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These 10 free ALNC questions are organized by exam domain, so you can see how each part of the Assisted Living Nurse Certification blueprint is tested. Reveal the answer and explanation under each question.
A resident's medication list includes oxybutynin, furosemide, sertraline, and donepezil. She develops dry mouth, blurred vision, constipation, and frequent small urinary leaks despite a sense that her bladder remains full. Which medication-effect pairing best explains the cluster?
Correct answer: A - Oxybutynin causing anticholinergic effects
Using her usual walker and footwear, a resident completes a correctly performed Timed Up and Go in 16 seconds. She rises and turns without hands-on assistance, denies dizziness, and has no acute change in condition. The finding supports which addition to her care plan?
Correct answer: B - Assess modifiable fall risks while supporting mobility at her assessed level.
Thirty days ago, a resident weighed 150 lb; today two measurements on the same scale confirm 141 lb. She has no edema or diuretic change and is not trying to lose weight. Painful hand arthritis prevents her from opening meal packages, but she feeds herself once they are opened. Her care plan requires provider notification for a loss of at least 5% in 30 days. Which entry combines the correct calculation with the most appropriate initial response?
Correct answer: A - 6.0% loss; notify the provider and add meal setup while preserving self-feeding.
At yesterday's evening meal, a resident with Alzheimer's disease talked with tablemates and fed herself after setup. By breakfast, she is unusually quiet, repeatedly loses track of a brief conversation, and dozes between questions. Her alertness varies over the next hour. Which interpretation best accounts for this change from baseline?
Correct answer: C - Hypoactive delirium superimposed on dementia
During morning rounds, a nurse finds an insulin-treated resident difficult to arouse. Blood glucose is 42 mg/dL. The resident is breathing but cannot follow instructions or swallow safely. A second staff member is present, and prescribed emergency glucagon is immediately available. Which response addresses the immediate danger?
Correct answer: D - Have the colleague activate EMS while administering prescribed glucagon and supporting the airway.
A urine culture ordered after staff noticed stronger urine odor grows bacteria in an 83-year-old resident. There is no dysuria, new urgency, suprapubic or flank pain, fever, or change in usual cognition or function. Vital signs are unchanged, and no urologic procedure is planned. When discussing the result with the prescriber, which recommendation is supported?
Correct answer: C - Avoid antibiotics for this finding alone; monitor for new attributable symptoms.
Over two weeks, an assisted living resident has lost interest in activities and reports poor sleep and low energy. Her PHQ-9 score is 13. The death/self-harm item is scored 0; direct questioning identifies no wish to die, intent, or plan. She remains able to participate in daily routines. How should the nurse use this result?
Correct answer: D - Document moderate depressive symptoms and arrange a fuller clinical assessment.
An LPN reviews records before a resident's first medication pass after hospitalization. The discharge list includes apixaban, while the prehospital medication administration record lists warfarin. The paperwork does not establish whether warfarin was stopped, when the last inpatient anticoagulant dose was given, or when apixaban should begin. The resident is stable, and no anticoagulant has been given since arrival. How should today's regimen be established?
Correct answer: D - Clarify the intended regimen and dose timing with the prescriber and pharmacist before administration.
In a provider-controlled assisted living residence subject to Medicaid home and community-based services (HCBS) settings requirements, one resident has a choking episode while eating at night. The administrator proposes prohibiting food access for every resident from 8 p.m. to 6 a.m. Which revision addresses the safety concern without imposing an improper restriction?
Correct answer: A - Preserve food access and address the affected resident's swallowing needs through an individualized service plan.
Under the applicable state rules, an RN has delegated routine assistance with an established meal plan to a trained aide. The aide's competence is current, directions are clear, and the RN is available. A resident who previously ate without difficulty begins coughing and develops a wet-sounding voice with drinks. The aide stops feeding and reports the change. Which delegation requirement is affected by the resident's new findings?
Correct answer: B - Right circumstance
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