ATI CBC Level 2 Actual Final Exam –
Practice Edition
Exam Instructions
Number of Questions: 150
Format: Multiple Choice
Answer Key & Rationales: Provided after each question
Domain 1: Case Management & Coordination of Care (Questions 1-25)
Question 1
A community health nurse is coordinating care for a client with complex mental health needs. Which
action best demonstrates the principle of continuity of care?
A) Providing the client with a list of community resources
B) Ensuring the client sees the same provider at each visit
C) Transferring all medical records to the new facility without client consent
D) Discharging the client once acute symptoms resolve
Correct Answer: B
Rationale: Continuity of care is characterized by consistent, uninterrupted care from the same provider
or team. Option B ensures a therapeutic relationship and coordinated treatment. Option A is resource
referral, not continuity. Option C violates HIPAA. Option D is abandonment.
Question 2
A case manager is evaluating a client’s progress toward discharge goals. Which finding indicates a need
for plan modification?
A) The client has attended 80% of scheduled physical therapy sessions
B) The client reports feeling “more anxious than usual”
C) The client’s blood pressure has stabilized within normal limits
D) The client’s family has installed grab bars in the bathroom
Correct Answer: B
Rationale: Increased anxiety may indicate unresolved issues or new stressors, requiring reassessment
and modification of the care plan. Options A, C, and D all indicate positive progress.
,Question 3
Which of the following is the primary responsibility of a nurse case manager in a community setting?
A) Direct bedside care for acutely ill patients
B) Prescribing medications for chronic conditions
C) Facilitating access to services and resources
D) Performing surgical procedures
Correct Answer: C
Rationale: The core role of a case manager is to coordinate services, advocate for clients, and facilitate
access to healthcare and community resources. Direct care (A) is limited; prescribing (B) and surgery (D)
are outside nursing scope unless advanced practice.
Question 4
A nurse is using the SBAR (Situation, Background, Assessment, Recommendation) tool when
communicating with a primary care provider about a client. Which statement represents the
“Recommendation” component?
A) “The client was admitted 3 days ago with pneumonia.”
B) “I think the client needs a chest X-ray and a change in antibiotics.”
C) “The client’s oxygen saturation is 88% on room air.”
D) “The client is a 72-year-old male with a history of COPD.”
Correct Answer: B
Rationale: Recommendation is what you think should happen next. Option B suggests specific actions.
Option A is Background, C is Assessment, D is Background.
Question 5
A community health nurse is planning discharge for a client who is homeless. What is the priority
intervention?
A) Provide a 30-day supply of all medications
B) Arrange shelter placement before discharge
C) Teach the client how to take medications correctly
D) Refer the client to a mental health counselor
Correct Answer: B
Rationale: Maslow’s hierarchy prioritizes basic physiological needs and safety. Without shelter,
medication adherence and health outcomes will be compromised. Securing housing is the priority.
Question 6
Which documentation entry by a case manager is most appropriate?
A) “Client seems noncompliant and difficult as usual.”
B) “Client refused medication stating, ‘I don’t need it anymore.’”
,C) “Client is clearly confused and does not understand instructions.”
D) “Client’s family is uncooperative and causing problems.”
Correct Answer: B
Rationale: Documentation must be objective, factual, and non-judgmental. Option B quotes the client
directly. Options A, C, and D contain subjective opinions and labels.
Question 7
A nurse is managing a caseload of 50 clients. Which task can be delegated to a licensed practical nurse
(LPN)?
A) Initial comprehensive assessment of a new client
B) Development of the nursing care plan
C) Administration of a routine intramuscular injection
D) Evaluation of client goal achievement
Correct Answer: C
Rationale: LPNs can administer medications, including injections, under the supervision of an RN.
Assessment (A), planning (B), and evaluation (D) are responsibilities of the RN.
Question 8
A client with diabetes and heart failure is being discharged. Which action reflects effective transitional
care?
A) Giving the client written instructions only
B) Scheduling a follow-up appointment within 7 days
C) Calling the client 48 hours post-discharge to review medications
D) Relying on the family to explain discharge instructions
Correct Answer: C
Rationale: Transitional care includes proactive follow-up contact to reinforce teaching and identify
issues early. Option C is evidence-based. Option B is important but less immediate. Option A lacks
reinforcement; D shifts responsibility improperly.
Question 9
A case manager identifies that a client has not filled a prescription for an antibiotic due to cost. What is
the most appropriate response?
A) Tell the client to take half doses to make the medication last longer
B) Contact the provider to request a generic or lower-cost alternative
C) Advise the client to skip the medication if symptoms improve
D) Document noncompliance and close the case
Correct Answer: B
Rationale: The nurse advocates for the client by seeking affordable alternatives. Option A is unsafe and
ineffective; C is incorrect; D fails to address the barrier.
, Question 10
Which of the following is an example of vertical integration in healthcare delivery?
A) A hospital that owns a skilled nursing facility and home health agency
B) Two community clinics agreeing to share weekend call coverage
C) A nurse referring a client to a specialty clinic
D) A client using telehealth for a follow-up visit
Correct Answer: A
Rationale: Vertical integration involves a single organization owning multiple levels of care (e.g.,
hospital, SNF, home health). Option B is horizontal integration; C is referral; D is technology use.
Question 11
A nurse is conducting a home visit for a client with mobility issues. Which observation poses the greatest
safety risk?
A) A throw rug in the hallway
B) Handrails in the bathroom
C) Nightlights in the bedroom
D) A raised toilet seat
Correct Answer: A
Rationale: Throw rugs are a fall hazard, especially for clients with mobility issues. Options B, C, and D are
safety enhancements.
Question 12
A client tells the case manager, “I don’t want my family to know my HIV status.” The family asks the
nurse for information. What should the nurse do?
A) Tell the family the client’s status because it affects them
B) Respect client confidentiality and decline to share information
C) Suggest the family ask the client directly
D) Document the request but take no further action
Correct Answer: B
Rationale: HIPAA and ethical principles require protecting client confidentiality unless there is a threat
of harm. Option B is correct; A violates privacy; C is not the nurse’s role to redirect without client
permission.
Question 13
Which indicator best measures the effectiveness of a case management program for clients with
asthma?
A) Number of home visits completed per month
B) Client satisfaction survey scores
Practice Edition
Exam Instructions
Number of Questions: 150
Format: Multiple Choice
Answer Key & Rationales: Provided after each question
Domain 1: Case Management & Coordination of Care (Questions 1-25)
Question 1
A community health nurse is coordinating care for a client with complex mental health needs. Which
action best demonstrates the principle of continuity of care?
A) Providing the client with a list of community resources
B) Ensuring the client sees the same provider at each visit
C) Transferring all medical records to the new facility without client consent
D) Discharging the client once acute symptoms resolve
Correct Answer: B
Rationale: Continuity of care is characterized by consistent, uninterrupted care from the same provider
or team. Option B ensures a therapeutic relationship and coordinated treatment. Option A is resource
referral, not continuity. Option C violates HIPAA. Option D is abandonment.
Question 2
A case manager is evaluating a client’s progress toward discharge goals. Which finding indicates a need
for plan modification?
A) The client has attended 80% of scheduled physical therapy sessions
B) The client reports feeling “more anxious than usual”
C) The client’s blood pressure has stabilized within normal limits
D) The client’s family has installed grab bars in the bathroom
Correct Answer: B
Rationale: Increased anxiety may indicate unresolved issues or new stressors, requiring reassessment
and modification of the care plan. Options A, C, and D all indicate positive progress.
,Question 3
Which of the following is the primary responsibility of a nurse case manager in a community setting?
A) Direct bedside care for acutely ill patients
B) Prescribing medications for chronic conditions
C) Facilitating access to services and resources
D) Performing surgical procedures
Correct Answer: C
Rationale: The core role of a case manager is to coordinate services, advocate for clients, and facilitate
access to healthcare and community resources. Direct care (A) is limited; prescribing (B) and surgery (D)
are outside nursing scope unless advanced practice.
Question 4
A nurse is using the SBAR (Situation, Background, Assessment, Recommendation) tool when
communicating with a primary care provider about a client. Which statement represents the
“Recommendation” component?
A) “The client was admitted 3 days ago with pneumonia.”
B) “I think the client needs a chest X-ray and a change in antibiotics.”
C) “The client’s oxygen saturation is 88% on room air.”
D) “The client is a 72-year-old male with a history of COPD.”
Correct Answer: B
Rationale: Recommendation is what you think should happen next. Option B suggests specific actions.
Option A is Background, C is Assessment, D is Background.
Question 5
A community health nurse is planning discharge for a client who is homeless. What is the priority
intervention?
A) Provide a 30-day supply of all medications
B) Arrange shelter placement before discharge
C) Teach the client how to take medications correctly
D) Refer the client to a mental health counselor
Correct Answer: B
Rationale: Maslow’s hierarchy prioritizes basic physiological needs and safety. Without shelter,
medication adherence and health outcomes will be compromised. Securing housing is the priority.
Question 6
Which documentation entry by a case manager is most appropriate?
A) “Client seems noncompliant and difficult as usual.”
B) “Client refused medication stating, ‘I don’t need it anymore.’”
,C) “Client is clearly confused and does not understand instructions.”
D) “Client’s family is uncooperative and causing problems.”
Correct Answer: B
Rationale: Documentation must be objective, factual, and non-judgmental. Option B quotes the client
directly. Options A, C, and D contain subjective opinions and labels.
Question 7
A nurse is managing a caseload of 50 clients. Which task can be delegated to a licensed practical nurse
(LPN)?
A) Initial comprehensive assessment of a new client
B) Development of the nursing care plan
C) Administration of a routine intramuscular injection
D) Evaluation of client goal achievement
Correct Answer: C
Rationale: LPNs can administer medications, including injections, under the supervision of an RN.
Assessment (A), planning (B), and evaluation (D) are responsibilities of the RN.
Question 8
A client with diabetes and heart failure is being discharged. Which action reflects effective transitional
care?
A) Giving the client written instructions only
B) Scheduling a follow-up appointment within 7 days
C) Calling the client 48 hours post-discharge to review medications
D) Relying on the family to explain discharge instructions
Correct Answer: C
Rationale: Transitional care includes proactive follow-up contact to reinforce teaching and identify
issues early. Option C is evidence-based. Option B is important but less immediate. Option A lacks
reinforcement; D shifts responsibility improperly.
Question 9
A case manager identifies that a client has not filled a prescription for an antibiotic due to cost. What is
the most appropriate response?
A) Tell the client to take half doses to make the medication last longer
B) Contact the provider to request a generic or lower-cost alternative
C) Advise the client to skip the medication if symptoms improve
D) Document noncompliance and close the case
Correct Answer: B
Rationale: The nurse advocates for the client by seeking affordable alternatives. Option A is unsafe and
ineffective; C is incorrect; D fails to address the barrier.
, Question 10
Which of the following is an example of vertical integration in healthcare delivery?
A) A hospital that owns a skilled nursing facility and home health agency
B) Two community clinics agreeing to share weekend call coverage
C) A nurse referring a client to a specialty clinic
D) A client using telehealth for a follow-up visit
Correct Answer: A
Rationale: Vertical integration involves a single organization owning multiple levels of care (e.g.,
hospital, SNF, home health). Option B is horizontal integration; C is referral; D is technology use.
Question 11
A nurse is conducting a home visit for a client with mobility issues. Which observation poses the greatest
safety risk?
A) A throw rug in the hallway
B) Handrails in the bathroom
C) Nightlights in the bedroom
D) A raised toilet seat
Correct Answer: A
Rationale: Throw rugs are a fall hazard, especially for clients with mobility issues. Options B, C, and D are
safety enhancements.
Question 12
A client tells the case manager, “I don’t want my family to know my HIV status.” The family asks the
nurse for information. What should the nurse do?
A) Tell the family the client’s status because it affects them
B) Respect client confidentiality and decline to share information
C) Suggest the family ask the client directly
D) Document the request but take no further action
Correct Answer: B
Rationale: HIPAA and ethical principles require protecting client confidentiality unless there is a threat
of harm. Option B is correct; A violates privacy; C is not the nurse’s role to redirect without client
permission.
Question 13
Which indicator best measures the effectiveness of a case management program for clients with
asthma?
A) Number of home visits completed per month
B) Client satisfaction survey scores
