CCM Certified Case Manager (CCM) MCQ 5 — Questions and Answers
Question 1: When conducting a functional assessment for a patient with multiple chronic conditions, the case manager should PRIMARILY evaluate:
- The patient's insurance coverage limits
- Activities of daily living (ADLs), instrumental ADLs, and cognitive status (Correct answer)
- Employer leave of absence eligibility
- The patient's dietary preferences
Correct answer: Activities of daily living (ADLs), instrumental ADLs, and cognitive status
Functional assessment in case management centers on ADLs, IADLs, and cognitive status to determine care needs and appropriate level of support.
Question 2: A patient declines a recommended surgery that the care team believes is necessary. The case manager's role is to:
- Override the patient's decision with family consent
- Ensure the patient has received complete information, document the informed refusal, and continue supporting the patient's choices (Correct answer)
- Discharge the patient from case management for non-compliance
- Pressure the patient to reconsider until they agree
Correct answer: Ensure the patient has received complete information, document the informed refusal, and continue supporting the patient's choices
Informed refusal must be documented after ensuring the patient understands consequences; case managers uphold patient autonomy while continuing to support.
Question 3: What is the primary purpose of a catastrophic case management program?
- To manage routine preventive care for all high-risk patients
- To coordinate complex, high-cost care for individuals with severe injuries or illnesses such as spinal cord injury or traumatic brain injury (Correct answer)
- To process insurance claims for catastrophic events
- To manage natural disaster response for healthcare systems
Correct answer: To coordinate complex, high-cost care for individuals with severe injuries or illnesses such as spinal cord injury or traumatic brain injury
Catastrophic case management focuses on coordinating intensive, long-term services for patients with severe, complex, and high-cost conditions.
Question 4: A case manager documents that a patient is at high risk for falls at home. Which intervention is MOST appropriate?
- Recommend the patient remain sedentary to prevent falls
- Refer for a home safety evaluation and physical therapy for strength and balance training (Correct answer)
- Prescribe sedatives to reduce nighttime fall risk
- Advise the family to watch the patient at all times
Correct answer: Refer for a home safety evaluation and physical therapy for strength and balance training
A home safety evaluation combined with physical therapy addresses both environmental hazards and the patient's physical deficits contributing to fall risk.
Question 5: Which federal law prohibits discrimination in healthcare based on disability and requires reasonable accommodations?
- HIPAA
- Americans with Disabilities Act (ADA) (Correct answer)
- COBRA
- ERISA
Correct answer: Americans with Disabilities Act (ADA)
The ADA prohibits discrimination against individuals with disabilities in healthcare settings and requires reasonable accommodations to ensure access.
Question 6: A case manager is preparing a patient with newly diagnosed Type 2 diabetes for self-management. Which element of the SMART goal framework should be applied when setting education goals?
- Goals should be subjective and flexible to accommodate patient mood
- Goals should be Specific, Measurable, Achievable, Relevant, and Time-bound (Correct answer)
- Goals should be set solely by the healthcare provider
- Goals should prioritize cost reduction over patient preferences
Correct answer: Goals should be Specific, Measurable, Achievable, Relevant, and Time-bound
SMART goals provide clear, actionable targets for self-management education that can be objectively evaluated and adjusted over time.
Question 7: Workers' compensation case management differs from standard health case management primarily because:
- It focuses exclusively on mental health recovery
- It coordinates care with the dual goal of medical recovery and return to work, within a legal and occupational framework (Correct answer)
- Payers have no role in workers' compensation cases
- Case managers in workers' comp do not interact with treating physicians
Correct answer: It coordinates care with the dual goal of medical recovery and return to work, within a legal and occupational framework
Workers' compensation case management balances medical treatment with vocational rehabilitation and return-to-work planning within a regulatory and legal structure.
CCM Certified Case Manager (CCM) MCQ 5
When conducting a functional assessment for a patient with multiple chronic conditions, the case manager should PRIMARILY evaluate: