WGU D220 Information Technology in Nursing Practice Objective
Assessment V2 Question Bank (Latest 2026/2027 Edition) –
Questions, Answers & Detailed Rationales
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SECTION 1: HEALTH INFORMATION SYSTEMS AND ELECTRONIC HEALTH RECORDS
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Question 1
A nurse manager is evaluating the implementation of a new electronic health record
(EHR) system in a 300-bed acute care hospital. During the go-live phase, nursing staff
report that medication barcode scanning is frequently failing, leading to workarounds.
Which systematic approach should the nurse manager prioritize to address this issue?
A. Immediately revert to paper-based medication administration records
B. Conduct a root cause analysis to identify hardware, software, and workflow factors
contributing to scan failures
C. Discipline staff members who are bypassing the barcode system
D. Request that the vendor disable the barcode scanning feature entirely
Correct Answer:
B — Conduct a root cause analysis to identify hardware, software, and workflow factors
contributing to scan failures
Rationale:
A root cause analysis systematically identifies underlying factors—such as poor
barcode print quality, scanner calibration issues, or workflow misalignment—enabling
targeted solutions rather than punitive or regressive measures. Reverting to
paper-based records eliminates safety benefits, while disciplining staff or disabling the
feature fails to address the systemic problem.
,Question 2
A clinical informatics nurse is configuring clinical decision support (CDS) alerts within
the EHR for anticoagulation therapy. Which design principle best balances patient safety
with alert fatigue prevention?
A. Generate an alert for every laboratory value outside the reference range
B. Use hard stops only for critical, life-threatening contraindications and soft alerts for
less urgent recommendations
C. Disable all alerts for experienced physicians to reduce interruptions
D. Set all alerts to require a mandatory 30-second delay before override is permitted
Correct Answer:
B — Use hard stops only for critical, life-threatening contraindications and soft alerts for
less urgent recommendations
Rationale:
Tiered alerting with hard stops for critical safety issues and soft alerts for
recommendations minimizes alert fatigue while preserving high-value safety
interventions. blanket alerts for all lab deviations or disabling alerts for experienced
providers compromise safety, while mandatory delays without clinical stratification
contribute to frustration without proportional benefit.
Question 3
A nurse is reviewing the audit log of an EHR system and discovers that a colleague has
accessed the records of multiple patients not assigned to her care. Which action is
most consistent with HIPAA regulations and organizational policy?
A. Confront the colleague directly and demand an explanation
B. Report the findings to the organization's privacy officer or compliance department for
investigation
C. Document the incident in the patient's medical record
D. Ignore the finding unless patient harm has already occurred
,Correct Answer:
B — Report the findings to the organization's privacy officer or compliance department
for investigation
Rationale:
Unauthorized access to patient records constitutes a potential HIPAA breach that must
be reported to the designated privacy officer for formal investigation, potential breach
notification, and corrective action. Direct confrontation compromises objectivity, chart
documentation violates patient confidentiality, and ignoring the finding violates both
legal and ethical obligations.
Question 4
A healthcare organization is transitioning from a legacy EHR to a new system using a
big-bang implementation strategy. Which risk is most significantly increased with this
approach compared to a phased rollout?
A. Higher total implementation costs due to extended vendor support
B. Organization-wide system failure affecting all departments simultaneously
C. Staff resistance due to prolonged uncertainty about the implementation timeline
D. Data inconsistency between departments using different systems
Correct Answer:
B — Organization-wide system failure affecting all departments simultaneously
Rationale:
The big-bang approach converts all departments simultaneously, creating the risk of
catastrophic, organization-wide failure if critical system flaws emerge. Phased rollouts
contain failures to pilot units. While big-bang may reduce total costs and timeline
uncertainty, the concentration of operational risk across all departments is its defining
vulnerability.
Question 5
, A nurse informaticist is designing a nursing documentation flowsheet in the EHR. Which
data element is most essential for supporting both clinical care and quality
measurement reporting to the Centers for Medicare & Medicaid Services (CMS)?
A. Patient's preferred language for communication
B. Structured, coded data fields for interventions and outcomes rather than free-text
narratives
C. Photographs of wound assessments uploaded as image files
D. Nursing shift handoff notes documented in a word processing document
Correct Answer:
B — Structured, coded data fields for interventions and outcomes rather than free-text
narratives
Rationale:
Structured, coded data enables automated extraction for quality metrics,
interoperability, and regulatory reporting to CMS and other agencies. Free-text
narratives, photographs without coding, and word processing documents cannot be
reliably parsed for quality measurement, despite their clinical utility for communication
and visualization.
Question 6
A hospital's EHR system experiences an unplanned downtime lasting four hours during
a busy clinical shift. Which contingency protocol best ensures continuity of safe
medication administration?
A. Suspend all medication administration until the EHR is restored
B. Implement downtime procedures using pre-printed, verified paper medication
administration records with a defined reconciliation process upon restoration
C. Allow nurses to administer medications from memory without documentation
D. Transfer all patients to another facility until system functionality returns
Correct Answer:
Assessment V2 Question Bank (Latest 2026/2027 Edition) –
Questions, Answers & Detailed Rationales
──────────────────────────────
SECTION 1: HEALTH INFORMATION SYSTEMS AND ELECTRONIC HEALTH RECORDS
──────────────────────────────
Question 1
A nurse manager is evaluating the implementation of a new electronic health record
(EHR) system in a 300-bed acute care hospital. During the go-live phase, nursing staff
report that medication barcode scanning is frequently failing, leading to workarounds.
Which systematic approach should the nurse manager prioritize to address this issue?
A. Immediately revert to paper-based medication administration records
B. Conduct a root cause analysis to identify hardware, software, and workflow factors
contributing to scan failures
C. Discipline staff members who are bypassing the barcode system
D. Request that the vendor disable the barcode scanning feature entirely
Correct Answer:
B — Conduct a root cause analysis to identify hardware, software, and workflow factors
contributing to scan failures
Rationale:
A root cause analysis systematically identifies underlying factors—such as poor
barcode print quality, scanner calibration issues, or workflow misalignment—enabling
targeted solutions rather than punitive or regressive measures. Reverting to
paper-based records eliminates safety benefits, while disciplining staff or disabling the
feature fails to address the systemic problem.
,Question 2
A clinical informatics nurse is configuring clinical decision support (CDS) alerts within
the EHR for anticoagulation therapy. Which design principle best balances patient safety
with alert fatigue prevention?
A. Generate an alert for every laboratory value outside the reference range
B. Use hard stops only for critical, life-threatening contraindications and soft alerts for
less urgent recommendations
C. Disable all alerts for experienced physicians to reduce interruptions
D. Set all alerts to require a mandatory 30-second delay before override is permitted
Correct Answer:
B — Use hard stops only for critical, life-threatening contraindications and soft alerts for
less urgent recommendations
Rationale:
Tiered alerting with hard stops for critical safety issues and soft alerts for
recommendations minimizes alert fatigue while preserving high-value safety
interventions. blanket alerts for all lab deviations or disabling alerts for experienced
providers compromise safety, while mandatory delays without clinical stratification
contribute to frustration without proportional benefit.
Question 3
A nurse is reviewing the audit log of an EHR system and discovers that a colleague has
accessed the records of multiple patients not assigned to her care. Which action is
most consistent with HIPAA regulations and organizational policy?
A. Confront the colleague directly and demand an explanation
B. Report the findings to the organization's privacy officer or compliance department for
investigation
C. Document the incident in the patient's medical record
D. Ignore the finding unless patient harm has already occurred
,Correct Answer:
B — Report the findings to the organization's privacy officer or compliance department
for investigation
Rationale:
Unauthorized access to patient records constitutes a potential HIPAA breach that must
be reported to the designated privacy officer for formal investigation, potential breach
notification, and corrective action. Direct confrontation compromises objectivity, chart
documentation violates patient confidentiality, and ignoring the finding violates both
legal and ethical obligations.
Question 4
A healthcare organization is transitioning from a legacy EHR to a new system using a
big-bang implementation strategy. Which risk is most significantly increased with this
approach compared to a phased rollout?
A. Higher total implementation costs due to extended vendor support
B. Organization-wide system failure affecting all departments simultaneously
C. Staff resistance due to prolonged uncertainty about the implementation timeline
D. Data inconsistency between departments using different systems
Correct Answer:
B — Organization-wide system failure affecting all departments simultaneously
Rationale:
The big-bang approach converts all departments simultaneously, creating the risk of
catastrophic, organization-wide failure if critical system flaws emerge. Phased rollouts
contain failures to pilot units. While big-bang may reduce total costs and timeline
uncertainty, the concentration of operational risk across all departments is its defining
vulnerability.
Question 5
, A nurse informaticist is designing a nursing documentation flowsheet in the EHR. Which
data element is most essential for supporting both clinical care and quality
measurement reporting to the Centers for Medicare & Medicaid Services (CMS)?
A. Patient's preferred language for communication
B. Structured, coded data fields for interventions and outcomes rather than free-text
narratives
C. Photographs of wound assessments uploaded as image files
D. Nursing shift handoff notes documented in a word processing document
Correct Answer:
B — Structured, coded data fields for interventions and outcomes rather than free-text
narratives
Rationale:
Structured, coded data enables automated extraction for quality metrics,
interoperability, and regulatory reporting to CMS and other agencies. Free-text
narratives, photographs without coding, and word processing documents cannot be
reliably parsed for quality measurement, despite their clinical utility for communication
and visualization.
Question 6
A hospital's EHR system experiences an unplanned downtime lasting four hours during
a busy clinical shift. Which contingency protocol best ensures continuity of safe
medication administration?
A. Suspend all medication administration until the EHR is restored
B. Implement downtime procedures using pre-printed, verified paper medication
administration records with a defined reconciliation process upon restoration
C. Allow nurses to administer medications from memory without documentation
D. Transfer all patients to another facility until system functionality returns
Correct Answer:
