WGU D220 – Nursing Informatics for Nursing
Practice
Verified Questions and Correct Answers | Graded A+ | 2026/2027 Edition
Aligned with WGU D220 Course Competencies and High-Stakes Proctored Assessment Blueprint | Comprehensive
Nursing Informatics Examination
Total Questions: 80 (Multiple Choice, 4 options each)
Cognitive Distribution: 25% Recall • 55% Application • 20% Analysis
Question Style: 80% Scenario-based • 20% Direct recall/terminology
Sections: 8 NI domain areas (Foundations → Emerging Tech)
Format: Question → A-D options → Correct Answer → Rationale
WGU D220 Course Competencies and High-Stakes Proctored Assessment
Aligned With:
Blueprint
Sections Covered
• Section 1: Foundations and Theoretical Frameworks — Definitions, DIKW Framework, History, Systems
Theory, and Practice Models (Q1-12)
• Section 2: Health Information Systems and Clinical Technologies — EHR, EMR, PHR, CPOE, CDSS, HIE,
Telehealth, mHealth, and Nursing Documentation Systems (Q13-25)
• Section 3: Standardized Terminologies and Classification Systems — SNOMED-CT, ICD-10-CM/PCS,
LOINC, CPT, RxNorm, NANDA-I, NIC, NOC, CCC, and Omaha System (Q26-35)
• Section 4: Data Management, Governance, and Information Literacy — Data Quality, Integrity, Governance,
Analytics, Visualization, and Information Literacy (Q36-45)
• Section 5: Informatics Competencies and Professional Practice — TIGER, QSEN, ANA Scope/Standards,
Certification, Informatics Nurse Roles, and Interprofessional Collaboration (Q46-55)
• Section 6: Legal, Ethical, and Regulatory Compliance — HIPAA, HITECH, Meaningful Use, MACRA, MIPS,
Privacy, Security, Breach Notification, and Ethical Decision-Making (Q56-65)
• Section 7: Quality Improvement, Patient Safety, and Evidence-Based Practice — CDSS, Data Analytics,
Patient Safety, Error Reduction, QI Methodologies, and EBP Integration (Q66-75)
• Section 8: Emerging Technologies and Future Trends — Artificial Intelligence, Machine Learning, Predictive
Analytics, Big Data, Genomics Informatics, and Population Health (Q76-80)
WGU Nursing Informatics Page 1 D220 High-Stakes Assessment
,WGU D220 – Nursing Informatics | Verified Q&A | Graded A+ 2026/2027 Edition
Examination Instructions: Each question has one best answer. Carefully read each scenario or definition,
identify the nursing informatics principle, theory, or terminology involved, then read all four options
completely before selecting. Rationales explain the correct answer and clarify why the distractors are
incorrect, with reference to the DIKW framework, ANA Scope and Standards, TIGER/QSEN competencies,
HIPAA/HITECH regulations, standardized terminologies, evidence-based practice, and quality/safety
principles. Use this practice exam as a self-assessment tool aligned with WGU D220 course competencies.
Section 1: Foundations and Theoretical Frameworks
Definitions, DIKW Framework, History, Systems Theory, and Practice Models (Q1-12)
Q1: A nurse manager explains to new staff that nursing informatics integrates three core sciences to
support nursing practice. According to the American Nurses Association (ANA) definition, which three
sciences are integrated?
A. Biology, chemistry, and pharmacology.
B. Nursing science, computer science, and information science to manage and communicate data,
information, knowledge, and wisdom in nursing practice. [CORRECT]
C. Healthcare administration, finance, and operations management.
D. Medicine, engineering, and biostatistics.
Correct Answer: B
Rationale:
The ANA defines nursing informatics as a specialty that integrates nursing science, computer science,
and information science to manage and communicate data, information, knowledge, and wisdom in
nursing practice. This definition emphasizes the synthesis of three distinct disciplines, not a single
domain. Option A reflects basic clinical sciences; Option C reflects healthcare administration; Option
D reflects medical and engineering sciences. The integration of these three sciences enables nurses to
manage information effectively, support clinical decision-making, and improve patient outcomes
through technology.
Q2: A nurse is caring for a patient with a heart rate of 130 beats/minute displayed on the cardiac
monitor. Using the DIKW framework, what does this heart rate value best represent?
A. Information, because it has been processed and contextualized.
B. Knowledge, because the nurse applies clinical expertise to interpret it.
C. Data, because it is a discrete, unprocessed objective fact. [CORRECT]
D. Wisdom, because it represents the appropriate clinical action.
Correct Answer: C
Rationale:
WGU Nursing Informatics Page 2 D220 High-Stakes Assessment
,WGU D220 – Nursing Informatics | Verified Q&A | Graded A+ 2026/2027 Edition
In the DIKW framework (Data → Information → Knowledge → Wisdom), data are discrete,
unprocessed facts without context (e.g., a numeric value like heart rate 130). Information is processed
data with context (e.g., 'The patient's heart rate is 130 bpm, which is tachycardic'). Knowledge is
synthesized information combined with clinical expertise (e.g., recognizing tachycardia may indicate
hypovolemia, fever, or arrhythmia). Wisdom is the appropriate application of knowledge to make
sound clinical decisions (e.g., administering fluids for hypovolemic tachycardia). The isolated numeric
value is data, not information.
Q3: A nurse reviews a patient's electronic health record and notes: blood pressure 90/50 mmHg, heart
rate 110 bpm, respiratory rate 24, and lethargy. The nurse recognizes these findings together suggest
hypovolemic shock and initiates the sepsis protocol. Which level of the DIKW framework does the
nurse's interpretation represent?
A. Data, because the values are raw numbers.
B. Information, because the values are displayed together.
C. Knowledge, because the nurse synthesizes the findings with clinical expertise to recognize a pattern
indicating hypovolemic shock. [CORRECT]
D. Wisdom, because the nurse administers fluids.
Correct Answer: C
Rationale:
Knowledge is the synthesis of information with clinical expertise, professional experience, and
evidence-based guidelines to recognize patterns and derive meaning. The nurse combined the abnormal
vital signs (information) with clinical knowledge of shock patterns (knowledge) to identify
hypovolemic shock. Data (Option A) are the raw values. Information (Option B) is the contextualized
display. Wisdom (Option D) would be the appropriate action taken based on that knowledge, such as
administering fluids or activating the sepsis protocol — the question asks about the interpretation step,
which is knowledge.
Q4: A nurse informaticist is designing an educational module to teach staff about the appropriate use of
clinical alerts. The informaticist demonstrates wisdom in the DIKW framework by:
A. Showing staff how to read the alert data (data level).
B. Displaying all patient vital signs together on one screen (information level).
C. Teaching staff to recognize patterns of deterioration (knowledge level).
D. Designing the alert system to deliver the right information to the right person at the right time to
support the best clinical decision, considering ethical, legal, and contextual factors. [CORRECT]
Correct Answer: D
Rationale:
WGU Nursing Informatics Page 3 D220 High-Stakes Assessment
, WGU D220 – Nursing Informatics | Verified Q&A | Graded A+ 2026/2027 Edition
Wisdom is the highest level of the DIKW framework and represents the appropriate, ethical application
of knowledge to make sound decisions. It involves judgment, values, and contextual understanding.
The informaticist who designs an alert system to deliver the right information to the right person at the
right time, considering ethical, legal, and contextual factors, demonstrates wisdom. Options A, B, and
C represent data, information, and knowledge levels, respectively. Wisdom integrates all lower levels
with judgment and values to optimize care.
Q5: A nurse educator is describing the historical evolution of nursing informatics. Which event is
correctly identified as a key milestone in the 1960s that contributed to the early development of the field?
A. The American Nurses Association formally recognized nursing informatics as a specialty (1992).
B. The development of early hospital information systems and the application of computer technology to
healthcare operations, including patient registration and billing. [CORRECT]
C. The Health Information Technology for Economic and Clinical Health (HITECH) Act was passed.
D. The first certification exam for nursing informatics was administered.
Correct Answer: B
Rationale:
The 1960s marked the early development of hospital information systems that applied computer
technology to administrative functions such as patient registration, billing, and basic data management.
This era laid the foundation for later clinical applications. ANA formally recognized nursing
informatics as a specialty in 1992 (Option A), the HITECH Act was passed in 2009 (Option C), and the
first informatics certification exam was administered in 1995 (Option D). The historical trajectory
spans from administrative systems (1960s) to clinical systems (1980s) to meaningful use (2010s) to AI
and interoperability (current).
Q6: A hospital is implementing a new electronic health record system. The informatics team applies
systems theory to plan the implementation. According to systems theory, which principle is most
important to consider?
A. The system should be implemented in isolation from other organizational units to avoid disruption.
B. The system is composed of interrelated subsystems (people, processes, technology) that interact and
affect each other, so changes in one subsystem will impact the others. [CORRECT]
C. Only the technical components need to be considered; human factors are secondary.
D. Systems theory is irrelevant to EHR implementation.
Correct Answer: B
Rationale:
WGU Nursing Informatics Page 4 D220 High-Stakes Assessment
Practice
Verified Questions and Correct Answers | Graded A+ | 2026/2027 Edition
Aligned with WGU D220 Course Competencies and High-Stakes Proctored Assessment Blueprint | Comprehensive
Nursing Informatics Examination
Total Questions: 80 (Multiple Choice, 4 options each)
Cognitive Distribution: 25% Recall • 55% Application • 20% Analysis
Question Style: 80% Scenario-based • 20% Direct recall/terminology
Sections: 8 NI domain areas (Foundations → Emerging Tech)
Format: Question → A-D options → Correct Answer → Rationale
WGU D220 Course Competencies and High-Stakes Proctored Assessment
Aligned With:
Blueprint
Sections Covered
• Section 1: Foundations and Theoretical Frameworks — Definitions, DIKW Framework, History, Systems
Theory, and Practice Models (Q1-12)
• Section 2: Health Information Systems and Clinical Technologies — EHR, EMR, PHR, CPOE, CDSS, HIE,
Telehealth, mHealth, and Nursing Documentation Systems (Q13-25)
• Section 3: Standardized Terminologies and Classification Systems — SNOMED-CT, ICD-10-CM/PCS,
LOINC, CPT, RxNorm, NANDA-I, NIC, NOC, CCC, and Omaha System (Q26-35)
• Section 4: Data Management, Governance, and Information Literacy — Data Quality, Integrity, Governance,
Analytics, Visualization, and Information Literacy (Q36-45)
• Section 5: Informatics Competencies and Professional Practice — TIGER, QSEN, ANA Scope/Standards,
Certification, Informatics Nurse Roles, and Interprofessional Collaboration (Q46-55)
• Section 6: Legal, Ethical, and Regulatory Compliance — HIPAA, HITECH, Meaningful Use, MACRA, MIPS,
Privacy, Security, Breach Notification, and Ethical Decision-Making (Q56-65)
• Section 7: Quality Improvement, Patient Safety, and Evidence-Based Practice — CDSS, Data Analytics,
Patient Safety, Error Reduction, QI Methodologies, and EBP Integration (Q66-75)
• Section 8: Emerging Technologies and Future Trends — Artificial Intelligence, Machine Learning, Predictive
Analytics, Big Data, Genomics Informatics, and Population Health (Q76-80)
WGU Nursing Informatics Page 1 D220 High-Stakes Assessment
,WGU D220 – Nursing Informatics | Verified Q&A | Graded A+ 2026/2027 Edition
Examination Instructions: Each question has one best answer. Carefully read each scenario or definition,
identify the nursing informatics principle, theory, or terminology involved, then read all four options
completely before selecting. Rationales explain the correct answer and clarify why the distractors are
incorrect, with reference to the DIKW framework, ANA Scope and Standards, TIGER/QSEN competencies,
HIPAA/HITECH regulations, standardized terminologies, evidence-based practice, and quality/safety
principles. Use this practice exam as a self-assessment tool aligned with WGU D220 course competencies.
Section 1: Foundations and Theoretical Frameworks
Definitions, DIKW Framework, History, Systems Theory, and Practice Models (Q1-12)
Q1: A nurse manager explains to new staff that nursing informatics integrates three core sciences to
support nursing practice. According to the American Nurses Association (ANA) definition, which three
sciences are integrated?
A. Biology, chemistry, and pharmacology.
B. Nursing science, computer science, and information science to manage and communicate data,
information, knowledge, and wisdom in nursing practice. [CORRECT]
C. Healthcare administration, finance, and operations management.
D. Medicine, engineering, and biostatistics.
Correct Answer: B
Rationale:
The ANA defines nursing informatics as a specialty that integrates nursing science, computer science,
and information science to manage and communicate data, information, knowledge, and wisdom in
nursing practice. This definition emphasizes the synthesis of three distinct disciplines, not a single
domain. Option A reflects basic clinical sciences; Option C reflects healthcare administration; Option
D reflects medical and engineering sciences. The integration of these three sciences enables nurses to
manage information effectively, support clinical decision-making, and improve patient outcomes
through technology.
Q2: A nurse is caring for a patient with a heart rate of 130 beats/minute displayed on the cardiac
monitor. Using the DIKW framework, what does this heart rate value best represent?
A. Information, because it has been processed and contextualized.
B. Knowledge, because the nurse applies clinical expertise to interpret it.
C. Data, because it is a discrete, unprocessed objective fact. [CORRECT]
D. Wisdom, because it represents the appropriate clinical action.
Correct Answer: C
Rationale:
WGU Nursing Informatics Page 2 D220 High-Stakes Assessment
,WGU D220 – Nursing Informatics | Verified Q&A | Graded A+ 2026/2027 Edition
In the DIKW framework (Data → Information → Knowledge → Wisdom), data are discrete,
unprocessed facts without context (e.g., a numeric value like heart rate 130). Information is processed
data with context (e.g., 'The patient's heart rate is 130 bpm, which is tachycardic'). Knowledge is
synthesized information combined with clinical expertise (e.g., recognizing tachycardia may indicate
hypovolemia, fever, or arrhythmia). Wisdom is the appropriate application of knowledge to make
sound clinical decisions (e.g., administering fluids for hypovolemic tachycardia). The isolated numeric
value is data, not information.
Q3: A nurse reviews a patient's electronic health record and notes: blood pressure 90/50 mmHg, heart
rate 110 bpm, respiratory rate 24, and lethargy. The nurse recognizes these findings together suggest
hypovolemic shock and initiates the sepsis protocol. Which level of the DIKW framework does the
nurse's interpretation represent?
A. Data, because the values are raw numbers.
B. Information, because the values are displayed together.
C. Knowledge, because the nurse synthesizes the findings with clinical expertise to recognize a pattern
indicating hypovolemic shock. [CORRECT]
D. Wisdom, because the nurse administers fluids.
Correct Answer: C
Rationale:
Knowledge is the synthesis of information with clinical expertise, professional experience, and
evidence-based guidelines to recognize patterns and derive meaning. The nurse combined the abnormal
vital signs (information) with clinical knowledge of shock patterns (knowledge) to identify
hypovolemic shock. Data (Option A) are the raw values. Information (Option B) is the contextualized
display. Wisdom (Option D) would be the appropriate action taken based on that knowledge, such as
administering fluids or activating the sepsis protocol — the question asks about the interpretation step,
which is knowledge.
Q4: A nurse informaticist is designing an educational module to teach staff about the appropriate use of
clinical alerts. The informaticist demonstrates wisdom in the DIKW framework by:
A. Showing staff how to read the alert data (data level).
B. Displaying all patient vital signs together on one screen (information level).
C. Teaching staff to recognize patterns of deterioration (knowledge level).
D. Designing the alert system to deliver the right information to the right person at the right time to
support the best clinical decision, considering ethical, legal, and contextual factors. [CORRECT]
Correct Answer: D
Rationale:
WGU Nursing Informatics Page 3 D220 High-Stakes Assessment
, WGU D220 – Nursing Informatics | Verified Q&A | Graded A+ 2026/2027 Edition
Wisdom is the highest level of the DIKW framework and represents the appropriate, ethical application
of knowledge to make sound decisions. It involves judgment, values, and contextual understanding.
The informaticist who designs an alert system to deliver the right information to the right person at the
right time, considering ethical, legal, and contextual factors, demonstrates wisdom. Options A, B, and
C represent data, information, and knowledge levels, respectively. Wisdom integrates all lower levels
with judgment and values to optimize care.
Q5: A nurse educator is describing the historical evolution of nursing informatics. Which event is
correctly identified as a key milestone in the 1960s that contributed to the early development of the field?
A. The American Nurses Association formally recognized nursing informatics as a specialty (1992).
B. The development of early hospital information systems and the application of computer technology to
healthcare operations, including patient registration and billing. [CORRECT]
C. The Health Information Technology for Economic and Clinical Health (HITECH) Act was passed.
D. The first certification exam for nursing informatics was administered.
Correct Answer: B
Rationale:
The 1960s marked the early development of hospital information systems that applied computer
technology to administrative functions such as patient registration, billing, and basic data management.
This era laid the foundation for later clinical applications. ANA formally recognized nursing
informatics as a specialty in 1992 (Option A), the HITECH Act was passed in 2009 (Option C), and the
first informatics certification exam was administered in 1995 (Option D). The historical trajectory
spans from administrative systems (1960s) to clinical systems (1980s) to meaningful use (2010s) to AI
and interoperability (current).
Q6: A hospital is implementing a new electronic health record system. The informatics team applies
systems theory to plan the implementation. According to systems theory, which principle is most
important to consider?
A. The system should be implemented in isolation from other organizational units to avoid disruption.
B. The system is composed of interrelated subsystems (people, processes, technology) that interact and
affect each other, so changes in one subsystem will impact the others. [CORRECT]
C. Only the technical components need to be considered; human factors are secondary.
D. Systems theory is irrelevant to EHR implementation.
Correct Answer: B
Rationale:
WGU Nursing Informatics Page 4 D220 High-Stakes Assessment
