NAB CORE Exam Questions and
Answers 2026–2027 | Complete Nursing
Home Administrator Prep Graded A+
Domain 1: Care Services & Quality of Care
Q1. A resident with dementia becomes increasingly agitated during
evening hours (sundowning). Which non-pharmacological intervention
should be implemented FIRST?
A. Administer PRN lorazepam
B. Apply a soft vest restraint
C. Increase ambient lighting and offer a warm drink
D. Move resident to a quiet room alone
Answer: C — Sundowning syndrome is managed with environmental cues
such as lighting and comfort items. Restraints and medications are last
resorts under OBRA '87 (F-Tag 221), and isolation may worsen agitation .
Q2. A resident with dementia repeatedly walks into other residents'
rooms. What is the MOST appropriate initial intervention?
A. Apply a seat belt to the wheelchair
B. Administer an as-needed sedative
C. Assign a staff member to redirect constantly
D. Install visual cues or stop signs on other residents' doors
,Answer: D — Environmental modifications respect the resident's need to
ambulate while protecting others. Restraints are heavily regulated and not
initial steps. Chemical restraints are a last resort .
Q3. A surveyor cites F-Tag 684 (Quality of Care). This most directly
relates to:
A. Staffing ratios
B. Pressure ulcer prevention
C. Resident grievance procedures
D. Medication administration
Answer: B — F-Tag 684 addresses quality of care standards, including
pressure ulcer prevention, falls management, and overall care quality .
Q4. Which of the following is a reportable incident to the state survey
agency under the Elder Justice Act?
A. Resident trips but is uninjured
B. Reasonable suspicion of a crime against a resident
C. A verbal dispute between two residents
D. A staff member calling in sick
Answer: B — The Elder Justice Act (2010) mandates reporting reasonable
suspicion of a crime (abuse, neglect, exploitation) within 2 hours if serious
harm, 24 hours otherwise .
,Q5. A resident with a urinary tract infection becomes confused and
tries to leave the building. The best initial intervention is:
A. Lock the exit doors
B. Redirect and assess for causes of delirium
C. Administer sedative medication
D. Call 911 for transport to the hospital
Answer: B — Delirium from UTI requires addressing the underlying
infection, not restraint. Redirecting while assessing is the appropriate least-
restrictive approach .
Q6. A resident refuses a shower for the third consecutive week. The
administrator should:
A. Document the refusal and attempt alternative bathing methods
B. Schedule the shower during sleep hours
C. Ask the family to force the resident
D. Discharge the resident for non-compliance
Answer: A — Resident refusal must be documented, and alternatives
should be explored. Forcing care or discharge is inappropriate under
resident rights (F-561) .
Q7. A resident with dysphagia is at highest risk for:
A. Aspiration pneumonia
B. Hypertension
C. Urinary tract infection
D. Falls
, Answer: A — Dysphagia (difficulty swallowing) leads to food/liquid
entering the lungs, causing aspiration pneumonia .
Q8. The MDS comprehensive assessment must be completed within
how many days of admission?
A. 14 days
B. 30 days
C. 45 days
D. 90 days
Answer: A — Federal regulations require MDS 3.0 comprehensive within 14
days of admission, quarterly, annually, and with significant change in
status .
Q9. An antipsychotic medication given to a resident with dementia
requires:
A. PRN order renewed weekly
B. Diagnosis of a psychotic disorder or specific FDA-approved dementia
indication
C. Family consent only
D. Daily blood draws
Answer: B — CMS F-Tag 758 requires a specific diagnosis (e.g.,
schizophrenia) or FDA-approved indication for dementia. Off-label use for
BPSD is heavily restricted .
Answers 2026–2027 | Complete Nursing
Home Administrator Prep Graded A+
Domain 1: Care Services & Quality of Care
Q1. A resident with dementia becomes increasingly agitated during
evening hours (sundowning). Which non-pharmacological intervention
should be implemented FIRST?
A. Administer PRN lorazepam
B. Apply a soft vest restraint
C. Increase ambient lighting and offer a warm drink
D. Move resident to a quiet room alone
Answer: C — Sundowning syndrome is managed with environmental cues
such as lighting and comfort items. Restraints and medications are last
resorts under OBRA '87 (F-Tag 221), and isolation may worsen agitation .
Q2. A resident with dementia repeatedly walks into other residents'
rooms. What is the MOST appropriate initial intervention?
A. Apply a seat belt to the wheelchair
B. Administer an as-needed sedative
C. Assign a staff member to redirect constantly
D. Install visual cues or stop signs on other residents' doors
,Answer: D — Environmental modifications respect the resident's need to
ambulate while protecting others. Restraints are heavily regulated and not
initial steps. Chemical restraints are a last resort .
Q3. A surveyor cites F-Tag 684 (Quality of Care). This most directly
relates to:
A. Staffing ratios
B. Pressure ulcer prevention
C. Resident grievance procedures
D. Medication administration
Answer: B — F-Tag 684 addresses quality of care standards, including
pressure ulcer prevention, falls management, and overall care quality .
Q4. Which of the following is a reportable incident to the state survey
agency under the Elder Justice Act?
A. Resident trips but is uninjured
B. Reasonable suspicion of a crime against a resident
C. A verbal dispute between two residents
D. A staff member calling in sick
Answer: B — The Elder Justice Act (2010) mandates reporting reasonable
suspicion of a crime (abuse, neglect, exploitation) within 2 hours if serious
harm, 24 hours otherwise .
,Q5. A resident with a urinary tract infection becomes confused and
tries to leave the building. The best initial intervention is:
A. Lock the exit doors
B. Redirect and assess for causes of delirium
C. Administer sedative medication
D. Call 911 for transport to the hospital
Answer: B — Delirium from UTI requires addressing the underlying
infection, not restraint. Redirecting while assessing is the appropriate least-
restrictive approach .
Q6. A resident refuses a shower for the third consecutive week. The
administrator should:
A. Document the refusal and attempt alternative bathing methods
B. Schedule the shower during sleep hours
C. Ask the family to force the resident
D. Discharge the resident for non-compliance
Answer: A — Resident refusal must be documented, and alternatives
should be explored. Forcing care or discharge is inappropriate under
resident rights (F-561) .
Q7. A resident with dysphagia is at highest risk for:
A. Aspiration pneumonia
B. Hypertension
C. Urinary tract infection
D. Falls
, Answer: A — Dysphagia (difficulty swallowing) leads to food/liquid
entering the lungs, causing aspiration pneumonia .
Q8. The MDS comprehensive assessment must be completed within
how many days of admission?
A. 14 days
B. 30 days
C. 45 days
D. 90 days
Answer: A — Federal regulations require MDS 3.0 comprehensive within 14
days of admission, quarterly, annually, and with significant change in
status .
Q9. An antipsychotic medication given to a resident with dementia
requires:
A. PRN order renewed weekly
B. Diagnosis of a psychotic disorder or specific FDA-approved dementia
indication
C. Family consent only
D. Daily blood draws
Answer: B — CMS F-Tag 758 requires a specific diagnosis (e.g.,
schizophrenia) or FDA-approved indication for dementia. Off-label use for
BPSD is heavily restricted .
