Case Analysis & Practical Application Flashcards
7 cards from real CMD practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Case Analysis & Practical Application flashcards as text
A SNF is cited for F-tag F758 (unnecessary antipsychotic drug use). As CMD, which intervention has the strongest evidence for reducing antipsychotic use in dementia residents?
Answer: Implementing structured non-pharmacological behavioral intervention programs
Non-pharmacological approaches such as person-centered activities, sensory interventions, and environmental modification are the evidence-based first-line treatment for behavioral symptoms of dementia.
A resident on chronic corticosteroids for COPD has not received a DEXA scan or fracture prevention therapy. This gap reflects a failure in which care dimension?
Answer: Effectiveness of preventive care
Failure to screen for steroid-induced osteoporosis and initiate bisphosphonate therapy represents a gap in effective preventive care delivery for a high-risk population.
During an emergency, a resident without a DNR enters cardiac arrest. The facility's AED is found to have a dead battery. The CMD's root-cause analysis should focus on:
Answer: Equipment maintenance policy failure and accountability for scheduled safety checks
A non-functional AED points to a systems-level equipment maintenance failure, not individual competency, and requires policy and accountability correction.
A resident with end-stage renal disease (ESRD) on dialysis develops sepsis. The family requests 'everything be done.' The CMD's most appropriate step is:
Answer: Clarify with the family what 'everything' means in the context of ESRD prognosis and goals of care
The term 'everything' is clinically ambiguous; a goals-of-care conversation clarifies realistic options and aligns treatment intensity with informed family understanding of ESRD-related prognosis.
A CMD reviews the facility's antibiogram and notes 70% of urinary isolates are resistant to fluoroquinolones. The BEST immediate policy response is:
Answer: Update empiric UTI treatment guidelines to reflect local resistance patterns
Antibiograms should directly inform empiric antibiotic selection guidelines; high local fluoroquinolone resistance necessitates updating facility protocols to improve treatment efficacy.
A CMD observes that a nurse practitioner working in the facility is practicing beyond her state-defined scope by independently ordering controlled substances without physician co-signature. The CMD should:
Answer: Immediately address the scope-of-practice violation and correct prescribing practices per state law and facility policy
Scope-of-practice violations for controlled substances carry legal and regulatory risk; the CMD must correct the practice immediately regardless of whether harm has occurred.
A facility's 30-day rehospitalization rate is 22%, well above the national average of 14%. Which analytical approach should the CMD use to identify the PRIMARY driver?
Answer: Stratify readmissions by diagnosis, time to readmission, and care transition quality to identify root causes
Stratified analysis of readmission diagnoses, timing, and transition processes pinpoints the highest-yield targets for quality improvement in rehospitalization reduction.