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Federal Nursing Home Administrator Exam – National Nursing Home Administrator Licensing E, Exams of Advanced Education

University of Pennsylvania (UPenn)Advanced Education

Federal Nursing Home Administrator Exam – National Nursing Home Administrator Licensing Examination Preparation, Academic Year 2026/2027 – Questions with Answers

Typology: Exams

2025/2026

Available from 03/17/2026

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Federal Nursing Home Administrator Exam – National Nursing
Home Administrator Licensing Examination Preparation,
Academic Year 2026/2027 – Questions with Answers
1) OBRA asserts some separate committees can be folded into the quality
improvement/assurance committee. Safety, Pharmacy and which committee
below can be added into QA/QI committee? - ANSWERInfection Control
2) Nursing homes are responsible for obtaining and providing dental care for
residents. Who usually pays for dental services? - ANSWERThe resident or a
family member
3) A facility is not allowed to charge a resident who is Medicaid and Medicare
eligible except for: - ANSWERCo-pays
4) You calculate the average percent of occupancy by: - ANSWERDividing the
total census (occupied bed days) by the total number of days, then multiply
by 100
5) Resident's rights should be explained to the resident and or family
member: - ANSWERPrior to admission
6) In case of an emergency, when no attending or back up physician is
available, the decision as to who will attend to the resident is to be made by
the: - ANSWERAdministrator
7) Federal law states that facilities must retain menus of food actually served
for at least: - ANSWER30 days
8) A resident with a living will and DPOA specified she wants to receive heroic
measures if necessary. Six months later the resident requires CPR, but is now
incompetent and the son request CPR be withheld. What is the right thing to
do? - ANSWERProvide the CPR
9) A resident asks to see his chart. The doctor tells the nurse not to allow the
resident access to the chart. What do you do? - ANSWERTell the doctor the
law gives the resident the right to view the medical records
10) Medical records belong to: - ANSWERFacility
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Federal Nursing Home Administrator Exam – National Nursing

Home Administrator Licensing Examination Preparation,

Academic Year 2026/2027 – Questions with Answers

  1. OBRA asserts some separate committees can be folded into the quality improvement/assurance committee. Safety, Pharmacy and which committee below can be added into QA/QI committee? - ANSWERInfection Control
  2. Nursing homes are responsible for obtaining and providing dental care for residents. Who usually pays for dental services? - ANSWERThe resident or a family member
  3. A facility is not allowed to charge a resident who is Medicaid and Medicare eligible except for: - ANSWERCo-pays
  4. You calculate the average percent of occupancy by: - ANSWERDividing the total census (occupied bed days) by the total number of days, then multiply by 100
  5. Resident's rights should be explained to the resident and or family member: - ANSWERPrior to admission
  6. In case of an emergency, when no attending or back up physician is available, the decision as to who will attend to the resident is to be made by the: - ANSWERAdministrator
  7. Federal law states that facilities must retain menus of food actually served for at least: - ANSWER30 days
  8. A resident with a living will and DPOA specified she wants to receive heroic measures if necessary. Six months later the resident requires CPR, but is now incompetent and the son request CPR be withheld. What is the right thing to do? - ANSWERProvide the CPR
  9. A resident asks to see his chart. The doctor tells the nurse not to allow the resident access to the chart. What do you do? - ANSWERTell the doctor the law gives the resident the right to view the medical records
  10. Medical records belong to: - ANSWERFacility
  1. When a resident passes away, the personal funds deposited with the facility must be given to the resident's estate with a final accounting of the funds within: - ANSWER30 days
  2. The suffix "algia" refers to: - ANSWERPain
  3. Physical restraints must be removed: - ANSWEREvery two hours
  4. Depression is one of many psychological changes related to the aging process. Others include the following except for: - ANSWERHearing loss
  5. "Nosocomal" refers to - ANSWERInfection occurring inside the facility (institutionalized)
  6. A capital budget is mostly about: - ANSWEREquipment and real estate
  7. Current debts are debts that are: - ANSWERDue within one year
  8. A ledger is a complete listing of: - ANSWERAccounts payable and receivable
  9. Which resource usually provides the least revenue for a nursing home? - ANSWERInsurance
  10. Past due accounts should not exceed: - ANSWER5%
  11. All of the following are a cash expense except: - ANSWERDepreciation
  12. A pro forma is primarily - ANSWERA financial statement or prediction
  13. A function of management is controlling, which means: - ANSWERMeasuring outcomes against benchmarks, then responding
  14. OBRA requires every facility to have: - ANSWERA governing body - The Omnibus Reconciliation Act
  15. Management by objectives means: - ANSWERA system that determines goals and objectives
  16. Policies are: - ANSWERGeneral and flexible statements that guid thinking
  1. In a bargaining unit, only ____ need to sign a card to call a union election:
  • ANSWER30 percent
  1. During an interview or on a job application, you may ask for all except: - ANSWERPlace of Birth
  2. To be eligible for FMLA, an employee must first work - ANSWER 1250 hours in the last 12 months
  3. If an employee works 52 hours in one week at a rate of $7 per hour, what would be the total gross salary? - ANSWER$
  4. Fire safety regulations come primarily from: - ANSWERLSC Life Safety Code
  5. The purpose of an enunciator panel is to: - ANSWERIndicate the zone of a fire
  6. Generators must be checked - ANSWERmontly
  7. Employee's Right to know refers to - ANSWERHazardous communicatins
  8. The primary fire - defense tools of a nursing home staff are: - ANSWERSmoke barriers, corridor walls, and resident rooms
  9. A maintenance program that saves time and money focuses on: - ANSWERPreventive maintenance
  10. Class C fires involve: - ANSWERElectricity PHYSICAL ENVIRONMENT ANT ATMOSPHERE - ANSWER PHYSICAL ENVIRONMENT ANT ATMOSPHERE - ANSWER
  11. Indoor temperatures - ANSWER 71 - 81 degrees ferinhight
  12. Disaster plans - ANSWEROBRA requirement for written plan
  13. Life Safety Code - ANSWERReasonably ensure the public protection from fire in public buildings
  1. MSDS - ANSWERInformation on potentially hazardous material
  2. OSHA - ANSWERfederal agency overseeing employee safety
  3. NFPA - ANSWERestablishes LSC
  4. Personnal Protective Equipment - ANSWERgloves
  5. Preventative measures - ANSWERtime for schedules repairs
  6. Offer HBV - ANSWERwithin 10 working days
  7. Smoke compartments - ANSWER200 feet or less
  8. Occupant loads for exit requirements: - ANSWERone person per 120 sq ft of floor area in sleeping areas and one person per 240 sq ft in treatment areas
  9. Means of Egress Requirements Emergency lighting: - ANSWERMandatory and Automatically available not requiring manual intervention for continuous operation when power is interupted
  10. Means of Egress Requirements Exit Marking: - ANSWERclearly marked with signs no more than 100 feet from exit
  11. Emergency Power: - ANSWERCheck generator weekly, test under full load for 30 minutes monthly
  12. Handrails at bottom of stairs must be: - ANSWERextended parallel to floor for 12 inches
  13. Windows must have opening force requirement: - ANSWERof no more than 5 lbs.
  14. Generator should provide for full load for - ANSWER4 hours, under emergency power need
  15. Resident rooms - ANSWERNo more than 4 residents per room 80 sq ft per resident in multi-bed rooms
  1. In-Out migration - ANSWERMovements of workers in and out of geographic area
  2. Pool - ANSWERGroup of temporary workers
  3. Labor Market - ANSWERgeographic area of recruitment
  4. Union election - ANSWERNLRB conducts; 50% plus 1 potential bargaining unit members VOTING wins LEADERSHIP AND MANAGEMENT (23% - 35 questions) - ANSWER
  5. Strategic Planning - ANSWERsetting long term goals
  6. Case mix - ANSWERresidents categorized by acuity
  7. Governing body - ANSWERlegally responsible for management
  8. Tactical planning - ANSWERselecting goals for one year
  9. Management - ANSWERachieve common goals thru organization
  10. Market segment - ANSWERpotential users of services
  11. Payor mix - ANSWERresidents categorized by payment type
  12. Rules - ANSWERcommands for action or non-action
  13. Procedures - ANSWERrequired methods for handling activities
  14. Risk management - ANSWERproactive means of anticipating problems
  15. Staff authority - ANSWERadvisory relationship with line management
  16. Forecasting - ANSWERprojects trends and needs which facility management must decide in future economic, social and political environment expected and resources available.
  17. Bench Marking - ANSWERimprove business by comparing with best practice of others (standards from which you measure)
  1. Upper-Level management - ANSWERresponsible for the overall functioning of the facility, normally interacting directly with the Board of Directors and/or owners.
  2. Middle-Level management - ANSWERreport to upper-level while interacting with lower-level (DON)
  3. Lower-level management - ANSWERdirectly supervise the staff who do the actual work
  4. Line Position (Authority): - ANSWERempowered by administrator to make decisions for organization (DON can fire, fire, give orders)
  5. Staff Position (Authority) - ANSWERnot empowered to make decisions; duties are primarily to advise (consultants, pharmacists, accountants, etc.)
  6. Functional Authority - ANSWERaction outside the normal lines of authority
  1. Violates unity of command
  2. Necessary due to principle of exception The two often have edges of distinction blurred
  1. Actionable - ANSWERconduct giving rise to legal action
  2. Aggrieved party - ANSWERone whose rights invaded or who suffered injury
  3. Burden of proof - ANSWERobligation of person bringing action
  4. Liable - ANSWERwritten defamation
  5. Slander - ANSWERverbal defamation
  6. Malice - ANSWERintentional doing of wrongful act
  7. Tort - ANSWERa wrong: legal duty owed, breached, and harm occured
  8. Worker Comp: - ANSWERresponsible for injuries occurring at work
  1. Aggregated - ANSWERformed by the conjunction or collection of particulars into a whole mass or sum; total; combined
  2. Contractual Discount - ANSWERUncollectible difference between charges and third party payor agreements
  3. Depreciation - ANSWERspreading of cost of capital assests over useful life
  4. Operating Statement - ANSWERtotal revenues - total expenses =net income (loss)138)
  5. Working Capital - ANSWERCurrent assets - current liabilities
  6. Entity Concept: - ANSWERThe facility, its records and monies are separate from owners. Ensuring consistency in accounting through full ownership disclosure.
  7. On-Going Concern: - ANSWERThe facility will continue to operate INDEFINITLEY
  8. Consistency: - ANSWERThe accounting reports will be prepared in the same way year to year to allow the facility to compare history to determine risks, and allow for clarity
  9. Full Disclosure: - ANSWERAll information must be shown in financial records accurately reflecting the financial standing of the facility
  10. Cash Accounting: - ANSWERExpenses are recorded when cash disbursed and revenues are recorded when money received. (Recorded money as it flows in and out of facility. Similar to checkbook) A. Advantage: Simplicity B. Disadvantage: Does not recognize depreciation, accounts receivable, or payable
  11. Time period: - ANSWERAccounting period (12 months) will be consistent year to year
  12. Objective Evidence: - ANSWERAccounting records are prepared with documentable records kept by facility (Audit Trail)
  1. Accrual Accounting: - ANSWERRevenues are recognized when they are earned and expenses when they are incurred, regardless of when cash transactions take place. A. Advantage: Measure revenues earnings after expenses incurred; include depreciation, AP and AR B. Disadvantage: Complexity
  2. Chart of accounts: - ANSWERlist of every account organized into: Assets, Liabilities, Capital, Revenue, Expenses
  3. Assets: - ANSWERthings the facility OWN
  4. Liabilities: - ANSWERthings the facility OWES
  5. Capital: - ANSWERNet worth or fund balance
  6. Revenues: - ANSWEREarnings
  7. Expenses: - ANSWERcost of personnel and supplies used in provision of service
  8. Journals: - ANSWERbooks of original entry (the first place transactions are recorded) Cash receipts, billing, accounts payable (purchases), cash disbursements, payroll, general.
  9. General: - ANSWERnon-repetitive entries. Used to make adjustments to conform to accrual system.
  10. Double entry: - ANSWERtwo entries for each transaction DEBIT and CREDIT
  11. General Ledger: - ANSWERsummary of all debits and credits contained in all the journals for the time period.
  1. Continuous balance for each account monthly
  2. Basis for "trail balance"
  1. Physician Extenders - ANSWERNurse Practitioner, Clinical Nurse Specialist or Physician Assistant
  2. Licensed Nurse - ANSWERCharge Nurse on each tour of duty
  3. Time between Super and Breakfast - ANSWER14 hours
  4. RN Coverage - ANSWER8 consecutive hours, 7 days per week
  5. Frequency of Activities - ANSWER7 days per week during hours requested
  6. Frequency of Doctor Visits - ANSWEREvery 30 days for first 90 days, then every 60 days
  7. Access to records - ANSWER24 hours of request
  8. Care Plans - ANSWER21 days after admissions
  9. Required in service for CENA - ANSWER12 hours per year
  10. QA meetings - ANSWERQuarterly
  11. Work before NA certified - ANSWER4 months
  12. Interest Bearing accounts - ANSWERtrust funds greater than $
  13. Involuntary Transfer Notice - ANSWER30 days
  14. CVA - ANSWERStroke
  15. COPD - ANSWEREmphysema, Asthma, Bronchitis
  16. ac - ANSWERbefore meals
  17. Meal service: - ANSWERKey to high resident morale. 3 - 5 meals per day with no more than 14 hours btw evening meal and next breakfast (16 if HS snack)
  18. Dishwashing - ANSWERwash at 150 to 1600 degrees F
  1. Hot food tray - ANSWERleave tray line above 140 degrees F
  2. Cold food - ANSWERleave tray line at less than 41*F
  3. Freezer - ANSWER0* - 20* F
  4. Refrigeration - ANSWER32* - 45*F
  5. Storage - ANSWERroom temperature
  6. RDA - ANSWERRecommended Daily Allowance Bread: 4 servings Fruit/veggies 2 cups Meat: 4 oz Milk: 2 cups
  7. Quality Assurance Committe - ANSWERDON, a physician, and 3 other staff members A. Care plan B. Infection Control C. Pharmacy Committee D. Safety Committe
  8. Administration - ANSWERA. License B. Compliance with standards and regulations C. Governing body D. Nurse Aide Training E. Medical Director F. Laboratory Services G. Radiology Service H. Clinical Services I. Disaster Plan J. Transfer Agreement K. Quality assurance L. Disclosure The most likely cause of for series of bankruptcies among larger nursing home chains around the year 2000 was - ANSWERPaying too much for acquisitions in 1998 and 1999

An administrator who adopts the management-by-walking-around (MBWA) approach by walking through the facility and intently observing weekly has - ANSWERFailed to understand MBWA Management-by-walking-around (MBWA) - ANSWERstyle of business management which involves managers wandering around, in an unstructured manner, through the workplace(s), at random, to check with employees, or equipment, about the staus of ongoing work The nursing home administrator who, using the management-by-walking- around (MBWA) technique, succeeds in atually making appropriate corrections on the spot during his rounds - ANSWERDoesnt understand (MBWA) The applicant for administrator of the facility insist that he has succcessfuly used democrate leadership to the exclusion of all other leadership styles. The intervier should - ANSWERcontinue to interview candidates The candidate for administrator said she used a variety of administrative styles, but could't say exactly which she would use in every circumstance. The interviewer should be - ANSWERfavorable impress The candidate for administrator indicated that she consistently choose the charismatic style of leadership. This should __________the interviewer. - ANSWERAlert The cost of providing subacute care to nursing home residents _________ - ANSWERIs perhaps triple that of more typical patient The nurse supervisor who had just been appointed DON announced at the first department head meeting that she had circulated a memo among the nurses that only formal communications were to be allowed in the nursing department. The administrator should - ANSWERAnticipate problems The department head was not surprised to learn that the employee had only heard his positive comments to the employee and ignored his criticism. The department head's grasp of the communicationn process is - ANSWERAppropriate

The administrator routinely accepted as his nearly exclusive information source the director of nursing's positive reports on how nursing was going well. The administrator is - ANSWERPlacing him at risk Periodic shortage of nurses available for nursing home employment _________ - ANSWERIs likely to remain for the foreseeable future Congress and the Federal rule makers behave as if the facility will run successfully if congress and CMS can write enough rules. They are - ANSWERIncorrect When the administrator notices the DON seeks to turn many duties as possible over to housekeeping, the administrator should conclude that the DON is - ANSWERBehaving normally The administrator insist that a timely copy of all reports generated within the facility come across her desk before anyone signs them. The administrator is _______ - ANSWERNot rationalizing her managemnt information system The administrator notices that incident reports are being insufficiently filled out, but does nothing, believing that the situation will likely correct itself. The administrator is ______ - ANSWERFailing to control effectively Corporate sends a directive its flagship facility administrator, directing the administrator's attention more towards outcome of resident care than cost of resident care during the coming 12 months. Corporate is more concerned with __________than with _________. - ANSWEREffectiveness/efficiency The long term care sector receiving increased funding and attention from the federal government is the ________________. - ANSWERHome health care sector The concept that nursing homes should be reimbursed by states for their actual costs was part of the _______ - ANSWERHatch Amendment The intense health care cost-shifting efforts among providers such as Medicare, Medicaid and local governments is _____________ - ANSWERLikely to continue Worried about the level of actual resident care being achieved in the facility, the administrator directs the nurses to spend less time charting and more

result will be___ - ANSWERBetter resident care, but increased deficiency citatons The new social worker informs the head of nursing that the admissions is all she has time for and that nursing must monitor and document each resident's socipsychological experiences. The new social worker is _____ - ANSWERResponding appropriately to prorities Attempting to find the right person for each well-defined job is known as the managementfunction ______ - ANSWERStaffing The administrator who takes steps that assures the goals are accomplished and that each job as planned is successful __ - ANSWERControlling quality The administrator's job is to assure that the ____employees do the task of the organization at an acceptable quality level. - ANSWERAppropriate The administrator who conducts a national serch for a director of nursing position and interviews 20 candidates from 7 different surrounding states by phone is engaged inthe managerial function of ______ - ANSWERStaffing In the end, it can be said that the administrator's responsiblity to meet resident care needs and facility needs ae ______ - ANSWERBoth are equal Superior performance depends on taking exceptional care of residents via superior service and _____ - ANSWERConstant innovations Superior performance for a nursing facility comes through __ - ANSWERInnovation in ways to serve residents The supeb nursingb facility is supurb by virtue of its ____ - ANSWERSuccess in serving the residents ANSWERing the phones and resident call bells with common courtesy and doing things that work are examples of ______ - ANSWERA blind flash of the obvious Giving every employee the space to innovate at least a little; listening to residents and acting on their ideas; and wandering around with residents,

staff, and suppliers are examples of the different-to-achieve ________ - ANSWERCommon sense, obvious In a facility of 120 beds, the administrator ____personally performs each of the management tasks. - ANSWERNeed not To assure that all the management tasks are successfully accomplished, the administrator of a 120-bed facility will typically divide management into _____ - ANSWERThree layers A licensed person responsible for formulating and enforcing policies that will be applied to an entire facility is thought of as a/an ____ - ANSWERUpper- level manager The staff member responsible for reporting to upper-level management and at the same time interacting significantly with several lower-level managers is the ______ - ANSWERDirector of Nursing The staff person for whom both upward and downward communication skills are most neccessary is the ____ - ANSWERDirector of nursing When the director of nursing makes an effective policy decision without consulting the administrator, that impacts all nursing personnel, the administrator should ______ - ANSWERBe pleased In the typical nursing facility, the decision-making process is _______ establishment of lower, middle, and upper levels of management. - ANSWERNoticeably more complicated than the simple Among the following positions the _____has no authority to make decisions for the facility. - ANSWERAssitant to the Administrator Decisions made by persons on the staff to whom the administrator has deligated line authority are, in the final analysis, regaurded as decisions by ______. - ANSWERThe administrator When a nurse practitioner, who is more highly qualified than the director of nursing, gives orders in the hallways, the director of nursing should feel _______ - ANSWERUndermined