Clinical Assessment & Risk Management 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 Clinical Assessment & Risk Management flashcards as text
A case manager identifies that a 78-year-old patient with heart failure has missed three consecutive medication refills. Which risk factor does this most directly indicate?
Answer: Medication non-adherence risk
Missed medication refills are a direct indicator of medication non-adherence risk, which significantly increases rehospitalization risk in heart failure patients.
The LACE Index is used in care management to predict which of the following?
Answer: 30-day hospital readmission risk
The LACE Index (Length of stay, Acuity of admission, Comorbidities, Emergency visits) is a validated tool for predicting 30-day hospital readmission risk.
When conducting a functional assessment, which tool specifically measures a patient's ability to perform instrumental activities of daily living (IADLs)?
Answer: Lawton IADL Scale
The Lawton IADL Scale assesses complex tasks such as managing finances, using transportation, and preparing meals that are classified as instrumental ADLs.
A case manager notices a patient's PHQ-9 score increased from 5 to 14 over the past month. What is the most appropriate immediate action?
Answer: Notify the treating physician and escalate the care plan
A PHQ-9 score of 14 indicates moderate depression; a significant increase warrants immediate physician notification and care plan escalation to prevent deterioration.
Which principle of risk stratification ensures that the highest-intensity case management resources are directed toward patients with the greatest clinical need?
Answer: Population segmentation
Population segmentation stratifies patients by risk level so that intensive case management resources are allocated to high-risk individuals who will benefit most.
A patient with COPD reports using their rescue inhaler more than twice per week. According to clinical guidelines, this pattern suggests:
Answer: Poorly controlled disease requiring care plan revision
Rescue inhaler use more than twice per week is a clinical marker of poorly controlled COPD or asthma, signaling the need for care plan revision.
During a home visit, a case manager observes expired food in the refrigerator, unpaid utility bills, and a confused patient living alone. Which risk domain is most immediately threatened?
Answer: Social determinants and safety risk
The combination of food insecurity, financial strain, utility risk, and cognitive confusion indicates an acute social determinants and safety risk requiring urgent intervention.