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North Carolina (NC) Assisted Living Administrator
Exam | Latest Verified Questions and Detailed
Answers
OVERVIEW DESCRIPTION:
This comprehensive set of multiple-choice questions is designed for the North Carolina
Assisted Living Administrator Exam. The questions closely follow NC administrative code
(10A NCAC 13F & .13G), covering essential domains such as resident rights, admission and
discharge criteria, medication management, physical environment standards, emergency
preparedness, abuse/neglect reporting, staffing requirements, and quality assurance. Each
question includes a correct answer and a concise expert rationale to reinforce key
regulatory and practical concepts needed for licensed administration in North Carolina
adult care homes.
QUESTION 1
An administrator is reviewing the admission requirements for a new resident. Which
condition would make an individual ineligible for admission to a North Carolina assisted
living facility?
A) Mild cognitive impairment requiring reminders for daily tasks
B) Use of a walker for ambulation
C) Being bedridden and requiring total care for all activities of daily living
D) Controlled diabetes with self-administration of insulin
CORRECT ANSWER: C
EXPERT RATIONALE: NC rules prohibit admission of individuals who are bedridden and
require total care, as assisted living is not a skilled nursing facility. Residents must be
able to transfer with assistance and participate in their own care.
QUESTION 2
How often must a resident’s medication regimen be reviewed by a licensed pharmacist
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or nurse consultant in a North Carolina assisted living facility?
A) Every 30 days
B) Every 60 days
C) Every 90 days
D) Upon each change in medication only
CORRECT ANSWER: B
EXPERT RATIONALE: NC regulations require a medication regimen review at least every
60 days to ensure appropriateness and minimize adverse effects. This review is
documented in the resident’s record.
QUESTION 3
What is the maximum number of consecutive hours a direct care staff member may
work in a North Carolina assisted living facility without a mandatory break?
A) 8 hours
B) 10 hours
C) 12 hours
D) 16 hours
CORRECT ANSWER: C
EXPERT RATIONALE: NC administrative code limits direct care staff to 12 consecutive
hours before an 8-hour break is required to prevent fatigue-related errors. Facilities
must schedule accordingly.
QUESTION 4
A resident who is capable of self-administering medications asks to keep their own
locked medication box. What is the administrator’s responsibility?
A) Prohibit this because all medications must be centrally stored
B) Allow it only if the resident signs a waiver of liability
C) Allow it after a nursing assessment confirms safe self-administration and secure
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storage
D) Allow it only for over-the-counter medications
CORRECT ANSWER: C
EXPERT RATIONALE: NC rules permit self-administration with a documented nursing
assessment of safety and a locked, resident-specific storage system. The facility must
monitor periodically.
QUESTION 5
What is the required staff-to-resident ratio for awake overnight staff in a 20-bed adult
care home in North Carolina?
A) 1:10
B) 1:15
C) 1:20
D) 1:25
CORRECT ANSWER: C
EXPERT RATIONALE: For adult care homes (assisted living), the overnight awake staff
ratio is 1:20 for facilities with 20 or fewer residents. Larger facilities have different
requirements.
QUESTION 6
Which of the following must be included in a resident’s service plan within 14 days of
admission?
A) Only medical diagnoses
B) Only financial arrangements
C) Specific interventions for identified needs, including activities of daily living support
D) A discharge summary from the previous residence
CORRECT ANSWER: C
EXPERT RATIONALE: The service plan must detail individualized interventions for ADLs,
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medication management, and psychosocial needs. It is developed with the resident or
their representative.
QUESTION 7
A resident has a stage 2 pressure ulcer. Under NC rules, what must the facility do?
A) Treat the ulcer with over-the-counter ointments only
B) Discharge the resident immediately because pressure ulcers are not allowed
C) Notify the resident’s physician and implement a written care plan, including turning
schedule
D) Ignore the ulcer if the resident refuses treatment
CORRECT ANSWER: C
EXPERT RATIONALE: NC rules require physician notification and a formal care plan for
any pressure ulcer. The facility must provide appropriate wound care and repositioning.
QUESTION 8
How often must fire drills be conducted in a North Carolina assisted living facility?
A) Monthly, on each shift
B) Quarterly, on each shift
C) Twice per year
D) Annually
CORRECT ANSWER: A
EXPERT RATIONALE: NC fire code mandates monthly fire drills, rotated across all shifts,
to ensure staff preparedness. Documentation of each drill is required.
QUESTION 9
Which statement best describes the administrator’s role regarding resident funds held
by the facility?
A) The facility cannot hold any resident funds
North Carolina (NC) Assisted Living Administrator
Exam | Latest Verified Questions and Detailed
Answers
OVERVIEW DESCRIPTION:
This comprehensive set of multiple-choice questions is designed for the North Carolina
Assisted Living Administrator Exam. The questions closely follow NC administrative code
(10A NCAC 13F & .13G), covering essential domains such as resident rights, admission and
discharge criteria, medication management, physical environment standards, emergency
preparedness, abuse/neglect reporting, staffing requirements, and quality assurance. Each
question includes a correct answer and a concise expert rationale to reinforce key
regulatory and practical concepts needed for licensed administration in North Carolina
adult care homes.
QUESTION 1
An administrator is reviewing the admission requirements for a new resident. Which
condition would make an individual ineligible for admission to a North Carolina assisted
living facility?
A) Mild cognitive impairment requiring reminders for daily tasks
B) Use of a walker for ambulation
C) Being bedridden and requiring total care for all activities of daily living
D) Controlled diabetes with self-administration of insulin
CORRECT ANSWER: C
EXPERT RATIONALE: NC rules prohibit admission of individuals who are bedridden and
require total care, as assisted living is not a skilled nursing facility. Residents must be
able to transfer with assistance and participate in their own care.
QUESTION 2
How often must a resident’s medication regimen be reviewed by a licensed pharmacist
,2|Page
or nurse consultant in a North Carolina assisted living facility?
A) Every 30 days
B) Every 60 days
C) Every 90 days
D) Upon each change in medication only
CORRECT ANSWER: B
EXPERT RATIONALE: NC regulations require a medication regimen review at least every
60 days to ensure appropriateness and minimize adverse effects. This review is
documented in the resident’s record.
QUESTION 3
What is the maximum number of consecutive hours a direct care staff member may
work in a North Carolina assisted living facility without a mandatory break?
A) 8 hours
B) 10 hours
C) 12 hours
D) 16 hours
CORRECT ANSWER: C
EXPERT RATIONALE: NC administrative code limits direct care staff to 12 consecutive
hours before an 8-hour break is required to prevent fatigue-related errors. Facilities
must schedule accordingly.
QUESTION 4
A resident who is capable of self-administering medications asks to keep their own
locked medication box. What is the administrator’s responsibility?
A) Prohibit this because all medications must be centrally stored
B) Allow it only if the resident signs a waiver of liability
C) Allow it after a nursing assessment confirms safe self-administration and secure
,3|Page
storage
D) Allow it only for over-the-counter medications
CORRECT ANSWER: C
EXPERT RATIONALE: NC rules permit self-administration with a documented nursing
assessment of safety and a locked, resident-specific storage system. The facility must
monitor periodically.
QUESTION 5
What is the required staff-to-resident ratio for awake overnight staff in a 20-bed adult
care home in North Carolina?
A) 1:10
B) 1:15
C) 1:20
D) 1:25
CORRECT ANSWER: C
EXPERT RATIONALE: For adult care homes (assisted living), the overnight awake staff
ratio is 1:20 for facilities with 20 or fewer residents. Larger facilities have different
requirements.
QUESTION 6
Which of the following must be included in a resident’s service plan within 14 days of
admission?
A) Only medical diagnoses
B) Only financial arrangements
C) Specific interventions for identified needs, including activities of daily living support
D) A discharge summary from the previous residence
CORRECT ANSWER: C
EXPERT RATIONALE: The service plan must detail individualized interventions for ADLs,
, 4|Page
medication management, and psychosocial needs. It is developed with the resident or
their representative.
QUESTION 7
A resident has a stage 2 pressure ulcer. Under NC rules, what must the facility do?
A) Treat the ulcer with over-the-counter ointments only
B) Discharge the resident immediately because pressure ulcers are not allowed
C) Notify the resident’s physician and implement a written care plan, including turning
schedule
D) Ignore the ulcer if the resident refuses treatment
CORRECT ANSWER: C
EXPERT RATIONALE: NC rules require physician notification and a formal care plan for
any pressure ulcer. The facility must provide appropriate wound care and repositioning.
QUESTION 8
How often must fire drills be conducted in a North Carolina assisted living facility?
A) Monthly, on each shift
B) Quarterly, on each shift
C) Twice per year
D) Annually
CORRECT ANSWER: A
EXPERT RATIONALE: NC fire code mandates monthly fire drills, rotated across all shifts,
to ensure staff preparedness. Documentation of each drill is required.
QUESTION 9
Which statement best describes the administrator’s role regarding resident funds held
by the facility?
A) The facility cannot hold any resident funds
