PROPHECY RN CASE MANAGEMENT
PRACTICE EXAM 2 QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2025
1. Which of the following is the primary goal of case management?
a) Provide direct patient care
b) Control costs and maximize quality outcomes
c) Perform diagnostic testing
d) Administer medications
Answer: b
Rationale: The main objective of case management is to coordinate
services that control costs while ensuring high-quality patient
outcomes.
2. Which statement best describes a case manager’s role in discharge
planning?
a) Directly provide all follow-up care
, b) Make decisions independently without the care team
c) Coordinate services to ensure safe transition to the next level of
care
d) Prescribe medications for outpatient care
Answer: c
Rationale: Case managers coordinate and arrange services to
support a safe, effective transition for the patient.
3. Which patient is most appropriate for case management referral?
a) A healthy individual having a wellness check
b) A patient with multiple comorbidities and frequent hospital
readmissions
c) A patient undergoing a routine vaccination
d) A patient with mild seasonal allergies
Answer: b
Rationale: High-risk patients with complex conditions benefit the
most from case management to reduce readmissions and costs.
4. A patient is being discharged but has no family support and limited
finances. What should the case manager prioritize?
a) Contacting hospice care
b) Arranging for home health and community resources
c) Delaying discharge indefinitely
d) Cancelling all services due to lack of funds
Answer: b
, Rationale: Identifying appropriate support services ensures a safe
discharge and continuity of care.
5. What is an essential legal consideration in case management?
a) Ignoring HIPAA when sharing information with providers
b) Obtaining informed consent for information sharing
c) Making decisions without patient input
d) Sharing information with any family member without restriction
Answer: b
Rationale: Protecting patient confidentiality and securing consent is
critical to comply with privacy laws.
6. Which of the following is an example of resource utilization?
a) Repeating tests unnecessarily
b) Coordinating durable medical equipment
c) Ignoring insurance restrictions
d) Ordering all medications regardless of need
Answer: b
Rationale: Resource utilization involves ensuring patients have
necessary equipment and services without waste.
7. A case manager must advocate for the patient. Which action best
demonstrates advocacy?
a) Making decisions for the patient without input
b) Encouraging patient participation in care decisions
c) Withholding cost information from the patient
, d) Focusing only on insurance needs
Answer: b
Rationale: Advocacy includes empowering patients to make informed
choices about their care.
8. Which tool is most useful for predicting readmission risk?
a) Blood pressure monitor
b) Electronic Health Record (EHR) readmission predictor
c) Stethoscope
d) Blood sugar log
Answer: b
Rationale: Many EHR systems include tools that identify patients at
risk for readmission, supporting proactive case management.
9. What is an appropriate outcome measure for effective case
management?
a) Increased length of stay
b) Higher readmission rates
c) Decreased emergency department visits
d) Increased patient complaints
Answer: c
Rationale: A key goal is to reduce unnecessary emergency visits
through better coordination.
10. Which factor should be assessed first when planning post-
discharge care?
PRACTICE EXAM 2 QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2025
1. Which of the following is the primary goal of case management?
a) Provide direct patient care
b) Control costs and maximize quality outcomes
c) Perform diagnostic testing
d) Administer medications
Answer: b
Rationale: The main objective of case management is to coordinate
services that control costs while ensuring high-quality patient
outcomes.
2. Which statement best describes a case manager’s role in discharge
planning?
a) Directly provide all follow-up care
, b) Make decisions independently without the care team
c) Coordinate services to ensure safe transition to the next level of
care
d) Prescribe medications for outpatient care
Answer: c
Rationale: Case managers coordinate and arrange services to
support a safe, effective transition for the patient.
3. Which patient is most appropriate for case management referral?
a) A healthy individual having a wellness check
b) A patient with multiple comorbidities and frequent hospital
readmissions
c) A patient undergoing a routine vaccination
d) A patient with mild seasonal allergies
Answer: b
Rationale: High-risk patients with complex conditions benefit the
most from case management to reduce readmissions and costs.
4. A patient is being discharged but has no family support and limited
finances. What should the case manager prioritize?
a) Contacting hospice care
b) Arranging for home health and community resources
c) Delaying discharge indefinitely
d) Cancelling all services due to lack of funds
Answer: b
, Rationale: Identifying appropriate support services ensures a safe
discharge and continuity of care.
5. What is an essential legal consideration in case management?
a) Ignoring HIPAA when sharing information with providers
b) Obtaining informed consent for information sharing
c) Making decisions without patient input
d) Sharing information with any family member without restriction
Answer: b
Rationale: Protecting patient confidentiality and securing consent is
critical to comply with privacy laws.
6. Which of the following is an example of resource utilization?
a) Repeating tests unnecessarily
b) Coordinating durable medical equipment
c) Ignoring insurance restrictions
d) Ordering all medications regardless of need
Answer: b
Rationale: Resource utilization involves ensuring patients have
necessary equipment and services without waste.
7. A case manager must advocate for the patient. Which action best
demonstrates advocacy?
a) Making decisions for the patient without input
b) Encouraging patient participation in care decisions
c) Withholding cost information from the patient
, d) Focusing only on insurance needs
Answer: b
Rationale: Advocacy includes empowering patients to make informed
choices about their care.
8. Which tool is most useful for predicting readmission risk?
a) Blood pressure monitor
b) Electronic Health Record (EHR) readmission predictor
c) Stethoscope
d) Blood sugar log
Answer: b
Rationale: Many EHR systems include tools that identify patients at
risk for readmission, supporting proactive case management.
9. What is an appropriate outcome measure for effective case
management?
a) Increased length of stay
b) Higher readmission rates
c) Decreased emergency department visits
d) Increased patient complaints
Answer: c
Rationale: A key goal is to reduce unnecessary emergency visits
through better coordination.
10. Which factor should be assessed first when planning post-
discharge care?
