Case Analysis & Practical Application Flashcards
7 cards from real CCM 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 case manager is assigned a patient with end-stage renal disease who is ambivalent about starting dialysis. The MOST appropriate initial approach is to:
Answer: Facilitate a goals-of-care conversation that includes the patient's values and preferences
A goals-of-care conversation respects autonomy and ensures the treatment decision aligns with the patient's values.
A case manager's caseload includes a patient with opioid use disorder who is non-adherent to medication-assisted treatment (MAT). The BEST intervention is to:
Answer: Assess barriers to MAT adherence and connect the patient to peer support services
Assessing barriers and engaging peer support are evidence-based strategies for improving MAT adherence in opioid use disorder.
A case manager is evaluating a transition plan for a patient being discharged from a skilled nursing facility. Which element is MOST critical to verify before discharge?
Answer: Confirmation that follow-up appointments, medications, and home services are arranged
Verifying follow-up appointments, medication reconciliation, and home services are the core elements that prevent post-discharge complications.
A pediatric case manager is working with a family whose child has autism spectrum disorder. The parents report difficulty navigating the school system. The MOST appropriate action is to:
Answer: Provide information about the IEP process and connect the family to a special education advocate
Educating families about the IEP process and linking them to advocacy resources is within the case manager's coordination and education role.
A case manager is reviewing outcomes data and finds that a subgroup of patients with congestive heart failure has a 60-day readmission rate of 40%. The MOST appropriate quality improvement step is to:
Answer: Conduct a root cause analysis to identify common barriers and care gaps in this subgroup
Root cause analysis is the foundational quality improvement method for identifying modifiable factors driving poor outcomes.
A case manager working in a managed care organization identifies a member with undiagnosed depression based on claims data patterns. The BEST proactive action is to:
Answer: Conduct outreach, administer a validated screening tool, and coordinate care if needed
Proactive outreach with validated screening tools enables early identification and treatment of undiagnosed behavioral health conditions.
A case manager is documenting a care plan and realizes that a goal set three months ago has not been achieved. The MOST appropriate response is to:
Answer: Reassess barriers, revise the goal if needed, and update the care plan collaboratively with the patient
Regular reassessment and collaborative revision of unmet goals reflects the dynamic, iterative nature of effective case management.