CMGT-BC Practice Test Questions and Answers

Prepare with confidence using this comprehensive CMGT-BC Practice Test, featuring 750 advanced multiple-choice questions and detailed answer explanations designed to help nurses succeed on the Nursing Case Management Board Certification Exam. This study guide focuses on real-world clinical scenarios, priority-setting questions, transitions of care, utilization management, and evidence-based decision-making commonly encountered by professional nurse case managers. Every question is written in a realistic case-vignette format to strengthen clinical judgment and prepare you for the complexity of the actual CMGT-BC examination.

Unlike generic review materials, this practice exam emphasizes patient-centered care, interdisciplinary coordination, social determinants of health, ethical dilemmas, and high-risk clinical situations. Whether you work in acute care, home health, managed care, rehabilitation, or population health, this resource helps reinforce the knowledge and critical thinking skills required for certification success.

What Is the CMGT-BC Exam?

The Nursing Case Management Board Certification Exam (CMGT-BC) is a specialty certification that validates a nurse’s expertise in case management across the continuum of care. The exam evaluates competencies in care coordination, discharge planning, resource management, utilization review, chronic disease management, ethics, patient advocacy, and quality improvement.

Successful candidates demonstrate the ability to:

• Coordinate complex patient care across multiple settings
• Reduce avoidable hospital readmissions
• Manage high-risk populations
• Address social determinants of health
• Apply ethical and legal principles
• Support patient-centered and value-based care
• Improve outcomes while controlling healthcare costs

Who Is This CMGT-BC Practice Test For?

This CMGT-BC study guide is designed for nurses preparing for board certification and healthcare professionals involved in care coordination and case management.

Ideal for:

• Registered Nurses (RNs)
• Nurse Case Managers
• Care Coordinators
• Utilization Review Nurses
• Population Health Nurses
• Managed Care Nurses
• Home Health Nurses
• Rehabilitation Nurses
• Transitional Care Nurses
• Hospital Case Managers
• Nurses preparing for the Nursing Case Management Board Certification Exam

Whether you are taking the exam for the first time or renewing your certification, these questions provide realistic practice that mirrors the clinical reasoning expected on the actual examination.

What You Will Learn From This CMGT-BC Practice Exam?

This comprehensive practice test helps strengthen the knowledge and decision-making skills needed in modern case management.

You will learn how to:

• Prioritize interventions using “best action” and “first action” approaches
• Recognize cardiac, oncology, renal, respiratory, neurologic, and behavioral health emergencies
• Perform effective discharge planning and transitional care management
• Select the appropriate level of care for complex patients
• Apply ethical and legal principles in difficult situations
• Coordinate multidisciplinary care and community resources
• Reduce readmissions and improve quality outcomes
• Identify barriers related to housing, transportation, food insecurity, and caregiver burden
• Manage chronic illnesses across the continuum of care
• Improve patient safety through medication reconciliation and utilization management

Topics Covered in This CMGT-BC Test Prep

The 750-question practice exam covers all major content domains tested on the certification exam.

Clinical Case Management

• Heart failure
• COPD
• Diabetes
• Stroke
• Chronic kidney disease
• Cancer care
• Dementia
• Neurologic disorders
• Behavioral health conditions

Transition of Care and Discharge Planning

• Medication reconciliation
• Follow-up care
• Readmission prevention
• Transitional care management
• Continuity of care

Level-of-Care Decisions

• Skilled Nursing Facility (SNF)
• Long-Term Acute Care Hospital (LTACH)
• Home Health
• Hospice
• Inpatient Rehabilitation Facility (IRF)
• Community-based services

Utilization Management and Quality Improvement

• Value-based care
• Resource management
• Quality metrics
• Hospital readmission reduction
• Population health strategies
• Performance improvement

Ethics and Legal Issues

• Autonomy
• Beneficence
• Nonmaleficence
• Justice
• Fidelity
• Advance directives
• Goals of care
• End-of-life decision making

Social Determinants of Health

• Food insecurity
• Transportation barriers
• Financial hardship
• Housing instability
• Health literacy
• Caregiver stress
• Mental health concerns

High-Risk Emergencies

• Sepsis and septic shock
• Tumor lysis syndrome
• Superior vena cava syndrome
• Spinal cord compression
• Hyperkalemia
• Respiratory failure
• Pulmonary embolism
• Febrile neutropenia
• Hypercalcemia of malignancy

Why Students Choose This CMGT-BC Study Guide

Nurses preparing for certification need more than simple memorization. They need realistic practice that reflects actual patient care situations. This study guide was created with that goal in mind.

Students appreciate:

• 750 advanced multiple-choice questions
• Detailed answer explanations
• Realistic case-vignette format
• Priority and first-action questions
• Transition-of-care scenarios
• Level-of-care placement decisions
• Oncology, renal, cardiac, respiratory, and neurologic emergencies
• Ethics and legal case studies
• Utilization management principles
• High-risk population management
• Social determinants of health scenarios
• Explanations focused on clinical reasoning
• Board-style questions that encourage critical thinking

Passing the CMGT-BC exam requires more than memorizing facts. Nurse case managers must understand how to prioritize care, coordinate services, address psychosocial barriers, and improve outcomes across the continuum of care. This 750-question CMGT-BC Practice Test provides realistic, scenario-based preparation that strengthens clinical judgment and builds confidence for exam day. Whether you work in acute care, managed care, rehabilitation, home health, or population health, this comprehensive study guide is designed to help you prepare smarter and approach the Nursing Case Management Board Certification Exam with confidence.

CMGT-BC Sample Questions and Answers

1. A nurse case manager is reviewing a newly admitted patient with heart failure who has been hospitalized three times in six months. Which intervention should be prioritized?

A. Schedule annual wellness visits only
B. Develop a comprehensive transitional care plan before discharge
C. Limit communication with family members
D. Refer the patient to a fitness center

Correct Answer: B. Develop a comprehensive transitional care plan before discharge

Explanation:
Frequent hospitalizations indicate poor disease management and increased risk for readmission. Transitional care planning is a core responsibility of nurse case managers and includes medication reconciliation, patient education, follow-up appointments, home health referrals, and identification of barriers to adherence. Evidence shows that coordinated discharge planning reduces avoidable readmissions and improves outcomes. Annual wellness visits alone are insufficient, and excluding family support may hinder adherence. The goal of case management is continuity of care across settings and ensuring the patient has the resources necessary for successful self-management after discharge.

2. Which principle is most important when obtaining informed consent?

A. Consent may be delegated to unlicensed staff.
B. The patient must understand risks, benefits, and alternatives.
C. Family members can sign regardless of patient competency.
D. Consent eliminates provider liability.

Correct Answer: B. The patient must understand risks, benefits, and alternatives.

Explanation:
Informed consent requires that the patient receives understandable information regarding the proposed treatment, associated risks, expected benefits, and available alternatives. The patient must voluntarily agree and possess decision-making capacity. A nurse case manager may reinforce information but cannot obtain consent for procedures beyond their scope. Family members cannot sign unless legally authorized. Consent does not protect providers from negligence. Patient autonomy and shared decision-making are essential ethical principles in case management, ensuring individuals actively participate in decisions affecting their health and treatment goals.

3. During utilization review, which finding most strongly supports continued inpatient hospitalization?

A. Stable vital signs and independent ambulation
B. Need for intravenous vasopressor therapy
C. Ability to tolerate oral medications
D. Completion of diagnostic tests

Correct Answer: B. Need for intravenous vasopressor therapy

Explanation:
Utilization management focuses on medical necessity and the appropriate level of care. Patients requiring vasopressor support are critically ill and need close monitoring unavailable in lower-acuity settings. Stable patients who are ambulatory and taking oral medications are often candidates for discharge or transfer to less intensive care. Completion of diagnostic tests alone does not justify inpatient status. Nurse case managers collaborate with physicians and payers to ensure that services meet established criteria while promoting quality care and avoiding unnecessary healthcare expenditures.

4. A patient repeatedly misses dialysis appointments because transportation is unavailable. Which action demonstrates advocacy?

A. Discharge the patient from services
B. Document noncompliance only
C. Connect the patient with transportation assistance programs
D. Recommend reducing dialysis frequency

Correct Answer: C. Connect the patient with transportation assistance programs

Explanation:
Case management addresses barriers that interfere with treatment adherence. Transportation difficulties represent a social determinant of health that can significantly affect outcomes. Advocacy involves identifying resources such as community transportation services, Medicaid transport benefits, or local agencies. Simply labeling the patient noncompliant ignores underlying issues and may worsen health outcomes. Reducing dialysis frequency without medical indication is unsafe. Effective case management emphasizes patient-centered solutions and addresses social and environmental factors contributing to healthcare disparities.

5. Which quality indicator is commonly used to evaluate the effectiveness of case management programs?

A. Number of employee vacations
B. Thirty-day hospital readmission rates
C. Parking availability
D. Cafeteria satisfaction scores

Correct Answer: B. Thirty-day hospital readmission rates

Explanation:
Thirty-day readmission rates are widely recognized indicators of quality and care coordination. Frequent readmissions often signal inadequate discharge planning, poor follow-up, or unmet patient needs. Nurse case managers use these data to evaluate interventions and improve transitions of care. Employee vacations and cafeteria services are unrelated to clinical outcomes. Monitoring quality metrics helps organizations enhance patient safety, reduce costs, and demonstrate value-based performance. Effective case management programs aim to reduce preventable admissions while improving patient satisfaction and long-term health outcomes.

6. Which patient is most appropriate for case management services?

A. Healthy adolescent with no chronic illness
B. Patient with multiple chronic conditions and frequent admissions
C. Individual receiving a routine vaccine
D. Patient with a minor sprain

Correct Answer: B. Patient with multiple chronic conditions and frequent admissions

Explanation:
Case management resources are directed toward patients with complex medical, psychosocial, and financial needs. Individuals with multiple chronic illnesses often require coordination among numerous providers and services. Frequent admissions suggest gaps in care and increased risk for complications. Healthy individuals or those with minor acute problems generally do not require intensive case management. The nurse case manager focuses on improving outcomes, promoting self-management, and reducing unnecessary utilization while ensuring continuity of care across healthcare settings.

7. Which federal legislation protects patient health information?

A. EMTALA
B. HIPAA
C. OSHA
D. COBRA

Correct Answer: B. HIPAA

Explanation:
The Health Insurance Portability and Accountability Act (HIPAA) establishes standards for protecting individually identifiable health information. Nurse case managers routinely access sensitive records and must maintain confidentiality while sharing information only for authorized treatment, payment, and healthcare operations. Violations can lead to legal and financial penalties. EMTALA governs emergency treatment requirements, OSHA addresses workplace safety, and COBRA concerns continuation of health insurance coverage. Protecting privacy strengthens trust and supports ethical healthcare practices.

8. Which communication technique best supports motivational interviewing?

A. Confronting resistance aggressively
B. Asking open-ended questions
C. Giving lengthy lectures
D. Threatening consequences

Correct Answer: B. Asking open-ended questions

Explanation:
Motivational interviewing promotes behavior change through collaboration rather than confrontation. Open-ended questions encourage patients to express concerns, identify goals, and explore readiness for change. This approach improves adherence and supports self-management. Aggressive confrontation and threats often increase resistance. Nurse case managers frequently use motivational interviewing when helping patients manage chronic diseases, stop smoking, or improve medication adherence. Respecting autonomy and eliciting the patient’s own reasons for change are central principles of this evidence-based communication technique.

9. A nurse case manager notices a physician ordering duplicate diagnostic tests. What should be the first action?

A. Ignore the orders
B. Discuss the concern with the physician
C. Cancel the tests independently
D. Notify the media

Correct Answer: B. Discuss the concern with the physician

Explanation:
Interprofessional collaboration is essential in case management. When duplicate or potentially unnecessary tests are identified, the nurse case manager should first communicate with the ordering provider to clarify clinical necessity. Canceling tests independently may exceed authority and compromise patient care. Ignoring the issue could result in increased costs and patient inconvenience. Open communication promotes patient safety, efficient resource utilization, and high-quality care. Professional dialogue often resolves misunderstandings and prevents unnecessary procedures.

10. Which social determinant of health most directly affects medication adherence?

A. Transportation and financial limitations
B. Hair color
C. Favorite foods
D. Marital status alone

Correct Answer: A. Transportation and financial limitations

Explanation:
Social determinants such as income, access to transportation, housing stability, and health literacy significantly influence a patient’s ability to obtain and take medications correctly. Financial hardship may lead to skipped doses or delayed refills, while transportation barriers can prevent pharmacy visits. Nurse case managers assess these factors and connect patients with assistance programs. Hair color and food preferences are irrelevant. Addressing social determinants is essential for improving health outcomes and reducing disparities in healthcare delivery.

11. Which Medicare program provides prescription drug coverage?

A. Part A
B. Part B
C. Part C only
D. Part D

Correct Answer: D. Part D

Explanation:
Medicare Part D provides outpatient prescription drug benefits through private plans approved by Medicare. Nurse case managers frequently educate patients about coverage options and help address medication affordability issues. Part A covers inpatient hospital services, Part B includes outpatient and preventive services, and Part C refers to Medicare Advantage plans. Understanding insurance benefits allows case managers to advocate for cost-effective treatment plans and minimize barriers that may affect adherence and disease management.

12. Which action reflects ethical beneficence?

A. Respecting patient confidentiality
B. Promoting actions that benefit the patient
C. Allowing the patient complete independence without support
D. Following policies regardless of patient needs

Correct Answer: B. Promoting actions that benefit the patient

Explanation:
Beneficence refers to acting in ways that promote the well-being and best interests of patients. Nurse case managers demonstrate beneficence by coordinating services, preventing harm, and advocating for appropriate care. Confidentiality relates to privacy, while blindly following policies may conflict with individualized patient needs. Ethical practice requires balancing autonomy, justice, nonmaleficence, and beneficence. These principles guide decision-making and ensure patient-centered care remains the primary focus of case management activities.

13. A patient with advanced cancer requests hospice services. Which prognosis generally meets hospice eligibility requirements?

A. Life expectancy of six months or less
B. Life expectancy greater than two years
C. Any terminal diagnosis regardless of prognosis
D. Complete recovery expected

Correct Answer: A. Life expectancy of six months or less

Explanation:
Hospice services are intended for patients with terminal illnesses who are expected to have a life expectancy of six months or less if the disease follows its normal course. Hospice emphasizes comfort, symptom management, and quality of life rather than curative treatment. Nurse case managers assist patients and families with education, referrals, and support during end-of-life care. Early discussions about goals of care help align treatment decisions with patient preferences and values.

14. Which action best supports patient-centered care?

A. Making decisions without patient input
B. Developing goals collaboratively with the patient
C. Prioritizing organizational costs over preferences
D. Using identical care plans for everyone

Correct Answer: B. Developing goals collaboratively with the patient

Explanation:
Patient-centered care involves respecting individual values, preferences, and goals. Nurse case managers work with patients and families to create realistic plans that support meaningful outcomes. Shared decision-making enhances engagement and adherence while improving satisfaction. Standardized approaches that ignore individual differences can reduce effectiveness. Collaboration empowers patients to participate actively in managing their health and promotes trust between healthcare providers and those receiving care.

15. Which level of prevention focuses on early disease detection?

A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention

Correct Answer: B. Secondary prevention

Explanation:
Secondary prevention aims to identify diseases early through screening and prompt intervention. Examples include mammograms, blood pressure screenings, and colonoscopies. Early detection improves outcomes and may prevent progression. Primary prevention seeks to prevent disease before it occurs, while tertiary prevention minimizes complications in established disease. Nurse case managers promote appropriate screenings and educate patients regarding preventive health practices. Supporting preventive care aligns with population health goals and value-based care initiatives.

16. Which scenario represents a conflict of interest?

A. Recommending the best service based on patient needs
B. Steering patients toward a company that provides personal financial benefits
C. Maintaining patient confidentiality
D. Coordinating follow-up appointments

Correct Answer: B. Steering patients toward a company that provides personal financial benefits

Explanation:
Case managers must maintain professional integrity and avoid situations where personal gain influences clinical decisions. Recommending services because of financial incentives creates a conflict of interest and violates ethical standards. Decisions should always prioritize patient welfare, quality, and appropriateness of care. Transparency and accountability are essential in maintaining trust. Ethical case management requires impartial recommendations based solely on the patient’s clinical and psychosocial needs.

17. Which document communicates a patient’s preferences regarding future healthcare decisions?

A. Incident report
B. Advance directive
C. Payroll form
D. Insurance claim

Correct Answer: B. Advance directive

Explanation:
Advance directives allow individuals to communicate their healthcare wishes if they become unable to make decisions. Documents may include living wills and durable powers of attorney for healthcare. Nurse case managers play an important role in educating patients and ensuring these preferences are documented and honored. Advance care planning supports patient autonomy and reduces uncertainty during serious illness. Early conversations with patients and families facilitate informed and value-based decisions.

18. Which strategy is most effective for reducing avoidable emergency department visits?

A. Eliminating follow-up calls
B. Providing timely post-discharge follow-up and education
C. Restricting access to healthcare providers
D. Encouraging self-treatment only

Correct Answer: B. Providing timely post-discharge follow-up and education

Explanation:
Early follow-up after discharge improves medication adherence, identifies complications, and reinforces self-care instructions. Patients who understand warning signs and have access to providers are less likely to seek emergency care unnecessarily. Nurse case managers coordinate appointments and ensure continuity across settings. Restricting access or eliminating communication increases the risk of adverse events. Effective transitions are key components of value-based healthcare and population health management.

19. Which patient would most benefit from palliative care?

A. Only patients receiving hospice care
B. A patient with chronic heart failure experiencing symptom burden
C. Healthy adults undergoing annual physical exams
D. Patients with minor injuries

Correct Answer: B. A patient with chronic heart failure experiencing symptom burden

Explanation:
Palliative care focuses on improving quality of life and managing symptoms for patients with serious illnesses, regardless of prognosis. Unlike hospice, palliative care can be provided alongside curative treatments. Patients with heart failure, cancer, COPD, or other chronic illnesses may benefit from symptom control and psychosocial support. Nurse case managers facilitate referrals and coordinate multidisciplinary services. Early palliative care improves patient satisfaction and may reduce unnecessary hospitalizations.

20. Which outcome best demonstrates successful case management?

A. Increased duplication of services
B. Reduced readmissions and improved patient satisfaction
C. More fragmented care
D. Increased emergency department utilization

Correct Answer: B. Reduced readmissions and improved patient satisfaction

Explanation:
Successful case management is measured by improved quality, patient satisfaction, continuity of care, and efficient use of healthcare resources. Reduced readmissions indicate effective coordination and discharge planning. Patients who understand their treatment plans and have access to community resources are more likely to achieve positive outcomes. Fragmented care and increased emergency visits suggest gaps in coordination. The ultimate goal of case management is to optimize health outcomes while supporting patient-centered, cost-effective care.

21. A 79-year-old woman with heart failure, diabetes, and chronic kidney disease is discharged after treatment for pulmonary edema. She lives alone, has limited health literacy, and states she cannot afford several medications. Which action should the nurse case manager take FIRST?

A. Arrange medication assistance and perform medication reconciliation
B. Schedule a nephrology appointment in six months
C. Encourage the patient to call 911 if symptoms worsen
D. Recommend over-the-counter diuretics

Correct Answer: A. Arrange medication assistance and perform medication reconciliation

Explanation:

Medication affordability and understanding are major predictors of readmission. The highest priority is ensuring access to prescribed medications and clarifying the treatment plan. Nurse case managers address financial barriers, coordinate pharmacy assistance programs, and reinforce education. Early intervention improves adherence and reduces preventable admissions. Timely medication reconciliation and follow-up are essential components of transitional care.

22. A 67-year-old man with metastatic lung cancer reports facial swelling, shortness of breath, and difficulty buttoning his shirt because of neck swelling. Which action should the nurse case manager take FIRST?

A. Arrange urgent evaluation for possible superior vena cava syndrome
B. Recommend fluid restriction
C. Schedule outpatient pulmonary rehabilitation
D. Encourage increased activity

 Correct Answer: A. Arrange urgent evaluation for possible superior vena cava syndrome

Explanation:

Facial edema, neck vein distention, and dyspnea are classic manifestations of superior vena cava syndrome. This oncologic emergency can rapidly progress to respiratory compromise. Nurse case managers should facilitate urgent oncology evaluation and educate patients regarding symptoms requiring immediate attention. Prompt treatment improves outcomes and quality of life.

23. A 74-year-old patient with dementia is hospitalized with pneumonia. His daughter, who is the primary caregiver, states she has not slept well in months and feels overwhelmed. Which intervention is MOST appropriate?

A. Refer the daughter to caregiver support and respite services
B. Recommend institutional placement immediately
C. Advise her to manage independently
D. Limit family involvement

 Correct Answer: A. Refer the daughter to caregiver support and respite services

Explanation:

Caregiver burnout negatively affects both the caregiver and the patient. Nurse case managers should assess caregiver strain and connect families with support groups and respite programs. These interventions improve coping, delay institutionalization, and enhance quality of life. Family-centered care recognizes caregivers as essential partners in chronic disease management.

24. A 72-year-old man with heart failure and chronic kidney disease is discharged after treatment for fluid overload. During a follow-up call, he reports increasing shortness of breath, sleeping in a recliner, and a 6-pound weight gain in four days. Which action should the nurse case manager take FIRST?

A. Arrange urgent evaluation by the provider
B. Recommend increasing fluid intake
C. Schedule a routine visit in one month
D. Encourage bed rest and observation

Correct Answer: A. Arrange urgent evaluation by the provider

Explanation:

Rapid weight gain, orthopnea, and worsening dyspnea indicate acute decompensated heart failure. Delaying treatment increases the risk of pulmonary edema and hospitalization. Nurse case managers educate patients about daily weight monitoring and symptom recognition. Prompt intervention, medication adjustments, and follow-up improve outcomes and reduce readmissions. Early action is a hallmark of effective transitional care.

25. A 63-year-old woman with ovarian cancer receiving chemotherapy develops abdominal pain, fever, and an absolute neutrophil count of 300/mm³. Which action is MOST appropriate?

A. Arrange emergency evaluation for febrile neutropenia
B. Recommend acetaminophen and rest at home
C. Schedule outpatient follow-up in one week
D. Encourage increased fluid intake only

 Correct Answer: A. Arrange emergency evaluation for febrile neutropenia

Explanation:

Febrile neutropenia is an oncologic emergency requiring prompt antibiotic therapy. Patients receiving chemotherapy who develop fever and severe neutropenia are at high risk for sepsis and death. Nurse case managers educate patients regarding fever reporting and coordinate urgent evaluation. Early intervention significantly improves survival and reduces complications.

26. A 76-year-old patient with diabetes and peripheral neuropathy is being discharged after treatment for cellulitis. He lives alone and reports difficulty inspecting his feet. Which intervention is BEST?

A. Arrange home health nursing and diabetic foot education
B. Delay discharge until family members are available
C. Recommend walking barefoot indoors
D. Advise follow-up in six months

Correct Answer: A. Arrange home health nursing and diabetic foot education

Explanation:

Peripheral neuropathy increases the risk of ulcers and infections. Home health services provide skilled assessment and reinforce preventive education. Nurse case managers identify functional limitations and coordinate community resources. Early interventions prevent amputations and improve self-management. Addressing patient safety during transitions reduces readmissions and complications.

27. A patient with metastatic colon cancer presents with severe constipation, confusion, and calcium level of 15.2 mg/dL. Which complication should the nurse case manager recognize?

A. Hypercalcemia of malignancy
B. Tumor lysis syndrome
C. SIADH
D. DIC

Correct Answer: A. Hypercalcemia of malignancy

Explanation:

Hypercalcemia of malignancy causes neurological symptoms, dehydration, constipation, and cardiac complications. This is an oncologic emergency requiring prompt treatment. Nurse case managers educate patients and caregivers regarding symptoms requiring urgent attention. Early hydration and treatment improve outcomes and quality of life. Hypercalcemia is a common board examination topic.

28. A 69-year-old man with severe COPD and cachexia reports increasing dyspnea and anxiety despite maximal therapy. Which intervention should the nurse case manager prioritize?

A. Referral to palliative care services
B. Discontinuation of bronchodilators
C. Delay discussions until hospice criteria are met
D. Encourage strenuous exercise

Correct Answer: A. Referral to palliative care services

Explanation:

Palliative care addresses symptom burden, anxiety, and quality of life in advanced disease. Patients do not need to be terminal or discontinue treatment to benefit. Nurse case managers facilitate symptom management and advance care planning. Early palliative involvement improves patient satisfaction and decreases unnecessary hospitalizations.

29. A 76-year-old woman with heart failure, diabetes, and mild cognitive impairment is discharged after treatment for acute pulmonary edema. During a follow-up call, she states she is taking both her old and new doses of furosemide because “the bottles look different.” What should the nurse case manager do FIRST?

A. Perform immediate medication reconciliation and clarify instructions
B. Schedule a cardiology appointment in six months
C. Encourage increased fluid intake
D. Wait until the home health nurse visits next week

Correct Answer: A. Perform immediate medication reconciliation and clarify instructions

Explanation:

Medication discrepancies after discharge are a common cause of readmissions and adverse drug events. Cognitive impairment increases the risk of errors. The nurse case manager’s priority is to reconcile medications immediately and ensure the patient understands the current regimen. Teach-back methods and caregiver involvement may be necessary. Early intervention prevents complications and supports safe transitions of care.

30. A 61-year-old man receiving chemotherapy for multiple myeloma reports new-onset severe back pain, bilateral leg weakness, and urinary hesitancy. Which action should the nurse case manager take FIRST?

A. Arrange emergency evaluation for spinal cord compression
B. Schedule outpatient physical therapy
C. Recommend a heating pad
D. Increase fluid intake

Correct Answer: A. Arrange emergency evaluation for spinal cord compression

Explanation:

Severe back pain accompanied by neurological symptoms and bladder dysfunction strongly suggests spinal cord compression, an oncologic emergency. Delay in treatment can lead to irreversible paralysis. Nurse case managers must recognize these red flags and coordinate urgent imaging and specialist evaluation. Early corticosteroids and definitive treatment improve neurological outcomes and quality of life.