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CASE MANAGER Multiple Choice Questions :-


1.Which of the following is a responsibility of a case
manager:

A. Avoid subject material in documentation.

B. Making medical decisions if the patient is unable to do so.

C. Obtain medical services for an incapacitated patient.

D. Obtain financial services for an incapacitated patient.


Download
ANS:- A

2. After obtaining work capacity documentation:

A. The case manager should perform job analysis.

B. The case manager should determine whether an IME is


appropriate.

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C. The case manager should determine appropriateness of work-


hardening process.

D. The case manager should submit documentation to the employer


and insurance company.

ANS:- D

3. What is meant by annulus:

A. It is a sign of a herniated disc.

B. It is the outer portion of an intervertebral disc.

C. It is the inner portion of an intervertebral disc.

Make an Impact

D. It is a medical procedure which is not common due to pain


involved.

ANS:- B

4. A meaning of the root word “myel” is:

A. Spinal cord

B. Muscle

C. Cartilage

D. Largeness

ANS:- A

5. Which of the following are bisphosphonates used to


prevent and treat osteoporosis in postmenopausal
women?


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Make an Impact

A. Evista and fosamax


B. Alendronate and risedronate

C. Estrogen and raloxifene

D. Estrogen and alendronate

ANS:- B

6. A transfer penalty:

A. Is only incurred if assets are given away to a spouse.

B. Is a period of time during which enrollee is not eligible for


Medicaid.

C. Is incurred when enrollee has given away assets; enrollee is no


longer eligible for Medicaid.

D. Is a penalty fine incurred when the enrollee has given away


assets.

ANS:- B

7. What is the Out of Area (OAC)?

A. Physicians who are located outside a prescribed geographic


radius

B. Treatment that is only available at a facility that does not lie


within the geographic radius included in the subscribed healthcare
plan

C. The treatment received by a member of a health care plan when


he/she is out of the network coverage area

D. Hospitals and facilities that are outside the geographic


boundaries of the available approved providers

ANS:- C

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8. In which model is care only reimbursed when paneled


providers are used?

Make an Impact

A. EPO (Exclusive Provider Organization)

B. IPA (Independent Practice Association)

C. Group Model

D. Staff Model

ANS:- A

9. What is meant by Functional impairment:?

A. It is an indicator of crisis likelihood.

B. It is the temporary exchange of roles to cope with a disability.

C. It is the ability of a client’s family to provide for the client’s needs


and still function.

D. It is when overwhelming distress hinders coping ability.

ANS:- A

10. The age group with the highest suicide rate:

A. Are people among the 10-24 year old age group.

B. Are white men over the age of 85.

C. Are people among the 10-14 year old age group.

D. Are people among the 15-24 year old age group.

ANS:- B


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CASE MANAGER MCQs

11. Patient participation in pain treatment:

A. Is a maladaptive coping behavior.

B. Is not suggested by JCAHO.

C. Is only necessary if the patient is without an appropriate


provider.

D. Is an adaptive coping mechanism.

ANS:- D

12. In legal terms, define “discovery period.”

A. This is not a legal term

B. The time in which all material evidence has to be produced and


exchanged

C. Time where mediation takes place

D. Time were all parties involved get together to resolve differences

ANS:- B

13. What is a Transcranial Doppler:

A. Assesses extent or location of injured brain tissue.


B. Provides 3-dimensional pictures of tissues.

C. Is a lengthy process assessing cognitive abilities or deficits.

D. Assesses brain’s arterial circulation.

ANS:- D

15. What is a nasal polyps?

A. Inflamed sinus

B. Inflamed rhinitis

C. Inflamed nasal cavity

D. Inflamed nasal mucosa

ANS:- D 
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16. What is the fullform of CPT-4?

A. Caseworkers with Professional Training, 4th year

B. Current Procedural Terminology

C. Caregivers Professional Tribute, 4th year

D. Caseworkers with Physical Techniques, 4th year

ANS:- B

17. What does a correlational study determine?

A. The relationship between two occurrences

B. The effects of A on B

C. Cause-effect

D. The effects of B on A

ANS:- A

18. Which of the following is an accurate statement about


prescription drug coverage for seniors:

Write e-Rx In 14 Languages

A. Prescription drug coverage is expected to remain at its current


situation, until reform is implemented.

B. Prescription drug coverage is expected to improve.

C. Prescription drug coverage is expected to decline.

D. Prescription drug coverage is a functioning benefit of Part B


Medicare insurance.

ANS:- C

19. What is DSM-IV?

A. Doctors Synthesis of Manuals- 4th edition


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B. Diagnosis of Sexual Manifestations- 4th edition

C. Doctors Standards for Medications, 4th edition

D. Diagnostic and Statistical Manual of Mental Disorders

ANS:- D

20. Which of the following statements is untrue regarding


crisis?

A. There are two types of crisis; developmental and situational

B. Crises are either resolved positively or negatively in a brief period


of time

C. A crisis is usually preceded by a particular identifiable event

D. There are three type of crisis; developmental, situational, and


individual

ANS:- D

21. The following is a high potency antipsychotic:

A. Clozaril

B. Thorazine

C. Mellaril

D. Haldol

ANS:- D

22. The breathing capacity of the lungs is measured


through:

A. Electromyography

B. Spirometry

C. Clinical observation

D. Fluorescent antinuclear antibody test

ANS:- B


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Write e-Rx In 14 Languages

23. Time out of work under worker’s compensation may


be included in the FMLA twelve week period:

A. Only if the employee is offered COBRA by the employer.

B. If the employee is out of work for a period over 18 months.

C. If the employee is notified in writing.

D. If the employer agrees to hold the employees position for more


than the twelve-week period.

ANS:- C

24. If a Medicare recipient does not enroll in Part B


insurance when he enrolls in Part A insurance:

A. The recipient may purchase Part B Medicare afterward, but will


experience a rise in Part B premiums until he enrolls in Part B.

B. The recipient may not purchase Part B Medicare afterward.

C. The recipient may purchase Part B Medicare afterward, and will


not experience a rise in premiums.

D. The recipient may purchase Part B Medicare afterward, but will


experience a rise in Part A premiums until he enrolls in Part B.

ANS:- A

25. Of the following test instruments, which would give


you the most reliable results?

A. MAPI

B. Ruler

C. House-Tree-Person

D. Beck Depression Inventory

ANS:- B

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26. Which is not a category of mental disorder contained


in the DSM IV?

A. Anxiety Disorders

B. Diagnostic Disorders

C. Cognitive Disorders

D. Mood disorders

ANS:- B

27. An incomplete injury is one in which:

A. There is no communication between the outside body and the


spinal cord.

B. There is some communication between the outside body and the


spinal cord.

C. There is no signal whatsoever traveling through the site of injury.

D. There are some signals traveling through the site of injury.


ANS:- D

28. Disability coverage programs:

A. May have limits of several years, or last until retirement age.

B. Typically end after a period of several years.

C. Invariably end after a two year duration.

D. Must continue until age of retirement.

ANS:- A

29. The DSM-IV defines Anxiety as:

A. An impoverishment in thinking that is inferred from observing


speech and language behavior

B. An inability to initiate and persist in goal-directed activities.

C. The apprehensive anticipation of future danger or misfortune


accompanied by a feeling of dysphoria or somatic symptoms of
tension

D. Waxy flexibility-rigid maintenance of a body position over an


extended period of time.

ANS:- C

30. Client abandonment is:



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A. Termination of case management services.

B. A case manager’s failure to annually renew criteria of consent for


client.

C. Lack of sufficient termination notice resulting in harm to Client.

D. Lack of sufficient understanding of client necessity for additional


services.

ANS:- C

31. What is meant by Bed Days:?

A. The number of days a physician requires a client to remain on


bed rest

B. The number of days a hospital will willingly provide a bed for a


client

C. The number of actual days a client stays in hospital or another


facility

D. The number of beds available in a hospital on any given day

ANS:- C

32. The following statement is not true with regard to


bipolar disorder :

A. Bipolar disorder is looked at as a biological disorder

B. Bipolar disorder runs in families

C. Prophylactic treatment is not typically warranted

D. The primary medication to treat bipolar disorder is lithium

ANS:- C


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33. When conflict is _______________, it is emotional


and focused on personal incompatibilities or disputes.

A. High

B. Dysfunctional

C. Emotional

D. Beneficial

ANS:- B

34. The low use of formal power had a strong


_______________ effect on interdisciplinary team
collaboration .

A. Influential

B. Negative

C. Collaborative

D. Positive

ANS:- D

35. Which is not a requirement for states to receive


Federal-matching funds?

A. AIDS screening for high-risk individuals

B. Medical and surgical dental services

C. Early and periodic screening, diagnosis and treatment services


for people under 21 years of age

D. Inpatient hospital services

ANS:- A

36. When a stressful situation is so overwhelming that it


blocks the client’s effective coping ability:

A. It is called disruption of homeostasis.

B. It may be an indicator of a client’s ability to effectively handle


disability.

C. It is called crisis.

D. It is called functional impairment.

ANS:- C

37. According to the DSM IV, a poly substance


dependence is: 
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A. A use of at least three substances simultaneously

B. A use of at least three substances in a short period

C. A use of at least three groups of substances in one year

D. A use of at least three substances in any given time frame

ANS:- C

38. Which is true of a EPO?

A. Care is not reimbursed if non-panel/non-network physicians are


used

B. Does not use gatekeeper approach services

C. It combines elements of HMO and Indemnity Plan

D. Subscriber pays little or nothing out-of-pocket

ANS:- A

39. What is AAPCC?

A. Ambulatory Americans Paying Cost of Care

B. Americans for abortion classified committee

C. American Association of Physicians Concerned about Costs

D. Adjusted Area Per Capita Cost

ANS:- D

40. Depression is an example of:

A. A long-term positive coping technique.

B. A short-term positive coping technique.

C. A stressor.

D. A maladaptive coping behavior.

ANS:- D

41. What is Pooling?

A. The act of combing the risk of all the groups in several groups
into one risk pool

B. The act of pooling resources of various individual subscribers so


as to make the cost of healthcare more manageable for all members
of the group

C. The act of pooling resources by a group of hospitals so as to


better manage the cost of healthcare

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D. The bundling together of various network providers so as to


compile a more effective and varied list of providers

ANS:- A

42. A concussion is:

A. An open injury

B. A type of skull fracture.

C. A violent shaking of the brain.

D. A bruise on brain tissue.

ANS:- C

43. The AAPPCC is used by CMS

A. As a means of estimating outlier expenses in a hospital setting

B. as a basis of payments to managed care plans

C. To limit healthcare benefits to specific covered conditions

D. As a way to define who qualifies for health care under a


particular managed care plan

ANS:- B

44. Medicare is available to:

A. All US citizens or permanent residents with disabilities.

B. All US citizens or permanent residents over age 65 who have paid


Medicare taxes, have a disability , or are diagnosed with kidney
failure.

C. All US citizens or permanent residents without resources for


medical payment.

D. All US citizens or permanent residents over age 65 who have


paid Medicare taxes.
ANS:- B

45. A quality system only _______________ the


positives on what needs to be worked on.

A. Eliminates

B. Enhances

C. Submits to

D. Completes

ANS:- B 
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46. Who most often provides rehabilitation services to


Social Security beneficiaries?

A. County agencies

B. Private sector

C. Federal agencies

D. State rehabilitation agencies

ANS:- D

47. The size of the lump sum payment to a hospital is


based on

A. The relative weight of the particular DRG

B. The DRG

C. Prospective reimbursement payment

D. Omnibus budget reconciliation actions

ANS:- A

48. An individual sustaining a sacral injury:

A. Will become a paraplegic and lose function of the chest,


abdomen, and other areas.

B. May retain function of most areas, depending upon extent of


injury.

C. Will become a quadriplegic and may require a ventilator.

D. May possibly be rendered paraplegic, depending upon extent of


injury.

ANS:- B

49. The reliability of an assessment tool is an indicator of:

A. Faking good or faking bad

B. Whether the assessment tool is measuring what it is supposed to


measure

C. How dependable the assessment tool is

D. How effective the assessment tool is with different cultural


populations

ANS:- C

50. Which of the following statements regarding


antidepressants is true? 
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A. When an individual feels better he/she can stop taking


antidepressants

B. Antidepressants can make one feel “normal”

C. Antidepressants are very effective when taken without other


forms of intervention

D. Antidepressants are addictive

ANS:- B

CASE MANAGER Objective type Questions with answers


51. What is meant by ICD-9CM?

A. Internal Causative Dictionary , with clinically modified


explanations

B. Internal Classification of Disease the Clinical Modification

C. International Classified Dictionary of the 9 clinical moods

D. International Committee of Doctors, 9th clinical module

ANS:- B

52. Due to its short half-life, which of the following


requires a divided dosing?

A. Paxil

B. Prozac

C. Elavil

D. Wellbutrin

ANS:- D

53. Individual Identifiable Health Information refers to:

A. It also includes the provision of healthcare and payment for the


provision of the insurance carrier

B. Health records from the time of birth

C. Any information related to a past, present or future physical or


mental health condition

D. All vaccination records

ANS:- B

54. _______________ or formal power is control of


something or someone.

A. Dominance

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B. Equal power

C. Conflict resolution

D. Unequal power

ANS:- A

55. Which is NOT a requirement to be met for the Social


Security Administration to consider a person “disabled”?

A. Physical or mental impairment

B. Cannot do substantial gainful work

C. Inability to get work

D. Unable to do previous work

ANS:- C

56. The elements of consent criteria:

A. Must be initiated once, and renewed annually.

B. Must be initiated once, and renewed on a monthly basis.

C. Must be initiated once upon beginning case management.

D. Must be initiated once, and renewed at each subsequent meeting


with case manager and client.

ANS:- A

57. What is meant by Disability?

A. Refers to people who have a work history

B. Means that an individual cannot work

C. Refers to physical impairment only

D. Refers to physical or mental impairment that substantially limits


one or more of the major life activities of the individual.

ANS:- D

58. If an employer wants to discontinue health benefits


for an employee who has taken leave for more than
twelve weeks:

A. He may; according to FMLA the employer may discontinue


health benefits at that point.

B. He may not; according to COBRA, the employer must provide


healthcare benefits for terminated employees for up to 18 months.

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C. He may; however, the employee must be notified in writing.

D. He may; however the employer must offer the employee the


option to purchase insurance at his group rate.

ANS:- D

59. Usually health insurance coverage for a employee


begins:

A. Immediately upon selecting coverage

B. When the insurance provider receives the paper work

C. 3 months after they start work

D. 30 days after starting employment

ANS:- C

60. Which of the following is a key component of


Medicare’s partnership with the home care industry to
monitor and facilitate improved home health care
results?

A. APC

B. OASIS

C. OBQI

D. HHA
ANS:- B

61. An individual sustaining a lumbar injury:

A. Will become a paraplegic and lose function of the chest,


abdomen, and other areas.

B. May retain function of most areas, depending upon extent of


injury.

C. Will become a quadriplegic and may require a ventilator.

D. May possibly be rendered paraplegic, depending upon extent of


injury.

ANS:- D

62. Which is true of anxiety disorders?

A. PTSD and OCD are two forms of anxiety disorder.

B. Anorexia nervosa is a form of anxiety disorder.

C. They are defined by significant cognitive deficiencies.



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D. They are often accompanied by somatic symptoms.

ANS:- B

63. Cortisone injections:

A. Are used for neither diagnoses nor treatments.

B. Are used for both diagnoses and treatments.

C. Are only used for repetitive motion disorder diagnoses.

D. Are only used for repetitive motion disorder treatments.

ANS:- B

64. State employment services offices employ:

A. The General Aptitude Test Battery

B. House-Tree-Person Test

C. The Symptom Checklist 90-R

D. Maslach Burnout Inventory

ANS:- A

65. An assessment tool’s reliability is responsible for its:

A. Upper limit of validity

B. Lower limit of validity

C. Test-retest limits
D. Test-reliability limits

ANS:- A

66. Which of the following would indicate a problem with


color vision?

A. inability to distinguish red from green

B. inability to vocalize color names

C. inability to differentiate between shades of gray

D. lack of knowledge regarding relationships of tints and hues

ANS:- A

67. Medicaid is funded by:

A. Federal governments.

B. Both federal and state governments.

C. Stage governments.

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D. The CMS.

ANS:- B

68. Defamation may be defined as:

A. Failure to take due care or carelessness.

B. Professional misconduct or negligence.


C. Taking from one’s reputation.

D. A civil injury committed against another person or their


property.

ANS:- C

69. The best way for a Case Manager to obtain the most
accurate data from a client is to:

A. Review the client’s chart

B. Use close-ended questions

C. Retrieve information from the client’s caregiver and ask if they


concur with the findings

D. Use open-ended questions

ANS:- D

70. Which is true of Medicare?

A. It pays 100% of rehabilitative services and other hospital services


and supplies for the first year in a skilled nursing facility

B. It does not cover hospice care

C. It pays 100% of approved amount for durable medical equipment


as part of a home care treatment

D. It pays 100% of approved amount for home health care

ANS:- C

71. “Sedentary” is:

A. A vocationally qualified level

B. A skill level

C. An exertion level

D. An educational level

ANS:- C

72. Defense mechanisms: 


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A. Are adaptive coping mechanisms.

B. Are neither adaptive or maladaptive but hinder adaptation.

C. May be maladaptive or adaptive.

D. Are maladaptive coping mechanisms.

ANS:- C

73. Injury or illness is an example of:

A. A long-term positive coping technique.

B. A maladaptive coping behavior.

C. A short-term positive coping technique.

D. A stressor.

ANS:- D

74. Which of the following is not one of the knowledge


domains elaborated by Michael Leahy of Michigan State
University in his 1992 national study?

A. Case Management Concepts Factor

B. Life Career Planning

C. Physical and Psychosocial Aspects Factor

D. Benefit Systems and Cost Benefit Analysis Factor

ANS:- B

75. An individual sustaining a cervical neck injury:

A. May possibly be rendered paraplegic, depending upon extent of


injury.

B. Will become a quadriplegic and may require a ventilator.

C. Will become a paraplegic and lose function of the chest,


abdomen, and other areas.

D. May retain function of most areas, depending upon extent of


injury.

ANS:- B

76. Which is true of the Outcomes and Assessment


Information Set (OASIS)?

A. It represents the core items of a comprehensive assessment for


adult home care.

B. It is a forum for assessing the cost effectiveness of particular 


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medications

C. It was developed as a comprehensive assessment tool for quality


of care

D. It is a productivity quotient, assessing the productivity of any


given group of healthcare workers in any given day

ANS:- A

77. A form of hepatitis, producing infections only when


HBV is present and exists at the expense of Hepatitis B,
it’s host, is named?

A. Hepatitis D

B. Hepatitis E

C. Hepatitis C
D. Hepatitis G

ANS:- A

78. The purpose for using clinical level of care criteria as


guidelines to support the case management process is so
that:

A) patients can be discharged as early as possible.

B) patients can be treated at the most appropriate level of care as


their condition changes.

C) hospitals can profit from the DRG arrangement.

D) physicians can follow the patients more efficiently from their


offices rather than in the hospital.

ANS:- B

79. The case manager’s identification of potential


problems or barriers to cost-effective, quality care begins
:

A) during the assessment phase.

B) throughout the case management process.

C) before discharge.

D) after completion of the case selection process.

ANS:- D

80. CPAP, continuous positive airway pressure, is most


often utilized in the home for:

A) ventilator dependent patients



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B) chronic obstructive lung disease.

C) obstructive sleep apnea.

D) cystic fibrosis.

ANS:- C

81. A case manager is developing a plan for a client


without an established support system, who is being
discharged home from a skilled nursing facility, following
a stroke. The knowledge area that will best assist the case
manager during this phase of the case management
process is:

A) cost-benefit analysis.

B) insurance principles.

C) community resources and support programs.

D) psychosocial aspects of chronic illness and disability.

ANS:- C

82. It is important for the case manager to be aware of


Medicare’s definition of part-time or intermittent, when
recommending ongoing services. Combined skilled
nursing and home health aide services cannot total more
than ____ hours per week.

A) 20

B) 24

C) 28

D) 30

ANS:- C

83. A case manager is working with a client diagnosed


with terminal metastatic cancer and in need of money to
pay for medical care and living expenses. Selling a life
insurance policy at 50-80% of its face value is:

A) not a viable option.

B) called a viatical settlement.

C) an option frequently recommended by case managers.

D) not ethical.

ANS:- B

84. Best practices are predicted to do all the following


EXCEPT:

A) Improve clinical outcomes


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B) Increase health care costs

C) Enhance administrative efficiency

D) Increase patient satisfaction

ANS:- B

85. Demand management, which provides risk


appraisals, telephone health information services, and
prevention and wellness initiatives, involves:

A) a health professional contacting the client at prespecified


intervals.

B) the client calling an independent call center, a center set up by


the health plan, or a number made available by the provider.

C) the client initiating a call for emergency needs when the case
manager is unavailable.

D) None of the above

ANS:- B

86. Upon meeting your client, a 40-year-old Asian


woman, you note that throughout the assessment process
she avoids eye contact. Your study of various cultural
practices helps you understand that the behavior in this
case is related to:

A) embarrassment about her health problem.

B) passivity.

C) language barrier.

D) a sign of deference.

ANS:- D

89. The root cause of problems such as malnutrition,


social isolation, alcohol abuse, and not adhering to
treatment in the elderly population, is most frequently
associated with:

A) dementia.

B) Alzheimer’s disease.

C) depression.

D) endocrine imbalance.

ANS:- C

90. The Glasgow Outcome Scale was commonly used


prior to the development of the Rancho Los Amigos
levels. Which of its five levels describes the stage where 
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the client is able to follow commands but requires


assistance for activities of daily living?

A) Gross disability

B) Severe disability

C) Moderate disability

D) Mild disability

ANS:- B

91. The most appropriate objective for conducting a job


analysis, which includes an in-depth review of the
purpose of the job, related tasks, and the frequency of the
tasks, in association with a disabled client in a return-to-
work program, is to:

A) evaluate whether a job description requires modifications.

B) best match job functions, expectations or requirements, with


abilities and limitations.

C) determine when an individual should be promoted.

D) comply with ADA (American Disabilities Act).

ANS:- B

92. Which is the most appropriate strategy for promoting


behavioral changes among adolescents with obesity?

A. Age-matched, self-help group discussions

B. Family-centered group discussions

C. Individualized nutrition counseling

D. Lectures on esteem enhancement

ANS:- A

93. As a member of an interdisciplinary cardiac


rehabilitation team, a nurse case manager’s primary
responsibility is to:

A. communicate with families or significant others in meeting the


client’s care objectives.

B. consult with health care professionals to coordinate resources


and arrange referrals.

C. coordinate with health insurance providers to formulate care


plans and meet predetermined outcomes.

D. document and disseminate assessment information from the



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team of health care professionals.

ANS:- B

94. A child who is ventilator-dependent and has a


gastrostomy button is scheduled to be discharged to
home with visits from a home health nurse. Prior to
discharge, the nurse case manager’s most critical action
is to:

A. assess the child’s long-term home care needs.

B. procure the required home medical equipment.

C. secure funding sources for home health care.

D. verify that the child is being discharged to a safe environment.

ANS:- D

95. Which type of authorization is generated when


services are rendered?

A. Concurrent

B. Prospective

C. Retrospective

D. Subauthorization

ANS:- A

96. Managing clinical outcomes, studying variance


trends, and evaluating actions taken to correct deviations
from critical pathways are components of:

A. performance improvement.

B. risk management.

C. the nursing process.

D. utilization review.

ANS:- A

97. During an annual gynecologic examination, a 28-year-


old female client with two small children requests a
resupply of oral contraceptives. The patient confides that
her husband is scheduled to be laid off next month and
the family cannot afford health insurance. The nurse case
manager’s most appropriate intervention is to:

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A. ask the clinic business office to arrange special payment for the
client.

B. direct the client to the local Planned Parenthood clinic for her
gynecologic and contraceptive needs.

C. recommend that the client change her contraceptive method to


condoms.

D. refer the client to local social services agencies.

ANS:- D

98. To avoid hospital readmission, a patient requires


services at a specialty clinic. Since the services are not
covered under the patient’s health care plan, a nurse case
manager intercedes with the patient’s insurance
company. In this situation, the nurse case manager is
acting in the role of:

A. broker.

B. consultant.

C. negotiator.

D. provider.

ANS:- C

99. When using a utilization tool to perform a concurrent


review, a nurse case manager recognizes that:

A. clients have a right to set length of stay without incurring


nonreimbursable costs.

B. discharge is required whenever the tool so indicates.

C. exceptions exist because utilization tools reflect only average


circumstances.

D. the use of utilization tools guarantees payment for services.

ANS:- C

100. Ideally, case management planning identifies goals


that are:

A. anticipated, acceptable, and appropriate.

B. challenging and timely.

C. patient-focused and cost-effective.

D. realistic, measurable, and specific.

ANS:- D 
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