CMGT-BC : ANCC Nursing Case Management Certification Exam

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Nursing
CMGT-BC
ANCC Nursing Case Management Certification
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Question: 658
A case manager is assessing the effectiveness of a new patient navigation program. If the program costs
$100,000 and results in a 25% increase in preventive care utilization among 400 patients, what is the estimated financial benefit if preventive care saves $500 per patient annually?
A. $80,000 B. $100,000 C. $200,000 D. $50,000
er: D
nation: A 25% increase means 100 more patients are utilizing preventive care. The total savin he increased utilization is 100 patients x $500 = $50,000, which does not cover the program
ion: 659
manager is evaluating a patient's eligibility for Medicare coverage for therapy services. Wh lowing conditions must be met for the patient to qualify for these services?
patient must demonstrate a significant improvement in their condition within 30 days patient must require therapy services for a minimum of 60 days
therapy must be deemed medically necessary and prescribed by a physician patient must attend therapy sessions at least three times a week
er: C
nation: For Medicare coverage, therapy services must be deemed medically necessary and bed by a physician, ensuring compliance with coverage criteria.
ion: 660
manager is analyzing the financial outcomes of a community health initiative that required of $250,000. If the initiative resulted in a 30% decrease in smoking rates among 1,000 pants, what is the potential financial benefit if the average cost of smoking-related healthcar
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A. $600,000 B. $700,000 C. $900,000 D. $800,000
Answer: C
Explanation: A 30% reduction means 300 fewer individuals smoking. The financial benefit is calculated
as 300 x $3,000 = $900,000.
Question: 661
While coordinating care for a patient transitioning from an acute care setting to home health services, the case manager discovers a discrepancy in medication lists between the hospital discharge summary and the outpatient pharmacy. What action should the case manager take first to resolve this issue?
1. Assume the outpatient pharmacy is correct and update the care plan accordingly
2. Instruct the patient to use the medications listed by the outpatient pharmacy
ntact the hospital's pharmacy to verify the discharge medications er: D
nation: Contacting the hospital's pharmacy to verify the discharge medications is the first ste safe and accurate medication management, which is critical for patient safety during transiti
ion: 662
manager is tasked with developing a care plan for a patient with a history of substance use er. According to the Case Management Society of America (CMSA) Standards of Practice, w ollowing principles should take precedence when creating this plan?
oritizing the patient's immediate medical needs over psychosocial factors
uring the plan is strictly confidential and only shared with the healthcare team using on compliance with treatment protocols to minimize relapse risk
olving the patient and their family in the decision-making process er: D
nation: Involving the patient and their family in the decision-making process is essential as it collaboration and ensures that the care plan aligns with the patient's values and preferences, re principle of the CMSA Standards.
Schedule a follow-up appointment to review the medications with the patient
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Question: 663
A case manager is tasked with evaluating the effectiveness of a newly implemented care coordination program. Which method would provide the most comprehensive data regarding the program's impact on patient outcomes?
1. Reviewing hospital readmission rates alongside patient feedback and health outcomes
2. Conducting a patient satisfaction survey only
3. Analyzing staff workload and efficiency metrics only
4. Gathering anecdotal evidence from case managers involved in the program
Answer: A
Explanation: Combining multiple data sources, including readmission rates and patient feedback, provides a holistic view of the program’s effectiveness and its impact on patient outcomes.
Question: 664
A case manager is reviewing a discharge plan for a patient with chronic kidney disease. Which component is essential to include in the plan to prevent complications?
neric information about kidney disease
ist of medications without dosage instructions
chedule for follow-up appointments without specific timings eferral for nutritional counseling focused on renal diet
er: D
nation: A referral for nutritional counseling focused on a renal diet is essential for managing disease and preventing complications related to dietary indiscretions.
ion: 665
year-old woman with multiple chronic conditions is experiencing difficulty managing her he cognitive decline. What is the most appropriate intervention for the case manager to imple uation?
hedule more frequent follow-up appointments to monitor her conditions er her to a geriatric specialist for comprehensive assessment
olve a caregiver or family member in her care planning and management vide written instructions for self-management without follow-up
er: C
nation: Involving a caregiver or family member in her care planning provides essential suppo that her health management is sustained and effective, especially in the context of cognitiv
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Question: 666
A case manager is assessing a patient's understanding of their chronic illness. What approach is best to ensure that the patient comprehends their health status and treatment plan?
1. Use medical jargon to explain
2. Encourage questions and provide clear explanations
3. Provide written materials only
4. Assume the patient understands without confirmation Answer: B
Explanation: Encouraging questions and providing clear explanations fosters understanding and empowers the patient in their care management.
Question: 667
entation of informed consent for treatment. What is the best course of action to rectify this i
date the documentation without notifying the providers involved ore the oversight as it is a minor issue
in staff on the importance of informed consent and implement a checklist cument the oversight in the compliance report without further action
er: C
nation: Training staff on the importance of informed consent and implementing a checklist is ure compliance moving forward.
ion: 668
ospital setting, a case manager identifies that patients with chronic pain are frequently readmi the best strategy for addressing this issue?
rease the use of pain medications for all patients
laborate with pain management specialists to create individualized care plans charge patients with chronic pain after a set number of days
cus solely on physical therapy as a treatment modality er: B
nation: Collaborating with pain management specialists allows for tailored care plans that ad
During a compliance audit, a case manager identifies that certain patient records lack proper
docum ssue?
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the multifaceted nature of chronic pain, potentially reducing readmissions.
Question: 669
In a case where a patient has limited understanding of their treatment options, which approach should the case manager take to ensure informed consent is obtained?
1. Use complex medical terminology to explain options
2. Rely solely on the physician's explanation of treatment
3. Allow family members to make decisions on behalf of the patient
4. Provide clear, simplified information and check for understanding Answer: D
Explanation: Providing clear, simplified information and checking for understanding is crucial for ensuring that the patient can make an informed decision regarding their treatment options.
Question: 670
ucate the patient about the healthcare system without considering their culture. ess the cultural factors influencing the patient's healthcare experience. commend that the patient follow the standard protocols.
cument the cultural barriers and move on to the next case. er: B
nation: Assessing cultural factors is essential for tailoring communication and interventions t ient's unique needs and enhance understanding.
ion: 671
ent recently discharged after heart surgery reports difficulty understanding follow-up care tions. What is the most appropriate action for the nurse to take to improve the patient’s ehension?
vide all instructions verbally to avoid confusion teach-back methods to confirm understanding
Give the patient a list of resources to read
sume the patient will remember the information discussed er: B
nation: Using teach-back methods allows the nurse to verify the patient's understanding and
In a case management scenario, a patient is experiencing barriers due to cultural differences and misunderstanding of the healthcare system. What is the case manager's most effective initial response?
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2. Ass
3. Re
4. Do
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reinforces the information in a patient-centered manner.
Question: 672
During a multidisciplinary team meeting, a case manager identifies a gap in services for a patient transitioning from hospital to home care. Which strategy should the case manager prioritize to advocate for policy changes that address this issue within the healthcare system?
1. Develop a budget proposal for new services
2. Collaborate with local legislators to influence policy reform
3. Organize a community awareness campaign
4. Conduct a survey to assess patient needs Answer: B
Explanation: Collaborating with local legislators to influence policy reform is essential for addressing systemic gaps in services. This approach can lead to legislative changes that provide better support for patients transitioning from hospital to home care.
Question: 673
manager is developing a care plan for a patient with a recent knee replacement who is encing significant pain and limited mobility. Which of the following interventions would bes
the patient's recovery process?
commend bed rest to minimize pain
courage gradual increase in physical activity and coordinate with physical therapy us only on pain management with medications
ggest the patient avoid any movement to prevent further injury er: B
nation: Encouraging gradual physical activity and coordinating with physical therapy is essen ry post-surgery, promoting healing and improving mobility.
ion: 674
manager is tasked with coordinating care for a patient with complex needs. Which accredit rd should guide the care coordination process to ensure compliance with best practices?
facility must maintain a minimum occupancy rate
facility must implement a patient-centered approach to care facility must prioritize cost-effective treatment options
facility must limit the number of specialists involved in the patient's care
er: B
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Explanation: Implementing a patient-centered approach to care is a fundamental accreditation standard that guides effective care coordination and ensures compliance with best practices.
Question: 675
A case manager is tasked with developing a budget for a new mental health outreach program. If the program costs $350,000 and is expected to prevent $1 million in costs associated with untreated mental health issues, what is the overall financial benefit?
A. $700,000 B. $500,000 C. $600,000 D. $650,000
Answer: D
Explanation: The overall financial benefit is calculated as the savings minus the costs: $1,000,000 -
$350,000 = $650,000.
manager is tasked with improving care coordination for patients with multiple chronic cond payment model would best support this initiative by incentivizing comprehensive care ement?
-for-service pitation
ndled payments ue-based care
er: D
nation: Value-based care models incentivize comprehensive care management by linking ursement to patient outcomes, making it an ideal choice for improving care coordination for
with multiple chronic conditions.
ion: 677
ansition from hospital care to a home-based care model, which of the following practices sho se manager implement to ensure patient safety and effective communication?
vide the patient with a brochure about home care services only
pend solely on the patient to relay information to home health providers mit follow-up communication to email correspondence
ablish a communication protocol between the hospital and home health providers to share up
Question: 676
A case itions.
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on the patient’s condition Answer: D
Explanation: Establishing a communication protocol between the hospital and home health providers is critical for ensuring that all parties are updated on the patient’s condition and needs.

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