NURS4045 – Nursing Informatics Midterm
Examination Questions & Answers
Question 1
A nurse is using an electronic health record (EHR) to document a patient's vital
signs. The nurse enters the data directly into a structured template. This is an
example of:
A) Clinical decision support
B) Computerized provider order entry
C) Direct data entry by clinician
D) Health information exchange
Answer: C) Direct data entry by clinician
Direct data entry (also called structured data entry) occurs when clinicians input
information directly into the EHR using predefined fields (e.g., vital signs,
assessment findings). This supports data reuse and quality measurement.
Question 2
A hospital implements a clinical decision support (CDS) system that alerts the
provider when ordering a medication to which the patient has a documented
allergy. This type of CDS is known as:
A) Drug-drug interaction alert
B) Drug-allergy checking
C) Clinical guideline reminder
D) Dose-range checking
Answer: B) Drug-allergy checking
,Drug-allergy checking is a fundamental CDS function that compares the ordered
medication against the patient's documented allergy list and alerts the prescriber if
a conflict exists. This prevents adverse drug events.
Question 3
Which term describes the ability of different health information systems to
exchange data and use the information without special effort?
A) Scalability
B) Usability
C) Interoperability
D) Redundancy
Answer: C) Interoperability
Interoperability is the ability of diverse health IT systems (EHRs, labs, pharmacies)
to communicate, exchange data, and use the information seamlessly. Four levels:
foundational, structural, semantic, and organizational.
Question 4
A nurse informaticist is evaluating the usability of a new EHR module. Which
characteristic is most critical for usability?
A) High cost
B) Ease of learning, efficiency, memorability, error prevention, and user
satisfaction
C) Large number of features
D) Complex navigation
Answer: B) Ease of learning, efficiency, memorability, error prevention, and
user satisfaction
Usability (ISO 9241-11) includes effectiveness, efficiency, and satisfaction. Poor
EHR usability contributes to clinician burnout and errors. Key attributes:
learnability, efficiency, memorability, error tolerance, and satisfaction.
,Question 5
A nurse is using a barcode medication administration (BCMA) system. The system
alerts the nurse that the medication does not match the patient's wristband. The
nurse should:
A) Override the alert if the patient looks correct
B) Stop, investigate the discrepancy, and not administer until resolved
C) Scan the medication again
D) Administer the medication and document later
Answer: B) Stop, investigate the discrepancy, and not administer until
resolved
BCMA alerts indicate a potential error. The "five rights" must be verified. The
nurse must stop, identify the cause (wrong patient, wrong medication, wrong time),
and resolve before proceeding. Bypassing alerts defeats safety.
Question 6
Which federal program provides financial incentives for healthcare providers to
adopt and meaningfully use certified EHR technology?
A) HIPAA
B) Medicare and Medicaid EHR Incentive Programs (Meaningful Use)
C) HITECH Act enforcement only
D) ACA insurance mandates
Answer: B) Medicare and Medicaid EHR Incentive Programs (Meaningful
Use)
The HITECH Act (2009) established the Meaningful Use program (later
Promoting Interoperability) to incentivize EHR adoption and use for specific
objectives (e.g., e-prescribing, clinical decision support, patient access).
, Question 7
A nurse informaticist is implementing a new clinical documentation system. Which
strategy best promotes user adoption?
A) Mandating use without training
B) Involving frontline nurses in system design and testing, and providing adequate
training
C) Purchasing the most expensive system
D) Eliminating all paper-based backup
Answer: B) Involving frontline nurses in system design and testing, and
providing adequate training
End-user involvement in selection, design, and testing increases buy-in and ensures
the system fits clinical workflow. Adequate training and ongoing support are
essential for adoption and safe use.
Question 8
A patient requests access to their electronic health information under the 21st
Century Cures Act. The hospital must:
A) Deny access to all information
B) Provide access without charge or delay, with only limited exceptions (e.g.,
privacy harm)
C) Require a written request and charge a fee
D) Only provide information on paper
Answer: B) Provide access without charge or delay, with only limited
exceptions (e.g., privacy harm)
The 21st Century Cures Act (2016) mandates that patients have electronic access
to their health information without delay or charge (except for reasonable fees).
Information blocking is prohibited.
Question 9
Examination Questions & Answers
Question 1
A nurse is using an electronic health record (EHR) to document a patient's vital
signs. The nurse enters the data directly into a structured template. This is an
example of:
A) Clinical decision support
B) Computerized provider order entry
C) Direct data entry by clinician
D) Health information exchange
Answer: C) Direct data entry by clinician
Direct data entry (also called structured data entry) occurs when clinicians input
information directly into the EHR using predefined fields (e.g., vital signs,
assessment findings). This supports data reuse and quality measurement.
Question 2
A hospital implements a clinical decision support (CDS) system that alerts the
provider when ordering a medication to which the patient has a documented
allergy. This type of CDS is known as:
A) Drug-drug interaction alert
B) Drug-allergy checking
C) Clinical guideline reminder
D) Dose-range checking
Answer: B) Drug-allergy checking
,Drug-allergy checking is a fundamental CDS function that compares the ordered
medication against the patient's documented allergy list and alerts the prescriber if
a conflict exists. This prevents adverse drug events.
Question 3
Which term describes the ability of different health information systems to
exchange data and use the information without special effort?
A) Scalability
B) Usability
C) Interoperability
D) Redundancy
Answer: C) Interoperability
Interoperability is the ability of diverse health IT systems (EHRs, labs, pharmacies)
to communicate, exchange data, and use the information seamlessly. Four levels:
foundational, structural, semantic, and organizational.
Question 4
A nurse informaticist is evaluating the usability of a new EHR module. Which
characteristic is most critical for usability?
A) High cost
B) Ease of learning, efficiency, memorability, error prevention, and user
satisfaction
C) Large number of features
D) Complex navigation
Answer: B) Ease of learning, efficiency, memorability, error prevention, and
user satisfaction
Usability (ISO 9241-11) includes effectiveness, efficiency, and satisfaction. Poor
EHR usability contributes to clinician burnout and errors. Key attributes:
learnability, efficiency, memorability, error tolerance, and satisfaction.
,Question 5
A nurse is using a barcode medication administration (BCMA) system. The system
alerts the nurse that the medication does not match the patient's wristband. The
nurse should:
A) Override the alert if the patient looks correct
B) Stop, investigate the discrepancy, and not administer until resolved
C) Scan the medication again
D) Administer the medication and document later
Answer: B) Stop, investigate the discrepancy, and not administer until
resolved
BCMA alerts indicate a potential error. The "five rights" must be verified. The
nurse must stop, identify the cause (wrong patient, wrong medication, wrong time),
and resolve before proceeding. Bypassing alerts defeats safety.
Question 6
Which federal program provides financial incentives for healthcare providers to
adopt and meaningfully use certified EHR technology?
A) HIPAA
B) Medicare and Medicaid EHR Incentive Programs (Meaningful Use)
C) HITECH Act enforcement only
D) ACA insurance mandates
Answer: B) Medicare and Medicaid EHR Incentive Programs (Meaningful
Use)
The HITECH Act (2009) established the Meaningful Use program (later
Promoting Interoperability) to incentivize EHR adoption and use for specific
objectives (e.g., e-prescribing, clinical decision support, patient access).
, Question 7
A nurse informaticist is implementing a new clinical documentation system. Which
strategy best promotes user adoption?
A) Mandating use without training
B) Involving frontline nurses in system design and testing, and providing adequate
training
C) Purchasing the most expensive system
D) Eliminating all paper-based backup
Answer: B) Involving frontline nurses in system design and testing, and
providing adequate training
End-user involvement in selection, design, and testing increases buy-in and ensures
the system fits clinical workflow. Adequate training and ongoing support are
essential for adoption and safe use.
Question 8
A patient requests access to their electronic health information under the 21st
Century Cures Act. The hospital must:
A) Deny access to all information
B) Provide access without charge or delay, with only limited exceptions (e.g.,
privacy harm)
C) Require a written request and charge a fee
D) Only provide information on paper
Answer: B) Provide access without charge or delay, with only limited
exceptions (e.g., privacy harm)
The 21st Century Cures Act (2016) mandates that patients have electronic access
to their health information without delay or charge (except for reasonable fees).
Information blocking is prohibited.
Question 9
