WGU D220 Informatics Exam 1
2026/2027 Edition — 50 Questions with Verified Correct Answers
Informatics for Nursing Practice — Western Governors University
Exam scope. This 50-question practice exam is structured to mirror the WGU D220 Informatics for Nursing Practice
Exam 1 blueprint, with full coverage of the foundations of nursing informatics (ANA definition, DIKW framework,
systems theory), health information systems and technology (EHR/EMR/PHR, CPOE, CDSS, HIE, telehealth, mHealth),
standardized terminologies (SNOMED-CT, ICD-10, LOINC, NANDA-I, NIC, NOC, RxNorm), informatics
competencies (TIGER, QSEN, ANA Scope and Standards, informatics nurse role), and legal, ethical, and regulatory
compliance (HIPAA, HITECH, Meaningful Use/Promoting Interoperability, MACRA/MIPS). Cognitive level
distribution: 25% recall, 55% application, 20% analysis. Approximately 75% of items are scenario-based; 25% are direct
recall/terminology identification. Each question includes a comprehensive rationale addressing theoretical frameworks,
clinical applications, legal/ethical standards, and quality/safety principles.
Section Domain Questions
1 Foundations of Nursing Informatics Q1-10
2 Health Information Systems and Technology Q11-22
3 Standardized Terminologies and Data Management Q23-32
4 Informatics Competencies and Nursing Practice Q33-40
5 Legal, Ethical, and Regulatory Compliance Q41-50
TOTAL 50 Questions
Section 1: Foundations of Nursing Informatics
Scope: Definitions, History, Scope, & Theoretical Frameworks (Q1-10)
This section covers the ANA definition of nursing informatics, the historical evolution from 1960s mainframe use through the
1992 ANA specialty recognition and into contemporary AI-enabled practice, the DIKW (Data, Information, Knowledge, Wisdom)
framework applied to clinical scenarios, systems theory as applied to health IT, and Benner's Novice to Expert model applied to
informatics competency.
Page 1 | WGU D220 — Informatics for Nursing Practice — 2026/2027
,WGU D220 Informatics Exam 1 — 2026/2027 — 50 Questions
Q1: Which definition of nursing informatics is MOST consistent with the American Nurses Association
(ANA) scope and standards?
A. The use of computer systems to document nursing care in acute-care hospitals.
B. The integration of nursing science, computer science, and information science to manage and
communicate data, information, knowledge, and wisdom in nursing practice.
C. The application of electronic health records to improve billing accuracy and reimbursement.
D. The technical management of hospital server infrastructure supporting clinical applications.
Correct Answer: B
Rationale: The ANA defines nursing informatics as the specialty that integrates nursing science with computer science and
information science to manage and communicate data, information, knowledge, and wisdom (the DIKW framework) in
nursing practice. The definition emphasizes the convergence of three sciences — not merely computer use, billing functions,
or IT infrastructure management — which are common exam distractors that confuse the scope of nursing informatics with
general health IT.
Q2: A nurse is documenting a patient's vital signs and observes that the patient's blood pressure has risen
steadily over three shifts. By recognizing this trend and adjusting the plan of care accordingly, the nurse is
demonstrating which level of the DIKW framework?
A. Data
B. Information
C. Knowledge
D. Wisdom
Correct Answer: C
Rationale: In the DIKW framework, data are discrete raw facts (a single BP value); information is organized data with
context (the trend across shifts); knowledge is the synthesis of information with experience and theory to inform decisions
(recognizing the trend suggests medication-related hypertension and warrants action); and wisdom is the ethical, judicious
application of knowledge in complex situations. Recognizing the pattern and integrating it with clinical judgment represents
knowledge — not wisdom, which would require moral/ethical discernment about the right action.
Q3: Which historical development is MOST closely associated with the formal recognition of nursing
informatics as a distinct specialty?
A. The 1960s introduction of mainframe computers in hospital billing departments.
B. The 1992 ANA recognition of nursing informatics as a specialty, establishing its scope and standards of
practice.
C. The 2009 HITECH Act's promotion of electronic health record adoption.
D. The 2015 launch of the Precision Medicine Initiative.
Correct Answer: B
Rationale: While nursing informatics roots trace to the 1960s with early hospital computer systems, the formal recognition
came in 1992 when the ANA designated it as a distinct nursing specialty with a defined scope of practice. The HITECH Act
(2009) accelerated EHR adoption but did not create the specialty, and the Precision Medicine Initiative (2015) reflects a later
genomic-data focus. Recognizing the 1992 milestone is foundational to understanding the specialty's evolution.
Page 2 | WGU D220 — Informatics for Nursing Practice — 2026/2027
, WGU D220 Informatics Exam 1 — 2026/2027 — 50 Questions
Q4: A nurse manager uses systems theory to evaluate a new barcode medication administration (BCMA)
system. Which approach BEST reflects a systems-thinking perspective?
A. Focusing solely on the scanner hardware malfunction rate.
B. Analyzing the interplay of hardware, software, workflow, nurse training, pharmacy processes, and
patient factors that together produce medication-administration outcomes.
C. Comparing only the purchase cost of competing barcode scanners.
D. Replacing nurses who fail to scan with new staff who are more tech-savvy.
Correct Answer: B
Rationale: Systems theory holds that a system is more than the sum of its parts; understanding the BCMA system requires
analyzing interactions among hardware, software, clinical workflow, user training, upstream pharmacy processes, and
patient factors. Reducing the analysis to a single component (hardware, cost, or personnel replacement) ignores the
interdependencies that determine real-world performance and patient-safety outcomes. Systems thinking is foundational to
effective informatics practice.
Q5: Which scenario BEST illustrates the WISDOM level of the DIKW framework applied in nursing
informatics?
A. A nurse records a blood glucose of 250 mg/dL in the EHR.
B. The EHR displays a trend showing the patient's glucose has averaged 220 mg/dL over the past week.
C. The nurse recognizes that the patient's uncontrolled diabetes combined with limited financial resources requires
a personalized care plan.
D. The nurse decides not to override an alert for a potentially inappropriate medication because the patient
has refused additional treatment consistent with documented advance directives, balancing clinical benefit
with the patient's autonomy and values.
Correct Answer: D
Rationale: Wisdom in the DIKW framework is the ethical, judicious application of knowledge — integrating values, ethics,
and context to choose the right action when competing principles are at play. Documenting a glucose value (A) is data;
displaying a trend (B) is information; recognizing a pattern with social determinants (C) is knowledge. Deciding to honor a
patient's documented autonomy in the face of a clinical alert reflects wisdom because it integrates knowledge with ethics and
the patient's individualized context.
Page 3 | WGU D220 — Informatics for Nursing Practice — 2026/2027
2026/2027 Edition — 50 Questions with Verified Correct Answers
Informatics for Nursing Practice — Western Governors University
Exam scope. This 50-question practice exam is structured to mirror the WGU D220 Informatics for Nursing Practice
Exam 1 blueprint, with full coverage of the foundations of nursing informatics (ANA definition, DIKW framework,
systems theory), health information systems and technology (EHR/EMR/PHR, CPOE, CDSS, HIE, telehealth, mHealth),
standardized terminologies (SNOMED-CT, ICD-10, LOINC, NANDA-I, NIC, NOC, RxNorm), informatics
competencies (TIGER, QSEN, ANA Scope and Standards, informatics nurse role), and legal, ethical, and regulatory
compliance (HIPAA, HITECH, Meaningful Use/Promoting Interoperability, MACRA/MIPS). Cognitive level
distribution: 25% recall, 55% application, 20% analysis. Approximately 75% of items are scenario-based; 25% are direct
recall/terminology identification. Each question includes a comprehensive rationale addressing theoretical frameworks,
clinical applications, legal/ethical standards, and quality/safety principles.
Section Domain Questions
1 Foundations of Nursing Informatics Q1-10
2 Health Information Systems and Technology Q11-22
3 Standardized Terminologies and Data Management Q23-32
4 Informatics Competencies and Nursing Practice Q33-40
5 Legal, Ethical, and Regulatory Compliance Q41-50
TOTAL 50 Questions
Section 1: Foundations of Nursing Informatics
Scope: Definitions, History, Scope, & Theoretical Frameworks (Q1-10)
This section covers the ANA definition of nursing informatics, the historical evolution from 1960s mainframe use through the
1992 ANA specialty recognition and into contemporary AI-enabled practice, the DIKW (Data, Information, Knowledge, Wisdom)
framework applied to clinical scenarios, systems theory as applied to health IT, and Benner's Novice to Expert model applied to
informatics competency.
Page 1 | WGU D220 — Informatics for Nursing Practice — 2026/2027
,WGU D220 Informatics Exam 1 — 2026/2027 — 50 Questions
Q1: Which definition of nursing informatics is MOST consistent with the American Nurses Association
(ANA) scope and standards?
A. The use of computer systems to document nursing care in acute-care hospitals.
B. The integration of nursing science, computer science, and information science to manage and
communicate data, information, knowledge, and wisdom in nursing practice.
C. The application of electronic health records to improve billing accuracy and reimbursement.
D. The technical management of hospital server infrastructure supporting clinical applications.
Correct Answer: B
Rationale: The ANA defines nursing informatics as the specialty that integrates nursing science with computer science and
information science to manage and communicate data, information, knowledge, and wisdom (the DIKW framework) in
nursing practice. The definition emphasizes the convergence of three sciences — not merely computer use, billing functions,
or IT infrastructure management — which are common exam distractors that confuse the scope of nursing informatics with
general health IT.
Q2: A nurse is documenting a patient's vital signs and observes that the patient's blood pressure has risen
steadily over three shifts. By recognizing this trend and adjusting the plan of care accordingly, the nurse is
demonstrating which level of the DIKW framework?
A. Data
B. Information
C. Knowledge
D. Wisdom
Correct Answer: C
Rationale: In the DIKW framework, data are discrete raw facts (a single BP value); information is organized data with
context (the trend across shifts); knowledge is the synthesis of information with experience and theory to inform decisions
(recognizing the trend suggests medication-related hypertension and warrants action); and wisdom is the ethical, judicious
application of knowledge in complex situations. Recognizing the pattern and integrating it with clinical judgment represents
knowledge — not wisdom, which would require moral/ethical discernment about the right action.
Q3: Which historical development is MOST closely associated with the formal recognition of nursing
informatics as a distinct specialty?
A. The 1960s introduction of mainframe computers in hospital billing departments.
B. The 1992 ANA recognition of nursing informatics as a specialty, establishing its scope and standards of
practice.
C. The 2009 HITECH Act's promotion of electronic health record adoption.
D. The 2015 launch of the Precision Medicine Initiative.
Correct Answer: B
Rationale: While nursing informatics roots trace to the 1960s with early hospital computer systems, the formal recognition
came in 1992 when the ANA designated it as a distinct nursing specialty with a defined scope of practice. The HITECH Act
(2009) accelerated EHR adoption but did not create the specialty, and the Precision Medicine Initiative (2015) reflects a later
genomic-data focus. Recognizing the 1992 milestone is foundational to understanding the specialty's evolution.
Page 2 | WGU D220 — Informatics for Nursing Practice — 2026/2027
, WGU D220 Informatics Exam 1 — 2026/2027 — 50 Questions
Q4: A nurse manager uses systems theory to evaluate a new barcode medication administration (BCMA)
system. Which approach BEST reflects a systems-thinking perspective?
A. Focusing solely on the scanner hardware malfunction rate.
B. Analyzing the interplay of hardware, software, workflow, nurse training, pharmacy processes, and
patient factors that together produce medication-administration outcomes.
C. Comparing only the purchase cost of competing barcode scanners.
D. Replacing nurses who fail to scan with new staff who are more tech-savvy.
Correct Answer: B
Rationale: Systems theory holds that a system is more than the sum of its parts; understanding the BCMA system requires
analyzing interactions among hardware, software, clinical workflow, user training, upstream pharmacy processes, and
patient factors. Reducing the analysis to a single component (hardware, cost, or personnel replacement) ignores the
interdependencies that determine real-world performance and patient-safety outcomes. Systems thinking is foundational to
effective informatics practice.
Q5: Which scenario BEST illustrates the WISDOM level of the DIKW framework applied in nursing
informatics?
A. A nurse records a blood glucose of 250 mg/dL in the EHR.
B. The EHR displays a trend showing the patient's glucose has averaged 220 mg/dL over the past week.
C. The nurse recognizes that the patient's uncontrolled diabetes combined with limited financial resources requires
a personalized care plan.
D. The nurse decides not to override an alert for a potentially inappropriate medication because the patient
has refused additional treatment consistent with documented advance directives, balancing clinical benefit
with the patient's autonomy and values.
Correct Answer: D
Rationale: Wisdom in the DIKW framework is the ethical, judicious application of knowledge — integrating values, ethics,
and context to choose the right action when competing principles are at play. Documenting a glucose value (A) is data;
displaying a trend (B) is information; recognizing a pattern with social determinants (C) is knowledge. Deciding to honor a
patient's documented autonomy in the face of a clinical alert reflects wisdom because it integrates knowledge with ethics and
the patient's individualized context.
Page 3 | WGU D220 — Informatics for Nursing Practice — 2026/2027
