Louisiana Nursing Home Administrator (LNHA)
License Exam EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE
1. Resident Care and Quality of Life
2. Human Resources Management and Labor Relations
3. Financial Management and Accounting
4. Federal and State Regulatory Compliance (OBRA/CMS)
5. Environmental Services and Physical Plant Management
6. Leadership, Strategic Planning, and Governance
7. Emergency Preparedness and Life Safety Code
8. Marketing and Public Relations
9. Dietary and Nutritional Services Management
10. Medical Records and Health Information Privacy (HIPAA)
1. A resident in a nursing facility develops a new stage II pressure ulcer despite a comprehensive
care plan. The DON requests a review. What is the most critical immediate administrative
action?
A. Notify the state survey agency immediately.
, B. Review the clinical record and care plan to determine if interventions were implemented
as prescribed.
C. Order a specialty air-loss mattress.
D. Terminate the nursing aide assigned to the resident.
Answer: B
CORRECT ANSWER : B
Rationale: The administrator must first verify if the existing care plan was followed to identify
the root cause of the breakdown. Notification (A) is not required for a single stage II ulcer, and
disciplinary action (D) or equipment changes (C) should only follow a thorough clinical root
cause analysis.
2. Your facility is preparing for an unannounced annual survey. You discover that a staff member’s
background check was filed incorrectly and missing the required documentation. What is the
standard action?
A. Shred the file and start over to avoid audit issues.
B. Immediately initiate the background check and document the non-compliance until the
results are received.
C. Wait for the surveyors to find it to see if they cite it.
D. Transfer the employee to a non-resident contact role until the check clears.
Answer: B
CORRECT ANSWER : B
Rationale: Regulatory compliance requires immediate corrective action upon discovery of
missing documentation to minimize the window of non-compliance. Shredding (A) constitutes
fraud, and delaying action (C) is a failure of oversight; documenting the process shows active
mitigation.
3. The facility’s census has dropped 15% over the last quarter, leading to a significant budget
deficit. Which strategy is most effective for long-term fiscal stabilization?
A. Reducing nursing staffing levels below mandatory ratios.
B. Conducting a SWOT analysis to identify market niche gaps and operational
inefficiencies.
, C. Closing the dining room to save on dietary costs.
D. Raising private pay rates by 30% overnight.
Answer: B
CORRECT ANSWER : B
Rationale: Strategic planning via SWOT analysis addresses the root cause of the census decline.
Cutting staffing (A) risks survey failure, and immediate rate hikes (D) will likely alienate existing
residents and damage reputation.
4. A resident’s family complains that their mother is being abused. As the administrator, what is
your mandatory first step?
A. Conduct an internal investigation and terminate staff if found guilty.
B. Implement immediate protection for the resident and report the allegation to the State
Department of Health.
C. Call the family back to schedule a formal grievance meeting.
D. Consult the facility attorney before notifying state authorities.
Answer: B
CORRECT ANSWER : B
Rationale: Abuse allegations require immediate reporting to the state and protective measures
for the resident per federal law. Internal investigation (A) is secondary to mandatory reporting,
and consulting an attorney (D) cannot delay the statutory reporting deadline.
5. The facility’s QAPI committee notes a trend of increased falls in the dementia unit. What is the
best approach to mitigate this?
A. Increase the use of physical restraints.
B. Perform a root cause analysis (RCA) to identify environmental or medication triggers.
C. Require that all residents use wheelchairs.
D. Hire more administrative staff.
Answer: B
CORRECT ANSWER : B
, Rationale: QAPI requires a data-driven, systematic approach to identify root causes. Restraints
(A) are against federal regulations, and wheelchair use (C) causes deconditioning and further
fall risk.
6. You are negotiating a contract with a new pharmacy provider. Which provision is most vital to
ensure compliance with CMS standards?
A. The pharmacy must be the cheapest option in the state.
B. The pharmacy must provide 24-hour consultant pharmacist services and timely drug
delivery.
C. The pharmacy must provide free gifts to the administrator.
D. The pharmacy must only handle electronic prescriptions.
Answer: B
CORRECT ANSWER : B
Rationale: Federal regulations mandate consultant pharmacist review and timely access to
medications. Cost (A) is secondary to quality of care, and receiving gifts (C) violates ethical and
potentially anti-kickback statutes.
7. A staff member reports a workplace injury but does not wish to fill out the incident report. What
must the administrator do?
A. Respect their privacy and not report it.
B. Require the report to be completed for OSHA compliance and worker’s compensation
protection.
C. Pay for the medical treatment out of petty cash.
D. Ignore it if the employee does not miss work.
Answer: B
CORRECT ANSWER : B
Rationale: Employers are legally obligated to record all work-related injuries under OSHA,
regardless of the employee's preference. Failing to document leaves the facility legally
vulnerable and violates recordkeeping standards.
8. Your facility is hit by a massive hurricane. The primary power grid fails. What is the most
critical document to follow?
License Exam EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE
1. Resident Care and Quality of Life
2. Human Resources Management and Labor Relations
3. Financial Management and Accounting
4. Federal and State Regulatory Compliance (OBRA/CMS)
5. Environmental Services and Physical Plant Management
6. Leadership, Strategic Planning, and Governance
7. Emergency Preparedness and Life Safety Code
8. Marketing and Public Relations
9. Dietary and Nutritional Services Management
10. Medical Records and Health Information Privacy (HIPAA)
1. A resident in a nursing facility develops a new stage II pressure ulcer despite a comprehensive
care plan. The DON requests a review. What is the most critical immediate administrative
action?
A. Notify the state survey agency immediately.
, B. Review the clinical record and care plan to determine if interventions were implemented
as prescribed.
C. Order a specialty air-loss mattress.
D. Terminate the nursing aide assigned to the resident.
Answer: B
CORRECT ANSWER : B
Rationale: The administrator must first verify if the existing care plan was followed to identify
the root cause of the breakdown. Notification (A) is not required for a single stage II ulcer, and
disciplinary action (D) or equipment changes (C) should only follow a thorough clinical root
cause analysis.
2. Your facility is preparing for an unannounced annual survey. You discover that a staff member’s
background check was filed incorrectly and missing the required documentation. What is the
standard action?
A. Shred the file and start over to avoid audit issues.
B. Immediately initiate the background check and document the non-compliance until the
results are received.
C. Wait for the surveyors to find it to see if they cite it.
D. Transfer the employee to a non-resident contact role until the check clears.
Answer: B
CORRECT ANSWER : B
Rationale: Regulatory compliance requires immediate corrective action upon discovery of
missing documentation to minimize the window of non-compliance. Shredding (A) constitutes
fraud, and delaying action (C) is a failure of oversight; documenting the process shows active
mitigation.
3. The facility’s census has dropped 15% over the last quarter, leading to a significant budget
deficit. Which strategy is most effective for long-term fiscal stabilization?
A. Reducing nursing staffing levels below mandatory ratios.
B. Conducting a SWOT analysis to identify market niche gaps and operational
inefficiencies.
, C. Closing the dining room to save on dietary costs.
D. Raising private pay rates by 30% overnight.
Answer: B
CORRECT ANSWER : B
Rationale: Strategic planning via SWOT analysis addresses the root cause of the census decline.
Cutting staffing (A) risks survey failure, and immediate rate hikes (D) will likely alienate existing
residents and damage reputation.
4. A resident’s family complains that their mother is being abused. As the administrator, what is
your mandatory first step?
A. Conduct an internal investigation and terminate staff if found guilty.
B. Implement immediate protection for the resident and report the allegation to the State
Department of Health.
C. Call the family back to schedule a formal grievance meeting.
D. Consult the facility attorney before notifying state authorities.
Answer: B
CORRECT ANSWER : B
Rationale: Abuse allegations require immediate reporting to the state and protective measures
for the resident per federal law. Internal investigation (A) is secondary to mandatory reporting,
and consulting an attorney (D) cannot delay the statutory reporting deadline.
5. The facility’s QAPI committee notes a trend of increased falls in the dementia unit. What is the
best approach to mitigate this?
A. Increase the use of physical restraints.
B. Perform a root cause analysis (RCA) to identify environmental or medication triggers.
C. Require that all residents use wheelchairs.
D. Hire more administrative staff.
Answer: B
CORRECT ANSWER : B
, Rationale: QAPI requires a data-driven, systematic approach to identify root causes. Restraints
(A) are against federal regulations, and wheelchair use (C) causes deconditioning and further
fall risk.
6. You are negotiating a contract with a new pharmacy provider. Which provision is most vital to
ensure compliance with CMS standards?
A. The pharmacy must be the cheapest option in the state.
B. The pharmacy must provide 24-hour consultant pharmacist services and timely drug
delivery.
C. The pharmacy must provide free gifts to the administrator.
D. The pharmacy must only handle electronic prescriptions.
Answer: B
CORRECT ANSWER : B
Rationale: Federal regulations mandate consultant pharmacist review and timely access to
medications. Cost (A) is secondary to quality of care, and receiving gifts (C) violates ethical and
potentially anti-kickback statutes.
7. A staff member reports a workplace injury but does not wish to fill out the incident report. What
must the administrator do?
A. Respect their privacy and not report it.
B. Require the report to be completed for OSHA compliance and worker’s compensation
protection.
C. Pay for the medical treatment out of petty cash.
D. Ignore it if the employee does not miss work.
Answer: B
CORRECT ANSWER : B
Rationale: Employers are legally obligated to record all work-related injuries under OSHA,
regardless of the employee's preference. Failing to document leaves the facility legally
vulnerable and violates recordkeeping standards.
8. Your facility is hit by a massive hurricane. The primary power grid fails. What is the most
critical document to follow?
