Nurse's Touch: Nursing Informatics and Technology Practice Assessment

A nurse manager on a cardiac unit is using a clinical information system to measure the outcomes of clients who were treated using the facility's acute cardiac event protocol. Which of the following is integrated inot the clinical information system to support clinical data access?

a. Performance improvement terminologies

b. Free text reporting

c. Coded entry system

Performance improvement terminologies

address safety indicators and regulatory requirements rather than clinical data outcomes.

Free text reporting is difficult to quantify due to inconsistencies in individual reports.

CORRECT c. Coded entry system

The use of standardized nursing terminologies, such as a coded entry system, in computerized reports, enhances the ability to use the data for reporting and future research, such as measuring client outcomes.

A charge nurse is teaching a seminar to other nurses about informatics and client care. Which of the following topics is appropriate for the charge nurse to include?

a. Reviewing trends of vital signs since admission

b. Monitoring use of airborne precautions

c. Conducting focused assessments with clients

CORRECT a. Reviewing trends of vital signs since admission

Trending of vital signs allows nurses to identify emerging or developing client conditions and is a useful informatics tool to improve client care.

Monitoring the use of airborne precautions

is not accomplished using informatics.

Conducting focused assessments with clients. It is not necessary to use informatics to conduct a focused assessment of a client.

A telehealth nurse is caring for a client who has a new prescription for an antihypertensive medication. The telehealth monitoring system reports the client's current blood pressure is 160/62. Which of the following actions should the nurse take first?

a. Notify the provider of the data received from the telehealth monitor.

b. Obtain information about medication compliance.

c. Instruct the client to retake his blood pressure.

a. Notify the provider of the data received from the telehealth monitor. Telehealth increases the communication of information between the client and provider. However, it is still important for the nurse to appropriately prioritize actions. Although this is an appropriate action, it is not the first action the nurse should take according to the nursing process approach to client care.

CORRECT: b. Obtain information about medication compliance.

Based on the nursing process approach to client care, assessment of medication compliance is the first action the nurse should take.

c. Instruct the client to retake his blood pressure. Telehealth increases the communication of information between the client and provider. However, it is still important for the nurse to appropriately prioritize actions. Although this is an appropriate action, it is not the first action the nurse should take according to the nursing process approach to client care.

A nurse is accessing clinical information systems while caring for a client. Which of the following is a benefit of using this technology?

a. Allows the health care team to gather feedback from a client about the plan of care

b. Improves therapeutic communication between the client and the health care team

c. Allows for an interdisciplinary approach when planning care for a client

a. Allows the health care team to gather feedback from a client about the plan of care. Clinical information systems do not allow the health care team to gather feedback from a client about the plan of care.

b. Improves therapeutic communication between the client and the health care team. Clinical information systems do not improve therapeutic communication between the client and the health care team.

CORRECT: c. Allows for an interdisciplinary approach when planning care for a client

Clinical information systems allow for an interdisciplinary approach when planning care for a client by increasing the health care team's access to information.

A nurse is teaching a client about the identification of reliable Internet resources. Which of the following online resources should the nurse identify as the most reliable?

a. Web sites ending in ".com"

b. Web sites ending in ".edu"

c. Web sites ending in ".gov"

Web sites ending in ".com" are for commercial users and companies. They are not the most reliable resource.

Web sites ending in ".edu" are supported by educational organizations. They are not the most reliable resource.

CORRECT: c. Web sites ending in ".gov"

Web sites ending in ".gov" are governmental Web sites that include professional contact information and are the most reliable resource.

A nurse manager is giving an in-service presentation to a group of nurses about uniform taxonomies in nursing practice. The nurse should explain that which of the following taxonomies helps quantify nursing care based on costs specific to nursing?

a. Nursing Management Minimum Data Set (NMMDS)

b. Systematic Nomenclature of Medicine (SNOMED)

International Classification for Nursing Practice (ICNP)

CORRECT: a Nursing Management Minimum Data Set (NMMDS)

The NMMDS is a standardized nursing terminology that focuses on numerical data, such as cost analysis figures, and provides a framework of uniform entry and management of data.

Systematic Nomenclature of Medicine (SNOMED). The SNOMED is a standardized nursing terminology that is recognized as a retired system by the committee for nursing practice information infrastructure.

International Classification for Nursing Practice (ICNP). ICNP is a standardized nursing terminology that focuses on nursing diagnoses, actions, and outcomes rather than numerical data.

A risk management nurse uses informatics research data to design an application to reduce the incidence of postoperative complications. Which of the following stages of nursing informatics competency describes the nurse?

a. Informatics nurse specialist

b. Experienced informatics nurse

c. Informatics innovator

Informatics nurse specialist

The informatics nurse specialist uses data to identify informatics and client care needs but does not design new applications.

Experienced informatics nurse

The experienced informatics nurse interprets trends in data entered in client outcomes but does not design new applications.

CORRECT: c. Informatics innovator

The highest level of competency is the informatics innovator. This level includes the design and development of new applications to improve client outcomes.

A charge nurse is reviewing confidentiality with a newly licensed nurse. Which of the following actions by the newly licensed nurse requires intervention?

a. Discussing a client's needs in a medication room

b. Using the computer to search for information about a client from another unit

c. Printing a client's name on a therapy schedule

Discussing a client's needs in a medication room does not breach the client's confidentiality. The medication room is not a public area.

CORRECT: b. Using the computer to search for information about a client from another unit

The nurse should access information only about clients she is caring for.

Printing a client's name on a therapy schedule is not a breach of confidentiality, and this information is available only to nursing personnel.

A nurse is observing a newly licensed nurse who is caring for a client. The client states, "How do I know that my information won't show up on the Internet?" Which of the following responses by the newly licensed nurse is appropriate?

a. "Security is provided by the hospital network."

b. "The hospital uses firewalls to protect records."

c. "Regulatory requirements allow the hospital to share client information with other providers."

"Security is provided by the hospital network."

Security is not provided by the hospital network. It is dependent on password protection and authorization of users.

CORRECT: b. "The hospital uses firewalls to protect records."

Firewalls are a component of network security systems.

"Regulatory requirements allow the hospital to share client information with other providers."

Clients must authorize the release of any information.

A nurse is entering data in a client's electronic health record (EHR). Which of the following protects the integrity of the data in the EHR?

a. Authentication

b. WebQuest

c. Automatic log out

CORRECT: a. Authentication

Login names and unique passwords ensure that only authorized individuals have access to read and make entries into the EHR.

WebQuest. Computerized record systems do not inherently protect the privacy and integrity of entries into the EHR. The health care system must limit access to the EHR to protect the information.

Automatic log out systems close the computer system if it is not used or entered for a specific amount of time. This helps keep the information confidential, but it does not ensure that only the appropriate staff members are viewing or making entries in the EHR.

A nurse educator is preparing an in-service program for nurses on the use of social media. Which of the following is an appropriate example of the use of social media?

a. Top of Form

a. Acknowledging a client's decision to post about her health care experience online

b. Referring clients with a similar diagnosis to each other for the purpose of social support

c. Initiating contact with a former client through a social media site

CORRECT: a. Acknowledging a client's decision to post about her health care experience online

A client has the right to disclose personal information on a social media site.

Referring clients with a similar diagnosis to each other for the purpose of social support on a social media site is a violation of HIPAA.

Initiating contact with a former client through social media is a violation of HIPAA.

A newly licensed nurse is concerned about the safety of a dosage for a prescribed medication. Which of the following resources is appropriate to promote evidence-based practice?

a. Pharmacological interactive videoconferencing

b. Instant messaging the facility's pharmacist

c. Pharmacological electronic resources

Pharmacological interactive videoconferencing provides access to education opportunities in remote communities, but it is not an appropriate resource.

Instant messaging the facility's pharmacist

is an informal mode of communication and is not an appropriate resource.

CORRECT: c. Pharmacological electronic resources allow the nurse to access best evidence-based practice information, medication dosages, and safe medication administration guidelines.

A nurse on an acute-care unit enters the admission data on a client who has a history of developing a deep vein thrombosis (DVT). When coordinating the plan of care in the electronic health record (EHR), which of the following should the nurse expect?

a. Automatic dosage calculation of the medication related to DVTs

b. Automatic guidelines and alerts related to DVTs

c. Automatic notification sent to the provider related to client history of DVTs

Automatic dosage calculation of the medication related to DVTs. Specific medication may be suggested to treat DVTs. However, no automatic dosage calculation should be expected by the nurse.

CORRECT: b. Automatic guidelines and alerts related to DVTs. Guidelines and alerts supported by evidence-based practice should be expected by the nurse. This is a part of the clinical decision support system available through EHRs.

Automatic notification sent to the provider related to client history of DVTs. Automatic notification concerning the client's DVT history is available to the provider when in the acute-care facility, but it should not automatically be sent directly to the provider.

A nurse is asked whether she is proficient in the use of nursing informatics. Which of the following indicates competency?

a. Accessing Holter monitor data

b. Using a sphygmomanometer

c. Evaluating a chest tube system

CORRECT: a. Accessing Holter monitor data. Accessing a client's Holter monitor data is an example of nursing informatics that includes using, managing, and communicating client electronic data in nursing practice.

Using a sphygmomanometer. Using a blood pressure apparatus demonstrates technical competency in obtaining one type of client assessment data, but does not indicate competency in the use of nursing informatics.

Evaluating a chest tube system demonstrates technical competency in obtaining one type of client assessment data, but does not indicate competency in the use of nursing informatics.

A nurse is caring for a client who has a pacemaker and requires telehealth monitoring. Which of the following is a benefit of this form of telehealth?

a. Notifies emergency services of a life-threatening cardiac event

b. Downloads client rhythm data in real-time

c. Alerts client to take anti-arrhythmia medication

Notifies emergency services of a life-threatening cardiac event. A client's pacemaker does not notify emergency services of a life-threatening cardiac event.

CORRECT: b. Downloads client rhythm data in real-time

Wireless technology allows cardiac data to be downloaded in real-time from the client's pacemaker. This is a benefit of telehealth monitoring.

Alerts client to take anti-arrythmia medication. The client's pacemaker does not alert the client to take medications.

A nurse manager wants to decrease the number of nosocomial urinary tract infections on her unit. Which of the following research databases should the nurse manager consult to obtain information on evidence-based practices?

a. Structured Query Language

b. National Library of Medicine

c. CINAHL cumulative index

Structured Query Language

This database is a collection of biography in context, Gale virtual references, literature resource center, Scribner Writer sources, and Twayne author series.

National Library of Medicine

This database provides archive collections in art and sciences, business, life sciences, and biological sciences.

CORRECT: c. CINAHL cumulative index

CINAHL is an online evidence-based resource and information system that offers a multitude of online services, which include Web site link sources, CINAHL's online nursing and allied health database, document delivery, and search services. This is the appropriate database to find updated research for the nurse to use.

A nurse is teaching a client who has an ostomy about the proper use of Internet resources. Which of the following statements by the client indicates a need for further teaching?

a. "I will use social media for information about ostomy care."

b. "I will use an online community for emotional support."

c. "I will order ostomy supplies through the Internet."

CORRECT: a. "I will use social media for information about ostomy care."

The nurse has a responsibility to be sure the patient can identify reliable and valid sources of information. Social media sites may be appropriate for support, but they may not provide credible information about ostomy care.

"I will use an online community for emotional support." There have been documented improvements in social support with the use of online support groups. This is an appropriate use of the Internet.

"I will order ostomy supplies through the Internet." Use of the Web to order supplies can be an efficient use of resources. This is an appropriate use of the Internet.

A nurse is instructing a newly licensed nurse about obtaining client assignments. The newly licensed nurse states, "I will make copies of my client's electronic health records so I can complete the care plan at home." Which of the following responses by the nurse is appropriate?

a. "Be sure to remove the client's name from the record."

b. "Client information should remain in the hospital."

c. "Be sure to shred copies of documents when you bring them back to the hospital."

"Be sure to remove the client's name from the record." Removing the client's name from the documents does not eliminate the risk of a breach of client confidentiality and is an unauthorized use of the client's health record.

CORRECT: b. "Client information should remain in the hospital."

Documents containing client information should remain in the facility due to the risk of a breach to client confidentiality.

"Be sure to shred copies of documents when you bring them back to the hospital." Documents containing client information should be shredded when the nurse is finished using the information. However, documents should not be removed from the facility due to the risk of a breach of client confidentiality.

A nurse is accessing a client information system to implement a standardized plan of care for a client. Which of the following is a goal of this technology?

a. Providing a framework for reimbursement

b. Optimizing client outcomes

c. Identifying potential alternative client treatments

Providing a framework for reimbursement is not a goal of providing a standardized plan of care.

CORRECT: b. Optimizing client outcomes

Using standardized care plans provides guidelines for treatments and interventions to optimize client outcomes.

Identifying potential alternative client treatments is not a goal of providing a standardized plan of care.

A nurse is teaching a newly licensed nurse about electronic health records (EHRs). Which of the following should the nurse include in the teaching?

a. An EHR identifies the best evidence-based practices.

b. An EHR activates a medication-dispensing system.

c. An EHR helps to develop a plan of care.

An EHR identifies the best evidence-based practices.

An EHR does not identify current and future needs of evidence-based practices.

An EHR activates a medication-dispensing system.

An EHR does not activate a medication-dispensing system.

CORRECT: c. An EHR helps to develop a plan of care.

An EHR provides the information needed to develop a client's plan of care from admission to discharge.

A nurse is caring for a client who has a new diagnosis of type two diabetes mellitus. The client tells the nurse that he is interested in doing research about diabetes online but that he has never used a computer. Which of the following responses by the nurse is appropriate?

a. "You may want to consider enrolling in a computer course."

b. "Let's take some time to look at Web sites about diabetes together."

c. "I have some printed information on diabetes that I can give you."

"You may want to consider enrolling in a computer course." This response ignores the client's need for information about diabetes.

CORRECT: b. "Let's take some time to look at Web sites about diabetes together."

This response addresses the client's desire to learn how to use a computer and ensures the client receives credible information about diabetes.

"I have some printed information on diabetes that I can give you." This response ignores the client's desire to learn how to use a computer.

A community health nurse receives a report of an outbreak of a communicable disease using a computerized data collection method. How does accurate reporting of the disease improve the quality of client care?

a. Information is analyzed to determine community treatment strategies.

b. Members of the community are notified that the outbreak is controlled.

c. Personnel are hired to clean and disinfect the contaminated areas.

CORRECT: a. Information is analyzed to determine community treatment strategies.

Early detection and reporting of a communicable disease promotes rapid response, case finding, and the development of appropriate treatment strategies.

Members of the community are notified that the outbreak is controlled.

Reassuring the public that the outbreak is controlled is important, but this does not improve the quality of care that can be provided by using a computerized data collection method.

Personnel are hired to clean and disinfect the contaminated areas.

Although it is important to clean and disinfect the areas of contamination, this does not improve the quality of care that can be provided by using a computerized data collection method.

A nurse is creating a social network as a support system for a group of clients. Which of the following practices would be appropriate in launching this site?

a. Uploading a distribution list of clients' e-mail addresses

b. Answering specific client questions in the discussion forum

c. Providing clients with links to reference information

Uploading a distribution list of clients' e-mail addresses. Participation in a social network is voluntary, and it is a violation of client privacy to automatically list client e-mail addresses.

Answering specific client questions in the discussion forum. Providing client-specific information and data on a social network is a violation of HIPAA.

CORRECT: c. Providing clients with links to reference information

Providing accurate and timely reference information would be an appropriate use of a social network.

A charge nurse is developing an in-service program on basic nursing informatics. Which of the following should the nurse include in the program?

a. Reviewing health care blogs

b. Querying the electronic health record

c. Removing cookies from a Web browser

Reviewing health care blogs is not a component of basic nursing informatics.

CORRECT: b. Querying the electronic health record

Accessing data from an electronic health record is used in nursing informatics and allows nurses to provide improved client care.

Removing cookies from a Web browser is not a component of basic nursing informatics.

A nurse is reinforcing teaching to a client about the use of the Internet to obtain credible information about a skin disorder. Which of the following is an appropriate statement by the nurse?

a. "You should access a blog to communicate with others who have similar symptoms."

b. "You should check the hospital Web site for a list of relevant resources."

c. "You should use an online search engine to research the topic."

a. "You should access a blog to communicate with others who have similar symptoms." A weblog allows the client to read another individual's online journal regarding a topic. However, this information may not be credible.

CORRECT: b. "You should check the hospital Web site for a list of relevant resources."

In this situation, the nurse can refer the client to a list of resources that have been identified as credible and reliable by the hospital.

"You should use an online search engine to research the topic." The use of a search engine can direct clients to Web sites, but it does not guarantee that the sites have been reviewed and are credible resources.

A nurse is documenting a client's assessment in the electronic health record. A prompt to provide a specific nursing intervention displays on the screen. This is an example of which of the following?

a. Staff development

b. Risk management

c. Evidence-based practice

Staff development is the process of providing opportunities for professional growth and skills development. Computerized information systems are used for professional growth and skills development, but not based on an individual client assessment.

Risk management is the process of identifying and analyzing whether a process is working and determining whether it meets specified requirements.

CORRECT: c. Evidence-based practice is embedded in the clinical information system. Prompts may display on the screen as a reminder.

A nurse takes a photo of a client. After the client gives verbal approval, the nurse posts the photo to a social network site. Which of the following violations has occurred?

a. Breach of confidentiality

b. Defamation of character

c. Conflict of interest

CORRECT: a. Breach of confidentiality

The photo on the social network site could be used to identify the client. This is a HIPAA violation because the consent must be in writing.

Defamation of character does not result from posting photos on a social network site.

Conflict of interest does not result from posting photos on a social network site.

A nurse is caring for a client who reports shortness of breath. Which of the following devices should the nurse use to obtain electronic data regarding the client's clinical manifestations?

a. Pulse oximeter

b. Incentive spirometer

c. Blood pressure monitor

CORRECT: a. Pulse oximeter

A pulse oximeter permits the indirect measurement of oxygen saturation using a light-emitting diode. This information can be transmitted to the client's health care record.

Incentive spirometer. An incentive spirometer is not an electronic device and does not measure a client's oxygen level.

Blood pressure monitor. A blood pressure monitor does not measure a client's oxygen saturation level.

A nurse is teaching a newly licensed nurse about the benefits of telehealth services. Which of the following is an example of a benefit of telehealth?

a. Remote administration of pain medication to a client who is in hospice

b. First responders transmit client data to the receiving facility

c. Prevents seizure activity in a client who has epilepsy

Remote administration of pain medication to a client who is in hospice

Telehealth services do not administer pain medication to a client who is in hospice.

CORRECT: b. First responders transmit client data to the receiving facility

The transmission of client data is a benefit of telehealth.

Prevents seizure activity in a client who has epilepsy

Telehealth monitors but does not prevent a seizure from occurring.

A nurse is conducting a home health visit with a client who has a Holter monitor due to recent syncopal episodes. The client asks, "Why will telemonitoring be used?" Which of the following responses by the nurse is appropriate?

a. "This will treat the underlying cause of the syncopal episodes."

b. "This will minimize the frequency of the syncopal episodes."

c. "This data will assist your provider in making a diagnosis."

"This will treat the underlying cause of the syncopal episodes."

Telemonitoring will not treat the underlying cause of the syncopal episodes.

"This will minimize the frequency of the syncopal episodes."

Telemonitoring will not minimize the frequency of syncopal episodes.

CORRECT: c. "This data will assist your provider in making a diagnosis."

Telemonitoring collects data that can assist the provider in making a medical diagnosis for a client experiencing syncopal episodes.

A nurse manager is implementing an electronic health record program. Which of the following indicates that data security is effectively managed by the program?

a. Guidelines are available about printing client information.

b. Providers store client health records on personal computers.

c. Employees give verbal consent to confidentiality guidelines.

CORRECT: a. Guidelines are available about printing client information.

Policies on printing and duplicating client information are implemented for effectively managing data security.

Providers store client health records on personal computers.

Providers can use facility-owned portable computers to store client information that is encrypted, but the information cannot be stored on personal computers.

Employees give verbal consent to confidentiality guidelines.

Written consent regarding confidentiality guidelines is required. Consent does not effectively manage data security.

A nurse manager is implementing criteria that promote a culture of safety as defined by the Agency of Healthcare Research and Quality (AHRQ). Which of the following criteria are included in the AHRQ guidelines? (Select all that apply.)

a. Encourage collaboration among disciplines to seek solutions to client safety problems.

b. Use state-of-the-art technology to determine high-risk activities within an organization.

c. Sustain a blame-free environment where staff is able to report errors without fear of reprimand.

d. Integrate silent alarm systems to reduce noise pollution in the hospital environment.

e. Encourage organizations to engage in root-cause analysis.

CORRECT ANSWERS:

a. Encourage collaboration among disciplines to seek solutions to client safety problems is correct. Collaboration demonstrates the manager's commitment to client safety and is a guideline of the AHRQ.

b. Use state-of-the-art technology to determine high-risk activities within an organization is correct. Identification of high-risk activities is required to determine appropriate interventions to promote safety and is a guideline of the AHRQ.

c. Sustain a blame-free environment where staff is able to report errors without fear of reprimand is correct. A blame-free environment transfers the focus from blame to client safety and is a guideline of the AHRQ.

e. Encourage organizations to engage in root-cause analysis is correct. This analysis places focus on client safety and is a guideline of the AHRQ.

INCORRECT ANSWER(S):

d. Integrate silent alarm systems to reduce noise pollution in the hospital environment is incorrect. Although noise pollution is a concern on a nursing unit, it does not take priority over client safety.

A nurse is preparing to interview a client during a telehealth interaction. Which of the following is a client identifier?

a. Client's home phone number

b. Name of the client's provider

c. Date and time of client's last visit

CORRECT: a. Client's home phone number

A client's home phone number is an acceptable identifier if it matches the electronic health record.

The name of the client's provider is not an acceptable client identifier. This does not identify the client and should not be used.

Date and time of client's last visit is not an acceptable client identifier. This does not identify the client and should not be used.

A nurse is caring for a client who asks about measures the nurse takes to protect client privacy. Which of the following is an appropriate response by the nurse?

a. "I minimize the screen when answering a call light."

b. "I use a single method of identification when clients have visitors present."

c. "I log off the computer between seeing clients."

"I minimize the screen when answering a call light."

By minimizing the screen, a person can still maximize and view client information.

"I use a single method of identification when clients have visitors present."

To ensure client safety, the same identifiers should be used whether or not visitors are present.

CORRECT: c. "I log off the computer between seeing clients."

HIPAA establishes national standards for the protection of certain health information. The privacy rule addresses the use and sharing of individual's health information. This can be violated if a client's health information is on the computer screen and the nurse leaves this up while attending to other clients.

A nurse on a pediatric unit is caring for a client. The client's mother asks the nurse, "Can you turn off the alarm that seems to go off all the time?" Which of the following actions by the nurse is appropriate?

a. Teach the mother how to silence the alarm.

b. Record the frequency of alarm.

c. Check the alarm function.

Teach the mother how to silence the alarm.

Although parents often learn how to silence an alarm by watching a nurse, it is a nursing responsibility. Parents should not be encouraged to silence the alarm.

Record the frequency of alarm.

Collecting this information would provide data to support the mother's complaint, but it would not address the problem.

CORRECT: c. Check the alarm function.

Checking the alarm function would include comparing alarm parameters to desired parameters to ensure they are appropriate.

A nurse is preparing to perform a dressing change on a client and is researching the appropriate technique to use. Which of the following should the nurse recognize as the source of information to use?

a. The provider's prescription

b. The facility's online procedure manual

c. A health application on a mobile device

The provider's prescription provides information on the type of dressing change to perform, but it does not provide guidance on the appropriate technique to use.

CORRECT: b. The facility's online procedure manual

A facility's policy and procedure manual is the official governing collection of evidence-based practice used to provide current, safe, and effective client care within that facility.

A health application on a mobile device. This is a method that could be used to investigate possible techniques for a dressing change. However, there is no assurance that an online resource retrieved by this search method would be the best resource, current, and supported by scholarly work.

A charge nurse is orienting a newly licensed nurse to the unit and demonstrates how to access data from the hospital information system. Which of the following actions by the newly licensed nurse requires intervention by the charge nurse?

a. Reviewing the discharge summary from a client's previous hospitalization

b. Obtaining x-ray findings from a client's emergency room visit

c. Reviewing the health record of a client on another unit with similar symptoms

Reviewing the discharge summary from a client's previous hospitalization

Nurses can review the discharge summary from a client's previous hospitalization to obtain data and assist in planning client care.

Obtaining x-ray findings from a client's emergency room visit

This information can be reviewed and accessed in the course of providing care and treatment to a client.

CORRECT: c. Reviewing the health record of a client on another unit with similar symptoms

Accessing the health record of a client who is not under the nurse's direct care is a violation of the client privacy regulations under HIPAA.

A nurse supervisor wants to review data on nurse-sensitive outcomes from other facilities related to falls. Which of the following is an appropriate resource to obtain this information?

a. Health Insurance Portability and Accountability Act (HIPAA)

b. National Database of Nursing Quality Indicators (NDNQI)

c. North American Nursing Diagnosis Association (NANDA)

Health Insurance Portability and Accountability Act (HIPAA) provides federal protection for personal health information held by covered entities.

CORRECT: b. National Database of Nursing Quality Indicators (NDNQI) provides data from multiple facilities for profiling and comparison. This allows data to be analyzed and isolates issues that require attention.

North American Nursing Diagnosis Association (NANDA) defines and promotes a taxonomy of nursing diagnostic terminology of general use to professional nurses.

A newly hired nurse is reviewing an institution's networking policy. Which of the following statements by the nurse indicates a need for further teaching?

a. "These policies determine acceptable social networks for employee use."

b. "These policies protect client privacy and individually identifiable information."

c. "These policies prevent the introduction of viruses into the network."

CORRECT: a. "These policies determine acceptable social networks for employee use."

An institutional networking policy includes confidentiality, availability, and integrity, but it does not specifically address acceptable social networks for employee use.

"These policies protect client privacy and individually identifiable information."

A component of a networking policy is confidentiality, which focuses on the protection of client privacy and information.

"These policies prevent the introduction of viruses into the network."

A component of a networking policy is availability, which includes protecting the network from viruses.

A nurse is caring for a client who is involved in a clinical trial being conducted by researchers at the facility. Which of the following resources facilitates time management for the research team?

a. Databases that compile data sets from participants

b. Search engines that define relevant literature

c. Videoconferencing with researchers in other facilities

CORRECT: a. Databases that compile data sets from participants

Databases that provide data sets facilitate time management for the research team.

Search engines that define relevant literature do not facilitate time management.

Videoconferencing with researchers in other facilities does not facilitate time management.

A nurse is providing care for a client on a medical-surgical unit. Which of the following interventions involves the use of informatics?

a. Auscultating heart sounds for cardiac arrhythmias

b. Using a glucometer to obtain blood glucose level

c. Palpating peripheral pulses to determine pulse strength

Auscultating heart sounds for cardiac arrhythmias

A nurse is not using informatics when auscultating heart sounds to detect cardiac arrhythmia.

CORRECT: b. Using a glucometer to obtain blood glucose level

A glucometer is an electronic device that transmits and calculates client blood glucose level to a database. This involves the use of nursing informatics.

Palpating peripheral pulses to determine pulse strength

A nurse is not using informatics when palpating peripheral pulses to determine pulse strength.

A nurse is discussing computerized provider order entry (CPOE) with a newly licensed nurse. Which of the following should the nurse identify as a benefit of this technology?

a. Identifies the provider of an unsafe medication dosage

b. Provides a medication allergy alert

c. Notifies the nurse when it's time for the medication to be administered

Identifies the provider of an unsafe medication dosage. CPOE does not identify the provider of an unsafe medication dosage.

CORRECT: b. Provides a medication allergy alert. CPOE provides medication allergy alerts to the provider and the nurse. This is a benefit of this technology.

Notifies the nurse when it's time for the medication to be administered. CPOE does not notify the nurse when it's time for medications to be administered.

A nurse in a primary care clinic completes a quality assurance project using the electronic health records of clients who have type one diabetes mellitus. Project findings reveal that clients had higher than expected capillary blood glucose levels following teaching by the clinic nurses. Which of the following conclusions should the nurse draw from these findings?

a. Additional records should be included in the review of data.

b. Prior professional development training was ineffective.

c. The development of clinical practice guidelines should be considered.

Additional records should be included in the review of data.

Including additional records does not affect client outcomes.

Prior professional development training was ineffective.

Research data can lead to changes in staff training, but it does not indicate that prior training was ineffective.

CORRECT: c. The development of clinical practice guidelines should be considered.

The development of clinical guidelines incorporates best practices, promotes uniformity and consistency in education programs, and improves client outcomes.

A nurse is caring for a patient who has a new diagnosis of asthma and is to be d/c home. Which of the following should the nurse use to help ensure the patient's medication compliance?

a. Send automated e-mail reminders for medication administration.

b. Offer online tutorials regarding medication management.

c. Ask the client to complete an online medication schedule.

Send automated e-mail reminders for medication administration does not monitor a client's medication compliance.

Offer online tutorials regarding medication management does not monitor a client's medication compliance.

CORRECT: c. Ask the client to complete an online medication schedule.

A weekly medication schedule allows the nurse to monitor the client's medication compliance, which is essential to preventative care and illness management.

A nurse is caring for a client who is scheduled to be discharged and sent home with a telehealth monitor. Which of the following actions should the nurse take first?

a. Set the date for the medical equipment service to install the device.

b. Have the client state what he knows about telehealth.

c. Set the schedule of telehealth visits.

Set the date for the medical equipment service to install the device. This is an appropriate action, but it is not the first action the nurse should take according to the nursing process approach to client care.

CORRECT: b. Have the client state what he knows about telehealth.

Identifying client teaching needs is part of assessment, which is the first step the nurse should take according to the nursing process approach to client care.

Set the schedule of telehealth visits. This is an appropriate action, but it is not the first action the nurse should take according to the nursing process approach to client care.

A nurse is reinforcing teaching with a client about the use of reputable Web sites to research osteoporosis. Which of the following guidelines should the nurse include in the teaching?

a. The Web site should include the author's contact information.

b. The author of the Web site should have a medical degree.

c. The Web site should have client testimonials posted.

CORRECT: a. The Web site should include the author's contact information.

A credible Web site includes the author's contact information to provide the opportunity for the client to seek verification of information.

The author of the Web site should have a medical degree. A medical degree does not constitute reliability and is therefore not a required guideline for a credible Web site.

The Web site should have client testimonials posted. Testimonials do not constitute reliability and are therefore not a required guideline for a credible Web site.

A nurse manager uses informatics technologies on her unit. Which of the following should the nurse use to reduce the incidence of medication errors?

a. Bar code scanning system

b. Risk management online reporting

c. Removable storage device

CORRECT: a. Bar code scanning systems are used in medication administration and reduce medication errors.

Risk management online reporting is an informatics technology, but its use does not reduce medication errors.

A removable storage device is not an informatics technology and does not reduce medication errors.

A nurse manager is reviewing hospital policies related to information security with a newly licensed nurse. Which of the following actions by the newly licensed nurse requires intervention?

a. Paging a client by last name to return to therapy

b. Logging off the computer before leaving the nurse's station

c. Showing a client his electronic health record

CORRECT: a. Paging a client by last name to return to therapy. This would publicize a client identifier and violate confidentiality.

Logging off the computer before leaving the nurse's station. This would protect client identifiers and is appropriate.

Showing a client his electronic health record. Information displayed on the monitor is part of the client's health record, and the client has the right to this information.

A nurse receives a phone call from an individual requesting information about a client's status on the day of surgery. Which of the following actions should the nurse take?

a. Tell the caller to speak directly with the client.

b. Encourage the caller to speak with the client's family member.

c. Verify whether client information can be communicated over the phone.

Tell the caller to speak directly with the client. The client may not be available or capable of providing information to a caller.

Encourage the caller to speak with the client's family member. The client determines who will speak on his behalf, if needed, and it may not be a family member. A family member may not be available to speak to a caller.

CORRECT: c. Verify whether client information can be communicated over the phone. The nurse should determine the identity of the caller and the caller's right to the information as established by the client.

A nurse is preparing an in-service on the use of informatics to improve client outcomes. Which of the following should the nurse include? (Select all that apply.)

a. Apply the use of standardized terminology.

b. Become an opponent in the technology implementation process.

c. Apply principles of lifelong learning.

d. Incorporate the use of Technology Informatics Guiding Education Reform (TIGER).

e. Incorporate the use of Quality and Safety Education for Nurses (QSEN).

CORRECT ANSWER(S):

a. Apply the use of standardized terminology is correct. The nurse should understand that new information management tools include the use of standardized terminology such as NANDA to document nursing-sensitive outcomes.

c. Apply principles of lifelong learning is correct. The nurse should apply principles of lifelong learning in order to understand information management tools, which creates an environment for effective nursing practice.

d. Incorporate the use of Technology Informatics Guiding Education Reform (TIGER) is correct. The use of TIGER establishes a common goal for the incorporation of informatics in the use of nursing education and practice.

e. Incorporate the use of Quality and Safety Education for Nurses (QSEN) is correct. QSEN incorporates key competencies into nursing informatics.

INCORRECT ANSWER(S):

b. Become an opponent in the technology implementation process is incorrect. The nurse should become an advocate, not an opponent, for new information management tools in order to create an environment for effective nursing practice.