CCM EXAM 2025 LATEST ACTUAL
EXAM QUESTIONS AND DETAILED
CORRECT ANSWERS | A+ GRADE
2025/2026 | CERTIFIED CASE MANAGER
CERTIFICATION
A client is medically stable, but needs intermittent. Nursing
intervention to maintain stability. The patient also needs
intermittent, subacute injections, routine, non-sterile,
suctioning, and a stable respiratory therapy plan. What
level of care is this patient receiving?
A. Assisted-living
B. Custodial care.
C. Intermediate care.
D. Skilled nursing. Correct Answer C. The scenario
describes intermediate care. Under assisted-living or
custodial care, the client is stable, takes a consistent
regimen of oral medication's, and does not need
suctioning. Skilled nursing is for complex, but state
generally stable, patients who may need central line
care, IV push medication, variable, adjustments, and
dosages of medicines, and assessment of laboratory
values.
Which of the following is true about a preferred provider
organization (PPO)?
A. A PPO is not an insurance model.
B. PPO's offer a preferred panel of physicians.
,C. PPO use physicians gatekeepers.
D. A PPO allows use of physicians and encourage a lower
cost to the member. Correct Answer B. A PPO is an
insurance model that offers patient to preferred panel
of physicians. A patient may choose to utilize an
outside physician, but this would result in lower
reimbursement and a greater cost to the patient
member. HMO use physicians as gatekeepers.
An insurance plan that supplement services is not covered
by Medicare is known as:
A. Medicaid.
B. Catastrophic coverage.
C. Medigap.
D. CAPITATION. Correct Answer C. Medigap plans are
insurance plans at supplement services, not covered
by Medicare. On the other hand, Medicaid is federally
funded insurance for the poor. Capitation is the
periodic fee paid to a healthcare practice by each
member enrolled in a health plan.
Which of the following is true about reporting elder abuse?
A. The person reporting the abuse can be sued for
slander.
B. Reporting abuse is optional.
C. Neglect is not considered a form of abuse.
D. Exploitation of property is a form of abuse. Correct
Answer D. Exploitation of property refers to an illegal
use of a vernal vulnerable adults resources for
personal profit. This is a form of elder abuse that has
several forms such as abuse of joint accounts and
,forgery. As long as a person reports abuse, in good
faith, he is protected from slander or liable claims.
Reporting of abuse as mandatory.
According to the CDC, which of the following is a
reportable disease?
A. Pertussis.
B. Breast cancer.
C. Asbestos.
D. Cystic fibrosis. Correct Answer A. Pertussis, more
commonly, called whooping cough, is listed as a
reportable disease by the centers for disease, control,
(CDC).
Payment based on a fixed daily dollar amount is known:
A. Per diem reimbursement.
B. Cost reimbursement.
C. Capitation.
D. Fee for service Correct Answer A. The question
defines a per diem reimbursement. A cost space
reimbursement refers to actual cost of the patient
care. In fee for service, the provider bills, the
insurance company and the company pays for
services. Citation is a fixed monthly payment paid to a
provider in advance of services.
The medical term for difficulty swallowing:
A. APHAKIA
B. Dysphasia.
C. Akathisia
, D. Dysphagia Correct Answer D. The term for difficulty
and swallowing is dysphagia. Dysphasia, on the other
head, refers to an absence of language function.
Aphakia Is an ophthalmologic term, referring to the
absence of the ocular lens. Lastly, akathisia is an
abnormal level of agitation or restlessness.
Which of the following is most characteristic of
assertiveness in a case management situation?
A. Assertiveness specifically direct you to do the most
important task first.
B. Assertiveness allows you to act instead of react in a
particular situation.
C. Assertiveness allows you to send messages using non-
verbal cues, such as posture and facial expressions.
D. Assertiveness allows you to act as a referee. Correct
Answer B. Assertiveness is an important part of
communication, and is a desirable skill for a case
manager, because of frequent encounters with tents
situations. It simply gets the patience needs met.
Answer a describes prioritization; answer, C
describes, non-verbal communication; and, acting as
a referee falls in the realm of conflict resolution.
Which of these statements is true about hospice care?
A. Hospice care is solely for patients with terminal
malignancies
B. Hospice is for patient to have six or fewer months to
live.
C. In hospice, all further medical treatment has been
stopped, including palliation.
EXAM QUESTIONS AND DETAILED
CORRECT ANSWERS | A+ GRADE
2025/2026 | CERTIFIED CASE MANAGER
CERTIFICATION
A client is medically stable, but needs intermittent. Nursing
intervention to maintain stability. The patient also needs
intermittent, subacute injections, routine, non-sterile,
suctioning, and a stable respiratory therapy plan. What
level of care is this patient receiving?
A. Assisted-living
B. Custodial care.
C. Intermediate care.
D. Skilled nursing. Correct Answer C. The scenario
describes intermediate care. Under assisted-living or
custodial care, the client is stable, takes a consistent
regimen of oral medication's, and does not need
suctioning. Skilled nursing is for complex, but state
generally stable, patients who may need central line
care, IV push medication, variable, adjustments, and
dosages of medicines, and assessment of laboratory
values.
Which of the following is true about a preferred provider
organization (PPO)?
A. A PPO is not an insurance model.
B. PPO's offer a preferred panel of physicians.
,C. PPO use physicians gatekeepers.
D. A PPO allows use of physicians and encourage a lower
cost to the member. Correct Answer B. A PPO is an
insurance model that offers patient to preferred panel
of physicians. A patient may choose to utilize an
outside physician, but this would result in lower
reimbursement and a greater cost to the patient
member. HMO use physicians as gatekeepers.
An insurance plan that supplement services is not covered
by Medicare is known as:
A. Medicaid.
B. Catastrophic coverage.
C. Medigap.
D. CAPITATION. Correct Answer C. Medigap plans are
insurance plans at supplement services, not covered
by Medicare. On the other hand, Medicaid is federally
funded insurance for the poor. Capitation is the
periodic fee paid to a healthcare practice by each
member enrolled in a health plan.
Which of the following is true about reporting elder abuse?
A. The person reporting the abuse can be sued for
slander.
B. Reporting abuse is optional.
C. Neglect is not considered a form of abuse.
D. Exploitation of property is a form of abuse. Correct
Answer D. Exploitation of property refers to an illegal
use of a vernal vulnerable adults resources for
personal profit. This is a form of elder abuse that has
several forms such as abuse of joint accounts and
,forgery. As long as a person reports abuse, in good
faith, he is protected from slander or liable claims.
Reporting of abuse as mandatory.
According to the CDC, which of the following is a
reportable disease?
A. Pertussis.
B. Breast cancer.
C. Asbestos.
D. Cystic fibrosis. Correct Answer A. Pertussis, more
commonly, called whooping cough, is listed as a
reportable disease by the centers for disease, control,
(CDC).
Payment based on a fixed daily dollar amount is known:
A. Per diem reimbursement.
B. Cost reimbursement.
C. Capitation.
D. Fee for service Correct Answer A. The question
defines a per diem reimbursement. A cost space
reimbursement refers to actual cost of the patient
care. In fee for service, the provider bills, the
insurance company and the company pays for
services. Citation is a fixed monthly payment paid to a
provider in advance of services.
The medical term for difficulty swallowing:
A. APHAKIA
B. Dysphasia.
C. Akathisia
, D. Dysphagia Correct Answer D. The term for difficulty
and swallowing is dysphagia. Dysphasia, on the other
head, refers to an absence of language function.
Aphakia Is an ophthalmologic term, referring to the
absence of the ocular lens. Lastly, akathisia is an
abnormal level of agitation or restlessness.
Which of the following is most characteristic of
assertiveness in a case management situation?
A. Assertiveness specifically direct you to do the most
important task first.
B. Assertiveness allows you to act instead of react in a
particular situation.
C. Assertiveness allows you to send messages using non-
verbal cues, such as posture and facial expressions.
D. Assertiveness allows you to act as a referee. Correct
Answer B. Assertiveness is an important part of
communication, and is a desirable skill for a case
manager, because of frequent encounters with tents
situations. It simply gets the patience needs met.
Answer a describes prioritization; answer, C
describes, non-verbal communication; and, acting as
a referee falls in the realm of conflict resolution.
Which of these statements is true about hospice care?
A. Hospice care is solely for patients with terminal
malignancies
B. Hospice is for patient to have six or fewer months to
live.
C. In hospice, all further medical treatment has been
stopped, including palliation.
