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CCMC CCM Exam Questions
Page 5 of 25
81.
Are those receiving SSI and/or SSDI eligible for vocational rehabilitational services?
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Yes, depending on the severity of underlying conditions
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No, under no circumstances
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Yes, under all circumstances
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No, unless they have a specific order from a physician
Correct answer: Yes, depending on the severity of underlying conditions
A person receiving SSI (Social Security Income) or (SSDI) Social Security Disability Insurance would be considered eligible for vocational rehabilitational services, as long as the underlying condition would not prevent them from being employed.
The eligibility is not dependent on a doctor's order.
82.
What is the Severe Violator Enforcement Program with respect to case management?
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A workplace safety initiative
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A penal system initiative
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A fraud initiative
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A patient accountability initiative
Correct answer: A workplace safety initiative
The Severe Violator Enforcement program was begun by OSHA (Occupational Safety and Health Administration) to focus on the worst offenders of workplace safety.
This program is not a penal system initiative, a fraud initiative, or a patient accountability initiative.
83.
Which of the following best describes capitation?
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A mode of reimbursement
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A business model
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A financial penalty
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A Medicare calculation
Correct answer: A mode of reimbursement
Capitation refers to a monthly or regular fee paid to a care provider for covered services rather than a payment for specific services.
It is not a business model, financial penalty, or Medicare calculation.
84.
About how many patients are nonadherent to treatment?
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40%-70%
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10%-20%
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30%-50%
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5%-15%
Correct answer: 40-70%
Nonadherence to treatment is a major factor in case management, as patients tend to be nonadherent to treatment in some way at a rate of 40 to 70 percent. This results in lost efficiency, additional cost, and poor outcomes.
85.
Which of the following best defines the purpose of a Health Risk Assessment (HRA)?
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The patient takes action to improve their health
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The case manager takes action to improve a patient's health
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The patient is more fully aware of potential financial outcomes
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The case manager is able to arrive at a more complete assessment of health
Correct answer: The patient takes action to improve their health
A Health Risk Assessment (HRA) is used by case managers and their clients to educate patients about potential risks so that the patient can take action to improve their health.
The case manager is always taking some action to help a client improve their health, but the HRA is designed to empower patients. The HRA is not designed to help a patient become more aware of potential financial outcomes, nor is it meant for the case manager to use primarily to inform other healthcare assessments.
86.
Which of the following would be the least effective question to ask a client?
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Do you know what to do after discharge?
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Do you know how to administer your treatment?
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When is your next doctor's appointment?
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Do you know what symptoms you have?
Correct answer: Do you know what to do after discharge?
In dealing with patients, it is best to connect with them about concrete items, not general questions. Questions that are very specific are more helpful:
- Do you know how to administer your treatment?
- When is your next doctor's appointment?
- Do you know what symptoms you have?
Questions that are more general, such as Do you know what to do after discharge? are much less useful, as they do not ask the client anything specific about their knowledge and will likely yield little information.
87.
Which of the following would not be considered one of the "5 Rs" of care delivery?
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Right medication
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Right client
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Right setting
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Right time
Correct answer: Right medication
The "5 Rs" of care delivery are ways health plans and health care organizations refer to optimized care. They are:
- Right Client
- Right Provider
- Right Setting
- Right Level of Care
- Right Time
88.
What is a viatical settlement?
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The selling of a life insurance policy
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An agreement to increase benefits
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An agreement to settle a case of early death
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An agreement not to prosecute negligence
Correct answer: The selling of a life insurance policy
A viatical settlement is the selling of the life insurance policy of a person with terminal or life-threatening illness who is not expected to live more than five years.
It is not an agreement to increase benefits, an agreement to settle a case of early death, or an agreement not to prosecute negligence.
89.
What is the purpose of predictive modeling?
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To identify individuals at risk for disease
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To calculate the risk for individuals who have diseases
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To identify risks for disease in a population
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To identify which diseases are most deadly
Correct answer: To identify individuals at risk for disease
Predictive modeling uses technology and statistical analysis to process large amounts of data to arrive at risk calculations for individual patients. The purpose is to identify at risk persons at an early stage.
Predictive modeling does not calculate the risks of an existing disease process, identify disease risks in larger populations, or identify which diseases are most deadly.
90.
What is the main reason patients do not change health behaviors?
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Ambivalence
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Poor education
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Poverty
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Substance abuse issues
Correct answer: Ambivalence
The main reason patients do not change problematic health behaviors is ambivalence; they sit on the edge of change without committing to change or not.
Poor education, poverty, and substance abuse issues may be factors, but they are not as significant as an overall ambivalence in those who do not change.
91.
Which should be completed first in cases of presenting behavioral symptoms?
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A medical assessment
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A psychiatric assessment
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Both a medical assessment and a psychiatric assessment should be completed at the same time
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A biopsychosocial assessment
Correct answer: A medical assessment
In cases where behavioral symptoms are presenting, a medical assessment should first be done in order to rule out possible physical causes. When this is complete and physical causes have been ruled out, a psychiatric or mental health assessment would be called for to further assess possible mental illness.
A biopsychosocial assessment would not be the first assessment to complete in cases of presenting behavioral symptoms.
92.
Which of the following is the most accurate statement with regard to what information should be shared about a patient?
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The minimum necessary to provide care
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All information requested in the healthcare environment
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All information authorized by family members
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All information authorized by the patient
Correct answer: The minimum necessary to provide care
Confidentiality applies to all documentation and communication about a patient's care. In principle, the minimum necessary should be shared in the interest of preserving the client's privacy.
Such information is subject to specific and not general requests. Though a client or their family may authorize a great deal of information sharing through consent, the principle of minimum necessary disclosure still applies.
93.
The distinction between "value-added" work from "non-value-added" work is most associated with which approach to quality improvement?
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Lean approach
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Delphi technique
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Six Sigma
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PDSA
Correct answer: Lean approach
In the Lean approach to healthcare quality improvement, a distinction is made between "value-added" and "non-value-added" work. The intention is to reduce "non-value-added" work in an effort to reduce waste and increase overall value and quality.
This distinction is not relevant to the Delphi technique, Six Sigma, or PDSA (Plan-Do-Study-Act).
94.
What is the purpose of benchmarking?
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To better assess strengths and weaknesses
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To increase accountability
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To meet industry standards
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To assess competitor weakness
Correct answer: To better assess strengths and weaknesses
Benchmarking is a process by which one compares oneself with one's closest competitor. The purpose of this is to assess strengths and weaknesses in advancing best practices to be more competitive.
It is not meant to increase accountability or to meet an industry standard, as it deals with direct competition. It is not meant to assess competitor weakness, but to better help one's own organization know itself better in relation to another.
95.
Which of the following most determines the risk level of a patient?
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The case management assessment
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Predictive analytics
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Physician consult
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Diagnosis code
Correct answer: The case management assessment
Though predictive analytics can help in many ways by sorting patients according to known factors, it is the case management assessment that finally determines the level of risk or complexity of a patient.
Physician consults can be part of gathering collateral information, but do not determine risk level. Similarly, diagnosis codes are significant data, but are only one piece of data in a larger assessment and risk assignment.
96.
How long does it take to perform a Functional Capacity Assessment?
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At least four hours
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At least six hours
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One full eight hour day
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Two sessions of four hours
Correct answer: At least four hours
A Functional Capacity Assessment (FCE), a measure of one's ability to perform work tasks, takes at least four hours to complete in a structured clinical setting, overseen by a clinician specifically trained to do so.
97.
Which of the following is an indicator of emotional abuse?
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Reports of controlling behavior
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Vaginal and rectal pain
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Reports of unauthorized financial transactions
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Dehydration
Correct answer: Reports of controlling behavior
Reports of controlling behavior can indicate that a patient is being emotionally abused. Emotional abuse consists of inflicting pain or distress through verbal acts and threats. Vaginal and rectal pain is most likely an indicator of physical abuse, not emotional abuse. Reports of unauthorized financial transactions can indicate financial abuse. Dehydration is an indicator of physical abuse.
98.
Who provides the majority of client care?
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Clients and their families
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Physicians
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Nurses
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Volunteers
Correct answer: Clients and their families
Clients and their families perform the majority of client care, which is one of the main reasons they must be so carefully engaged in treatment planning and wellness strategies.
99.
What is the purpose of the Nursing Licensure Compact (NLC)?
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To allow nurses to practice in states other than licensed
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To create a database of nurses sanctioned for violations
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To ensure communication among states concerning practice standards
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To create one standard of nursing licensure internationally
Correct answer: To allow nurses to practice in states other than licensed
The purpose of the Nursing Licensure Compact (NLC) is to allow nurses to enjoy licensure reciprocity and practice in states other than those in which they may be licensed.
The NLC is not designed to create a database of nurses sanctioned for violations, to ensure communication among states concerning practice standards, or to create one standard of nursing licensure internationally.
100.
Which of the following conditions is not necessary for an ethical dilemma to be present?
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A dissatisfied party is present
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A decision that must be made
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Different courses of action are available
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An ethical principle will be compromised
Correct answer: A dissatisfied party is present
An ethical dilemma is a situation in which a decision must be made in which different courses of action are available. The problem is that in a dilemma, an ethical principle is likely to be compromised; hence the difficulty of these situations.
A dissatisfied party is not necessary for a dilemma to exist.