Deck 13: Case Management

Question 1

The case manager explains to two disagreeing parties that coming to an agreement will save personnel costs for both of them. Which of the following terms best describes this action?

A)Assertiveness
B)Collaboration
C)Cooperation
D)Compromising

Answer 1

Collaboration

Question 2

A nurse is using the problem identification phase of the case management process. To which of the following phases of the nursing process does this correspond?

A)Assessment phase
B)Diagnosis phase
C)Planning phase
D)Implementation phase

Answer 2

Diagnosis phase

Question 3

Which of the following best describes the primary problem that can result from health care today being given by many different care providers?

A)Clients are not sure which provider to see first.
B)Health care providers have to make referrals to other providers.
C)Clients sometimes are not sure who their primary provider is.
D)Overuse, underuse, or gaps in care may result.

Answer 3

Overuse, underuse, or gaps in care may result.

Question 4

A nurse is completing a case management advocacy activity which corresponds to the implementation phase of the nursing process. Which of the following activities would the nurse most likely use?

A)Asking the client what is most important
B)Seeking appropriate referrals for the client
C)Assuring the client that his wishes will be supported
D)Determining the order in which actions will occur

Question 5

A client spends a great deal of his time on the Internet or reading articles related to diabetes and its long-term effects. One day the client asks why the nurse has not suggested a life care plan. Which of the following would be the best response by the nurse?

A)"Life care plans are only for young persons who are newly diagnosed."
B)"Life care plans are primarily used to determine long-term financial needs for legal reasons."
C)"You are receiving appropriate care for your diabetes without serious side effects, so a life care plan isn't really appropriate."
D)"I was waiting for you to express interest in having a life care plan."

Question 6

A nurse reviews with the client what the client can expect during the next 3 days, as well as how the client should expect to feel each of those days. The client laughs and says, "You've got my care all mapped out." Which of the following tools is the nurse using to determine what will happen when?

A)Care planning
B)Critical pathway
C)Demand management
D)Use management

Question 7

A nurse is using a case management plan to maximize patient care outcomes. Which of the following describes an important consideration that should be made by the nurse?

A)Case management plans should be used only by nurses to manage care.
B)Case management plans should be individualized for each client.
C)Case managements plans provide additional expense to the client and family.
D)Case management plans focus on the natural progression of the disease.

Question 8

Which of the following best explains why every client doesn't receive care from a case manager?

A)Case management time is demanding; thus it is restricted to complex cases.
B)Many health agencies do not employ case managers.
C)Most clients would not benefit from case management.
D)Most nurses do not know how to function as case managers.

Question 9

A case manager implements a primary prevention activity. Which of the following actions would the nurse most likely complete?

A)Advocating for the client whose values conflict with those of the medical service provider
B)Collaborating between nursing and occupational health personnel
C)Educating a group regarding community services that are available if ever needed
D)Resolving conflict between a primary care clinic and a tertiary health care facility

Question 10

Which of the following best describes the goal or priority of the nurse advocate?

A)To gain organizational and governmental support for the promotion of nursing objectives
B)To improve community service needs identified by research findings
C)To integrate evidence-based practice guidelines in the provision of community nursing service
D)To promote the client's rights and self-determination

Question 11

Which of the following Medicaid clients would most likely receive case management?

A)An elderly person
B)A person receiving rehabilitation following an injury
C)A person who has a high-cost chronic disease
D)A person with acute illness

Question 12

A nurse, client, family, and other care providers meet to discuss what will be the best approach to use to continue care. Which of the following best describes why the nurse suggests changing the goal from obtaining appropriate long-term care placement to ensuring that the client's convalescence is beneficial and safe?

A)To consider all possible consequences of long-term care placement
B)To encourage the group to review the client outcomes in the different settings
C)To expand the goal so that different solutions can be generated and considered
D)To help the group focus on the critical aspects the client's family considered most important

Question 13

A case manager advocates for a client by helping an insurer understand the client's needs and desires and by helping the client understand programs and benefits offered by the insurer. What role is the nurse?

A)Arbitrator
B)Counselor
C)Mediator
D)Negotiator

Question 14

Which of the following is the primary goal of case management? (Select all that apply.)

A)To ensure that care coordination occurs across the continuum
B)To emphasize evidence-based clinical decision making
C)To manage resource use and control expenses
D)To stress the advantages and benefits of community-based care

Question 15

The nurse suggests use of telehealth to assess how a client is progressing. Which of the following resources must be available for continuing care to be implemented?

A)A physician who is willing to use wireless prescriptions and plans of care
B)Family permission for the nurse to make home visits
C)Long-distance telephone service or a computer with Internet access
D)Willingness of the caregiver to drive the client to the nearest clinic

Question 16

A case manager is concerned about his exposure to possible lawsuits. Which of the following are appropriate actions to take to minimize this risk? (Select all that apply.)

A)Assure clients they can appeal any decision.
B)Carefully document client involvement and reasons for decisions.
C)Share client information with the other involved providers and agencies.
D)Confirm credentials and capabilities of providers or agencies to give care.

Question 17

Which of the following public health nurse applicants is the least qualified for a position of case manager in a rural county?

A)A 24-year-old who has a master's degree in public health
B)A 34-year-old who will be moving from a large city
C)A 44-year-old who was born and raised in the community
D)A 54-year-old who, until recently, was a member of the community's school board

Question 18

Which of the following best describes why planning care for an individual is so challenging in today's health care system?

A)Because today's clients have high expectations of the health care system
B)Because multiple providers, payers, and settings have to be coordinated
C)Because of the new high technology constantly being created and used for client treatment
D)Because so many different health care providers are in the acute care setting today

Question 19

Which of the following best describes case management?

A)A tool of health maintenance organizations
B)Targeted toward a specific segment of the population
C)Implemented with individual clients
D)Used to monitor the health status, resources, and outcomes for an aggregate