership strategy most effectively promotes a culture of resident-centered
care throughout a nursing facility?
A. Reward departments solely for reducing expenses.
B. Focus quality improvement exclusively on survey deficiencies.
C. Encourage interdisciplinary collaboration and resident participation in care
planning.
D. Delegate all resident concerns to the social services department.
Correct Answer: C. Encourage interdisciplinary collaboration and resident
participation in care planning.
Explanation: Resident-centered care depends on interdisciplinary teamwork and active
resident involvement in decision-making. Cost reduction alone (A), reactive compliance
(B), or isolated responsibility (D) does not foster a sustainable quality culture.
QUESTION 5
Which situation most likely represents an infringement of resident dignity?
A. Calling residents by preferred names.
B. Explaining procedures before providing care.
C. Discussing care needs loudly in a shared dining room.
D. Encouraging resident participation during care conferences.
Correct Answer: C. Discussing care needs loudly in a shared dining room.
