CMC (NACCM) Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

dementia with Lewy bodies.: Lewy body dementia also fluctuates, but it develops gradually, not over two days in someone with intact cognition.

late-onset depression.: Depression does not cause abrupt inattention and picking behavior.

delirium.: Correct. Acute onset over days, fluctuating attention and a likely medical trigger (infection, new medication) are the hallmarks of delirium, a medical problem needing prompt evaluation.

rapid progression of Alzheimer's disease.: She had no prior cognitive impairment, and Alzheimer's disease progresses gradually.

Sudden onset plus fluctuating attention means delirium until proven otherwise; dementia is gradual.

Answer: B

Her diagnosis means she cannot sign any document: A diagnosis alone does not remove capacity.

She may still have capacity to name a health care agent: Correct. Capacity is decision-specific: losing the ability to manage finances does not mean losing the ability to choose a trusted agent, which she shows by a consistent, reasoned choice.

Her son should be named because he is next of kin: Family rank does not override a capable client's own choice.

A guardian must be appointed before she chooses: Guardianship is the most restrictive option and is not needed if she can still decide.

Judge capacity for the specific decision at hand; a person who cannot manage money may still be able to appoint a health care agent.

Answer: B

The acetaminophen for knee pain: Acetaminophen is not anticholinergic and is usually preferred for older adults' pain.

The diphenhydramine sleep aid: Correct. Diphenhydramine is a strongly anticholinergic antihistamine that the AGS Beers Criteria list as potentially inappropriate for older adults; forgetfulness, constipation and dry mouth fit its effects.

The atorvastatin taken each evening: A statin does not produce this anticholinergic cluster of symptoms.

The daily vitamin D supplement: Vitamin D does not cause forgetfulness, dry mouth and constipation.

Over-the-counter sleep aids and other strong anticholinergics are Beers Criteria red flags; new confusion with dry mouth and constipation should prompt a report to the prescriber.

Answer: B

Send the son a service agreement and fee schedule: Wrong party and wrong order: the payer is not necessarily the client, and the client has not yet agreed to the service.

Ask whether his mother agrees to the referral: Correct. The mother, who appears to have capacity, is the client even though the son pays. Identifying the client and confirming her willingness to be contacted comes before contracts, plans or meetings.

Tour assisted living options near the son's home: This builds a plan around the son's goal before the client is even involved or assessed.

Schedule a family meeting to present the move: A family-driven agenda; it presents a decision instead of learning what the client wants.

Whoever calls or pays, first identify the client and confirm that a capable client knows of and agrees to the referral.

Answer: C

comfort medications for her terminal illness.: Drugs for pain and symptom control related to the terminal illness are covered.

nursing and aide visits by the hospice team.: Hospice team visits are core covered services.

her room and board in the nursing home.: Correct. Medicare hospice covers the hospice team, comfort drugs and equipment for the terminal illness, but not room and board where she lives; short inpatient and respite stays arranged by hospice are the exception.

short-term inpatient care for pain control.: Short-term inpatient care for symptoms is covered when hospice arranges it.

Hospice pays for hospice services, not the cost of living in a nursing home or other residence.

Answer: B

She cannot qualify with only one ADL impaired: Overlooks the separate cognitive-impairment trigger in the policy.

She may qualify through the cognitive trigger: Correct. The policy has two separate benefit triggers. Severe cognitive impairment needing supervision can meet the trigger even with only one ADL impaired; benefits then follow the elimination period.

Benefits start now and skip the waiting period: The elimination period still applies once a trigger is met.

She must be hospitalized before benefits begin: The policy terms given include no hospital-stay requirement.

Read the policy terms: LTC insurance pays on ADL or cognitive triggers, after the elimination period.

Answer: A

Build goals around staying home while addressing the fall risk: Correct. A capable client sets the direction of her own plan. Goals that honor her choice and address the son's legitimate safety concern are client-centered and least restrictive.

Base the goals on the son's plan because he pays the fees: The payer is not the client, and his goal overrides a capable client.

Postpone setting goals until mother and son agree: Leaves the fall risk unaddressed and hands the son a veto.

Set a trial at home and plan a move after any new fall: Imposes a condition she has not agreed to; one fall does not end her right to decide.

Goals are mutually agreed with the client; family concerns are addressed within the client's choices, not instead of them.

Answer: C

Explain the pendant is required and ask her to wear it: The plan belongs to the client; insisting overrides a capable choice and is unlikely to work.

Accept her choice and drop fall response from the plan: Accepting the refusal is right, but dropping fall response ignores the recent fall and her living alone.

Offer alert options she will accept plus daily check-ins: Correct. She has capacity, so her refusal stands; because she lives alone and recently fell, the plan still manages the risk with alternatives she accepts (such as a watch-style device or a daily call).

Ask her son to persuade her to wear the pendant again: Using family pressure is paternalistic and bypasses the client.

When a capable client refuses a service or device, honor the refusal and modify the plan to manage the risk in a way she accepts.

Answer: B

Arrange emergency respite so he can rest this week: Respite is likely needed, but risk must be assessed first.

Ask him directly whether he is thinking of harming himself or his wife: Correct. The statement may signal suicidal or homicidal thinking; assessing risk directly comes before planning respite or resources.

Give him the number for a caregiver support line: A phone number underreacts to a possible statement of intent to harm.

Call 911 and ask that he be taken for an evaluation: Calling emergency services may follow, but acting before any risk assessment overreacts and can harm trust.

In crisis intervention, assess for danger to self or others directly before choosing a level of response.

Answer: C

Let both of them air their complaints fully before moving on: Venting can escalate the conflict and further distress the client.

Pause the meeting and refer them both to family counseling: Counseling may help later, but pausing now leaves the plan unresolved and sidelines the client.

Refocus on his goals and assign clear tasks to each relative: Correct. Redirecting to the client’s goals and concrete roles (such as who arranges rides to appointments) de-escalates the conflict and keeps the client at the center.

Ask the client to decide which relative was at fault: Putting the client in the middle of his family’s dispute adds to his distress and does not solve the missed appointments.

In family meetings, manage conflict by returning to the client’s goals and assigning clear, specific roles.

Answer: B

Send the full assessment, since she signed an authorization: The authorization covers relevant information; it does not justify sending everything.

Send only the information the program needs to serve her: Correct. Even with an authorization, the minimum-necessary principle limits disclosure to what the recipient needs for its purpose.

Ask the program to request the records from her physician: This shifts the task without protecting her privacy any better.

Send a summary by regular, unencrypted email to save time: Unsecured email risks exposing protected health information.

Share PHI with authorization, limited to the minimum necessary, by secure means.

Answer: D

Arrange it, since the daughter is named as health care agent: Naming an agent does not activate the agent’s authority while the mother can still decide.

Suggest a hidden camera so the mother will not be upset: Covert monitoring violates the client’s dignity and the aide’s right to notice.

Decline because home cameras are forbidden under HIPAA: HIPAA does not ban home cameras; the issue is consent and privacy.

Discuss the camera with the mother and seek her consent: Correct. Monitoring technology intrudes on privacy; the client, who can express preferences, must be consulted and agree before anything else.

Before using cameras, sensors or trackers, obtain the client’s informed consent and consider others in the home, such as aides.

Answer: C

Respect her request for secrecy, since she has capacity to decide: Capacity does not remove the limits of confidentiality when exploitation and threats are disclosed.

Help her open a separate bank account and keep monitoring closely: Protective steps may help, but they do not replace a report to adult protective services.

Explain confidentiality limits and report to adult protective services: Correct. Under the Client Confidentiality standard, confidentiality has limits when a client is being harmed: telling her why and reporting to adult protective services, as applicable law requires, respects her while protecting her.

Confront the grandson about the missing checks at the next visit: Confronting the alleged abuser can increase the danger to the client.

Confidentiality has limits: suspected abuse or exploitation is reported under applicable law, with the client told why.

Answer: A

Clarify that she is the client and agree on reports she consents to: Correct. The person served is the client even when a trust pays; what is reported, and to whom, rests on her consent or her legal representative’s.

Send full monthly reports, since the trust pays for the services: The payer is not necessarily the client; payment does not authorize disclosure.

Treat the trust officer as the client because the trust contracts: Contracting for services does not make the trust officer the client.

Decline the case because a third party is paying for it: Third-party payment is common and manageable when roles are clarified.

Identify the client at the outset: the person receiving services, not the payer, and set reporting rules with her consent.