Nursing Informatics: 2026 EHR & Digital Safety Guide
1. A nurse is describing the scope of nursing informatics to a group of new nursing graduates.
According to the American Nurses Association (ANA), how should nursing informatics be defined?
A. The use of social media and email to coordinate patient care.
B. A specialty that integrates nursing science, computer science, and information science to manage and
communicate data, information, knowledge, and wisdom in nursing practice.
C. The process of coding diagnoses for billing and insurance purposes.
D. The maintenance of hospital hardware, databases, and network firewalls.
Correct Answer: B. A specialty that integrates nursing science, computer science, and information science
to manage and communicate data, information, knowledge, and wisdom in nursing practice.
Rationale: Nursing informatics is officially recognized by the ANA as a specialty that combines nursing science,
computer science, and information/cognitive science to manage data, information, knowledge, and wisdom to
support patients, nurses, and other providers in their decision-making. Coding (C) is medical billing/health
information management. Hardware/network maintenance (D) is general information technology.
2. The Data, Information, Knowledge, and Wisdom (DIKW) framework is a cornerstone of nursing
informatics. A nurse documents a patient's temperature as "38.9°C (102°F)" in the electronic health
record. Under the DIKW hierarchy, this raw entry is classified as:
A. Data.
B. Information.
C. Knowledge.
D. Wisdom.
Correct Answer: A. Data.
Rationale: In the DIKW framework, **Data** represents raw, uninterpreted facts, numbers, or symbols without
context. The number "38.9°C" is data. Once it is associated with a patient and a context (e.g., indicating a fever
post-surgery), it becomes information.
3. A nurse reviews the electronic flowsheet and notices that the patient's temperature of 38.9°C is
elevated and represents a new fever 6 hours after an abdominal surgery. In the DIKW framework, this
interpretation represents:
A. Data.
B. Information.
C. Knowledge.
D. Wisdom.
Correct Answer: B. Information.
,Rationale: **Information** is data that has been structured, processed, or contextualized to give it meaning.
Recognizing that "38.9°C" is an elevated temperature for a postoperative patient gives the raw data meaning and
context, elevating it to information.
4. In the DIKW hierarchy, a clinical nurse specialist synthesizes the patient's postoperative fever,
elevated white blood cell count, and surgical site redness to conclude that the patient is developing a
surgical site infection. This synthesis represents:
A. Data.
B. Information.
C. Knowledge.
D. Wisdom.
Correct Answer: C. Knowledge.
Rationale: **Knowledge** is the synthesis of information. It involves identifying relationships, patterns, and
trends by combining multiple pieces of information (fever + red wound + high WBC = surgical site infection)
based on clinical experience and education.
5. Based on the understanding that a patient is developing a surgical site infection, the nurse decides to
hold the scheduled discharge, initiate sepsis protocols, obtain blood cultures, and notify the surgeon. In
the DIKW framework, the nurse's clinical decision-making represents:
A. Data.
B. Information.
C. Knowledge.
D. Wisdom.
Correct Answer: D. Wisdom.
Rationale: **Wisdom** is the highest level of the DIKW hierarchy. It is the ethical and practical application of
knowledge to solve human problems, make decisions, and formulate clinical actions. Wisdom requires human
judgment, values, and clinical expertise.
6. A hospital is implementing a new electronic health record system. The project manager wants to
ensure staff nurses have peer support on each unit during go-live. The manager recruits staff nurses to
act as "Super Users." What is the primary role of a Super User?
A. To write the software code for the new EHR database.
B. To act as a peer resource, provide on-the-spot troubleshooting, and support colleagues in adopting the new
system on their specific unit.
C. To discipline nurses who are slow to learn the system.
D. To reset passwords for all hospital systems.
,Correct Answer: B. To act as a peer resource, provide on-the-spot troubleshooting, and support colleagues
in adopting the new system on their specific unit.
Rationale: Super Users are staff members trained in the new system who assist their peers in real-time during
implementation (go-live). They help reduce anxiety, facilitate workflow integration, and solve minor issues
directly at the bedside. They do not code software (A) or possess administrative access for password resets (D).
7. An Informatics Nurse Specialist (INS) is working on the "Requirements Gathering" phase of a new
EHR documentation module. According to the Systems Development Life Cycle (SDLC), what is the
focus of this phase?
A. Writing the software code and configuring servers.
B. Formally testing the system for database bugs.
C. Interviewing staff nurses, mapping current workflows, and identifying the specific functional needs and
problems the new system must solve.
D. Purchasing the computers and mounting hardware.
Correct Answer: C. Interviewing staff nurses, mapping current workflows, and identifying the specific
functional needs and problems the new system must solve.
Rationale: Requirements gathering is part of the Analysis phase of the SDLC. The goal is to understand what the
users need and how they work, ensuring the system is designed to support clinical workflows rather than disrupt
them. Coding is the Development phase (A). Testing is the Testing/Validation phase (B). Hardware is part of
Implementation (D).
8. During which phase of the Systems Development Life Cycle (SDLC) does the informatics team
design screen layouts, user interfaces, database structures, and map data flows before any coding
begins?
A. Planning Phase
B. Design Phase
C. Implementation Phase
D. Maintenance Phase
Correct Answer: B. Design Phase
Rationale: The Design Phase of the SDLC is where the conceptual blueprints of the system are created. This
includes designing user interfaces, navigation flows, and database schemas based on the requirements identified
during the Analysis phase.
9. A hospital goes live with a new barcoded medication administration (BCMA) system. The
informatics team monitors the system, conducts usability surveys, and tracks medication error rates 3
months post go-live. Under which phase of the SDLC does this post-implementation audit fall?
A. Analysis Phase
B. Design Phase
, C. Evaluation Phase
D. Planning Phase
Correct Answer: C. Evaluation Phase
Rationale: The Evaluation Phase involves assessing the system's performance, usability, and impact on clinical
outcomes (such as safety and efficiency) after it has been implemented. This helps identify necessary system
tweaks, additional training needs, or workflow corrections.
10. What is the primary function of a Clinical Decision Support System (CDSS) within an Electronic
Health Record (EHR)?
A. To automatically charge patients for medications administered.
B. To provide clinicians with clinical knowledge and patient-specific information, intelligently filtered and
presented at appropriate times, to enhance health and healthcare.
C. To replace clinical judgment with computerized algorithms.
D. To dictate which treatment plans the doctor must select.
Correct Answer: B. To provide clinicians with clinical knowledge and patient-specific information,
intelligently filtered and presented at appropriate times, to enhance health and healthcare.
Rationale: A CDSS is a tool designed to aid clinical decision-making. It integrates patient-specific data with a
clinical knowledge base to provide alerts, reminders, order sets, and guidelines. It is meant to support, not replace,
clinical judgment (C), and does not dictate care (D).
11. A nurse is entering an order for intravenous potassium chloride. A pop-up window appears on the
screen, warning: "ALERT: Patient's latest serum potassium is 5.8 mEq/L (High). Do you wish to
proceed?" This pop-up window is an example of what type of alert?
A. Passive alert
B. Active (interruptive) alert
C. Informational footnote
D. Administrative alert
Correct Answer: B. Active (interruptive) alert
Rationale: An active or interruptive alert is a CDSS warning that halts the user's workflow, appearing as a pop-up
dialog box that requires the user to read, acknowledge, and take an action (such as canceling the order or entering
an override reason) to proceed. A passive alert (A) displays information non-disruptively on the screen (such as
highlighting a lab value in red) without blocking the user's progress.
12. A physician is ordering medications for a patient. Instead of typing individual orders for a
postoperative cardiac patient, the physician selects "Post-Op CABG Order Set." What is the benefit of
standardized order sets in CPOE?
A. They allow the physician to avoid looking at the patient's chart.
1. A nurse is describing the scope of nursing informatics to a group of new nursing graduates.
According to the American Nurses Association (ANA), how should nursing informatics be defined?
A. The use of social media and email to coordinate patient care.
B. A specialty that integrates nursing science, computer science, and information science to manage and
communicate data, information, knowledge, and wisdom in nursing practice.
C. The process of coding diagnoses for billing and insurance purposes.
D. The maintenance of hospital hardware, databases, and network firewalls.
Correct Answer: B. A specialty that integrates nursing science, computer science, and information science
to manage and communicate data, information, knowledge, and wisdom in nursing practice.
Rationale: Nursing informatics is officially recognized by the ANA as a specialty that combines nursing science,
computer science, and information/cognitive science to manage data, information, knowledge, and wisdom to
support patients, nurses, and other providers in their decision-making. Coding (C) is medical billing/health
information management. Hardware/network maintenance (D) is general information technology.
2. The Data, Information, Knowledge, and Wisdom (DIKW) framework is a cornerstone of nursing
informatics. A nurse documents a patient's temperature as "38.9°C (102°F)" in the electronic health
record. Under the DIKW hierarchy, this raw entry is classified as:
A. Data.
B. Information.
C. Knowledge.
D. Wisdom.
Correct Answer: A. Data.
Rationale: In the DIKW framework, **Data** represents raw, uninterpreted facts, numbers, or symbols without
context. The number "38.9°C" is data. Once it is associated with a patient and a context (e.g., indicating a fever
post-surgery), it becomes information.
3. A nurse reviews the electronic flowsheet and notices that the patient's temperature of 38.9°C is
elevated and represents a new fever 6 hours after an abdominal surgery. In the DIKW framework, this
interpretation represents:
A. Data.
B. Information.
C. Knowledge.
D. Wisdom.
Correct Answer: B. Information.
,Rationale: **Information** is data that has been structured, processed, or contextualized to give it meaning.
Recognizing that "38.9°C" is an elevated temperature for a postoperative patient gives the raw data meaning and
context, elevating it to information.
4. In the DIKW hierarchy, a clinical nurse specialist synthesizes the patient's postoperative fever,
elevated white blood cell count, and surgical site redness to conclude that the patient is developing a
surgical site infection. This synthesis represents:
A. Data.
B. Information.
C. Knowledge.
D. Wisdom.
Correct Answer: C. Knowledge.
Rationale: **Knowledge** is the synthesis of information. It involves identifying relationships, patterns, and
trends by combining multiple pieces of information (fever + red wound + high WBC = surgical site infection)
based on clinical experience and education.
5. Based on the understanding that a patient is developing a surgical site infection, the nurse decides to
hold the scheduled discharge, initiate sepsis protocols, obtain blood cultures, and notify the surgeon. In
the DIKW framework, the nurse's clinical decision-making represents:
A. Data.
B. Information.
C. Knowledge.
D. Wisdom.
Correct Answer: D. Wisdom.
Rationale: **Wisdom** is the highest level of the DIKW hierarchy. It is the ethical and practical application of
knowledge to solve human problems, make decisions, and formulate clinical actions. Wisdom requires human
judgment, values, and clinical expertise.
6. A hospital is implementing a new electronic health record system. The project manager wants to
ensure staff nurses have peer support on each unit during go-live. The manager recruits staff nurses to
act as "Super Users." What is the primary role of a Super User?
A. To write the software code for the new EHR database.
B. To act as a peer resource, provide on-the-spot troubleshooting, and support colleagues in adopting the new
system on their specific unit.
C. To discipline nurses who are slow to learn the system.
D. To reset passwords for all hospital systems.
,Correct Answer: B. To act as a peer resource, provide on-the-spot troubleshooting, and support colleagues
in adopting the new system on their specific unit.
Rationale: Super Users are staff members trained in the new system who assist their peers in real-time during
implementation (go-live). They help reduce anxiety, facilitate workflow integration, and solve minor issues
directly at the bedside. They do not code software (A) or possess administrative access for password resets (D).
7. An Informatics Nurse Specialist (INS) is working on the "Requirements Gathering" phase of a new
EHR documentation module. According to the Systems Development Life Cycle (SDLC), what is the
focus of this phase?
A. Writing the software code and configuring servers.
B. Formally testing the system for database bugs.
C. Interviewing staff nurses, mapping current workflows, and identifying the specific functional needs and
problems the new system must solve.
D. Purchasing the computers and mounting hardware.
Correct Answer: C. Interviewing staff nurses, mapping current workflows, and identifying the specific
functional needs and problems the new system must solve.
Rationale: Requirements gathering is part of the Analysis phase of the SDLC. The goal is to understand what the
users need and how they work, ensuring the system is designed to support clinical workflows rather than disrupt
them. Coding is the Development phase (A). Testing is the Testing/Validation phase (B). Hardware is part of
Implementation (D).
8. During which phase of the Systems Development Life Cycle (SDLC) does the informatics team
design screen layouts, user interfaces, database structures, and map data flows before any coding
begins?
A. Planning Phase
B. Design Phase
C. Implementation Phase
D. Maintenance Phase
Correct Answer: B. Design Phase
Rationale: The Design Phase of the SDLC is where the conceptual blueprints of the system are created. This
includes designing user interfaces, navigation flows, and database schemas based on the requirements identified
during the Analysis phase.
9. A hospital goes live with a new barcoded medication administration (BCMA) system. The
informatics team monitors the system, conducts usability surveys, and tracks medication error rates 3
months post go-live. Under which phase of the SDLC does this post-implementation audit fall?
A. Analysis Phase
B. Design Phase
, C. Evaluation Phase
D. Planning Phase
Correct Answer: C. Evaluation Phase
Rationale: The Evaluation Phase involves assessing the system's performance, usability, and impact on clinical
outcomes (such as safety and efficiency) after it has been implemented. This helps identify necessary system
tweaks, additional training needs, or workflow corrections.
10. What is the primary function of a Clinical Decision Support System (CDSS) within an Electronic
Health Record (EHR)?
A. To automatically charge patients for medications administered.
B. To provide clinicians with clinical knowledge and patient-specific information, intelligently filtered and
presented at appropriate times, to enhance health and healthcare.
C. To replace clinical judgment with computerized algorithms.
D. To dictate which treatment plans the doctor must select.
Correct Answer: B. To provide clinicians with clinical knowledge and patient-specific information,
intelligently filtered and presented at appropriate times, to enhance health and healthcare.
Rationale: A CDSS is a tool designed to aid clinical decision-making. It integrates patient-specific data with a
clinical knowledge base to provide alerts, reminders, order sets, and guidelines. It is meant to support, not replace,
clinical judgment (C), and does not dictate care (D).
11. A nurse is entering an order for intravenous potassium chloride. A pop-up window appears on the
screen, warning: "ALERT: Patient's latest serum potassium is 5.8 mEq/L (High). Do you wish to
proceed?" This pop-up window is an example of what type of alert?
A. Passive alert
B. Active (interruptive) alert
C. Informational footnote
D. Administrative alert
Correct Answer: B. Active (interruptive) alert
Rationale: An active or interruptive alert is a CDSS warning that halts the user's workflow, appearing as a pop-up
dialog box that requires the user to read, acknowledge, and take an action (such as canceling the order or entering
an override reason) to proceed. A passive alert (A) displays information non-disruptively on the screen (such as
highlighting a lab value in red) without blocking the user's progress.
12. A physician is ordering medications for a patient. Instead of typing individual orders for a
postoperative cardiac patient, the physician selects "Post-Op CABG Order Set." What is the benefit of
standardized order sets in CPOE?
A. They allow the physician to avoid looking at the patient's chart.
