CCM practice questions: Ethical, Legal, & Practice Standards Flashcards
Which benefit listed below is NOT considered an essential health benefit under the ACA?
A. Behavioral health counseling
B. Adult dental
C. Prescriptions
D. Newborn care
B. Correct. Pediatric dental is included, but adult dental care is not. Other choices are essential health benefits under the ACA.
The ADA states that reasonable accommodations must be met for disabled employees. Which example accommodation listed below may NOT be awarded under the ADA?
A. A new bathroom to accommodate an employee who uses a power wheelchair
B. Longer breaks for an employee who has type one diabetes
C. A recorder that has frequent job task reminders for an employee with a developmental disability
D. A basket and cushion for an employee with a physical disability
A. Correct. Constructing a new bathroom may cause undue hardship to the employer, as it could be both expensive and disruptive to the company’s work.
Incorrect answers
B. Work schedules may be modified under the ADA.
C. A tape recorder would not be a costly accommodation.
D. A cushion and a basket are reasonable, they are inexpensive accommodations.
OSHA sets standards to keep employees safe at work. Which of the following is NOT addressed by OSHA standards?
A. Limiting exposure to hazardous chemicals
B. Fall protection for workers who use ladders
C. Drug testing during the interview process
D. Preventing transmission of specific infectious diseases
C. Correct. OSHA made drug test persons involved in workplace accidents, but the agency does not set standards for drug tests that occur during the hiring process. OSHA sets standards for these situations described in the other choices.
Which of the following is most likely a violation of HIPAA?
A. Using a password to log into a shared computer
B. Shredding medical records when they are expired
C. Accessing the medical record of a client’s parents
D. Faxing the results of an ultrasound to a client’s primary care provider
C. Correct. Under HIPAA, the case manager is not allowed to access the medical records of people whose care she is not involved in.
Incorrect answers
A. Passwords are vital for electronic records and should be used on every computer in the medical office.
B. Records containing Phi have expiration dates and need to be shredded at that time.
D. Faxing test results should fall under the Privacy Rule Authorization form signed by the client at the beginning of their care.
The provider wishes to earn a Meaningful Use incentive. Which objective listed below BEST helps to eliminate gaps in care?
A. Reporting specific cases
B. Structured electronic transmission of laboratory test results
C. Use of electronic discharge prescriptions
D. Electronic exchanges of summary of care
D. Correct. Electronic exchanges of summary of care improve coordination of care.
Incorrect answers
A. Reporting specific cases to registries helps with identification of specific cases and trends.
B. Structured electronic transmission of laboratory test results improves access to those results, but exchanges of summary of care provide more information and better coordination of care.
C. Electronic discharge prescriptions ensure that medications are prescribed quickly.
Which of the following clients, all employed by a company covered by the FMLA, will most likely NOT be eligible for FMLA?
A. An employee with a mother-in-law who is beginning in-home Hospice care
B. An employee who has recently adopted a three-year-old child
C. An employee who was unexpectedly left without childcare after his military spouse was deployed
D. An employee recently diagnosed with lung cancer
A. Correct. The FMLA does not cover leave of absence for employees to care for in-laws.
Incorrect answers
B. The FMLA covers leave for all new parents following an adoption, pregnancy, or foster care placement.
C. Leave for exigent circumstances caused by military deployment falls under FMLA.
D. This employee has a serious health condition that will likely require hospitalization or continual care, so they will likely qualify for FMLA.
Which of the following best describes the Mental Health Parity and Addiction Equality Act (MHPAEA)?
A. The MHPAEA requires insurance companies to cover mental health benefits.
B. The MHPAEA prevents insurance companies from imposing limits to mental health benefits
C. The MHPAEA requires Insurance companies to use the same benefit structure for mental health and medical/surgical benefits.
D. The MHPAEA requires Insurance companies from denying coverage to people with substance use disorders.
C. Correct. The MHPAEA requires that insurance companies not impose limits on mental health benefits that are different from the limits on medical/surgical benefits.
Incorrect answers
A. The ACA, not the MHPAEA, requires companies to cover mental health benefits.
B. The MHPAEA does not prevent companies from imposing limits on mental health benefits.
D. The MHPAEA does not dictate who can receive insurance coverage.
Which of the following patient complaints would warrant a potential medical malpractice lawsuit?
A. My doctor refused to order an MRI for me even though I requested one.
B. My nurse had to stick me five times in a row to draw a blood sample.
C. My grandfather with dementia is not receiving meals in a nursing home.
D. My doctor gave me a first round of antibiotics that didn’t treat my infection.
C. Correct. This patient may not be able to feed himself. A malpractice suit is warranted if the patient becomes malnourished and sufferers related to illness or injury.
Incorrect answers
A. The doctor is working within professional standards to deny an unnecessary MRI, even if the patient requests it.
B. While the nurse may not have met the required standard of care, the blood draw did not cause significant harm.
D. The doctor has not violated standards of care: It is not unusual for the first round of antibiotics to be ineffective.
Roy, client, was in an auto accident and is in a coma. He had a durable power of attorney on file and list his mother as his agent for medical and financial needs. Which action listed below will Roy’s mother most likely to be able to do as his agent?
A. Make legal decision about Roy’s will if he passes
B. Pay Roy’s car payment
C. Let Roy’s father be Co-agent
D. Make medical decisions that she desires
B. Correct. As financial agent, she may pay Roy’s bills.
Incorrect answers
A. She may not be the executor of Roy’s will.
C. Unless Roy has specified his father as Co-agent, he cannot be Co-agent.
D. To the best of her ability, Roy’s mother must make the medical decisions that he would desire.
Which example below BEST describes beneficence?
A. Allowing a patient to die as requested in her living will
B. Explaining a surgical procedure to a nervous client
C. Going to court with a client who is suing a health care provider
D. Establishing boundaries with new clients
A. Correct. The CCM is allowing the client’s wishes to be fulfilled.
Incorrect answers
B. The CCM is practicing veracity.
C. This CCM is practicing justice.
D. The CCM is practicing fidelity.
Which of the following would most likely be a violation of the CCM Standards of Practice?
A. A CCM does not impose her values on her client.
B. A CCM transfers her credentials to an organization.
C. A CCM works with her client to develop goals.
D. A CCM keeps clients records protected.
B. Correct. The CCM may not transfer her credentials. The other choices are part of the CCM Standards of Practice.
What is the best rationale for why timely documentation is so important for the case manager?
A. To establish a rapport with the client
B. To ensure advanced directives are enforced
C. To defend against a claim of negligence
D. To begin educating the client and family
C. Correct. Timely documentation may serve to defend the case manager.
Incorrect answers
A. The report can be established without timely documentation.
B. Advanced directives are separate from timely documentation.
D. Documentation should be timely with education, but this is not the best answer.
A nurse accidentally gave a patient a double dosage of a medication. Risk management is involved to identify the potential for reoccurrence. Which example below should the primary focus be of the RCA?
A. Determining why the nurse made the error
B. Calculating financial losses
C. Determining the medication system used by the nurse
D. Decreasing malpractice claims
C. Correct. The RCA will focus on the medication system.
Incorrect answers
A. Although it is important to discover why the nurse made the error, the RCA does not focus on human error.
B. Calculating financial losses is a component of the RCA, but not the primary focus.
D. Decreasing malpractice claims is not the primary focus of the RCA.
Which of the following is NOT an appropriate method of case manager self-care?
A. Keeping separate phones for professional and private contacts
B. Refusing to answer calls from a client who is verbally abusive
C. Setting aside an hour a day to eat lunch and take a walk
D. Contacting the CMC when struggling with an ethical dilemma presented by a client
B. Correct. The CCM should not stop communicating with the client. Instead, the CCM should work with her supervisor and the client to manage the behavior in a way that minimizes the negative impact on the client’s care.
Incorrect answers
A. Keeping separate professional and private phones is an appropriate way to set boundaries.
C. A healthy diet and exercise are important components of self-care.
D. Reaching out to the CCMC with professional questions. Is an appropriate way to handle the stress of an ethical dilemma.
