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Navigating Long-Term Care:
Comprehensive Practice Exam (Fall
2025/2026 Study Edition)
1. Which federal law established the Minimum Data Set (MDS)
as a mandatory assessment tool for all Medicare- and Medicaid-
certified nursing homes?
A) Affordable Care Act (ACA)
B) Omnibus Budget Reconciliation Act (OBRA) of 1987
C) Health Insurance Portability and Accountability Act (HIPAA)
D) Older Americans Act (OAA)
Answer: B
Rationale: OBRA 1987 mandated the Resident Assessment
Instrument (RAI), including the MDS, to ensure comprehensive,
standardized assessment of nursing home residents.
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2. Scenario: A long-term care facility is cited for failing to
conduct a quarterly MDS assessment for a resident whose
condition changed significantly. Which federal agency has
oversight for this deficiency?
A) Department of Housing and Urban Development (HUD)
B) Centers for Medicare & Medicaid Services (CMS)
C) Occupational Safety and Health Administration (OSHA)
D) Food and Drug Administration (FDA)
Answer: B
Rationale: CMS oversees Medicare/Medicaid certification and
enforces OBRA requirements through state survey agencies. MDS
compliance is a condition of participation.
3. The acronym "PASRR" stands for:
A) Pre-Admission Screening and Resident Review
B) Post-Acute Skilled Rehabilitation and Recovery
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C) Patient Assessment and Safety Risk Reduction
D) Periodic Assessment of Skilled Resident Rights
Answer: A
Rationale: PASRR is a federal requirement to screen individuals with
serious mental illness or intellectual disability before admission to a
Medicaid-certified nursing facility.
4. Scenario: A nursing home resident with dementia wanders into
another resident's room and is found sleeping in that resident's
bed. The facility fails to revise the care plan. This may constitute:
A) Neglect
B) Assault
C) Battery
D) False imprisonment
Answer: A
Rationale: Neglect is failure to provide necessary care, including
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supervision to prevent harm. Wandering risk should be addressed
in care plan; failure to do so is neglect.
5. Which of the following is NOT one of the “five star” rating
components for nursing homes under CMS’s Nursing Home
Compare?
A) Health inspections
B) Staffing levels
C) Quality measures
D) Resident family satisfaction surveys
Answer: D
Rationale: The Five-Star Quality Rating System includes health
inspections, staffing (RN hours, total staffing), and quality
measures (clinical outcomes). Family satisfaction is not a formal
component, though some states have separate surveys.
6. The Long-Term Care Ombudsman Program is mandated by
which legislation?
Navigating Long-Term Care:
Comprehensive Practice Exam (Fall
2025/2026 Study Edition)
1. Which federal law established the Minimum Data Set (MDS)
as a mandatory assessment tool for all Medicare- and Medicaid-
certified nursing homes?
A) Affordable Care Act (ACA)
B) Omnibus Budget Reconciliation Act (OBRA) of 1987
C) Health Insurance Portability and Accountability Act (HIPAA)
D) Older Americans Act (OAA)
Answer: B
Rationale: OBRA 1987 mandated the Resident Assessment
Instrument (RAI), including the MDS, to ensure comprehensive,
standardized assessment of nursing home residents.
,Page 2 of 139
2. Scenario: A long-term care facility is cited for failing to
conduct a quarterly MDS assessment for a resident whose
condition changed significantly. Which federal agency has
oversight for this deficiency?
A) Department of Housing and Urban Development (HUD)
B) Centers for Medicare & Medicaid Services (CMS)
C) Occupational Safety and Health Administration (OSHA)
D) Food and Drug Administration (FDA)
Answer: B
Rationale: CMS oversees Medicare/Medicaid certification and
enforces OBRA requirements through state survey agencies. MDS
compliance is a condition of participation.
3. The acronym "PASRR" stands for:
A) Pre-Admission Screening and Resident Review
B) Post-Acute Skilled Rehabilitation and Recovery
,Page 3 of 139
C) Patient Assessment and Safety Risk Reduction
D) Periodic Assessment of Skilled Resident Rights
Answer: A
Rationale: PASRR is a federal requirement to screen individuals with
serious mental illness or intellectual disability before admission to a
Medicaid-certified nursing facility.
4. Scenario: A nursing home resident with dementia wanders into
another resident's room and is found sleeping in that resident's
bed. The facility fails to revise the care plan. This may constitute:
A) Neglect
B) Assault
C) Battery
D) False imprisonment
Answer: A
Rationale: Neglect is failure to provide necessary care, including
, Page 4 of 139
supervision to prevent harm. Wandering risk should be addressed
in care plan; failure to do so is neglect.
5. Which of the following is NOT one of the “five star” rating
components for nursing homes under CMS’s Nursing Home
Compare?
A) Health inspections
B) Staffing levels
C) Quality measures
D) Resident family satisfaction surveys
Answer: D
Rationale: The Five-Star Quality Rating System includes health
inspections, staffing (RN hours, total staffing), and quality
measures (clinical outcomes). Family satisfaction is not a formal
component, though some states have separate surveys.
6. The Long-Term Care Ombudsman Program is mandated by
which legislation?
