CPC Patient Navigation and Advocacy 3 — Questions and Answers
Question 1: A patient with congestive heart failure is readmitted within 30 days for the third time. Which navigation strategy is MOST likely to reduce future readmissions?
- Increasing emergency dispatch priority for this patient
- Implementing a care transition plan with scheduled home visits and medication reconciliation (Correct answer)
- Advising the patient to call 911 instead of their physician
- Limiting home visits to reduce healthcare costs
Correct answer: Implementing a care transition plan with scheduled home visits and medication reconciliation
Structured care transition plans with medication reconciliation and home follow-up are evidence-based strategies to reduce heart failure readmissions.
Question 2: What is the purpose of a 'warm handoff' in patient navigation?
- Transferring a patient physically to a hospital
- A direct introduction between the patient and the next provider to ensure continuity (Correct answer)
- Providing written discharge instructions
- Calling 911 when a patient declines further treatment
Correct answer: A direct introduction between the patient and the next provider to ensure continuity
A warm handoff is a direct, real-time introduction between the patient and their next provider to reduce care gaps.
Question 3: Which ethical principle is MOST central to patient advocacy in community paramedicine?
- Beneficence alone
- Autonomy — respecting the patient's right to make informed decisions (Correct answer)
- Paternalism — the provider knows best
- Nonmaleficence — avoiding all risk
Correct answer: Autonomy — respecting the patient's right to make informed decisions
Autonomy underpins advocacy by ensuring patients are informed and empowered to direct their own care.
Question 4: A patient is enrolled in Medicare. Which program MOST directly assists with out-of-pocket drug costs for low-income Medicare beneficiaries?
- CHIP
- Medicare Part D Extra Help (Low Income Subsidy) (Correct answer)
- TRICARE
- Veterans Choice Program
Correct answer: Medicare Part D Extra Help (Low Income Subsidy)
Medicare Part D Extra Help (Low Income Subsidy) reduces prescription drug costs for qualifying low-income Medicare beneficiaries.
Question 5: During a home visit, a community paramedic discovers a patient is unable to perform basic ADLs (activities of daily living). Which referral is MOST appropriate?
- Psychiatric services
- Home health aide or personal care attendant services (Correct answer)
- Emergency department for hospitalization
- Cardiac rehabilitation program
Correct answer: Home health aide or personal care attendant services
Home health aides and personal care attendants directly assist patients with ADL deficits in their own homes.
Question 6: A community paramedic is working with a patient who has mental illness and is reluctant to engage with psychiatric services. What is the BEST approach?
- Arrange involuntary commitment immediately
- Build therapeutic rapport over multiple visits and use motivational interviewing to explore barriers (Correct answer)
- Discharge from the program due to non-compliance
- Contact family members to force the patient into treatment
Correct answer: Build therapeutic rapport over multiple visits and use motivational interviewing to explore barriers
Motivational interviewing and consistent rapport-building are evidence-based methods to engage reluctant patients with mental illness.
Question 7: Which tool is MOST commonly used by community paramedics to screen for depression during home visits?
- Glasgow Coma Scale (GCS)
- PHQ-9 (Patient Health Questionnaire-9) (Correct answer)
- APGAR score
- Ottawa Ankle Rules
Correct answer: PHQ-9 (Patient Health Questionnaire-9)
The PHQ-9 is a validated, widely used tool for screening depression severity in community and primary care settings.
CPC Patient Navigation and Advocacy 3
A patient with congestive heart failure is readmitted within 30 days for the third time.
Which navigation strategy is MOST likely to reduce future readmissions?