RN Care Management Competency
Exam — Code: RN-CM-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
A 78-year-old patient with heart failure is being discharged after treatment for
fluid overload. During medication reconciliation, the patient states, “I take the
blue water pill when my ankles swell,” but cannot identify the medication name
or dose. What is the nurse’s priority action?
A. Document that the patient has limited medication knowledge
B. Ask the patient to bring all medications to the follow-up appointment
C. Clarify the medication regimen and reconcile all medications before discharge
D. Teach the patient to recognize medications by color
,Answer: C. Clarify the medication regimen and reconcile all medications before
discharge
Rationale: Medication reconciliation identifies discrepancies, duplications,
omissions, and incorrect dosing that can contribute to readmission. Color-based
identification is unreliable, and waiting until follow-up leaves the patient at risk
after discharge.
2.
A patient with chronic obstructive pulmonary disease has been hospitalized three
times in six months. Which care-management intervention is most likely to
reduce preventable readmissions?
A. Schedule routine laboratory testing every month
B. Develop an individualized transition plan addressing medications, symptoms,
follow-up, and self-management
C. Encourage the patient to return to the emergency department for worsening
symptoms
D. Restrict family participation in discharge planning
Answer: B. Develop an individualized transition plan addressing medications,
symptoms, follow-up, and self-management
Rationale: Effective transitional care addresses clinical needs, medication
management, early recognition of deterioration, follow-up, and patient self-
management.
3.
A nurse case manager identifies that a patient repeatedly misses specialty
appointments because transportation is unavailable. Which intervention is most
appropriate?
,A. Document patient noncompliance
B. Tell the patient to arrange transportation independently
C. Coordinate an appropriate transportation resource and reassess barriers to
appointment attendance
D. Cancel the specialty referral
Answer: C. Coordinate an appropriate transportation resource and reassess
barriers to appointment attendance
Rationale: Care management addresses social determinants and barriers that
interfere with access to care rather than labeling the patient as noncompliant.
4.
A patient with diabetes has an A1C of 11.2% and reports difficulty affording
insulin. What should the care manager do first?
A. Recommend that the patient reduce insulin doses
B. Assess medication-access barriers and coordinate appropriate financial or
assistance resources
C. Tell the patient that adherence is required
D. Recommend purchasing insulin from an unverified online source
Answer: B. Assess medication-access barriers and coordinate appropriate
financial or assistance resources
Rationale: Cost-related medication nonadherence requires assessment and
resource coordination. The nurse should never independently instruct a patient
to alter prescribed insulin therapy.
5.
Which patient should receive the highest priority for care-management
intervention?
, A. Patient requesting educational materials about exercise
B. Patient with stable hypertension who attends all appointments
C. Patient discharged yesterday who has no medications, no follow-up
appointment, and worsening symptoms
D. Patient requesting information about wellness programs
Answer: C. Patient discharged yesterday who has no medications, no follow-up
appointment, and worsening symptoms
Rationale: This patient has multiple immediate risks for clinical deterioration
and readmission, requiring rapid intervention and coordination.
6.
A nurse is developing a care plan with a patient who has chronic kidney disease.
Which goal is most appropriate?
A. “Patient will understand kidney disease.”
B. “Patient will comply with all recommendations.”
C. “Patient will accurately describe the prescribed medication regimen and
identify symptoms requiring prompt evaluation.”
D. “Patient will avoid all complications.”
Answer: C. “Patient will accurately describe the prescribed medication regimen
and identify symptoms requiring prompt evaluation.”
Rationale: Effective care-management goals are specific, measurable, patient-
centered, and achievable.
7.
A patient with heart failure reports gaining 3 kg over several days. Which action
should the care manager prioritize?
Exam — Code: RN-CM-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
A 78-year-old patient with heart failure is being discharged after treatment for
fluid overload. During medication reconciliation, the patient states, “I take the
blue water pill when my ankles swell,” but cannot identify the medication name
or dose. What is the nurse’s priority action?
A. Document that the patient has limited medication knowledge
B. Ask the patient to bring all medications to the follow-up appointment
C. Clarify the medication regimen and reconcile all medications before discharge
D. Teach the patient to recognize medications by color
,Answer: C. Clarify the medication regimen and reconcile all medications before
discharge
Rationale: Medication reconciliation identifies discrepancies, duplications,
omissions, and incorrect dosing that can contribute to readmission. Color-based
identification is unreliable, and waiting until follow-up leaves the patient at risk
after discharge.
2.
A patient with chronic obstructive pulmonary disease has been hospitalized three
times in six months. Which care-management intervention is most likely to
reduce preventable readmissions?
A. Schedule routine laboratory testing every month
B. Develop an individualized transition plan addressing medications, symptoms,
follow-up, and self-management
C. Encourage the patient to return to the emergency department for worsening
symptoms
D. Restrict family participation in discharge planning
Answer: B. Develop an individualized transition plan addressing medications,
symptoms, follow-up, and self-management
Rationale: Effective transitional care addresses clinical needs, medication
management, early recognition of deterioration, follow-up, and patient self-
management.
3.
A nurse case manager identifies that a patient repeatedly misses specialty
appointments because transportation is unavailable. Which intervention is most
appropriate?
,A. Document patient noncompliance
B. Tell the patient to arrange transportation independently
C. Coordinate an appropriate transportation resource and reassess barriers to
appointment attendance
D. Cancel the specialty referral
Answer: C. Coordinate an appropriate transportation resource and reassess
barriers to appointment attendance
Rationale: Care management addresses social determinants and barriers that
interfere with access to care rather than labeling the patient as noncompliant.
4.
A patient with diabetes has an A1C of 11.2% and reports difficulty affording
insulin. What should the care manager do first?
A. Recommend that the patient reduce insulin doses
B. Assess medication-access barriers and coordinate appropriate financial or
assistance resources
C. Tell the patient that adherence is required
D. Recommend purchasing insulin from an unverified online source
Answer: B. Assess medication-access barriers and coordinate appropriate
financial or assistance resources
Rationale: Cost-related medication nonadherence requires assessment and
resource coordination. The nurse should never independently instruct a patient
to alter prescribed insulin therapy.
5.
Which patient should receive the highest priority for care-management
intervention?
, A. Patient requesting educational materials about exercise
B. Patient with stable hypertension who attends all appointments
C. Patient discharged yesterday who has no medications, no follow-up
appointment, and worsening symptoms
D. Patient requesting information about wellness programs
Answer: C. Patient discharged yesterday who has no medications, no follow-up
appointment, and worsening symptoms
Rationale: This patient has multiple immediate risks for clinical deterioration
and readmission, requiring rapid intervention and coordination.
6.
A nurse is developing a care plan with a patient who has chronic kidney disease.
Which goal is most appropriate?
A. “Patient will understand kidney disease.”
B. “Patient will comply with all recommendations.”
C. “Patient will accurately describe the prescribed medication regimen and
identify symptoms requiring prompt evaluation.”
D. “Patient will avoid all complications.”
Answer: C. “Patient will accurately describe the prescribed medication regimen
and identify symptoms requiring prompt evaluation.”
Rationale: Effective care-management goals are specific, measurable, patient-
centered, and achievable.
7.
A patient with heart failure reports gaining 3 kg over several days. Which action
should the care manager prioritize?
