CASE MANAGEMENT NURSING-BOARD CERTIFIED (CMGT-BC™) EXAMINATION
QUESTIONS AND CORRECT ANSWERS WITH DETAILED RATIONALES | LATEST VERSION PDF
SECTION ONE: QUESTIONS 1–100
1. A case manager is working with a client who has a complex medical history and multiple specialists. The
client expresses confusion about their treatment plan. What is the case manager's priority action?
A. Refer the client to a social worker for counseling.
B. Schedule a multidisciplinary team conference to clarify the plan.
C. Provide the client with written instructions and educational materials.
D. Advise the client to write down questions for their next physician appointment.
🟢 B. Schedule a multidisciplinary team conference to clarify the plan.
🔴 RATIONALE: The case manager's primary role is to facilitate coordination and communication among the
healthcare team. A multidisciplinary conference directly addresses the root cause of the confusion by ensuring
all providers and the client are aligned on the treatment plan.
2. Under the Health Insurance Portability and Accountability Act (HIPAA), which of the following constitutes
a permissible disclosure of protected health information (PHI) without client authorization?
,A. Sharing information with the client's employer for disability paperwork.
B. Providing information to a journalist for a story on the client's condition.
C. Disclosing information to a public health official for disease tracking.
D. Releasing records to the client's attorney for a pending lawsuit.
🟢 C. Disclosing information to a public health official for disease tracking.
🔴 RATIONALE: HIPAA permits disclosure of PHI without authorization for public health activities, such as
reporting disease or vital statistics, to a public health authority. The other options require specific client
authorization or are not legally permissible without it.
3. A case manager is evaluating the effectiveness of a discharge plan. Which outcome measurement is the
most significant indicator of a successful transition of care?
A. The client's satisfaction score on a post-discharge survey.
B. The absence of hospital readmission within 30 days.
C. The client's ability to name all their prescribed medications.
D. The completion of the discharge summary within 24 hours.
🟢 B. The absence of hospital readmission within 30 days.
🔴 RATIONALE: Avoidance of hospital readmission is a key quality and cost-containment metric that indicates
the discharge plan was effective in maintaining the client's stability in the community. While satisfaction and
knowledge are important, readmission rates are a direct measure of outcome success.
,4. In the context of case management, what is the primary purpose of a "critical pathway" or "clinical
pathway"?
A. To provide a billing structure for reimbursement.
B. To standardize the care process for a specific diagnosis.
C. To replace the need for a physician's clinical judgment.
D. To document legal consent for treatment procedures.
🟢 B. To standardize the care process for a specific diagnosis.
🔴 RATIONALE: Clinical pathways are multidisciplinary care plans that map out the expected sequence of
interventions for a specific patient population. Their primary purpose is to standardize care, improve quality,
and reduce variation in practice.
5. A case manager identifies a potential delay in a client's care due to a shortage of available rehabilitation
beds. This is an example of a barrier related to:
A. Client's psychosocial status.
B. Clinical status.
C. System and resource availability.
D. Healthcare provider communication.
🟢 C. System and resource availability.
🔴 RATIONALE: A shortage of beds is a systemic and resource-based barrier. It is not related to the client's
individual clinical or psychosocial condition, nor is it a communication failure between providers.
, 6. Which of the following ethical principles is primarily exercised when a case manager respects a client's
right to refuse a recommended treatment?
A. Beneficence.
B. Non-maleficence.
C. Autonomy.
D. Justice.
🟢 C. Autonomy.
🔴 RATIONALE: The principle of autonomy recognizes the client's right to make their own decisions regarding
their healthcare, including the right to refuse treatment. Beneficence (doing good), non-maleficence (doing no
harm), and justice (fairness) are also important but do not directly address the right to self-determination in this
scenario.
7. A case manager is using motivational interviewing techniques with a client who is hesitant to begin a
cardiac rehabilitation program. Which question is the most effective in eliciting "change talk"?
A. "What are the risks if you do not attend the program?"
B. "On a scale of 1 to 10, how ready are you to start?"
C. "What benefits do you see in making this change for your health?"
D. "Have you considered that your family wants you to participate?"
QUESTIONS AND CORRECT ANSWERS WITH DETAILED RATIONALES | LATEST VERSION PDF
SECTION ONE: QUESTIONS 1–100
1. A case manager is working with a client who has a complex medical history and multiple specialists. The
client expresses confusion about their treatment plan. What is the case manager's priority action?
A. Refer the client to a social worker for counseling.
B. Schedule a multidisciplinary team conference to clarify the plan.
C. Provide the client with written instructions and educational materials.
D. Advise the client to write down questions for their next physician appointment.
🟢 B. Schedule a multidisciplinary team conference to clarify the plan.
🔴 RATIONALE: The case manager's primary role is to facilitate coordination and communication among the
healthcare team. A multidisciplinary conference directly addresses the root cause of the confusion by ensuring
all providers and the client are aligned on the treatment plan.
2. Under the Health Insurance Portability and Accountability Act (HIPAA), which of the following constitutes
a permissible disclosure of protected health information (PHI) without client authorization?
,A. Sharing information with the client's employer for disability paperwork.
B. Providing information to a journalist for a story on the client's condition.
C. Disclosing information to a public health official for disease tracking.
D. Releasing records to the client's attorney for a pending lawsuit.
🟢 C. Disclosing information to a public health official for disease tracking.
🔴 RATIONALE: HIPAA permits disclosure of PHI without authorization for public health activities, such as
reporting disease or vital statistics, to a public health authority. The other options require specific client
authorization or are not legally permissible without it.
3. A case manager is evaluating the effectiveness of a discharge plan. Which outcome measurement is the
most significant indicator of a successful transition of care?
A. The client's satisfaction score on a post-discharge survey.
B. The absence of hospital readmission within 30 days.
C. The client's ability to name all their prescribed medications.
D. The completion of the discharge summary within 24 hours.
🟢 B. The absence of hospital readmission within 30 days.
🔴 RATIONALE: Avoidance of hospital readmission is a key quality and cost-containment metric that indicates
the discharge plan was effective in maintaining the client's stability in the community. While satisfaction and
knowledge are important, readmission rates are a direct measure of outcome success.
,4. In the context of case management, what is the primary purpose of a "critical pathway" or "clinical
pathway"?
A. To provide a billing structure for reimbursement.
B. To standardize the care process for a specific diagnosis.
C. To replace the need for a physician's clinical judgment.
D. To document legal consent for treatment procedures.
🟢 B. To standardize the care process for a specific diagnosis.
🔴 RATIONALE: Clinical pathways are multidisciplinary care plans that map out the expected sequence of
interventions for a specific patient population. Their primary purpose is to standardize care, improve quality,
and reduce variation in practice.
5. A case manager identifies a potential delay in a client's care due to a shortage of available rehabilitation
beds. This is an example of a barrier related to:
A. Client's psychosocial status.
B. Clinical status.
C. System and resource availability.
D. Healthcare provider communication.
🟢 C. System and resource availability.
🔴 RATIONALE: A shortage of beds is a systemic and resource-based barrier. It is not related to the client's
individual clinical or psychosocial condition, nor is it a communication failure between providers.
, 6. Which of the following ethical principles is primarily exercised when a case manager respects a client's
right to refuse a recommended treatment?
A. Beneficence.
B. Non-maleficence.
C. Autonomy.
D. Justice.
🟢 C. Autonomy.
🔴 RATIONALE: The principle of autonomy recognizes the client's right to make their own decisions regarding
their healthcare, including the right to refuse treatment. Beneficence (doing good), non-maleficence (doing no
harm), and justice (fairness) are also important but do not directly address the right to self-determination in this
scenario.
7. A case manager is using motivational interviewing techniques with a client who is hesitant to begin a
cardiac rehabilitation program. Which question is the most effective in eliciting "change talk"?
A. "What are the risks if you do not attend the program?"
B. "On a scale of 1 to 10, how ready are you to start?"
C. "What benefits do you see in making this change for your health?"
D. "Have you considered that your family wants you to participate?"
