LOUISIANA NURSING HOME ADMINISTRATOR (LNHA) LICENSE
EXAM 2026/2027 HIGH YIELD PRACTICE QUESTIONS AND STUDY
GUIDE COMPLETE ACCURATE EXAM APPROVED QUESTIONS
WITH WELL ELABORATED ANSWERS PLUS RATIONALES
(RELIABLE SOLUTIONS) CURRENTLY UPDATED VERSION 2026
EDITION |GUARANTEED PASS A+ | FULL REVISED LOUISIANA
NURSING HOME ADMINISTRATOR (LNHA) LICENSE APPROVED
EXAM |INSTANT PDF
1. A 92-year-old resident with advanced dementia exhibits progressive weight loss
and recurrent refusal of oral intake. The family insists on artificial nutrition via a
PEG tube, while the resident's previously documented advance directive explicitly
states a desire for no life-prolonging measures. The facility's ethics committee is
consulted. Which of the following actions best aligns with both legal and ethical
standards of care?
A. Proceed with PEG tube placement to honor the family's wishes and avoid
potential litigation.
B. Initiate a court proceeding to appoint a guardian ad litem to make the final
decision.
C. Withhold PEG tube placement based on the resident's documented advance
directive and provide comfort-focused care. (Correct Answer)
D. Request a transfer of the resident to an acute care hospital for further evaluation
and management.
Detailed Rationale: The principle of autonomy and federal regulations (OBRA
'87) uphold a resident's right to make healthcare decisions, including the refusal
of treatment, through advance directives. When a resident lacks decision-making
capacity, the advance directive is legally binding and takes precedence over
family wishes if they conflict . Option C is correct because it respects the
,resident's documented wishes, aligns with the ethical principles of autonomy and
beneficence, and follows federal law. Option A is incorrect because it violates the
resident's autonomy and could constitute battery. Option B is usually
unnecessary and costly when a valid advance directive exists. Option D delays
necessary care and does not resolve the conflict .
2. During a routine state survey, the surveyor identifies that a resident's care plan
for falls was not updated after a significant fall with injury, and the interventions
were not implemented by the nursing staff. The facility has a policy requiring
immediate care plan revision after any incident. Which deficiency would the
surveyor most likely cite?
A. F-tag 684: Quality of Care
B. F-tag 656: Care Plan Implementation
C. F-tag 658: Nursing Services (Correct Answer)
D. F-tag 741: Staff Competency
Detailed Rationale: F-tag 658 specifically addresses the requirement that
nursing services must be provided as ordered and in accordance with the
resident's care plan . The failure to implement the planned interventions
demonstrates a direct failure in nursing services delivery. While related, F-tag
656 (Care Plan Implementation) is a broader tag that could also apply, but F-tag
658 is more specific to the nursing staff's performance of their duties . F-tag 684
(Quality of Care) relates to the outcome (the injury), while F-tag 741 (Staff
Competency) addresses whether staff have the skills to perform their jobs .
3. The administrator is reviewing the facility's quarterly financial statement and
notices that the days in accounts receivable (A/R) has increased from 45 to 72
days. This trend is concerning because it indicates:
A. The facility is effectively managing its cash flow and has increased liquidity.
,B. The facility is taking significantly longer to collect payments from payers,
which could lead to a cash flow shortage. (Correct Answer)
C. The facility has successfully reduced its operating expenses and improved its
profit margin.
D. The facility is experiencing a higher than average occupancy rate compared to
the previous quarter.
Detailed Rationale: Days in A/R is a key financial metric that measures the
average time it takes for a facility to collect payment from residents or payers
after a service is provided . An increase from 45 to 72 days indicates a slowdown
in collections, which directly constrains cash flow. This is a major concern for
any business, especially in healthcare where operational costs are high . Option
B correctly identifies this risk. Option A is incorrect because higher A/R days
mean poorer cash management. Option C is unrelated to A/R; it is more directly
tied to operational efficiency. Option D is incorrect as occupancy increases
typically improve revenue, but the A/R metric measures collection efficiency, not
revenue volume.
4. A new employee, who is a Certified Nursing Assistant (CNA), reports for their
first day of work. What is the maximum number of days the facility has to conduct
a criminal background check on this employee to remain in compliance with
federal regulations?
A. 30 days
B. 60 days
C. 90 days
D. 120 days (Correct Answer)
Detailed Rationale: Federal regulations mandate that long-term care facilities
must conduct a criminal background check on all new employees who provide
direct care. The facility has up to 120 days from the date of hire to complete this
, check, provided the employee is not left alone with residents until the results are
received . Options A, B, and C are incorrect as they do not align with the specific
regulatory timeframe.
5. The facility's Medical Director has recommended that all staff receive annual
influenza vaccinations to protect residents. A nurse declines the vaccine due to a
personal, non-medical belief. What is the facility's most appropriate course of
action under current CMS requirements?
A. Terminate the nurse's employment immediately for non-compliance.
B. Allow the nurse to continue working without restrictions.
C. Require the nurse to wear a mask during influenza season while providing direct
patient care. (Correct Answer)
D. File a complaint with the state Board of Nursing.
Detailed Rationale: CMS regulations require facilities to offer influenza
vaccinations to all staff and volunteers. Staff who decline the vaccine for reasons
other than medical contraindications are generally required to wear a mask
during the flu season when working in patient care areas . This policy balances
the rights of the employee with the need to protect vulnerable residents from the
spread of influenza. Option A is too severe unless mandated by state law or
facility policy. Option B puts residents at risk. Option D is not appropriate as
declining a vaccine for non-medical reasons is not a violation of the nursing
practice act.
6. A resident with a history of elopement is being admitted to the facility. The
interdisciplinary team is developing the care plan to address this risk. Which of the
following interventions should be the PRIMARY focus of the care plan?
A. Placing a bed alarm on the resident's bed at all times.
EXAM 2026/2027 HIGH YIELD PRACTICE QUESTIONS AND STUDY
GUIDE COMPLETE ACCURATE EXAM APPROVED QUESTIONS
WITH WELL ELABORATED ANSWERS PLUS RATIONALES
(RELIABLE SOLUTIONS) CURRENTLY UPDATED VERSION 2026
EDITION |GUARANTEED PASS A+ | FULL REVISED LOUISIANA
NURSING HOME ADMINISTRATOR (LNHA) LICENSE APPROVED
EXAM |INSTANT PDF
1. A 92-year-old resident with advanced dementia exhibits progressive weight loss
and recurrent refusal of oral intake. The family insists on artificial nutrition via a
PEG tube, while the resident's previously documented advance directive explicitly
states a desire for no life-prolonging measures. The facility's ethics committee is
consulted. Which of the following actions best aligns with both legal and ethical
standards of care?
A. Proceed with PEG tube placement to honor the family's wishes and avoid
potential litigation.
B. Initiate a court proceeding to appoint a guardian ad litem to make the final
decision.
C. Withhold PEG tube placement based on the resident's documented advance
directive and provide comfort-focused care. (Correct Answer)
D. Request a transfer of the resident to an acute care hospital for further evaluation
and management.
Detailed Rationale: The principle of autonomy and federal regulations (OBRA
'87) uphold a resident's right to make healthcare decisions, including the refusal
of treatment, through advance directives. When a resident lacks decision-making
capacity, the advance directive is legally binding and takes precedence over
family wishes if they conflict . Option C is correct because it respects the
,resident's documented wishes, aligns with the ethical principles of autonomy and
beneficence, and follows federal law. Option A is incorrect because it violates the
resident's autonomy and could constitute battery. Option B is usually
unnecessary and costly when a valid advance directive exists. Option D delays
necessary care and does not resolve the conflict .
2. During a routine state survey, the surveyor identifies that a resident's care plan
for falls was not updated after a significant fall with injury, and the interventions
were not implemented by the nursing staff. The facility has a policy requiring
immediate care plan revision after any incident. Which deficiency would the
surveyor most likely cite?
A. F-tag 684: Quality of Care
B. F-tag 656: Care Plan Implementation
C. F-tag 658: Nursing Services (Correct Answer)
D. F-tag 741: Staff Competency
Detailed Rationale: F-tag 658 specifically addresses the requirement that
nursing services must be provided as ordered and in accordance with the
resident's care plan . The failure to implement the planned interventions
demonstrates a direct failure in nursing services delivery. While related, F-tag
656 (Care Plan Implementation) is a broader tag that could also apply, but F-tag
658 is more specific to the nursing staff's performance of their duties . F-tag 684
(Quality of Care) relates to the outcome (the injury), while F-tag 741 (Staff
Competency) addresses whether staff have the skills to perform their jobs .
3. The administrator is reviewing the facility's quarterly financial statement and
notices that the days in accounts receivable (A/R) has increased from 45 to 72
days. This trend is concerning because it indicates:
A. The facility is effectively managing its cash flow and has increased liquidity.
,B. The facility is taking significantly longer to collect payments from payers,
which could lead to a cash flow shortage. (Correct Answer)
C. The facility has successfully reduced its operating expenses and improved its
profit margin.
D. The facility is experiencing a higher than average occupancy rate compared to
the previous quarter.
Detailed Rationale: Days in A/R is a key financial metric that measures the
average time it takes for a facility to collect payment from residents or payers
after a service is provided . An increase from 45 to 72 days indicates a slowdown
in collections, which directly constrains cash flow. This is a major concern for
any business, especially in healthcare where operational costs are high . Option
B correctly identifies this risk. Option A is incorrect because higher A/R days
mean poorer cash management. Option C is unrelated to A/R; it is more directly
tied to operational efficiency. Option D is incorrect as occupancy increases
typically improve revenue, but the A/R metric measures collection efficiency, not
revenue volume.
4. A new employee, who is a Certified Nursing Assistant (CNA), reports for their
first day of work. What is the maximum number of days the facility has to conduct
a criminal background check on this employee to remain in compliance with
federal regulations?
A. 30 days
B. 60 days
C. 90 days
D. 120 days (Correct Answer)
Detailed Rationale: Federal regulations mandate that long-term care facilities
must conduct a criminal background check on all new employees who provide
direct care. The facility has up to 120 days from the date of hire to complete this
, check, provided the employee is not left alone with residents until the results are
received . Options A, B, and C are incorrect as they do not align with the specific
regulatory timeframe.
5. The facility's Medical Director has recommended that all staff receive annual
influenza vaccinations to protect residents. A nurse declines the vaccine due to a
personal, non-medical belief. What is the facility's most appropriate course of
action under current CMS requirements?
A. Terminate the nurse's employment immediately for non-compliance.
B. Allow the nurse to continue working without restrictions.
C. Require the nurse to wear a mask during influenza season while providing direct
patient care. (Correct Answer)
D. File a complaint with the state Board of Nursing.
Detailed Rationale: CMS regulations require facilities to offer influenza
vaccinations to all staff and volunteers. Staff who decline the vaccine for reasons
other than medical contraindications are generally required to wear a mask
during the flu season when working in patient care areas . This policy balances
the rights of the employee with the need to protect vulnerable residents from the
spread of influenza. Option A is too severe unless mandated by state law or
facility policy. Option B puts residents at risk. Option D is not appropriate as
declining a vaccine for non-medical reasons is not a violation of the nursing
practice act.
6. A resident with a history of elopement is being admitted to the facility. The
interdisciplinary team is developing the care plan to address this risk. Which of the
following interventions should be the PRIMARY focus of the care plan?
A. Placing a bed alarm on the resident's bed at all times.
