, Question 1
A hospital's nursing quality dashboard shows a rising rate of hospital-acquired
pressure injuries (HAPI) despite stable staffing ratios. Which
informatics-driven action best addresses the underlying data-to-knowledge
gap?
A. Implement a real-time clinical decision support (CDS) alert for
repositioning based on Braden subscale scores.
B. Increase the frequency of manual chart audits for skin assessments.
C. Add a new HAPI indicator to the dashboard without changing
workflow.
D. Replace the Braden Scale with a simpler risk assessment tool.
Correct Answer: A - Implement a real-time clinical decision
support (CDS) alert for repositioning based on Braden subscale
scores.
RATIONALE
The DIKW framework suggests that data (Braden scores) must be
transformed into actionable knowledge. A real-time CDS alert
operationalizes this by integrating patient-specific data into workflow,
prompting timely interventions. Manual audits and dashboard
additions do not close the loop, and replacing a validated tool is not
evidence-based.
Question 2
Which standardized nursing terminology is most appropriate for capturing
nursing-sensitive quality indicator data across multiple EHR systems to enable
benchmarking?
A. ICD-10-CM
B. SNOMED CT
C. NANDA-I
D. LOINC
Page 2
,Correct Answer: B - SNOMED CT
RATIONALE
SNOMED CT is a comprehensive, multilingual clinical healthcare
terminology that enables cross-system interoperability and is used in
the UMLS. It supports nursing diagnoses, interventions, and
outcomes, making it ideal for benchmarking NSQIs. ICD-10-CM is
for billing, NANDA-I is a nursing diagnosis classification not
designed for EHR interoperability, and LOINC is for laboratory and
clinical observations.
Question 3
A nurse leader is comparing the unit's central line-associated bloodstream
infection (CLABSI) rate to the National Database of Nursing Quality
Indicators (NDNQI) benchmark. Which statistical measure best accounts for
varying patient days?
A. Raw number of CLABSI events
B. CLABSI per 1,000 central line days
C. Percentage of patients with CLABSI
D. Average length of stay for CLABSI patients
Correct Answer: B - CLABSI per 1,000 central line days
RATIONALE
NDNQI and other quality benchmarks use rates per 1,000 device days
to normalize for exposure risk. This allows valid comparison across
units with different volumes. Raw counts, percentages, and length of
stay do not adjust for central line days and can mislead.
Question 4
Which data visualization technique is most effective for displaying monthly
variation in a nursing-sensitive indicator alongside a benchmark and control
limits?
Page 3
, A. Pie chart
B. Bar graph
C. Statistical process control (SPC) chart
D. Scatter plot
Correct Answer: C - Statistical process control (SPC) chart
RATIONALE
SPC charts plot data over time with control limits to distinguish
common-cause from special-cause variation, essential for quality
improvement. Pie charts and bar graphs lack temporal control limits,
and scatter plots show correlation, not time-series variation.
Question 5
A nurse informaticist is designing a fall prevention dashboard. Which
nursing-sensitive indicator directly measures the outcome of nursing care?
A. Number of fall risk assessments completed
B. Fall rate per 1,000 patient days
C. Percentage of staff trained in fall prevention
D. Average time to respond to call lights
Correct Answer: B - Fall rate per 1,000 patient days
RATIONALE
Nursing-sensitive indicators reflect the structure, process, and
outcomes of nursing care. Fall rate per 1,000 patient days is an
outcome indicator directly influenced by nursing interventions. The
others are process or structural measures.
Question 6
In the context of the HITECH Act and meaningful use, which criterion most
directly supports nursing-sensitive quality indicator reporting?
A. Computerized provider order entry (CPOE)
B. Electronic prescribing (e-Rx)
Page 4
A hospital's nursing quality dashboard shows a rising rate of hospital-acquired
pressure injuries (HAPI) despite stable staffing ratios. Which
informatics-driven action best addresses the underlying data-to-knowledge
gap?
A. Implement a real-time clinical decision support (CDS) alert for
repositioning based on Braden subscale scores.
B. Increase the frequency of manual chart audits for skin assessments.
C. Add a new HAPI indicator to the dashboard without changing
workflow.
D. Replace the Braden Scale with a simpler risk assessment tool.
Correct Answer: A - Implement a real-time clinical decision
support (CDS) alert for repositioning based on Braden subscale
scores.
RATIONALE
The DIKW framework suggests that data (Braden scores) must be
transformed into actionable knowledge. A real-time CDS alert
operationalizes this by integrating patient-specific data into workflow,
prompting timely interventions. Manual audits and dashboard
additions do not close the loop, and replacing a validated tool is not
evidence-based.
Question 2
Which standardized nursing terminology is most appropriate for capturing
nursing-sensitive quality indicator data across multiple EHR systems to enable
benchmarking?
A. ICD-10-CM
B. SNOMED CT
C. NANDA-I
D. LOINC
Page 2
,Correct Answer: B - SNOMED CT
RATIONALE
SNOMED CT is a comprehensive, multilingual clinical healthcare
terminology that enables cross-system interoperability and is used in
the UMLS. It supports nursing diagnoses, interventions, and
outcomes, making it ideal for benchmarking NSQIs. ICD-10-CM is
for billing, NANDA-I is a nursing diagnosis classification not
designed for EHR interoperability, and LOINC is for laboratory and
clinical observations.
Question 3
A nurse leader is comparing the unit's central line-associated bloodstream
infection (CLABSI) rate to the National Database of Nursing Quality
Indicators (NDNQI) benchmark. Which statistical measure best accounts for
varying patient days?
A. Raw number of CLABSI events
B. CLABSI per 1,000 central line days
C. Percentage of patients with CLABSI
D. Average length of stay for CLABSI patients
Correct Answer: B - CLABSI per 1,000 central line days
RATIONALE
NDNQI and other quality benchmarks use rates per 1,000 device days
to normalize for exposure risk. This allows valid comparison across
units with different volumes. Raw counts, percentages, and length of
stay do not adjust for central line days and can mislead.
Question 4
Which data visualization technique is most effective for displaying monthly
variation in a nursing-sensitive indicator alongside a benchmark and control
limits?
Page 3
, A. Pie chart
B. Bar graph
C. Statistical process control (SPC) chart
D. Scatter plot
Correct Answer: C - Statistical process control (SPC) chart
RATIONALE
SPC charts plot data over time with control limits to distinguish
common-cause from special-cause variation, essential for quality
improvement. Pie charts and bar graphs lack temporal control limits,
and scatter plots show correlation, not time-series variation.
Question 5
A nurse informaticist is designing a fall prevention dashboard. Which
nursing-sensitive indicator directly measures the outcome of nursing care?
A. Number of fall risk assessments completed
B. Fall rate per 1,000 patient days
C. Percentage of staff trained in fall prevention
D. Average time to respond to call lights
Correct Answer: B - Fall rate per 1,000 patient days
RATIONALE
Nursing-sensitive indicators reflect the structure, process, and
outcomes of nursing care. Fall rate per 1,000 patient days is an
outcome indicator directly influenced by nursing interventions. The
others are process or structural measures.
Question 6
In the context of the HITECH Act and meaningful use, which criterion most
directly supports nursing-sensitive quality indicator reporting?
A. Computerized provider order entry (CPOE)
B. Electronic prescribing (e-Rx)
Page 4
