Deck 19: Case Management

Question 1

Which of the following is a case management activity most likely implemented by a BSN prepared nurse rather than an advanced practice nurse (APN)?

A) Working with community aggregates
B) Working with systems of disease
C) Working with individuals
D) Working with outcomes management processes

Answer 1

Working with individuals

Question 2

Life care planning is a tool used by case management. It assesses the current and future needs of a client for catastrophic or chronic disease over a life span. Which of the following is true about life care planning?

A) It provides a timeline of life events.
B) It dictates what patients request at all phases of their illness
C) It is a customized, medically based document that provides assessment of present and future needs.
D) Plans are based on set costs for medical care.

Answer 2

It is a customized, medically based document that provides assessment of present and future needs.

Question 3

Critical pathways are tools that specify activities providers may use in a timely sequence to achieve desired outcomes. Which of the following is true about critical pathways?

A) Critical pathways are used only by nurses who are case managers.
B) Pathways are useful in pinpointing compliance issues.
C) Pathways are used when clients spend more than $10,000 on health care.
D) These pathways can be used with specific diagnoses.

Answer 3

These pathways can be used with specific diagnoses.

Question 4

The role of the case manager as coordinator is to:

A) Provide information to all parties on the state of the member and situations affecting client
B) Educate client and providers about the case management process so that informed decisions can be make
C) Support all parties to work toward mutual goals
D) Arrange, regulate, and balance needed health services for clients

Question 5

Which of the following would be used to help clients improve their health status and therefore make fewer demands on the health care system?

A) Utilization management
B) Case management
C) Disease management
D) Demand management

Question 6

Healthy People 2010 includes goals to increase both quality of life and the elimination of health disparities. Which of the following is critical to the success of case management?

A) Eliminating health disparities in individuals in the community
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B) Providing services for every citizen
C) Evidence-based practice
D) Planning interventions that will ensure that every citizen is well by 2010

Question 7

Case management has many concepts. As with medication administration, there are five "rights" of case management: They include:

A) Care, time, provider, setting, and price
B) Patient, medication, route, time, documentation
C) Place, setting, patient, plan, outcomes
D) Disease process, time, place, beneficence, advocate

Question 8

The contemporary focus of the integrated health systems defines the nature of the clients as a population rather than an individual. Population management involves which of the following activities?

A) Census taking to determine the total number of people in the community's population
B) Assessing the needs of the client population through health histories, claims, use of service patterns, and risk factors
C) Providing case management services for every citizen in the community
D) Selecting programs for wellness that are repeated annually

Question 9

The case manager who uses effective collaboration and team strategies to make arrangements for services is performing the role of:

A) Broker
B) Negotiator
C) Liaison
D) Facilitator

Question 10

There are several knowledge domains essential for case management. These include:

A) Legal issues involving malpractice recognition
B) Teaching, counseling, and education skills
C) Political campaigning
D) Grant and contracts

Question 11

The health care industry comprises systems that integrate financing, management, and delivery of services. Population management includes wellness and illness prevention. The use of integrated systems has had important consequences such as:

A) Management has shifted from inpatient care to primary care providers as points of entry.
B) Emphasis is on population health management rather than on episodes of illness for an individual.
C) Care management services and programs do not provide access and accountability, but case management services do.
D) Population management no longer requires assessment.

Question 12

An enduring process in which a manager establishes systems and monitors the health status, resources, and outcomes for a targeted aggregate of the population is called:

A) Case management
B) Care management
C) Advocacy
D) Continuity of care

Question 13

A patient with a long history of asthma with many hospital admissions is referred to a case manager to assist in the management of her disease. Disease management targets:

A) Chronic and costly disease conditions that require long-term care interventions.
B) Patients who cannot handle their disease.
C) Those who seek to control use by providing clients with correct information.
D) Patients who will need an advanced practice nurse instead of physician for monitoring.

Question 14

A cause-and-effect grid that identifies expected client/family and staff behaviors against a timeline for a case-type or otherwise defined homogenous population is called:

A) A critical path
B) A "Care Map"
C) A multidisciplinary action plan
D) Standards of client care

Question 15

When case managers provide a formal communication link among all parties concerning the plan of care management, they are assuming the role of:

A) Facilitator
B) Liaison
C) Coordinator
D) Negotiator

Question 16

When the case manager contacts providers and negotiates services and price, which of the following phases of the nursing process is used?

A) Assessment
B) Diagnosis
C) Planning/outcome
D) Implementation

Question 17

The statement, "95% of 2-year-olds will be immunized," is an example of:

A) Unmet clinical quality indicators
B) Timeline standard
C) Outcome criteria
D) Variance

Question 18

In case management, the process of performing interdisciplinary, family, and client conferences would occur during which of the following phases of the nursing process?

A) Assessment
B) Diagnosis
C) Planning/outcome
D) Implementation

Question 19

Which of the following are examples of case-managed conditions?

A) Bankruptcy, financial distress, depression
B) Flu, colds, frequent headaches
C) Malaria, bird flu, Dengue fever
D) AIDS, spinal cord injury, ventilator dependency

Question 20

A critical path is best defined as:

A) One of the five "rights" of case management
B) A competency required for practicing case management
C) A case management tool used to achieve a measurable outcome for a specific client case
D) An effective approach to conflict resolution

Question 21

Which of the following models addresses the structure and processes of using the population-based tools of disease management and critical pathways to offer care for client populations?

A) Client-focused
B) System-focused
C) Social service
D) Long-term care

Question 22

The nurse is involved in a conflict resolution situation with the parents of a 2-year-old boy. The parents are deciding if "spanking" the child is a disciplinary method that they will employ. The mother says, "I do not believe in spanking. I see it as abusive and demeaning." The mother's statement is an example of:

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

Question 23

The process of moving conflicting parties toward an outcome is called:

A) Negotiation
B) Conflict management
C) Problem-purpose expansion method
D) Brainstorming

Question 24

Case management requires many competencies. The knowledge and skills required to become a competent case manager include which of the following? Select all that apply.

A) Knowledge of community resources and financing mechanisms.
B) Written and oral communication and documentation.
C) Proficient negotiating and conflict-resolving practices.
D) Apply evidenced-based practices and outcomes measures.
E) None of the above

Question 25

The nurse and client, a 20-year-old expectant mother, are discussing the advantages and disadvantages of breastfeeding. To enhance understanding of the implications of breastfeeding, the nurse says, "Tell me more about how you will work full time and breast feed." Asking this question is an example of which aspect of the advocacy process?

A) Verification
B) Clarification
C) Amplification
D) Affirmation

Question 26

The public health nurse working with the chronically ill and families with young children needing age-specific health maintenance is using which of the following models of case management?

A) Client-focused
B) System-focused
C) Social service
D) Long-term care

Question 27

An individual who pursues neither his or her concerns nor another's concerns is using which of the following behaviors of conflict management?

A) Accommodating
B) Collaborating
C) Avoiding
D) Compromising

Question 28

The ethical principle that can be influenced when care in a managed system is provided by less-experienced providers is:

A) Autonomy
B) Beneficence
C) Confidentiality
D) Justice

Question 29

Mutual benefit with limited loss for everyone is a goal of:

A) Negotiating
B) Assertiveness
C) Conflict management
D) Cooperation

Question 30

Upholding a client's right to make a choice and to act on the choice involves:

A) Affirming
B) Supporting
C) Informing
D) Decision making

Question 31

The first stage of collaboration is:

A) Trust building
B) Consensus
C) Collegiality
D) Awareness

Question 32

Which of the following principles of justice is influenced when excessive attention to cost containment supersedes or impairs the nurse's duty to provide measures to improve health or relieve suffering?

A) Autonomy
B) Beneficence
C) Confidentiality
D) Justice