Case Manager Certification Exam 2026
Questions and Answers
case management - Correct answer-the dynamic and systematic collaborative
approach to providing and coordinating health care services to a defined
population.
- participative process to identify and facility options and services for meeting
individual healthcare needs while decreasing fragmentation and duplication of care
and increasing quality and cost effective clinical outcomes.
standards of care - Correct answer-parameters to measure the quality of healthcare
clinical guidelines - Correct answer-statements to help make decisions about health
specific circumstances.
clinical pathway - Correct answer-structured multi-disciplined plan of care to
support clinical guidelines and protocol to improve continuity and coordination.
4 parts of clinical pathway - Correct answer-1. timeline
2. categories of care/activities and interventions
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,3. intermediate and long term outcome criteria
4. variance tracking
are 4 parts of what?
decision tree - Correct answer-used to select the best course of action in decisions
where there is no clear decisions.
descriptive screening tool - Correct answer-identifies characteristics about a
population to show health prevention.
predictive screening tool - Correct answer-shows what may happen to a specific
population.
evaluative screening tool - Correct answer-evaluates the
understanding/effectiveness
SF-36 - Correct answer-predictive screening tool to assess functional health and
well being. Assesses physical and mental health.
- used in health economics, cost-effectiveness of health tx
-evals individual patient health status.
- does not consider sleep
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,-scored 00-100, lower score-> incr. disability
patient activation measure - Correct answer-13 item predictive screening tool to
evaluate patient's knowledge, skills, confidence in self-care.
- higher the score the better (scored 0-52)
-predicts health care outcomes, medication adherence and ER visits.
health risk assessment - Correct answer-predictive screening tool: patient's self
assessment of their health and how likely they will seek care.
- predicts future health costs
- predicts likely-hood of progression of their illness to a worse condition.
- examples: PHQ-9, etc.
rose Q - Correct answer-health risk assessment for angina, MI, coronary heart
disease.
defined angina pectoris as, "a chest pain or discomfort with these characteristics:
(a) the site must include either the sternum (any level) or the left arm and left
anterior chest (defined as the anterior chest wall between the levels of clavicle and
lower end of sternum),
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, (b) it must be provoked by either hurrying or walking uphill (or by walking on the
level, for those who never attempt more),
(c) when it occurs on walking it must make the subject either stop or slacken pace,
unless nitroglycerin is taken, (d) it must disappear on a majority of occasions in 10
min or less from the time when the subject stands still."
Possible myocardial infarction1 was defined as, "one or more attacks of severe
pain across the front of the chest lasting for 30 min or longer."
seattle angina questionnaire - Correct answer-19-item self-administered health risk
assessment for angina and functional artery disease measuring five dimensions of
coronary artery disease:
1 physical limitation, 2 anginal stability, 3 anginal frequency, 4 treatment
satisfaction and 5 disease perception.
-score of 0 to 100, where higher scores indicate better function (eg, less physical
limitation, less angina, and better quality of life).
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
Questions and Answers
case management - Correct answer-the dynamic and systematic collaborative
approach to providing and coordinating health care services to a defined
population.
- participative process to identify and facility options and services for meeting
individual healthcare needs while decreasing fragmentation and duplication of care
and increasing quality and cost effective clinical outcomes.
standards of care - Correct answer-parameters to measure the quality of healthcare
clinical guidelines - Correct answer-statements to help make decisions about health
specific circumstances.
clinical pathway - Correct answer-structured multi-disciplined plan of care to
support clinical guidelines and protocol to improve continuity and coordination.
4 parts of clinical pathway - Correct answer-1. timeline
2. categories of care/activities and interventions
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,3. intermediate and long term outcome criteria
4. variance tracking
are 4 parts of what?
decision tree - Correct answer-used to select the best course of action in decisions
where there is no clear decisions.
descriptive screening tool - Correct answer-identifies characteristics about a
population to show health prevention.
predictive screening tool - Correct answer-shows what may happen to a specific
population.
evaluative screening tool - Correct answer-evaluates the
understanding/effectiveness
SF-36 - Correct answer-predictive screening tool to assess functional health and
well being. Assesses physical and mental health.
- used in health economics, cost-effectiveness of health tx
-evals individual patient health status.
- does not consider sleep
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,-scored 00-100, lower score-> incr. disability
patient activation measure - Correct answer-13 item predictive screening tool to
evaluate patient's knowledge, skills, confidence in self-care.
- higher the score the better (scored 0-52)
-predicts health care outcomes, medication adherence and ER visits.
health risk assessment - Correct answer-predictive screening tool: patient's self
assessment of their health and how likely they will seek care.
- predicts future health costs
- predicts likely-hood of progression of their illness to a worse condition.
- examples: PHQ-9, etc.
rose Q - Correct answer-health risk assessment for angina, MI, coronary heart
disease.
defined angina pectoris as, "a chest pain or discomfort with these characteristics:
(a) the site must include either the sternum (any level) or the left arm and left
anterior chest (defined as the anterior chest wall between the levels of clavicle and
lower end of sternum),
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, (b) it must be provoked by either hurrying or walking uphill (or by walking on the
level, for those who never attempt more),
(c) when it occurs on walking it must make the subject either stop or slacken pace,
unless nitroglycerin is taken, (d) it must disappear on a majority of occasions in 10
min or less from the time when the subject stands still."
Possible myocardial infarction1 was defined as, "one or more attacks of severe
pain across the front of the chest lasting for 30 min or longer."
seattle angina questionnaire - Correct answer-19-item self-administered health risk
assessment for angina and functional artery disease measuring five dimensions of
coronary artery disease:
1 physical limitation, 2 anginal stability, 3 anginal frequency, 4 treatment
satisfaction and 5 disease perception.
-score of 0 to 100, where higher scores indicate better function (eg, less physical
limitation, less angina, and better quality of life).
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
