TEXAS NURSING HOME ADMINISTRATOR EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
Section One: Questions 1–100
Question 1
Under Texas Health and Safety Code Chapter 242, what is the maximum number of days a nursing
facility has to request an informal dispute resolution (IDR) after receiving an official statement of
violations?
A. 10 calendar days
B. 10 working days
C. 15 calendar days
D. 15 working days
🟢 B. 10 working days
🔴 RATIONALE: Texas regulatory standards specify that a facility must submit a written request for an
informal dispute resolution within 10 working days of receiving the official statement of violations.
Question 2
Which of the following describes the minimum nursing hours per resident day (NHPRD) required under
federal baseline rules, which Texas integrates into its licensing standards?
A. 2.0 hours
B. 3.0 hours
C. 3.5 hours
D. 4.1 hours
🟢 B. 3.0 hours
🔴 RATIONALE: While Texas requires sufficient staff to meet resident needs, federal baselines
integrated into state checks look for at least 3.0 total nursing hours per resident day to avoid standard
programmatic understaffing citations.
,Question 3
A resident with advanced dementia continuously wanders into other residents' rooms. The
interdisciplinary team should first implement which intervention?
A. Administer a low-dose antipsychotic as PRN
B. Place a physical restraint on the resident while in bed
C. Assign a scheduled, personalized life-enrichment activity based on past hobbies
D. Install a personal room alarm on the resident's clothing
🟢 C. Assign a scheduled, personalized life-enrichment activity based on past hobbies
🔴 RATIONALE: Regulatory and ethical standards dictate that non-pharmacological, individualized
interventions must be attempted and documented before chemical or physical restraints are considered.
Question 4
An accounting practice where expenditure items are recorded when they are incurred, regardless of
when the cash is actually paid out, is known as:
A. Cash-basis accounting
B. Accrual-basis accounting
C. Cost-allocation accounting
D. Fund-balance accounting
🟢 B. Accrual-basis accounting
🔴 RATIONALE: Accrual accounting matches revenues to the period they are earned and expenses to
the period they are incurred, providing a more accurate fiscal picture for nursing home operations than
cash-basis systems.
Question 5
During a annual survey, a Texas surveyor discovers that the facility failed to perform criminal history
background checks for two CNA hires made three months ago. This violation will most likely be cited
under which category?
A. Quality of Care
B. Resident Rights
,C. Administration / Infection Control
D. Operational Personnel Requirements
🟢 D. Operational Personnel Requirements
🔴 RATIONALE: Failing to verify criminal backgrounds violates state and federal personnel qualifications
designed to protect vulnerable residents from abuse or exploitation.
Question 6
What is the primary operational objective of a facility's Quality Assurance and Performance Improvement
(QAPI) committee?
A. To discipline employees who commit medication errors
B. To review and analyze data to systematically correct operational vulnerabilities and improve care
quality
C. To reduce operating expenditures by cutting clinical supply lines
D. To prepare a marketing strategy for the facility's short-term rehab wing
🟢 B. To review and analyze data to systematically correct operational vulnerabilities and improve care
quality
🔴 RATIONALE: QAPI is a data-driven, proactive approach to improving quality in nursing homes,
requiring ongoing monitoring and systemic corrections rather than reactive discipline.
Question 7
A facility receives an immediate jeopardy (IJ) citation during a complaint investigation. The administrator
must submit an acceptable plan of removal within what timeframe to prevent enforcement actions like
temporary management or termination?
A. 24 hours
B. 48 hours
C. 5 working days
D. 10 calendar days
🟢 A. 24 hours
, 🔴 RATIONALE: An immediate jeopardy citation represents a situation where a facility's noncompliance
has caused, or is likely to cause, serious injury, harm, impairment, or death. A removal plan must be
implemented immediately, typically within 24 hours.
Question 8
According to Life Safety Code (NFPA 101) standards applicable to Texas nursing facilities, what is the
maximum travel distance from any point in a room to an exit access door in a smoke compartment?
A. 100 feet
B. 150 feet
C. 200 feet
D. 250 feet
🟢 C. 200 feet
🔴 RATIONALE: The Life Safety Code mandates that the travel distance within a room to an exit access
door must not exceed 200 feet in buildings protected throughout by an approved automatic sprinkler
system.
Question 9
Which document outlines the specific financial agreements, rights, responsibilities, and service
provisions between the nursing facility and the resident upon admission?
A. Comprehensive Care Plan
B. Admission Agreement / Residency Contract
C. MDS 3.0 Summary Sheet
D. Advance Directive Form
🟢 B. Admission Agreement / Residency Contract
🔴 RATIONALE: The Admission Agreement is the legally binding contract that establishes the fiscal
rules, obligations, services included in the base rate, and explicit state-mandated resident rights
disclosures.
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
Section One: Questions 1–100
Question 1
Under Texas Health and Safety Code Chapter 242, what is the maximum number of days a nursing
facility has to request an informal dispute resolution (IDR) after receiving an official statement of
violations?
A. 10 calendar days
B. 10 working days
C. 15 calendar days
D. 15 working days
🟢 B. 10 working days
🔴 RATIONALE: Texas regulatory standards specify that a facility must submit a written request for an
informal dispute resolution within 10 working days of receiving the official statement of violations.
Question 2
Which of the following describes the minimum nursing hours per resident day (NHPRD) required under
federal baseline rules, which Texas integrates into its licensing standards?
A. 2.0 hours
B. 3.0 hours
C. 3.5 hours
D. 4.1 hours
🟢 B. 3.0 hours
🔴 RATIONALE: While Texas requires sufficient staff to meet resident needs, federal baselines
integrated into state checks look for at least 3.0 total nursing hours per resident day to avoid standard
programmatic understaffing citations.
,Question 3
A resident with advanced dementia continuously wanders into other residents' rooms. The
interdisciplinary team should first implement which intervention?
A. Administer a low-dose antipsychotic as PRN
B. Place a physical restraint on the resident while in bed
C. Assign a scheduled, personalized life-enrichment activity based on past hobbies
D. Install a personal room alarm on the resident's clothing
🟢 C. Assign a scheduled, personalized life-enrichment activity based on past hobbies
🔴 RATIONALE: Regulatory and ethical standards dictate that non-pharmacological, individualized
interventions must be attempted and documented before chemical or physical restraints are considered.
Question 4
An accounting practice where expenditure items are recorded when they are incurred, regardless of
when the cash is actually paid out, is known as:
A. Cash-basis accounting
B. Accrual-basis accounting
C. Cost-allocation accounting
D. Fund-balance accounting
🟢 B. Accrual-basis accounting
🔴 RATIONALE: Accrual accounting matches revenues to the period they are earned and expenses to
the period they are incurred, providing a more accurate fiscal picture for nursing home operations than
cash-basis systems.
Question 5
During a annual survey, a Texas surveyor discovers that the facility failed to perform criminal history
background checks for two CNA hires made three months ago. This violation will most likely be cited
under which category?
A. Quality of Care
B. Resident Rights
,C. Administration / Infection Control
D. Operational Personnel Requirements
🟢 D. Operational Personnel Requirements
🔴 RATIONALE: Failing to verify criminal backgrounds violates state and federal personnel qualifications
designed to protect vulnerable residents from abuse or exploitation.
Question 6
What is the primary operational objective of a facility's Quality Assurance and Performance Improvement
(QAPI) committee?
A. To discipline employees who commit medication errors
B. To review and analyze data to systematically correct operational vulnerabilities and improve care
quality
C. To reduce operating expenditures by cutting clinical supply lines
D. To prepare a marketing strategy for the facility's short-term rehab wing
🟢 B. To review and analyze data to systematically correct operational vulnerabilities and improve care
quality
🔴 RATIONALE: QAPI is a data-driven, proactive approach to improving quality in nursing homes,
requiring ongoing monitoring and systemic corrections rather than reactive discipline.
Question 7
A facility receives an immediate jeopardy (IJ) citation during a complaint investigation. The administrator
must submit an acceptable plan of removal within what timeframe to prevent enforcement actions like
temporary management or termination?
A. 24 hours
B. 48 hours
C. 5 working days
D. 10 calendar days
🟢 A. 24 hours
, 🔴 RATIONALE: An immediate jeopardy citation represents a situation where a facility's noncompliance
has caused, or is likely to cause, serious injury, harm, impairment, or death. A removal plan must be
implemented immediately, typically within 24 hours.
Question 8
According to Life Safety Code (NFPA 101) standards applicable to Texas nursing facilities, what is the
maximum travel distance from any point in a room to an exit access door in a smoke compartment?
A. 100 feet
B. 150 feet
C. 200 feet
D. 250 feet
🟢 C. 200 feet
🔴 RATIONALE: The Life Safety Code mandates that the travel distance within a room to an exit access
door must not exceed 200 feet in buildings protected throughout by an approved automatic sprinkler
system.
Question 9
Which document outlines the specific financial agreements, rights, responsibilities, and service
provisions between the nursing facility and the resident upon admission?
A. Comprehensive Care Plan
B. Admission Agreement / Residency Contract
C. MDS 3.0 Summary Sheet
D. Advance Directive Form
🟢 B. Admission Agreement / Residency Contract
🔴 RATIONALE: The Admission Agreement is the legally binding contract that establishes the fiscal
rules, obligations, services included in the base rate, and explicit state-mandated resident rights
disclosures.
