NAB EXAM(NAB NHA EXAMINATION QUESTIONS WITH COMPLETE
SOLUTIONS PLUS RATIONALES 2026
1. A nursing home administrator is developing an annual operational plan for a
skilled nursing facility and wants to ensure that the organization's activities
remain centered on resident needs while also meeting regulatory, financial,
staffing, and quality requirements. Which approach best reflects effective
long-term care administration?
A. Prioritize occupancy and revenue even when resident preferences are
affected
B. Delegate regulatory responsibilities entirely to the director of nursing
C. Integrate resident-centered care, regulatory compliance, quality
improvement, financial stewardship, and workforce management into the
facility's operations
D. Allow each department to establish separate priorities without
coordination
Answer: C. Integrate resident-centered care, regulatory compliance, quality
improvement, financial stewardship, and workforce management into the
facility's operations
2. A facility administrator notices that several departments are meeting their
individual goals, but residents are experiencing inconsistent communication
and fragmented services. Which administrative intervention would most
directly address the problem?
A. Eliminate departmental meetings
B. Establish interdisciplinary communication processes and shared
organizational goals
C. Increase documentation requirements without changing communication
practices
D. Transfer all departmental decisions to the administrator
Answer: B. Establish interdisciplinary communication processes and shared
organizational goals
pg. 1
, 3. A nursing facility administrator is preparing for a regulatory survey and
discovers that several policies have not been reviewed recently. What
should the administrator do first?
A. Destroy outdated policies to avoid survey deficiencies
B. Wait until surveyors identify the deficiencies
C. Conduct a systematic review against current regulatory requirements and
facility practices
D. Ask residents to rewrite the policies
Answer: C. Conduct a systematic review against current regulatory
requirements and facility practices
4. A resident-centered organization wants to measure whether its services are
actually improving residents' quality of life. Which measure would provide
the most meaningful information?
A. Number of administrative meetings held
B. Amount spent on office supplies
C. Resident outcomes, satisfaction, functional status, and quality-of-life
indicators
D. Number of emails sent by department heads
Answer: C. Resident outcomes, satisfaction, functional status, and quality-
of-life indicators
5. A facility's administrator is establishing a quality assurance and
performance improvement program. Which principle should guide the
program?
A. Quality improvement should occur only after a serious incident
B. Performance improvement should use data to identify problems,
determine causes, implement interventions, and evaluate results
C. Quality assurance should focus exclusively on employee discipline
D. Quality improvement should be conducted only by outside consultants
Answer: B. Performance improvement should use data to identify problems,
determine causes, implement interventions, and evaluate results
pg. 2
, 6. A nursing facility has experienced an increase in resident falls over the past
quarter. The administrator wants to use a structured quality-improvement
process rather than immediately disciplining staff. What should occur first?
A. Identify and analyze patterns and contributing factors associated with the
falls
B. Terminate employees involved in every fall
C. Stop all resident activities
D. Remove all residents from their rooms
Answer: A. Identify and analyze patterns and contributing factors associated
with the falls
7. A facility implements a fall-prevention intervention and observes that falls
initially decrease. What should the administrator do next?
A. End all monitoring because the intervention worked
B. Continue collecting data to determine whether improvement is sustained
C. Remove the intervention immediately
D. Assume the reduction was unrelated to the intervention
Answer: B. Continue collecting data to determine whether improvement is
sustained
8. A nursing home administrator is reviewing a facility's mission statement.
Which statement best represents an effective mission statement for a long-
term care organization?
A. It should describe only the facility's financial objectives
B. It should identify the organization's purpose, population served, and
commitment to care
C. It should list every employee's individual responsibilities
D. It should contain only regulatory terminology
Answer: B. It should identify the organization's purpose, population served,
and commitment to care
9. A facility is considering a major renovation. The administrator wants the
project to support residents rather than simply improve the appearance of
the building. Which consideration is most important?
pg. 3
, A. Whether the renovation increases administrative office space
B. Whether the project supports safety, accessibility, dignity, privacy,
functionality, and resident quality of life
C. Whether the project eliminates all common areas
D. Whether the renovation reduces the number of resident rooms
Answer: B. Whether the project supports safety, accessibility, dignity,
privacy, functionality, and resident quality of life
10. A nursing home administrator is asked to explain the difference between
governance and management. Which explanation is most accurate?
A. Governance establishes oversight, direction, and accountability, while
management carries out organizational operations
B. Governance performs all daily clinical tasks
C. Management has no responsibility for implementation
D. Governance is limited to employee scheduling
Answer: A. Governance establishes oversight, direction, and accountability,
while management carries out organizational operations
11. A facility's governing body asks the administrator to provide information
needed for effective oversight. Which report would be most useful?
A. A list of employee birthdays
B. A comprehensive dashboard containing quality, financial, staffing,
compliance, and operational indicators
C. A list of unused office furniture
D. A personal opinion about every employee
Answer: B. A comprehensive dashboard containing quality, financial,
staffing, compliance, and operational indicators
12. A facility's occupancy rate has increased substantially, but staffing levels and
resident-acuity requirements have remained unchanged. Which concern
should the administrator evaluate most carefully?
A. Whether staffing resources remain sufficient for resident needs
B. Whether the facility should eliminate quality measures
C. Whether resident activities should be discontinued
pg. 4
SOLUTIONS PLUS RATIONALES 2026
1. A nursing home administrator is developing an annual operational plan for a
skilled nursing facility and wants to ensure that the organization's activities
remain centered on resident needs while also meeting regulatory, financial,
staffing, and quality requirements. Which approach best reflects effective
long-term care administration?
A. Prioritize occupancy and revenue even when resident preferences are
affected
B. Delegate regulatory responsibilities entirely to the director of nursing
C. Integrate resident-centered care, regulatory compliance, quality
improvement, financial stewardship, and workforce management into the
facility's operations
D. Allow each department to establish separate priorities without
coordination
Answer: C. Integrate resident-centered care, regulatory compliance, quality
improvement, financial stewardship, and workforce management into the
facility's operations
2. A facility administrator notices that several departments are meeting their
individual goals, but residents are experiencing inconsistent communication
and fragmented services. Which administrative intervention would most
directly address the problem?
A. Eliminate departmental meetings
B. Establish interdisciplinary communication processes and shared
organizational goals
C. Increase documentation requirements without changing communication
practices
D. Transfer all departmental decisions to the administrator
Answer: B. Establish interdisciplinary communication processes and shared
organizational goals
pg. 1
, 3. A nursing facility administrator is preparing for a regulatory survey and
discovers that several policies have not been reviewed recently. What
should the administrator do first?
A. Destroy outdated policies to avoid survey deficiencies
B. Wait until surveyors identify the deficiencies
C. Conduct a systematic review against current regulatory requirements and
facility practices
D. Ask residents to rewrite the policies
Answer: C. Conduct a systematic review against current regulatory
requirements and facility practices
4. A resident-centered organization wants to measure whether its services are
actually improving residents' quality of life. Which measure would provide
the most meaningful information?
A. Number of administrative meetings held
B. Amount spent on office supplies
C. Resident outcomes, satisfaction, functional status, and quality-of-life
indicators
D. Number of emails sent by department heads
Answer: C. Resident outcomes, satisfaction, functional status, and quality-
of-life indicators
5. A facility's administrator is establishing a quality assurance and
performance improvement program. Which principle should guide the
program?
A. Quality improvement should occur only after a serious incident
B. Performance improvement should use data to identify problems,
determine causes, implement interventions, and evaluate results
C. Quality assurance should focus exclusively on employee discipline
D. Quality improvement should be conducted only by outside consultants
Answer: B. Performance improvement should use data to identify problems,
determine causes, implement interventions, and evaluate results
pg. 2
, 6. A nursing facility has experienced an increase in resident falls over the past
quarter. The administrator wants to use a structured quality-improvement
process rather than immediately disciplining staff. What should occur first?
A. Identify and analyze patterns and contributing factors associated with the
falls
B. Terminate employees involved in every fall
C. Stop all resident activities
D. Remove all residents from their rooms
Answer: A. Identify and analyze patterns and contributing factors associated
with the falls
7. A facility implements a fall-prevention intervention and observes that falls
initially decrease. What should the administrator do next?
A. End all monitoring because the intervention worked
B. Continue collecting data to determine whether improvement is sustained
C. Remove the intervention immediately
D. Assume the reduction was unrelated to the intervention
Answer: B. Continue collecting data to determine whether improvement is
sustained
8. A nursing home administrator is reviewing a facility's mission statement.
Which statement best represents an effective mission statement for a long-
term care organization?
A. It should describe only the facility's financial objectives
B. It should identify the organization's purpose, population served, and
commitment to care
C. It should list every employee's individual responsibilities
D. It should contain only regulatory terminology
Answer: B. It should identify the organization's purpose, population served,
and commitment to care
9. A facility is considering a major renovation. The administrator wants the
project to support residents rather than simply improve the appearance of
the building. Which consideration is most important?
pg. 3
, A. Whether the renovation increases administrative office space
B. Whether the project supports safety, accessibility, dignity, privacy,
functionality, and resident quality of life
C. Whether the project eliminates all common areas
D. Whether the renovation reduces the number of resident rooms
Answer: B. Whether the project supports safety, accessibility, dignity,
privacy, functionality, and resident quality of life
10. A nursing home administrator is asked to explain the difference between
governance and management. Which explanation is most accurate?
A. Governance establishes oversight, direction, and accountability, while
management carries out organizational operations
B. Governance performs all daily clinical tasks
C. Management has no responsibility for implementation
D. Governance is limited to employee scheduling
Answer: A. Governance establishes oversight, direction, and accountability,
while management carries out organizational operations
11. A facility's governing body asks the administrator to provide information
needed for effective oversight. Which report would be most useful?
A. A list of employee birthdays
B. A comprehensive dashboard containing quality, financial, staffing,
compliance, and operational indicators
C. A list of unused office furniture
D. A personal opinion about every employee
Answer: B. A comprehensive dashboard containing quality, financial,
staffing, compliance, and operational indicators
12. A facility's occupancy rate has increased substantially, but staffing levels and
resident-acuity requirements have remained unchanged. Which concern
should the administrator evaluate most carefully?
A. Whether staffing resources remain sufficient for resident needs
B. Whether the facility should eliminate quality measures
C. Whether resident activities should be discontinued
pg. 4
