CCM Client Advocacy and Engagement 4 — Questions and Answers
Question 1: Which technique is MOST effective when a client appears resistant to a recommended care plan change?
- Explaining the consequences of non-compliance in detail
- Exploring the client's ambivalence using open-ended questions and reflective listening (Correct answer)
- Having the physician reinforce the recommendation with authority
- Scheduling the change without further discussion to reduce decision fatigue
Correct answer: Exploring the client's ambivalence using open-ended questions and reflective listening
Motivational interviewing techniques—open questions and reflective listening—are the evidence-based approach to resolving ambivalence and resistance.
Question 2: A client with diabetes consistently misses appointments. Before labeling the client as 'non-compliant,' the case manager should:
- Send a formal warning letter about program termination
- Assess for social determinants of health such as transportation barriers, work schedule conflicts, or financial hardship (Correct answer)
- Reduce the frequency of scheduled appointments
- Transfer the client to a more compliant panel
Correct answer: Assess for social determinants of health such as transportation barriers, work schedule conflicts, or financial hardship
Missed appointments often reflect unaddressed social determinants of health, and the case manager must assess these root causes before any other action.
Question 3: Shared decision-making differs from informed consent primarily because it:
- Requires physician approval for every client choice
- Is a collaborative process where clinician expertise and client values jointly guide the treatment decision (Correct answer)
- Only applies to elective procedures
- Eliminates the need for written documentation
Correct answer: Is a collaborative process where clinician expertise and client values jointly guide the treatment decision
Shared decision-making integrates clinical evidence with the client's personal values and preferences to reach a mutually agreed-upon plan.
Question 4: When a client is transitioning from inpatient to home care, what is the case manager's PRIMARY advocacy responsibility?
- Ensuring the hospital's length of stay metrics are met
- Verifying that all post-discharge services, equipment, and follow-up are in place before the client leaves (Correct answer)
- Arranging the earliest possible discharge to free the bed
- Delegating all discharge planning to the social worker
Correct answer: Verifying that all post-discharge services, equipment, and follow-up are in place before the client leaves
The case manager must ensure a safe, coordinated transition by confirming all needed services and supports are secured prior to discharge.
Question 5: A client with a terminal diagnosis wants to pursue aggressive curative treatment against the palliative care team's recommendation. The case manager should:
- Support the palliative care team's recommendation as the clinical standard
- Ensure the client's wishes are documented, respected, and that all options including palliative care are fully explained (Correct answer)
- Contact the family to convince the client to accept palliative care
- Delay care planning until the client reconsiders
Correct answer: Ensure the client's wishes are documented, respected, and that all options including palliative care are fully explained
The client's autonomous decision to pursue curative treatment must be honored while ensuring they have complete information about all care options.
Question 6: Which of the following BEST describes the concept of 'health literacy' in the context of client engagement?
- The client's ability to read and write at a high school level
- The client's capacity to obtain, process, and understand basic health information needed to make appropriate health decisions (Correct answer)
- The case manager's ability to explain medical terminology
- The number of health education sessions the client has attended
Correct answer: The client's capacity to obtain, process, and understand basic health information needed to make appropriate health decisions
Health literacy encompasses the full range of skills needed to navigate the healthcare system and make informed decisions, beyond just reading ability.
Question 7: A case manager is working with a client who has a substance use disorder and is not ready to pursue abstinence. The most appropriate approach is to:
- Decline to work with the client until they commit to sobriety
- Apply harm reduction strategies to reduce health risks while meeting the client where they are (Correct answer)
- Refer the client exclusively to a 12-step program
- Document the client's refusal of treatment and close the case
Correct answer: Apply harm reduction strategies to reduce health risks while meeting the client where they are
Harm reduction is an evidence-based, client-centered approach that reduces health risks for clients not yet ready for abstinence-based treatment.
CCM Client Advocacy and Engagement 4
Which technique is MOST effective when a client appears resistant to a recommended care plan change?