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. - ANSWER 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. - ANSWER 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.
1
,D. Monitoring. - ANSWER 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. - ANSWER 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 - ANSWER 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 - ANSWER B. A relationship between healthcare practitioners and
patients is paternalistic and beneficial. This means that people trust the practitioner to do
2
,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. - ANSWER 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 - ANSWER 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
3
, C. Viatical settlement.
D. Gatekeeping. - ANSWER 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. - ANSWER 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. - ANSWER 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.
4
work?
A. Pain tolerance evaluation.
B. Functional capacity evaluation.
C. Disability evaluation.
D. Evaluation by client interview. - ANSWER 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. - ANSWER 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.
1
,D. Monitoring. - ANSWER 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. - ANSWER 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 - ANSWER 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 - ANSWER B. A relationship between healthcare practitioners and
patients is paternalistic and beneficial. This means that people trust the practitioner to do
2
,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. - ANSWER 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 - ANSWER 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
3
, C. Viatical settlement.
D. Gatekeeping. - ANSWER 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. - ANSWER 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. - ANSWER 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.
4
