NR 599 NURSING INFORMATICS FINAL EXAM 2026/2027 | FULL TEST BANK QUESTIONS & ANSWERS | CLINICAL SYS… EXAM
P R O F E S S I O N A L P R A C T I C E M AT E R I A L S
NR 599 Nursing Informatics Final Exam
2026/2027 | Full Test Bank Questions &
Answers | Clinical Systems, Telehealth,
Privacy, HIPAA & CDS Support Tools
Verified Answers Exam Ready With Rationales
76 QUESTIONS
DOCUMENT OVERVIEW
This document provides 76 practice questions with correct answers and detailed rationales covering
clinical informatics. It's designed for students to study and review comprehensive nursing informatics
topics. This resource is ideal for exam preparation and understanding key concepts in areas like clinical
systems, telehealth, and privacy.
CONTENTS
01 Clinical Decision Support & EHR Functionality Q1–Q20
02 Ethical & Legal Considerations Q21–Q33
03 Telehealth & mHealth Q34–Q43
04 Medical Coding & Reimbursement Q44–Q68
05 Medical Device Regulation Q69–Q76
E XA M Q U EST I O N S
Q1 QUESTION 1 OF 76
A nurse is reviewing the electronic health record for a patient admitted with a new diagnosis of atrial fibrillation. The patient's latest electrocardiogram (ECG)
shows a heart rate of 135 bpm with irregular R-R intervals. The nurse is tasked with developing the initial nursing care plan, considering both the patient's
physiological needs and the ethical implications of care decisions. Which of the following actions would be MOST appropriate in addressing the ethical
dimensions of this patient's care? (Select all that apply.)
A) Prioritize immediate administration of prescribed rate-controlling medication to stabilize the cardiac rhythm.
B) Inform the patient about the diagnosis and available treatment options, ensuring their understanding before proceeding.
C) Document the ECG findings and vital signs accurately in the patient's chart.
D) Discuss the patient's treatment preferences and values with the family, assuming the patient is unable to communicate.
Page 1
,E) Immediately initiate anticoagulation therapy as per standard protocol for atrial fibrillation.
F) Consult the ethics committee to review the patient's complex medical history and potential treatment conflicts.
CORRECT ANSWER
B) Inform the patient about the diagnosis and available treatment options, ensuring their understanding before proceeding.
D) Discuss the patient's treatment preferences and values with the family, assuming the patient is unable to communicate.
RATIONALE
Ethical decision-making requires balancing scientific knowledge with moral principles by making informed choices based on differentiating right from wrong; this involves
patient autonomy and shared decision-making as crucial components. Informing the patient and considering family input when appropriate directly addresses these
principles.
Q2 QUESTION 2 OF 76
The clinical decision support system (CDS) flags a critical alert for potential drug-drug interaction between warfarin and a newly prescribed antifungal for a
patient initiated on anticoagulation therapy last Tuesday, October 24, 2023. The alert cites a 75% increased risk of bleeding based on the pharmacodynamic
model. As the on-call informatics nurse navigator, what action MOST accurately reflects a rational justification for addressing this alert?
A) Override the alert and proceed with the antifungal prescription, as the alert is likely a false positive.
B) Document the alert and continue current medication orders, deferring discussion until the patient's scheduled primary care provider visit in three weeks.
C) Escalate the alert immediately to the prescribing provider and pharmacist, providing them with the system's documented risk assessment and supporting
facts.
D) Inform the patient about the potential interaction and have them monitor for bleeding signs, without involving other healthcare team members.
CORRECT ANSWER
C) Escalate the alert immediately to the prescribing provider and pharmacist, providing them with the system's documented risk assessment and supporting facts.
RATIONALE
A rational justification for CDS alerts involves a logical process considering facts, alternative perspectives, and consequences to all stakeholders, necessitating escalation
to the involved providers and pharmacist for a shared decision-making process. This approach ensures patient safety and adherence to ethical principles of shared
responsibility.
Q3 QUESTION 3 OF 76
A critical care nurse is reviewing the real-time telemetry data for a patient admitted with decompensated heart failure, showing a sudden onset of frequent
premature ventricular contractions (PVCs) at a rate of 12 per minute. The nurse also notes a blood pressure of 88/52 mmHg and a heart rate of 115 bpm. The
patient is conscious but reporting mild shortness of breath. Which of the following actions should the nurse take NEXT? (Select all that apply.)
A) Administer a bolus of intravenous normal saline.
B) Notify the on-call cardiologist regarding the dysrhythmia and hemodynamic changes.
C) Administer a prescribed IV dose of amiodarone.
D) Initiate synchronized cardioversion at 50 joules.
E) Increase the rate of the patient's scheduled diuretic infusion.
F) Reassess the patient's lung sounds and oxygen saturation.
CORRECT ANSWER
B) Notify the on-call cardiologist regarding the dysrhythmia and hemodynamic changes.
F) Reassess the patient's lung sounds and oxygen saturation.
RATIONALE
The patient's symptomatic presentation and hemodynamic instability require immediate assessment and notification of the physician; therefore, reassessing lung sounds
and oxygen saturation is indicated, and notifying the cardiologist is crucial for further management decisions. While amiodarone is a potential treatment for PVCs, it
requires physician order and further assessment before administration in this unstable patient.
Page 2
, Q4 QUESTION 4 OF 76
A registered nurse is implementing a new electronic health record (EHR) system designed to streamline medication administration. The system requires
scanning the patient's wristband, the medication package, and the nurse's badge before dispensing and documenting. The nurse notes that this sequence of
actions is significantly increasing the time spent at the patient's bedside for each medication, impacting the timely delivery of scheduled doses by an average
of 15 minutes per patient per shift. This sequential, task-oriented process is impacting the overall efficiency of care delivery by disrupting the established
pattern of activities. The nurse is tasked with optimizing this new process. Which of the following actions should the nurse consider to improve the efficiency
and effectiveness of this system implementation? (Select all that apply.)
A) Documenting the medication administration in the EHR *after* leaving the patient's room to save time at the bedside.
B) Discussing the observed delays and potential workflow bottlenecks with the informatics team or EHR super-user.
C) Recommending a system configuration change that allows for a single scan of the medication and patient wristband, bypassing the nurse badge scan.
D) Training new nursing staff to perform the scanning sequence in a different order, such as scanning the nurse's badge first.
E) Advocating for the return to a paper-based medication administration system to avoid EHR-related delays.
F) Suggesting that nurses administer medications for multiple patients consecutively in one room to reduce the number of room entries and associated
scanning events.
CORRECT ANSWER
B) Discussing the observed delays and potential workflow bottlenecks with the informatics team or EHR super-user.
C) Recommending a system configuration change that allows for a single scan of the medication and patient wristband, bypassing the nurse badge scan.
RATIONALE
Process inefficiencies should be reported to the informatics team for system optimization, and advocating for the removal of redundant steps like the nurse badge scan
can improve workflow directly.
Q5 QUESTION 5 OF 76
A registered nurse is assigned to optimize the electronic health record (EHR) system's medication reconciliation process on a busy medical-surgical unit. The
current workflow involves nurses manually cross-referencing physician orders with the patient’s home medication list. Which actions by the nurse directly
support the observation and documentation of this workflow to identify potential improvements? (Select all that apply.)
A) Shadowing nurses during medication administration to record time spent on reconciliation.
B) Interviewing unit pharmacists about their role in the current medication reconciliation process.
C) Analyzing the EHR's audit trail for frequency of manual order entry versus automated imports.
D) Developing a new standardized order set for common admission diagnoses.
E) Requesting data reports on average patient length of stay for the past fiscal year.
CORRECT ANSWER
A) Shadowing nurses during medication administration to record time spent on reconciliation.
B) Interviewing unit pharmacists about their role in the current medication reconciliation process.
C) Analyzing the EHR's audit trail for frequency of manual order entry versus automated imports.
RATIONALE
Evaluating the existing process by directly observing actions, gathering input from related disciplines, and reviewing system logs are key components of workflow analysis
needed to identify areas for system enhancement. Actions such as developing new order sets or analyzing length of stay data do not directly address the current
reconciliation workflow observation.
Q6 QUESTION 6 OF 76
In the context of evaluating an existing clinical information system's efficiency, which methods are primarily employed to visually represent the flow of patient
data and processes? (Select all that apply.)
A) Gantt charts displaying project timelines
B) Flowcharts detailing sequential steps and decision points
C) Use case diagrams illustrating system interactions
D) Network diagrams showing system architecture
Page 3
P R O F E S S I O N A L P R A C T I C E M AT E R I A L S
NR 599 Nursing Informatics Final Exam
2026/2027 | Full Test Bank Questions &
Answers | Clinical Systems, Telehealth,
Privacy, HIPAA & CDS Support Tools
Verified Answers Exam Ready With Rationales
76 QUESTIONS
DOCUMENT OVERVIEW
This document provides 76 practice questions with correct answers and detailed rationales covering
clinical informatics. It's designed for students to study and review comprehensive nursing informatics
topics. This resource is ideal for exam preparation and understanding key concepts in areas like clinical
systems, telehealth, and privacy.
CONTENTS
01 Clinical Decision Support & EHR Functionality Q1–Q20
02 Ethical & Legal Considerations Q21–Q33
03 Telehealth & mHealth Q34–Q43
04 Medical Coding & Reimbursement Q44–Q68
05 Medical Device Regulation Q69–Q76
E XA M Q U EST I O N S
Q1 QUESTION 1 OF 76
A nurse is reviewing the electronic health record for a patient admitted with a new diagnosis of atrial fibrillation. The patient's latest electrocardiogram (ECG)
shows a heart rate of 135 bpm with irregular R-R intervals. The nurse is tasked with developing the initial nursing care plan, considering both the patient's
physiological needs and the ethical implications of care decisions. Which of the following actions would be MOST appropriate in addressing the ethical
dimensions of this patient's care? (Select all that apply.)
A) Prioritize immediate administration of prescribed rate-controlling medication to stabilize the cardiac rhythm.
B) Inform the patient about the diagnosis and available treatment options, ensuring their understanding before proceeding.
C) Document the ECG findings and vital signs accurately in the patient's chart.
D) Discuss the patient's treatment preferences and values with the family, assuming the patient is unable to communicate.
Page 1
,E) Immediately initiate anticoagulation therapy as per standard protocol for atrial fibrillation.
F) Consult the ethics committee to review the patient's complex medical history and potential treatment conflicts.
CORRECT ANSWER
B) Inform the patient about the diagnosis and available treatment options, ensuring their understanding before proceeding.
D) Discuss the patient's treatment preferences and values with the family, assuming the patient is unable to communicate.
RATIONALE
Ethical decision-making requires balancing scientific knowledge with moral principles by making informed choices based on differentiating right from wrong; this involves
patient autonomy and shared decision-making as crucial components. Informing the patient and considering family input when appropriate directly addresses these
principles.
Q2 QUESTION 2 OF 76
The clinical decision support system (CDS) flags a critical alert for potential drug-drug interaction between warfarin and a newly prescribed antifungal for a
patient initiated on anticoagulation therapy last Tuesday, October 24, 2023. The alert cites a 75% increased risk of bleeding based on the pharmacodynamic
model. As the on-call informatics nurse navigator, what action MOST accurately reflects a rational justification for addressing this alert?
A) Override the alert and proceed with the antifungal prescription, as the alert is likely a false positive.
B) Document the alert and continue current medication orders, deferring discussion until the patient's scheduled primary care provider visit in three weeks.
C) Escalate the alert immediately to the prescribing provider and pharmacist, providing them with the system's documented risk assessment and supporting
facts.
D) Inform the patient about the potential interaction and have them monitor for bleeding signs, without involving other healthcare team members.
CORRECT ANSWER
C) Escalate the alert immediately to the prescribing provider and pharmacist, providing them with the system's documented risk assessment and supporting facts.
RATIONALE
A rational justification for CDS alerts involves a logical process considering facts, alternative perspectives, and consequences to all stakeholders, necessitating escalation
to the involved providers and pharmacist for a shared decision-making process. This approach ensures patient safety and adherence to ethical principles of shared
responsibility.
Q3 QUESTION 3 OF 76
A critical care nurse is reviewing the real-time telemetry data for a patient admitted with decompensated heart failure, showing a sudden onset of frequent
premature ventricular contractions (PVCs) at a rate of 12 per minute. The nurse also notes a blood pressure of 88/52 mmHg and a heart rate of 115 bpm. The
patient is conscious but reporting mild shortness of breath. Which of the following actions should the nurse take NEXT? (Select all that apply.)
A) Administer a bolus of intravenous normal saline.
B) Notify the on-call cardiologist regarding the dysrhythmia and hemodynamic changes.
C) Administer a prescribed IV dose of amiodarone.
D) Initiate synchronized cardioversion at 50 joules.
E) Increase the rate of the patient's scheduled diuretic infusion.
F) Reassess the patient's lung sounds and oxygen saturation.
CORRECT ANSWER
B) Notify the on-call cardiologist regarding the dysrhythmia and hemodynamic changes.
F) Reassess the patient's lung sounds and oxygen saturation.
RATIONALE
The patient's symptomatic presentation and hemodynamic instability require immediate assessment and notification of the physician; therefore, reassessing lung sounds
and oxygen saturation is indicated, and notifying the cardiologist is crucial for further management decisions. While amiodarone is a potential treatment for PVCs, it
requires physician order and further assessment before administration in this unstable patient.
Page 2
, Q4 QUESTION 4 OF 76
A registered nurse is implementing a new electronic health record (EHR) system designed to streamline medication administration. The system requires
scanning the patient's wristband, the medication package, and the nurse's badge before dispensing and documenting. The nurse notes that this sequence of
actions is significantly increasing the time spent at the patient's bedside for each medication, impacting the timely delivery of scheduled doses by an average
of 15 minutes per patient per shift. This sequential, task-oriented process is impacting the overall efficiency of care delivery by disrupting the established
pattern of activities. The nurse is tasked with optimizing this new process. Which of the following actions should the nurse consider to improve the efficiency
and effectiveness of this system implementation? (Select all that apply.)
A) Documenting the medication administration in the EHR *after* leaving the patient's room to save time at the bedside.
B) Discussing the observed delays and potential workflow bottlenecks with the informatics team or EHR super-user.
C) Recommending a system configuration change that allows for a single scan of the medication and patient wristband, bypassing the nurse badge scan.
D) Training new nursing staff to perform the scanning sequence in a different order, such as scanning the nurse's badge first.
E) Advocating for the return to a paper-based medication administration system to avoid EHR-related delays.
F) Suggesting that nurses administer medications for multiple patients consecutively in one room to reduce the number of room entries and associated
scanning events.
CORRECT ANSWER
B) Discussing the observed delays and potential workflow bottlenecks with the informatics team or EHR super-user.
C) Recommending a system configuration change that allows for a single scan of the medication and patient wristband, bypassing the nurse badge scan.
RATIONALE
Process inefficiencies should be reported to the informatics team for system optimization, and advocating for the removal of redundant steps like the nurse badge scan
can improve workflow directly.
Q5 QUESTION 5 OF 76
A registered nurse is assigned to optimize the electronic health record (EHR) system's medication reconciliation process on a busy medical-surgical unit. The
current workflow involves nurses manually cross-referencing physician orders with the patient’s home medication list. Which actions by the nurse directly
support the observation and documentation of this workflow to identify potential improvements? (Select all that apply.)
A) Shadowing nurses during medication administration to record time spent on reconciliation.
B) Interviewing unit pharmacists about their role in the current medication reconciliation process.
C) Analyzing the EHR's audit trail for frequency of manual order entry versus automated imports.
D) Developing a new standardized order set for common admission diagnoses.
E) Requesting data reports on average patient length of stay for the past fiscal year.
CORRECT ANSWER
A) Shadowing nurses during medication administration to record time spent on reconciliation.
B) Interviewing unit pharmacists about their role in the current medication reconciliation process.
C) Analyzing the EHR's audit trail for frequency of manual order entry versus automated imports.
RATIONALE
Evaluating the existing process by directly observing actions, gathering input from related disciplines, and reviewing system logs are key components of workflow analysis
needed to identify areas for system enhancement. Actions such as developing new order sets or analyzing length of stay data do not directly address the current
reconciliation workflow observation.
Q6 QUESTION 6 OF 76
In the context of evaluating an existing clinical information system's efficiency, which methods are primarily employed to visually represent the flow of patient
data and processes? (Select all that apply.)
A) Gantt charts displaying project timelines
B) Flowcharts detailing sequential steps and decision points
C) Use case diagrams illustrating system interactions
D) Network diagrams showing system architecture
Page 3
