NURSING HOME ADMINISTRATION
NAB NHA EXAM — 2026/2027 Official Exam
A+
Complete Domain Coverage
A+ 6 100%
QUESTIONS VERIFIED CORE DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Quality of Care & Clinical Services
Section 2: Quality of Life & Resident Rights
Section 3: Financial Management & Reimbursement
Section 4: Human Resources & Risk Management
Section 5: Environment, Safety & Infection Control
Section 6: Leadership, Compliance & Quality Improvement
STUVIAACTUALEXAM
,NAB NHA EXAM — 2026/2027 Official Exam
Each question is worth 1 mark. Total: 100 marks. Passing score: 75% (75 correct). Select the single best answer.
SECTION 1: Quality of Care & Clinical Services
Q1
Q1. A resident develops a Stage 3 pressure injury. The interdisciplinary team reviews the care plan. Which administrator action best
supports regulatory compliance and quality outcomes?
A. Direct staff to document the injury only if the family complains
B. Ensure a comprehensive assessment, root-cause analysis, and updated care plan with measurable interventions
C. Transfer the resident immediately without investigation
D. Reduce turning frequency to minimize staff workload
Correct Answer: B
Rationale: Regulations require thorough assessment, investigation of avoidable factors, and individualized interventions. Documentation and care-plan
updates are essential for compliance and prevention of further harm.
Q2
Q2. Surveyors cite the facility for medication errors involving high-alert drugs. Which system-level response is most appropriate for the
administrator?
A. Blame individual nurses without system review
B. Implement independent double-checks, pharmacy review of high-alert medications, and staff competency verification
C. Discontinue all high-alert medications facility-wide
D. Ignore the citation until the next survey cycle
Correct Answer: B
Rationale: High-alert medication safety requires system controls such as double-checks, standardized processes, and competency validation rather than
individual blame alone.
Q3
Q3. A resident on hospice shows signs of uncontrolled pain. The family requests increased opioids. Which administrator responsibility is
most relevant?
A. Override the medical director without consultation
B. Ensure timely physician/nurse practitioner assessment and adherence to the pain-management care plan
C. Limit opioids because of regulatory fear
D. Transfer the resident off hospice automatically
Correct Answer: B
Rationale: Residents have the right to effective pain management. The administrator ensures systems support timely clinical assessment and appropriate
orders consistent with the plan of care.
Q4
Q4. The MDS coordinator reports inconsistent coding of Section GG functional scores. How should the administrator respond?
A. Ignore coding accuracy because it does not affect payment
B. Require interdisciplinary training, concurrent review, and audit of functional assessments for accuracy
C. Instruct staff to code the highest possible scores always
D. Eliminate functional assessments from the care process
Correct Answer: B
Rationale: Accurate MDS coding, including Section GG, affects care planning and reimbursement under PDPM. Training and audits improve reliability and
compliance.
Q5
Q5. A resident experiences an acute change in condition overnight. The night nurse did not notify the practitioner until morning. Which policy
element should the administrator reinforce?
A. Notification only during business hours
B. Clear change-in-condition protocols with immediate practitioner notification criteria
C. Documentation only without notification
D. Family notification as a substitute for clinical notification
Correct Answer: B
Rationale: Timely notification of changes in condition is a fundamental quality and regulatory requirement. Protocols must define triggers and expected
response times.
, Q6
Q6. The medical director identifies several residents with untreated depression. Which administrator action supports quality of care?
A. Discourage psychiatric consultation to control costs
B. Facilitate access to mental health evaluation and integrate findings into care plans
C. Assume depression is normal aging and require no intervention
D. Limit antidepressants facility-wide
Correct Answer: B
Rationale: Depression is not a normal part of aging. Administrators support systems for assessment, treatment, and care-plan integration for behavioral health
needs.
Q7
Q7. A resident on dialysis misses two scheduled treatments because transportation failed. What is the administrator's priority?
A. Document the misses and take no further action
B. Investigate the transportation failure, arrange alternative transport, and review contracts for reliability
C. Discontinue dialysis services for the resident
D. Blame the resident for noncompliance
Correct Answer: B
Rationale: Missed dialysis can be life-threatening. The administrator ensures reliable ancillary services and contingency plans for essential treatments.
Q8
Q8. Infection control data show rising catheter-associated urinary tract infections. Which evidence-based action should leadership prioritize?
A. Increase catheter use for convenience
B. Implement catheter necessity review, aseptic insertion protocols, and daily necessity assessment
C. Stop all infection surveillance
D. Transfer all catheterized residents
Correct Answer: B
Rationale: CAUTI prevention centers on reducing unnecessary catheter days and maintaining aseptic technique. System-level protocols drive improvement.
Q9
Q9. A resident's advance directive specifies do-not-hospitalize. Staff call 911 for a non-emergent issue. How should the administrator
address this?
A. Ignore the directive because hospitalization is always safer
B. Retrain staff on honoring advance directives and establish clear decision algorithms for when to transfer
C. Revoke all advance directives in the facility
D. Require family presence for every clinical decision
Correct Answer: B
Rationale: Honoring advance directives is both a resident right and a regulatory expectation. Staff must understand and follow documented preferences.
Q10
Q10. The pharmacy consultant reports excessive use of antipsychotic medications without supporting diagnoses. What is the administrator's
best response?
A. Accept the usage as normal for dementia care
B. Initiate gradual dose reduction reviews, non-pharmacologic interventions, and medical director oversight
C. Increase antipsychotic doses to manage behaviors
D. Prohibit all behavioral interventions
Correct Answer: B
Rationale: Unnecessary antipsychotics are a quality measure and regulatory focus. GDR, non-drug approaches, and physician engagement are required.
Q11
Q11. A newly admitted resident has a complex wound. The wound nurse is on leave for two weeks. Which action protects the resident?
A. Delay wound care until the specialist returns
B. Arrange qualified coverage, ensure protocol-driven care, and monitor healing progress
C. Assign untrained staff to improvise treatment
D. Discharge the resident immediately
Correct Answer: B
Rationale: Continuity of specialized care requires contingency staffing and adherence to evidence-based protocols so treatment is not interrupted.
NAB NHA EXAM — 2026/2027 Official Exam
A+
Complete Domain Coverage
A+ 6 100%
QUESTIONS VERIFIED CORE DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Quality of Care & Clinical Services
Section 2: Quality of Life & Resident Rights
Section 3: Financial Management & Reimbursement
Section 4: Human Resources & Risk Management
Section 5: Environment, Safety & Infection Control
Section 6: Leadership, Compliance & Quality Improvement
STUVIAACTUALEXAM
,NAB NHA EXAM — 2026/2027 Official Exam
Each question is worth 1 mark. Total: 100 marks. Passing score: 75% (75 correct). Select the single best answer.
SECTION 1: Quality of Care & Clinical Services
Q1
Q1. A resident develops a Stage 3 pressure injury. The interdisciplinary team reviews the care plan. Which administrator action best
supports regulatory compliance and quality outcomes?
A. Direct staff to document the injury only if the family complains
B. Ensure a comprehensive assessment, root-cause analysis, and updated care plan with measurable interventions
C. Transfer the resident immediately without investigation
D. Reduce turning frequency to minimize staff workload
Correct Answer: B
Rationale: Regulations require thorough assessment, investigation of avoidable factors, and individualized interventions. Documentation and care-plan
updates are essential for compliance and prevention of further harm.
Q2
Q2. Surveyors cite the facility for medication errors involving high-alert drugs. Which system-level response is most appropriate for the
administrator?
A. Blame individual nurses without system review
B. Implement independent double-checks, pharmacy review of high-alert medications, and staff competency verification
C. Discontinue all high-alert medications facility-wide
D. Ignore the citation until the next survey cycle
Correct Answer: B
Rationale: High-alert medication safety requires system controls such as double-checks, standardized processes, and competency validation rather than
individual blame alone.
Q3
Q3. A resident on hospice shows signs of uncontrolled pain. The family requests increased opioids. Which administrator responsibility is
most relevant?
A. Override the medical director without consultation
B. Ensure timely physician/nurse practitioner assessment and adherence to the pain-management care plan
C. Limit opioids because of regulatory fear
D. Transfer the resident off hospice automatically
Correct Answer: B
Rationale: Residents have the right to effective pain management. The administrator ensures systems support timely clinical assessment and appropriate
orders consistent with the plan of care.
Q4
Q4. The MDS coordinator reports inconsistent coding of Section GG functional scores. How should the administrator respond?
A. Ignore coding accuracy because it does not affect payment
B. Require interdisciplinary training, concurrent review, and audit of functional assessments for accuracy
C. Instruct staff to code the highest possible scores always
D. Eliminate functional assessments from the care process
Correct Answer: B
Rationale: Accurate MDS coding, including Section GG, affects care planning and reimbursement under PDPM. Training and audits improve reliability and
compliance.
Q5
Q5. A resident experiences an acute change in condition overnight. The night nurse did not notify the practitioner until morning. Which policy
element should the administrator reinforce?
A. Notification only during business hours
B. Clear change-in-condition protocols with immediate practitioner notification criteria
C. Documentation only without notification
D. Family notification as a substitute for clinical notification
Correct Answer: B
Rationale: Timely notification of changes in condition is a fundamental quality and regulatory requirement. Protocols must define triggers and expected
response times.
, Q6
Q6. The medical director identifies several residents with untreated depression. Which administrator action supports quality of care?
A. Discourage psychiatric consultation to control costs
B. Facilitate access to mental health evaluation and integrate findings into care plans
C. Assume depression is normal aging and require no intervention
D. Limit antidepressants facility-wide
Correct Answer: B
Rationale: Depression is not a normal part of aging. Administrators support systems for assessment, treatment, and care-plan integration for behavioral health
needs.
Q7
Q7. A resident on dialysis misses two scheduled treatments because transportation failed. What is the administrator's priority?
A. Document the misses and take no further action
B. Investigate the transportation failure, arrange alternative transport, and review contracts for reliability
C. Discontinue dialysis services for the resident
D. Blame the resident for noncompliance
Correct Answer: B
Rationale: Missed dialysis can be life-threatening. The administrator ensures reliable ancillary services and contingency plans for essential treatments.
Q8
Q8. Infection control data show rising catheter-associated urinary tract infections. Which evidence-based action should leadership prioritize?
A. Increase catheter use for convenience
B. Implement catheter necessity review, aseptic insertion protocols, and daily necessity assessment
C. Stop all infection surveillance
D. Transfer all catheterized residents
Correct Answer: B
Rationale: CAUTI prevention centers on reducing unnecessary catheter days and maintaining aseptic technique. System-level protocols drive improvement.
Q9
Q9. A resident's advance directive specifies do-not-hospitalize. Staff call 911 for a non-emergent issue. How should the administrator
address this?
A. Ignore the directive because hospitalization is always safer
B. Retrain staff on honoring advance directives and establish clear decision algorithms for when to transfer
C. Revoke all advance directives in the facility
D. Require family presence for every clinical decision
Correct Answer: B
Rationale: Honoring advance directives is both a resident right and a regulatory expectation. Staff must understand and follow documented preferences.
Q10
Q10. The pharmacy consultant reports excessive use of antipsychotic medications without supporting diagnoses. What is the administrator's
best response?
A. Accept the usage as normal for dementia care
B. Initiate gradual dose reduction reviews, non-pharmacologic interventions, and medical director oversight
C. Increase antipsychotic doses to manage behaviors
D. Prohibit all behavioral interventions
Correct Answer: B
Rationale: Unnecessary antipsychotics are a quality measure and regulatory focus. GDR, non-drug approaches, and physician engagement are required.
Q11
Q11. A newly admitted resident has a complex wound. The wound nurse is on leave for two weeks. Which action protects the resident?
A. Delay wound care until the specialist returns
B. Arrange qualified coverage, ensure protocol-driven care, and monitor healing progress
C. Assign untrained staff to improvise treatment
D. Discharge the resident immediately
Correct Answer: B
Rationale: Continuity of specialized care requires contingency staffing and adherence to evidence-based protocols so treatment is not interrupted.
