A patient presents to the ED of

1.     A patient presents to the ED of a hospital due to a fall. The

patient is diagnosed with a subdural hematoma and is transported to another hospital. The first hospital uses one EHR system and the admitting hospital uses a different EHR system. What does the nurse need to do in order to obtain the patient’s information from the ED visit?
a.     Obtain access to the ED’s electronic health system
b.     Request the patient’s information from the family members who were at the ED
c.     Have the PCP fax the information
d.     Request a copy of the medical record from the transport team
2.     A patient goes to the hospital to have a baby. The hospital uses one HER for L&D and another for all other hospital settings. The provider places labs and pharmacy orders after delivery for both mother and baby. How should this nurse discover which order were placed?
a.     By signing out of L&D systems and into the hospital system
b.     By asking the pt what the provider ordered from the 2 different departments
c.     By contacting the provider directly and obtain the information verbally
d.     By calling the different departments to obtain the information
3.     A nurse practitioner is entering a medication order and encounters a warning that the entry is a duplicate. Which action should this nurse practitioner take?
a.     Display the active orders list and review the medication, dose, and frequency
b.     Call the pharmacist to discuss the issue and to have the medication order entered remotely
c.     Continue entering the medication order and let the pharmacist resolve the issue
d.     Research the medication using an online clinical decision support resource
4.     Users are confused about why the legend may change across different pages of the EHR. How can this be explained to these users?
a.     Users should be told this indicates the EHR contains an error
b.     Users should be told that it is not a big concern for the EHR
c.     Users should be told the symbols used are specific to the EHR category
d.     Users should be directed to memorize different symbols in the EHR
5.     Where can a nurse find a copy of the physician orders for life-sustaining treatment (POLST) in an EHR?
a.     In the “Scanned Documents” section or “Media” tab
b.     In the hard copy of chart components
c.     In the “Results” section or “Laboratory” tab
d.     In the patient’s room
6.     A nurse receives an alert that there are new orders to review. Where does this nurse look to verify this information?
a.     Order entry tab
b.     Order summary tab
c.     Kardex tab
d.     SBAR tab
7.     A nurse could not document the administration of a BP medication until the end of the shift. Which effect could this situation have on patient care?
a.     It could delay a radiology procedure
b.     It could expedite an adverse event safeguard
c.     It could improve aggregation of patient information
d.     It could influence clinical decision-making
8.     A patient informs the nurse that the discharge medications are to be sent to the pharmacy of choice. Where should the nurse enter this information?
a.     In the patient portal
b.     In the admission assessment history
c.     In the personal health record
d.     In the discharge summary
9.     Medication administration times must be altered due to a patient being off the unit at tests all morning. What is the best way to adjust the medication administration times?
a.     Communicate with the pharmacy to adjust the administration times based on standard administration times for the classification of medications
b.     Administer all the missed medications at one time when the patient returns to the unit and then continue with the ordered schedule
c.     Hold all medications until the next day and then administer them at that time
d.     Inform the charge nurse and ask for suggestions regarding when the medication should be given
10.  What is accurate regarding the alerts in an EHR?
a.     The alerts are added by the vendor to demonstrate clinical decision support
b.     The alerts indicate an immediate or potential adverse event that can occur
c.     The alerts are an audit trial that are warning clinicians
d.     The alerts should be ignored after the second time of entering a record
11.  Which statement describes workflow redesign?
a.     It defines the series of events undertaken by nurses working the unit in question
b.     It considers the patient, work done by all the care providers, and organizational need
c.     It is needed only when making a change from a paper system to an automated system
d.     It should be undertaken after the EHR has been implemented
12.  An informatics nurse and an ED nurse are looking to improve efficiency surrounding patient administration from the ED. Which tool should these nurses use to support the interdisciplinary healthcare team?
a.     SWOT analysis
b.     Gap analysis
c.     Strategic goals and mission analysis
d.     Workflow analysis
13.  What is an effective way to reduce risk of access to electronic protected health information (ePHI) by unauthorized users?
a.     Ensure all users use the same user ID but different passwords
b.     Ensure all users have personalized passwords that meet the security criteria of the facility
c.     Ensure all users adhere to the patient portal policy set forth by the facility
d.     Ensure all users change their passwords weekly
14.  An informatics nurse is developing a web-based application for patient care. Which statement accurately describes the internet?
a.     A network controlled by a high-level government agency
b.     A physical cable connecting all associated computers
c.     A secure way of processing data
d.     An unregulated network of networks
15.  How does a healthcare policy assure access to health information by authorized users?
a.     It defines a standard for transmitting instant authorization
b.     It ensures data sharing is governed by cloud computing
c.     It increases the encryption technology of interoperability within EHR
d.     It creates a reliable method to verify the identities of users accessing health information
16.  What describes an example of “opt-in” or “opt-out” choice regarding the disclosure of personal health information?
a.     A patient may choose to share her personal health information with universities for research purposes
b.     A patient may choose to sign a consent to acknowledge the healthcare privacy act
c.     A patient may choose to sign a consent to obtain printed medical records
d.     A patient may choose to sign a consent to transfer personal healthcare information to another facility
17.  What is an example of phishing?
a.     A web page link that opens a dialogue box to download a program
b.     An electronic message sent in an unsolicited bulk message
c.     A log-in prompt that actually records the username and password
d.     An email that contains a link asking for sensitive data to be entered
18.  What is data governance?
a.     The data being limited to internal data within the geographic enterprise to prevent outsiders from accessing the system
b.     The approach to maximizing the value and mitigating risks associated with creating, using, and sharing enterprise data
c.     The security risks and vulnerability being retroactively managed to safeguard data
d.     The overall management of the availability, usability, integrity, and security of data used in an enterprise
19.  What is an important security consideration related to the use of email applications to send and receive patient data?
a.     Emails should not be forwarded to others
b.     Emails should not be used to communicate patient information
c.     Email communication is protected by HIPPA
d.     Email can be susceptible to interceptions from unwanted individuals
20.  What are common reasons for HIPPA infractions? Choose 3
a.     Nurses accessing patient information from the archives of the organization
b.     Nurses gossiping about patients to friends or coworkers
c.     Leaving a chart in the patient’s exam room available for another patient to see
d.     Theft of protected health information through lose or stolen laptops or other devices
e.     Posting a photo of a patient wound without identifying the patient name
f.      Texting encrypted patient information such as vital signs
21.  What is a physical safeguard?
a.     An encrypted network to transmit communication of healthcare providers
b.     An encrypted lock on stored data
c.     A lock on the USB port on computers
d.     Security measure that protect data, policies, procedures, and conduct of personnel in protecting data
22.  What is a technical safeguard of electronic protected health information (ePHI)?
a.     Keeping an inventory of mobile data devices used to transmit ePHI
b.     Installing and updating anti malicious software on mobile devices
c.     Installing locked on the DVD drive on computers
d.     Installing biometric access on mobile devices that contain ePHI
23.  What is a structured method used to analyze serious adverse events?
a.     A root cause analysis (RCA)
b.     A failure mode effect analysis (FMEA)
c.     A define, measure, analyze, improve, control (DMAIC)
d.     A quality and safety education for nurses (QSEN)
24.  Which tool is used to promote quality initiatives in healthcare?
a.     Value stream mapping
b.     Pareto charting
c.     Flow charting
d.     Data modeling
25.  A laboratory manager requested a report of all patients that had a BS greater than 400 for the month of July to provide to the corporate office. Which type of report should the nurse informaticist create using information stored in the HER for this one time request?
a.     Temporary report
b.     Ad hoc report
c.     Standing report
d.     Routine report
26.  A nurse is attempting to administer a patient’s medications using the bar code medication administration (BCMA). When scanning the patient’s armband, the nurse receives an alert that the scanner is unable to scan the armband. Which action should this nurse take in this instance?
a.     Checking the patient’s armband for damage to the bar code itself, and changing the armband if needed
b.     Notifying the patient’s physician of the armband error
c.     Not administering the medications; notifying the pharmacy of the armband error
d.     Creating an incident report regarding the faulty armband
27.  Which government agency recommended the use of bar code medication administration?
a.     The Office of the National Coordinator for Health Information Technology (ONCHIT)
b.     The Food and Drug Administration (FDA)
c.     The Health Information Technology for Economic and Clinical Health (HITECH) office
d.     The Centers for Disease Control and Prevention (CDC)
28.  Within the EHR, a built-in clinical decision support tool alerts the nurse that the patient’s platelets are too low to receive the medication. Which action should this nurse take?
a.     Confirming the lab results for clarification and contacting the provider
b.     Calling the pharmacy technician to ask how to bypass the alert
c.     Holding all of the patients’ other medications
d.     Asking the patient if they are comfortable receiving their medication
29.  What are two barriers to adopting the use of clinical decision support (CDS)tools in an EHR? Choose 2
a.     Implementation challenges
b.     Lack of organizational support
c.     Adequate data sources
d.     Lengthy clinical guidelines
30.  What describes the relationship between meaningful use and merit-based incentive payment systems (MIPS)?
a.     They work together to improve quality, safety, and efficiency and to reduce health disparities
b.     They allow a patient’s private information to be openly viewed by anyone
c.     They work together to decrease the administration of medications, patient complaints, and billing errors
d.     They allow a patient’s family to play a role in the patients’ healthcare outcomes
31.  What do the goals of meaningful use and merit-based incentive programs have in common?
a.     Advancing care information
b.     Improving the quality of care
c.     Increasing the number of tests ordered
d.     Improving the usage rate of EHRs
32.  Which government organization oversees the meaningful use program?
a.     The social security administration (SSA)
b.     The centers for Medicare and Medicaid services (CMS)
c.     The food and drug administration (FDA)
d.     The center for disease control (CDC)
33.  What were 2 objectives of meaningful use as defined by the American reinvestment and recovery act (ARRA)? Choose 2
a.     Include clinical lab test results in the electronic patient portal
b.     Exchange drug formulary data across organizations
c.     Document patient-collected data directly into the EHR
d.     Submit electronic data to health information exchange (HIEs)
34.  A healthcare provider had a hospital laptop stolen from its vehicle. What should be on this laptop to protect it from a data breach?
a.     Two-factor authentication
b.     Two-minute sign off
c.     A hot spot device
d.     File-sharing applications
35.  What should healthcare staff who use mobile devices to access electronic protected health information (ePHI) do to protect devices before they are lost or stolen?
a.     Autoconnect to the hot spot
b.     Create a backup of the device
c.     Turn off file sharing
d.     Install a serial number tracker
36.  During which phase of the systems development life cycle should a system be activated to effectively be used by end users?
a.     Development
b.     Planning
c.     Implementation
d.     Testing
37.  What are 3 tasks in the design phase during the systems development life cycle (SDLC)?
a.     Plan the project, define the scope, and conduct the SWOT analysis
b.     Configure screen layouts, create dashboards, and customize views
c.     Develop short-term training plans, transmit data, and analyze help desk tickets
d.     Install systems upgrades, aggregate data, and obtain research funding
38.  In which stage of the system development life cycle would data be collected from system users regarding their needs?
a.     Planning
b.     Design
c.     Development
d.     Analysis
39.  The initiating phase involves analyzing the project goals and needs. What is the term to describe an unanticipated growth of a project?
a.     Workflow analysis
b.     Regression testing
c.     System of life
d.     Scope creep
40.  What is an objective of user acceptance testing of a health information system?
a.     To ensure the system modules are free of defects
b.     To identify and resolve any system discrepancies
c.     To determine the readiness of the system to exchange data
d.     To confirm the system meets the agreed upon criteria

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