CCMC CCM Exam Questions

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121.

Which of the following stages of change is most characterized by ambivalence about change?

  • Contemplation

  • Pre-contemplation

  • Action

  • Maintenance

Correct answer: Contemplation

Contemplation is the stage characterized by ambivalence about change.

Pre-contemplation is the stage of change in which a person doesn't understand the need for change. Preparation is when the person has decided on change and is making plans. Action is the stage where the person has begun to enact the change process. Maintenance describes the stage where a person has begun change and must work to maintain and reinforce it.

122.

Which of the following kinds of inpatient observation will a patient need who is currently suicidal?

  • 1 to 1

  • 15 minute checks

  • 30 minute checks

  • There is no specific level of observation per se

Correct answer: 1 to 1

A patient who is admitted to an inpatient treatment setting for being suicidal is most likely to be placed on a 1 to 1 observational status until basic safety can be contracted for.

Specific levels of observation are common in inpatient psychiatric settings.

123.

Which of the following is not forbidden under the "anti-kickback statute"?

  • Consulting fees

  • Meals

  • Expensive trips

  • Cash

Correct answer: Consulting fees 

The anti-kickback statute is federal law that prohibits undue incentives to reward referrals or to generate federal healthcare program business. Under this law, any undue reward or incentive is prohibited, including meals, expensive trips, and outright cash payments.

Though an excessive consulting fee would be prohibited, an appropriate fee for consulting services would not.

124.

Which of the following questions of a job interviewee would be allowed under the ADA?

  • How long were you employed at your last job?

  • Do you have a mental illness that would impact your ability to work for us?

  • Have you ever been injured while working?

  • How much sick leave did you take at your last job?

Correct answer: How long were you employed at your last job?

According to the provisions of the Americans with Disabilities Act of 1990, it is prohibited to ask certain questions of an interviewee before an offer has been extended. These include questions about mental health, previous job injuries, and sick leave taken in previous employment. These could be seen as questions designed to help a potential employer avoid employing someone due to a disability.

Asking about the length of previous tenure is usually considered allowable.

125.

Which of the following would be the least likely example of an ergonomic intervention?

  • On-the-job counseling

  • Stand-up workstation

  • Measurement of posture

  • Detachable keyboard

Correct answer: On-the-job counseling

Ergonomics is the science of measuring the work task and environment and making adjustments to reduce risks of repetitive motion or other injuries. These interventions tend to be adjustments to the worker's physical environment, such as measuring posture or the installation of a stand-up workstation or detachable keyboard.

As ergonomics is much more concerned with the physical environment than the psychological, on-the-job counseling would be the least likely such intervention. 

126.

Who is served by CHIP?

  • Children in families without insurance

  • Children in families below the poverty line

  • Children in families facing homelessness

  • Children with mental illness

Correct answer: Children in families without insurance

The Children's Health Insurance Program (CHIP) provides health coverage to children in families that do not qualify for Medicaid, but who cannot afford healthcare coverage.

CHIP does not necessarily serve children in families below the poverty line, as these may qualify for coverage under Medicaid. The families concerned may be facing homelessness and the children concerned may have mental illness, but these are not the primary criteria.

127.

What is the most appropriate level of care for people with drug and alcohol problems who have been unsuccessful with outpatient treatment, but are not appropriate for inpatient care?

  • Residential treatment

  • Group home

  • Assisted living

  • Intermediate care

Correct answer: Residential treatment 

Residential treatment is a level of care that is appropriate for people with drug and alcohol (or other mental health issues) that have been unsuccessful with outpatient treatment but who do not meet the requirements for inpatient care.

A group home would be more appropriate for those with chronic disabilities. Assisted living would be more useful for those who have difficulty completing activities of daily living on their own. Intermediate care is a step above custodial care, but does not include skilled nursing; it is not ideally suited for psychiatric issues.

128.

What two things must be proved in a malpractice claim?

  • Negligence and harm

  • Negligence and fraud

  • Fraud and harm

  • Intent and harm

Correct answer: Negligence and harm

In a malpractice suit, two things must be proved for the claim to be recognized: one, that the case manager was negligent, and two, that there was some harm or injury resulting from that negligence.

Fraud and intent need not be proved in malpractice suits per se.

129.

In general, how much physical activity a day is recommended? 

  • Thirty minutes of moderate physical activity

  • Ten minutes of moderate physical activity 

  • Thirty minutes of strenuous physical activity

  • Ten minutes of strenuous physical activity 

Correct answer: Thirty minutes of moderate physical activity

In general, thirty minutes of moderate physical activity is recommended for adults.

Strenuous physical activity may not be recommended at all, and its recommendation would be more carefully advised. 

130.

Which of the following distinguishes a Group Model HMO from others?

  • The physicians are employed by the physician group

  • The physicians audit their own billing

  • The physicians observe a multipractice agreement 

  • The physicians are all specialists 

Correct answer: The physicians are employed by the physician group

As opposed to other models that involve the physicians working for the health maintenance organization directly or in another arrangement, the distinguishing feature of a Group Model HMO is that the physicians concerned are employed by their own group and share profits and losses with the HMO. 

In this model, the physicians do not necessarily audit their own billing, observe multipractice agreements, and they are likely not specialists.

131.

Who administers Medicaid?

  • State governments 

  • Federal government agencies

  • Local municipalities

  • Hospital systems

Correct answer: State governments 

Medicaid is a benefit program intended to support those whose financial resources are limited, among other factors of vulnerability. It is administered by state governments.

It is not administered by the federal government, local municipalities, or hospital systems.

132.

What does CAHPS stand for?

  • Consumer Assessment of Healthcare Providers and Systems

  • Consumer Awareness of Hospital Providers and Systems

  • Client Assessment of Healthcare Providers and Safety

  • Consumer Assessment of Healthcare Providers and Safety

Correct answer: Consumer Assessment of Healthcare Providers and Systems

The CAHPS (Consumer Assessment of Healthcare Providers and Systems) is a publicly-reported, patient-completed assessment that rates a patient's overall healthcare experience. It is meant to make the consumer's voice heard in the marketplace and increase accountability and transparency in healthcare organizations.

133.

Between clinical guidelines and clinical standards, which is the more strict?

  • Clinical standards

  • Clinical guidelines

  • They are equally strict

  • It is a matter of state and local law

Correct answer: Clinical standards

Clinical or practice standards define the acceptable level of performance for that kind of practice, and are more strict than clinical guidelines, which are meant to assist practitioners with knowledge and guidance.

State and local law do not define the hierarchical relationship between clinical guidelines and clinical standards.

134.

Which of the following accurately describes an ethical dilemma?

  • When the choices are equally acceptable or unacceptable

  • When there is clear ethical direction in the situation

  • When there are no alternatives

  • When there are multiple decision-makers

Correct answer: When the choices are equally acceptable or unacceptable

An ethical dilemma is a choice between two choices that are either equally acceptable or equally unacceptable, leading to a choice between equivalents. 

An ethical dilemma is not determined by the number of decision-makers or the number of alternatives.

135.

Which of the following is the best definition of spirituality in client experience?

  • No universal definition exists

  • A belief in a higher power

  • A sense of connection with all living creatures 

  • A method for finding meaning in life

Correct answer: No universal definition exists

Spirituality is a necessary part of the experience of many patients, yet it is difficult to define in a way that captures all client experiences. In fact, no adequate universal definition exists, and it is valuable for the practitioner to remember that concepts of spirituality are as diverse as patients themselves.

Spirituality may mean a belief in a higher power, a sense of connection with all living creatures, or a method of finding meaning in life. It may mean all of these or none; the best guidance is to let clients lead in defining what it means to them.

136.

Which of the following health literacy instruments is quickest to administer?

  • The Newest Vital Sign

  • Test of Functional Health Literacy Assessment (TOFHLA)

  • Rapid Estimate of Adult Literacy in Medicine (REALM)

  • Test of Functional Health Literacy Assessment, Short form (S-TOFHLA)

Correct answer: The Newest Vital Sign

Of the various health literacy instruments available, The Newest Vital Sign is the quickest to administer, taking only three minutes.

The Test of Functional Health Literacy Assessment (TOFHLA) may take 20 minutes. The Test of Functional Health Literacy Assessment, Short form (S-TOFHLA) takes 12 minutes. The Rapid Estimate of Adult Literacy in Medicine (REALM) is an assessment taking a variable amount of time asking a variety of questions, and takes more than three minutes. 

137.

Which of the following is the purpose of the Measures Applications Partnership (MAP)?

  • To provide performance measures for federal health programs

  • To provide trained accreditors for federal health programs 

  • To identify waste and inefficiency in federal health programs 

  • To provide data to Congress on Medicare reimbursement strategy

Correct answer: To provide performance measures for federal health programs

The Measures Applications Partnership (MAP) was formed to provide a consistent base of performance measures for federal health programs. Its efforts inform more than 20 federally funded health programs, and it is composed of more than 150 healthcare leaders and experts.

MAP does not provide trained accreditors for federal health programs, nor does it explicitly identify waste and inefficiency in federal health programs. It is not tasked with providing data to Congress on Medicare reimbursement strategy.

138.

Can a skilled care setting have various levels of care?

  • Yes

  • No, skilled nursing is a level of care

  • No, only nursing is offered in skilled care

  • Yes, when state regulations allow it

Correct answer: Yes

A skilled care setting can have many different levels of care depending on the need of the client. Level of care refers more to the specific resources used to meet the need of the patient. For example, a client may need occupational therapy or physical therapy or nursing. The skilled care setting is the location of care and not the level of care. 

This differentiation is not a matter of state law.

139.

Which of the following is untrue about negotiation?

  • It involves a third party

  • The parties form their own decisions

  • Agreement is reached without oversight

  • The intention is compromise

Correct answer: It involves a third party

Negotiation is a conflict resolution strategy that takes place between the two parties concerned, in which they are allowed to pursue the process in their own way and form their own solutions with the intention of reaching compromise. 

There is no oversight or third party interference in a negotiation.

140.

Which of the following is the purpose of work adjustment?

  • To improve attitude and behavior

  • To recover from physical injury

  • To adjust to physical injury

  • To train strength to a certain level

Correct answer: To improve attitude and behavior

Work adjustment seeks to improve the attitude, behavior, and interpersonal skills of a person to make them more employable and effective in the workplace.

This is in contrast to work hardening or work conditioning, which have more to do with recovery from injury or debility and the achievement of certain strength goals.