Relias - Case Management Assessment A Detailed Exam Study Questions with Verified Answers | Guarantee Pass!

Relias - Case Management Assessment A Detailed Exam Study Questions with Verified Answers | Guarantee Pass! 1. Which of the following is true of accepting healthcare for people with SPMI? - ANSWER Many people with SPMI access their medical treatment through urgent care or emergency departments 2. Which of the following is true of health insurance coverage for your clients? - ANSWER It is important to be aware of the filing and update requirements for maintaining health insurance coverage. 3. True or False: Individuals with SPMI are more likely to seek primary care service than behavioral health services - ANSWER False 4. You are using aggregated diagnosis groups (ADGs) to classify your patient's care. In which ADG would you classify your patient's infection? - ANSWER Disease etiology 5. Your patient is stable and needs continuous infusion therapy. You are completing the care transition portion of the plan of care and discharge plan. What would be the MOST appropriate care delivery plan for the patient? - ANSWER Ensure a PICC or port access is placed in the hospital. Then give the patient the name of an ambulatory infusion site of care for their infusions. 6. What law was enacted to protect rights to access to their information and encourage patients to create an advance directive for medical care wishes? - ANSWER HIPAA 7. You are implementing a care plan for your patient with schizophrenia. What PRIORITY diagnoses would you consider them to be at high risk? - ANSWER multiple diagnoses (depression, mania) and violent/unstable behavior 8. A patient is admitted for inpatient services who has Medicare. Medicare Part A pays at 100% of the inpatient stay minus the patient's Part A deductible (if they have not met the deductible previously) for how many days? - ANSWER Day 1- 60 9. What Social Determinate of Health (SDOH) factor does the 2023 HEDIS measures have an updated focus on the patient outcomes? - ANSWER health equity 10. Your patient struggles with polysubstance use of alcohol and narcotics. Their family is struggling to support the patient and how to best care for them once out of the hospital. What community support program? - ANSWER Al Anon 11. Your patient has an alcohol use disorder. They state that they are considering entering an Alcoholics Anonymous program sometime soon but are unsure. What state of behavioral change is your patient in? - ANSWER contemplation 12. You are submitting a quarterly report demonstrating costs and savings regarding case management activities. What is the name of this report? - ANSWER Costs-Analysis Report 13. You have a patient who is likely to suffer adverse health consequences upon discharge. At what stage of hospitalization do the CMS Conditions of Participation require hospitals to identify these types of patients? - ANSWER Early stage of hospitalization 14. You are a key advocare for you patients and their families. By acting in this way you are helping care for them in the best possible way. What ethical principle are you exhibiting? - ANSWER beneficence 15. What criteria are used to classify Medicare patient within inpatient rehabilitation into tiers? - ANSWER specific comorbidities that increase the cost of care 16. 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? - ANSWER Admissions, review, dismissal (ARD) 17. The CMS Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)survey consists of what 3 main composite scoring categories? - ANSWER Communication w/ Nurse Provider Responsiveness of Hospital Staff 18. Which of the following is true of comorbid conditions and individuals with SPMI? - ANSWER The vast majority of comorbid conditions in the SPMI population are cardio metabolic conditions. 19. True or False: Jails and prisons currently provide more mental health treatment than any other institution. - ANSWER True 20. True or False: Individuals with SPMI experience significantly poorer health outcomes than the general population. - ANSWER True 21. The development of a comprehensive treatment plan includes input from the client,... - ANSWER Anyone else the client wishes to include, such as family 22. Which of the following is a primary service provided by a care manger... - ANSWER Coordinate services among many healthcare providers 23. What is one thing you can do with your client to help them plan for a medical visit? - ANSWER Assist in preparing a list of questions for the medical provider. 24. Which of the following is true of trauma and victimization for people with SPMI? - ANSWER People with SPMI are at a grater risk for victimization than the general population. 25. 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? - ANSWER Comfort your patient, listen to their concerns, and inform them of referrals to inpatient psychosocial services and an oncology nurse navigator. 26. In your psychosocial assessment you suspect the parent of you 6-year-old patient to be committing Munchhausen by Proxy Syndrome. What PRIORITY actions would you take to protect your patient? - ANSWER Immediately alert you patient's care team, report you suspicions to Child protective services, document you findings in the patient's chart, and get psychiatry consult STAT to appropriately separate the parent from the child or have the parent monitored in the room by a sitter