CMD Case Analysis & Practical Application 2

Question 1

A skilled nursing facility's antibiotic usage rate is 3x the national benchmark. As CMD, what is your FIRST action?

Accepted Answer

Conduct a root-cause analysis of prescribing patterns and indications

Answer

A root-cause analysis identifies whether overuse stems from diagnostic ambiguity, culture-and-treat habits, or family pressure before interventions are designed.

Question 2

An 84-year-old resident with advanced dementia develops a fever of 101.8°F. The family insists on hospitalization. The care plan indicates comfort-focused goals. What is the most appropriate CMD response?

Accepted Answer

Hold a goals-of-care meeting to realign family expectations with the documented care plan

Answer

A goals-of-care conversation ensures the family understands the existing plan and allows shared decision-making consistent with the resident's documented wishes.

Question 3

Your facility reports a sudden cluster of 6 residents with diarrhea over 48 hours. As CMD, which pathogen should you prioritize ruling out FIRST?

Accepted Answer

Clostridioides difficile

Answer

C. difficile is the most common healthcare-associated diarrheal pathogen in SNFs and requires immediate contact precautions and stool testing.

Question 4

A newly admitted resident's medication reconciliation reveals 14 active medications. Under the STOPP/START criteria, the CMD should focus on which action?

Accepted Answer

Perform a systematic deprescribing review targeting potentially inappropriate medications

Answer

STOPP/START criteria are validated tools specifically designed to identify potentially inappropriate prescribing and trigger deprescribing in older adults.

Question 5

A SNF administrator asks the CMD to sign physician orders for a resident the CMD has never evaluated. What is the correct response?

Accepted Answer

Refuse to sign until the resident has been personally assessed

Answer

A CMD must perform or directly supervise a personal assessment before co-signing orders to maintain licensure standards and resident safety.

(CMD) Certified Medical Director Practice Test

(CMD) Certified Medical Director Practice Test

CMD Case Analysis & Practical Application 2