NURSING INFORMATICS AND THE
FOUNDATION OF KNOWLEDGE
6TH EDITION
• AUTHOR(S)DEE MCGONIGLE;
KATHLEEN MASTRIAN
TEST BANK
1.
Reference: Ch. 1 — Foundation of Knowledge Model — DIKW
application
Stem: A nurse uses a continuous heart-rate trend graph from
the EHR to notice a gradual rise in a postop patient's heart rate
over 6 hours. The EHR flags a pulse-rate alert but no single
reading has crossed thresholds. Which action best represents
moving from information to knowledge in the DIKW model?
A. Document the highest heart rate as a problem in the chart.
B. Combine trend data with pain scores, medication times, and
fluid status to infer probable pain-related tachycardia.
C. Ignore the trend because individual readings are within
normal limits.
,D. Increase frequency of vital-sign checks without interpreting
cause.
Correct Answer: B
Rationale (Correct): Integrating multiple information elements
(trends, pain, meds, fluids) to form an explanatory
understanding demonstrates transformation of information into
knowledge; it supports clinical reasoning and informs an
intervention. This aligns with DIKW where context and synthesis
create knowledge.
Incorrect A: Recording a single value is data/information
capture only; it doesn't synthesize meaning.
Incorrect C: Dismissing trends ignores emergent knowledge
from aggregated information and risks delayed response.
Incorrect D: More data collection without interpretation
postpones knowledge generation and may compromise timely
care.
Teaching Point: Synthesis of contextual data creates actionable
knowledge from information.
Citation: McGonigle, D., & Mastrian, K. (2022). Nursing
Informatics and the Foundation of Knowledge (6th ed.). Ch. 1.
2.
Reference: Ch. 1 — The Nurse as a Knowledge Worker —
Workflow integration
Stem: An inpatient unit adds a new CDS pathway that suggests
,fluid bolus for tachycardic patients with hypotension. A charge
nurse notices frequent inappropriate suggestions for patients
whose tachycardia is due to beta-agonist therapy. What should
the nurse do first to improve system usefulness?
A. Disable the CDS pathway for the unit.
B. Report cases and request a rules review with clinical
informatics to refine triggers.
C. Ignore the CDS and continue current practice.
D. Manually override each suggestion without documenting
errors.
Correct Answer: B
Rationale (Correct): Knowledge workers (nurses) should engage
with informatics teams to refine decision rules; reporting real-
world mismatches leads to system improvement and safer,
context-aware CDS. This reflects systems thinking and the
nurse’s role in shaping knowledge artifacts.
Incorrect A: Disabling the tool removes potential benefit for
appropriate cases and avoids collaborative improvement.
Incorrect C: Ignoring reduces patient-safety feedback loops and
undermines continuous quality improvement.
Incorrect D: Frequent manual overrides without system-level
reporting fails to correct underlying rule issues and risks
inconsistent care.
Teaching Point: Nurses must report CDS mismatches to improve
rule accuracy and safety.
Citation: McGonigle, D., & Mastrian (2022). Ch. 1.
, 3.
Reference: Ch. 1 — The Nature of Knowledge — Tacit vs.
explicit knowledge
Stem: A new nurse struggles to interpret a complex wound-
assessment template in the EHR. A senior nurse mentors them,
sharing heuristics and pattern-recognition tips learned over
years. Which knowledge form is the senior nurse primarily
transferring?
A. Explicit knowledge through standardized templates.
B. Tacit knowledge via experiential heuristics and judgment.
C. Data captured in structured fields.
D. System code for wound scoring.
Correct Answer: B
Rationale (Correct): Heuristics and pattern recognition based
on experience are tacit knowledge—hard to codify but essential
to clinical judgment; mentorship helps convert tacit insights into
usable practice.
Incorrect A: Templates are explicit knowledge artifacts, not the
informal experiential tips described.
Incorrect C: Data are raw entries, not interpretive experience.
Incorrect D: System code is technical, not experiential
mentorship.
Teaching Point: Tacit knowledge is experience-based and often
shared through mentorship.
Citation: McGonigle & Mastrian (2022). Ch. 1.
FOUNDATION OF KNOWLEDGE
6TH EDITION
• AUTHOR(S)DEE MCGONIGLE;
KATHLEEN MASTRIAN
TEST BANK
1.
Reference: Ch. 1 — Foundation of Knowledge Model — DIKW
application
Stem: A nurse uses a continuous heart-rate trend graph from
the EHR to notice a gradual rise in a postop patient's heart rate
over 6 hours. The EHR flags a pulse-rate alert but no single
reading has crossed thresholds. Which action best represents
moving from information to knowledge in the DIKW model?
A. Document the highest heart rate as a problem in the chart.
B. Combine trend data with pain scores, medication times, and
fluid status to infer probable pain-related tachycardia.
C. Ignore the trend because individual readings are within
normal limits.
,D. Increase frequency of vital-sign checks without interpreting
cause.
Correct Answer: B
Rationale (Correct): Integrating multiple information elements
(trends, pain, meds, fluids) to form an explanatory
understanding demonstrates transformation of information into
knowledge; it supports clinical reasoning and informs an
intervention. This aligns with DIKW where context and synthesis
create knowledge.
Incorrect A: Recording a single value is data/information
capture only; it doesn't synthesize meaning.
Incorrect C: Dismissing trends ignores emergent knowledge
from aggregated information and risks delayed response.
Incorrect D: More data collection without interpretation
postpones knowledge generation and may compromise timely
care.
Teaching Point: Synthesis of contextual data creates actionable
knowledge from information.
Citation: McGonigle, D., & Mastrian, K. (2022). Nursing
Informatics and the Foundation of Knowledge (6th ed.). Ch. 1.
2.
Reference: Ch. 1 — The Nurse as a Knowledge Worker —
Workflow integration
Stem: An inpatient unit adds a new CDS pathway that suggests
,fluid bolus for tachycardic patients with hypotension. A charge
nurse notices frequent inappropriate suggestions for patients
whose tachycardia is due to beta-agonist therapy. What should
the nurse do first to improve system usefulness?
A. Disable the CDS pathway for the unit.
B. Report cases and request a rules review with clinical
informatics to refine triggers.
C. Ignore the CDS and continue current practice.
D. Manually override each suggestion without documenting
errors.
Correct Answer: B
Rationale (Correct): Knowledge workers (nurses) should engage
with informatics teams to refine decision rules; reporting real-
world mismatches leads to system improvement and safer,
context-aware CDS. This reflects systems thinking and the
nurse’s role in shaping knowledge artifacts.
Incorrect A: Disabling the tool removes potential benefit for
appropriate cases and avoids collaborative improvement.
Incorrect C: Ignoring reduces patient-safety feedback loops and
undermines continuous quality improvement.
Incorrect D: Frequent manual overrides without system-level
reporting fails to correct underlying rule issues and risks
inconsistent care.
Teaching Point: Nurses must report CDS mismatches to improve
rule accuracy and safety.
Citation: McGonigle, D., & Mastrian (2022). Ch. 1.
, 3.
Reference: Ch. 1 — The Nature of Knowledge — Tacit vs.
explicit knowledge
Stem: A new nurse struggles to interpret a complex wound-
assessment template in the EHR. A senior nurse mentors them,
sharing heuristics and pattern-recognition tips learned over
years. Which knowledge form is the senior nurse primarily
transferring?
A. Explicit knowledge through standardized templates.
B. Tacit knowledge via experiential heuristics and judgment.
C. Data captured in structured fields.
D. System code for wound scoring.
Correct Answer: B
Rationale (Correct): Heuristics and pattern recognition based
on experience are tacit knowledge—hard to codify but essential
to clinical judgment; mentorship helps convert tacit insights into
usable practice.
Incorrect A: Templates are explicit knowledge artifacts, not the
informal experiential tips described.
Incorrect C: Data are raw entries, not interpretive experience.
Incorrect D: System code is technical, not experiential
mentorship.
Teaching Point: Tacit knowledge is experience-based and often
shared through mentorship.
Citation: McGonigle & Mastrian (2022). Ch. 1.
