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Free NAB NHA Practice Questions

10 free, exam-style NAB Nursing Home Administrator Exam (NAB NHA) practice questions with answers and explanations. No signup required. Work through them below, then take the full free NAB NHA practice test to study every exam domain.

These 10 free NAB NHA questions are organized by exam domain, so you can see how each part of the NAB Nursing Home Administrator Exam blueprint is tested. Reveal the answer and explanation under each question.

Domain 1: Care, Services, and Supports

Question 1

A certified nursing assistant reports to the charge nurse that she witnessed a coworker forcefully grab a resident's arm during morning care, leaving visible bruising. The charge nurse immediately notifies the administrator. What is the administrator's FIRST obligation?

  1. Place the alleged perpetrator on administrative suspension and notify Human Resources
  2. Report the allegation to the State Survey Agency and law enforcement within 2 hours
  3. Direct the Director of Nursing to conduct an internal investigation before any external report is made
  4. Document the incident in the medical record and notify the resident's responsible party
Show answer & explanation

Correct answer: B - Report the allegation to the State Survey Agency and law enforcement within 2 hours

Question 2

A resident with moderate Alzheimer's disease living in a memory care unit frequently attempts to leave through exit doors. The nursing staff requests a standing physician order for lorazepam to be administered whenever the resident approaches the exits. Under OBRA regulations, this practice would MOST likely constitute:

  1. A physical restraint, since the primary purpose is to limit the resident's freedom of movement
  2. A legitimate pharmacological treatment, since the order would be issued by a licensed physician
  3. A chemical restraint, since the drug restricts behavior rather than treats a medical symptom
  4. An appropriate PRN medication subject to gradual dose reduction and the 14-day antipsychotic limit
Show answer & explanation

Correct answer: C - A chemical restraint, since the drug restricts behavior rather than treats a medical symptom

Question 3

The interdisciplinary team has just completed the comprehensive MDS assessment for a newly admitted resident. According to 42 CFR §483.21, by when must the comprehensive care plan be completed?

  1. Within 7 calendar days of the completion of the comprehensive MDS assessment
  2. Within 48 hours of the resident's admission to the facility
  3. Within 14 calendar days of the resident's admission
  4. Within 21 days of completing the most recent comprehensive or quarterly assessment
Show answer & explanation

Correct answer: A - Within 7 calendar days of the completion of the comprehensive MDS assessment

Question 4

A nursing facility resident is transferred to an acute care hospital for a hip fracture. The resident's son, who holds healthcare power of attorney, calls the administrator and asks whether his father's bed will be held. The administrator's response should primarily be based on:

  1. Federal Medicare law, which requires all certified facilities to hold a resident's bed for a minimum of 30 days
  2. The state Medicaid bed-hold policy and the pre-transfer disclosure made to the resident
  3. The facility's current occupancy rate and financial capacity to reserve the bed
  4. The attending physician's projected length of stay at the acute care facility
Show answer & explanation

Correct answer: B - The state Medicaid bed-hold policy and the pre-transfer disclosure made to the resident

Domain 2: Operations

Question 5

Under the Patient-Driven Payment Model (PDPM), how is the Non-Therapy Ancillary (NTA) component payment adjusted during days 1 through 3 of a Medicare Part A SNF stay?

  1. Paid at 50% of the established rate during the initial diagnostic assessment period
  2. Paid at the standard per diem rate with no adjustment for the first three days
  3. Paid at 300% of the established per diem rate
  4. Paid at 150% of the standard rate to account for elevated complexity at admission
Show answer & explanation

Correct answer: C - Paid at 300% of the established per diem rate

Question 6

A patient spent 5 days in the hospital before being referred to a skilled nursing facility for rehabilitation. Review of the medical record shows 2 days classified as inpatient admission status and 3 days under observation status. Does this patient meet the Medicare Part A SNF qualifying stay requirement?

  1. Yes - the total hospital stay exceeded the 3-day threshold regardless of billing status
  2. No - only days with inpatient admission status count toward the 3-midnight requirement
  3. Yes - observation days convert to inpatient status once the total stay exceeds 48 hours
  4. No - the SNF admission did not occur within 30 days of the qualifying inpatient days
Show answer & explanation

Correct answer: B - No - only days with inpatient admission status count toward the 3-midnight requirement

Question 7

An administrator discovers that a nurse aide hired four months ago has been listed on the OIG Exclusion List (LEIE) since before her date of hire. What is the facility's MOST immediate obligation?

  1. File a report with the State Nurse Aide Registry to flag the hire as a compliance error
  2. Contact the OIG directly to report the inadvertent hire and formally request a retroactive waiver for billing claims submitted during the period of exclusion
  3. Remove the individual from resident care and stop billing Medicare or Medicaid for their services
  4. Place the employee on administrative leave while the compliance officer investigates the matter
Show answer & explanation

Correct answer: C - Remove the individual from resident care and stop billing Medicare or Medicaid for their services

Domain 3: Environment and Quality

Question 8

During a recertification survey, the team identifies an Immediate Jeopardy situation related to a systemic failure in medication administration. The facility implements corrective actions during the survey that, in the surveyors' judgment, adequately remove the Immediate Jeopardy. How does this affect the citation?

  1. The deficiency is removed entirely from the Statement of Deficiencies
  2. The citation is downgraded to a lower scope/severity level, but the underlying noncompliance is still cited
  3. A 23-day Medicare termination notice is still required once Immediate Jeopardy has been identified during the survey
  4. The survey is closed with a finding of substantial compliance
Show answer & explanation

Correct answer: B - The citation is downgraded to a lower scope/severity level, but the underlying noncompliance is still cited

Question 9

An administrator is establishing the Quality Assessment and Assurance (QAA) committee as required by 42 CFR §483.75. Which of the following individuals is **NOT** required to be a member of this committee?

  1. The Director of Nursing
  2. The Medical Director
  3. The Director of Social Services
  4. The designated Infection Preventionist
Show answer & explanation

Correct answer: C - The Director of Social Services

Question 10

A nursing facility's Care Compare profile shows a 3-star health inspection rating, a 1-star staffing rating, and a 3-star quality measures rating. What overall star rating will this facility receive?

  1. 1 star
  2. 2 stars
  3. 3 stars
  4. 2.33 stars, calculated as the weighted average of the three component ratings
Show answer & explanation

Correct answer: B - 2 stars

The rest of the NAB NHA blueprint

The NAB NHA exam also covers these domains. Drill them in the full free practice test:

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