Case Management Nursing (CMGT-BC) Practice
Examination 100% Verified Answers LATEST
UPDATE
1. A case manager is reviewing the definition of case management according to
the Case Management Society of America (CMSA). Which statement best
captures the philosophy?
A) Case management is primarily a utilization review function to reduce costs
B) Case management is a collaborative process of assessment, planning,
facilitation, care coordination, evaluation, and advocacy to meet an individual’s
and family’s comprehensive health needs
C) Case management focuses solely on discharge planning from acute care
D) Case management is a gatekeeping role to deny unnecessary services
Answer: B
Rationale: CMSA defines case management as a collaborative process that
includes assessment, planning, facilitation, care coordination, evaluation, and
advocacy. It is holistic and person-centered, not limited to utilization review or
discharge.
2. A case manager is applying the “Case Management Process.” After completing
a comprehensive assessment, the next step is:
A) Closing the case
B) Developing a plan of care with the patient and family
C) Filing a report with the insurance company
,D) Referring the patient to a specialist
Answer: B
Rationale: The standard case management process follows:
screening/identification, assessment, planning, implementation (care
coordination), monitoring/evaluation, and transition or closure. Planning with the
patient follows assessment.
3. A patient with multiple chronic conditions is enrolled in a case management
program. Which screening tool is commonly used to identify patients who would
benefit from case management?
A) Braden Scale
B) Morse Fall Scale
C) Health Risk Assessment (HRA) or predictive risk modeling
D) Glasgow Coma Scale
Answer: C
Rationale: Health risk assessments and risk stratification tools are used to identify
high-risk, high-cost patients appropriate for case management. Braden and Morse
are specific to pressure injuries and falls.
4. A case manager is coordinating care for a patient transitioning from hospital to
home. The patient will require home health services, durable medical equipment
(DME), and transportation to follow-up visits. The best term for this coordinated
set of services is:
A) Continuum of care
B) Episode of care
,C) Integrated care delivery
D) Care coordination across the continuum
Answer: D
Rationale: Care coordination across the continuum involves deliberately
organizing patient care activities and sharing information among all participants
to achieve safer and more effective transitions.
5. The case manager is educating a patient about advance directives. The
document that designates a healthcare proxy to make decisions when the patient
is incapacitated is the:
A) Living will
B) Durable power of attorney for healthcare
C) Do-not-resuscitate (DNR) order
D) Physician Orders for Life-Sustaining Treatment (POLST)
Answer: B
Rationale: A durable power of attorney for healthcare (or healthcare proxy)
appoints an individual to make medical decisions if the patient cannot. A living
will (A) states wishes; POLST (D) translates those wishes into medical orders.
6. A case manager is using motivational interviewing to help a patient with
diabetes improve adherence. Which statement best demonstrates the spirit of
motivational interviewing?
A) “You must start taking your insulin or you'll end up in the hospital.”
B) “What do you feel is the biggest barrier to taking your medication, and how
might we work through it?”
, C) “I will tell you exactly what to do to control your blood sugar.”
D) “It’s your choice, but I don’t think you care about your health.”
Answer: B
Rationale: Motivational interviewing explores ambivalence and elicits the
patient’s own motivations and barriers in a nonjudgmental, collaborative manner.
7. A case manager is completing an initial assessment and asks about housing,
food security, and transportation. These are known as:
A) Clinical risk factors
B) Social determinants of health
C) Medical comorbidities
D) Advanced care planning
Answer: B
Rationale: Social determinants of health include economic stability, education,
social and community context, health and healthcare access, and neighborhood
environment—all of which affect health outcomes.
8. A patient with end-stage heart failure decides to forego further aggressive
treatment and focus on comfort. The case manager’s priority is to:
A) Encourage the patient to reconsider
B) Advocate for the patient’s wishes and facilitate referral to palliative care or
hospice
C) Tell the family they must agree with the decision
D) Ensure the patient signs out against medical advice
Examination 100% Verified Answers LATEST
UPDATE
1. A case manager is reviewing the definition of case management according to
the Case Management Society of America (CMSA). Which statement best
captures the philosophy?
A) Case management is primarily a utilization review function to reduce costs
B) Case management is a collaborative process of assessment, planning,
facilitation, care coordination, evaluation, and advocacy to meet an individual’s
and family’s comprehensive health needs
C) Case management focuses solely on discharge planning from acute care
D) Case management is a gatekeeping role to deny unnecessary services
Answer: B
Rationale: CMSA defines case management as a collaborative process that
includes assessment, planning, facilitation, care coordination, evaluation, and
advocacy. It is holistic and person-centered, not limited to utilization review or
discharge.
2. A case manager is applying the “Case Management Process.” After completing
a comprehensive assessment, the next step is:
A) Closing the case
B) Developing a plan of care with the patient and family
C) Filing a report with the insurance company
,D) Referring the patient to a specialist
Answer: B
Rationale: The standard case management process follows:
screening/identification, assessment, planning, implementation (care
coordination), monitoring/evaluation, and transition or closure. Planning with the
patient follows assessment.
3. A patient with multiple chronic conditions is enrolled in a case management
program. Which screening tool is commonly used to identify patients who would
benefit from case management?
A) Braden Scale
B) Morse Fall Scale
C) Health Risk Assessment (HRA) or predictive risk modeling
D) Glasgow Coma Scale
Answer: C
Rationale: Health risk assessments and risk stratification tools are used to identify
high-risk, high-cost patients appropriate for case management. Braden and Morse
are specific to pressure injuries and falls.
4. A case manager is coordinating care for a patient transitioning from hospital to
home. The patient will require home health services, durable medical equipment
(DME), and transportation to follow-up visits. The best term for this coordinated
set of services is:
A) Continuum of care
B) Episode of care
,C) Integrated care delivery
D) Care coordination across the continuum
Answer: D
Rationale: Care coordination across the continuum involves deliberately
organizing patient care activities and sharing information among all participants
to achieve safer and more effective transitions.
5. The case manager is educating a patient about advance directives. The
document that designates a healthcare proxy to make decisions when the patient
is incapacitated is the:
A) Living will
B) Durable power of attorney for healthcare
C) Do-not-resuscitate (DNR) order
D) Physician Orders for Life-Sustaining Treatment (POLST)
Answer: B
Rationale: A durable power of attorney for healthcare (or healthcare proxy)
appoints an individual to make medical decisions if the patient cannot. A living
will (A) states wishes; POLST (D) translates those wishes into medical orders.
6. A case manager is using motivational interviewing to help a patient with
diabetes improve adherence. Which statement best demonstrates the spirit of
motivational interviewing?
A) “You must start taking your insulin or you'll end up in the hospital.”
B) “What do you feel is the biggest barrier to taking your medication, and how
might we work through it?”
, C) “I will tell you exactly what to do to control your blood sugar.”
D) “It’s your choice, but I don’t think you care about your health.”
Answer: B
Rationale: Motivational interviewing explores ambivalence and elicits the
patient’s own motivations and barriers in a nonjudgmental, collaborative manner.
7. A case manager is completing an initial assessment and asks about housing,
food security, and transportation. These are known as:
A) Clinical risk factors
B) Social determinants of health
C) Medical comorbidities
D) Advanced care planning
Answer: B
Rationale: Social determinants of health include economic stability, education,
social and community context, health and healthcare access, and neighborhood
environment—all of which affect health outcomes.
8. A patient with end-stage heart failure decides to forego further aggressive
treatment and focus on comfort. The case manager’s priority is to:
A) Encourage the patient to reconsider
B) Advocate for the patient’s wishes and facilitate referral to palliative care or
hospice
C) Tell the family they must agree with the decision
D) Ensure the patient signs out against medical advice
