WGU D220 Information Technology in Nursing Practice Exam Questions and Answers | Updated Study Guide
WGU D220 Information Technology in Nursing Practice
Exam Questions and Answers | Updated Study Guide
Aligned with WGU D220 Curriculum Standards | 2026/2027 Edition
70 Verified Questions with Correct Answer Rationales | Cognitive Mix: 25% Recall, 55% Application, 20% Analysis
75% Scenario-Based Application | 25% Direct Recall/Identification | 6 Sections Spanning IT Fundamentals to Quality,
Safety, and EBP with Technology
Section 1: Information Technology Fundamentals in Healthcare
Definitions | IT Infrastructure | Networks | Hardware | Software | Systems Integration | Questions 1–12
Q1: A hospital's clinical server room contains servers, storage arrays, and networking gear that
host the EHR. Which term BEST describes this collection of physical and virtual resources?
A. Software-as-a-Service (SaaS) layer
B. On-premises IT infrastructure [CORRECT]
C. Personal Health Record (PHR) system
D. Health Information Exchange (HIE) hub
Correct Answer: B
Rationale: On-premises IT infrastructure refers to the hardware, storage, network, and virtualization resources owned
and operated by the organization within its own facilities. SaaS is a cloud delivery model where software is hosted by
a vendor. PHR is patient-controlled health record. HIE hub is for inter-organizational data exchange. D220
emphasizes that infrastructure decisions affect uptime, security, scalability, and total cost of ownership, and
increasingly include hybrid cloud models.
Q2: A nurse accesses the EHR from a workstation on wheels (WoW) using Wi-Fi. The signal is
dropped repeatedly when moving between rooms. Which network infrastructure component
should be evaluated FIRST?
A. Domain Name System (DNS) server
B. Wireless access point placement and roaming configuration [CORRECT]
C. Database backup schedule
D. Server rack cooling system
Correct Answer: B
Rationale: Frequent Wi-Fi drops during roaming typically indicate insufficient or misconfigured wireless access
point (AP) coverage and roaming settings. Adding APs and tuning roaming thresholds improves seamless handoff
between coverage cells. DNS (option A) resolves domain names but does not affect signal strength. Database backups
(option C) and server cooling (option D) are unrelated to wireless connectivity. D220 expects nurses to recognize how
infrastructure affects clinical workflows and patient safety at the point of care.
Page 1 | Verified Questions and Correct Answer Rationales
,WGU D220 Information Technology in Nursing Practice Exam Questions and Answers | Updated Study Guide
Q3: A small outpatient clinic stores patient data on a server hosted by a vendor and accessed via
the internet. The vendor manages all hardware, software, security, and backups. Which
deployment model is the clinic using?
A. On-premises private cloud
B. Cloud-based (vendor-hosted) computing [CORRECT]
C. Local area network (LAN) only
D. Standalone personal computer
Correct Answer: B
Rationale: Cloud computing delivers computing services (servers, storage, software) over the internet, managed by a
vendor. Benefits include reduced capital expense, automatic updates, scalability, and remote access; risks include
internet dependency, data security concerns, and vendor lock-in. On-premises private cloud is internally hosted.
LAN-only is a local network without external hosting. A standalone PC is not a multi-user system. D220 covers cloud
models because they shape security, compliance, and continuity planning in nursing practice.
Q4: A nurse is using application software on a hospital workstation. Which of the following is an
example of application software (rather than system software)?
A. Operating system (Windows)
B. Electronic Health Record (EHR) software [CORRECT]
C. Device driver for a barcode scanner
D. Network firewall firmware
Correct Answer: B
Rationale: Application software performs specific user tasks; the EHR is application software used for clinical
documentation, orders, and results. System software (operating systems, device drivers, utilities, firmware) manages
hardware and supports applications. Distinguishing system from application software matters because installation,
updates, and troubleshooting paths differ. D220 expects nurses to recognize the role each software layer plays when
reporting issues to IT support.
Q5: A hospital uses an interface engine to translate data between the EHR, laboratory system, and
radiology system so they all display cohesively. Which concept is being applied?
A. Data silos
B. Systems integration and interoperability [CORRECT]
C. Vendor lock-in
D. Manual data re-entry
Correct Answer: B
Rationale: Systems integration connects separate systems to share and consolidate data, while interoperability is the
ability of systems to exchange and meaningfully use that data. An interface engine (e.g., Mirth Connect, Rhapsody)
standardizes messaging so the EHR can display labs, imaging, and medications cohesively. Data silos are isolated
stores preventing sharing. Vendor lock-in is dependence on a single vendor. Manual re-entry introduces error risk.
D220 emphasizes integration as the foundation for safe, efficient care.
Page 2 | Verified Questions and Correct Answer Rationales
, WGU D220 Information Technology in Nursing Practice Exam Questions and Answers | Updated Study Guide
Q6: An informatics nurse compares a local hospital EHR (used within one organization) to a
comprehensive EHR designed to follow patients across multiple care settings. Which statement is
MOST accurate?
A. EMR and EHR are interchangeable terms with no difference
B. An EMR is the legal record within a single practice; an EHR is designed to be shared across
organizations and follow the patient [CORRECT]
C. An EHR only contains billing data
D. An EMR is always superior to an EHR
Correct Answer: B
Rationale: Per the ONC/National Alliance for Health IT, an Electronic Medical Record (EMR) is the legal record
within a single practice or organization, while an Electronic Health Record (EHR) is designed to be interoperable
across multiple care settings and follow the patient over time. Confusing the two is a common D220 pitfall. Neither is
billing-only, and superiority depends on context. This distinction has direct implications for interoperability planning
and HIE participation.
Q7: A clinic transitions from paper records to an EHR. Which statement BEST describes a server
in this new environment?
A. The server is the front-end interface the nurse uses to chart
B. The server is a computer that provides services (data storage, application hosting) to other computers
on the network [CORRECT]
C. The server is a backup printer
D. The server is the operating system only
Correct Answer: B
Rationale: A server is a computer that provides services (file storage, application hosting, database management,
authentication) to client computers over a network. The nurse's workstation is a client. An operating system is
software, not hardware. Printers are peripherals. D220 expects nurses to understand basic client-server architecture
because it explains how data flows, why downtime occurs, and how to communicate effectively with IT.
Q8: A nurse manager wants to ensure data is preserved in case of hardware failure. Which IT
concept addresses this requirement?
A. Data backup and disaster recovery [CORRECT]
B. User access provisioning
C. Single sign-on (SSO)
D. Workflow analysis
Correct Answer: A
Rationale: Data backup and disaster recovery protect data through periodic copies (backups) and a plan to restore
systems after a failure or disaster (disaster recovery). HIPAA Security Rule requires a contingency plan including
backups, disaster recovery, and emergency mode operation. Access provisioning is about user permissions. SSO
simplifies login. Workflow analysis redesigns processes. D220 links backup/recovery planning directly to patient
safety, regulatory compliance, and continuity of care.
Page 3 | Verified Questions and Correct Answer Rationales
WGU D220 Information Technology in Nursing Practice
Exam Questions and Answers | Updated Study Guide
Aligned with WGU D220 Curriculum Standards | 2026/2027 Edition
70 Verified Questions with Correct Answer Rationales | Cognitive Mix: 25% Recall, 55% Application, 20% Analysis
75% Scenario-Based Application | 25% Direct Recall/Identification | 6 Sections Spanning IT Fundamentals to Quality,
Safety, and EBP with Technology
Section 1: Information Technology Fundamentals in Healthcare
Definitions | IT Infrastructure | Networks | Hardware | Software | Systems Integration | Questions 1–12
Q1: A hospital's clinical server room contains servers, storage arrays, and networking gear that
host the EHR. Which term BEST describes this collection of physical and virtual resources?
A. Software-as-a-Service (SaaS) layer
B. On-premises IT infrastructure [CORRECT]
C. Personal Health Record (PHR) system
D. Health Information Exchange (HIE) hub
Correct Answer: B
Rationale: On-premises IT infrastructure refers to the hardware, storage, network, and virtualization resources owned
and operated by the organization within its own facilities. SaaS is a cloud delivery model where software is hosted by
a vendor. PHR is patient-controlled health record. HIE hub is for inter-organizational data exchange. D220
emphasizes that infrastructure decisions affect uptime, security, scalability, and total cost of ownership, and
increasingly include hybrid cloud models.
Q2: A nurse accesses the EHR from a workstation on wheels (WoW) using Wi-Fi. The signal is
dropped repeatedly when moving between rooms. Which network infrastructure component
should be evaluated FIRST?
A. Domain Name System (DNS) server
B. Wireless access point placement and roaming configuration [CORRECT]
C. Database backup schedule
D. Server rack cooling system
Correct Answer: B
Rationale: Frequent Wi-Fi drops during roaming typically indicate insufficient or misconfigured wireless access
point (AP) coverage and roaming settings. Adding APs and tuning roaming thresholds improves seamless handoff
between coverage cells. DNS (option A) resolves domain names but does not affect signal strength. Database backups
(option C) and server cooling (option D) are unrelated to wireless connectivity. D220 expects nurses to recognize how
infrastructure affects clinical workflows and patient safety at the point of care.
Page 1 | Verified Questions and Correct Answer Rationales
,WGU D220 Information Technology in Nursing Practice Exam Questions and Answers | Updated Study Guide
Q3: A small outpatient clinic stores patient data on a server hosted by a vendor and accessed via
the internet. The vendor manages all hardware, software, security, and backups. Which
deployment model is the clinic using?
A. On-premises private cloud
B. Cloud-based (vendor-hosted) computing [CORRECT]
C. Local area network (LAN) only
D. Standalone personal computer
Correct Answer: B
Rationale: Cloud computing delivers computing services (servers, storage, software) over the internet, managed by a
vendor. Benefits include reduced capital expense, automatic updates, scalability, and remote access; risks include
internet dependency, data security concerns, and vendor lock-in. On-premises private cloud is internally hosted.
LAN-only is a local network without external hosting. A standalone PC is not a multi-user system. D220 covers cloud
models because they shape security, compliance, and continuity planning in nursing practice.
Q4: A nurse is using application software on a hospital workstation. Which of the following is an
example of application software (rather than system software)?
A. Operating system (Windows)
B. Electronic Health Record (EHR) software [CORRECT]
C. Device driver for a barcode scanner
D. Network firewall firmware
Correct Answer: B
Rationale: Application software performs specific user tasks; the EHR is application software used for clinical
documentation, orders, and results. System software (operating systems, device drivers, utilities, firmware) manages
hardware and supports applications. Distinguishing system from application software matters because installation,
updates, and troubleshooting paths differ. D220 expects nurses to recognize the role each software layer plays when
reporting issues to IT support.
Q5: A hospital uses an interface engine to translate data between the EHR, laboratory system, and
radiology system so they all display cohesively. Which concept is being applied?
A. Data silos
B. Systems integration and interoperability [CORRECT]
C. Vendor lock-in
D. Manual data re-entry
Correct Answer: B
Rationale: Systems integration connects separate systems to share and consolidate data, while interoperability is the
ability of systems to exchange and meaningfully use that data. An interface engine (e.g., Mirth Connect, Rhapsody)
standardizes messaging so the EHR can display labs, imaging, and medications cohesively. Data silos are isolated
stores preventing sharing. Vendor lock-in is dependence on a single vendor. Manual re-entry introduces error risk.
D220 emphasizes integration as the foundation for safe, efficient care.
Page 2 | Verified Questions and Correct Answer Rationales
, WGU D220 Information Technology in Nursing Practice Exam Questions and Answers | Updated Study Guide
Q6: An informatics nurse compares a local hospital EHR (used within one organization) to a
comprehensive EHR designed to follow patients across multiple care settings. Which statement is
MOST accurate?
A. EMR and EHR are interchangeable terms with no difference
B. An EMR is the legal record within a single practice; an EHR is designed to be shared across
organizations and follow the patient [CORRECT]
C. An EHR only contains billing data
D. An EMR is always superior to an EHR
Correct Answer: B
Rationale: Per the ONC/National Alliance for Health IT, an Electronic Medical Record (EMR) is the legal record
within a single practice or organization, while an Electronic Health Record (EHR) is designed to be interoperable
across multiple care settings and follow the patient over time. Confusing the two is a common D220 pitfall. Neither is
billing-only, and superiority depends on context. This distinction has direct implications for interoperability planning
and HIE participation.
Q7: A clinic transitions from paper records to an EHR. Which statement BEST describes a server
in this new environment?
A. The server is the front-end interface the nurse uses to chart
B. The server is a computer that provides services (data storage, application hosting) to other computers
on the network [CORRECT]
C. The server is a backup printer
D. The server is the operating system only
Correct Answer: B
Rationale: A server is a computer that provides services (file storage, application hosting, database management,
authentication) to client computers over a network. The nurse's workstation is a client. An operating system is
software, not hardware. Printers are peripherals. D220 expects nurses to understand basic client-server architecture
because it explains how data flows, why downtime occurs, and how to communicate effectively with IT.
Q8: A nurse manager wants to ensure data is preserved in case of hardware failure. Which IT
concept addresses this requirement?
A. Data backup and disaster recovery [CORRECT]
B. User access provisioning
C. Single sign-on (SSO)
D. Workflow analysis
Correct Answer: A
Rationale: Data backup and disaster recovery protect data through periodic copies (backups) and a plan to restore
systems after a failure or disaster (disaster recovery). HIPAA Security Rule requires a contingency plan including
backups, disaster recovery, and emergency mode operation. Access provisioning is about user permissions. SSO
simplifies login. Workflow analysis redesigns processes. D220 links backup/recovery planning directly to patient
safety, regulatory compliance, and continuity of care.
Page 3 | Verified Questions and Correct Answer Rationales
