Case Manager Certification Exam (CNML) Questions With
Complete Solutions
1. Provider
2. Services
3. Setting
4. Time
5. Cost Correct Answers 5 rights of utilization review
211 Correct Answers federally funded support referral services
and crisis management.
25 Correct Answers the dollar amount the gifts are limited to to
avoid conflict of interest
4 parts of clinical pathway Correct Answers 1. timeline
2. categories of care/activities and interventions
3. intermediate and long term outcome criteria
4. variance tracking
are 4 parts of what?
55 Correct Answers Medicare will begin coverage of home
oxygen with an arterial blood gas result at or above a partial
pressure of ___mm Hg while at rest on room air.
80% Correct Answers medicare covers what percent?
80% Correct Answers Medicare Part B only covers what
percent?
,88 Correct Answers medicare will cover home oxygen if O2
sat is at or below _____% while at rest on room air, exercising
on room air or while asleep or a greater than normal fall in
oxygen level during sleep (a decrease in arterial PO 2 more than
10 mm Hg, or decrease in arterial oxygen saturation more than
5%) associated with symptoms or signs reasonably attributable
to hypoxemia (e.g., impairment of cognitive processes and
nocturnal restlessness or insomnia).
A Correct Answers What part of Medicare covers skilled
nursing facility?
abandonment Correct Answers willful neglect of responsibility
of another person by a person who is assigned to care for that
patient or by a person in a caregiving position.
access, inspect, copy Correct Answers HIPAA individual right
#3 is the individual's right to their health information to do
what?
accountable care organizations Correct Answers groups of
doctors, hospitals, and other health care providers, who come
together voluntarily to give coordinated high quality care to their
Medicare patients.They decrease fragmentation and improve
collaboration. Created from the affordable care act. "medical
neighborhood"
Acute care Correct Answers A hospital the largest Healthcare
setting in the United States. Case managers need to ensure tests
are done in a timely meander results are given to provider and
Healthcare team determines the next step.
,ad litem Correct Answers guardianship appointed to represent a
child when the parents conflict or in situations such as abuse.
adults Correct Answers These learners are autonomous, goal
and relevancy oriented, have experience, care about what is
practical and need respect.
advanced directive Correct Answers written statement of
medical wishes in the future in the event they are unable to make
decisions for themselves. It includes a living will or a durable
power of attorney.
affordable care act Correct Answers this law in 2010 created
the innovation center with in the center for medicare and
medicaid services which assists with research regarding quality.
aggregate data Correct Answers data that has a common
variable. An example would be diabetes.
all patient refined diagnosis related groups (APDRG) Correct
Answers type of payment with 2 subclasses based on 1. severity
of illness (organ system failure or loss of funtion and 2. risk of
mortality
Americans with disabilities act Correct Answers this act
established in 1990 has 5 titles.
companies cannot discriminate and must make reasonable
accommodations if they have 15 or more employees, must have
access to public transportation, have access to
, telecommunication devices, and seek restitution for damage
caused by inaccessibility of services.
Appeal Correct Answers A formal way of lodging a
disagreement with a claim payment or benefit denial
arthritis impact measurement scales Correct Answers health
risk assessment: Disease-specific measure of physical, social,
and emotional well-being designed as a measure of outcome in
arthritis.
-scales: mobility, physical activity (walking, bending, lifting),
dexterity, household activity (managing money and medications,
housekeeping), social activities, activities of daily living, pain,
depression, and anxiety.
Score range: Range is 0-10 for each section. Total health score
0-60.
--> Zero represents good health status, 10 and 60 represent poor
health status.
Assess, plan, implement/intervention, monitor/evaluation
Correct Answers 4 stages of case management
assult Correct Answers an intentional tort/act of threatening or
attempting to touch without consent.
autonomy Correct Answers respecting the individual's right to
make their own decisions
Autonomy vs. shame Correct Answers Erickson 1 1/5-3
Complete Solutions
1. Provider
2. Services
3. Setting
4. Time
5. Cost Correct Answers 5 rights of utilization review
211 Correct Answers federally funded support referral services
and crisis management.
25 Correct Answers the dollar amount the gifts are limited to to
avoid conflict of interest
4 parts of clinical pathway Correct Answers 1. timeline
2. categories of care/activities and interventions
3. intermediate and long term outcome criteria
4. variance tracking
are 4 parts of what?
55 Correct Answers Medicare will begin coverage of home
oxygen with an arterial blood gas result at or above a partial
pressure of ___mm Hg while at rest on room air.
80% Correct Answers medicare covers what percent?
80% Correct Answers Medicare Part B only covers what
percent?
,88 Correct Answers medicare will cover home oxygen if O2
sat is at or below _____% while at rest on room air, exercising
on room air or while asleep or a greater than normal fall in
oxygen level during sleep (a decrease in arterial PO 2 more than
10 mm Hg, or decrease in arterial oxygen saturation more than
5%) associated with symptoms or signs reasonably attributable
to hypoxemia (e.g., impairment of cognitive processes and
nocturnal restlessness or insomnia).
A Correct Answers What part of Medicare covers skilled
nursing facility?
abandonment Correct Answers willful neglect of responsibility
of another person by a person who is assigned to care for that
patient or by a person in a caregiving position.
access, inspect, copy Correct Answers HIPAA individual right
#3 is the individual's right to their health information to do
what?
accountable care organizations Correct Answers groups of
doctors, hospitals, and other health care providers, who come
together voluntarily to give coordinated high quality care to their
Medicare patients.They decrease fragmentation and improve
collaboration. Created from the affordable care act. "medical
neighborhood"
Acute care Correct Answers A hospital the largest Healthcare
setting in the United States. Case managers need to ensure tests
are done in a timely meander results are given to provider and
Healthcare team determines the next step.
,ad litem Correct Answers guardianship appointed to represent a
child when the parents conflict or in situations such as abuse.
adults Correct Answers These learners are autonomous, goal
and relevancy oriented, have experience, care about what is
practical and need respect.
advanced directive Correct Answers written statement of
medical wishes in the future in the event they are unable to make
decisions for themselves. It includes a living will or a durable
power of attorney.
affordable care act Correct Answers this law in 2010 created
the innovation center with in the center for medicare and
medicaid services which assists with research regarding quality.
aggregate data Correct Answers data that has a common
variable. An example would be diabetes.
all patient refined diagnosis related groups (APDRG) Correct
Answers type of payment with 2 subclasses based on 1. severity
of illness (organ system failure or loss of funtion and 2. risk of
mortality
Americans with disabilities act Correct Answers this act
established in 1990 has 5 titles.
companies cannot discriminate and must make reasonable
accommodations if they have 15 or more employees, must have
access to public transportation, have access to
, telecommunication devices, and seek restitution for damage
caused by inaccessibility of services.
Appeal Correct Answers A formal way of lodging a
disagreement with a claim payment or benefit denial
arthritis impact measurement scales Correct Answers health
risk assessment: Disease-specific measure of physical, social,
and emotional well-being designed as a measure of outcome in
arthritis.
-scales: mobility, physical activity (walking, bending, lifting),
dexterity, household activity (managing money and medications,
housekeeping), social activities, activities of daily living, pain,
depression, and anxiety.
Score range: Range is 0-10 for each section. Total health score
0-60.
--> Zero represents good health status, 10 and 60 represent poor
health status.
Assess, plan, implement/intervention, monitor/evaluation
Correct Answers 4 stages of case management
assult Correct Answers an intentional tort/act of threatening or
attempting to touch without consent.
autonomy Correct Answers respecting the individual's right to
make their own decisions
Autonomy vs. shame Correct Answers Erickson 1 1/5-3
