CHAMBERLAIN COLLEGE OF NURSING NR 599
NURSING INFORMATICS FOR ADVANCED
PRACTICE Actual WEEK 4 CUMULATIVE FINAL
EXAM (2026)
Integrated Scenarios (Questions 1-60)
Q1: A Family Nurse Practitioner in a primary care clinic notices the new AI-powered
CDSS is frequently suggesting antibiotic prescriptions for upper respiratory infections
that are likely viral. The system's algorithm is proprietary, and the FNP cannot discern its
logic. According to ANA Standard 8 (Education) and informatics ethics, what is the
MOST appropriate first action?
A. Disable the CDSS alerts for antibiotics to prevent potential misuse and protect
patients.
B. Follow the CDSS recommendations to maintain consistency and avoid legal risk from
deviating from a "standard of care" tool.
C. Document in each patient's record, "CDSS suggestion overridden based on clinical
judgment," and continue practice as usual.
D. Collaborate with the clinic's informatics nurse specialist to investigate the algorithm's
evidence base and request transparency from the vendor.
Correct Answer: D
,Synthesis Rationale: This is correct because it successfully integrates Strand D (APN
Role/Advocacy) and Strand A (Ethics). The APN collaborates with an informatics expert
(applying ANA Standard 8 on seeking education) to investigate the "black box"
algorithm, upholding the ethical principle of nonmaleficence and data integrity. This
action treats the CDSS as a tool for inquiry, not an unquestioned authority, embodying
the informaticist role.
Why the Others Fail Synthesis:
● A: While addressing a safety concern (Strand C), this choice unilaterally disables
a system component without investigation, violating ANA Standard 7 (Ethics)
principles of accountability and potentially depriving patients of a beneficial tool
if improved.
● B: This blindly follows technology, abdicating professional judgment and violating
the ANA Scope of Practice, which requires the APN to be the ultimate
decision-maker in care.
● C: This documents an action but is passive and does not use informatics
principles (Strand B, D) to improve the system or practice for future patients,
failing the synthesis required for advanced practice.
Chamberlain Competency Link: Synthesizes knowledge from nursing science,
informatics, and ethical principles to advocate for the design and implementation
of safe, effective care systems.
Q2: A Nurse Midwife is developing a patient education protocol for a new telehealth
prenatal monitoring program. She wants to ensure the protocol maximizes patient
engagement and health literacy while collecting usable patient-generated health data
(PGHD). Applying the DIKW model and HTI principles, which strategy is BEST?
A. Use a single, detailed PDF document emailed to patients, explaining all technical
aspects of the monitoring devices and data upload process.
,B. Implement a tiered approach: short video tutorials for device use (addressing
knowledge), a simple mobile app with visual data trackers (creating information), and
scheduled telehealth check-ins to discuss trends and goals (generating wisdom).
C. Provide the most accurate, medical-grade instructions from the device manufacturer
to ensure data fidelity.
D. Rely on verbal instructions during the first prenatal visit, as personal interaction is the
most effective teaching method.
Correct Answer: B
Synthesis Rationale: This is correct because it deliberately applies the DIKW model
(Strand A) to design an intervention. It moves patients from data (raw device readings)
to information (visualized trends in an app) to potential wisdom (insights discussed with
the APN). It simultaneously follows HTI principles (Strand B) by using multiple,
patient-centered modalities (video, app, discussion).
Why the Others Fail Synthesis:
● A: This provides data/information but in a static, low-engagement format that
fails to facilitate the progression to knowledge or wisdom. It ignores HTI best
practices for user-centered design.
● C: This focuses solely on data accuracy (Strand C), privileging technical quality
over patient understanding and engagement, thus failing the synthesis with
patient education ethics.
● D: This values interaction but is not scalable or consistent, and fails to leverage
informatics tools (Strand B, D) to support the patient between visits, missing a
key benefit of telehealth.
Chamberlain Competency Link: Designs patient-centered informatics
interventions that enhance access, equity, and the nurse-patient relationship.
Q3: An Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) serving as the unit's
quality improvement lead reviews six months of sepsis alert data from the EHR. The
, data shows that while alert sensitivity remains high, specificity has decreased
significantly, resulting in alert fatigue among nurses and delayed responses to genuine
cases. Applying Six Sigma methodology and ANA Standard 10 (Quality of Practice),
what is the MOST appropriate initial step?
A. Immediately increase the alert threshold parameters to reduce false positives and
eliminate the fatigue problem.
B. Form a multidisciplinary team to conduct a root cause analysis (RCA) using the
DMAIC (Define, Measure, Analyze, Improve, Control) framework to identify variables
contributing to decreased specificity.
C. Disable the sepsis alert temporarily until the vendor can provide a system patch to
improve accuracy.
D. Educate nurses to document sepsis risk factors more thoroughly so the algorithm
has better data to process.
Correct Answer: B
Synthesis Rationale: This is correct because it integrates Strand C (Data Analytics/QI)
with Strand D (APN Leadership). Using Six Sigma's DMAIC framework demonstrates
systematic quality improvement methodology, while engaging a multidisciplinary team
exemplifies ANA Standard 10 and Standard 13 (Collaboration). This approach treats
alert fatigue as a complex systems issue requiring data-driven analysis rather than
reactive fixes.
Why the Others Fail Synthesis:
● A: This jumps to solution implementation without analysis (Strand C failure),
risking patient safety by potentially filtering out true positives, thus violating ANA
Standard 7 (Ethics) regarding nonmaleficence.
NURSING INFORMATICS FOR ADVANCED
PRACTICE Actual WEEK 4 CUMULATIVE FINAL
EXAM (2026)
Integrated Scenarios (Questions 1-60)
Q1: A Family Nurse Practitioner in a primary care clinic notices the new AI-powered
CDSS is frequently suggesting antibiotic prescriptions for upper respiratory infections
that are likely viral. The system's algorithm is proprietary, and the FNP cannot discern its
logic. According to ANA Standard 8 (Education) and informatics ethics, what is the
MOST appropriate first action?
A. Disable the CDSS alerts for antibiotics to prevent potential misuse and protect
patients.
B. Follow the CDSS recommendations to maintain consistency and avoid legal risk from
deviating from a "standard of care" tool.
C. Document in each patient's record, "CDSS suggestion overridden based on clinical
judgment," and continue practice as usual.
D. Collaborate with the clinic's informatics nurse specialist to investigate the algorithm's
evidence base and request transparency from the vendor.
Correct Answer: D
,Synthesis Rationale: This is correct because it successfully integrates Strand D (APN
Role/Advocacy) and Strand A (Ethics). The APN collaborates with an informatics expert
(applying ANA Standard 8 on seeking education) to investigate the "black box"
algorithm, upholding the ethical principle of nonmaleficence and data integrity. This
action treats the CDSS as a tool for inquiry, not an unquestioned authority, embodying
the informaticist role.
Why the Others Fail Synthesis:
● A: While addressing a safety concern (Strand C), this choice unilaterally disables
a system component without investigation, violating ANA Standard 7 (Ethics)
principles of accountability and potentially depriving patients of a beneficial tool
if improved.
● B: This blindly follows technology, abdicating professional judgment and violating
the ANA Scope of Practice, which requires the APN to be the ultimate
decision-maker in care.
● C: This documents an action but is passive and does not use informatics
principles (Strand B, D) to improve the system or practice for future patients,
failing the synthesis required for advanced practice.
Chamberlain Competency Link: Synthesizes knowledge from nursing science,
informatics, and ethical principles to advocate for the design and implementation
of safe, effective care systems.
Q2: A Nurse Midwife is developing a patient education protocol for a new telehealth
prenatal monitoring program. She wants to ensure the protocol maximizes patient
engagement and health literacy while collecting usable patient-generated health data
(PGHD). Applying the DIKW model and HTI principles, which strategy is BEST?
A. Use a single, detailed PDF document emailed to patients, explaining all technical
aspects of the monitoring devices and data upload process.
,B. Implement a tiered approach: short video tutorials for device use (addressing
knowledge), a simple mobile app with visual data trackers (creating information), and
scheduled telehealth check-ins to discuss trends and goals (generating wisdom).
C. Provide the most accurate, medical-grade instructions from the device manufacturer
to ensure data fidelity.
D. Rely on verbal instructions during the first prenatal visit, as personal interaction is the
most effective teaching method.
Correct Answer: B
Synthesis Rationale: This is correct because it deliberately applies the DIKW model
(Strand A) to design an intervention. It moves patients from data (raw device readings)
to information (visualized trends in an app) to potential wisdom (insights discussed with
the APN). It simultaneously follows HTI principles (Strand B) by using multiple,
patient-centered modalities (video, app, discussion).
Why the Others Fail Synthesis:
● A: This provides data/information but in a static, low-engagement format that
fails to facilitate the progression to knowledge or wisdom. It ignores HTI best
practices for user-centered design.
● C: This focuses solely on data accuracy (Strand C), privileging technical quality
over patient understanding and engagement, thus failing the synthesis with
patient education ethics.
● D: This values interaction but is not scalable or consistent, and fails to leverage
informatics tools (Strand B, D) to support the patient between visits, missing a
key benefit of telehealth.
Chamberlain Competency Link: Designs patient-centered informatics
interventions that enhance access, equity, and the nurse-patient relationship.
Q3: An Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) serving as the unit's
quality improvement lead reviews six months of sepsis alert data from the EHR. The
, data shows that while alert sensitivity remains high, specificity has decreased
significantly, resulting in alert fatigue among nurses and delayed responses to genuine
cases. Applying Six Sigma methodology and ANA Standard 10 (Quality of Practice),
what is the MOST appropriate initial step?
A. Immediately increase the alert threshold parameters to reduce false positives and
eliminate the fatigue problem.
B. Form a multidisciplinary team to conduct a root cause analysis (RCA) using the
DMAIC (Define, Measure, Analyze, Improve, Control) framework to identify variables
contributing to decreased specificity.
C. Disable the sepsis alert temporarily until the vendor can provide a system patch to
improve accuracy.
D. Educate nurses to document sepsis risk factors more thoroughly so the algorithm
has better data to process.
Correct Answer: B
Synthesis Rationale: This is correct because it integrates Strand C (Data Analytics/QI)
with Strand D (APN Leadership). Using Six Sigma's DMAIC framework demonstrates
systematic quality improvement methodology, while engaging a multidisciplinary team
exemplifies ANA Standard 10 and Standard 13 (Collaboration). This approach treats
alert fatigue as a complex systems issue requiring data-driven analysis rather than
reactive fixes.
Why the Others Fail Synthesis:
● A: This jumps to solution implementation without analysis (Strand C failure),
risking patient safety by potentially filtering out true positives, thus violating ANA
Standard 7 (Ethics) regarding nonmaleficence.
