NAB Exam | 2026/2027 Edition | Real Exam
Questions with 100% Verified Correct Answers
National Association of Long-Term Care Administrator Boards (NAB) CORE
Examination | Expert-Verified Q&A | Certification-Ready Format
Executive Introduction & Evaluation Scope
This comprehensive evaluation document provides an authoritative assessment for the National
Association of Long-Term Care Administrator Boards (NAB) CORE Examination, aligned with the
2026/2027 NAB examination blueprint and leadership curriculum. The content emphasizes the critical
integration of human resources management, fiscal and financial operations, environmental and physical
plant compliance, and resident care quality assurance to ensure safe, efficient, and regulatory-compliant
healthcare facility leadership. Every item is built around foundational principles of long-term care
administration, statutory nursing home requirements of participation, and ethical administrative
conduct. All 125 questions are expert-verified with 100% accurate answers and detailed clinical, financial,
and legal rationales, specifically designed for thorough evaluation and certification-level readiness.
Content Area Overview & Exam Blueprint
Content Area Domain Blueprint Weight Number of Key Topics &
Questions Competencies
Domain 1: Human 25% 31 (Q1–Q31) Federal employment
Resources Management laws (FLSA, ADEA,
FMLA, Title VII), nurse
aide registry
verification, OIG
screening, progressive
discipline, grievance
procedures, OSHA
ergonomics and
bloodborne pathogens,
union relations under
NLRA.
Domain 2: 25% 31 (Q32–Q62) GAAP accrual
Fiscal/Financial accounting, balance
Management sheet equation, zero-
based budgeting,
Medicare Part A PDPM
reimbursement,
Medicaid PPS,
Accounts Receivable
aging, resident trust
funds and surety bond
requirements, GPO
procurement, D&O and
employer legal liability
insurance.
Domain 3: 25% 31 (Q63–Q93) NFPA 101 Life Safety
Environmental/Physical Code, 8-foot corridor
Plant Management widths, RACE and
PASS fire protocols,
emergency generator
testing
, (weekly/monthly),
CEMP emergency
planning, hot water
anti-scald mixing
valves vs. Legionella
control, negative air
pressure, wander guard
security.
Domain 4: Resident 25% 32 (Q94–Q125) Federal requirements
Care & Quality of participation, MDS
Assurance 14-day assessment
schedule, QAPI root-
cause analysis, freedom
from physical/chemical
restraints, pressure
ulcer prevention,
antipsychotic
stewardship, survey
immediate jeopardy,
elder abuse mandatory
reporting.
Total Comprehensive 100% 125 Questions Complete
Evaluation Suite 2026/2027 NAB
CORE Examination
Blueprint Coverage
Comprehensive Examination Questions & Verified Answers
Domain 1: Human Resources Management
1. Under federal employment standards governing long-term care facilities, what is the
primary operational requirement of the Fair Labor Standards Act (FLSA) regarding non-
exempt nursing employees working a standard 14-day work period under the '8 and 80'
overtime system?
A. Employees must receive overtime compensation at one and one-half times their regular hourly rate
for any hours worked over 40 in a single calendar week, without exception.
B. The facility must pay overtime compensation at one and one-half times the regular hourly rate for
all hours worked exceeding 8 hours in any single workday AND for all hours worked exceeding 80
hours during the designated 14-day work period.
C. Salaried supervisors are permitted to bank employee overtime hours as future compensatory time
off at a one-to-one ratio.
D. Part-time employees are exempt from overtime calculations regardless of hours worked during
emergency staffing shortages.
Correct Answer: B. The facility must pay overtime compensation at one and one-half times
the regular hourly rate for all hours worked exceeding 8 hours in any single workday AND
for all hours worked exceeding 80 hours during the designated 14-day work period.
Rationale: Under Section 7(j) of the Fair Labor Standards Act (FLSA), healthcare and residential care
facilities are permitted to utilize an optional 14-day work period instead of the standard 7-day
workweek for calculating overtime, provided there is a prior agreement with the employees. Under this
'8 and 80' system, the facility must pay overtime at time-and-a-half for any hours worked over 8 in any
single workday, as well as any hours worked over 80 in the entire 14-day period.
,2. In long-term care human resources administration, what represents the mandatory
federal screening requirement before hiring a prospective Certified Nurse Aide (CNA) or
healthcare worker?
A. Conducting a screening exclusively through local municipal credit bureaus.
B. Verifying the individual's active status and clean record on the state Nurse Aide Registry and
verifying that the applicant is not listed on the Office of Inspector General (OIG) List of Excluded
Individuals/Entities (LEIE).
C. Requiring the applicant to submit a personal driving record from the Department of Motor
Vehicles.
D. Obtaining verbal recommendations from three personal neighbors without written documentation.
Correct Answer: B. Verifying the individual's active status and clean record on the state
Nurse Aide Registry and verifying that the applicant is not listed on the Office of Inspector
General (OIG) List of Excluded Individuals/Entities (LEIE).
Rationale: Federal long-term care regulations mandate that facilities must not employ individuals who
have been found guilty of resident abuse, neglect, exploitation, or misappropriation of property by a
court of law or who have a substantiated finding on the state Nurse Aide Registry. Furthermore,
facilities must screen all prospective employees against the OIG Excluded Individuals/Entities list
(LEIE) to ensure they are not excluded from participating in federal healthcare programs such as
Medicare and Medicaid.
3. Under the federal Family and Medical Leave Act (FMLA), how many weeks of unpaid,
job-protected leave is an eligible long-term care facility employee entitled to receive during
a designated 12-month period for the birth of a child or to care for a spouse with a serious
health condition?
A. 6 weeks of unpaid leave
B. 8 weeks of unpaid leave
C. 12 weeks of unpaid leave
D. 16 weeks of unpaid leave
Correct Answer: C. 12 weeks of unpaid leave
Rationale: The Family and Medical Leave Act (FMLA) mandates that covered employers (including
healthcare facilities with 50 or more employees) provide eligible employees up to 12 workweeks of
unpaid, job-protected leave within a 12-month period for qualifying family and medical reasons, such
as childbirth, newborn adoption, personal serious illness, or caring for an immediate family member
with a serious medical condition, while maintaining group health insurance benefits.
4. Which of the following pre-employment interview inquiries by a nursing home human
resources director violates Title VII of the Civil Rights Act or the Americans with
Disabilities Act (ADA)?
A. Asking if the candidate has any physical limitations or prescription medication requirements that
would require attendance adjustments.
B. Asking if the candidate can perform the essential functions of the nursing aide position, such as
lifting 50 pounds with or without reasonable accommodation.
C. Asking if the candidate is legally authorized to work within the United States upon employment
verification.
D. Asking if the candidate can work the assigned rotating night shifts and weekend schedules required
by the facility.
Correct Answer: A. Asking if the candidate has any physical limitations or prescription
medication requirements that would require attendance adjustments.
Rationale: Under the Americans with Disabilities Act (ADA) and federal Equal Employment
Opportunity (EEO) guidelines, employers are strictly prohibited from asking disability-related
questions, inquiring about medical histories, or asking about prescription medication usage prior to
making a conditional offer of employment. Employers may only ask whether the applicant can perform
the essential functions of the job, with or without reasonable accommodation.
, 5. According to occupational safety regulations governing healthcare facilities, what is the
mandatory employer obligation regarding the Hepatitis B vaccination series for newly
hired direct-care staff exposed to bloodborne pathogens?
A. The employer must require staff to obtain the vaccine at their own personal expense within 90 days
of employment.
B. The employer must make the Hepatitis B vaccination series available to all occupationally exposed
employees at no financial cost to the employee within 10 working days of initial assignment, unless
the employee signs a mandatory declination form.
C. The employer can mandate that staff sign an absolute waiver of workers' compensation liability if
they refuse the vaccine.
D. The employer is exempt from vaccination offers if the facility has experienced zero needle-stick
injuries over the previous 12 months.
Correct Answer: B. The employer must make the Hepatitis B vaccination series available to
all occupationally exposed employees at no financial cost to the employee within 10
working days of initial assignment, unless the employee signs a mandatory declination
form.
Rationale: Under the OSHA Bloodborne Pathogens Standard (Title 29 Code of Federal Regulations),
healthcare employers are legally required to offer the Hepatitis B vaccination series to all employees
with occupational exposure to blood or other potentially infectious materials. The vaccine must be
offered at no cost to the employee, at a reasonable time and place, and within 10 working days of initial
assignment. Employees who decline must sign a standardized OSHA declination statement.
6. In employee performance administration, what is the primary operational objective of a
'Progressive Discipline' system within a long-term care facility?
A. To immediately terminate employees upon their first minor operational infraction without prior
warning.
B. To provide a fair, transparent, and documented sequence of corrective actions (such as verbal
warning, written warning, suspension, and termination) designed to give employees an opportunity to
correct unsatisfactory behavioral or performance deficiencies.
C. To replace formal performance evaluations by deducting salary percentages for attendance
tardiness.
D. To shift the burden of proof to the employee during state unemployment insurance hearings.
Correct Answer: B. To provide a fair, transparent, and documented sequence of corrective
actions (such as verbal warning, written warning, suspension, and termination) designed
to give employees an opportunity to correct unsatisfactory behavioral or performance
deficiencies.
Rationale: Progressive discipline is a foundational human resources methodology in healthcare
management. Rather than utilizing immediate punitive termination for non-catastrophic infractions,
progressive discipline establishes a graduated series of formal warnings and corrective intervention
steps. This structured process provides clear notice of deficiencies, sets measurable expectations for
improvement, protects employee due process rights, and generates objective legal documentation if
employment termination ultimately becomes necessary.
7. Under the National Labor Relations Act (NLRA), which of the following administrative
actions by a nursing home administrator during a union organizing campaign is classified
as an Unfair Labor Conduct violation under statutory rules?
A. Explaining the factual costs of union monthly dues and initiation fees during an open staff meeting.
B. Threatening employees with loss of benefits, facility closure, or wage reductions if they vote to
authorize union representation.
C. Restricting union organizers from entering resident clinical care areas and resident bedrooms.
D. Sharing factual comparisons of current facility wages against local unionized competitor facilities.
Correct Answer: B. Threatening employees with loss of benefits, facility closure, or wage
reductions if they vote to authorize union representation.
Questions with 100% Verified Correct Answers
National Association of Long-Term Care Administrator Boards (NAB) CORE
Examination | Expert-Verified Q&A | Certification-Ready Format
Executive Introduction & Evaluation Scope
This comprehensive evaluation document provides an authoritative assessment for the National
Association of Long-Term Care Administrator Boards (NAB) CORE Examination, aligned with the
2026/2027 NAB examination blueprint and leadership curriculum. The content emphasizes the critical
integration of human resources management, fiscal and financial operations, environmental and physical
plant compliance, and resident care quality assurance to ensure safe, efficient, and regulatory-compliant
healthcare facility leadership. Every item is built around foundational principles of long-term care
administration, statutory nursing home requirements of participation, and ethical administrative
conduct. All 125 questions are expert-verified with 100% accurate answers and detailed clinical, financial,
and legal rationales, specifically designed for thorough evaluation and certification-level readiness.
Content Area Overview & Exam Blueprint
Content Area Domain Blueprint Weight Number of Key Topics &
Questions Competencies
Domain 1: Human 25% 31 (Q1–Q31) Federal employment
Resources Management laws (FLSA, ADEA,
FMLA, Title VII), nurse
aide registry
verification, OIG
screening, progressive
discipline, grievance
procedures, OSHA
ergonomics and
bloodborne pathogens,
union relations under
NLRA.
Domain 2: 25% 31 (Q32–Q62) GAAP accrual
Fiscal/Financial accounting, balance
Management sheet equation, zero-
based budgeting,
Medicare Part A PDPM
reimbursement,
Medicaid PPS,
Accounts Receivable
aging, resident trust
funds and surety bond
requirements, GPO
procurement, D&O and
employer legal liability
insurance.
Domain 3: 25% 31 (Q63–Q93) NFPA 101 Life Safety
Environmental/Physical Code, 8-foot corridor
Plant Management widths, RACE and
PASS fire protocols,
emergency generator
testing
, (weekly/monthly),
CEMP emergency
planning, hot water
anti-scald mixing
valves vs. Legionella
control, negative air
pressure, wander guard
security.
Domain 4: Resident 25% 32 (Q94–Q125) Federal requirements
Care & Quality of participation, MDS
Assurance 14-day assessment
schedule, QAPI root-
cause analysis, freedom
from physical/chemical
restraints, pressure
ulcer prevention,
antipsychotic
stewardship, survey
immediate jeopardy,
elder abuse mandatory
reporting.
Total Comprehensive 100% 125 Questions Complete
Evaluation Suite 2026/2027 NAB
CORE Examination
Blueprint Coverage
Comprehensive Examination Questions & Verified Answers
Domain 1: Human Resources Management
1. Under federal employment standards governing long-term care facilities, what is the
primary operational requirement of the Fair Labor Standards Act (FLSA) regarding non-
exempt nursing employees working a standard 14-day work period under the '8 and 80'
overtime system?
A. Employees must receive overtime compensation at one and one-half times their regular hourly rate
for any hours worked over 40 in a single calendar week, without exception.
B. The facility must pay overtime compensation at one and one-half times the regular hourly rate for
all hours worked exceeding 8 hours in any single workday AND for all hours worked exceeding 80
hours during the designated 14-day work period.
C. Salaried supervisors are permitted to bank employee overtime hours as future compensatory time
off at a one-to-one ratio.
D. Part-time employees are exempt from overtime calculations regardless of hours worked during
emergency staffing shortages.
Correct Answer: B. The facility must pay overtime compensation at one and one-half times
the regular hourly rate for all hours worked exceeding 8 hours in any single workday AND
for all hours worked exceeding 80 hours during the designated 14-day work period.
Rationale: Under Section 7(j) of the Fair Labor Standards Act (FLSA), healthcare and residential care
facilities are permitted to utilize an optional 14-day work period instead of the standard 7-day
workweek for calculating overtime, provided there is a prior agreement with the employees. Under this
'8 and 80' system, the facility must pay overtime at time-and-a-half for any hours worked over 8 in any
single workday, as well as any hours worked over 80 in the entire 14-day period.
,2. In long-term care human resources administration, what represents the mandatory
federal screening requirement before hiring a prospective Certified Nurse Aide (CNA) or
healthcare worker?
A. Conducting a screening exclusively through local municipal credit bureaus.
B. Verifying the individual's active status and clean record on the state Nurse Aide Registry and
verifying that the applicant is not listed on the Office of Inspector General (OIG) List of Excluded
Individuals/Entities (LEIE).
C. Requiring the applicant to submit a personal driving record from the Department of Motor
Vehicles.
D. Obtaining verbal recommendations from three personal neighbors without written documentation.
Correct Answer: B. Verifying the individual's active status and clean record on the state
Nurse Aide Registry and verifying that the applicant is not listed on the Office of Inspector
General (OIG) List of Excluded Individuals/Entities (LEIE).
Rationale: Federal long-term care regulations mandate that facilities must not employ individuals who
have been found guilty of resident abuse, neglect, exploitation, or misappropriation of property by a
court of law or who have a substantiated finding on the state Nurse Aide Registry. Furthermore,
facilities must screen all prospective employees against the OIG Excluded Individuals/Entities list
(LEIE) to ensure they are not excluded from participating in federal healthcare programs such as
Medicare and Medicaid.
3. Under the federal Family and Medical Leave Act (FMLA), how many weeks of unpaid,
job-protected leave is an eligible long-term care facility employee entitled to receive during
a designated 12-month period for the birth of a child or to care for a spouse with a serious
health condition?
A. 6 weeks of unpaid leave
B. 8 weeks of unpaid leave
C. 12 weeks of unpaid leave
D. 16 weeks of unpaid leave
Correct Answer: C. 12 weeks of unpaid leave
Rationale: The Family and Medical Leave Act (FMLA) mandates that covered employers (including
healthcare facilities with 50 or more employees) provide eligible employees up to 12 workweeks of
unpaid, job-protected leave within a 12-month period for qualifying family and medical reasons, such
as childbirth, newborn adoption, personal serious illness, or caring for an immediate family member
with a serious medical condition, while maintaining group health insurance benefits.
4. Which of the following pre-employment interview inquiries by a nursing home human
resources director violates Title VII of the Civil Rights Act or the Americans with
Disabilities Act (ADA)?
A. Asking if the candidate has any physical limitations or prescription medication requirements that
would require attendance adjustments.
B. Asking if the candidate can perform the essential functions of the nursing aide position, such as
lifting 50 pounds with or without reasonable accommodation.
C. Asking if the candidate is legally authorized to work within the United States upon employment
verification.
D. Asking if the candidate can work the assigned rotating night shifts and weekend schedules required
by the facility.
Correct Answer: A. Asking if the candidate has any physical limitations or prescription
medication requirements that would require attendance adjustments.
Rationale: Under the Americans with Disabilities Act (ADA) and federal Equal Employment
Opportunity (EEO) guidelines, employers are strictly prohibited from asking disability-related
questions, inquiring about medical histories, or asking about prescription medication usage prior to
making a conditional offer of employment. Employers may only ask whether the applicant can perform
the essential functions of the job, with or without reasonable accommodation.
, 5. According to occupational safety regulations governing healthcare facilities, what is the
mandatory employer obligation regarding the Hepatitis B vaccination series for newly
hired direct-care staff exposed to bloodborne pathogens?
A. The employer must require staff to obtain the vaccine at their own personal expense within 90 days
of employment.
B. The employer must make the Hepatitis B vaccination series available to all occupationally exposed
employees at no financial cost to the employee within 10 working days of initial assignment, unless
the employee signs a mandatory declination form.
C. The employer can mandate that staff sign an absolute waiver of workers' compensation liability if
they refuse the vaccine.
D. The employer is exempt from vaccination offers if the facility has experienced zero needle-stick
injuries over the previous 12 months.
Correct Answer: B. The employer must make the Hepatitis B vaccination series available to
all occupationally exposed employees at no financial cost to the employee within 10
working days of initial assignment, unless the employee signs a mandatory declination
form.
Rationale: Under the OSHA Bloodborne Pathogens Standard (Title 29 Code of Federal Regulations),
healthcare employers are legally required to offer the Hepatitis B vaccination series to all employees
with occupational exposure to blood or other potentially infectious materials. The vaccine must be
offered at no cost to the employee, at a reasonable time and place, and within 10 working days of initial
assignment. Employees who decline must sign a standardized OSHA declination statement.
6. In employee performance administration, what is the primary operational objective of a
'Progressive Discipline' system within a long-term care facility?
A. To immediately terminate employees upon their first minor operational infraction without prior
warning.
B. To provide a fair, transparent, and documented sequence of corrective actions (such as verbal
warning, written warning, suspension, and termination) designed to give employees an opportunity to
correct unsatisfactory behavioral or performance deficiencies.
C. To replace formal performance evaluations by deducting salary percentages for attendance
tardiness.
D. To shift the burden of proof to the employee during state unemployment insurance hearings.
Correct Answer: B. To provide a fair, transparent, and documented sequence of corrective
actions (such as verbal warning, written warning, suspension, and termination) designed
to give employees an opportunity to correct unsatisfactory behavioral or performance
deficiencies.
Rationale: Progressive discipline is a foundational human resources methodology in healthcare
management. Rather than utilizing immediate punitive termination for non-catastrophic infractions,
progressive discipline establishes a graduated series of formal warnings and corrective intervention
steps. This structured process provides clear notice of deficiencies, sets measurable expectations for
improvement, protects employee due process rights, and generates objective legal documentation if
employment termination ultimately becomes necessary.
7. Under the National Labor Relations Act (NLRA), which of the following administrative
actions by a nursing home administrator during a union organizing campaign is classified
as an Unfair Labor Conduct violation under statutory rules?
A. Explaining the factual costs of union monthly dues and initiation fees during an open staff meeting.
B. Threatening employees with loss of benefits, facility closure, or wage reductions if they vote to
authorize union representation.
C. Restricting union organizers from entering resident clinical care areas and resident bedrooms.
D. Sharing factual comparisons of current facility wages against local unionized competitor facilities.
Correct Answer: B. Threatening employees with loss of benefits, facility closure, or wage
reductions if they vote to authorize union representation.
