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Chapter 15 Case Management

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Chapter 15 Case Management

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  • August 22, 2024
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  • 2024/2025
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Chapter 15: Case Management
Stanhope: Foundations for Population Health in Community/Public Health Nursing,


MULTIPLE CHOICE

1. Which of the following best describes case management?
a. A tool of health maintenance organizations
b. Targeted toward a specific segment of the population
c. Implemented with individual clients
d. Used to monitor the health status, resources, and outcomes for an aggregate
ANS: C
Case management, in contrast to the definition of care management, involves activities implemented w
system. Managed care is a tool of health maintenance organizations. Care management is an enduring
population manager establishes systems and monitors the health status, resources, and outcomes for an
segment of the population or a group.

2. Which of the following best describes why planning care for an individual is so challenging in today’s
a. Because today’s clients have high expectations of the health care system
b. Because multiple providers, payers, and settings have to be coordinated
c. Because of the new high technology constantly being created and used for client
treatment
d. Because so many different health care providers are in the acute care setting today
ANS: B
Case management practice is complex because of the coordinating activities of multiple providers, pay
a client’s continuum of care. Planning care is so challenging because of the complexities of the system
of the population, new technology, or different providers. Coordination of all of these aspects of care, n
makes planning so difficult.

3. Which of the following best describes the primary problem that can result from health care today being
care providers?
a. Clients are not sure which provider to see first.
b. Health care providers have to make referrals to other providers.
c. Clients sometimes are not sure who their primary provider is.
d. Overuse, underuse, or gaps in care may result.
ANS: D
A particularly challenging problem is the fragmenting of services, which can result in overuse, underu
miscommunication. Clients who have a primary care provider typically know who that provider is and
provider that should be seen first. The referral system is not a primary problem with health care being
It is the fragmentation of services that causes the problems within the system.

4. Which of the following public health nurse applicants is the least qualified for a position of case manag
a. A 24-year-old who has a master’s degree in public health
b. A 34-year-old who will be moving from a large city
c. A 44-year-old who was born and raised in the community
d. A 54-year-old who, until recently, was a member of the community’s school
board
ANS: B
Case management competency requires the following knowledge and skills: knowledge of community
methods; written and oral communication and documentation skills; negotiation and conflict resolution
processes to identify and prioritize problems from the provider and client views; and identification of b
desired outcomes. Because communities are unique, someone new to the area will lack knowledge of c
financing methods. There is nothing in the descriptions of the other public health nurses that indicates
or skills.

5. Which of the following best explains why every client doesn’t receive care from a case manager?

, lOMoAR cP SD |12827 373




6. The nurse suggests use of telehealth to assess how a client is progressing. Which of the following resou
continuing care to be implemented?
a. A primary care provider who is willing to use wireless prescriptions and plans of
care
b. Family permission for the nurse to make home visits
c. Long-distance telephone service or a computer with Internet access
d. Willingness of the caregiver to drive the client to the nearest clinic
ANS: C
Telehealth is an organized health care delivery approach to triage and to provide advice, counseling, an
health problem using phones or computers with cameras. The client is usually in the home, and the nur
facility, or phone bank location. Wireless prescriptions and plans of care are not necessary for a client
services. Home visits may not be necessary for a telehealth client. Through the use of telehealth, the ne
decreased.

7. A nurse is using a case management plan to maximize patient care outcomes. Which of the following d
consideration that should be made by the nurse?
a. Case management plans should be used only by nurses to manage care.
b. Case management plans should be individualized for each client.
c. Case management plans provide additional expense to the client and family.
d. Case management plans focus on the natural progression of the disease.
ANS: B
Adaptation of the case management care plan to each client’s characteristics is a crucial skill for standa
outcome of care. It links multiple provider interventions to client responses and offers reasonable pred
outcomes. Institutions report that sharing case management plans with clients empowers the clients to
monitoring and adhering to the plan of care. Case management plans should link the care that is provid
multiple providers. Case management is part of the standard of care that is provided and does not prov
the client, although it may cause an additional expense to the agency. Disease management, not case m
natural progression of the disease.

8. A client spends a great deal of time on the Internet or reading articles related to diabetes and its long-te
client asks why the nurse has not suggested a life care plan. Which of the following would be the best
a. “Life care plans are only for young persons who are newly diagnosed.”
b. “Life care plans are primarily used to determine long-term financial needs for
legal reasons.”
c. “You are receiving appropriate care for your diabetes without serious side effects,
so a life care plan isn’t currently appropriate.”
d. “I was waiting for you to express interest in having a life care plan.”
ANS: C
Life care plans are typically used for clients experiencing catastrophic illness or adverse events resultin
malpractice. Others who benefit from life care planning are those who have sustained injury when you
requirements have changed as a result of aging. Life care plans are typically used for clients experienc
adverse events resulting from professional malpractice, not young persons with a newly diagnosed illn
a customized, medical-based document that provides assessment of all present and future needs (i.e., m
psychological, vocational, spiritual, physical, and social), including services, equipment, supplies, and
client. These plans may be used by either a plaintiff or a defense lawyer to analyze damages. They are
rewards, which can be used to pay for care in the future and create a lifetime care plan.

9. Which of the following Medicaid clients would most likely receive case management?
a. An elderly person
b. A person receiving rehabilitation following an injury
c. A person who has a high-cost chronic disease
d. A person with acute illness
ANS: C
Some states, through their Medicaid programs, are developing disease management programs for high
their populations, such as asthma and diabetes. An elderly person is most likely to receive Medicare se
services. Additionally, there is not any information that states that the elderly person has a high-cost ch

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