WGU D220: INFORMATION
TECHNOLOGY IN NURSING PRACTICE –
2026/2027 MASTERY GUIDE &
PRACTICE EXAM
PART 1: ESSENTIAL INFORMATICS CONCEPTS
SUMMARY
Domain A: Foundations of Nursing Informatics
● Definition: Nursing informatics integrates nursing science with information and
analytical sciences to identify, define, manage, and communicate data, information,
knowledge, and wisdom in nursing practice.
● Nurse Informaticist Roles: Facilitate EHR implementation, design clinical
workflows, train staff, ensure system usability, and support evidence-based practice
through data analysis.
● DIKW Model:
○ Data: Raw facts (e.g., patient temperature = 101.2°F)
○ Information: Organized data with context (e.g., fever noted at 3 PM post-op)
○ Knowledge: Synthesis of information to guide action (e.g., fever may indicate
infection)
○ Wisdom: Application of knowledge ethically for patient benefit (e.g., initiating
sepsis protocol)
● ANA Scope & Standards (2026): Emphasizes informatics competencies for all
nurses, including data literacy, system evaluation, and ethical use of technology.
● Impact on Nursing: Enhances clinical decision-making, reduces errors, supports
documentation efficiency, and enables population health management.
Domain B: Healthcare Information Systems (HIS)
● EHR vs. EMR: EMR = digital chart within one organization; EHR = interoperable
record sharing across settings (per ONC 2026 standards).
● PHR: Patient-controlled health record (e.g., Apple Health, MyChart PHR module).
● CDSS: Provides real-time alerts (e.g., drug-allergy interactions, sepsis prediction);
must be evidence-based and non-intrusive.
● CPOE: Eliminates handwritten orders; reduces medication errors by 55% (AHRQ,
2026).
● BCMA: Scans patient wristband and medication barcode before administration—part
of the "Five Rights" verification.
, ● Pharmacy Systems: Integrate with CPOE for dose checking, formulary compliance,
and automated dispensing.
● Telehealth Platforms: HIPAA-compliant video/conferencing tools (e.g., Zoom for
Healthcare, Doxy.me) enabling remote assessments and chronic disease
management.
Domain C: Data, Information, & Knowledge Management
● Data Integrity: Requires accuracy (correct values), timeliness (real-time entry),
completeness (all required fields), and consistency (standardized terms, e.g.,
SNOMED CT, LOINC).
● Databases: Structured collections (e.g., SQL) storing patient data; relational
databases link tables (e.g., patient → medications).
● Data Warehousing: Central repository for aggregated, historical data from multiple
sources for reporting and analytics.
● Data Mining: Using algorithms to discover patterns (e.g., predicting hospital
readmissions).
● EBP Integration: Nurses use dashboards and clinical registries to access current
evidence and benchmark outcomes.
Domain D: Privacy, Security, & Ethical/Legal Compliance
● HIPAA Privacy Rule: Governs use/disclosure of PHI; requires patient consent for
non-treatment uses.
● HIPAA Security Rule: Mandates administrative, physical, and technical safeguards
for electronic PHI (ePHI).
● PHI Examples: Name, DOB, MRN, diagnosis, lab results—18 identifiers under
HIPAA.
● Authentication: Multi-factor (e.g., password + biometric) required per NIST 2026
guidelines.
● Encryption: Data must be encrypted in transit (TLS 1.3+) and at rest (AES-256).
● Audit Trails: System logs tracking who accessed/modified records—critical for
breach investigations.
● Ethical Principles: Beneficence (use tech to improve care), Non-maleficence
(prevent harm via poor design), Autonomy (patient control over data).
Domain E: Technology-Enhanced Care & Patient Engagement
● Patient Portals: Secure messaging, appointment scheduling, lab result
viewing—enhances shared decision-making.
● Wearables & RPM: Devices (e.g., ECG patches, glucose monitors) transmit
real-time data to clinicians for proactive intervention.
● mHealth Apps: Must be FDA-cleared if diagnostic (e.g., Apple AFib detection);
nurses educate on validated apps only.
● User-Centered Design: Tools should be accessible (ADA-compliant), intuitive, and
culturally appropriate—tested with diverse patient groups.
, Domain F: Professional Development & Emerging Trends
● Digital Literacy: Core competency for all nurses—includes EHR navigation, data
interpretation, and tech troubleshooting.
● AI/ML: Used for early sepsis detection, imaging analysis, and predictive staffing;
nurses validate outputs and retain final decision authority.
● Interoperability: HL7 FHIR (Fast Healthcare Interoperability Resources) is the 2026
standard for EHR data exchange via APIs.
● IoMT: Network of connected devices (infusion pumps, monitors) generating real-time
data streams for analytics.
● Lifelong Learning: Required via CEUs on informatics topics (e.g., ONC Health IT
Playbook updates).
PART 2: COMPREHENSIVE PRACTICE EXAM
1. According to the American Nurses Association (ANA) Scope and Standards of Nursing
Informatics (2026), which activity is a foundational competency for all registered nurses?
A) Designing EHR database schemas
B) Leading hospital-wide informatics strategic planning
C) Using health information systems to support clinical decision-making
D) Writing SQL queries for clinical data extraction
Answer: C
The ANA emphasizes that all nurses must use technology to enhance care, regardless of
role. Options A, B, and D describe advanced informaticist functions, not baseline
competencies for every RN.
2. A nurse reviews a patient’s temperature trend in the EHR and correlates it with new-onset
confusion to suspect a urinary tract infection. This action best represents which level of the
DIKW model?
A) Data
B) Information
C) Knowledge
D) Wisdom
TECHNOLOGY IN NURSING PRACTICE –
2026/2027 MASTERY GUIDE &
PRACTICE EXAM
PART 1: ESSENTIAL INFORMATICS CONCEPTS
SUMMARY
Domain A: Foundations of Nursing Informatics
● Definition: Nursing informatics integrates nursing science with information and
analytical sciences to identify, define, manage, and communicate data, information,
knowledge, and wisdom in nursing practice.
● Nurse Informaticist Roles: Facilitate EHR implementation, design clinical
workflows, train staff, ensure system usability, and support evidence-based practice
through data analysis.
● DIKW Model:
○ Data: Raw facts (e.g., patient temperature = 101.2°F)
○ Information: Organized data with context (e.g., fever noted at 3 PM post-op)
○ Knowledge: Synthesis of information to guide action (e.g., fever may indicate
infection)
○ Wisdom: Application of knowledge ethically for patient benefit (e.g., initiating
sepsis protocol)
● ANA Scope & Standards (2026): Emphasizes informatics competencies for all
nurses, including data literacy, system evaluation, and ethical use of technology.
● Impact on Nursing: Enhances clinical decision-making, reduces errors, supports
documentation efficiency, and enables population health management.
Domain B: Healthcare Information Systems (HIS)
● EHR vs. EMR: EMR = digital chart within one organization; EHR = interoperable
record sharing across settings (per ONC 2026 standards).
● PHR: Patient-controlled health record (e.g., Apple Health, MyChart PHR module).
● CDSS: Provides real-time alerts (e.g., drug-allergy interactions, sepsis prediction);
must be evidence-based and non-intrusive.
● CPOE: Eliminates handwritten orders; reduces medication errors by 55% (AHRQ,
2026).
● BCMA: Scans patient wristband and medication barcode before administration—part
of the "Five Rights" verification.
, ● Pharmacy Systems: Integrate with CPOE for dose checking, formulary compliance,
and automated dispensing.
● Telehealth Platforms: HIPAA-compliant video/conferencing tools (e.g., Zoom for
Healthcare, Doxy.me) enabling remote assessments and chronic disease
management.
Domain C: Data, Information, & Knowledge Management
● Data Integrity: Requires accuracy (correct values), timeliness (real-time entry),
completeness (all required fields), and consistency (standardized terms, e.g.,
SNOMED CT, LOINC).
● Databases: Structured collections (e.g., SQL) storing patient data; relational
databases link tables (e.g., patient → medications).
● Data Warehousing: Central repository for aggregated, historical data from multiple
sources for reporting and analytics.
● Data Mining: Using algorithms to discover patterns (e.g., predicting hospital
readmissions).
● EBP Integration: Nurses use dashboards and clinical registries to access current
evidence and benchmark outcomes.
Domain D: Privacy, Security, & Ethical/Legal Compliance
● HIPAA Privacy Rule: Governs use/disclosure of PHI; requires patient consent for
non-treatment uses.
● HIPAA Security Rule: Mandates administrative, physical, and technical safeguards
for electronic PHI (ePHI).
● PHI Examples: Name, DOB, MRN, diagnosis, lab results—18 identifiers under
HIPAA.
● Authentication: Multi-factor (e.g., password + biometric) required per NIST 2026
guidelines.
● Encryption: Data must be encrypted in transit (TLS 1.3+) and at rest (AES-256).
● Audit Trails: System logs tracking who accessed/modified records—critical for
breach investigations.
● Ethical Principles: Beneficence (use tech to improve care), Non-maleficence
(prevent harm via poor design), Autonomy (patient control over data).
Domain E: Technology-Enhanced Care & Patient Engagement
● Patient Portals: Secure messaging, appointment scheduling, lab result
viewing—enhances shared decision-making.
● Wearables & RPM: Devices (e.g., ECG patches, glucose monitors) transmit
real-time data to clinicians for proactive intervention.
● mHealth Apps: Must be FDA-cleared if diagnostic (e.g., Apple AFib detection);
nurses educate on validated apps only.
● User-Centered Design: Tools should be accessible (ADA-compliant), intuitive, and
culturally appropriate—tested with diverse patient groups.
, Domain F: Professional Development & Emerging Trends
● Digital Literacy: Core competency for all nurses—includes EHR navigation, data
interpretation, and tech troubleshooting.
● AI/ML: Used for early sepsis detection, imaging analysis, and predictive staffing;
nurses validate outputs and retain final decision authority.
● Interoperability: HL7 FHIR (Fast Healthcare Interoperability Resources) is the 2026
standard for EHR data exchange via APIs.
● IoMT: Network of connected devices (infusion pumps, monitors) generating real-time
data streams for analytics.
● Lifelong Learning: Required via CEUs on informatics topics (e.g., ONC Health IT
Playbook updates).
PART 2: COMPREHENSIVE PRACTICE EXAM
1. According to the American Nurses Association (ANA) Scope and Standards of Nursing
Informatics (2026), which activity is a foundational competency for all registered nurses?
A) Designing EHR database schemas
B) Leading hospital-wide informatics strategic planning
C) Using health information systems to support clinical decision-making
D) Writing SQL queries for clinical data extraction
Answer: C
The ANA emphasizes that all nurses must use technology to enhance care, regardless of
role. Options A, B, and D describe advanced informaticist functions, not baseline
competencies for every RN.
2. A nurse reviews a patient’s temperature trend in the EHR and correlates it with new-onset
confusion to suspect a urinary tract infection. This action best represents which level of the
DIKW model?
A) Data
B) Information
C) Knowledge
D) Wisdom
