NC ASSISTED LIVING ADMINISTRATOR EXAM QUESTIONS AND
ANSWERS| EXAM PREP |ALL QUESTIONS AND ANSWERS |
VERIFIED ANSWERS PLUS RATIONALES | GRADED Q&A
COMPREHENSIVE STUDY GUIDE | VERIFIED LATEST
1. According to North Carolina Assisted Living licensure standards, what is the minimum
frequency with which a licensed health care professional must conduct a review of personal
care services provided to residents in an adult care home?
A. Bi-weekly
B. Monthly
C. Quarterly
D. Annually
Answer: C
This answer is correct because North Carolina licensure rules mandate that a licensed health
care professional (such as a registered nurse) must conduct a review of personal care services
and resident care plans at least quarterly to ensure care remains appropriate and aligns with
current physician orders.
2. A resident who was recently admitted to an assisted living facility begins demonstrating
sudden onset confusion and spatial disorientation. Which initial action should the
administrator instruct the direct care staff to take?
A. Immediately initiate a referral for psychiatric evaluation
B. Perform a baseline cognitive assessment and notify the primary care physician
C. Contact the family to arrange for 24-hour private duty care
D. Apply a soft physical restraint to prevent wandering
Answer: B
This answer is correct because a sudden change in mental status often indicates an underlying
acute medical condition, such as a urinary tract infection or delirium. Staff must observe,
document baselines, and notify the physician immediately for clinical evaluation rather than
assuming it is chronic dementia progression.
3. What is the maximum number of days an adult care home has to submit a written plan
of correction following the receipt of an official Statement of Deficiencies from the North
Carolina Division of Health Service Regulation (DHSR)?
A. 5 calendar days
B. 10 calendar days
,C. 15 calendar days
D. 30 calendar days
Answer: B
This answer is correct because North Carolina administrative rules specify that facilities must
submit an acceptable written plan of correction within 10 calendar days of receiving a
Statement of Deficiencies to address cited non-compliance.
4. Under North Carolina rules governing resident rights, under which condition may a
facility involuntarily discharge a resident without providing a standard 30-day advance
written notice?
A. The resident fails to pay monthly rent for two consecutive months
B. The resident requires a level of care the facility is not licensed to provide or poses an
immediate health/safety threat
C. The resident frequently refuses scheduled group social activities
D. The resident files a formal grievance with the state long-term care ombudsman
Answer: B
This answer is correct because regulatory protections allow for immediate discharge or
transfer only when a resident's medical needs exceed the facility's licensed scope of care or
when the resident presents an immediate danger to the health and safety of themselves or
others.
5. A direct care staff member fails to report a noticed pressure injury on a resident's
sacrum during routine bathing, leading to a stage 3 ulcer. How is this failure legally
categorized under adult protective service regulations?
A. Neglect
B. Exploitation
C. Physical abuse
D. Malpractice
Answer: A
This answer is correct because neglect is defined as the failure of a caregiver to provide
necessary services, care, or supervision needed to maintain a resident's physical or mental
health, resulting in harm or risk of harm.
6. What is the minimum required temperature that an adult care home must maintain in
all resident-occupied areas during cold weather months according to NC administrative
code?
A. 65°F (18.3°C)
,B. 68°F (20.0°C)
C. 71°F (21.6°C)
D. 75°F (23.8°C)
Answer: C
This answer is correct because North Carolina licensure standards mandate that facility
heating systems must be capable of maintaining, and must maintain, a minimum
temperature of 71°F in all areas occupied by residents during cold climate conditions to
prevent hypothermia and promote comfort.
7. When administering PRN (as-needed) medications, what critical documentation element
must be recorded in the Medication Administration Record (MAR) in addition to the time
and dosage?
A. The full medical history of the resident
B. The specific reason for administration and the evaluated outcome/effectiveness
C. The signature of two witnessing medication aides
D. The prescribing physician's state license number
Answer: B
This answer is correct because complete PRN documentation requires recording the clinical
indication for giving the medication as well as follow-up documentation detailing the
resident's response and the medication's effectiveness.
8. An administrator observes that a medication aide left a medication cart unlocked and
unattended in a hallway while entering a resident's room. What immediate corrective
action must the administrator take?
A. Terminate the medication aide's employment immediately
B. Secure the medication cart immediately and re-educate the employee on medication security
rules
C. File a formal report with the Drug Enforcement Administration (DEA)
D. Place a lock on the resident's room door
Answer: B
This answer is correct because unsecured medication carts present a severe risk of diversion
and accidental ingestion. The administrator must immediately eliminate the safety risk by
locking the cart and addressing the regulatory breach with the employee.
9. How many hours of continuing education must a certified Assisted Living Administrator
complete annually in North Carolina to maintain active licensure?
A. 10 hours
, B. 20 hours
C. 30 hours
D. 40 hours
Answer: C
This answer is correct because North Carolina rules require certified assisted living
administrators to earn 30 hours of approved continuing education every two years (averaging
15 hours annually, or 30 hours per renewal cycle) to maintain licensure currency and
competency.
10. A resident with mild cognitive impairment requests to keep a small lockbox containing
personal jewelry in their room. How should the facility handle this request?
A. Deny the request, as personal lockboxes are strictly prohibited in assisted living settings
B. Permit the lockbox and document the arrangement while ensuring the resident's rights to
personal property are respected
C. Require the administrator to hold the key to the lockbox at all times
D. Confiscate the jewelry and deposit it into the facility's corporate bank account
Answer: B
This answer is correct because residents have a fundamental right to retain and use personal
possessions. The facility should support this independence while assisting with appropriate
property inventories if requested.
11. What is the maximum initial dosage supply of a Schedule II controlled substance that
may be dispensed upon oral order in an emergency situation, provided a written
prescription follows?
A. 24-hour supply
B. 72-hour supply
C. 7-day supply
D. 30-day supply
Answer: B
This answer is correct because Federal and North Carolina pharmacy regulations restrict
emergency oral dispensings of Schedule II medications to the quantity necessary to treat the
emergency period, not to exceed a 72-hour supply, pending receipt of a written prescription.
12. During an annual fire safety inspection, the local fire marshal cites an assisted living
facility for blocked corridor exit doors. Which entity holds primary administrative
responsibility for maintaining fire safety compliance?
A. The shift supervisor
ANSWERS| EXAM PREP |ALL QUESTIONS AND ANSWERS |
VERIFIED ANSWERS PLUS RATIONALES | GRADED Q&A
COMPREHENSIVE STUDY GUIDE | VERIFIED LATEST
1. According to North Carolina Assisted Living licensure standards, what is the minimum
frequency with which a licensed health care professional must conduct a review of personal
care services provided to residents in an adult care home?
A. Bi-weekly
B. Monthly
C. Quarterly
D. Annually
Answer: C
This answer is correct because North Carolina licensure rules mandate that a licensed health
care professional (such as a registered nurse) must conduct a review of personal care services
and resident care plans at least quarterly to ensure care remains appropriate and aligns with
current physician orders.
2. A resident who was recently admitted to an assisted living facility begins demonstrating
sudden onset confusion and spatial disorientation. Which initial action should the
administrator instruct the direct care staff to take?
A. Immediately initiate a referral for psychiatric evaluation
B. Perform a baseline cognitive assessment and notify the primary care physician
C. Contact the family to arrange for 24-hour private duty care
D. Apply a soft physical restraint to prevent wandering
Answer: B
This answer is correct because a sudden change in mental status often indicates an underlying
acute medical condition, such as a urinary tract infection or delirium. Staff must observe,
document baselines, and notify the physician immediately for clinical evaluation rather than
assuming it is chronic dementia progression.
3. What is the maximum number of days an adult care home has to submit a written plan
of correction following the receipt of an official Statement of Deficiencies from the North
Carolina Division of Health Service Regulation (DHSR)?
A. 5 calendar days
B. 10 calendar days
,C. 15 calendar days
D. 30 calendar days
Answer: B
This answer is correct because North Carolina administrative rules specify that facilities must
submit an acceptable written plan of correction within 10 calendar days of receiving a
Statement of Deficiencies to address cited non-compliance.
4. Under North Carolina rules governing resident rights, under which condition may a
facility involuntarily discharge a resident without providing a standard 30-day advance
written notice?
A. The resident fails to pay monthly rent for two consecutive months
B. The resident requires a level of care the facility is not licensed to provide or poses an
immediate health/safety threat
C. The resident frequently refuses scheduled group social activities
D. The resident files a formal grievance with the state long-term care ombudsman
Answer: B
This answer is correct because regulatory protections allow for immediate discharge or
transfer only when a resident's medical needs exceed the facility's licensed scope of care or
when the resident presents an immediate danger to the health and safety of themselves or
others.
5. A direct care staff member fails to report a noticed pressure injury on a resident's
sacrum during routine bathing, leading to a stage 3 ulcer. How is this failure legally
categorized under adult protective service regulations?
A. Neglect
B. Exploitation
C. Physical abuse
D. Malpractice
Answer: A
This answer is correct because neglect is defined as the failure of a caregiver to provide
necessary services, care, or supervision needed to maintain a resident's physical or mental
health, resulting in harm or risk of harm.
6. What is the minimum required temperature that an adult care home must maintain in
all resident-occupied areas during cold weather months according to NC administrative
code?
A. 65°F (18.3°C)
,B. 68°F (20.0°C)
C. 71°F (21.6°C)
D. 75°F (23.8°C)
Answer: C
This answer is correct because North Carolina licensure standards mandate that facility
heating systems must be capable of maintaining, and must maintain, a minimum
temperature of 71°F in all areas occupied by residents during cold climate conditions to
prevent hypothermia and promote comfort.
7. When administering PRN (as-needed) medications, what critical documentation element
must be recorded in the Medication Administration Record (MAR) in addition to the time
and dosage?
A. The full medical history of the resident
B. The specific reason for administration and the evaluated outcome/effectiveness
C. The signature of two witnessing medication aides
D. The prescribing physician's state license number
Answer: B
This answer is correct because complete PRN documentation requires recording the clinical
indication for giving the medication as well as follow-up documentation detailing the
resident's response and the medication's effectiveness.
8. An administrator observes that a medication aide left a medication cart unlocked and
unattended in a hallway while entering a resident's room. What immediate corrective
action must the administrator take?
A. Terminate the medication aide's employment immediately
B. Secure the medication cart immediately and re-educate the employee on medication security
rules
C. File a formal report with the Drug Enforcement Administration (DEA)
D. Place a lock on the resident's room door
Answer: B
This answer is correct because unsecured medication carts present a severe risk of diversion
and accidental ingestion. The administrator must immediately eliminate the safety risk by
locking the cart and addressing the regulatory breach with the employee.
9. How many hours of continuing education must a certified Assisted Living Administrator
complete annually in North Carolina to maintain active licensure?
A. 10 hours
, B. 20 hours
C. 30 hours
D. 40 hours
Answer: C
This answer is correct because North Carolina rules require certified assisted living
administrators to earn 30 hours of approved continuing education every two years (averaging
15 hours annually, or 30 hours per renewal cycle) to maintain licensure currency and
competency.
10. A resident with mild cognitive impairment requests to keep a small lockbox containing
personal jewelry in their room. How should the facility handle this request?
A. Deny the request, as personal lockboxes are strictly prohibited in assisted living settings
B. Permit the lockbox and document the arrangement while ensuring the resident's rights to
personal property are respected
C. Require the administrator to hold the key to the lockbox at all times
D. Confiscate the jewelry and deposit it into the facility's corporate bank account
Answer: B
This answer is correct because residents have a fundamental right to retain and use personal
possessions. The facility should support this independence while assisting with appropriate
property inventories if requested.
11. What is the maximum initial dosage supply of a Schedule II controlled substance that
may be dispensed upon oral order in an emergency situation, provided a written
prescription follows?
A. 24-hour supply
B. 72-hour supply
C. 7-day supply
D. 30-day supply
Answer: B
This answer is correct because Federal and North Carolina pharmacy regulations restrict
emergency oral dispensings of Schedule II medications to the quantity necessary to treat the
emergency period, not to exceed a 72-hour supply, pending receipt of a written prescription.
12. During an annual fire safety inspection, the local fire marshal cites an assisted living
facility for blocked corridor exit doors. Which entity holds primary administrative
responsibility for maintaining fire safety compliance?
A. The shift supervisor
