GALEN COLLEGE OF NURSING
Course Code: NSG 3155
Instructor:
Date: 2026
FINAL EXAM – HEALTHCARE INFORMATICS
1. A hospital implements a new Clinical Decision Support System (CDSS)
that generates 15 alerts per patient per day. Nurses begin ignoring many
alerts. This phenomenon is known as:
A) Alert override
B) Alert fatigue
C) Decision paralysis
D) Cognitive overload
Answer: B
Rationale: Alert fatigue occurs when clinicians are exposed to excessive
alerts, leading to desensitization and ignoring important warnings. Studies
show 49-96% of alerts are overridden. Effective CDSS implementation
requires optimizing alert specificity and clinical relevance to prevent this
dangerous phenomenon.
2. A nurse accesses a colleague's medical record without a clinical need.
This violates which HIPAA principle?
A) Minimum necessary standard
B) Notice of privacy practices
C) Administrative safeguards
D) Breach notification rule
Answer: A
Rationale: The minimum necessary standard requires accessing only the PHI
needed for the specific job function. Accessing records without clinical need
violates this principle and HIPAA privacy rules. This can result in termination,
fines up to $50,000, and potential criminal charges.
3. Your hospital is implementing a new EHR system. During the testing
phase, you discover a workflow issue where medication orders require 12
1
,clicks instead of the previous 3. This is an example of:
A) Change management failure
B) Usability problem
C) Interoperability issue
D) Data integrity error
Answer: B
Rationale: Usability refers to how effectively, efficiently, and satisfactorily
users can interact with a system. Excessive clicks increase time, frustration,
and error potential. Good EHR design follows human factors principles,
minimizing clicks and optimizing workflow efficiency.
4. Which interoperability standard is considered the most modern approach
for health information exchange, using web-based APIs?
A) HL7 Version 2.x
B) HL7 Version 3
C) Fast Healthcare Interoperability Resources (FHIR)
D) Digital Imaging and Communications in Medicine (DICOM)
Answer: C
Rationale: FHIR is the newest HL7 standard using RESTful APIs, JSON, and
XML for data exchange. It enables mobile applications and patient portals to
access EHR data efficiently. FHIR is increasingly required for certified EHR
systems and supports modern healthcare applications.
5. A patient portal allows patients to view their laboratory results before the
physician has reviewed them. What ethical principle does this support?
A) Beneficence
B) Autonomy
C) Justice
D) Nonmaleficence
Answer: B
Rationale: Autonomy respects patients' right to make informed decisions
about their healthcare. OpenNotes and immediate lab result access
empower patients with their health information. While some providers worry
about patient anxiety, research shows most patients want immediate access
to their results.
6. During a cyberattack, the hospital's EHR system becomes unavailable.
What is the most appropriate immediate response?
A) Wait for IT to restore the system
B) Activate downtime procedures and paper documentation
C) Send patients to other facilities
D) Cancel all non-emergency procedures
Answer: B
Rationale: Every healthcare facility must have downtime procedures for EHR
outages. These include paper charting, medication administration protocols,
and communication plans. Patient care continues during downtimes using
2
, established backup processes. Preparation and regular drills are essential.
7. A nurse uses a smartphone to photograph a patient's wound for
documentation. What is the primary informatics concern?
A) Image quality may be insufficient
B) The device may not be secure or encrypted
C) It takes too much storage space
D) Other apps might interfere
Answer: B
Rationale: Personal devices often lack encryption, secure authentication, and
remote wipe capabilities required for PHI. If lost or stolen, patient data is
compromised. Healthcare organizations must provide approved, secured
devices with mobile device management (MDM) for clinical photography.
8. Computerized Provider Order Entry (CPOE) systems have been shown to
reduce which type of medical error most significantly?
A) Diagnostic errors
B) Prescribing and transcription errors
C) Surgical errors
D) Communication errors
Answer: B
Rationale: CPOE eliminates handwriting interpretation errors and ensures
complete orders with required elements. Studies show 50-80% reduction in
medication errors. However, CPOE can introduce new errors (wrong patient
selection, order set misuse) requiring careful implementation and monitoring.
9. A healthcare organization is selecting a new EHR vendor. Which
certification is most important to verify for compliance with federal
requirements?
A) ISO 9001
B) Joint Commission accreditation
C) ONC Health IT Certification
D) HIMSS Analytics Stage 7
Answer: C
Rationale: ONC (Office of the National Coordinator) Health IT Certification
ensures EHR systems meet federal requirements for Promoting
Interoperability programs (formerly Meaningful Use). Certified systems
support required functionalities, interoperability standards, and security
measures. This certification is mandatory for federal incentive program
participation.
10. Which of the following best describes the role of a Clinical Nurse
Informaticist?
A) Provides technical support for computer problems
B) Bridges clinical practice and information technology to optimize patient
care
C) Manages the hospital's IT department
3
Course Code: NSG 3155
Instructor:
Date: 2026
FINAL EXAM – HEALTHCARE INFORMATICS
1. A hospital implements a new Clinical Decision Support System (CDSS)
that generates 15 alerts per patient per day. Nurses begin ignoring many
alerts. This phenomenon is known as:
A) Alert override
B) Alert fatigue
C) Decision paralysis
D) Cognitive overload
Answer: B
Rationale: Alert fatigue occurs when clinicians are exposed to excessive
alerts, leading to desensitization and ignoring important warnings. Studies
show 49-96% of alerts are overridden. Effective CDSS implementation
requires optimizing alert specificity and clinical relevance to prevent this
dangerous phenomenon.
2. A nurse accesses a colleague's medical record without a clinical need.
This violates which HIPAA principle?
A) Minimum necessary standard
B) Notice of privacy practices
C) Administrative safeguards
D) Breach notification rule
Answer: A
Rationale: The minimum necessary standard requires accessing only the PHI
needed for the specific job function. Accessing records without clinical need
violates this principle and HIPAA privacy rules. This can result in termination,
fines up to $50,000, and potential criminal charges.
3. Your hospital is implementing a new EHR system. During the testing
phase, you discover a workflow issue where medication orders require 12
1
,clicks instead of the previous 3. This is an example of:
A) Change management failure
B) Usability problem
C) Interoperability issue
D) Data integrity error
Answer: B
Rationale: Usability refers to how effectively, efficiently, and satisfactorily
users can interact with a system. Excessive clicks increase time, frustration,
and error potential. Good EHR design follows human factors principles,
minimizing clicks and optimizing workflow efficiency.
4. Which interoperability standard is considered the most modern approach
for health information exchange, using web-based APIs?
A) HL7 Version 2.x
B) HL7 Version 3
C) Fast Healthcare Interoperability Resources (FHIR)
D) Digital Imaging and Communications in Medicine (DICOM)
Answer: C
Rationale: FHIR is the newest HL7 standard using RESTful APIs, JSON, and
XML for data exchange. It enables mobile applications and patient portals to
access EHR data efficiently. FHIR is increasingly required for certified EHR
systems and supports modern healthcare applications.
5. A patient portal allows patients to view their laboratory results before the
physician has reviewed them. What ethical principle does this support?
A) Beneficence
B) Autonomy
C) Justice
D) Nonmaleficence
Answer: B
Rationale: Autonomy respects patients' right to make informed decisions
about their healthcare. OpenNotes and immediate lab result access
empower patients with their health information. While some providers worry
about patient anxiety, research shows most patients want immediate access
to their results.
6. During a cyberattack, the hospital's EHR system becomes unavailable.
What is the most appropriate immediate response?
A) Wait for IT to restore the system
B) Activate downtime procedures and paper documentation
C) Send patients to other facilities
D) Cancel all non-emergency procedures
Answer: B
Rationale: Every healthcare facility must have downtime procedures for EHR
outages. These include paper charting, medication administration protocols,
and communication plans. Patient care continues during downtimes using
2
, established backup processes. Preparation and regular drills are essential.
7. A nurse uses a smartphone to photograph a patient's wound for
documentation. What is the primary informatics concern?
A) Image quality may be insufficient
B) The device may not be secure or encrypted
C) It takes too much storage space
D) Other apps might interfere
Answer: B
Rationale: Personal devices often lack encryption, secure authentication, and
remote wipe capabilities required for PHI. If lost or stolen, patient data is
compromised. Healthcare organizations must provide approved, secured
devices with mobile device management (MDM) for clinical photography.
8. Computerized Provider Order Entry (CPOE) systems have been shown to
reduce which type of medical error most significantly?
A) Diagnostic errors
B) Prescribing and transcription errors
C) Surgical errors
D) Communication errors
Answer: B
Rationale: CPOE eliminates handwriting interpretation errors and ensures
complete orders with required elements. Studies show 50-80% reduction in
medication errors. However, CPOE can introduce new errors (wrong patient
selection, order set misuse) requiring careful implementation and monitoring.
9. A healthcare organization is selecting a new EHR vendor. Which
certification is most important to verify for compliance with federal
requirements?
A) ISO 9001
B) Joint Commission accreditation
C) ONC Health IT Certification
D) HIMSS Analytics Stage 7
Answer: C
Rationale: ONC (Office of the National Coordinator) Health IT Certification
ensures EHR systems meet federal requirements for Promoting
Interoperability programs (formerly Meaningful Use). Certified systems
support required functionalities, interoperability standards, and security
measures. This certification is mandatory for federal incentive program
participation.
10. Which of the following best describes the role of a Clinical Nurse
Informaticist?
A) Provides technical support for computer problems
B) Bridges clinical practice and information technology to optimize patient
care
C) Manages the hospital's IT department
3
