Exam #1: Case Management Test
With Questions and Answers
2025/2026
What is a case manager accountable for? - Correct Answers-The case manager
is accountable for collaboratively facilitating the assessment, planning,
implementation and evaluation of care coordination and care transitions in the
acute care setting.
What are case managers advocates for? - Correct Answers-Nurse case
managers serve as advocates for options and services to meet the patient and
family needs, while promoting quality, cost effective outcomes for the assigned
case types.
What are 5 key functions and responsibilities of a case manager? - Correct
Answers-1. Coordination and facilitation of care
2. Utilization and resource management
3. Tracking of avoidable delays
4. Transitional and discharge planning
5. Quality and process improvement
A nurse case manager must encompass a knowledge of the health care
environment with regards to what 4 aspects? - Correct Answers-1. Clinical
2. Business/Financial
3. Managerial
4. Professionalism
In the clinical setting, what type of assessment does the case manager
perform? - Correct Answers-Patient and family interview and review of medical
record
What type of planning is performed by the case manager in a clinical setting? -
Correct Answers-Consult with the physician, health care team and
patient/family - develop plan of care to facilitate a timely discharge /transition
plan
What type of implementation is performed by the case manager in the clinical
setting? - Correct Answers-Implements the plan of care in a timely manner to
facilitate accomplishment of goals and interventions.
What type of evaluations do case managers perform in the clinical setting? -
Correct Answers-Reassessment for any decline in status and plan revisions
, What are 4 roles of the case manager in managing business/financial
concerns? - Correct Answers-1. Ensure that the level of care is appropriate and
services are medically necessary
2. Proactively identify delays in care, delays in discharge and risk of
readmission
3. Maintain competence of utilization review (inpatient vs. observation status)
4. Document avoidable delays/days
What are 5 managerial duties of the case manager? - Correct Answers-1. A
nurse case manager must display leadership skills in decision making and
problem solving
2. Must actively participate in Interdisciplinary Team Meetings and maintain
open communication with physicians
3. Strive to make productive use of time through the setting of priorities
4. Foster an environment of professionalism
5. Utilize the Chain of Command effectively in addressing complex/unusual
situations
What are 5 key points that the case manager is responsible for in instituting
professionalism in the profession? - Correct Answers-1. Integrate high ethical
standards and core values
2. Hold self and others accountable
3. Perform work in an accurate and timely manner
4. Serve as a role model and mentor
5. Maintain current clinical knowledge and leadership skills
What is a clinical pathway? - Correct Answers-A clinical pathway is a map of
clinical practice for a particular diagnosis - also known as care maps. It is a
timeline for patient care activities which is used by all disciplines
What are clinical pathways used to achieve? - Correct Answers-Clinical
pathways have emerged as a popular method to standardize care while
reducing costs and improving quality of care
What term has Cone Health renamed their clinical pathways and why? -
Correct Answers-Cone Health has renamed them to "Patient Care Plan" in an
attempt to make them more individualized
What are 3 advantages of clinical pathways? - Correct Answers-1. Enhances
interdisciplinary collaboration
2. Helps to reduce unnecessary variations in patient care and outcomes,
improving quality
3. A tool to incorporate local and national guidelines into everyday practices
With Questions and Answers
2025/2026
What is a case manager accountable for? - Correct Answers-The case manager
is accountable for collaboratively facilitating the assessment, planning,
implementation and evaluation of care coordination and care transitions in the
acute care setting.
What are case managers advocates for? - Correct Answers-Nurse case
managers serve as advocates for options and services to meet the patient and
family needs, while promoting quality, cost effective outcomes for the assigned
case types.
What are 5 key functions and responsibilities of a case manager? - Correct
Answers-1. Coordination and facilitation of care
2. Utilization and resource management
3. Tracking of avoidable delays
4. Transitional and discharge planning
5. Quality and process improvement
A nurse case manager must encompass a knowledge of the health care
environment with regards to what 4 aspects? - Correct Answers-1. Clinical
2. Business/Financial
3. Managerial
4. Professionalism
In the clinical setting, what type of assessment does the case manager
perform? - Correct Answers-Patient and family interview and review of medical
record
What type of planning is performed by the case manager in a clinical setting? -
Correct Answers-Consult with the physician, health care team and
patient/family - develop plan of care to facilitate a timely discharge /transition
plan
What type of implementation is performed by the case manager in the clinical
setting? - Correct Answers-Implements the plan of care in a timely manner to
facilitate accomplishment of goals and interventions.
What type of evaluations do case managers perform in the clinical setting? -
Correct Answers-Reassessment for any decline in status and plan revisions
, What are 4 roles of the case manager in managing business/financial
concerns? - Correct Answers-1. Ensure that the level of care is appropriate and
services are medically necessary
2. Proactively identify delays in care, delays in discharge and risk of
readmission
3. Maintain competence of utilization review (inpatient vs. observation status)
4. Document avoidable delays/days
What are 5 managerial duties of the case manager? - Correct Answers-1. A
nurse case manager must display leadership skills in decision making and
problem solving
2. Must actively participate in Interdisciplinary Team Meetings and maintain
open communication with physicians
3. Strive to make productive use of time through the setting of priorities
4. Foster an environment of professionalism
5. Utilize the Chain of Command effectively in addressing complex/unusual
situations
What are 5 key points that the case manager is responsible for in instituting
professionalism in the profession? - Correct Answers-1. Integrate high ethical
standards and core values
2. Hold self and others accountable
3. Perform work in an accurate and timely manner
4. Serve as a role model and mentor
5. Maintain current clinical knowledge and leadership skills
What is a clinical pathway? - Correct Answers-A clinical pathway is a map of
clinical practice for a particular diagnosis - also known as care maps. It is a
timeline for patient care activities which is used by all disciplines
What are clinical pathways used to achieve? - Correct Answers-Clinical
pathways have emerged as a popular method to standardize care while
reducing costs and improving quality of care
What term has Cone Health renamed their clinical pathways and why? -
Correct Answers-Cone Health has renamed them to "Patient Care Plan" in an
attempt to make them more individualized
What are 3 advantages of clinical pathways? - Correct Answers-1. Enhances
interdisciplinary collaboration
2. Helps to reduce unnecessary variations in patient care and outcomes,
improving quality
3. A tool to incorporate local and national guidelines into everyday practices
