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NCLEX-RN Case management practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Case management sits inside the Management of Care category of the NCLEX-RN. Our bank holds 33 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Case management sample questions

Question 1

A 68-year-old client with heart failure has been hospitalized three times in the past two months. The client lives alone, has a fixed income, and reports difficulty affording prescribed diuretics. Which action should the nurse take?

  1. A Document the financial concern in the chart and continue with routine discharge teaching.
  2. B Teach the client to take the diuretic only on days when leg swelling becomes noticeable.
  3. C Advise the client to ask a neighbor to help pay for the prescribed diuretic medication.
  4. D Refer the client to a case manager to coordinate resources and follow-up after discharge.
Show the answer and explanation

Correct answer: D

Repeated readmissions linked to the cost of diuretics point to a resource problem. A case manager can connect the client with medication assistance programs and community services and arrange follow-up, which addresses the root cause of the readmissions.

Why the other options are wrong:
A: Documenting the concern without acting on it leaves the barrier in place and makes another readmission likely.
B: Taking the diuretic only when swelling appears is unsafe; fluid overload begins before edema is visible.
C: Relying on a neighbor is neither reliable nor appropriate and does not create a sustainable solution.

Question 2

A 58-year-old client with chronic obstructive pulmonary disease is being discharged home on oxygen at 2 L/min via nasal cannula. The client lives alone and reports difficulty walking to the mailbox. Which intervention should the case manager prioritize before discharge?

  1. A Schedule a pulmonary rehabilitation program to begin within two weeks after discharge.
  2. B Arrange for a home health aide to visit daily for personal care and meal preparation.
  3. C Order a portable oxygen tank and arrange for oxygen delivery to the client's home.
  4. D Refer the client to social services for evaluation of financial assistance for utilities.
Show the answer and explanation

Correct answer: C

The client is being discharged on oxygen, so oxygen equipment must be in the home at discharge. A portable system also lets the client move about safely, including walking to the mailbox.

Why the other options are wrong:
A: Pulmonary rehabilitation is valuable but long term, not a requirement for a safe discharge.
B: A home health aide helps with care but does not provide the prescribed oxygen.
D: Financial help may be needed later, but the oxygen supply must be arranged first.

Question 3

A 62-year-old client with chronic obstructive pulmonary disease and diabetes is being discharged home after a 5-day hospitalization for pneumonia. The client lives alone and has no family nearby. The nurse case manager is coordinating the discharge plan. Which intervention should the nurse prioritize to reduce the risk of readmission?

  1. A Arrange for a 30-day supply of all prescribed medications to be delivered before the client leaves.
  2. B Schedule a follow-up appointment with the primary care provider within 7 days of discharge.
  3. C Refer the client to a home health agency for skilled nursing visits and pulmonary rehabilitation.
  4. D Provide the client with a written list of emergency department contact information and warning signs.
Show the answer and explanation

Correct answer: C

A client who lives alone with COPD and diabetes after pneumonia needs ongoing support at home. Home health skilled nursing visits provide monitoring, medication and inhaler teaching, and early detection of problems, and pulmonary rehabilitation improves conditioning, which together reduce readmission risk.

Why the other options are wrong:
A: Having medications on hand supports adherence but provides no monitoring or teaching.
B: An early follow-up visit is important, but a client living alone needs in-home monitoring and support between visits.
D: Warning signs and emergency numbers are standard teaching but do not provide professional follow-up care.

Question 4

A 74-year-old client with a new diagnosis of heart failure is preparing for discharge home after a 5-day hospital stay. The case manager meets with the client to coordinate services. Which action is the primary responsibility of the case manager in this situation?

  1. A Teach the client how to use the new medication delivery device prescribed at discharge.
  2. B Coordinate referrals for home health nursing, physical therapy, and durable medical equipment.
  3. C Perform the client's final physical assessment before the discharge order is written.
  4. D Administer the client's discharge medications and review common side effects with the client.
Show the answer and explanation

Correct answer: B

A case manager coordinates care across settings, arranging the referrals, services, and equipment a client needs after discharge. Setting up home health nursing, physical therapy, and durable medical equipment is the core of that role and supports a safe transition home.

Why the other options are wrong:
A: Teaching the client to use a new medication device is direct care performed by the discharging nurse.
C: The final physical assessment is a bedside nursing responsibility, not a case management function.
D: Administering medications and reviewing their side effects is done by the nurse providing direct care.

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