Relias - Case Management Assessment A Study Guide Test Containing 54 Questions with Certif, Exams of Nursing

Download Relias - Case Management Assessment A Study Guide Test Containing 54 Questions with Certif and more Exams Nursing in PDF only on Docsity! Relias - Case Management Assessment A Relias - Case Management Assessment A Study Guide Test Containing 54 Questions with Certified Solutions 2024- 2025. Your patient received a cancer diagnosis. You find them crying on their bed. They state they just got divorced and do not have family in town. What would be your PRIORITY action? - Answer: Comfort your patient, listen to their concerns, and inform them of referrals to inpatient psychosocial services and an oncology nurse navigator. Relias - Case Management Assessment A In your psychosocial assessment you suspect the parent of you 6-year-old patient to be committing Munchhausen by Proxy Syndrome. What PRIORITY actions would you take to protect your patient? - Answer: Immediately alert you patient's care team, report you suspicions to Child protective services, document you findings in the patient's chart, and get psychiatry consult STAT to appropriately separate the parent from the child or have the parent monitored in the room by a sitter You see a family friend on your case management case load. You know you cannot care for this person as it would be a conflict of interest. If you were to quickly review their medical chart, what legal act would you be violating? - Answer: HIPPA Your patient is school-aged and has special needs. Their family is very concerned their child will be bullied because of these special needs. What communication and planning tool would you recommend for the family with members of the school prior to start of school? - Answer: ARD Your patient with a pre-existing condition purchased an individual healthcare plan online directly from the insurance payer. They did not purchase it on the Healthcare Market Exchange that is covered under the Affordable Care Act. They are upset that their plan does not cover pre-existing conditions for 6 months. What would be your response? - Answer: The insurance plan you acquired directly from the insurance payer operates outside the Healthcare Market Exchange covered under the Affordable Care Act. As a result, it might have Relias - Case Management Assessment A You are a key advocare for you patients and their families. By acting in this way you are helping care for them in the best possible way. What ethical principle are you exhibiting? - Answer: beneficence What criteria are used to classify Medicare patient within inpatient rehabilitation into tiers? - Answer: specific comorbidities that increase the cost of care Your patient is school-aged and has special needs. Their family is very concerned their child will bebullied because of these speical needs. What communication and planning tool would you recommend for the family with members of the school prior to start of school? - Answer: Admissions, review, dismissal (ARD) Your patient recieved a cancer diagnosis. You find them crying on their bed. They state they just got divorced and do not have family in town. What would be your PRIORITY action? - Answer: Comfort your patient, listen to their concerns, and inform them of referrals to inpatient psychosocial services and an oncology nurse navigator. The CMS Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)survery consists of what 3 main composite scoring categories? - Answer: Communication w/ Nurse > Provider > Responsiveness of Hospital Staff Your patient with end-stage liver cancer has elected for care transition to hospice. As you are education the family they say, " I am so happy their chem can continue in hospice and have the options of being cured. "What would be your BEST Relias - Case Management Assessment A response to educate the family member about the reality of the patient's hospice service? - Answer: I appreciate you would like the opportunity for a cure. However, I want to make sure you understand they are entering hospice care which will provide measures for their comfort until they pass Your patient is admitted for a 24-hour observation . What are the 3 conditions (acuities) Medicare pays for the inpatient observation without further utilization review? - Answer: chest pain, asthma, heart failure What is the FIRST step you need to submit when seeking approval for services of procedures for a patient? - Answer: prior authorization A patient is admitted with a diagnosis of a pulmonary embolism. you see interqual criteria to implement the meidcal necessity an acuity level of the admission plan for the patient. Upon revisting the patient you notice unilateral eye drooping an dslurred speech. You immediately call for a stroke alert. What would be your BEST next step regarding you current plan of care assessment? - Answer: Decreasing the acuity of the Plan of Care (POC), decreasing the length of stay, care transition, and discharge planning might not be appropriate because the patient's condition has potentially deteriorated and requires further assessment and intervention. You are educating your patient with heart failure about taking spironolactone (Aldactone) . How would you BEST educate your patient on how spironolactone works and its relationship to potassium? - Answer: Spironolactone is a potassium- sparing diuretic used to prevent hyperkalemia (high potassium levels) and to Relias - Case Management Assessment A manage conditions like heart failure. This medication helps your body remove excess sodium and water while retaining potassium You would use predictive modeling tools to do what in your care plan assessment? - Answer: to identify a patient acuity level What condition does CMS require additional criteria for payment when compared to the Medicare inpatient reahabilitation facility (IRF) 60 percent rule? - Answer: stroke You need to standardize a care plan to optimize efficiencey. What would you Implement? - Answer: clinical measures Your patient is asking a lot of personal question that make you feel unabomfortable and cross professional boundaries. The patient states. I have a friend who would be perfect for you . Let me set you up to meet them. What would be your BEST response? - Answer: What is the OVERALL goal of case management services for CMRNs? - Answer: To meet patient needs through assessment, coordination, planning, resources, and evaluation of the plan of care A patient with a history of HIV is admitted with an infection and you are monitoring their febrile status. What symptoms would trigger a sepsis alert? - Answer: Hypotension, tachycardia, dyspnea, and altered mental state Relias - Case Management Assessment A In what way does motivational interviewing elicit behavior change from a patient? - Answer: It encourages patients to explore and resolve any concerns and ambivalence in a positive engaging manner. You are submitting a quarterly report demonstrating costs and savings regarding case management activities. What is the name of this report? - Answer: Cost- benefits report A patient has a NEW complaint of pain. Which statement is BEST for eliciting an initial assessment screening? - Answer: Can you describe your pain to me and when it started? Your patient is having surgery. The pre-op nurse forgot to have your patient sign an informed consent about the surgery. Your patient just received a light-sedative IV medication but is highly coherent. Their spouse is with them and is their legal medical proxy. How would you handle this situation? - Answer: Although your patient is highly coherent they have been medicated and may not be cognitively sound to sign the informed consent. Have the spouse sign the informed consent as the legal medical proxy. Your patient identifies as transgender. The patient's family is with them. You notice some familial conflict about your patient's gender identity. How would you support your patient in this situation? - Answer: Ask your patient if they want to Relias - Case Management Assessment A speak with you privately about some of their concerns and that you could politely ask the family to leave the room for a short time. Your patient states they are overwhelmed by all the information about their disease and care plan. As a result it is difficult for them to adequately express their thoughts. What type of barrier to communication is your patient experiencing? - Answer: Psychological noise (?) You encounter a patient with their spouse in their hospital room. They are overwhelmed by the recent diagnosis and subsequent care transitions needed upon discharge. What would be your BEST education practice to assure that both the patient and their spouse understand and are comfortable with the inpatient care plan and discharge plan? - Answer: Teach-back method You have an older patient every time her care giver comes to visit you knows the patients bottle signs increase in a pair of that very nervous. They always quickly cover them selves in their bed, my name, and asked not to be left alone with the caregiver, what type of piece would you most likely suspect? - Answer: concerns about potential elder abuse or mistreatment You are preparing a patient for discharge. They have COPD and require continuous supplemental oxygen upon discharge. The patient is resisting the oxygen at home. What would be your IMMEDIATE intervention? - Answer: Inquire with open- ended questions as to why the patient is uncomfortable with oxygen at home. Relias - Case Management Assessment A Further inquire if it is resistance or lack of education of their disease process. Re- assess their discharge planning. A patient with a history of HIV is admitted with an infection and you are monitoring their febrile status. What symptoms would trigger a sepsis alert? - Answer: Hypotension, tachycardia, dyspnea, and altered mental state Your patient has autism . They are at risk of elopement from their hospital room to outside of the hospital. What precaution would you implement as part of their psychosocial assessment? - Answer: Your are communicationg with your patient's hospitalist. How would you provide information regarding you patient's risk for an infection due to their current symptoms and recent labs? - Answer: