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100+ Free ACM-RN Practice Questions

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An RN case manager must assess a patient's support system. Which finding indicates the STRONGEST support for a safe home discharge?

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Sample ACM-RN Practice Questions

Try these sample questions to test your ACM-RN exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1An RN case manager is admitting a 74-year-old patient with new-onset stroke. Which information source is the MOST appropriate FIRST step to begin a comprehensive case management assessment?
A.Wait for the discharge order before gathering any assessment data
B.Obtain information from the patient, family/support system, and care providers
C.Rely solely on the admitting physician's history and physical
D.Collect only insurance and demographic data from registration
Explanation: The ACM content outline (Domain 1A) requires obtaining information and data for patient assessment from the patient, family, support system, and/or care providers. A multi-source assessment captures clinical and psychosocial factors that a single source would miss.
2While assessing a newly admitted patient, the RN case manager wants to gauge how well the patient understands medication instructions and follow-up care. Which assessment component does this BEST represent?
A.Functional status
B.Advance directives
C.Health literacy
D.Decisional capacity
Explanation: Health literacy (Domain 1B1) is the degree to which a patient can obtain, process, and understand health information needed to make appropriate decisions. Assessing comprehension of instructions directly measures health literacy and predicts readmission risk.
3A patient lives alone in a third-floor walk-up apartment with no elevator, has limited income, and no nearby family. Which assessment domain do these findings primarily reflect?
A.Social determinants of health
B.Developmental level
C.Decisional capacity
D.Health behaviors
Explanation: Living situation, financial status, and availability of a support system are social determinants of health (Domain 1B5). These non-medical factors strongly influence the feasibility of a discharge plan and the risk of readmission.
4A patient with advanced dementia cannot reliably state treatment preferences. The RN case manager needs to identify who can make medical decisions. Which assessment element is the priority?
A.Health literacy assessment
B.Reviewing functional status
C.Documenting cultural beliefs
D.Identifying the designated decision maker
Explanation: When a patient lacks decisional capacity (Domain 1B6), the case manager must identify the designated/surrogate decision maker, such as a healthcare proxy or power of attorney, to ensure decisions are legally and ethically authorized.
5An RN case manager reviews a chart and finds the patient has a properly executed advance directive naming a healthcare agent. What is the MOST appropriate next action?
A.Verify the document is current and communicate its contents to the care team
B.Override the directive if it conflicts with the physician's plan
C.Disregard it because the patient currently has capacity
D.File it without notifying the treatment team
Explanation: Advance directives (Domain 1B7) must be verified for currency and communicated to the care team so treatment aligns with the patient's documented wishes. Ensuring the team is aware prevents care that conflicts with the patient's preferences.
6A 68-year-old post-hip-replacement patient was independent at home but now needs assistance with bathing, dressing, and ambulation. Assessing these activities of daily living evaluates which element?
A.Functional status
B.Health literacy
C.Belief or value system
D.Readmission risk score
Explanation: Activities of daily living (bathing, dressing, ambulation) measure functional status (Domain 1B8). Functional status guides decisions about the appropriate level of post-acute care, such as skilled nursing or home health.
7A patient declines a blood transfusion citing religious convictions. The RN case manager documents this finding under which assessment category?
A.Decisional capacity
B.Belief or value system (cultural influences)
C.Functional status
D.Health behaviors
Explanation: Refusing a treatment based on religious convictions reflects the patient's belief or value system (Domain 1B4), which includes cultural influences. The case manager must integrate these values into the plan of care while respecting autonomy.
8During assessment, the RN case manager identifies that a patient with congestive heart failure has had three admissions in the past 90 days. Identifying this pattern primarily supports which assessment task?
A.Documenting advance directives
B.Assessing developmental level
C.Identifying barriers to discharge and readmission risk
D.Verifying payor authorization
Explanation: Frequent recent admissions are a marker of high readmission risk and signal barriers to a durable discharge (Domain 1D). Recognizing this pattern early lets the case manager target interventions that reduce avoidable readmissions.
9An RN case manager completes an assessment revealing significant unmet home-care needs. According to the content outline, what should the case manager do with these assessment findings?
A.Keep them confidential from the care team until discharge
B.Document them only in a personal log
C.Wait for the physician to request them
D.Communicate assessment findings to the interdisciplinary team
Explanation: Domain 1C requires the case manager to communicate assessment findings. Sharing findings with the interdisciplinary team ensures the care plan addresses identified needs and barriers in real time.
10A patient with a new diagnosis of type 2 diabetes expresses fear and denial about the condition. The RN case manager recognizes this as part of assessing the patient's:
A.Response to illness
B.Functional status
C.Decisional capacity
D.Advance directives
Explanation: A patient's emotional reaction such as fear or denial is part of the response to illness (Domain 1B1), assessed alongside health literacy and behaviors. Understanding the response helps tailor education and engagement strategies.

About the ACM-RN Exam

The ACM-RN is the registered-nurse pathway of ACMA's Accredited Case Manager credential for health care delivery system case management. The exam pairs a 110-item multiple-choice core (90 scored) with an RN-specific simulation of 12 cases (31 questions), both delivered through Pearson VUE since December 2025. Eligibility requires a current RN license in good standing and at least 1 year (2,080 hours) of supervised, paid case management experience.

Assessment

Two scored portions: a 110-question multiple-choice core (90 scored + 20 pretest) and a discipline-specific simulation of 12 cases with 31 multiple-choice questions. RN candidates must pass both.

Time Limit

2 hours for the multiple-choice core; 90 minutes for the specialty simulation (a 10-minute break is built in between portions).

Passing Score

Set by a modified Angoff method during a passing point study; the exact passing point varies by exam form and is not publicly disclosed. Both the core and simulation portions must be passed.

Exam Fee

$359 (covers both portions); expedited scheduling adds $46. Retest of both portions is $359; retest of one portion is $200. (American Case Management Association (ACMA) / National Board for Case Management (NBCM))

ACM-RN Exam Content Outline

42%

Screening and Assessment

Gathering and assessing patient data including health literacy, medical and psychosocial history, developmental/cognitive status, cultural beliefs, social determinants of health, decisional capacity, advance directives, functional status, discharge barriers, readmission risk, and patient goals (38 of 90 scored core items).

50%

Care Coordination, Intervention, and Transition Management

Collaborating with care teams, building the plan of care, entitlement programs, regulatory compliance (HIPAA, CMS, EMTALA), legal and ethical practice, service coordination, referrals, utilization review of medical necessity and level of care, payor issues, cultural competence, and avoidable delays (45 of 90 scored core items).

8%

Process Improvement and Evaluation

Collecting timely, accurate data to evaluate interventions, identifying additional external resources, and identifying and resolving patient safety and risk management issues (7 of 90 scored core items).

Simulation

Specialty Simulation (Assessment, Care Coordination, and Intervention)

Discipline-specific RN simulation of 12 cases / 31 questions covering screening, information gathering, level-of-care review, payor authorization, service coordination, response-to-care evaluation, additional education, non-coverage/appeal notices, external resources, and transition re-evaluation.

How to Pass the ACM-RN Exam

What You Need to Know

  • Passing score: Set by a modified Angoff method during a passing point study; the exact passing point varies by exam form and is not publicly disclosed. Both the core and simulation portions must be passed.
  • Assessment: Two scored portions: a 110-question multiple-choice core (90 scored + 20 pretest) and a discipline-specific simulation of 12 cases with 31 multiple-choice questions. RN candidates must pass both.
  • Time limit: 2 hours for the multiple-choice core; 90 minutes for the specialty simulation (a 10-minute break is built in between portions).
  • Exam fee: $359 (covers both portions); expedited scheduling adds $46. Retest of both portions is $359; retest of one portion is $200.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

ACM-RN Study Tips from Top Performers

1Download the ACM Candidate Handbook and study the content outline directly: weight your prep toward Care Coordination, Intervention, and Transition Management (45 of 90 scored items) and Screening and Assessment (38 items).
2Practice applying regulations in scenarios (HIPAA, EMTALA, CMS medical-necessity and level-of-care review, Medicare discharge appeal notices) rather than memorizing definitions, since the exam is heavily applied and case-based.
3Prepare for the RN simulation by reasoning through cases step by step: screen, gather/assess information, verify payor authorization, coordinate services, evaluate the response to care, and re-evaluate the transition plan when the situation changes.

Frequently Asked Questions

How many questions are on the ACM-RN exam?

The multiple-choice core has 110 questions (90 scored and 20 unscored pretest items), and the discipline-specific simulation has 12 cases with a total of 31 multiple-choice questions. RN candidates must pass both portions.

How much does the ACM-RN exam cost?

The examination fee is $359 and covers both the core and simulation portions. Expedited scheduling adds $46. Retesting both portions costs $359, and retesting a single portion costs $200.

What is the passing score for the ACM-RN?

The passing standard is determined using a modified Angoff method during a passing point study by a panel of experts. The exact passing point varies by exam form and is not publicly disclosed; candidates must pass both the core and simulation portions.

Who administers the ACM-RN exam and what are the eligibility requirements?

ACMA/NBCM administers the ACM through Pearson VUE (test center or OnVUE online). RN candidates must hold a current, valid nursing license in good standing and have at least 1 year (2,080 hours) of supervised, paid case management work experience.