NAB Core Exam Study Guide 2026 | Nursing
Home Administrator Licensing Exam | 200+
Verified Practice Questions & Answers |
Comprehensive NAB Core Exam Prep PDF
NAB CORE EXAM STUDY GUIDE 2026 | NURSING HOME ADMINISTRATOR
LICENSING EXAM
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OVERVIEW
• This comprehensive study guide contains 200 verified practice questions designed
to prepare you for the NAB Core Exam, covering resident care, compliance, human
resources, finance, and operations management.
• Study strategically by reviewing each question's rationale, identifying weak topic
areas, and revisiting those sections until you achieve mastery across all five major
exam domains.
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Question 1
A nursing home administrator receives a complaint from a family member
regarding inadequate pain management for their mother who has severe
arthritis. Under federal regulations, how should the administrator respond?
A) Advise the family that pain management is the physician's responsibility and the
facility has no role
B) Schedule a meeting with the family to review the resident's care plan and pain
management strategies
C) Immediately discharge the resident to prevent further complaints
D) Tell the family to contact the state health department directly
E) Document the complaint but take no action unless repeated
,✓ CORRECT ANSWER: B) Schedule a meeting with the family to review the
resident's care plan and pain management strategies
Rationale: Under 42 CFR §483.12 (Pain Management), nursing homes must ensure
comprehensive and appropriate management of resident pain. The administrator
must be proactive in addressing family concerns, reviewing individualized pain
management plans, and ensuring interdisciplinary team collaboration. This
demonstrates resident-centered care, regulatory compliance, and proper grievance
resolution—all core responsibilities of a nursing home administrator.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
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Question 2
Which federal law specifically mandates that nursing homes must establish
policies for infection prevention and control?
A) The Americans with Disabilities Act (ADA)
B) The Health Insurance Portability and Accountability Act (HIPAA)
C) The Centers for Medicare & Medicaid Services (CMS) Conditions of Participation
D) The Occupational Safety and Health Administration (OSHA) General Duty Clause
E) The Patient Self-Determination Act (PSDA)
✓ CORRECT ANSWER: C) The Centers for Medicare & Medicaid Services (CMS)
Conditions of Participation
Rationale: 42 CFR §483.80 establishes mandatory infection prevention and control
standards that nursing homes must implement. These standards require facilities
to establish written infection prevention programs, train staff, maintain surveillance
data, report and investigate outbreaks, and implement preventive measures.
Compliance with CMS Conditions of Participation is required for Medicare and
Medicaid certification.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
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Question 3
A resident with moderate dementia refuses to take prescribed medications
for hypertension. As the administrator, what is the most appropriate
response?
A) Authorize staff to place medication in the resident's food without consent
B) Ensure the care team conducts a capacity assessment and respects the
resident's autonomy while exploring alternatives
C) Discharge the resident for non-compliance
D) Contact the family and tell them to force the resident to take the medication
E) Discontinue the medication without physician notification
✓ CORRECT ANSWER: B) Ensure the care team conducts a capacity assessment
and respects the resident's autonomy while exploring alternatives
Rationale: 42 CFR §483.12 and state regulations require respect for resident rights
and self-determination. Even residents with dementia retain rights unless
adjudicated incompetent. Administrators must ensure informed consent processes,
capacity assessments, and person-centered care approaches. Alternatives may
include different medications, dose adjustments, or enhanced monitoring,
balancing autonomy with safety.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
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Question 4
What is the primary purpose of developing a detailed organizational chart in a
nursing home?
A) To impress surveyors during inspections
, B) To establish clear lines of authority, accountability, and communication
throughout the facility
C) To reduce staff salaries based on organizational levels
D) To limit employee responsibilities to narrow job descriptions
E) To comply with HIPAA security requirements
✓ CORRECT ANSWER: B) To establish clear lines of authority, accountability,
and communication throughout the facility
Rationale: An organizational chart defines reporting relationships, spans of control,
and communication pathways. This clarity enables efficient operations, clear
accountability, improved decision-making, and ensures that all functions are
assigned and supervised. It's essential for effective management, regulatory
compliance, and operational excellence in nursing home administration.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
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Question 5
A nursing home discovers that several staff members have been taking
controlled substances from the medication supply. What is the
administrator's legal obligation?
A) Handle the matter internally and discipline staff privately
B) Report the incident only to the nursing director
C) Report to law enforcement and the state licensing authority immediately
D) Dismiss staff without investigation to avoid liability
E) Document the incident but take no further action
✓ CORRECT ANSWER: C) Report to law enforcement and the state licensing
authority immediately
Rationale: Theft of controlled substances is a felony. The administrator has a legal
duty to report to law enforcement and must also report to state licensing
Home Administrator Licensing Exam | 200+
Verified Practice Questions & Answers |
Comprehensive NAB Core Exam Prep PDF
NAB CORE EXAM STUDY GUIDE 2026 | NURSING HOME ADMINISTRATOR
LICENSING EXAM
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
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━━━━━━━━━━━━━━━━
OVERVIEW
• This comprehensive study guide contains 200 verified practice questions designed
to prepare you for the NAB Core Exam, covering resident care, compliance, human
resources, finance, and operations management.
• Study strategically by reviewing each question's rationale, identifying weak topic
areas, and revisiting those sections until you achieve mastery across all five major
exam domains.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━
Question 1
A nursing home administrator receives a complaint from a family member
regarding inadequate pain management for their mother who has severe
arthritis. Under federal regulations, how should the administrator respond?
A) Advise the family that pain management is the physician's responsibility and the
facility has no role
B) Schedule a meeting with the family to review the resident's care plan and pain
management strategies
C) Immediately discharge the resident to prevent further complaints
D) Tell the family to contact the state health department directly
E) Document the complaint but take no action unless repeated
,✓ CORRECT ANSWER: B) Schedule a meeting with the family to review the
resident's care plan and pain management strategies
Rationale: Under 42 CFR §483.12 (Pain Management), nursing homes must ensure
comprehensive and appropriate management of resident pain. The administrator
must be proactive in addressing family concerns, reviewing individualized pain
management plans, and ensuring interdisciplinary team collaboration. This
demonstrates resident-centered care, regulatory compliance, and proper grievance
resolution—all core responsibilities of a nursing home administrator.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━
Question 2
Which federal law specifically mandates that nursing homes must establish
policies for infection prevention and control?
A) The Americans with Disabilities Act (ADA)
B) The Health Insurance Portability and Accountability Act (HIPAA)
C) The Centers for Medicare & Medicaid Services (CMS) Conditions of Participation
D) The Occupational Safety and Health Administration (OSHA) General Duty Clause
E) The Patient Self-Determination Act (PSDA)
✓ CORRECT ANSWER: C) The Centers for Medicare & Medicaid Services (CMS)
Conditions of Participation
Rationale: 42 CFR §483.80 establishes mandatory infection prevention and control
standards that nursing homes must implement. These standards require facilities
to establish written infection prevention programs, train staff, maintain surveillance
data, report and investigate outbreaks, and implement preventive measures.
Compliance with CMS Conditions of Participation is required for Medicare and
Medicaid certification.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━
Question 3
A resident with moderate dementia refuses to take prescribed medications
for hypertension. As the administrator, what is the most appropriate
response?
A) Authorize staff to place medication in the resident's food without consent
B) Ensure the care team conducts a capacity assessment and respects the
resident's autonomy while exploring alternatives
C) Discharge the resident for non-compliance
D) Contact the family and tell them to force the resident to take the medication
E) Discontinue the medication without physician notification
✓ CORRECT ANSWER: B) Ensure the care team conducts a capacity assessment
and respects the resident's autonomy while exploring alternatives
Rationale: 42 CFR §483.12 and state regulations require respect for resident rights
and self-determination. Even residents with dementia retain rights unless
adjudicated incompetent. Administrators must ensure informed consent processes,
capacity assessments, and person-centered care approaches. Alternatives may
include different medications, dose adjustments, or enhanced monitoring,
balancing autonomy with safety.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━
Question 4
What is the primary purpose of developing a detailed organizational chart in a
nursing home?
A) To impress surveyors during inspections
, B) To establish clear lines of authority, accountability, and communication
throughout the facility
C) To reduce staff salaries based on organizational levels
D) To limit employee responsibilities to narrow job descriptions
E) To comply with HIPAA security requirements
✓ CORRECT ANSWER: B) To establish clear lines of authority, accountability,
and communication throughout the facility
Rationale: An organizational chart defines reporting relationships, spans of control,
and communication pathways. This clarity enables efficient operations, clear
accountability, improved decision-making, and ensures that all functions are
assigned and supervised. It's essential for effective management, regulatory
compliance, and operational excellence in nursing home administration.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━
Question 5
A nursing home discovers that several staff members have been taking
controlled substances from the medication supply. What is the
administrator's legal obligation?
A) Handle the matter internally and discipline staff privately
B) Report the incident only to the nursing director
C) Report to law enforcement and the state licensing authority immediately
D) Dismiss staff without investigation to avoid liability
E) Document the incident but take no further action
✓ CORRECT ANSWER: C) Report to law enforcement and the state licensing
authority immediately
Rationale: Theft of controlled substances is a felony. The administrator has a legal
duty to report to law enforcement and must also report to state licensing
