Nursing Informatics: Final Exam (Comprehensive) - Questions
with Correct Answers
100 questions
1. Electronic prescribing of controlled substances (EPCS) requires:
A. No identification
B. Additional security such as two-factor authentication for prescribers
C. Prescriptions sent by personal text message
D. Paper backup copies for all orders
Correct Answer: B. Additional security such as two-factor authentication for prescribers
Rationale: DEA rules require identity proofing and two-factor authentication to prevent
diversion. Texting and lack of identification are not permitted.
2. Charting by exception in an EHR means that the nurse:
A. Documents nothing at all
B. Writes long narratives for every normal finding
C. Charts only when the patient is discharged
D. Documents only findings that deviate from established normal parameters
Correct Answer: D. Documents only findings that deviate from established normal parameters
Rationale: Charting by exception reduces redundancy but requires clear defined norms and
policies. It still requires documentation of abnormal findings and care provided.
3. Because patients may read their notes immediately, nurses should document:
A. Using slang and abbreviations
B. Personal opinions about the patient's character
C. Objectively and respectfully, avoiding stigmatizing language
D. Less information
Correct Answer: C. Objectively and respectfully, avoiding stigmatizing language
Rationale: Respectful, factual documentation supports trust and accuracy. Stigmatizing
language can harm relationships and bias other clinicians.
,4. Structural (syntactic) interoperability refers to:
A. Shared building architecture
B. Exchange of handwritten notes
C. A common format and structure for data exchange so fields can be interpreted at the data
field level
D. Organizational policies only
Correct Answer: C. A common format and structure for data exchange so fields can be
interpreted at the data field level
Rationale: Messaging standards such as HL7 define structure so the receiving system can parse
data. Policies and governance relate to organizational interoperability.
5. The United States Core Data for Interoperability (USCDI) is:
A. A medical school curriculum
B. A drug formulary
C. A type of computer
D. A standardized set of health data classes and elements required for nationwide exchange
Correct Answer: D. A standardized set of health data classes and elements required for
nationwide exchange
Rationale: USCDI defines the data, such as allergies, medications, problems and clinical notes,
that certified systems must support, and it is updated in versions. It is not a curriculum or
formulary.
6. An interruptive alert that requires a response before the clinician can continue is described as:
A. Passive CDS
B. A reference library
C. Active (interruptive) CDS
D. A dashboard
Correct Answer: C. Active (interruptive) CDS
Rationale: Interruptive alerts demand attention, so they should be reserved for important
situations. Passive CDS, such as reference links, is available without interrupting work.
,7. Predictive analytics in CDS differs from traditional alerts because it:
A. Only reports past events
B. Estimates the likelihood of future events, such as deterioration or readmission
C. Cannot use patient data
D. Is always correct
Correct Answer: B. Estimates the likelihood of future events, such as deterioration or
readmission
Rationale: Predictive models forecast risk to allow earlier intervention, but they can be wrong
and need monitoring. Traditional alerts often respond to current values.
8. Electronic hand hygiene monitoring systems use sensors on dispensers and badges to:
A. Disinfect hands automatically
B. Diagnose infections
C. Measure compliance with hand hygiene opportunities and provide feedback to staff
D. Replace infection control nurses
Correct Answer: C. Measure compliance with hand hygiene opportunities and provide
feedback to staff
Rationale: Automated monitoring captures far more opportunities than direct observation and
supports improvement efforts. It does not clean hands, diagnose infection or replace infection
prevention staff.
9. BCMA cannot prevent which type of error?
A. Giving a drug to the wrong patient
B. An incorrect medication order that was entered and verified, because the scan matches the
wrong order
C. Giving the wrong drug when scanned
D. Giving a dose at the wrong time
Correct Answer: B. An incorrect medication order that was entered and verified, because the
scan matches the wrong order
Rationale: BCMA checks administration against the order, so an incorrect order will match.
Prescribing and verification errors need other safeguards.
, 10. When state privacy laws are more protective than HIPAA:
A. HIPAA always overrides them
B. Neither applies
C. Hospitals may choose either
D. The more stringent state law generally applies
Correct Answer: D. The more stringent state law generally applies
Rationale: HIPAA sets a federal floor, and more protective state laws, such as those for mental
health or minors, take precedence.
11. Confidential information about a minor, such as reproductive health services the minor
consented to, may be:
A. Protected from parental access depending on state law
B. Always shared with parents
C. Posted publicly
D. Shared with schools automatically
Correct Answer: A. Protected from parental access depending on state law
Rationale: Many states protect certain services minors can consent to, and portals may restrict
proxy access accordingly. Automatic sharing can violate law and deter care.
12. Post-implementation optimization focuses on:
A. Removing the system
B. Stopping all support
C. Refining the system and workflows based on user feedback and performance data after
go-live
D. Ignoring user feedback
Correct Answer: C. Refining the system and workflows based on user feedback and
performance data after go-live
Rationale: Optimization improves efficiency and safety once the system is in use. Ignoring
feedback leaves problems unresolved.
with Correct Answers
100 questions
1. Electronic prescribing of controlled substances (EPCS) requires:
A. No identification
B. Additional security such as two-factor authentication for prescribers
C. Prescriptions sent by personal text message
D. Paper backup copies for all orders
Correct Answer: B. Additional security such as two-factor authentication for prescribers
Rationale: DEA rules require identity proofing and two-factor authentication to prevent
diversion. Texting and lack of identification are not permitted.
2. Charting by exception in an EHR means that the nurse:
A. Documents nothing at all
B. Writes long narratives for every normal finding
C. Charts only when the patient is discharged
D. Documents only findings that deviate from established normal parameters
Correct Answer: D. Documents only findings that deviate from established normal parameters
Rationale: Charting by exception reduces redundancy but requires clear defined norms and
policies. It still requires documentation of abnormal findings and care provided.
3. Because patients may read their notes immediately, nurses should document:
A. Using slang and abbreviations
B. Personal opinions about the patient's character
C. Objectively and respectfully, avoiding stigmatizing language
D. Less information
Correct Answer: C. Objectively and respectfully, avoiding stigmatizing language
Rationale: Respectful, factual documentation supports trust and accuracy. Stigmatizing
language can harm relationships and bias other clinicians.
,4. Structural (syntactic) interoperability refers to:
A. Shared building architecture
B. Exchange of handwritten notes
C. A common format and structure for data exchange so fields can be interpreted at the data
field level
D. Organizational policies only
Correct Answer: C. A common format and structure for data exchange so fields can be
interpreted at the data field level
Rationale: Messaging standards such as HL7 define structure so the receiving system can parse
data. Policies and governance relate to organizational interoperability.
5. The United States Core Data for Interoperability (USCDI) is:
A. A medical school curriculum
B. A drug formulary
C. A type of computer
D. A standardized set of health data classes and elements required for nationwide exchange
Correct Answer: D. A standardized set of health data classes and elements required for
nationwide exchange
Rationale: USCDI defines the data, such as allergies, medications, problems and clinical notes,
that certified systems must support, and it is updated in versions. It is not a curriculum or
formulary.
6. An interruptive alert that requires a response before the clinician can continue is described as:
A. Passive CDS
B. A reference library
C. Active (interruptive) CDS
D. A dashboard
Correct Answer: C. Active (interruptive) CDS
Rationale: Interruptive alerts demand attention, so they should be reserved for important
situations. Passive CDS, such as reference links, is available without interrupting work.
,7. Predictive analytics in CDS differs from traditional alerts because it:
A. Only reports past events
B. Estimates the likelihood of future events, such as deterioration or readmission
C. Cannot use patient data
D. Is always correct
Correct Answer: B. Estimates the likelihood of future events, such as deterioration or
readmission
Rationale: Predictive models forecast risk to allow earlier intervention, but they can be wrong
and need monitoring. Traditional alerts often respond to current values.
8. Electronic hand hygiene monitoring systems use sensors on dispensers and badges to:
A. Disinfect hands automatically
B. Diagnose infections
C. Measure compliance with hand hygiene opportunities and provide feedback to staff
D. Replace infection control nurses
Correct Answer: C. Measure compliance with hand hygiene opportunities and provide
feedback to staff
Rationale: Automated monitoring captures far more opportunities than direct observation and
supports improvement efforts. It does not clean hands, diagnose infection or replace infection
prevention staff.
9. BCMA cannot prevent which type of error?
A. Giving a drug to the wrong patient
B. An incorrect medication order that was entered and verified, because the scan matches the
wrong order
C. Giving the wrong drug when scanned
D. Giving a dose at the wrong time
Correct Answer: B. An incorrect medication order that was entered and verified, because the
scan matches the wrong order
Rationale: BCMA checks administration against the order, so an incorrect order will match.
Prescribing and verification errors need other safeguards.
, 10. When state privacy laws are more protective than HIPAA:
A. HIPAA always overrides them
B. Neither applies
C. Hospitals may choose either
D. The more stringent state law generally applies
Correct Answer: D. The more stringent state law generally applies
Rationale: HIPAA sets a federal floor, and more protective state laws, such as those for mental
health or minors, take precedence.
11. Confidential information about a minor, such as reproductive health services the minor
consented to, may be:
A. Protected from parental access depending on state law
B. Always shared with parents
C. Posted publicly
D. Shared with schools automatically
Correct Answer: A. Protected from parental access depending on state law
Rationale: Many states protect certain services minors can consent to, and portals may restrict
proxy access accordingly. Automatic sharing can violate law and deter care.
12. Post-implementation optimization focuses on:
A. Removing the system
B. Stopping all support
C. Refining the system and workflows based on user feedback and performance data after
go-live
D. Ignoring user feedback
Correct Answer: C. Refining the system and workflows based on user feedback and
performance data after go-live
Rationale: Optimization improves efficiency and safety once the system is in use. Ignoring
feedback leaves problems unresolved.
