Clinical Assessment & Risk Management Flashcards

When assessing a patient's readiness to change a health behavior, the Transtheoretical Model (Stages of Change) identifies which stage as involving active modification of behavior for less than six months?

Answer: Action

The Action stage is defined by active behavior change that has been ongoing for less than six months, distinguishing it from the longer-term Maintenance stage.

A case manager discovers that a patient's care plan has not been updated in 18 months despite multiple hospitalizations. This represents a failure in which core case management function?

Answer: Ongoing monitoring and reassessment

Regular monitoring and reassessment is a core case management function that ensures care plans reflect the patient's current clinical status and are updated after significant events like hospitalizations.

The Vulnerable Elders Survey-13 (VES-13) is designed to identify which patient population?

Answer: Community-dwelling older adults at risk for functional decline or death over 2 years

VES-13 is a validated self-report tool that identifies community-dwelling older adults at elevated risk for functional decline and mortality within a two-year period.

A patient with schizophrenia repeatedly declines home health services. The case manager should first:

Answer: Assess the patient's decision-making capacity and explore barriers to acceptance

Before escalating, the case manager must assess whether the patient has decision-making capacity and understand the specific barriers driving the refusal to guide a patient-centered response.

Which clinical indicator would most appropriately trigger an immediate unplanned outreach call to a heart failure patient enrolled in a remote monitoring program?

Answer: Weight gain of 3 lbs in 24 hours with new-onset dyspnea

Rapid weight gain of 3 lbs in 24 hours combined with dyspnea is a hallmark sign of acute fluid retention and heart failure decompensation requiring immediate clinical response.

In risk management, 'failure mode and effects analysis' (FMEA) is best described as:

Answer: A proactive method to identify potential failure points in a process before harm occurs

FMEA is a proactive quality and safety tool that systematically identifies potential process failures and their effects before they cause patient harm.

When performing a pain assessment on a non-verbal dementia patient, which tool is most appropriate?

Answer: PAINAD (Pain Assessment in Advanced Dementia)

The PAINAD scale assesses pain in non-verbal patients with advanced dementia by observing breathing, vocalization, facial expression, body language, and consolability.