Expiration Date: December 31, 2011. No CE contact hours (CH) will be given after this date.
This continuing education module should be taken ONLY by those who have purchased the Nursing Case Management Review & Resource Manual, 3rd Edition. During the process of purchasing this CE module, you will be asked to input the proof of purchase code which can be obtained by sending an e-mail to revmanuals@ana.org.
The actual questions that will be on the test have been posted below.
When you purchase the CE module, you will be issued a password which will allow you to access all CE modules purchased on the NursingWorld Web site. This password is NOT to be confused with the proof of purchase code you received when you purchased the manual. It is important that you remember this password, as you MUST use it if you wish to log out of the system and return at a later time to take the test or to print duplicates of your certificate of completion.
IMPORTANT NOTE: The test for Contact Hours for Cardiac Vascular Review and Resource Manual contains 25 questions. You may find that you are not able to complete the entire test in one sitting. If this is the case, simply click on "Grade My Test" at the bottom of the test page even though you have not yet completed the test. This will allow the system to store your test for your return visit.
When you wish to return, click on "Log Back In" from the CE home page menu and input the CE password you were issued when you first registered for ANA's online CE. Again, do not input the purchase code you were issued as proof of purchase of the manual. Once you are logged back into the system, you will see a list of the ISMs you have completed and ones that are incomplete. Click on "Take Test" next to any incomplete ISM and you will be told how many questions you have completed and how many are left to complete.
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Test Questions
1. Planning is one of the core components of the case management process. Which statement is true concerning a patient's plan of care?
a. The plan of care should be patient centered.
b. The plan of care is based on the treatment patterns of the primary care physician.
c. No one can make recommendations to the plan of care except the physicians involved in the treatment of the patient
d. The plan of care is an ongoing process that has no time limits.
2. The basic skill for a successful negation is:
a. the ability to build solid relationships among all parties involved.
b. the ability to achieve the goals regardless of the interest of others.
c. the ability to achieve positive results that benefit your position.
d. the ability to achieve the results that limit exposure for thecompany negotiator, regardless of the needs of the patient.
3. Case managers have a crucial role in promotion of health and wellness. Which of the following statements is true concerning health and wellness promotion?
a. The promotion of health and wellness has always been a longstanding goal of the healthcare team because it is the foundation of containing healthcare costs and improving the quality of life.
b. The healthcare infrastructure allows for the majority of care to be preventative in nature.
c. Society has long believed that only those who have healthcare insurance have the right to preventative care.
d. In 2008, the Partnership for Health Act recognized health as a state of complete physical, mental, and social well-being, not merely the absence of disease or injury.
4. When caring for a complicated medical patient and a needed treatment or services is denied by the payor, choose the statement that best explains the plan of action you would be most likely to choose.
a. Gather evidence-based documentation that supports the plan of care and ask the payor to review the information as part of the appeal process
b. Inform the ordering physician that the care was denied
c. Inform the patient the care was denied and that he or she has no recourse
d. Discharge the patient as no more can be done for the patient according to the managed care organization.
5. Cost–benefit analysis is used by case managers in all settings part of the plan of care. Which statement is true concerning cost benefit analysis?
a. Documentation of savings achieved or use of a product or service that resulted in increased revenue for the organization is an example of cost–benefit analysis.
b. The nurse case manager can claim savings even if she or he was not directly involved in the decision that resulted in cost savings.
c. Examples of areas where savings can be achieved as a result of the involvement of a case manger include patient compliance, enhancement of quality of care, prevention of greater illness or injury, and better/more appropriate use of resources.
d. Cost savings that can demonstrate the effectiveness of the case manager should be factored in when it is time to decide on end-of-year bonuses.
6. Data management and reporting of data is an essential component of continuous quality improvement efforts throughout the continuum of care. Which statement is true concerning data management and its relationship to case management outcomes?
a. Nurse case mangers are not positioned well to move the healthcare agenda as it relates to information technology forward.
b. Data needs to be complete, accurate, and timely.
c. Data management provides the case manager with processes and structure to identify medical errors so risk management can investigate to ensure there is a plausible answer in case of a lawsuit.
d. Information at the point of care is needed to be able to have accurate billing, which would increase revenue for the organization.
7. Volunteer organizations are important resources nurse case managers can use when designing a plan of care for a patient. Which statement is true concerning volunteer organizations?
a. Volunteer organizations are a fundamental component of community resources.
b. Case managers wishing to achieve cost savings should have a reliable list of voluntary organizations so they do not have to use the patient's benefits.
c. Nonprofit organizations such as the Red Cross and United Way charge for the resources provided.
d. National support groups do not provide resources for patients with major illnesses or injuries due to the cost associated.
8. When ordering medical equipment or supplies for a patient, the case manager should not:
a. follow up to ensure that the equipment is delivered.
b. ensure that the patient received training on how to use the supplies or equipment.
c. ensure that the equipment is in good working order, and the patient is using the equipment.
d. personally go to the patient's home to inspect the supplies and equipment.
9. If there are questions regarding benefits or if the claim does not meet medical criteria used, the claim is turned over to:
a. the medical director, who makes the final decision.
b. the pharmacy director, who makes the final decision.
c. the case manager.
d. the employer.
10. Quality improvement organizations (QIOs) are a national network of peer review organizations that are under the directions of the Centers for Medicare and Medicaid to ensure quality services for consumers. Which of the following goals would be recommended as an outcome that the QIO would report?
a. Producing data to demonstrate that patients with insurance received the right care at the right time in the least restrictive manner.
b. Preserving the integrity of the Medicare trust fund by ensuring that patients without Medicare are billed at a higher rate.
c. Reduction of providers in overcrowded networks, achieved by encouraging patients to report complaints.
d. Improved practice through peer review actions that are not punitive in nature.
11. Nurse case managers are legally responsible for the care they provide to patients and can be prosecuted if found guilty by a court of law. To ensure an understanding of the categories of civil laws or torts that could apply, choose the act that would be designated as an intentional tort.
a. Assault
b. Negligence
c. Malpractice
d. Invasion of privacy
12. Nurse case managers, because of their role as patient advocates, have to be aware and able to recognize situations that may be viewed as a conflict of interest. Which of the following about conflicts of interest is true?
a. A conflict of interest can create an appearance of impropriety that can undermine confidence in the person, profession, or court system.
b. Conflicts of interest only occur in healthcare situations.
c. To avoid conflicts of interest, case managers should be not accept any information on a product or service if the information is provided by an employee of the company who makes the product or provides the service.
d. If a case manager recognizes she or he may have a conflict of interest, the best course of action is to leave the job.
13. Which law draws from the ethical principle of autonomy?
a. Patient Self-Determination Act
b. Health Insurance Portability and Accountability Act
c. Emergency Medical Treatment and Active Labor Act
d. Americans With Disabilities Act
14. Case managers, regardless of setting, have a role in educating patients in order to improve outcomes. Which statement is true concerning patient education programs?
a. The three key outcomes case managers claim through effective case management are education and empowerment, care coordination, and adherence to care.
b. To achieve positive outcomes, the case manager must take control of the patient's care because the healthcare system is too complicated to navigate.
c. As professionals, case managers no longer need to participate in their own continuing education.
d. An effective educator is one who works with the family members of a patient with a chronic condition because the patient is unable to comprehend the depth of their condition and plan of care.
15. Nurse case managers require specialized knowledge, training, and expertise to perform their duties of caring for patients in today's healthcare system. These actions can be demonstrated through educational levels, professional licensure, and certification. Which statement is true regarding professional licensure?
a. Licensure and certification are interchangeable.
b. A professional license is an official and legal form of validation required by the state government.
c. Licenses are issued to keep track of professionals so if problems occur, they can be found and disciplined.
d. Licenses tell the public that the practitioner is allowed to practice in the state where the patient resides as well as the state where the professional lives.
16. One of the core components of case management is planning. For nurse case managers to develop an effective plan of care, standards are utilized. Which statement best illustrates standard of care?
a. Standards of care provide minimal parameters from which to measure quality health care.
b. Standards of care are the same for all healthcare professionals.
c. Standards of care provide a rigid set of rules that healthcare professionals must follow when treating and managing patients.
d. Standards of care do not focus on a particular discipline, but provide general guidelines for all professionals to follow when treating patients.
17. Learners who take part in learning mainly because of the social contact they can get from the experience are:
a. goal-oriented learners.
b. activity-oriented learners
c. learning-oriented learners
d. self-directed-oriented learners.
18. Case management is not a profession, but a practice within various disciples. To ensure the various disciplines that make up the practice of case management understand the core functions of the practice, choose the statement that best explains concepts utilized to educate new professionals who are new to the practice of case management.
a. Formal training programs are instituted as part of orientation programs to inform new case managers about the history of the practice, introduce case management standards of practice, provide an overview of their job description, and train in the organization's policies and procedures.
b. Training includes informing new case managers that they no longer need to follow their own discipline's standards of care, and will now be held accountable only to standards of care for case managers.
c. Training that shows the core components of the practice of case management are specific to individual settings and how they apply.
d. A preceptor differs from a mentor; a preceptor is the person to assist case managers with career development and personal and professional growth ideas through a consultative approach over a long time.
19. To have robust leadership in the future, senior management must :
a. be involved in the mentoring programs of their primary professionals.
b. mandate certification as a requirement of professional practice.
c. promote PhD programs for all professionals.
d. limit the age of those entering nursing programs to ensure longevity of the practice.