RELIAS CASE MANAGEMENT ASSESSMENT A ACTUAL EXAM
2026/2027 PREP QUESTIONS AND STUDY GUIDE ACCURATE EXAM
APPROVED QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (RELIABLE ANSWERS) CURRENTLY UPDATED
VERSION 2026 EDITION (BRAND NEW!) FULL REVISED RELIAS CASE
MANAGEMENT ASSESSMENT A |JUST RELEASED
1. Your patient received a cancer diagnosis. You find them crying on their bed.
They state they just got divorced and do not have family in town. What would be
your PRIORITY action?
A) Inform the patient that they will need to find a family member to stay with them
during treatment.
B) Comfort your patient, listen to their concerns, and inform them of referrals to
inpatient psychosocial services and an oncology nurse navigator.
C) Contact the hospital chaplain without asking the patient.
D) Tell the patient that everything will be fine.
Correct Answer: B) Comfort your patient, listen to their concerns, and inform them
of referrals to inpatient psychosocial services and an oncology nurse navigator.
Rationale: The priority action is to provide immediate emotional support and
assess the patient's urgent psychosocial needs. The patient is expressing distress
and a lack of social support. Listening, providing comfort, and connecting them
with specialized support services like psychosocial oncology and a nurse
navigator directly addresses their crisis and initiates a comprehensive care plan.
This is a core function of case management, focusing on holistic patient-
centered care .
2. In your psychosocial assessment, you suspect the parent of your 6-year-old
patient to be committing Munchhausen by Proxy Syndrome. What PRIORITY
actions would you take to protect your patient?
A) Confront the parent about your suspicions to get their side of the story.
,B) Document your suspicions and wait for further evidence.
C) Immediately alert your patient's care team, report your suspicions to Child
Protective Services, document your findings in the patient's chart, and get a
psychiatry consult STAT to appropriately separate the parent from the child or
have the parent monitored in the room by a sitter.
D) Discharge the patient home and schedule a follow-up appointment.
Correct Answer: C) Immediately alert your patient's care team, report your
suspicions to Child Protective Services, document your findings in the patient's
chart, and get a psychiatry consult STAT to appropriately separate the parent from
the child or have the parent monitored in the room by a sitter.
Rationale: Suspected Munchausen by Proxy (now more commonly known as
Factitious Disorder Imposed on Another) is a form of child abuse. The patient is
in immediate danger, and the case manager has a mandatory duty to protect the
child. This requires a coordinated, immediate response that includes alerting the
care team, reporting to authorities (Child Protective Services), documenting
findings, and taking steps to ensure the child's immediate safety, which may
include supervised visits for the parent .
3. You see a family friend on your case management case load. You know you
cannot care for this person as it would be a conflict of interest. If you were to
quickly review their medical chart, what legal act would you be violating?
A) The Affordable Care Act (ACA)
B) HIPAA (Health Insurance Portability and Accountability Act)
C) The Patient Self-Determination Act
D) The EMTALA (Emergency Medical Treatment and Labor Act)
Correct Answer: B) HIPAA (Health Insurance Portability and Accountability Act)
Rationale: HIPAA is the federal law that protects the privacy and security of
patients' protected health information (PHI). Accessing the medical chart of a
,patient, even a friend or family member, without a legitimate, work-related
"need to know" is a violation of their privacy rights. Because you have already
identified a conflict of interest and have no legitimate reason to provide care,
reviewing the chart would be an unauthorized access and a breach of HIPAA
regulations .
4. Your patient is school-aged and has special needs. Their family is very
concerned their child will be bullied because of these special needs. What
communication and planning tool would you recommend for the family with
members of the school prior to start of school?
A) A formal IEP (Individualized Education Program) meeting.
B) An ARD (Admission, Review, and Dismissal) meeting.
C) A 504 Plan meeting.
D) A parent-teacher conference.
Correct Answer: B) An ARD (Admission, Review, and Dismissal) meeting.
Rationale: An ARD meeting is a specific term used in some states (like Texas)
for the annual meeting of the IEP team. In the context of this question, "ARD"
or "Admission, Review, and Dismissal" is the correct term to identify the formal,
legally mandated process involving the school and family to discuss and plan for
a child's special education services and accommodations. This meeting is the
primary platform for addressing concerns like bullying and creating a
supportive, safe environment .
5. Your patient with a pre-existing condition purchased an individual healthcare
plan online directly from the insurance payer. They did not purchase it on the
Healthcare Market Exchange that is covered under the Affordable Care Act. They
are upset that their plan does not cover pre-existing conditions for 6 months. What
would be your response?
A) Advise the patient that this is illegal and they should file a complaint.
, B) Explain that the insurance plan they acquired directly from the insurance payer
operates outside the Healthcare Market Exchange covered under the Affordable
Care Act, and as a result, it might have different terms and conditions, including
waiting periods for pre-existing conditions.
C) Tell them that no insurance plans can have a waiting period for pre-existing
conditions.
D) Suggest they contact the insurance company to demand coverage.
Correct Answer: B) Explain that the insurance plan they acquired directly from the
insurance payer operates outside the Healthcare Market Exchange covered under
the Affordable Care Act, and as a result, it might have different terms and
conditions, including waiting periods for pre-existing conditions.
Rationale: The ACA's protections for pre-existing conditions apply to plans
purchased on the Health Insurance Marketplace. Plans purchased directly from
an insurer (off-Marketplace) are not always subject to the same rules and may
have waiting periods or exclusions for pre-existing conditions. The case manager
must be able to explain these nuances of the healthcare system to the patient
accurately and without judgment .
6. What are the three key domains of a functional status assessment?
A) Cognitive, emotional, and spiritual.
B) Medical history, family history, and social history.
C) ADLs, IADLs, and mobility (fall risk).
D) Financial, environmental, and transportation.
Correct Answer: C) ADLs, IADLs, and mobility (fall risk).
Rationale: A functional status assessment evaluates a patient's ability to perform
activities necessary for daily living. The three core domains are Activities of
Daily Living (ADLs) which are basic self-care tasks, Instrumental Activities of
Daily Living (IADLs) which are more complex tasks needed for independent
2026/2027 PREP QUESTIONS AND STUDY GUIDE ACCURATE EXAM
APPROVED QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (RELIABLE ANSWERS) CURRENTLY UPDATED
VERSION 2026 EDITION (BRAND NEW!) FULL REVISED RELIAS CASE
MANAGEMENT ASSESSMENT A |JUST RELEASED
1. Your patient received a cancer diagnosis. You find them crying on their bed.
They state they just got divorced and do not have family in town. What would be
your PRIORITY action?
A) Inform the patient that they will need to find a family member to stay with them
during treatment.
B) Comfort your patient, listen to their concerns, and inform them of referrals to
inpatient psychosocial services and an oncology nurse navigator.
C) Contact the hospital chaplain without asking the patient.
D) Tell the patient that everything will be fine.
Correct Answer: B) Comfort your patient, listen to their concerns, and inform them
of referrals to inpatient psychosocial services and an oncology nurse navigator.
Rationale: The priority action is to provide immediate emotional support and
assess the patient's urgent psychosocial needs. The patient is expressing distress
and a lack of social support. Listening, providing comfort, and connecting them
with specialized support services like psychosocial oncology and a nurse
navigator directly addresses their crisis and initiates a comprehensive care plan.
This is a core function of case management, focusing on holistic patient-
centered care .
2. In your psychosocial assessment, you suspect the parent of your 6-year-old
patient to be committing Munchhausen by Proxy Syndrome. What PRIORITY
actions would you take to protect your patient?
A) Confront the parent about your suspicions to get their side of the story.
,B) Document your suspicions and wait for further evidence.
C) Immediately alert your patient's care team, report your suspicions to Child
Protective Services, document your findings in the patient's chart, and get a
psychiatry consult STAT to appropriately separate the parent from the child or
have the parent monitored in the room by a sitter.
D) Discharge the patient home and schedule a follow-up appointment.
Correct Answer: C) Immediately alert your patient's care team, report your
suspicions to Child Protective Services, document your findings in the patient's
chart, and get a psychiatry consult STAT to appropriately separate the parent from
the child or have the parent monitored in the room by a sitter.
Rationale: Suspected Munchausen by Proxy (now more commonly known as
Factitious Disorder Imposed on Another) is a form of child abuse. The patient is
in immediate danger, and the case manager has a mandatory duty to protect the
child. This requires a coordinated, immediate response that includes alerting the
care team, reporting to authorities (Child Protective Services), documenting
findings, and taking steps to ensure the child's immediate safety, which may
include supervised visits for the parent .
3. You see a family friend on your case management case load. You know you
cannot care for this person as it would be a conflict of interest. If you were to
quickly review their medical chart, what legal act would you be violating?
A) The Affordable Care Act (ACA)
B) HIPAA (Health Insurance Portability and Accountability Act)
C) The Patient Self-Determination Act
D) The EMTALA (Emergency Medical Treatment and Labor Act)
Correct Answer: B) HIPAA (Health Insurance Portability and Accountability Act)
Rationale: HIPAA is the federal law that protects the privacy and security of
patients' protected health information (PHI). Accessing the medical chart of a
,patient, even a friend or family member, without a legitimate, work-related
"need to know" is a violation of their privacy rights. Because you have already
identified a conflict of interest and have no legitimate reason to provide care,
reviewing the chart would be an unauthorized access and a breach of HIPAA
regulations .
4. Your patient is school-aged and has special needs. Their family is very
concerned their child will be bullied because of these special needs. What
communication and planning tool would you recommend for the family with
members of the school prior to start of school?
A) A formal IEP (Individualized Education Program) meeting.
B) An ARD (Admission, Review, and Dismissal) meeting.
C) A 504 Plan meeting.
D) A parent-teacher conference.
Correct Answer: B) An ARD (Admission, Review, and Dismissal) meeting.
Rationale: An ARD meeting is a specific term used in some states (like Texas)
for the annual meeting of the IEP team. In the context of this question, "ARD"
or "Admission, Review, and Dismissal" is the correct term to identify the formal,
legally mandated process involving the school and family to discuss and plan for
a child's special education services and accommodations. This meeting is the
primary platform for addressing concerns like bullying and creating a
supportive, safe environment .
5. Your patient with a pre-existing condition purchased an individual healthcare
plan online directly from the insurance payer. They did not purchase it on the
Healthcare Market Exchange that is covered under the Affordable Care Act. They
are upset that their plan does not cover pre-existing conditions for 6 months. What
would be your response?
A) Advise the patient that this is illegal and they should file a complaint.
, B) Explain that the insurance plan they acquired directly from the insurance payer
operates outside the Healthcare Market Exchange covered under the Affordable
Care Act, and as a result, it might have different terms and conditions, including
waiting periods for pre-existing conditions.
C) Tell them that no insurance plans can have a waiting period for pre-existing
conditions.
D) Suggest they contact the insurance company to demand coverage.
Correct Answer: B) Explain that the insurance plan they acquired directly from the
insurance payer operates outside the Healthcare Market Exchange covered under
the Affordable Care Act, and as a result, it might have different terms and
conditions, including waiting periods for pre-existing conditions.
Rationale: The ACA's protections for pre-existing conditions apply to plans
purchased on the Health Insurance Marketplace. Plans purchased directly from
an insurer (off-Marketplace) are not always subject to the same rules and may
have waiting periods or exclusions for pre-existing conditions. The case manager
must be able to explain these nuances of the healthcare system to the patient
accurately and without judgment .
6. What are the three key domains of a functional status assessment?
A) Cognitive, emotional, and spiritual.
B) Medical history, family history, and social history.
C) ADLs, IADLs, and mobility (fall risk).
D) Financial, environmental, and transportation.
Correct Answer: C) ADLs, IADLs, and mobility (fall risk).
Rationale: A functional status assessment evaluates a patient's ability to perform
activities necessary for daily living. The three core domains are Activities of
Daily Living (ADLs) which are basic self-care tasks, Instrumental Activities of
Daily Living (IADLs) which are more complex tasks needed for independent
