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NAB Domain 1: Resident Care/Quality of Life
— 2026 Definitive Exam
TOTAL QUESTIONS: 228
QUESTION 1:
Which of the following best defines the "minimum data set" (MDS) 3.0 v2.0 in long-term
care?
A) A billing tool for Medicare Part A reimbursement only
B) A standardized clinical assessment of all residents' functional and medical status
C) A staffing ratio compliance document submitted to CMS quarterly
D) A quality measure report for public posting on Care Compare
CORRECT ANSWER: B
RATIONALE: The MDS is a standardized assessment tool used to evaluate residents'
physical, psychological, and functional status. While it influences reimbursement (A), its
primary purpose is clinical assessment. It is not a staffing document (C) nor exclusively a
public reporting tool (D), though data feeds into quality measures.
QUESTION 2:
Under OBRA '87 regulations, a resident's care plan must be reviewed and revised at
minimum...
A) Weekly
B) Monthly
C) Quarterly
D) Annually
CORRECT ANSWER: C
RATIONALE: OBRA requires comprehensive care plan review at least quarterly and with
any significant change in condition. Weekly (A) is excessive unless clinically indicated.
Monthly (B) is not the federal minimum. Annual (D) is insufficient for regulatory
compliance.
QUESTION 3:
A resident refuses to bathe for seven consecutive days. The facility should FIRST:
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A) Document refusal and attempt alternative approaches
B) Notify the resident's family of noncompliance
C) Bathe the resident using two-person assist for safety
D) Discharge the resident for failure to maintain hygiene
CORRECT ANSWER: A
RATIONALE: Resident rights under OBRA include refusal of treatment. The facility must
document refusals and attempt person-centered alternatives (sponge bath, bed bath,
different time of day). Forcing care (C) is illegal. Discharge (D) is inappropriate without
exhaustive attempts. Family notification (B) may breach confidentiality.
QUESTION 4:
Which F-tag directly addresses a resident's right to be free from unnecessary physical
restraints?
A) F584 (Room and Bathroom Temperatures)
B) F600 (Free from Abuse, Neglect, and Exploitation)
C) F604 (Free from Physical and Chemical Restraints)
D) F689 (Free from Accident Hazards)
CORRECT ANSWER: C
RATIONALE: F604 specifically prohibits unnecessary physical and chemical restraints for
discipline or convenience. F600 covers abuse/neglect broadly. F689 addresses accident
hazards. F584 covers environmental comfort.
QUESTION 5:
The primary purpose of the Resident Assessment Instrument (RAI) is to:
A) Maximize Medicare reimbursement through accurate coding
B) Develop individualized, interdisciplinary care plans based on resident needs
C) Comply with state survey requirements every 12 months
D) Replace physician orders for routine nursing care
CORRECT ANSWER: B
RATIONALE: The RAI's clinical purpose is care planning based on identified needs. While
reimbursement (A) and survey compliance (C) are secondary benefits, the primary is
person-centered care. The RAI does not replace physician orders (D).
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QUESTION 6:
Under MDS 3.0 v2.0, a comprehensive assessment must be completed within how many
days of admission?
A) 5 days
B) 14 days
C) 30 days
D) 90 days
CORRECT ANSWER: B
RATIONALE: Federal regulations require the comprehensive MDS assessment to be
completed within 14 days of admission. The 5-day assessment (A) is the initial scheduled
assessment, not the comprehensive. Thirty days (C) and 90 days (D) exceed federal
timeframes.
QUESTION 7:
The Care Area Assessment (CAA) process is triggered by:
A) Random selection by the MDS coordinator
B) Specific MDS item responses that indicate potential risks
C) Physician request only
D) State surveyor observation during annual inspection
CORRECT ANSWER: B
RATIONALE: CAAs are triggered by specific MDS responses indicating potential clinical
risks or need for further evaluation. They are not random (A), physician-initiated only (C),
or survey-driven (D).
QUESTION 8:
Which MDS 3.0 v2.0 section assesses a resident's ability to perform upper body
dressing?
A) Section G: Functional Status
B) Section GG: Functional Abilities and Goals
C) Section F: Preferences for Customary Routine
D) Section E: Behavior
CORRECT ANSWER: B
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RATIONALE: Section GG contains the functional assessment items for admission and
discharge tracking, including upper body dressing. Section G (A) contains older ADL
items but GG is the standardized functional assessment. Sections F (C) and E (D) do not
assess dressing ability.
QUESTION 9:
A Significant Change in Status Assessment (SCSA) is required when:
A) The resident requests a room change
B) A major decline or improvement in condition is not expected to resolve quickly
C) The family disagrees with the care plan
D) A new diet order is written by the physician
CORRECT ANSWER: B
RATIONALE: An SCSA is completed when a resident experiences a major change in
condition that is not expected to resolve without intervention. Room changes (A), family
disagreements (C), and routine diet orders (D) do not trigger SCSA requirements.
QUESTION 10:
The Interdisciplinary Team (IDT) care planning conference must include at minimum:
A) The physician, director of nursing, and resident or representative
B) Only nursing staff assigned to the resident
C) The administrator and medical director exclusively
D) Social services and activities staff only
CORRECT ANSWER: A
RATIONALE: Federal regulations require the physician, registered nurse, and
resident/representative participation in care planning. Other disciplines participate as
needed, but the core minimum includes medical and nursing leadership with resident
input.
QUESTION 11:
Which of the following is NOT a required component of the comprehensive care plan
per F656?
A) Measurable objectives and timetables
B) Discharge planning when appropriate
NAB Domain 1: Resident Care/Quality of Life
— 2026 Definitive Exam
TOTAL QUESTIONS: 228
QUESTION 1:
Which of the following best defines the "minimum data set" (MDS) 3.0 v2.0 in long-term
care?
A) A billing tool for Medicare Part A reimbursement only
B) A standardized clinical assessment of all residents' functional and medical status
C) A staffing ratio compliance document submitted to CMS quarterly
D) A quality measure report for public posting on Care Compare
CORRECT ANSWER: B
RATIONALE: The MDS is a standardized assessment tool used to evaluate residents'
physical, psychological, and functional status. While it influences reimbursement (A), its
primary purpose is clinical assessment. It is not a staffing document (C) nor exclusively a
public reporting tool (D), though data feeds into quality measures.
QUESTION 2:
Under OBRA '87 regulations, a resident's care plan must be reviewed and revised at
minimum...
A) Weekly
B) Monthly
C) Quarterly
D) Annually
CORRECT ANSWER: C
RATIONALE: OBRA requires comprehensive care plan review at least quarterly and with
any significant change in condition. Weekly (A) is excessive unless clinically indicated.
Monthly (B) is not the federal minimum. Annual (D) is insufficient for regulatory
compliance.
QUESTION 3:
A resident refuses to bathe for seven consecutive days. The facility should FIRST:
, 2
A) Document refusal and attempt alternative approaches
B) Notify the resident's family of noncompliance
C) Bathe the resident using two-person assist for safety
D) Discharge the resident for failure to maintain hygiene
CORRECT ANSWER: A
RATIONALE: Resident rights under OBRA include refusal of treatment. The facility must
document refusals and attempt person-centered alternatives (sponge bath, bed bath,
different time of day). Forcing care (C) is illegal. Discharge (D) is inappropriate without
exhaustive attempts. Family notification (B) may breach confidentiality.
QUESTION 4:
Which F-tag directly addresses a resident's right to be free from unnecessary physical
restraints?
A) F584 (Room and Bathroom Temperatures)
B) F600 (Free from Abuse, Neglect, and Exploitation)
C) F604 (Free from Physical and Chemical Restraints)
D) F689 (Free from Accident Hazards)
CORRECT ANSWER: C
RATIONALE: F604 specifically prohibits unnecessary physical and chemical restraints for
discipline or convenience. F600 covers abuse/neglect broadly. F689 addresses accident
hazards. F584 covers environmental comfort.
QUESTION 5:
The primary purpose of the Resident Assessment Instrument (RAI) is to:
A) Maximize Medicare reimbursement through accurate coding
B) Develop individualized, interdisciplinary care plans based on resident needs
C) Comply with state survey requirements every 12 months
D) Replace physician orders for routine nursing care
CORRECT ANSWER: B
RATIONALE: The RAI's clinical purpose is care planning based on identified needs. While
reimbursement (A) and survey compliance (C) are secondary benefits, the primary is
person-centered care. The RAI does not replace physician orders (D).
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QUESTION 6:
Under MDS 3.0 v2.0, a comprehensive assessment must be completed within how many
days of admission?
A) 5 days
B) 14 days
C) 30 days
D) 90 days
CORRECT ANSWER: B
RATIONALE: Federal regulations require the comprehensive MDS assessment to be
completed within 14 days of admission. The 5-day assessment (A) is the initial scheduled
assessment, not the comprehensive. Thirty days (C) and 90 days (D) exceed federal
timeframes.
QUESTION 7:
The Care Area Assessment (CAA) process is triggered by:
A) Random selection by the MDS coordinator
B) Specific MDS item responses that indicate potential risks
C) Physician request only
D) State surveyor observation during annual inspection
CORRECT ANSWER: B
RATIONALE: CAAs are triggered by specific MDS responses indicating potential clinical
risks or need for further evaluation. They are not random (A), physician-initiated only (C),
or survey-driven (D).
QUESTION 8:
Which MDS 3.0 v2.0 section assesses a resident's ability to perform upper body
dressing?
A) Section G: Functional Status
B) Section GG: Functional Abilities and Goals
C) Section F: Preferences for Customary Routine
D) Section E: Behavior
CORRECT ANSWER: B
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RATIONALE: Section GG contains the functional assessment items for admission and
discharge tracking, including upper body dressing. Section G (A) contains older ADL
items but GG is the standardized functional assessment. Sections F (C) and E (D) do not
assess dressing ability.
QUESTION 9:
A Significant Change in Status Assessment (SCSA) is required when:
A) The resident requests a room change
B) A major decline or improvement in condition is not expected to resolve quickly
C) The family disagrees with the care plan
D) A new diet order is written by the physician
CORRECT ANSWER: B
RATIONALE: An SCSA is completed when a resident experiences a major change in
condition that is not expected to resolve without intervention. Room changes (A), family
disagreements (C), and routine diet orders (D) do not trigger SCSA requirements.
QUESTION 10:
The Interdisciplinary Team (IDT) care planning conference must include at minimum:
A) The physician, director of nursing, and resident or representative
B) Only nursing staff assigned to the resident
C) The administrator and medical director exclusively
D) Social services and activities staff only
CORRECT ANSWER: A
RATIONALE: Federal regulations require the physician, registered nurse, and
resident/representative participation in care planning. Other disciplines participate as
needed, but the core minimum includes medical and nursing leadership with resident
input.
QUESTION 11:
Which of the following is NOT a required component of the comprehensive care plan
per F656?
A) Measurable objectives and timetables
B) Discharge planning when appropriate
