NURSING HOME ADMINISTRATOR EXAM (JAMES ALLEN) COMPLETE
EXAM MASTERY GUIDE WITH VERIFIED ANSWERS (2025–2026)
1. The most likely single cause for the series of bankruptcies among larger nursing home chains
around the year 2000 was ____.
1. Too small increases in government reimbursement rates
2. Paying too much for acquisitions in 1998 and 1999
3. Not taking advantage of falling interest rates
4. Thinking too small - correct answer -2
2. In a chance conversation with the owner of an eight-facility chain, the newly hired
administrator for the oldest facility in the chain indicates that, because the mortgage is fully
retired, the administrator will concentrate more on being effec- tive than efficient since the
Quality Indicators are all at or above the state's aver-age. The owner would likely ____.
1. Be pleased
2. Be distressed
3. Be content
4. Praise the newly hired administrator - correct answer -2
3.
Occupancy of Facility A has been a steady 70% since the Prospective Payment System was
introduced. Two weeks ago, a new 120-bed, equally equipped facil- ity opened several blocks
away. The Facility A administrator tells the admissions counselor to continue the usual
recruitment approach. The chain owners ought to _____.
1. Rest comfortably
2. Seek a new administrator
3. Appoint a new admissions counselor
4. Take no action - correct answer -2
,4. Bankruptcies among larger nursing home chains prior to 2000 _____.
1. Were frequent
2. Were ubiquitous
3. Were highly unusual
4. Were routinely declared to avoid too much accumulated debt - correct answer -3
5. Under the Prospective Payment System, nursing facilities' reimbursed costs _____.
1. Were about the same as previously
2. Were more bundled
3. Used an unbundled cost structure
4. Were reimbursement for actual costs - correct answer -2
6. In recent years, Medicare has _____.
1. Allowed facilities to make a modest profit
2. Shifted more costs onto nursing facilities
3. Eased up on economic pressures previously placed on facilities
4. Remained relatively unchanged in its reimbursement structure - correct answer -2
7. The nurse newly promoted to director of nursing insists on giving four RN hours of patient
care each day on the Alzheimer's wing in the 175-bed facility. The administrator should _____.
1. Praise the new director of nursing for her resident centeredness
2. Appoint an assistant director of nursing
3. Adapt the job description to fit her pattern
4. Seek a new director of nursing - correct answer -4
,8. The applicant for the administrator position in a facility near a large teaching hospital insists
that, as before in his rural facility, if hied he would not let the Medicare reimbursement policies
affect his case mix. This applicant _____.
1. Should be hired
2. Is likely to succeed if hired
3. Can likely succeed in his goal
4. Is out of touch - correct answer -4
9. The newly hired assistant to the administrator insists that the organizational chart dotted line
between this position and the Department of Nursing be a solid line. The administrator should
_____.
1. Agree in general
2. Agree to this special case
3. Ask the director of nursing for his or her opinion 4. Be forewarned - correct answer -4
10. The medical supplies provider tells the administrator of a facility that has not paid bills for
the past 3 months but is now operating under a bankruptcy judge's approved plan for
restructuring, that no more deliveries will be made until past bills are fully paid. The medical
supplies provider _____.
1. Is smart to cut losses at that point
2. Does not understand how bankruptcy works 3. Will now likely get his past due bills paid
4. Is farsighted - correct answer -2
11. An administrator who adopts the leadership-by-walking-around (LBWA) approach by
walking through the facility weekly and intently observing has _____.
1. Become an effective leader
2. Chosen a good management style 3. Failed to understand LBWA
4. Implemented a useful strategy - correct answer -3
, 12. The nursing facility administrator who, using the leadership-by-walking around (LBWA)
technique, succeeds in actually making appropriate corrections on the spot during her rounds
_____.
1. Is effectively implementing the concept
2. Gains additional power through the process 3. Exhibits appropriate leadership
4. Does not understand LBWA - correct answer -4
13. The rate of increase in the total number of nursing facilities in the United States during the
years 2008 to 2012 is _____.
1. Likely to be about level
2. Likely to double
3. Likely to triple to accommodate the baby boomer generation 4. Likely to decrease markedly -
correct answer -1
14. The applicant for administrator of the facility insists that he has successfully used
democratic leadership to the exclusion of all other leadership styles. The interviewer should
_____.
1. Recommend hiring this candidate
2. Praise the candidate
3. Be favorably impressed
4. Continue to interview candidates - correct answer -4
15. The candidate for administrator said that she used a variety of administrative styles, but
could not say exactly which she would use in every circumstance. The interviewer should be
_____.
1. Favorably impressed
2. Unfavorably impressed
EXAM MASTERY GUIDE WITH VERIFIED ANSWERS (2025–2026)
1. The most likely single cause for the series of bankruptcies among larger nursing home chains
around the year 2000 was ____.
1. Too small increases in government reimbursement rates
2. Paying too much for acquisitions in 1998 and 1999
3. Not taking advantage of falling interest rates
4. Thinking too small - correct answer -2
2. In a chance conversation with the owner of an eight-facility chain, the newly hired
administrator for the oldest facility in the chain indicates that, because the mortgage is fully
retired, the administrator will concentrate more on being effec- tive than efficient since the
Quality Indicators are all at or above the state's aver-age. The owner would likely ____.
1. Be pleased
2. Be distressed
3. Be content
4. Praise the newly hired administrator - correct answer -2
3.
Occupancy of Facility A has been a steady 70% since the Prospective Payment System was
introduced. Two weeks ago, a new 120-bed, equally equipped facil- ity opened several blocks
away. The Facility A administrator tells the admissions counselor to continue the usual
recruitment approach. The chain owners ought to _____.
1. Rest comfortably
2. Seek a new administrator
3. Appoint a new admissions counselor
4. Take no action - correct answer -2
,4. Bankruptcies among larger nursing home chains prior to 2000 _____.
1. Were frequent
2. Were ubiquitous
3. Were highly unusual
4. Were routinely declared to avoid too much accumulated debt - correct answer -3
5. Under the Prospective Payment System, nursing facilities' reimbursed costs _____.
1. Were about the same as previously
2. Were more bundled
3. Used an unbundled cost structure
4. Were reimbursement for actual costs - correct answer -2
6. In recent years, Medicare has _____.
1. Allowed facilities to make a modest profit
2. Shifted more costs onto nursing facilities
3. Eased up on economic pressures previously placed on facilities
4. Remained relatively unchanged in its reimbursement structure - correct answer -2
7. The nurse newly promoted to director of nursing insists on giving four RN hours of patient
care each day on the Alzheimer's wing in the 175-bed facility. The administrator should _____.
1. Praise the new director of nursing for her resident centeredness
2. Appoint an assistant director of nursing
3. Adapt the job description to fit her pattern
4. Seek a new director of nursing - correct answer -4
,8. The applicant for the administrator position in a facility near a large teaching hospital insists
that, as before in his rural facility, if hied he would not let the Medicare reimbursement policies
affect his case mix. This applicant _____.
1. Should be hired
2. Is likely to succeed if hired
3. Can likely succeed in his goal
4. Is out of touch - correct answer -4
9. The newly hired assistant to the administrator insists that the organizational chart dotted line
between this position and the Department of Nursing be a solid line. The administrator should
_____.
1. Agree in general
2. Agree to this special case
3. Ask the director of nursing for his or her opinion 4. Be forewarned - correct answer -4
10. The medical supplies provider tells the administrator of a facility that has not paid bills for
the past 3 months but is now operating under a bankruptcy judge's approved plan for
restructuring, that no more deliveries will be made until past bills are fully paid. The medical
supplies provider _____.
1. Is smart to cut losses at that point
2. Does not understand how bankruptcy works 3. Will now likely get his past due bills paid
4. Is farsighted - correct answer -2
11. An administrator who adopts the leadership-by-walking-around (LBWA) approach by
walking through the facility weekly and intently observing has _____.
1. Become an effective leader
2. Chosen a good management style 3. Failed to understand LBWA
4. Implemented a useful strategy - correct answer -3
, 12. The nursing facility administrator who, using the leadership-by-walking around (LBWA)
technique, succeeds in actually making appropriate corrections on the spot during her rounds
_____.
1. Is effectively implementing the concept
2. Gains additional power through the process 3. Exhibits appropriate leadership
4. Does not understand LBWA - correct answer -4
13. The rate of increase in the total number of nursing facilities in the United States during the
years 2008 to 2012 is _____.
1. Likely to be about level
2. Likely to double
3. Likely to triple to accommodate the baby boomer generation 4. Likely to decrease markedly -
correct answer -1
14. The applicant for administrator of the facility insists that he has successfully used
democratic leadership to the exclusion of all other leadership styles. The interviewer should
_____.
1. Recommend hiring this candidate
2. Praise the candidate
3. Be favorably impressed
4. Continue to interview candidates - correct answer -4
15. The candidate for administrator said that she used a variety of administrative styles, but
could not say exactly which she would use in every circumstance. The interviewer should be
_____.
1. Favorably impressed
2. Unfavorably impressed
