TEXAS NURSING HOME ADMINISTRATOR
EXAM 2026 STUDY GUIDE | VERIFIED
QUESTIONS & ANSWERS | COMPREHENSIVE
LICENSURE EXAM PREP
TEXAS NURSING HOME ADMINISTRATOR EXAM 2026 STUDY GUIDE
VERIFIED QUESTIONS & ANSWERS | COMPREHENSIVE LICENSURE EXAM PREP
DOCUMENT OVERVIEW
• This comprehensive study guide contains 200 verified practice questions designed
to prepare you for the Texas Nursing Home Administrator licensure examination,
covering all major domains including regulations, resident care, staff management,
infection control, documentation, and compliance standards.
• Study this material systematically by reviewing each question with its detailed
rationale to build mastery across regulatory requirements, ethical decision-making,
and operational management essential for nursing home leadership.
1. Under the Omnibus Budget Reconciliation Act (OBRA) of 1987, what is the
primary requirement for nursing home administrators in Texas?
A) To maximize profit margins for facility owners
B) To ensure residents receive quality of care and quality of life services
C) To reduce staffing levels to minimize expenses
D) To implement only state regulations, not federal standards
E) To prioritize administrative tasks over resident needs
CORRECT ANSWER: B) To ensure residents receive quality of care and quality
of life services
RATIONALE: OBRA established minimum standards requiring nursing home
administrators to ensure residents receive both quality care (appropriate medical
,treatment) and quality of life (dignity, respect, and social engagement). This is the
foundational principle guiding all administrative decisions in long-term care
facilities.
2. Which of the following is a core responsibility of a nursing home
administrator regarding resident rights in Texas?
A) Limit resident communication with family members
B) Post and make available a written statement of resident rights and
responsibilities
C) Control all personal possessions of residents
D) Prevent residents from making complaints to regulatory agencies
E) Require residents to participate in all facility activities
CORRECT ANSWER: B) Post and make available a written statement of
resident rights and responsibilities
RATIONALE: Nursing home administrators must ensure resident rights are clearly
communicated in writing and posted in accessible locations. This includes rights to
privacy, dignity, autonomy in decision-making, visitation, and the right to voice
concerns without retaliation.
3. What is the minimum staffing requirement for nursing homes in Texas
according to federal regulations?
A) One nurse for every 20 residents at all times
B) One registered nurse (RN) for 8 hours per day and nursing staff 24/7
C) Staff ratios determined solely by facility administrators
D) No minimum requirement; facilities determine their own needs
E) One administrator for every 50 residents
,CORRECT ANSWER: B) One registered nurse (RN) for 8 hours per day and
nursing staff 24/7
RATIONALE: Federal regulations require a minimum of one licensed nurse on duty
24 hours a day, 7 days a week, with at least one RN for a minimum of 8 hours daily.
This ensures adequate supervision and clinical oversight of resident care.
4. Under Texas and federal regulations, what must occur before a facility can
admit a resident?
A) Verbal agreement with the resident's family
B) A comprehensive pre-admission assessment and signed admission agreement
C) Payment of the first month's bill in advance
D) Completion of orientation training by the resident
E) Approval from the state health department only
CORRECT ANSWER: B) A comprehensive pre-admission assessment and signed
admission agreement
RATIONALE: Before admission, facilities must conduct a thorough assessment to
determine if they can meet the resident's needs and complete a signed admission
agreement outlining rights, responsibilities, costs, and facility policies. This protects
both the resident and facility.
5. Which regulation requires nursing homes to establish and maintain
procedures to prevent, identify, and report suspected abuse, neglect, or
exploitation of residents?
A) The Health Insurance Portability and Accountability Act (HIPAA)
B) The Americans with Disabilities Act (ADA)
C) The Resident Rights and Responsibilities regulations (42 CFR Part 483.12)
D) The Medicare Conditions of Participation for Hospitals
, E) The Joint Commission Accreditation Standards
CORRECT ANSWER: C) The Resident Rights and Responsibilities regulations (42
CFR Part 483.12)
RATIONALE: Federal regulations 42 CFR 483.12 mandate that facilities establish
written policies and procedures for reporting and preventing abuse, neglect,
exploitation, and mistreatment. All staff must receive training on recognizing and
reporting these issues.
6. What is the primary purpose of conducting comprehensive assessments
and reassessments of residents in nursing homes?
A) To determine billing rates for insurance companies
B) To develop individualized care plans that address identified needs and problems
C) To reduce the number of healthcare services provided
D) To satisfy family member requests for information
E) To document reasons for discharge
CORRECT ANSWER: B) To develop individualized care plans that address
identified needs and problems
RATIONALE: Comprehensive assessments using the Minimum Data Set (MDS) are
required to identify each resident's physical, psychological, social, and functional
status. These assessments form the foundation for developing individualized care
plans that meet each resident's specific needs.
7. Which of the following best describes a facility's obligation regarding
infection control in a nursing home?
A) Only isolate residents who have active symptoms of infection
B) Implement a written infection control program with documented procedures
and staff training
EXAM 2026 STUDY GUIDE | VERIFIED
QUESTIONS & ANSWERS | COMPREHENSIVE
LICENSURE EXAM PREP
TEXAS NURSING HOME ADMINISTRATOR EXAM 2026 STUDY GUIDE
VERIFIED QUESTIONS & ANSWERS | COMPREHENSIVE LICENSURE EXAM PREP
DOCUMENT OVERVIEW
• This comprehensive study guide contains 200 verified practice questions designed
to prepare you for the Texas Nursing Home Administrator licensure examination,
covering all major domains including regulations, resident care, staff management,
infection control, documentation, and compliance standards.
• Study this material systematically by reviewing each question with its detailed
rationale to build mastery across regulatory requirements, ethical decision-making,
and operational management essential for nursing home leadership.
1. Under the Omnibus Budget Reconciliation Act (OBRA) of 1987, what is the
primary requirement for nursing home administrators in Texas?
A) To maximize profit margins for facility owners
B) To ensure residents receive quality of care and quality of life services
C) To reduce staffing levels to minimize expenses
D) To implement only state regulations, not federal standards
E) To prioritize administrative tasks over resident needs
CORRECT ANSWER: B) To ensure residents receive quality of care and quality
of life services
RATIONALE: OBRA established minimum standards requiring nursing home
administrators to ensure residents receive both quality care (appropriate medical
,treatment) and quality of life (dignity, respect, and social engagement). This is the
foundational principle guiding all administrative decisions in long-term care
facilities.
2. Which of the following is a core responsibility of a nursing home
administrator regarding resident rights in Texas?
A) Limit resident communication with family members
B) Post and make available a written statement of resident rights and
responsibilities
C) Control all personal possessions of residents
D) Prevent residents from making complaints to regulatory agencies
E) Require residents to participate in all facility activities
CORRECT ANSWER: B) Post and make available a written statement of
resident rights and responsibilities
RATIONALE: Nursing home administrators must ensure resident rights are clearly
communicated in writing and posted in accessible locations. This includes rights to
privacy, dignity, autonomy in decision-making, visitation, and the right to voice
concerns without retaliation.
3. What is the minimum staffing requirement for nursing homes in Texas
according to federal regulations?
A) One nurse for every 20 residents at all times
B) One registered nurse (RN) for 8 hours per day and nursing staff 24/7
C) Staff ratios determined solely by facility administrators
D) No minimum requirement; facilities determine their own needs
E) One administrator for every 50 residents
,CORRECT ANSWER: B) One registered nurse (RN) for 8 hours per day and
nursing staff 24/7
RATIONALE: Federal regulations require a minimum of one licensed nurse on duty
24 hours a day, 7 days a week, with at least one RN for a minimum of 8 hours daily.
This ensures adequate supervision and clinical oversight of resident care.
4. Under Texas and federal regulations, what must occur before a facility can
admit a resident?
A) Verbal agreement with the resident's family
B) A comprehensive pre-admission assessment and signed admission agreement
C) Payment of the first month's bill in advance
D) Completion of orientation training by the resident
E) Approval from the state health department only
CORRECT ANSWER: B) A comprehensive pre-admission assessment and signed
admission agreement
RATIONALE: Before admission, facilities must conduct a thorough assessment to
determine if they can meet the resident's needs and complete a signed admission
agreement outlining rights, responsibilities, costs, and facility policies. This protects
both the resident and facility.
5. Which regulation requires nursing homes to establish and maintain
procedures to prevent, identify, and report suspected abuse, neglect, or
exploitation of residents?
A) The Health Insurance Portability and Accountability Act (HIPAA)
B) The Americans with Disabilities Act (ADA)
C) The Resident Rights and Responsibilities regulations (42 CFR Part 483.12)
D) The Medicare Conditions of Participation for Hospitals
, E) The Joint Commission Accreditation Standards
CORRECT ANSWER: C) The Resident Rights and Responsibilities regulations (42
CFR Part 483.12)
RATIONALE: Federal regulations 42 CFR 483.12 mandate that facilities establish
written policies and procedures for reporting and preventing abuse, neglect,
exploitation, and mistreatment. All staff must receive training on recognizing and
reporting these issues.
6. What is the primary purpose of conducting comprehensive assessments
and reassessments of residents in nursing homes?
A) To determine billing rates for insurance companies
B) To develop individualized care plans that address identified needs and problems
C) To reduce the number of healthcare services provided
D) To satisfy family member requests for information
E) To document reasons for discharge
CORRECT ANSWER: B) To develop individualized care plans that address
identified needs and problems
RATIONALE: Comprehensive assessments using the Minimum Data Set (MDS) are
required to identify each resident's physical, psychological, social, and functional
status. These assessments form the foundation for developing individualized care
plans that meet each resident's specific needs.
7. Which of the following best describes a facility's obligation regarding
infection control in a nursing home?
A) Only isolate residents who have active symptoms of infection
B) Implement a written infection control program with documented procedures
and staff training
