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Which evaluation would you perform to determine if a client has the capability to return to work? A. Pain tolerance evaluation. B. Functional capacity evaluation. C. Disability evaluation. D. Evaluation by client interview. correct answers B. The functional capacity exam is a process of as...

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  • August 11, 2024
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  • 2024/2025
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CCM exam secrets practice test || A+ Verified Solutions.
Which evaluation would you perform to determine if a client has the capability to return to
work?

A. Pain tolerance evaluation.
B. Functional capacity evaluation.
C. Disability evaluation.
D. Evaluation by client interview. correct answers B. The functional capacity exam is a process
of assessing a persons, physical and functional abilities to perform task. The patients
performance level should match the demands of the occupation and question. The purpose of the
exam is to determine if a patient is ready to go back to work after an injury.

Risk management is a sub domain of which of the following court case management domains?
A. Psychosocial aspects.
Be. Healthcare management, and delivery.
C. Principles of practice.
D. Case management concepts. correct answers C. There are six domains for case management
practice. These include case management concepts, case management principles, and practice
strategy/practice, psychosocial and support systems, health management, and delivery,
healthcare, reimbursement, and vocational concepts/strategies. Risk management is a sub domain
of case management principles, and practice/strategies.

The case management process of documenting goals, objectives, and actions to meet a clients
needs is:
A. Assessment
B. Coordination.
C. Planning.
D. Monitoring. correct answers C. Planning is the process by which case manager, documents,
goals, objectives, and actions that will meet a clients needs. Assessment entails gathering data
about a client special needs and situation prior to forming a case management plan. Coordination
involves organization, modification, and documentation of resources necessary to achieve goals.
Set forth in the plan, and monitoring involves securing information needed to gauge the
effectiveness of the plan.

Which of the following is a major component of essential knowledge for case manager?
A. Healthcare reimbursement.
B. Moral character.
C. Independent practice principles.
D. Statistical analysis. correct answers A. Healthcare reimbursement is one of the major
categories of knowledge necessary for a case manager, because there are many different
reimbursement mechanisms available, depending upon the patients particular situation.

The primary role of the case manager is to act as a:
A. Patient advocate.
B. Disease manager.

,C. Utilization reviewer
D. Care plan creator correct answers A. Patient advocate is the best answer. Advocacy is
essential to a case managers daily practice. A case manager acts on behalf of clients who may not
be able to speak for themselves or who are not knowledgeable about healthcare. Above all, the
case manager should always have the clients best interest in mind.

Which model of healthcare decision-making best demonstrates the principle of beneficence?
A. Patient sovereignty.
B. Paternalism
C. Shared decision-making.
D. Maternalism correct answers B. A relationship between healthcare practitioners and patients
is paternalistic and beneficial. This means that people trust the practitioner to do what is in the
best medical interest of the patient. Paternalism is justified in that patient usually don't
comprehend medical concepts well enough to make the correct decision about their care. In the
patient sovereignty model, the patient is open. "boss." In this case, one could argue that the
patient knows better than anyone else what is in his best interest. Shared decision making means
the healthcare team and the patient work together.

According to the standards of practice for case managers, there are four key functions of a case
manager. Which of the following is not one of the key functions?
A. Planner
B. Assessor.
See. Litigator.
D. Advocate. correct answers C. The four key functions of the case manager are planner,
assessor, facilitator, and advocate. A case manager must assess a situation to identify problems
that need case management. The case manager must also planned long and short term goals, and
collaboration with the client, the clients family, and with other healthcare professionals.
Facilitation includes coordinating and implementing the care plan, maintaining communication,
and expediting care. As an advocate, the case manager, ensure that the clients needs are
identified and addressed.

Nursing case management that is "within the walls" refers to which setting?
A. Outpatient setting.
B. Community clinic setting.
See. Health maintenance organization (HMO).
D. Acute hospital setting correct answers D. The term "within the walls" (WTW) refers to
activities within the acute hospital environment. This is distinct from "beyond the walls" (BTW),
which refers to case management in outpatient and community settings.

A terminally ill. Client is exhausting, all financial resources to pay medical cost. The case
manager has suggested obtaining cash value on his life insurance policy prior to death. This
process is known as a:
a. Nontraditional policy.
B. Supplementary policy
C. Viatical settlement.

,D. Gatekeeping. correct answers C. This scenario describes the process known as viatical
settlement, whereby a patient can obtain a cash value from a life insurance policy prior to death.
Answers a, B, and D are irrelevant to the situation.

A relationship, whereby a case manager act in a client best interest based on trust is known as:
A. Fiduciary.
B. Ex parte.
C tort
D. Due diligence. correct answers A. A case manager establishes a relationship with a client to
advocate for his best interest. This makes the case manager a fiduciary. The term ex parte refers
to illegal, proceeding or a legal order. A tort, on the other hand, refers to a wrongful act
performed will it fully. When a person investigates a business or personal relationship prior to
signing a contract, he is performing due diligence.

When a case manager refers a client to a specific provider, what type of relationship exist
between the case manager, and the provider?
A. Vicarious agency.
B. Advocate.
C. Ostensible agency.
D. Favoritism. correct answers C. The relationship that exists between the case manager, and a
referral provider is an ostensible agency. If that provider works to perform negligent actions. The
referring case manager may also become subject to litigation. A fiduciary is a relationship,
whereby the case manager act in the clients best interest. The case manager is an advocate for the
client, not the provider.

A case manager knowingly refers a patient to a provider who is unqualified to render services to
the patient. This is known as:
A. Temporary referral
B. Dual relationship.
C. Referral by client consent.
D. Negligent referral correct answers D. The case manager has to have knowledge of the referral
providers, credentials, and clinical experience. If a case manager sends a patient to an
unqualified referral provider, this constitutes a negligent referral. It is important for the case
managers to check in with patients afterward, to assure that they had a positive experience with
the provider. It is also the case managers responsibility to report any misconduct on the part of
that provider.

You have decided to become a case manager for a friend. Which of the following best describes
the situation?
A. Unbiased relationship.
B. Favoritism.
C. Dual relationship.
D. Professional courtesy correct answers C. This type of relationship is a dual relationship,
because you are both friend and case manager. This often leads to a conflict of interest. Having a
friendship with a client outside of the clinical arena, introduces biases that interfere with your
performance as a professional.

, A manage care contract may have provisions that prohibit Doctors from discussing treatment
choices with patients if the choices are not covered by their manage care plan. This provision is
an example of:
A. Confidentiality provision.
B. Gag clause.
C. Ethical dilemma.
D. Clinical pathway. correct answers B. In a managed healthcare plan, a gag clause prevents
healthcare providers from discussing with the patient treatment options that are not covered by
that particular manage care plan.

Which of these statements is true about advanced directives?
A. The documents did not be the legally executed.
B. Advanced directives are used if the patient becomes incompetent.
C. Advanced directors remove autonomy from the patient.
D. Advanced directives can be drawn up by the next of if patient is incompetent. correct answers
B. In advanced directive is legally executed. The document delineates the patient's health related
decisions. The patient draws it up while he/she is still mentally competent.

Which of the following is not an advanced directive?
A. living will
B. Medical power of attorney.
C. Durable power of attorney.
D. Last will and testament correct answers D. Medical power of attorney is a document, allowing
a person to appoint someone else to make medical care decisions in the event that he/she can't
communicate. Living wills, medical, power of attorney, and durable power of attorney are all
types of advanced directives.

The term polypharmacy ref:
A. The use of multiple medications.
B. The use of multiple pharmacies to fill prescriptions.
C. Patients who are appropriately taking multiple medication's for a chronic illness.
D. None of the above. correct answers A. Polypharmacy refers to the use of multiple
medication's, or the taking of more medication's at our medically indicated. It is a common
phenomenon in the elderly.

The case manager is part of a team of physicians, who assume care for the PCP when patients are
admitted to the hospital. This is known:
A. Skilled nursing facility.
B. Entrepreneurial setting.
C. Hospitalist team.
D. Hospice setting. correct answers C. Physicians who care for hospitalized patients are known
as hospitalist. This eliminates the burden on the PCP so that he or she can focus on office
practice. There is often at least one case manager on a hospitalist team. Entrepreneurial case
managers run their own case management businesses. Hospice case managers, coordinate care of

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