ACM certification Practice test

Question 1

A pediatric patient who is ventilator-dependent and has a gastrostomy button is scheduled to be discharged home with visits from a home health nurse. Prior to discharge, the nursing case manager’s most critical action is to:
A. assess the patient’s long-term home care needs
B. procure the required home medical equipment
C. secure funding sources for home health care
D. verify that the patient is being discharged to a safe environment

Answer 1

D. Verify that the patient is being discharged to a safe environment

Question 2

Which type of authorization is generated when services are rendered?
A. Concurrent
B. Prospective
C. Retrospective
D. Subauthorization

Answer 2

A. concurrent

Question 3

Managing clinical outcomes, studying variance trends, and evaluating actions taken to correct deviations from critical pathways are components of:
A. Performance improvement
B. Risk management
C. the nursing process
D. utilization review

Answer 3

A. Performance improvement

Question 4

Medication errors, orders for unnecessary tests, and omission of standard tests or procedures are classified as which type of variance?
A. Community
B. Operational
C. Patient
D. Practitioner

Answer 4

D. Practitioner

Question 5

To avoid hospital readmission, a patient requires services at a specialty clinic.  Because the services are not covered under the patient's healthcare plan, the nursing case manager intercedes with the patient's insurance company.  In this situation, the nurse is acting in the role of:
A. broker
B. consultant
C. negotiator 
D. provider

Answer 5

C. Negotiator

Question 6

When using a utilization tool to perform a concurrent review, the nursing case manager recognizes that:
A. Discharge is required whenever the tool so indicates
B. Exceptions exist because utilization tools reflect only average circumstances.
C. Patients have a right to set length of stay without incurring non reimbursable costs
D. the use of utilization tools guarantees payment for services

Answer 6

B. Exceptions exist because utilization tools reflect only average circumstances

Question 7

Ideally, nursing case management planning identifies goals that are:
A. anticipated, acceptable, and appropriate
B. challenging and timely
C. patient focused and cost effective
D. realistic, measurable, and specific

Answer 7

D. Realistic, measurable, and specific

Question 8

A patient who is homeless has been admitted to the hospital with multiple health care problems.  The nursing case manager, physician, social worker, and clinical dietician work together to care for the patient.  This interprofessional interaction is referred to as:
A. collaboration
B. consultation
C. continuity
D. coordination

Answer 8

A. Collaboration

Question 9

Which healthcare provider at a rehabilitation facility addresses the cognitive, behavioral, and psychological problems that result following a patient's traumatic brain injury?
A. Medical social worker
B. Neuropsychiatrist
C. Neurosurgeon
D. Psychologist

Answer 9

B. Neuropsychiatrist

Question 10

A 15-year-old single mother has a three month old infant.  If the infant needs to be hospitalized for a non-emergent illness, the consent for admission and treatment must be signed by the:
A. infant's grandparent
B. infant's mother
C. mother's attorney
D. mother's legal guardian

Answer 10

B. Infant’s mother

Question 11

The nursing case manager receives a referral to provide case management services for an adolescent mother who was recently diagnosed with HIV. Which statement indicates that the patient understands her illness?
A. “I can never have sex again, so I guess I will always be a single parent”
B. “I will wear gloves when I’m caring for my baby because I could infect my baby with AIDS.”
C. “My CD4 count is 200 and my T cells are less than 14%. I need to stay at these levels by eating and sleeping well and staying healthy.”
D. “My CD4 count is 800 and my T cells are greater than 14 %. I need to stay at these levels by eating and sleeping well and staying healthy.”

Answer 11

D. “My CD4 count is 800 and my T cells are greater than 14%. I need to stay at these levels by eating and sleeping well and staying healthy.”

Question 12

To treat an infected foot, a patient with Medicare Part A is prescribed a two-week course of IV antibiotics, wound care, and physical therapy for mobility training.  The nursing case manager recommends discharge to:
A. a skilled nursing facility
B. an acute care hospital
C. an acute rehabilitation facility
D. home health services

Answer 12

A. A skilled nursing facility

Question 13

The nursing case manager reviews information about the number of patients with asthma who have received care by a specialist, those who have not, and the number of emergency department visits and inpatient hospitalizations for both groups.  When comparing the data to develop interventions, the nurse engages in:
A. aggregate data analysis
B. benchmarking
C. collaboration
D.  integrated data solutions

Answer 13

A. aggregate data analysis

Question 14

The nursing case manager meets with a 15-year-old patient with type 1 diabetes, who has a recent A1C of 8%. The patient reports smoking two to three cigarettes per day, denies using alcohol, and states, “I hate having diabetes; I just want to be like my friends.” Which referral will benefit this patient’s immediate needs?
A. A smoking cessation group for adolescents.
B. A support group for adolescents with diabetes.
C. An education session about insulin, aimed at
adolescents.
D. Family counseling.

Answer 14

B. a support group for adolescents with diabetes

Question 15

Which ethical principle is grounded in truth?

A. Autonomy.
B. Beneficence.
C. Fairness.
D. Veracity.

Answer 15

D. Veracity

Question 16

To cover the cost of durable medical equipment, a patient who is enrolled in Medicare is required to:

A. appeal for coverage.
B. request coverage.
C. seek supplemental insurance.
D. share in the cost.

Answer 16

D. Share in the cost

Question 17

When developing a program offering for patients who are newly diagnosed with diabetes, the nursing case manager demonstrates an understanding of learning styles by:

A. administering a pre- and post-test assessment.
B. allowing attendees time to voice their opinions.
C. providing a snack with a low glycemic index.
D. utilizing a variety of educational materials.

Answer 17

D. Utilizing a variety of educational materials

Question 18

Which primary resource guides the nursing case manager’s practice?

A. American Case Management Association Member
Code of Conduct.
B. Case Management Society of America’s Standards
of Practice.
C. Nursing: Scope and Standards of Practice.
D. Nursing’s Social Policy Statement: The Essence of
the Profession.

Answer 18

B. Case management society of America’s standards of practice

Question 19

The nursing case manager, who refers a 67-year-old patient to a skilled nursing facility for rehabilitative care, knows that it will be billed under which component of Medicare?

A. Medicare Part A.
B. Medicare Part B.
C. Medicare Part D.
D. Medigap.

Answer 19

A. Medicare Part A

Question 20

Which right is a provision in the American Hospital Association’s Patients’ Bill of Rights?

A.Competent patients must be informed about
advance directives and be able to accept or refuse
treatment.
B. Patients must have access to an interpreter or
translation services to effectively communicate
concerns and discuss the treatment plan, provide
consent, and receive discharge information.
C. Patients must receive a timely response following a
request of care and appropriate, professional care
as ordered by a physician.
D. Patients must receive any necessary examination
and treatment during any emergency or when
female patients are in labor, dependent on their
ability to pay.

Answer 20

B. Patients must have access to an interpreter or translation services to effectively communicate concerns and discuss the treatment plan, provide consent, and receive discharge information.

Question 21

A doctor wants to order a brand-name fibromyalgia medication that is not covered by a patient’s insurance provider. As the patient has failed multiple agents prior to this prescription, the nursing case manager:

A. advises the doctor that the medication is not
covered and suggests revisiting some medications
that were ordered before.
B. directs the patient to the website of the drug
company’s patient assistance program for alternative
medications.
C. negotiates the self-pay cost for the brand-name
medication with the pharmacy.
D. submits the request for prior authorization to the
insurance company with accompanying medical
justification.

Answer 21

D. Submits the request for prior authorization to the insurance company with accompanying medical justification.

Question 22

A patient with hypertension resides in a homeless shelter 30 minutes from the patient’s primary clinic. The patient’s physician recommends checking blood pressure three times per week to determine efficacy of the patient’s antihypertensive medications. The nursing case manager:

A. contacts a clinic more accessible to the patient for
follow-up.
B. has the patient purchase a blood pressure machine
to self-monitor.
C. informs the patient that he or she has to provide his
or her own transportation.
D. instructs the patient to use a blood pressure
machine at a local store.

Answer 22

A. Contacts a clinic more accessible to the patient for follow-up

Question 23

The nursing case manager is concerned about the increase in the number of falls requiring hospitalization among older members of the local population. In order to identify those people at greater risk of readmission, the nurse:

A. administers the Short Form 36 questionnaire at a
community health fair.
B. interviews individual patients with their families present.
C. requires in-home evaluations by physical and
occupational therapists.
D. reviews the patients’ daily nutrition diaries and
medication lists.

Answer 23

A. administers the short form 36 questionnaire at a community health fair

Question 24

In synthesizing data for a disease management program, the nursing case manager uses which source of data triangulation to validate a conclusion?

A. Cost, containment, and length of stay.
B. Method, cause, and reaction.
C. Reason, rationale, and resolution.
D. Time, space, and person.

Answer 24

D. Time, space, and person

Question 25

Upon discharge from the hospital following total knee replacement surgery, a patient covered by Medicare with limited financial means will require six weeks of IV antibiotic therapy. The patient wants to go home. During the assessment, the nursing case manager discovers the patient lives alone, has no support at home, and lacks the dexterity to perform the infusion. What is the nurse’s next step?

A. Collaborate with the insurance company to allow the
patient to stay six weeks.
B. Explain to the patient about the barriers to going
home and discuss other options.
C. Make a home infusion referral because this is what
the patient has requested.
D. Order occupational therapy dexterity training for
self-administration.

Answer 25

B. explain to the patient about the barriers to going home and discuss other options