TEXAS NURSING HOME ADMINISTRATOR
LICENSURE EXAM PRACTICE TEST (2026 EDITION)
| COMPREHENSIVE QUESTIONS WITH VERIFIED
ANSWERS & DETAILED RATIONALES | LONG-
TERM CARE ADMINISTRATION SUCCESS GUIDE |
HIGH-YIELD STUDY PDF
TEXAS NURSING HOME ADMINISTRATOR LICENSURE EXAM
PRACTICE TEST — 2026 EDITION
200 Comprehensive Questions | Verified Answers & Detailed EXPERT
RATIONALE
• How to Use This Material: Work through each question independently before
revealing the answer — treat every question as a real exam item, review the
EXPERT RATIONALE carefully even when correct, and revisit any topic area where
you miss two or more consecutive questions.
• Features: 200 high-yield questions with verified correct answers, detailed EXPERT
RATIONALE, full A–E options, bold highlights on correct answers, and
comprehensive coverage of all Texas NHA licensure exam domains including
federal and state regulations, resident care, HR, finance, safety, and ethics.
1. Under the Texas Health & Safety Code, which state agency is primarily
responsible for licensing nursing home administrators in Texas?
A. Texas Department of State Health Services (DSHS)
B. Texas Medical Board (TMB)
C. Health and Human Services Commission (HHSC)
D. Texas Board of Nursing (BON)
E. Texas Department of Aging and Disability Services (DADS)
Correct Answer: C. Health and Human Services Commission (HHSC)
,EXPERT RATIONALE: The HHSC oversees the licensure of nursing home administrators in
Texas following the consolidation of DADS functions into HHSC. It is the regulatory
authority responsible for issuing, renewing, and revoking NHA licenses in the state.
2. The federal law that established the basic framework for nursing home
standards and resident rights is:
A. The Social Security Act of 1935
B. The Older Americans Act of 1965
C. OBRA 1987 (Omnibus Budget Reconciliation Act)
D. The Americans with Disabilities Act of 1990
E. The Medicare Modernization Act of 2003
Correct Answer: C. OBRA 1987 (Omnibus Budget Reconciliation Act)
EXPERT RATIONALE: OBRA 1987 established comprehensive federal requirements for
nursing facilities participating in Medicare and Medicaid, including resident rights,
quality of care standards, staffing requirements, and the RAI/MDS process.
3. A nursing facility resident refuses to take their prescribed medication. The
administrator should ensure staff respond by:
A. Documenting and administering the medication covertly in food
B. Calling the physician to override the refusal
C. Documenting the refusal and notifying the physician and family per care plan
D. Transferring the resident to a psychiatric unit
E. Consulting only the family without involving the resident further
Correct Answer: C. Documenting the refusal and notifying the physician
and family per care plan
,EXPERT RATIONALE: Residents have the right to refuse treatment under federal and
Texas law. Staff must respect this right, document the refusal thoroughly, notify the
attending physician, and involve the care team — never administer medication covertly,
as this violates resident rights and constitutes abuse.
4. Under CMS regulations, the minimum staffing requirement for a Registered
Nurse (RN) in a Medicare/Medicaid-certified nursing facility is:
A. An RN on duty 24 hours a day, 7 days a week
B. An RN on duty at least 8 consecutive hours per day, 7 days a week
C. An RN available on call 24 hours per day
D. An RN on duty at least 16 hours per day
E. An RN present only during the day shift Monday through Friday
Correct Answer: B. An RN on duty at least 8 consecutive hours per day, 7
days a week
EXPERT RATIONALE: Federal regulations (42 CFR §483.35) require that a nursing facility
have an RN on duty at least 8 consecutive hours per day, 7 days a week. Note: CMS has
proposed new minimum staffing rules that may increase this requirement;
administrators must stay current with regulatory updates.
5. The Minimum Data Set (MDS) is best described as:
A. A financial billing tool used only by Medicare contractors
B. A comprehensive assessment instrument used to evaluate the care needs and
health status of nursing facility residents
C. A state-specific form used for admission and discharge planning only
D. A quarterly survey tool completed by surveyors during inspections
E. An optional quality improvement tool available to large facilities
, Correct Answer: B. A comprehensive assessment instrument used to
evaluate the care needs and health status of nursing facility residents
EXPERT RATIONALE: The MDS (Minimum Data Set) is part of the Resident Assessment
Instrument (RAI) mandated by OBRA 1987. It is completed by facility staff and drives care
planning, reimbursement under PDPM, and quality measure reporting.
6. What is the maximum number of days Medicare Part A covers skilled
nursing facility (SNF) care per benefit period?
A. 30 days
B. 60 days
C. 90 days
D. 100 days
E. 120 days
Correct Answer: D. 100 days
EXPERT RATIONALE: Medicare Part A covers up to 100 days of SNF care per benefit
period — days 1–20 are fully covered, and days 21–100 require a daily co-insurance
payment from the beneficiary. After day 100, Medicare provides no coverage.
7. A Texas nursing home administrator must renew their license every:
A. 1 year
B. 2 years
C. 3 years
D. 4 years
E. 5 years
Correct Answer: B. 2 years
LICENSURE EXAM PRACTICE TEST (2026 EDITION)
| COMPREHENSIVE QUESTIONS WITH VERIFIED
ANSWERS & DETAILED RATIONALES | LONG-
TERM CARE ADMINISTRATION SUCCESS GUIDE |
HIGH-YIELD STUDY PDF
TEXAS NURSING HOME ADMINISTRATOR LICENSURE EXAM
PRACTICE TEST — 2026 EDITION
200 Comprehensive Questions | Verified Answers & Detailed EXPERT
RATIONALE
• How to Use This Material: Work through each question independently before
revealing the answer — treat every question as a real exam item, review the
EXPERT RATIONALE carefully even when correct, and revisit any topic area where
you miss two or more consecutive questions.
• Features: 200 high-yield questions with verified correct answers, detailed EXPERT
RATIONALE, full A–E options, bold highlights on correct answers, and
comprehensive coverage of all Texas NHA licensure exam domains including
federal and state regulations, resident care, HR, finance, safety, and ethics.
1. Under the Texas Health & Safety Code, which state agency is primarily
responsible for licensing nursing home administrators in Texas?
A. Texas Department of State Health Services (DSHS)
B. Texas Medical Board (TMB)
C. Health and Human Services Commission (HHSC)
D. Texas Board of Nursing (BON)
E. Texas Department of Aging and Disability Services (DADS)
Correct Answer: C. Health and Human Services Commission (HHSC)
,EXPERT RATIONALE: The HHSC oversees the licensure of nursing home administrators in
Texas following the consolidation of DADS functions into HHSC. It is the regulatory
authority responsible for issuing, renewing, and revoking NHA licenses in the state.
2. The federal law that established the basic framework for nursing home
standards and resident rights is:
A. The Social Security Act of 1935
B. The Older Americans Act of 1965
C. OBRA 1987 (Omnibus Budget Reconciliation Act)
D. The Americans with Disabilities Act of 1990
E. The Medicare Modernization Act of 2003
Correct Answer: C. OBRA 1987 (Omnibus Budget Reconciliation Act)
EXPERT RATIONALE: OBRA 1987 established comprehensive federal requirements for
nursing facilities participating in Medicare and Medicaid, including resident rights,
quality of care standards, staffing requirements, and the RAI/MDS process.
3. A nursing facility resident refuses to take their prescribed medication. The
administrator should ensure staff respond by:
A. Documenting and administering the medication covertly in food
B. Calling the physician to override the refusal
C. Documenting the refusal and notifying the physician and family per care plan
D. Transferring the resident to a psychiatric unit
E. Consulting only the family without involving the resident further
Correct Answer: C. Documenting the refusal and notifying the physician
and family per care plan
,EXPERT RATIONALE: Residents have the right to refuse treatment under federal and
Texas law. Staff must respect this right, document the refusal thoroughly, notify the
attending physician, and involve the care team — never administer medication covertly,
as this violates resident rights and constitutes abuse.
4. Under CMS regulations, the minimum staffing requirement for a Registered
Nurse (RN) in a Medicare/Medicaid-certified nursing facility is:
A. An RN on duty 24 hours a day, 7 days a week
B. An RN on duty at least 8 consecutive hours per day, 7 days a week
C. An RN available on call 24 hours per day
D. An RN on duty at least 16 hours per day
E. An RN present only during the day shift Monday through Friday
Correct Answer: B. An RN on duty at least 8 consecutive hours per day, 7
days a week
EXPERT RATIONALE: Federal regulations (42 CFR §483.35) require that a nursing facility
have an RN on duty at least 8 consecutive hours per day, 7 days a week. Note: CMS has
proposed new minimum staffing rules that may increase this requirement;
administrators must stay current with regulatory updates.
5. The Minimum Data Set (MDS) is best described as:
A. A financial billing tool used only by Medicare contractors
B. A comprehensive assessment instrument used to evaluate the care needs and
health status of nursing facility residents
C. A state-specific form used for admission and discharge planning only
D. A quarterly survey tool completed by surveyors during inspections
E. An optional quality improvement tool available to large facilities
, Correct Answer: B. A comprehensive assessment instrument used to
evaluate the care needs and health status of nursing facility residents
EXPERT RATIONALE: The MDS (Minimum Data Set) is part of the Resident Assessment
Instrument (RAI) mandated by OBRA 1987. It is completed by facility staff and drives care
planning, reimbursement under PDPM, and quality measure reporting.
6. What is the maximum number of days Medicare Part A covers skilled
nursing facility (SNF) care per benefit period?
A. 30 days
B. 60 days
C. 90 days
D. 100 days
E. 120 days
Correct Answer: D. 100 days
EXPERT RATIONALE: Medicare Part A covers up to 100 days of SNF care per benefit
period — days 1–20 are fully covered, and days 21–100 require a daily co-insurance
payment from the beneficiary. After day 100, Medicare provides no coverage.
7. A Texas nursing home administrator must renew their license every:
A. 1 year
B. 2 years
C. 3 years
D. 4 years
E. 5 years
Correct Answer: B. 2 years
