CCM practice questions: Case Management Concepts & Care Delivery Flashcards
A patient underwent cardiac surgery and is given instructions to rest from their physician. Which of the following actions would NOT promote the goals of case management?
a) completing a medical reconciliation against the discharge papers
b) finding transportation for the patient for medical appointments
c) allowing the patient to rest while the CCM meets with providers
d) researching lower-cost medications
c) correct.
Although the patient is supposed to rest, the CCM should promote autonomy and self-advocacy. the CCM should encourage the patient to play an active role in their health care management.
a) incorrect. The CCM wants to ensure that the patient is not at risk for readmission to the hospital and has all the correct medications.
b) incorrect. The CCm’s goal is to ensure the patient has the optimum level of care.
d) incorrect. The CCM wishes to lower health care costs.
The CCM calls the client’s doctor to ask if a fax was received from the pharmacist regarding a discrepancy in the hospital discharge summary. This is an example of which phase in the case management process?
a) planning
b) assessing
c) evaluation
d) following up
d) correct.
The CCM followed up with the physician to resolve a gap in care.
a) incorrect. The CCM is not planning.
b) incorrect. This is not the assessing phase.
c) incorrect. This action is not part of the evaluation phase.
The client had routine labs drawn, and his goal was to achieve an A1c Value of 6. The lab value was 7, so the goal was not achieved. What type of goal is this?
a) subjective
b) compliant
c) objective
d) mandated
c) correct.
The goal was evidenced by lab values.
a) incorrect. This goal was not strictly perceived by the patient.
b) incorrect. This is not a goal of compliance.
d) incorrect. This goal was not mandated.
What is the primary goal of a CCM in a physician office setting?
a) discharge planning
b) prevention of medical concerns
c) communication with the client’s employer
d) utilization management
b) correct.
Prevention of medical concerns is a primary focus for a physician office CCM.
a) incorrect. A CCM working in a hospital focus on discharge planning.
c) incorrect. Communicating with the employer is a role of a Workers’Compensation CCM.
d) incorrect. Utilization management is more specific to a CCM working in a hospital.
When considering discharge or transitional care planning for a client, the case manager should be familiar with all the following EXCEPT:
a) the client’s admission diagnosis
b) the client’s treatment plan
c) other disciplines consulting on the client’s case
d) the client’s initial stage of hospitalization only
d) correct
The case manager will have thorough knowledge of each stage of the client’s care.
a) incorrect. The case manager can and will review the admission diagnosis, as well as any other diagnoses that are made throughout the health care continuum.
b) incorrect. The case manager can and will continually review/update the client’s treatment plan.
c) incorrect. The case manager is aware of and has reviewed all the consults on the client’s case, as well as their findings and recommendations.
A patient has been admitted to the intensive care unit (ICU) after a heart attack. What level of care is the patient receiving?
a) acute care
b) subacute care
c) transitional care
d) ambulatory care
a) correct
acute care
others are incorrect answers so no rationale.
Mary is a 68-year-old female who was mentally sound and capable of performing ADLs until she suffered a severe stroke one year ago. Mary is now unable to feed or dress and requires assistance with toileting and bathing. At which facility will she most likely receive the care she needs?
a) assisted living facility
b) nursing home
c) group home
d) residential treatment facility
b) correct
a nursing home would be the best option for this client, as she needs a lot of help with feeding, dressing, toileting, and bathing herself.
a) incorrect. An assisted living facility is for independent adults who need minimal assistance with ADLs
c) incorrect. A group home is more appropriate for individuals who require a lot of care and supervision but are somewhat independent.
d) incorrect. A residential treatment facility is the best choice for individuals shoe are trying to overcome substance abuse or addiction.
Which of the following health care providers can prescribe medication?
a) psychologists
b) nurse practitioners
c) registered nurses
d) licensed professional counselors
b) correct
A nurse practitioner can prescribe medication.
The others are incorrect answers. Psychologists, registered nurses, and licensed professional counselors cannot prescribe medications.
Within the interdisciplinary care team (ICT), the role of the case manager is to
a) make a diagnosis
b) refer the client to a specialist
c) coordinate care
d) provide emotional counseling
c) correct
The case manager ensures continuity of care between all providers.
a) incorrect. The attending physician or a specialist provider will make diagnosis.
b) incorrect. The attending physician will refer client to specialists for further assessments.
d) incorrect. While the case manager may provide emotional support, the ICT should include licensed mental health professionals to provide counseling.
Which of the following is an instrumental activity of daily living (iADL)?
a) bathing
b) toileting
c) eating
d) cooking
c) correct
Cooking is considered an instrumental activity of daily living (iADL), as it is associated with necessary functioning throughout the day. the other choices are ADLs.
You are the case manager for a 7-year-old client whose mother reports that he has been acting out, cursing, and throwing tantrums at home, at school, and in public. Which type of behavioral assessment will most likely be conducted?
a) clinical
b) functional
c) mental
d) emotional
a) correct
A clinical behavioral assessment will be conducted on this client, as he is exhibiting similar and inappropriate behaviors in more than one setting.
b) incorrect. a functional behavioral assessment is typically used to explore the causes of specific behavior.
c) incorrect. a mental health assessment is sometimes used interchangeably with a behavioral health assessment but differs from a clinical behavioral health assessment.
d) incorrect. an emotional health assessment would not be appropriate at this time but may serve to determine additional treatment options in the future.
Blanca is the charge nurse for the medical-surgical unit and is making assignments for the oncoming shift. For nursing care, she knows that the higher the acuity level, the
a) higher the nurse-to-client ratio.
b) higher the physician-to-client ratio.
c) lower the nurse-to-client ratio.
d) lower the physician-to-client ratio.
c) correct
If client acuity is high, the nurse will have fewer clients to care for.
a) incorrect. the opposite is correct
b) incorrect.
d) incorrect.
Ratio of physician to client is not relevant to nursing or case management
All of the following could be consequences of noncompliance with a treatment plan EXCEPT
a) improvement of a condition
b) worsening of a condition
c) development of an acute condition
d) death
a) correct
Condition improvement is not likely in the face of treatment plan
b) incorrect. Worsening or exacerbation of a chronic condition will almost always happen during noncompliance.
c) incorrect. The development of an acute condition will almost always happen when a client is noncompliant with a treatment plan.
d) incorrect. Death can sometimes be a consequence of noncompliance with a treatment plan.
The purpose of the complementary nursing care model is to do all of the following EXCEPT
a) decrease the client’s health care costs
b) improve care coordination for the client
c) prevent readmissions of the client to the hospital
d) increase the number of providers the client sees
d) correct
In the complementary nursing care module, care is administered b fewer providers instead of many.
a) incorrect. Complementary nursing supports decreased health care costs
b) incorrect. Complementary nursing results in an improvement in care coordination
c) incorrect. Complementary nursing prevents readmissions
Care coordination for the chronically ill client would rely heavily upon all of the following EXCEPT
a) collaboration among interdisciplinary and multidisciplinary care teams
b) identifying barriers to access to care
c) anticipation of possible post-discharge complications
d) maintaining the same treatment plan throughout care
d) correct
Throughout stages and transitions of care, a chronically ill client’s care plan will change and evolve.
a) incorrect. collaboration within ICT and MCT is essential in caring for chronically ill clients, as each team has valuable input about how to best manage client care.
b) incorrect. identification of barriers to access to care must be done to assess readiness for self-management and discharge.
c) incorrect. The nurse case manager will anticipate possible post-discharge complications while the client is still under his or her care to determine the need for additional care options.
