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1. A nurse manager was orienting new staff members to computerized charting. To understand computerized charting, staff members must understand informatics. The three core concepts in informatics are:
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a. hardware, software, and printers.
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b. data, information, and knowledge.
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c. decision making, data gathering, and reporting.
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d. wireless technology, voice recognition, and handheld devices.
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2. The nursing manager of a surgical unit has been asked by administration to evaluate client outcomes post cardiac catheterization. Using data about client outcomes post cardiac catheterization for the past 6 months in order to modify practice is an example of:
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3. Mr. Cruiser has been surfing the Web. He is looking for healthcare information on low back pain. He shows the clinic nurse a webpage he thinks is great and tells her that he has been following the exercises recommended by the author. He wants to know what she thinks about the site. When the clinic nurse evaluates this site, she discovers that its author is a personal trainer. No credentials are listed. In several testimonials on the page, people (their pictures are included) say how wonderful they feel after having done these exercises. The exercises all have animated demos when you click on the pertinent highlighted text or icon. They seem easy to follow. The site was posted 5 years earlier and was last updated 3 years before. The clinic nurse advises Mr. Cruiser to:
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a. avoid this site.
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b. check with his primary healthcare provider.
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c. continue with the exercises.
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d. contact the author for additional exercise and feedback.
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4. A primary care clinic in a small urban center sees a high volume of cardiology patients. Patients who attend the clinic have smart cards that they use at hospitals, clinics, and Emergency Departments within that region of the state. A primary benefit of the smart card for these patients would be:
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a. rapid and accurate treatment in emergency situations.
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b. reduced wait times to see specialists.
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c. e-mail notification of test results.
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d. readily available information regarding medications.
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5. The clinic nurse has just accessUed Sa cliNent’Ts chartOon the computer. The resident comes over
and asks her to stay logged on because he needs to add a note to that client’s chart. She should say:
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a. “No problem. Just log me off when you’re done.”
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b. “I’ll put the note in for you. What do you want to say?”
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c. “Just make sure that you sign your note because it’s under my password.”
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d. “I’m sorry, but you will have to enter the information using your own password.”
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6. A home health nurse has been assigned to cover a 300-square-mile area of remote Montana. Mrs. Baker has just been discharged home following bowel surgery and has a new colostomy. She will need daily contacts for at least 2 weeks and then regular weekly contact following that week. Because it is not possible to visit Mrs. Baker in person every day and see all of the other clients, the nurse gives her a laptop computer with net meeting software installed. Each morning, both dial in at an agreed-upon time and discuss her progress. The home health nurse assesses whether or not the client needs to be seen that day and is able to view the colostomy site. This type of technology is called:
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7. At a newly built outpatient surgical center, an integrated information system has been purchased. The chief nursing officer creates a series of staff development classes to orient the staff to this new system. One of the advantages of an integrated information system is that client-care data from all sites can be stored in and retrieved from a:
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8. Nurses need to know how to operate a computer, compare data across time, and look for patterns in client responses to treatments. These are examples of:
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9. Leaders in nursing must advocate for information and knowledge systems that support nursing practice. This is best accomplished by:
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a. participating in organizational information technology committees.
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b. submitting written requests for needed information systems.
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c. requesting budgetary funds needed for systems.
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d. sending staff nurses to conferences that discuss cutting-edge technologies.
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10. You are in the process of designing a patient education program that will provide education and monitoring for patients with hypertension. To support your planning, you draw out and
present patient data from:
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11. You document your patient’s vital signs into a bedside documentation device and are able to compare your patient’s vital signs with patients who have similar diagnoses and similar medications, and who are of a similar age. You are accessing:
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a. e-mail.
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b. telecommunications.
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c. a database.
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d. technology.
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12. In an ICU, you order new devices to measure heart rhythm and rate, respiratory rate, oxygen levels, and intracranial pressure. These devices involve:
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13. As the head nurse involved in leading determination of which patient surveillance systems to acquire for your unit, one of your aims is to avoid adverse events through the implementation of appropriate technology. This particular aim recognizes that:
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a. human error is significant in contributing to adverse events.
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b. documentation of patient data is often illegible and therefore, misinterpreted.
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c. data systems provide backup documentation with adverse events that staff cannot
provide.
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d. physiologic monitoring systems enable detection of early changes before an
adverse event occurs.
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14. A 39-year-old patient awaits a kidney transplant. Because he must immediately arrange to get to the hospital when a donor kidney is available, it is important that he can be reached anywhere and at any time. To ensure that he receives the message, what type of technology is most effective?
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a. Internet
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b. Telecommunications
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c. WL pager
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d. CDS
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15. A recent nursing graduate in a busy Emergency Department triages a patient who has sustained a large, deep puncture wound in his foot while working at a construction site. He is bleeding and is in pain. The nurse enters the triage data that she has obtained from the patient into a computerized, standard emergency patient-classification system. After she enters the assessment data, she notices an alert on the computer screen that prompts her to ask the patient about the status of his tetanus immunization. What system of technology is involved in generating the alert?
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a. Clinical decision support
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b. WL technology
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c. Computerized provider order
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d. Electronic health record
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16. Despite the implementation of bar-code medication administration (BCMA) on your busy medical unit, you notice that the number of medication errors has not significantly decreased. Which of the following reasons might explain the lack of change in errors?
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a. A number of new medications have been introduced into the hospital pharmacy
that are not yet recognized in the CDS.
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b. There have been an unusually high number of patients on the unit who have been
unable to confirm their identity at the time of medication administration.
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c. Lack of staff understanding and support for BCMA has led to overrides or failures
to scan bar codes during busy times.
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d. Clinical data that have been entered into the system to guide administration of the
medications are outdated.
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17. A rural-urban health consortium enables physicians in a rural remote setting to consult with specialists in care through electronic conferencing, which includes consultation using intranet radiology images. This system may be in which phase of electronic medical technology adoption, according to the Healthcare Information and Management Systems Society (HIMSS)?
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18. As a nurse manager representative on a clinical information system selection team, you would be particularly concerned if the favored system:
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a. involves screen displays that are best configured for nonclinical users.
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b. requires an upgrade to servers in the facility.
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c. requires staff orientation and training during implementation of the software.
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d. minimizes the amount of data entry necessary.
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19. When assessing the appropriateness of adopting WL COWs for a nursing unit, you need to consider the advantages, which include:
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20. A nurse manager is excited by the possible use of speech recognition (SR) systems for documentation of patient care, especially during crisis situations when staff members need to focus on performing rapid assessments and implementation of procedures. She learns, however, that SR systems would be impractical at this point. What would lead to this conclusion?
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a. SR systems are not available outside pilot projects.
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b. The type of speech required for voice recognition is unlikely to occur in a
pressured situation.
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c. The hands-free function has not been perfected in SR technology.
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d. Wireless communications are prone to unreliability in transmission.
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21. As a nurse manager, one challenge is to orient new staff to your agency’s policies and procedures, as well as to provide training across various shifts. A cost-effective and effective learning strategy would be:
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a. development of new learning modules and software to support document retrieval.
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b. e-mail distribution to staff home e-mail addresses regarding important policies.
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c. preparation of DVDs that can be viewed on computers at the nursing station during
“down times.”
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d. linking policies and procedures to the network for access when required at the
point-of-care.
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22. A necessary, basic condition foUr suScceNssfuTl integrOation of clinical information systems is:
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a. software.
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b. standard medical nomenclature.
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c. confirmatory evidence from nursing-led studies.
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d. strong interdisciplinary cultures.
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23. To improve outcomes on the stroke recovery unit, the unit manager leads an evidence-based practice (EBP) project. The goal of this project is to:
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a. enable detection of variations in clinical outcomes from well-researched standards
that are supported by confirmatory evidence.
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b. gain quick access to literature based on studies of patients and families who have
experienced stroke.
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c. develop a list of articles that could be accessed to address clinical issues and
problems with stroke patients.
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d. advance the development of staff who are able to conduct independent nursing
research on stroke outcomes.
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24. As part of an information technology implementation team, you are implementing a clinical decision support system. Particular considerations for successful implementation of this project include:
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a. ensuring that the system is reliable.
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b. ensuring that patient information is reliable.
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c. developing unique identifiers for individuals.
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d. developing rules that support inferences.
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1. As a nurse manager, you want to institute point-of-care devices on your unit. The rationale that you provide to support the point g=of care devices includes (select all that apply)
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a. reduction in incidents of medication error.
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b. immediate documentation of care.
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c. comparison of patient data with previous data.
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d. immediate access to staffing schedules.