Nursing Home Administrator Exam – Q&A with Answers, NHA Prep 2026/2027 (THE ULTIMATE GUIDE)

TEXAS
NURSING HOME ADMINISTRATOR
EXAM (JAMES ALLEN)
1. The most likely single cause for the series of bankruptcies among larger nursing home chains
around the year 2000 was .
1. Too small increases in government reimbursement rates
2. Paying too much for acquisitions in 1998 and 1999
3. Not taking advantage of falling interest rates
4. Thinking too small - Answer-2

2. In a chance conversation with the owner of an eight-facility chain, the newly hired
administrator for the oldest facility in the chain indicates that, because the mortgage is fully
retired, the administrator will concentrate more on being effec- tive than efficient since the
Quality Indicators are all at or above the state's aver-age. The owner would likely .
1. Be pleased
2. Be distressed
3. Be content
4. Praise the newly hired administrator - Answer-2

3.
Occupancy of Facility A has been a steady 70% since the Prospective Payment System was
introduced. Two weeks ago, a new 120-bed, equally equipped facil- ity opened several blocks
away. The Facility A administrator tells the admissions counselor to continue the usual
recruitment approach. The chain owners ought to .
1. Rest comfortably
2. Seek a new administrator
3. Appoint a new admissions counselor
4. Take no action - Answer-2

4. Bankruptcies among larger nursing home chains prior to 2000 .
1. Were frequent
2. Were ubiquitous
3. Were highly unusual
4. Were routinely declared to avoid too much accumulated debt - Answer-3

5. Under the Prospective Payment System, nursing facilities' reimbursed costs .
1. Were about the same as previously
2. Were more bundled
3. Used an unbundled cost structure
4. Were reimbursement for actual costs - Answer-2

6. In recent years, Medicare has .
1. Allowed facilities to make a modest profit
2. Shifted more costs onto nursing facilities
3. Eased up on economic pressures previously placed on facilities
4. Remained relatively unchanged in its reimbursement structure - Answer-2

,7. The nurse newly promoted to director of nursing insists on giving four RN hours of
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patient care each day on the Alzheimer's wing in the 175-bed facility. The administrator
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should
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1. Praise the new director of nursing for her resident centeredness
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2. Appoint an assistant director of nursing
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3. Adapt the job description to fit her pattern
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4. Seek a new director of nursing - Answer-4
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8. The applicant for the administrator position in a facility near a large teaching hospital
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insists that, as before in his rural facility, if hied he would not let the Medicare
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reimbursement policies affect his case mix. This applicant
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1. Should be hired
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2. Is likely to succeed if hired
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3. Can likely succeed in his goal
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4. Is out of touch - Answer-4
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9. The newly hired assistant to the administrator insists that the organizational chart
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dotted line between this position and the Department of Nursing be a solid line. The
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administrator should
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1. Agree in general
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2. Agree to this special case
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3. Ask the director of nursing for his or her opinion 4. Be forewarned - Answer-4
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10. The medical supplies provider tells the administrator of a facility that has not paid bills
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for the past 3 months but is now operating under a bankruptcy judge's approved plan for
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restructuring, that no more deliveries will be made until past bills are fully paid. The
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medical supplies provider
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1. Is smart to cut losses at that point
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2. Does not understand how bankruptcy works 3. Will now likely get his past due bills
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paid
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4. Is farsighted - Answer-2
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11. An administrator who adopts the leadership-by-walking-around (LBWA) approach by
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walking through the facility weekly and intently observing has
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1. Become an effective leader
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2. Chosen a good management style 3. Failed to understand LBWA
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4. Implemented a useful strategy - Answer-3
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12. The nursing facility administrator who, using the leadership-by-walking around (LBWA)
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technique, succeeds in actually making appropriate corrections on the spot during her
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rounds
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1. Is effectively implementing the concept
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2. Gains additional power through the process 3. Exhibits appropriate leadership
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4. Does not understand LBWA - Answer-4
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13. The rate of increase in the total number of nursing facilities in the United States
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during the years 2008 to 2012 is
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1. Likely to be about level
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2. Likely to double
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, 3. Likely to triple to accommodate the baby boomer generation 4. Likely to decrease
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markedly - Answer-1
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14. The applicant for administrator of the facility insists that he has successfully used
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democratic leadership to the exclusion of all other leadership styles. The interviewer
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should
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1. Recommend hiring this candidate
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2. Praise the candidate
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3. Be favorably impressed
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4. Continue to interview candidates - Answer-4
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15. The candidate for administrator said that she used a variety of administrative styles,
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but could not say exactly which she would use in every circumstance. The interviewer
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should be
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1. Favorably impressed
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2. Unfavorably impressed
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3. Concerned about possible indecisiveness 4. Looking for one leadership style - Answer-
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1

16. The candidate for administrator indicated that he consistently chose the charis- matic
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style of leadership. This should
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1. Reassure
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2. Alert
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3. Confirm the candidate's qualifications to 4. Please - Answer-2
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17. The costs of providing subacute care to nursing home residents
x2 x2 x2 x2 x2 x2 x2 x2 x2 x2 x2 . 1. Is perhaps
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triple that of the more typical patient
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2. Covered by Medicare
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3. Absorbed by Medicaid if Medicare coverage is inadequate
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4. Mostly covered by private insurance - Answer-1
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18. The nurse supervisor who had just been appointed director of nursing announced at
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the first department head meeting that she had circulated a memo among the nurses
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that only formal communications were to be allowed in the nursing department. The
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administrator should
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1. Be relieved
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2. Confirm the decision 3. Be supportive
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4. Anticipate problems - Answer-4
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19. The department head was not surprised to learn that an employee had heard only
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the positive comments to the employee and ignored the criticisms. The department
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head's grasp of the communication process is
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1. Deficient
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2. Appropriate 3. Out of focus 4. Inadequate - Answer-2
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20. The administrator routinely accepted as a nearly exclusive information source the
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director of nursing's positive reports that nursing was going well. The administrator is
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x2 .
1. Showing appropriate confidence in the director of nursing
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2. Utilizing the director of nursing properly
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