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ANCC Nursing Case Management (RN) Practice Tests & Test Prep by Exam Edge - Topics


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Understanding what is on the ANCC Nursing Case Management exam is crucial step in preparing for the exam. You will need to have an understanding of the testing domain (topics covered) to be sure you are studing the correct information.

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ANCC Nursing Case Management Exam Blueprint

Understanding the exact breakdown of the ANCC Nursing Case Management test will help you know what to expect and how to most effectively prepare. The ANCC Nursing Case Management has 125 multiple-choice questions The exam will be broken down into the sections below:

ANCC Nursing Case Management Exam Blueprint
Domain Name % Number of
Questions
Professional Foundation 20% 25
Care Coordination 30% 38
Quality Management 30% 38
Health Promotion 20% 25

ANCC Nursing Case Management - Exam Topics Sample Questions

Which of the following actions is NOT an intentional tort?

Correct Answer:
negligence


to understand why negligence is not considered an intentional tort, it's important to first comprehend the basic distinction between intentional torts and unintentional torts. an intentional tort involves deliberate actions. this means that the person committing the tort makes a conscious decision to perform an act that is likely to cause harm to others. examples of intentional torts include assault, battery, and false imprisonment. in each of these cases, the perpetrator acts with a specific intent to bring about a particular outcome that infringes on the rights of another person.

negligence, on the other hand, differs significantly in its nature as it does not involve a deliberate intention to cause harm. instead, negligence arises from a failure to take reasonable care to avoid causing injury or loss to another person. in legal terms, negligence is defined by the breach of a duty of care that results in damage. it involves a lack of intention to harm, which is the critical factor differentiating it from intentional torts.

for example, if someone accidentally hits another car while driving because they were momentarily distracted, this is negligence. they did not intend to cause the crash; however, their lack of attention breached the duty of care owed to other road users. in contrast, if someone deliberately rams their car into another car during a road rage incident, this action would likely be classified as an intentional tort (specifically, battery), as it involves a conscious decision to cause harm.

thus, while intentional torts require a direct intent to injure or harm, negligence is fundamentally about carelessness or the failure to act with the prudence that a reasonable person would exercise under the same circumstances. this distinction is crucial in law, as it affects both the type of legal claims that can be made and the kind of defenses that may be available to the defendant. understanding this difference helps clarify why negligence is categorized as an unintentional tort, setting it apart from actions like assault, battery, and false imprisonment, which are intentional by nature.

With case management, TPA stands for which of the following?

Correct Answer:
third-party administrators
in the context of case management, tpa stands for third-party administrators. this term refers to independent firms that provide essential services primarily to employers who opt for self-insured models. a third-party administrator acts as an intermediary that handles the administration of insurance claims and employee benefit plans on behalf of the self-insuring company.

the role of a tpa is critical in managing the complexities associated with health plans, workers' compensation, and other similar employee benefits. by outsourcing these responsibilities to a tpa, companies can focus more on their core business activities while ensuring that claims and benefits are managed efficiently and professionally.

third-party administrators bring expertise in navigating the legal, medical, and administrative aspects of claims processing. they are equipped with the technology and specialized knowledge required for managing vast amounts of claims data, facilitating speedy and accurate processing. furthermore, tpas often provide additional services such as underwriting, customer service, and consulting on cost control and risk management.

often described as an "administrative services only" (aso) provider, a tpa differs from traditional insurance companies in that they do not assume any risk themselves. instead, the financial risk remains with the employer, while the tpa focuses on the administrative tasks. this arrangement can lead to cost savings for employers and more personalized service for the insured individuals.

in summary, in the field of case management, tpa stands for third-party administrators. these entities play a pivotal role in supporting self-insured organizations by managing employee benefits and claims, providing specialized services that streamline operations, reduce administrative burdens, and potentially lower costs while maintaining high standards of service and compliance.