Case Manager Certification Exam – 2025–2026
– Study Guide and Practice Questions
case management - ANS✔✔ 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 - ANS✔✔ parameters to measure the quality of healthcare
clinical guidelines - ANS✔✔ statements to help make decisions about health specific
circumstances.
clinical pathway - ANS✔✔ structured multi-disciplined plan of care to support clinical guidelines
and protocol to improve continuity and coordination.
4 parts of clinical pathway - ANS✔✔ 1. timeline
2. categories of care/activities and interventions
3. intermediate and long term outcome criteria
4. variance tracking
are 4 parts of what?
decision tree - ANS✔✔ used to select the best course of action in decisions where there is no
clear decisions.
,descriptive screening tool - ANS✔✔ identifies characteristics about a population to show health
prevention.
predictive screening tool - ANS✔✔ shows what may happen to a specific population.
evaluative screening tool - ANS✔✔ evaluates the understanding/effectiveness
SF-36 - ANS✔✔ 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
-scored 00-100, lower score-> incr. disability
patient activation measure - ANS✔✔ 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 - ANS✔✔ 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 - ANS✔✔ 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),
(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 - ANS✔✔ 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).
arthritis impact measurement scales - ANS✔✔ health risk assessment: Disease-specific measure
of physical, social, and emotional well-being designed as a measure of outcome in arthritis.
-scales: mobility, physical activity (walking, bending, lifting), dexterity, household activity
(managing money and medications, housekeeping), social activities, activities of daily living,
pain, depression, and anxiety.
Score range: Range is 0-10 for each section. Total health score 0-60.
--> Zero represents good health status, 10 and 60 represent poor health status.
functional living index-cancer - ANS✔✔ health risk assessment: Cancer-specific, functionally-
oriented quality of life instrument.
– Study Guide and Practice Questions
case management - ANS✔✔ 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 - ANS✔✔ parameters to measure the quality of healthcare
clinical guidelines - ANS✔✔ statements to help make decisions about health specific
circumstances.
clinical pathway - ANS✔✔ structured multi-disciplined plan of care to support clinical guidelines
and protocol to improve continuity and coordination.
4 parts of clinical pathway - ANS✔✔ 1. timeline
2. categories of care/activities and interventions
3. intermediate and long term outcome criteria
4. variance tracking
are 4 parts of what?
decision tree - ANS✔✔ used to select the best course of action in decisions where there is no
clear decisions.
,descriptive screening tool - ANS✔✔ identifies characteristics about a population to show health
prevention.
predictive screening tool - ANS✔✔ shows what may happen to a specific population.
evaluative screening tool - ANS✔✔ evaluates the understanding/effectiveness
SF-36 - ANS✔✔ 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
-scored 00-100, lower score-> incr. disability
patient activation measure - ANS✔✔ 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 - ANS✔✔ 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 - ANS✔✔ 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),
(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 - ANS✔✔ 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).
arthritis impact measurement scales - ANS✔✔ health risk assessment: Disease-specific measure
of physical, social, and emotional well-being designed as a measure of outcome in arthritis.
-scales: mobility, physical activity (walking, bending, lifting), dexterity, household activity
(managing money and medications, housekeeping), social activities, activities of daily living,
pain, depression, and anxiety.
Score range: Range is 0-10 for each section. Total health score 0-60.
--> Zero represents good health status, 10 and 60 represent poor health status.
functional living index-cancer - ANS✔✔ health risk assessment: Cancer-specific, functionally-
oriented quality of life instrument.
