Exam #1: Case Management exam
questions with correct answers
2025/2026
Save
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
How are clinical pathways used? (3) correct answers 1. Permanent part of medical
record
2. Used in lieu of Care Plan and Orders
3. The nurse in charge and the attending physician will select the appropriate on
admission
questions with correct answers
2025/2026
Save
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
How are clinical pathways used? (3) correct answers 1. Permanent part of medical
record
2. Used in lieu of Care Plan and Orders
3. The nurse in charge and the attending physician will select the appropriate on
admission
