CMGT-BC Practice Questions (2026) — Free Sample Questions with Answers

Answer: B

The nurse's first duty is to the employer that pays for the case management program: Employment obligations matter, but the Code is explicit that the nurse's primary commitment is to the patient, not the organization.

The nurse's primary commitment is to the patient, so she should advocate for the right surface: Correct. Provision 2 states the nurse's primary commitment is to the recipient of care; she should advocate through exception or appeal processes for what the member clinically needs.

The nurse should defer to the supervisor, who carries the legal accountability for the decision: Nurses are accountable for their own practice (Provision 4); deferring does not remove her ethical obligation.

The nurse should let the member choose after hearing only the costs of the two mattress options: Presenting only costs without the clinical differences does not support informed choice and does not meet the duty to advocate.

ANA Code Provision 2: the nurse's primary commitment is to the patient, whether an individual, family, group, community or population, even when organizational interests compete.

Answer: D

A home visit by the case manager within 24 hours of discharge: TCM does not require a home visit within 24 hours; the face-to-face visit may occur in the office within 7 or 14 days.

A mailed letter to the patient summarizing the hospital stay: A mailed letter is not interactive contact and does not meet the TCM communication requirement.

A face-to-face visit within 30 days after the hospital discharge: Thirty days is the TCM service period; the face-to-face visit must happen within 7 or 14 days.

Interactive contact with the patient within 2 business days: Correct. TCM requires interactive contact (phone, electronic or in person) within 2 business days of discharge, medication reconciliation, and a face-to-face visit within 7 days (high complexity) or 14 days (moderate).

TCM (CPT 99495/99496): contact within 2 business days, face-to-face within 14 or 7 days depending on complexity, and med reconciliation by the visit.

Answer: A

The employer group health plan: Correct. Under Medicare Secondary Payer rules, for people 65 or older with coverage through their own or a spouse's current employment at an employer with 20 or more employees, the group health plan pays first.

Medicare Part A, since he is over 65: Age alone does not make Medicare primary when there is current-employment group coverage from a large employer.

Both payers equally, splitting the bill: Coordination of benefits assigns primary and secondary payers; they do not split claims equally.

Medicaid, as the payer of last resort: There is no Medicaid coverage in this scenario, and Medicaid always pays last, not first.

Medicare Secondary Payer (working aged): employer with ≥20 employees → group plan primary; with <20 employees → Medicare primary.

Answer: B

Refer the patient to the hospital's own agency to keep care in the system: Automatically steering patients to an affiliated agency violates the patient's freedom to choose.

Give a list of agencies, disclose the tie and respect his choice: Correct. Hospitals must tell patients of their freedom to choose, give a list of qualified post-acute providers in the area, disclose any financial interest, and respect patient preferences.

Let the physician choose the agency, since it is a medical decision: The choice of post-acute provider belongs to the patient (or representative), not only the physician.

Pick the agency with the lowest cost so the patient saves money: Cost may be one consideration, but the case manager must present choices and let the patient decide.

Discharge planning CoP: patient freedom of choice, list of post-acute providers, disclosure of hospital financial interest, and quality data to help the patient choose.

Answer: D

Start a program that offers the same text reminders to all patients: One-size-fits-all outreach may help overall but can leave or widen gaps if the barriers differ by group.

Wait for the next year's data to see if the overall rate improves: Overall improvement can hide persistent or growing disparities.

Send all of the uncontrolled patients to cardiology for a medication review: Mass specialty referral is costly, does not identify disparities or their causes, and may not be needed.

Break down the rate by race, ethnicity, language and payer to find gaps: Correct. Stratifying quality measures by demographic and social factors is the first step in health equity work, so interventions can target groups with the largest gaps.

Health equity starts with stratified data: break measures down by race, ethnicity, language, payer and SDOH to find and target disparities.

Answer: A

Within 4 weeks after she goes home: Correct. GOLD recommends starting pulmonary rehab within 4 weeks after discharge for an exacerbation, which reduces readmissions and improves quality of life.

Only after a full year with no flares: Waiting a year delays a proven benefit for the patients at highest risk of readmission.

On the inpatient unit before she leaves: Starting rehab during the hospital stay has not shown benefit and was linked to harm in one trial; post-discharge timing is preferred.

Not at all, as rehab is for mild COPD: Pulmonary rehab benefits patients across COPD severity, especially those with frequent exacerbations.

After a COPD exacerbation hospitalization, start pulmonary rehabilitation within 4 weeks of discharge (not during the admission).