TEST BANK for Health Informatics;An Interprofessional Approach 2nd Edition by Nelson & Staggers

TEST BANK

TEST BANK

Prof.Exams

COMPLETE Elaborated Test Bank for

Health Informatics: An Interprofessional Approach

2nd Edition Ramona Nelson Nancy Staggers

Prof.Exams

Health Informatics: An Interprofessional Approach 2nd Edition by Ramona Nelson & Nancy Staggers.

ISBN-10 0323402313 ISBN-13 978-0323402316 Test Bank for Health Informatics: An Interprofessional Approach 2nd Edition by Ramona Nelson & Nancy Staggers.

ISBN-10 0323402313 ISBN-13 978-0323402316

THIS IS NOT THE ACTUAL BOOK. YOU ARE BUYING it is the Official Test Bank -version INSTANTDOWNLOAD >The test bank is what most professors use as a template when making exams for their students, whichmeansthere’s avery high chance that you will see the exact questions in the tests! >The file is either in.pdf, excel, or zipped in the package and can easily be read on PCs and Macs. >Delivery is INSTANT. You can download the files IMMEDIATELY once payment is done.

If you have any questions, please feel free to contact us. Our response is the fastest. All questionswill always beanswered in 6 hours, most of the time within 30mins.

We also faced similar difficulties when we were students, and we understand how you feel.But now, with theOfficial Test Bank, you will be able to

* * * * * *

Anticipate the type of the questions that will appear in your exam.

Know the correct answers to those questions.

Reduce the hassle and stress of your student life.

Improve your studying and get a better grade!

Get prepared for examination questions.

Save you time and help you understand the material.

Unit 1: Foundational Information in Health Informatics Chapter 1: An Introduction to Health Informatics Chapter 2: Theoretical Foundations of Health Informatics Chapter 3: Evidence-Based Practice, Practice-Based Evidence, and Health Informatics Chapter 4: Models, Theories, and Research for Program Evaluation Chapter 5: Technical Infrastructure to Support Healthcare

Unit 2: Information Systems and Applications for the Delivery of Healthcare Chapter 6: Electronic Health Records and Applications for Managing Patient Care Chapter 7: Administrative Applications Supporting Healthcare Delivery Chapter 8: Telehealth and Applications for Delivering Care at a Distance Chapter 9: Home Health and Related Community-Based Systems Chapter 10: Clinical Decision Support Systems in Healthcare Chapter 11: Public Health Informatics

Unit 3: Participatory Healthcare Informatics Chapter 12: The Engaged ePatient Chapter 13: Social Media Tools for Practice and Education Chapter 14: Personal Health Records Chapter 15: mHealth: The Intersection of Mobile Technology and Health

Unit 4: Managing the Life Cycle of a Health Information System Chapter 16: Strategic Planning and Selecting an Information System Chapter 17: Project Management Principles for Health Informatics Chapter 18: Contract Negotiations and Software Licensing Chapter 19: Implementing and Upgrading an Information System Chapter 20: Downtime and Disaster Recovery for Health Information Systems

Unit 5: User Experience, Standards, Safety, and Analytics in Health Informatics Chapter 21: Improving the User Experience for Health Information Technology Chapter 22: Informatics-Related Standards and Standards-Setting Organizations Chapter 23: Data Science and Analytics in Healthcare Chapter 24: Patient Safety and Quality Initiatives in Health Informatics

Unit 6: Governance Structures, Legal, and Regulatory Issues in Health Informatics Chapter 25: Legal Issues, Federal Regulations, and Accreditation Chapter 26: Privacy and Security Chapter 27: The Health Information Technology for Education and Clinical Health Act, Meaningful Use, and Medicare Access and CHIP Reauthorization Act of 2015 Chapter 28: Health Policy and Health Informatics Chapter 29: Health Information Technology Governance

Unit 7: Education and Health Informatics Chapter 30: Informatics in the Curriculum for Healthcare Professionals Chapter 31: Distance Education: Applications, Techniques, and Issues Chapter 32: Informatics Tools for Educating Healthcare Professionals Chapter 33: Simulation in Healthcare Education

Unit 8: International Health Informatics Efforts Chapter 34: International Efforts, Issues, and Innovations Chapter Unit 9: Historical Implications and Future Directions in Health Informatics Chapter 35: The Evolution of Health Informatics Chapter 36: Future Directions and Future Research in Health Informatics

TEST BANK

TEST BANK

Prof.Exams

COMPLETE Elaborated Test Bank for

Health Informatics: An Interprofessional Approach

2nd Edition Ramona Nelson Nancy Staggers

Prof.Exams

Health Informatics: An Interprofessional Approach 2nd Edition by Ramona Nelson & Nancy Staggers.

ISBN-10 0323402313 ISBN-13 978-0323402316 Test Bank for Health Informatics: An Interprofessional Approach 2nd Edition by Ramona Nelson & Nancy Staggers.

ISBN-10 0323402313 ISBN-13 978-0323402316

THIS IS NOT THE ACTUAL BOOK. YOU ARE BUYING it is the Official Test Bank -version INSTANTDOWNLOAD >The test bank is what most professors use as a template when making exams for their students, whichmeansthere’s avery high chance that you will see the exact questions in the tests! >The file is either in.pdf, excel, or zipped in the package and can easily be read on PCs and Macs. >Delivery is INSTANT. You can download the files IMMEDIATELY once payment is done.

If you have any questions, please feel free to contact us. Our response is the fastest. All questionswill always beanswered in 6 hours, most of the time within 30mins.

We also faced similar difficulties when we were students, and we understand how you feel.But now, with theOfficial Test Bank, you will be able to

* * * * * *

Anticipate the type of the questions that will appear in your exam.

Know the correct answers to those questions.

Reduce the hassle and stress of your student life.

Improve your studying and get a better grade!

Get prepared for examination questions.

Save you time and help you understand the material.

Unit 1: Foundational Information in Health Informatics Chapter 1: An Introduction to Health Informatics Chapter 2: Theoretical Foundations of Health Informatics Chapter 3: Evidence-Based Practice, Practice-Based Evidence, and Health Informatics Chapter 4: Models, Theories, and Research for Program Evaluation Chapter 5: Technical Infrastructure to Support Healthcare

Unit 2: Information Systems and Applications for the Delivery of Healthcare Chapter 6: Electronic Health Records and Applications for Managing Patient Care Chapter 7: Administrative Applications Supporting Healthcare Delivery Chapter 8: Telehealth and Applications for Delivering Care at a Distance Chapter 9: Home Health and Related Community-Based Systems Chapter 10: Clinical Decision Support Systems in Healthcare Chapter 11: Public Health Informatics

Unit 3: Participatory Healthcare Informatics Chapter 12: The Engaged ePatient Chapter 13: Social Media Tools for Practice and Education Chapter 14: Personal Health Records Chapter 15: mHealth: The Intersection of Mobile Technology and Health

Unit 4: Managing the Life Cycle of a Health Information System Chapter 16: Strategic Planning and Selecting an Information System Chapter 17: Project Management Principles for Health Informatics Chapter 18: Contract Negotiations and Software Licensing Chapter 19: Implementing and Upgrading an Information System Chapter 20: Downtime and Disaster Recovery for Health Information Systems

Unit 5: User Experience, Standards, Safety, and Analytics in Health Informatics Chapter 21: Improving the User Experience for Health Information Technology Chapter 22: Informatics-Related Standards and Standards-Setting Organizations Chapter 23: Data Science and Analytics in Healthcare Chapter 24: Patient Safety and Quality Initiatives in Health Informatics

Unit 6: Governance Structures, Legal, and Regulatory Issues in Health Informatics Chapter 25: Legal Issues, Federal Regulations, and Accreditation Chapter 26: Privacy and Security Chapter 27: The Health Information Technology for Education and Clinical Health Act, Meaningful Use, and Medicare Access and CHIP Reauthorization Act of 2015 Chapter 28: Health Policy and Health Informatics Chapter 29: Health Information Technology Governance

Unit 7: Education and Health Informatics Chapter 30: Informatics in the Curriculum for Healthcare Professionals Chapter 31: Distance Education: Applications, Techniques, and Issues Chapter 32: Informatics Tools for Educating Healthcare Professionals Chapter 33: Simulation in Healthcare Education

Unit 8: International Health Informatics Efforts Chapter 34: International Efforts, Issues, and Innovations Chapter Unit 9: Historical Implications and Future Directions in Health Informatics Chapter 35: The Evolution of Health Informatics Chapter 36: Future Directions and Future Research in Health Informatics

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chapter 1: Introduction: The Evolution of Health Informatics Test Bank MULTIPLE CHOICE 1. The historical roots of computer science can be traced to: a. language development, especially English. b. mathematics and engineering. c. library science. d. medicine and nursing.

ANS: B

The historical roots of computer science can be traced back to mathematics and engineering.

The historical roots of information science began in library science. Language development and medicine and nursing are not the roots of computer science.

DIF: Cognitive Level: Understand

REF: p. 3

2. The historical roots of information science can be traced to: a. language development, especially English. b. mathematics and engineering. c. library science. d. medicine and nursing.

ANS: C

The historical roots of information science began in library science. The historical roots of computer science can be traced back to mathematics and engineering. Language development and medicine and nursing are not the roots of information science.

DIF: Cognitive Level: Understand

REF: pp. 3-4

3. The first book to include the term nursing informatics in the title was written in the: a. 1960s. b. 1970s. c. 1980s. d. 1990s.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: C

The first book to include the term nursing informatics in the title was published in 1988.

DIF: Cognitive Level: Remember

REF: p. 6

4. As knowledge develops and expands within a discipline, which information source will include

the oldest but best organized representation of that knowledge? a. Conference presentations b. Conference proceedings c. Journal articles d. Books

ANS: D

The information source that includes the oldest but best organized representation of knowledge is books.

DIF: Cognitive Level: Apply

REF: p. 5

5. Which technical development created a tension between centralized and decentralized computer

management in healthcare? a. The development of punch cards b. The elimination of punch cards c. The development of the mainframe computer d. The development of the personal computer

ANS: D

The development of the personal computer created tension between centralized and decentralized computer management in healthcare. The other responses highlight aspects of decentralized computer management.

DIF: Cognitive Level: Apply

REF: p. 3

6. Which of the following is not a member organization but rather a group of organizations? a. AMIA b. HIMSS c. AHIMA d. ANI

ANS: D

The Alliance for Nursing Informatics (ANI) is an organization of organizations. This is not a member group. AMIA, HIMSS, and AHIMA are all member groups.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

DIF: Cognitive Level: Remember

REF: p. 7

7. Which statement concerning educational programs in health informatics is correct? a. All health informatics programs are offered at the graduate level. b. Informatics programs offered by medical schools always require students to have earned an

MD for admission. c. All health informatics programs are located within health-related departments or schools such as nursing, medicine, or pharmacy. d. Health informatics programs range from certificate programs offered at the community college level to post-doctoral programs offered at major research institutions.

ANS: D

The correct response is health informatics programs range from certificate programs offered at the community college level to post-doctoral programs offered at major research institutions.

Not all informatics programs require an MD, are at the graduate level, or are located within schools of health sciences.

DIF: Cognitive Level: Apply

REF: pp. 9-10

8. Which statement related to certification in health informatics is correct? a. A master’s in nursing is required to sit for the NI examination offered by ANCC. b. To be certified in clinical informatics in association with AMIA, one must first be a

physician. c. There are no specific educational requirements for CPHIMS certification through HIMSS, but three years of full-time clinical experience in health IT is required. d. To be certified as CPHIMS, you must be a nurse.

ANS: B

To be certified in clinical informatics in association with AMIA, one must first be a physician.

You do not need to have an MSN to sit for the NI exam by the ANCC. There are specific requirements for CPHIMS, but being a nurse is not one of them.

DIF: Cognitive Level: Apply

REF: p. 11

MULTIPLE RESPONSE 9.

The term informatics is derived from: (Select all that apply.) a. Dutch. b. English. c. Russian. d. Arabic. e. French.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: B, C, E

The term informatics was derived from the following languages: English, Russian, and French.

DIF: Cognitive Level: Understand

REF: p. 4

10. When the AMIA model is used, which subfields are categorized as clinical informatics? (Select

all that apply.) a. Medical informatics b. Nursing informatics c. Dental informatics d. Chemical informatics e. Business informatics

ANS: A, B, C

When the AMIA model is used, the following disciplines are categorized as clinical informatics: medical informatics, nursing informatics, and dental informatics. The other responses are not clinically related.

DIF: Cognitive Level: Analyze

REF: p. 14

Chapter 2: Theoretical Foundations of Health Informatics Test Bank MULTIPLE CHOICE 1. What is the primary difference between an open and closed system? a. An open system has no boundary, and therefore there are no limits to the inputs and outputs

between an open system and the environment. b. An open system has a semipermeable boundary and therefore will filter both inputs and outputs when interacting with the environment. c. A closed system has a semipermeable boundary and therefore will filter both inputs and outputs when interacting with the environment. d. A closed system does not have a boundary and therefore will not interact with the environment.

ANS: B

With an open system the boundary is semipermeable, thereby controlling what will be accepted as input and what will be permitted to leave the system.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) DIF: Cognitive Level: Understand

REF: p. 20

2. The primary characteristics used to analyze an open system include: a. structure, purpose, and functions. b. sub-system, target system, and super-system. c. boundary, attributes, and environment. d. hierarchical, web, and hybrid.

ANS: A

Using these three characteristics, one can determine why the system exists, what functions it performs to achieve its purpose, and how it is structured to achieve its purpose.

DIF: Cognitive Level: Analyze

REF: p. 20

3. A change made to any aspect of an open system, whether it is a health care system or a computer

system, will produce change in other aspects of that same system. As a result, any change can produce unintended consequences. This process is called: a. dynamic homeostasis. b. semi-planned change. c. negentropy. d. reverberation.

ANS: D

Change within any part of the system will be reflected across the total system through a process termed reverberation. Reverberation is reflected in the intended and unintended consequences of system change.

DIF: Cognitive Level: Remember

REF: p. 23

4. Chaotic systems are in a constant state of change. This degree or scope of change that can occur

has been described as the butterfly effect. The butterfly effect refers to: a. a minor change in input can create a major change in output, or a major change in input can result in minor changes in output. b. a major change in input will create a major change in output, and a minor change in input will create minor changes in output. c. a minor change in input can create a minor change in output; however, a major change in input will result in minor changes in output. d. a minor change in input may create a major change in output; however, a major change in input will create a major change in output.

ANS: A

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chaotic systems are dynamic systems with reiterative feedback loops. A minor change in input can create a major change in output. This is often described as the butterfly effect. A butterfly’s flapping wings in California can over time become a hurricane in New York.

DIF: Cognitive Level: Analyze

REF: p. 24

5. Which statement describes the measurement of information as defined by the Shannon and Weaver

model? a. The amount of information is measured by the amount of data in the message. b. The amount of information is measured by the number of meanings that can be assigned to a message. c. The amount of information is measured by the extent the message decreases entropy. d. The amount of information is measured by the number of characters used to create the message.

ANS: C

By decreasing entropy one decreases uncertainty. If a coin is thrown into the air, it may land on either of two possible sides, heads up or tails up. Once it lands, the other side of the coin canbe determined. The options are coded zero (0) and one (1) and are the basis for building computer code.

DIF: Cognitive Level: Remember

REF: pp. 25-26

6. The number 190 is an example of: a. data. b. information. c. knowledge. d. wisdom.

ANS: A

The number 190 could refer to anything such as a person’s weight, blood glucose level, or systolic blood pressure reading and therefore has no meaning by itself.

DIF: Cognitive Level: Apply

REF: p. 26

7. Knowing when and how to use knowledge is referred to as: a. procedural knowledge. b. cognitive knowledge. c. decision support system. d. wisdom.

ANS: D

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Wisdom is defined as the appropriate use of knowledge in managing or solving human problems. It is knowing when and how to use knowledge in managing patient need(s) or problem(s).

DIF: Cognitive Level: Remember

REF: pp. 26-27

8. Which concepts are used to describe the different types of learning outcomes and can be used to

write learning objectives? a. Input, throughput, and output b. Adult learning theories, constructionist theories, and learning styles c. Cognitive, affective, and psychomotor d. Short, intermediate, and long-term memory

ANS: C

Learning is defined as an increase in knowledge, a change in attitude or values, or the development of new skills.

DIF: Cognitive Level: Apply

REF: p. 30-31

9. Which group will test out new technology but are not usually seen as leaders within an

organization? a. Innovators b. Early adopters c. Early majority d. Late majority

ANS: A

Innovators will test out a new technology; however, they are too far ahead of the social group to be seen as leaders by other members of the social system. Early adopters are seen as much more discreet in their selection of new technology and are therefore better at selling a new technology to a group of potential users.

DIF: Cognitive Level: Understand

REF: p. 33

MULTIPLE RESPONSE 10. The systems life cycle (SLC) is a guide for informatics projects. Typical phases of the SLC include

(select all that apply): a. implementation. b. planning. c. evaluation. d. security. e. diagnosis.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: A, B, C

According to published reports, the SLC contains between 3 and 7 stages. The three that are common in each of these reports are implementation, planning, and evaluation.

DIF: Cognitive Level: Remember

REF: p. 35

Chapter 3: Evidence-Based Practice and Informatics Test Bank MULTIPLE CHOICE 1. Knowledge is the point of convergence across the areas of: a. evidence-based practice, quality assurance, and informatics. b. evidence-based practice, improvement, and informatics. c. evidence-based practice, quality assurance, and improvement. d. improvement, quality assurance, and informatics.

ANS: B

Knowledge is the point of convergence across the areas of evidence-based practice, informatics, and improvement. None of the other answers include all of these aspects.

DIF: Cognitive Level: Remember

REF: p. 42

2. Which two hurdles does the STAR Model address in employing evidence-based practice? a. The volume and form of knowledge b. The quality and form of knowledge c. The volume and outcomes of knowledge d. The adequacy and form of knowledge

ANS: A

The STAR Model addresses two major hurdles in employing evidence-based practice (EBP).

These two hurdles are the volume of current professional knowledge and the form of knowledge that healthcare professionals attempt to apply in practice.

DIF: Cognitive Level: Remember

REF: pp. 43-44

3. What is the form of knowledge in discovery research? a. Single research studies b. Meta-synthesis

Health Informatics-An Interprofessional Approach 2Ed(Staggers) c. Systematic review d. Meta-analysis

ANS: A

Discovery research represents knowledge produced in the form of single research studies. The other three choices represent synthesis of multiple studies.

DIF: Cognitive Level: Remember

REF: p. 44

4. Which type of review is considered the most rigorous? a. Literature reviews b. Systematic reviews c. Integrative reviews d. Single study reviews

ANS: B

Evidence summaries include evidence synthesis, systematic reviews, integrative reviews, and reviews of the literature, with systematic reviews being the most rigorous approach to evidence summary.

DIF: Cognitive Level: Remember

REF: pp. 44-45

5. A facility calls in experts to review evidence developed in research and develop guidelines for

clinical practice. Which stage of EBP is represented? a. Evidence summary b. Translation to guidelines c. Practice integration d. Evaluation of process and outcomes

ANS: B

In the third stage of EBP, translation, experts are called on to consider the evidence summary, fill in gaps with consensus expert opinion, and merge research knowledge with expertise to produce clinical practice guidelines (CPGs).

DIF: Cognitive Level: Understand

REF: pp. 46-47

6. Which indicators have been established for healthcare improvement and for public reporting? a.

Quality indicators b. Efficiency indicators c. Cost indicators d. Longevity indicators

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: A

Evaluation of specific outcomes has risen to a high level of public interest. As a result, quality indicators are being established for health improvement and public reporting.

DIF: Cognitive Level: Knowledge

REF: p. 50

MULTIPLE RESPONSE 7.

The goal of the intersection of informatics and evidence-based practice is to transform healthcare to be: (select all that apply.) a. reliable. b. safe. c. effective. d. efficient.

ANS: A, B, C

The field of informatics and the concept of evidence-based practice (EBP) intersect at the crucial junction of knowledge for clinical decisions with the goal of transforming healthcare to be reliable, safe, and effective. While efficiency is always a goal in healthcare, it is not a primary goal of EBP. DIF: Cognitive Level: Knowledge 8.

REF: p. 40

Which of the following are evidence summaries: (select all that apply.) a. Literature reviews b. Systematic reviews c. Integrative reviews d. Single study reviews

ANS: A, B, C

Evidence summaries include evidence synthesis, systematic reviews, integrative reviews, and reviews of the literature.

DIF: Cognitive Level: Knowledge 9.

REF: pp. 44-45

Using the STAR Model, which of the following points indicate knowledge transformation has occurred? (Select all that apply.) a. Discovery research b. Evidence summary c. Translation to guidelines d. Practice integration e. Testing the hypothesis

Health Informatics-An Interprofessional Approach 2Ed(Staggers) f.

Evaluation of process and outcomes

ANS: A, B, C, D, F

The knowledge transformation process in the STAR Model occurs at five points, which can be conceptualized as a five-point star. These five points include discovery research, evidence summary, translation to guidelines, practice integration, and evaluation of process and outcomes. Testing the hypothesis is not a specific point in the STAR Model.

DIF: Cognitive Level: Knowledge

REF: pp. 43-44

10. Standardized terminology is requisite for: (Select all that apply.) a. naming evidence. b. classifying evidence. c. tagging evidence. d. locating evidence. e. simplifying evidence.

ANS: A, B, C, D

Standardized terminology is requisite for naming, classifying, tagging, and locating evidence in order to use it in practice.

DIF: Cognitive Level: Knowledge

REF: p. 42

Chapter 4: Knowledge Discovery, Data Mining, and Practice-Based Evidence Test Bank MULTIPLE CHOICE 1. Which measure is most important for evaluating the performance of classifiers, models that predict

class membership? a. Root mean squared error (RMSE) b. Area under the receiver operating characteristic (ROC) curve c. Percentage of correctly classified cases d. Hosmer-Lemeshow statistic

ANS: B

The area under the receiver operating characteristic (ROC) curve is the most important overall measure of classifier performance.

DIF: Cognitive Level: Remember

REF: p. 62

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

2. Which specialized method(s) is (are) used in knowledge discovery and data mining? a. Stratified

sampling b. Conceptual analytic methods c. Selection of the optimal subset of variables/features for use in modeling d. Machine learning

ANS: C

Knowledge discovery and data mining (KDDM) makes use of specialized analytic methods, characteristically machine learning, to identify patterns in a semi-automated fashion.

DIF: Cognitive Level: Remember

REF: p. 56

3. The process of knowledge discovery and data mining is best characterized as: a. machine learning, use of statistical methods, large amounts of data. b. a process wherein patients are selected for clinical trials. c. “fishing” for information in data. d. cleaning data for further analysis using other methods.

ANS: A

Knowledge discovery and data mining (KDDM) is a process in which machine learning and statistical methods are applied to analyze large amounts of data.

DIF: Cognitive Level: Remember

REF: p. 56

4. Which characteristic is an advantage that practice-based evidence studies have over RCTs? a. Large sample sizes can be obtained easily. b. Multiple sites are typically enrolled, resulting in greater generalizability. c. Study efficacy is greater. d. Multiple variables can be studied.

ANS: C

Practice-based evidence (PBE) designs trade away the internal validity of RCTs for external validity. PBE designs have high external validity because they include virtually all patients with, or at risk for, the condition under study, as well as potential confounders that could alter treatment responses. PBE designs attempt to minimize threats to internal validity by trying to collect information on all patient variables – demographic, medical, nursing, functional, and socioeconomic – that might account for differences in outcome. By doing so, PBE designs minimize the need for compensating statistical techniques such as instrumental variables and propensity scoring to mitigate selection bias effects, unknown sources of variance, and threats to internal validity.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) DIF: Cognitive Level: Understand

REF: pp. 62-64

5. Which is not a common step in a practice-based evidence study? a. Assemble a multidisciplinary project team b. Measure patient severity c. Obtain patient consent d. Collect data

ANS: C

It is not necessary to obtain patient consent when treatment is not altered.

DIF: Cognitive Level: Understand

REF: pp. 66-67

6. Practice-based evidence studies differ from traditional observational designs in several main ways.

What is one of those main differences? a. Exhaustive attention paid to patient characteristics b. Excluding clinicians in the study design to improve treatment efficacy c. Use of small sample sizes and specific patient sources/settings d. General, unstructured documentation of interventions

ANS: A

Practice-based evidence involves intense attention to patient characteristics; including clinicians in the design; use of large sample sizes and diverse patient sources/settings; and detailed, standardized structured documentation of interventions.

DIF: Cognitive Level: Apply

REF: p. 56

MULTIPLE RESPONSE 7. Which methods are examples of data mining? (Select all that apply.) a. Decision trees b. Stratified random sampling c. Bayesian networks d. Artificial neural networks e. Factor analysis

ANS: A, C, D

Decision trees, Bayesian networks, and artificial neural networks are methods commonly used in data mining.

DIF: Cognitive Level: Remember

REF: p. 61; Table 4-2

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

8. Practice-based evidence requires close partnering with informatics specialists to: (select all that

apply) a. b. c. d.

design screens and terms to capture interventions. create and maintain the databases required for PBE studies. upgrade EHR modules so all sites are on the same version of software. ensure all end users are trained.

ANS: A, B

While upgrades are an informatics responsibility, sites do not have to be on the same version of software to do PBE studies.

DIF: Cognitive Level: Understand

REF: pp. 66-67

9. In which aspects does practice-based evidence differ from evidence-based practice? (select all that

apply) a. b. c. d. e.

PBE incorporates patient choices in decision-making.

EBP determines best practices using best evidence like results from RCTs. PBE includes family involvement.

PBE is prospective, while EBP is retrospective.

PBE attempts to capture the complexity and variability of actual clinical care.

ANS: B, D, E

EBP refers to identifying the evidence for clinical practice and conducting practice according to the best evidence. PBE is an innovative prospective research design that uses data gathered from current practice to identify what care processes work in the real world. PBE study designs attempt to capture the complexity presented by patient and treatment differences, offering a naturalistic view of treatment by examining what actually happens in the care process, not altering or standardizing the treatment regimen to evaluate efficacy of a particular intervention, as one does in an RCT or other types of experimental designs. EBP is about using evidence to guide practice. PBE is about obtaining evidence from practice.

DIF: Cognitive Level: Analyze

REF: pp. 62-64

COMPLETION 10.

refers to the assignment of individual records or rows in a data set to a specific purpose: model development (training, incremental testing of models during development) or validation (data held out from the development process for the purpose of unbiased performance estimation).

ANS:

Partitioning

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Partitioning refers to the assignment of individual records or rows in a data set to a specific purpose: model development (training, incremental testing of models during development) or validation (data held out from the development process for the purpose of unbiased performance estimation).

DIF: Cognitive Level: Remember

REF: p. 59

Chapter 5: Program Evaluation and Research Techniques Test Bank MULTIPLE CHOICE 1. Your organization hires you to conduct a formative evaluation of a new informatics intervention.

Which areas would you focus on in a formative evaluation? a. Cost, patient safety, and patient outcomes b. Intervention fidelity, implementation quality, and types of personnel c. Errors, change in provider decision-making, and cost d. Unintended outcomes, delays in implementation, and cost

ANS: B

Intervention fidelity, implementation quality, and types of personnel are areas that would be focused upon in formative evaluation. Results of the formative evaluation are used as feedback to the program for continuous improvement.

DIF: Cognitive Level: Apply

REF: p. 73

2. Which statement is true regarding the differences between research and evaluation? a. Evaluation is concerned with the goals of a specific program and usually has multiple

stakeholders as compared to research, which has specific scientific hypotheses and fewer stakeholders. b. Evaluation studies have higher generalizability, whereas research is concerned with only internal generalizability. c. Evaluation studies use few methods, whereas research studies use multiple methods. d. Evaluation studies have longer timelines and more resources, compared to research with shorter timelines and fewer resources.

ANS: A

Evaluation is concerned with the goals of a specific program, whereas research focuses on a specific scientific hypothesis. There are also fewer stakeholders in research than in evaluation.

The scope of research is limited, whereas evaluation has a much broader scope. There are many components in evaluation that cannot be easily put into one category.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) DIF: Cognitive Level: Understand

REF: pp. 72-74

3. Which list includes the 3 levels of theory relevant to evaluation? a. Program, summative, and interpersonal theories b. Scientific, formative, and descriptive theories c. Scientific, implementation models, and program theories d. Scientific, statistical, and models

ANS: C

The three levels of theory relevant to evaluation are scientific theories, implementation models, and program theories. The other choices are either not theories or are specific theories, not levels of theory.

DIF: Cognitive Level: Remember

REF: p. 75

4. You decide to base the evaluation plan of your informatics project on the theory of planned

behavior. Which constructs will you use to develop your measurements? a. Values, normative expectations, others’ beliefs, and overall prior knowledge b. Values, beliefs about self-efficacy, normative beliefs, and intrinsic motivation c. Values, expectations of others, behaviors, and perceived self-efficacy d. Habit, normative expectations, beliefs about resources, and overall prior knowledge

ANS: C

The theory of planned behavior focuses on the ability to predict intentions and behavior as a function of beliefs about the value of an outcome, the likelihood that the outcome will occur given the behavior, beliefs about the expectations of others, and self-efficacy beliefs about the personal ability to engage in the activity.

DIF: Cognitive Level: Understand

REF: p. 75

5. The stages of change identified in diffusion of innovation theory are: a. contemplation, persuasion, action, and knowledge. b. knowledge, persuasion, decision, implementation, and confirmation. c. awareness, understanding, action, implementation, and confirmation. d. contemplation, decision, action, and knowledge.

ANS: B

The stages of change identified in the diffusion of innovation theory are knowledge, persuasion, decision, implementation, and confirmation. The stages of change are one way to understand and evaluate how the change has occurred.

DIF: Cognitive Level: Remember

REF: p. 75

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 6. If you choose to evaluate an informatics intervention by examining the impact on a clinician’s

ability to think ahead about future events, which level of situation awareness would you be measuring? a. Social b. Perception c. Comprehension d. Projection

ANS: D

Projections are expectations of outcomes in the future. Projections are driven by implicit theories and knowledge about the causal mechanisms underlying events.

DIF: Cognitive Level: Understand

REF: p. 75

7. UTAUT is a theory of: a. user’s knowledge of social networks. b. acceptance and use of technology. c. decision-making skills. d. technology support options.

ANS: B

The unified theory of acceptance and use of technology (UTUAT) assesses factors associated with effective use.

DIF: Cognitive Level: Understand

REF: pp. 76-77

8. You decide to interview all the key stakeholders involved in an informatics intervention as part of

the planning process. Together you identify the resources available, the likely barriers, and the short-term and long-term objectives. Which kind of theoretical model are you using? a. Scientific theory b. Theory of planned behavior c. Logic model d. Diffusion model

ANS: C

Program theory models consist of the implicit ideas and beliefs of key stakeholders. A logic model is a representation of components and mechanisms of the program. Basically, a logic model is a systematic and visual way to present and share your understanding of the relationship among the resources you have to operate your program, the activities you plan, and the changes or results you hope to achieve.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) DIF: Cognitive Level: Apply

REF: pp. 79-80

9. In a social network analysis, each node is usually a(n): a. individual or unit of analysis. b. event. c. location. d. attitude.

ANS: A

Nodes are individuals, and lines are connections. The size of the line is often the number of interactions between individuals, and the size of the node is the number of interactions with that unit.

DIF: Cognitive Level: Understand

REF: p. 83

MULTIPLE RESPONSE 10. You decide to conduct an evaluation of a new informatics intervention for nurses in the ICU. You

decide to use only qualitative methods. Which methods would be conducted? (Select all that apply.) a. Observing nurses in the ICU at randomly selected time periods and recording their activities b. Conducting semi-structured interviews and conducting thematic analysis c. Collecting log reports for computer access, grouping sites accessed by nurses into similar categories, and seeing what the categories look like d. Measuring the amount of time nurses spent on the computer

ANS: A, B, C

Random observations, semi-structured interviews, and categorization without counting are all examples of qualitative activities. Counting, measuring, and calibrating are quantitative activities.

DIF: Cognitive Level: Apply

REF: pp. 80-82

Chapter 6: Electronic Health Records and Applications for Managing Patient Care Test Bank MULTIPLE CHOICE 1. Which description best defines the electronic health record (EHR)? a. An electronic version of the traditional paper record created and used by the healthcare

provider b. An electronic stand-alone database implemented and used in hospitals

Health Informatics-An Interprofessional Approach 2Ed(Staggers) c. An electronic version of a patient’s medical record used in the clinical setting d. An electronic record of patient health information created by encounters across multiple

settings

ANS: D

The Healthcare Information Management Systems Society (HIMSS) provides a definition of the EHR as a longitudinal electronic record of patient health information produced by encounters in one or more care settings. Every person will have a birth to death (and even postmortem) record of health-related information in electronic form from multiple sources, such as physician office visits, inpatient and outpatient hospital encounters, medications, allergies, and multiple other medical services to support care. All other answers refer to a single facility use, which is not the EHR but a potential component of the EHR. DIF: Cognitive Level: Remember

REF: pp. 88-89

2. The Health Information Management Systems Society (HIMSS) developed an EMR adoption

model that includes eight stages toward creating a paperless patient record environment. All application capabilities within each stage must be operational before the next stage can be achieved. Your organization has implemented systems for Stages 1 and 2. Which system should your organization consider as Stage 3 adoption? a. Computerized provider order entry (CPOE) and clinical decision support b. Nursing/clinical documentation (flow sheets) and clinical decision support c. Closed loop medication administration d. Physician-structured documentation and clinical decision support

ANS: B

Stage 1 includes the installation of ancillaries (lab, radiology, pharmacy). Stage 2 includes clinical data repository (CDR), controlled medical vocabulary, and clinical decision support system (CDSS) and may also include document imaging and health information exchange.

Stage 3 would require clinical documentation (flow sheets), CDSS (error checking), and a picture archiving system (PACS) available outside radiology.

DIF: Cognitive Level: Apply

REF: p. 92

3. Which system is recommended as a method to address patient safety and reduce errors that occur

during the actual administration of medicines? a. Computerized provider order entry (CPOE) b. Bar code medication administration (BCMA) c. Electronic medication administration record (eMAR) d. Electronic prescribing (eprescribing)

ANS: B

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Bar code medication administration (BCMA) is a method used to address patient safety and reduce errors that occur during the actual administration of medicines. CPOE is used to decrease transcription errors during the ordering process. ePrescribing is also used by the physician to order the medication (not administer). The eMAR is used to document the medications that are given.

DIF: Cognitive Level: Apply

REF: pp. 93-94

4. Which would be considered a niche application? a. Computerized provider order entry (CPOE) b. Laboratory information system (LIS) c. Clinical decision support system (CDSS) d. Surgical information system (SIS)

ANS: D

Some examples of specialty department niche systems include perioperative or surgical services, maternity care, neonatal intensive care, and the emergency department. The LIS is an ancillary system. CPOE and CDSS are basic components of the EHR. DIF: Cognitive Level: Apply

REF: p. 95

5. A university hospital wants to implement a “closed-loop” medication management system. Current

systems include registration, computerized provider order entry, electronic medication administration record, laboratory, radiology, and pharmacy. Which system is needed to complete the loop? a. Clinical documentation b. Clinical decision support system c. Bar-coding system d. Electronic prescribing

ANS: C

A closed-loop medication management system would connect the pharmacy system to the CPOE, eMAR, and bar-coding systems.

DIF: Cognitive Level: Apply

REF: p. 96

6. As the U.S. moves toward the implementation of an interoperable EHR, which statement about the

future “ownership” of the patient record is appropriate? a. The electronic medical record will be the property of the service institution. b. Provider access to the electronic record would not require consumer consent. c. Ownership may be driven by who has control and access to the data. d. Consumers will control and own the record.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: C

Traditional medical records have always been the property of the service institution, but this may not be true in the future. Consumer consent is required for health professionals to retrieve or share patient records to ensure personal information is not accessed inappropriately.

Ultimately, ownership may be driven by who has control and access to the data.

DIF: Cognitive Level: Analyze

REF: p. 99

7. As EHR adoption expands to include data from multiple healthcare entities, more opportunities for

error exist. Which process can affect data integrity? a. System failure b. Data analysis c. Data downloading d. Data mining

ANS: A

Data integrity refers to the accuracy and consistency of stored and transmitted data that can be compromised when information is entered incorrectly, deliberately altered, or the system protections are not working correctly or suddenly fail.

DIF: Cognitive Level: Analyze

REF: pp. 99-100

MULTIPLE RESPONSE 8.

Which issues are considered impediments to a fully functional electronic health record (EHR) system? (Select all that apply.) a. Cost b. Standardization c. Care coordination d. Organizational culture e. Privacy and confidentiality f. Education

ANS: A, B, D, E

Despite the many advances in technology, there are still many issues to resolve associated with implementation costs, ownership, data integrity, privacy and confidentiality, organizational culture, human factors, and development of an infrastructure to support a nationwide EHR. Care coordination is considered an advantage, and education is not a major issue.

DIF: Cognitive Level: Understand

REF: p. 99

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 9.

The core set of Stage 1 Meaningful Use objectives requires hospitals and providers to take which actions? (Select all that apply.) a. Use computerized provider order entry for medication orders b. Transmit prescriptions electronically c. Provide patients with discharge instructions or summary of office visit d. Record and chart changes in vital signs as structured data e. Maintain current problem and diagnoses list

ANS: A, B, C, E

Use computerized provider order entry for medication orders, transmit prescriptions electronically, provide patients with discharge instructions or summary of office visit, and maintain current problem and diagnoses list are all Stage 1 Meaningful Use objectives.

Recording and charting changes in vital signs as structured data is a Stage 2 objective because the use of structured data will not be enforced until this later stage.

DIF: Cognitive Level: Remember

REF: pp. 89-91

10. The university hospital is getting ready to implement computerized provider order entry and some

decision support capabilities to include drug-drug and drug-allergy alerts. Which actions should the implementation team take to increase user acceptance of the system? (Select all that apply.) a. Involve users early in the design, testing, and implementation of the system b. Conduct a quantitative research study to provide deeper insight into CPOE issues c. Design the new system to support communication and work flow d. Educate clinicians on how to use the system features e. Plan for continuous safety monitoring

ANS: A, C, D, E

Qualitative measures such as early involvement, ensuring design supports communication and workflow, clinician education and continuous safety monitoring provide deeper insight into the benefits and issues surrounding computerized provider order entry and some decision support capabilities. Quantitative research is helpful but would not provide the deeper content of the issues.

DIF: Cognitive Level: Apply

REF: p. 93

11. The general attitude of consumers toward health information technology is positive. Which items

are perceived EHR benefits for the consumer? (Select all that apply.) a. Collaborative interaction between patients and providers b. Security and privacy of personal information c. Timely access to personal health information d. Online access to educational materials e. Customize care through reminders

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: A, C, D, E

From a consumer perspective, an EHR system should provide the ability to customize care through appointment reminders, health risk assessments, and timely access to personal health information. The availability of online educational resources will improve understanding of treatment choices and offer more control over personal health outcomes. Consumers also benefit from EHR technology when there is collaborative interaction between patients and physicians. Although the EHR has the potential to address these items, security and privacy of personal information are perceived as major concerns and, therefore, are not a benefit to the consumer.

DIF: Cognitive Level: Apply

REF: p. 97

Chapter 7: Applications for Managing Institutions Delivering Healthcare Test Bank MULTIPLE CHOICE 1. A financial information system (FIS) includes: a. accounts receivable management, accounts payable management, and fiscal reporting

management. b. clinical systems management, accounts receivable management, and fiscal reporting management. c. accounts payable management, accounts receivable management, and clinical systems management. d. fiscal reporting management, accounts payable management, and clinical systems management.

ANS: A

FISs are not involved with the clinical management of care. Accounts receivable management, accounts payable management, and fiscal reporting management are financial management processes and included in an FIS. DIF: Cognitive Level: Remember

REF: pp. 108-110

2. Financial reporting is a vital part of decision making in healthcare organizations. Which report

would be used to show a snapshot of the bottom line? a. Balance sheet or statement of financial position b. Cash flow statements c. Assets, liabilities, and equity d. Income statement or statement of operation

Health Informatics-An Interprofessional Approach 2Ed(Staggers) ANS: D

Income statements reflect the following formula: revenue – expenses = profit. This is often referred to as the bottom line. The balance sheet, on the other hand, reflects an organization’s assets, liability, and equity.

DIF: Cognitive Level: Understand

REF: p. 110

3. Return on investment (ROI) in financial information systems (FISs) is challenging because: a. patient accounting is considered an intangible asset. b. FISs systems are very complex. c. FISs often lose money due to complexity. d. staff requires substantial training, which is very costly.

ANS: A

Decision makers may have a more challenging time realizing the return on investment or understanding the importance of the investment in FISs, since information technology software applications, such as patient accounting or revenue, are considered intangible assets.

DIF: Cognitive Level: Apply

REF: p. 110

4. The supply item master is: a. an electronic history of all transactions. b. an electronic pricing list of all supplies and services. c. a list of all items available to order in the organization. d. a list of vendors who supply items to the organization.

ANS: C

The supply item master is the master list of supplies available to order in the organization.

DIF: Cognitive Level: Remember

REF: p. 116

5. Business practices and information systems in the supply chain must: a. counterbalance each other to ensure safety. b. work together to best manage the system and support patient care. c. never work in tandem to minimize errors. d. only provide financial information for the organization.

ANS: B

Information systems must reflect an organization’s business practices.

DIF: Cognitive Level: Comprehension

REF: pp. 115-116

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

6. A vendor master file is: a. a list of federally approved pharmaceutical companies. b. a list of suppliers used by the organization. c. a list of criteria for supplier compliance. d. a list of EHR vendors.

ANS: B

The terms vendor and supplier are synonymous, so a vendor master file is a list of suppliers used by the organization.

DIF: Cognitive Level: Remember

REF: p. 116

7. Open shift management: a. refers to a theory of peer-based leadership in which no single person is in charge. b. forecasts openings in the schedule using predictive models. c. refers to a form of scheduling expediency in which staff qualifications are not considered

when making scheduling assignments. d. is a form of web-based self-scheduling.

ANS: D

Open shift management uses web-based technologies to allow employee self-scheduling. Other terms used include shift bidding systems. These systems allow employees to sign up for open shifts over the Internet.

DIF: Cognitive Level: Remember

REF: p. 120

MULTIPLE RESPONSE 8.

When using the online billing and payment tool, which functions directly benefit the patient?

(Select all that apply.) a. Self-management of open accounts b. Ability to pay outstanding balances c. Gives providers a dashboard to view critical clinical and financial information d. Secure communication on a 24/7 basis with the business office e. Ability to update address or demographic changes f. Automate the provider’s day as much as possible

ANS: A, B, D, E

Self-management of open accounts, ability to pay outstanding balances, secure communication on a 24/7 basis with the business office, and ability to update address or demographic changes

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

are components of the online billing and payment system that benefit patients. These functions benefit patients because patients can access the system to perform the listed functions at their convenience. Though they may indirectly benefit the patient, automating the provider’s day and providing the provider with a dashboard view are direct benefits for the provider.

DIF: Cognitive Level: Understand 9.

REF: p. 115

The supply chain in healthcare includes: (Select all that apply.) a. transportation of supplies. b. storage of supplies. c. management of supplies. d. prediction of supplies used.

ANS: A, B, C

The healthcare supply chain includes the following processes: transportation of supplies, storage of supplies, and management of supplies. It does not include a prediction of the supplies used.

DIF: Cognitive Level: Understand

REF: p. 115

10. Supply charge capture is a process that: (Select all that apply.) a. uses the CDM to charge a patient for supplies used in the patient’s care. b. is a method to manage and inventory supplies. c. accounts for pharmaceutical supplies based on federal requirements. d. closely links the supply chain to the revenue management system.

ANS: A, D

The supply charge master assigns a charge for the care provided to a patient. Without a charge being assigned, the patient will not be billed, so this is also a critical part of the revenue cycle.

DIF: Cognitive Level: Apply

REF: pp. 117-118

Chapter 8: Telehealth and Applications for Delivering Care at a Distance Test Bank MULTIPLE CHOICE 1. Which government organization manages the largest telehealth program in the United States as of

this writing? a. Department of Defense b. NASA c. Department of Veterans Affairs

Health Informatics-An Interprofessional Approach 2Ed(Staggers) d. Office for the Advancement of Telehealth

ANS: C

The Department of Veterans Affairs manages the largest telehealth program in the United States. The remaining responses are incorrect.

DIF: Cognitive Level: Remember

REF: p. 128

2. What are the two overarching types of telehealth technologies? a. Live and real time b. Web-based and synchronous c. Asynchronous and videoconferencing d. Synchronous and asynchronous

ANS: D

Synchronous and asynchronous are the two overarching types of telehealth technologies. The remaining responses are components of telehealth.

DIF: Cognitive Level: Remember

REF: p. 128

3. The majority of healthcare delivered globally is: a. acute care. b. emergency care. c. self-care. d. primary care.

ANS: C

The majority of healthcare that is delivered globally is self-care. The remaining responses are types of healthcare one finds in modernized or western countries.

DIF: Cognitive Level: Remember

REF: pp. 140-141

4. What is the most important element for operationalizing and ensuring telehealth acceptance by

providers? a. Cost of telehealth technology b. Training c. Location of equipment d. Transmission speed

ANS: B

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Training is one of the most important elements in the acceptance of telehealth by providers.

The remaining responses, although relevant, are not important drivers of acceptance.

DIF: Cognitive Level: Understand

REF: p. 133

5. The migration of informatics and telehealth toward uhealth means: a. ecosystems of interoperable technologies and services organized to meet global patients’

needs in a ubiquitous manner. b. an approach toward underground installation of fiber optics and cable networks organized

to meet global patients’ needs in a ubiquitous manner. c. understanding of telehealth implementation barriers organized to meet global patients’ needs in a ubiquitous manner. d. university programs for training healthcare providers organized to meet global patients’ needs in a ubiquitous manner.

ANS: A

The migration of informatics and telehealth toward uhealth means ecosystems of interoperable technologies and services will be organized to meet global patients’ needs in a ubiquitous manner.

DIF: Cognitive Level: Apply

REF: p. 142

6. The first use of telehealth was documented in: a. 1897. b. 1935. c. 1999. d. 2002.

ANS: A

The first use of telehealth was documented in 1897. The remaining responses are not correct.

DIF: Cognitive Level: Remember

REF: p. 127

MULTIPLE RESPONSE 7.

Policy issues directly impacting telehealth practice for healthcare providers include: (Select all that apply.) a. technology. b. malpractice. c. licensure. d. credentialing. e. reimbursement. f. broadband

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: B, C, D, E

Policy issues directly impacting telehealth practice for healthcare providers include malpractice, licensure, credentialing, and reimbursement. Technology and broadband are both available and do not directly impact healthcare providers.

DIF: Cognitive Level: Understand 8.

REF: p. 138

Telehealth programs with high-quality clinical practice require which tools? (Select all that apply.) a. Standards and guidelines b. Protocols and procedures c. Evaluation/quality improvement methods d. Certification programs

ANS: A, B, C

Telehealth programs with high-quality clinical practice require the following tools: standards and guidelines, protocols and procedures, and evaluation/quality improvement methods.

Certification programs are not tools.

DIF: Cognitive Level: Apply 9.

REF: p. 131

eHealth literacy for consumers includes which elements? (Select all that apply.) a. Visual literacy b. Computer literacy c. Financial literacy d. Business modeling literacy e. Information literacy f. Digital literacy

ANS: A, B, E, F

eHealth literacy for consumers includes the following elements: visual literacy, computer literacy, information literacy, and digital literacy. The other two forms of literacy are not required for consumers.

DIF: Cognitive Level: Understand

REF: p. 141

10. What are the advantages of telehealth for patients? (Select all that apply.) a. Decreased travel time or distance and removal of travel barriers b. Ease of reimbursement for costs c. Immediate access to care d. Early detection of disease processes or health issues e. Ownership of healthcare and feelings of empowerment

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: A, C, D, E

The advantages of telehealth for patients include immediate access to care, decreased travel time, early detection of health issues, and ownership of healthcare. Ease of reimbursement is an advantage for providers.

DIF: Cognitive Level: Apply

REF: p. 126

Chapter 9: Home Health and Related Community-Based Systems Test Bank MULTIPLE CHOICE 1. Which payer is the largest for home health services? a. Private insurance b. Patients and families in the form of self-pay c. Medicare d. Medicaid

ANS: C

As the largest payer, Medicare, through its Conditions of Participation, represents the standard for the services provided by home health agencies and the payment for these services by many commercial insurance payers and state Medicaid programs.

DIF: Cognitive Level: Understand

REF: p. 149

2. What are the two important purposes of the OASIS data set? a. Determine payment and measure quality and outcomes b. Determine payment and standardize data c. Determine the time of visits and measure quality and outcomes d. Determine efficiency and measure quality and outcomes

ANS: A

OASIS, or the Outcome and Information Set, is a standardized data set with two important purposes: it is the basis for determining payment for each 60-day episode of care, and it measures the quality and outcomes of services delivered by home health agency clinicians.

DIF: Cognitive Level: Understand

REF: p. 151

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 3. When did formalized home health and community-based systems originate in the United States? a. 1776 b. 1800s c. 1965 d. 2001

ANS: B

Early home health services originated in the United States in the 1800s and were based on the district nursing model developed in England. Often, initial programs evolved into visiting nurse associations. Home health services increased and changed considerably after Medicare was enacted in 1965.

DIF: Cognitive Level: Remember

REF: p. 148

4. What technology has been described as the next frontier for home health and related community-

based systems? a. EHR b. CDS c. EMR d. BCMA

ANS: B

Clinical decision support (CDS) systems may be the next frontier for home health and related community-based systems. CDS systems are applications that analyze data and help providers make clinical decisions.

DIF: Cognitive Level: Remember

REF: p. 153

MULTIPLE RESPONSE 5.

Which of the following tools will the standardized hospice data set probably contain? (Select all that apply.) a. National Data Set for Hospice b. Family Evaluations of Care c. Survey of Team Attitudes and Relationships d. Survey of Missed Nursing Care

ANS: A, B, C

The data set will probably incorporate frequently used tools such as the National Data Set for Hospice, Family Evaluations of Care, Survey of Team Attitudes and Relationships, and End Result Outcome Measures.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

DIF: Cognitive Level: Understand 6.

REF: p. 151

What are the key tenants of the Triple Aim for Health Care? (Select all that apply.) a. Better care for individuals b. Better health for populations c. Better working conditions for nurses d. Reduction of per capita costs

ANS: A, B, D

The Triple Aim for Health Care is a broad philosophy designed to address the most abstract level of healthcare services in the United States. It includes better care for individuals, better health for populations, and reduction of per capita costs.

DIF: Cognitive Level: Understand 7.

REF: p. 150

What are the primary goals for using EHRs in home health and related community-based systems? (Select all that apply.) a. To provide an effective and efficient method for tracking cost and related billing b. To capture clinicians’ documentation that supported interaction with patients at the point of care c. To support clinical decision making and quality of care by presenting best practices and evidence-based practice options d. To improve communication e. To teach patients how to use technology

ANS: A, B, C, D

Agency providers are embracing technology as an effective tool to manage all aspects of care.

Patients do not participate in the development of EHRs. DIF: Cognitive Level: Remember 8.

REF: pp. 151-152

The Omaha System consists of components that capture: (Select all that apply.) a. evaluation data. b. cost data. c. assessment data. d. service delivery/activity data.

ANS: A, C, D

The Omaha System is a standardized terminology designed to operationalize the nursing or problem-solving process. It consists of the Problem Classification Scheme (assessment), Intervention Scheme (service delivery/activities), and the Problem Rating Scale for Outcomes

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

(evaluation). When nurses and other clinicians use the Omaha System, they can describe, quantify, and communicate details about their practice.

DIF: Cognitive Level: Remember 9.

REF: pp. 154-155

What are the core values of nurses who work in home health and community-based systems?

(Select all that apply.) a. Embrace interprofessional collaboration b. Involve patients and families in care and decision making c. Schedule home visits and travel to begin and end each work day on time d. Provide patient-centered care

ANS: A, B, D

The core values are essential so that nurses help patients and their families increase their knowledge, gain skills, and become independent with their care. Nurses must be very flexible; they need to modify their schedules frequently.

DIF: Cognitive Level: Remember

REF: pp. 149-150

10. Why is it important for software used by nurses who work for home health and related

community-based systems to be based on a standardized terminology? (Select all that apply.) a. To support evidence-based practice b. To generate reports needed to monitor care, improve the quality of services, and track costs c. To improve patient understanding of their medical records d. To improve communication among care providers at multiple locations e. To describe and quantify practice for clinicians, managers, administrators, and thirdparty reviewers

ANS: A, B, D, E

Software needs to be based on a standardized terminology for many reasons. A reasonable level of standardization involving practice, documentation, and information management helps home health nurses and other related community-based system clinicians provide better quality care and share details about that care with those within and outside of their organizations.

DIF: Cognitive Level: Understand

REF: p. 154

Chapter 10: Clinical Decision Support Systems in Healthcare Test Bank MULTIPLE CHOICE

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 1. Why have most CDS systems not shown to significantly impact patient outcomes in clinical trials,

despite the fact that a majority of systems have been shown to significantly improve careprocesses? a. CDS systems have not been evaluated in clinical trials. b. Very few studies have assessed the impact of CDS systems on patient outcomes. c. Many CDS system evaluation trials are underpowered to detect changes in care outcomes. d. CDS systems have been implemented and evaluated in too many diverse institutions.

ANS: C

The sample sizes of many CDS system evaluation studies were too small or conducted with too short of a time period to detect changes in care outcomes.

DIF: Cognitive Level: Analyze

REF: p. 170

2. Which group would have a financial incentive to implement CDS? a. A community hospital b. An inner-city clinic c. A national insurer d. Depends on CDS and healthcare payment model

ANS: D

Whether a particular stakeholder group has a financial incentive to implement CDS depends on the specific CDS under consideration and the governing healthcare payment model in place.

DIF: Cognitive Level: Apply

REF: p. 171

3. A healthcare system has implemented a functionality where patients who are overdue or almost

due for a mammogram are sent letters notifying them to schedule a mammogram based on available data and current clinical care guidelines. Which type of CDS system is this? a. This is not a CDS. b. A personal health record system c. A reminder system d. An alerting system

ANS: C

This is a classic example of a reminder system. Patients are also potential targets of CDS interventions.

DIF: Cognitive Level: Apply

REF: pp. 166-167 | p. 173

4. Which statement is not part of the Ten Commandments of CDS? a. Speed is everything.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) b. Fit into the user’s workflow. c. Alerting is the most effective approach to CDS. d. Ask for additional information only when you really need it.

ANS: C

The Ten Commandments of CDS include speed is everything, fit into the user’s workflow, and ask for additional information only when you really need it. Alerting may not be the most effective approach to CDS as it may cause alert fatigue, so it is not one of the Ten Commandments of CDS. DIF: Cognitive Level: Remember

REF: p. 172

5. Which incentive has the strongest potential to spur the nationwide adoption of advanced CDS? a. Freely available CDS knowledge in a machine-executable form b. Significant government funding for research efforts to share CDS c. Shift of healthcare payment from a fee-for-service model to approaches rewarding the

delivery of better quality and outcomes at lower cost d. Meaningful Use Stage 1 requirements related to CDS

ANS: C

All of these are important elements encouraging nationwide adoption of advanced CDS. However, as discussed in the chapter, the shift of healthcare payment from a fee-for-service model to approaches rewarding the delivery of better quality and outcomes at lower cost appears to have the strongest potential for change.

DIF: Cognitive Level: Apply

REF: p. 173

MULTIPLE RESPONSE 6.

Which tools are examples of CDS? (Select all that apply.) a. An order set b. A reminder c. A phone call d. An infobutton

ANS: A, B, D

Despite CDS often being limited to alerts and reminders, an order set, a reminder, and an infobutton are also examples that represent CDS types. A phone call is not a type of CDS. DIF: Cognitive Level: Apply

REF: pp. 166-170

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 7.

Why is CDS important for healthcare institutions? (Select all that apply). a. It can reduce the need for registered nurses. b. It can help reduce medical errors. c. It is a required element of Meaningful Use regulations. d. It can help improve care value.

ANS: B, C, D

CDS is important on multiple levels. CDS has been found to reduce medical errors, is required as part of Meaningful Use, and has the potential to improve the value of care. CDS have not been found to reduce the need for registered nurses.

DIF: Cognitive Level: Apply 8.

REF: pp. 164-167

Why are expert diagnostic decision support systems not integrated into clinical settings ? (Select all that apply.) a. They have not been shown to be comparable to the performance of human experts. b. Clinicians generally must go out of their routine workflows to use the systems, and these systems generally require time-consuming data entry. c. There are limited financial incentives to use such systems. d. The systems have been found to be detrimental to patient care.

ANS: B, C

There has been a lot of attention and promise on diagnostic decision support systems, including trials showing how they could outperform clinician experts. However, as discussed in other sections of the chapter, systems that are misaligned with the clinician’s workflow and limited financial incentives are reasons for limited use of diagnostic CDS systems. Diagnostic CDS can be comparable to human experts when used appropriately. Also, these systems have not been found to be detrimental to patient care.

DIF: Cognitive Level: Analyze 9.

REF: pp. 171-172

Which of the following are challenges or barriers to CDS adoption? (Select all that apply) a. Lack of evidence of CDS effectiveness b. Misaligned financial incentives c. Inadequate EHR adoption d. Lack of widely adopted standards for CDS

ANS: B, C, D

All of the choices except lack of evidence of CDS effectiveness are challenges or barriers to CDS adoption. There is evidence to suggest that CDSs are effective. Misaligned financial incentives, inadequate EHR adoption, and a lack of widely adopted standards for CDS are challenges and barriers to adoption.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

DIF: Cognitive Level: Remember

REF: pp. 171-172

10. Which of the following practices are included in the CDS Five Rights? (Select all that apply.) a.

Providing the right information b. Providing to the right person c. Providing at the right point in work flow d. Providing the right reference information

ANS: A, B, C

The CDS Five Rights include providing the right information to the right person at the right point in the work flow. Providing applicable reference information has been suggested by others to be a potential best practice for CDS. However, it is not one of the CDS Five Rights.

DIF: Cognitive Level: Remember

REF: pp. 172-173

Chapter 11: Public Health Informatics Test Bank MULTIPLE CHOICE 1. Which is not an activity of public health? a. Direct clinical services b. Disease outbreak management c. Bariatric surgery because obesity is a national public health problem d. Rat and mosquito abatement

ANS: C

Although obesity is a national public health problem, public health does not provide surgical services. Surgical services are typically provided in the acute care or outpatient care settings.

The other responses are activities of public health.

DIF: Cognitive Level: Understand

REF: pp. 179-180

2. Public health differs from clinical practice in important ways. Which statement reflects the

differences? a. Public health is focused on the prevention and health of populations before they are ill. b. Public health is focused on one individual at a time to ensure the best possible outcome. c. The health of a community is measured by the use of sophisticated technologies like MRIs. d. Public health is focused on one family at a time to ensure the best possible outcome.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: A

Public health is concerned with the health of populations and communities rather than the individual, and therefore, its focus is on the health and prevention of illness of populations.

DIF: Cognitive Level: Analyze

REF: pp. 180-181

3. You are asked to justify the creation of the first public health informatics (PHI) program in your

jurisdiction. You will emphasize this likely benefit by ensuring: a. current PHI can enhance public health surveillance such as identifying clusters of diseases. b. privacy and security issues are avoided because public health informatics data are deidentified at the community level. c. interoperability already exists for public health IT. d. standards already exist for PHI.

ANS: A

Emphasizing the likely benefit of a PHI program (e.g. identifying clusters of diseases) will ensure that current PHI can enhance public health surveillance. The others are still issues in public health informatics, but they do not ensure benefit.

DIF: Cognitive Level: Analyze

REF: pp. 185-187

4. Despite the challenges, public health systems are now available. Good examples of these systems

have implemented vocabulary and messaging standards, are used to make public health decisions in a clinical setting, and provide data for public health policy. One of the best examples is: a. the linkage of local electronic health records in the 50 states to public health reporting databases. b. immunization information systems. c. geographical informatics systems for reporting environmental issues. d. direct lab reporting of conditions and diseases such as lead poisoning.

ANS: B

Immunization information systems exemplify public health systems that implement vocabulary and messaging standards, that are used to make public health decisions in a clinical setting, and that provide data for public health policy. The others lack one or more of the stated elements.

DIF: Cognitive Level: Understand

REF: pp. 187-189

5. The public health supply chain needs to evolve to an information ecology approach for the future

direction. This would involve: a. standardizing public health supplies and suppliers. b. being partners with others to receive, reuse, and republish data. c. allowing public health departments to exclude data sharing to protect patient privacy.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) d. allowing public health departments to include data sharing to protect patient privacy.

ANS: B

Information ecology involves the reuse and sharing of data.

DIF: Cognitive Level: Apply

REF: pp. 192-193

6. Public health could benefit from improved technical architectures in the future. Which of these is

not a likely technology for the future? a. Service-oriented architecture (SOA) b. Software as a service (SaaS) c. Open source methods such as OpenELS or OpenMRS d. Mobile devices such as the iPhone

ANS: D

While mobile devices are popular, they are not considered infrastructure and they do not allow sharing between device manufacturers, the very function that public health would require.

DIF: Cognitive Level: Remember

REF: pp. 193-194

MULTIPLE RESPONSE 7.

Which social and political challenges impact public health informatics? (Select all that apply.) a.

The limits of federal authority b. The evolution of public health primarily as state and local functions c. The lack of resources to implement health IT d. The presence of standards to implement health IT

ANS: A, B

Social and political challenges impacting public health informatics include the limits of federal authority and the evolution of public health primarily as state and local functions. Public health is not nationally organized and monitored.

DIF: Cognitive Level: Apply 8.

REF: p. 183

Blueprint Version 2.0 updates public health surveillance activities for the 21st century. Which methods exemplify these activities? (Select all that apply.) a. Analysis of population data to describe disease characteristics and risk factors b. Analysis of electronic health record data c. Biomonitoring and environmental monitoring d. Analysis of individual data to describe disease characteristics and risk factors

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: A, B, C

Methods that exemplify Blueprint Version 2.0 updates for public health surveillance activities for the 21st century include analysis of population data to describe disease characteristics and risk factors, analysis of electronic health record data, and biomonitoring and environmental monitoring.

DIF: Cognitive Level: Apply 9.

REF: p. 186

Informatics opportunities for reportable conditions include: (Select all that apply.) a. the use of computable logic to define where and how reports should be sent. b. automation of patient education from electronic health records. c. automation of information extraction from electronic health records. d. standardization of message structure and content for reporting.

ANS: A, C, D

Informatics opportunities for reportable conditions include the use of computable logic to define where and how reports should be sent, automation of information extraction from electronic health record, and standardization of message structure and content for reporting.

DIF: Cognitive Level: Remember

REF: p. 191

10. Immunization information systems are used to record at least some of the immunizations for about

75% of children in the U.S. Which benefits are provided by the use of these systems?

(Select all that apply.) a. A high return on investment b. The ability to provide consolidated immunization histories to avoid over- or undervaccinating c. The ability to improve vaccination rates by integrating data across the country d. Integration across nations

ANS: A, B, C

Immunization information systems provide the following benefits: a high return on investment, the ability to provide consolidated immunization histories to avoid over- or under-vaccinating, and the ability to improve vaccination rates by integrating data across the country. Integration across nations is not available as yet.

DIF: Cognitive Level: Remember

REF: pp. 187-189

Chapter 12: Technical Infrastructure to Support Healthcare Test Bank

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

MULTIPLE CHOICE 1. Which item is an example of information we might find in an EHR’s clinical data repository? a. A

physician’s surgical schedule b. The list of medications available in a hospital’s formulary c. The result of a patient’s microbiology lab test d. Monthly billing charges for the radiology department

ANS: C

The result of a patient’s microbiology lab test is an example of information we would find in a CDR. The other items would be found in other administrative databases.

DIF: Cognitive Level: Understand

REF: p. 198

2. Which factor would strongly influence the reliability of an EHR’s repository? a. Technical architecture, such as replication of the repository on standby servers b. Clinician training on EHR applications c. The coding system used for laboratory results d. The use of strong passwords

ANS: A

Technical architecture, such as replication of the repository on standby servers, is a factor that would contribute to the reliability of an EHR’S data repository. The other items affect application use, accessibility, and security.

DIF: Cognitive Level: Understand 3.

REF: p. 198

Which statement describes a repository with central storage of a longitudinal record? a. Patient data are from a single hospital’s data for the most current encounters. b. Data from multiple hospitals are kept compact and efficient by deleting “old” data. c. Portions of a patient’s lifetime medical record are stored in databases at the facility where the data were collected. d. The information collected by the organization is stored in a single database no matter when or where the patient was seen.

ANS: D

The information collected by an organization that is stored in a single database no matter when or where the patient was seen is an example of a repository with central storage of a longitudinal record. The other items describe aspects of distributed and/or encounter-based records.

DIF: Cognitive Level: Apply

REF: p. 199

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

4. Which example best describes knowledge base content? a. Standard admission order sets based on presenting problems b. Patient contact information c. Organizational structure of a healthcare enterprise d. The most recent lab results for current inpatients

ANS: A

An example of knowledge base content is standard admission order sets based on presenting problems. The other choices would not typically be found in a knowledge base.

DIF: Cognitive Level: Apply

REF: p. 202

5. You are leading an effort to implement a clinical decision support system. In order to improve the

patient specificity of your CDS rules, you would: a. make sure that rules cannot be changed once they are implemented. b. give the results of the rules directly to the patient. c. store rules in a knowledge base and allow clinician experts to review and update the rules. d. ensure that the rules were written in the most up-to-date programming language available.

ANS: C

In order to improve CDS rules, you would store rules in a knowledge base and allow clinician experts to review and update the rules. The other choices do not address patient specificity; allowing experts to update rules and make the rules immediately available to the CDS can improve patient specificity.

DIF: Cognitive Level: Analyze

REF: pp. 202-203

6. For healthcare infrastructures with many communicating systems, an interface engine is helpful

because: a. it increases the administrative overhead with maintaining interfaces. b. it decreases the number of interfaces that must be maintained and lessens complexity. c. there is no other way to connect systems. d. government regulations require the use of an interface engine in healthcare settings.

ANS: B

An interface engine is helpful because it decreases the number of interfaces that must be maintained and lessens complexity. The other choices do not accurately describe the use of an interface engine, the ability to connect systems, or regulatory requirements.

DIF: Cognitive Level: Understand

REF: p. 203

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 7. A method for exchanging patient data between healthcare organizations that is endorsed by the

federal government is: a. copying information to a secure USB drive and giving it to another organization. b. providing EHR log-in accounts to providers outside the organization. c. implementing a secure Internet connection using components of the Nationwide Health Information Network (NwHIN). d. The federal government does not endorse sharing health information between organizations.

ANS: C

Implementing a secure Internet connection using components of the Nationwide Health Information Network (NwHIN) is a method for exchanging data endorsed by the federal government. The other methods listed are not considered safe and confidential, and the federal government does endorse health information sharing.

DIF: Cognitive Level: Remember

REF: p. 205

8. Which is a significant challenge to technical infrastructures in healthcare environments? a. Implementing a data repository that will grow with changes in medicine and store a patient’s

lifetime health data b. Arranging data entry components properly in a documentation application to improve data collection efficiency c. Training clinicians to use EHRs effectively d. Agreeing on policies for sharing information between healthcare organizations

ANS: A

A significant challenge to technical infrastructure in healthcare environments is implementing a data repository that will grow with changes in medicine and store a patient’s lifetime health data. The other choices describe usability, user training, and organizational policy.

DIF: Cognitive Level: Understand

REF: p. 206

MULTIPLE RESPONSE 9.

Which examples describe how clinical applications are tied to other components in the EHR infrastructure? (Select all that apply.) a. Searching and extracting data from the repository for reporting purposes b. Using the data dictionary to code assessment information with a documentation application c. Utilizing clinical decision support system rules to assist with appropriate lab test ordering d. Utilizing the master patient index to document vital signs e. Utilizing the financial system to determine patient insurance copays

Health Informatics-An Interprofessional Approach 2Ed(Staggers) ANS: A, B, C

Examples of how clinical applications are tied to other components of the EHR infrastructure include searching and extracting data from a repository, using the data dictionary to code assessment information, and utilizing CDSS rules to assist in ordering the appropriate lab test.

The other two choices are not examples of how clinical applications use other EHR components.

DIF: Cognitive Level: Apply

REF: pp. 200-203

10. Which functions are characteristic of a master person index? (Select all that apply.) a. Store the current and former names of a patient b. Store the most recent vital signs information for each patient c. Coordinate the various identifiers a patient uses, such as medical record number, insurance

account number, and driver’s license ID d. Provide a unique identifier for each patient that is used by components of the EHR to positively identify the patient

ANS: A, C, D

Storing current and former names of a patient, coordinating various identifiers a patient uses, and providing a unique identifier for each patient are characteristics of a master person index (MPI). The MPI is not used to store clinical information.

DIF: Cognitive Level: Remember

REF: p. 199

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chapter 13: The Evolving ePatient Test Bank MULTIPLE CHOICE 1. An epatient is best described as one who: a. seeks health information from various sources and uses the information for decision making

with health providers. b. manages health decisions, uses the Internet and uses biosensors. c. collaborates with the health provider, has a chronic illness, and writes blogs. d. makes all decisions, prepares for doctor visits, and gathers data points.

ANS: A

Someone who seeks health information from various sources and uses the information for decision making with health providers is inclusive of all types of epatients. Not all epatients use biosensors, nor do they all write blogs. Epatients collaborate with their provider to arrive at a decision.

DIF: Cognitive Level: Understand

REF: pp. 212-213

2. Which of these best describes participatory medicine? a. Integrated care model b. Authoritative care model c. Community care model d. Cooperative care model

ANS: D

Participatory medicine is described as a cooperative model of healthcare that encourages and expects active involvement by all connected parties, including patients, caregivers, and healthcare professionals, as integral to the full continuum of care. Integrated care focuses on coordinating care between the healthcare disciplines. Authoritative care is paternalistic and does not include the patient in the decision-making process. Community care focuses on coordinating care across resources found in the community where the patient resides.

DIF: Cognitive Level: Understand

REF: p. 218

3. A quantified selfer is best described as one who: a. graphs data. b. tracks personal metrics. c. records lab values. d. uses a sleep diary.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: B

Graphs data, records lab values, and uses a sleep diary are all traits of a quantified selfer; however, tracking personal metrics best describes the quantified selfer.

DIF: Cognitive Level: Remember

REF: p. 217

4. Which factor has influenced the epatient movement? a. The Internet b. The Human Genome Project c. The Association of Cancer Online Resources d. The quantified self

ANS: A

A factor that has influenced the epatient movement is the Internet. The Human Genome Project involves identifying genes in human DNA. The Association for Cancer Online Resources is a useful resource for cancer patients. The quantified self is a term used to describe people who are invested in using tools and data to quantify and monitor their daily experiences using personal metrics.

DIF: Cognitive Level: Remember

REF: p. 213

5. The maxim “Doctors know best”: a. is one of the tenets of participatory medicine. b. was coined by epatient Dave. c. was coined by Gilles Frydman. d. is the paradigm for the paternalistic care model.

ANS: D

“Doctors know best” is the paradigm for the paternalistic care model. Participatory medicine is characterized by including the patient as a partner in setting goals of care and participating in shared decision making. ePatient Dave is known for statements such as “Gimme my damn data” and promotes the maxim of “Nothing about me, without me.” Gilles Frydman is an epatient activist known for his work with the Association of Cancer Online Resources.

DIF: Cognitive Level: Remember

REF: p. 217

6. The culture of the patient-clinician partnership always includes: a. requirements found in the Patient Protection and Affordable Care Act. b. guided discovery. c. involvement of technology specialists and social media activists. d. epatients and clinicians working in collaboration towards shared goals.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: D

The culture of the patient-clinician partnership always includes epatients and clinicians working in collaboration towards shared goals. The Patient Protection and Affordable Care Act does not require patient-clinician partnerships. Guided discovery may be used in a patient-clinician partnership, but not always. Technology specialists and social media activists are not part of the patient-clinician partnership.

DIF: Cognitive Level: Understand

REF: pp. 217-218

7. One trend that is influencing healthcare reform is: a. disruptive technology. b. Hospital Consumer Assessment of Healthcare Providers and Systems. c. Veterans Health Information System and Technology Architecture Implementation. d. Everett Rogers’ theory of diffusion of innovation.

ANS: A

Disruptive technology and trends have drastically altered the way in which we communicate with one another. Americans are using the Internet and mobile devices in their daily lives to connect to one another and to access information.

DIF: Cognitive Level: Remember

REF: p. 219

8. Transparency of PHR data is limited due to: a. current functionality. b. anticipatory worry. c. nonparticipatory physicians. d. differing philosophies over governance.

ANS: D

Due to differing philosophies over governance, the transparency of PHR data is limited. Many policy standards do not exist for the PHR, and organizations are facing cultural, technological, legal, and privacy challenges for managing PHRs. DIF: Cognitive Level: Remember

REF: p. 219

9. What defines the “Google generation?” a. A person who was born after about 1989 b. A person who desires immediate access to information and is Internet savvy c. A person who uses simplified search engines rather than site-specific searches d. A person who is an epatient

Health Informatics-An Interprofessional Approach 2Ed(Staggers) ANS: B

A person who desires immediate access to information and is Internet savvy is characteristic of an individual belonging to the Google generation. The other choices are not characteristic of being part of the Google generation.

DIF: Cognitive Level: Remember

REF: pp. 221-222

MULTIPLE RESPONSE 10. What defines Health 2.0? (Select all that apply.) a. Updated versions of old health information b. Marketing health products based on the patient’s Internet preferences c. Health-related mobile applications d. Mobile health-monitoring devices e. Web-based content f. Social networks

ANS: C, E, F

Health 2.0 is defined by health-related mobile applications, web-based content, and social networks. Updated versions of old health information, marketing health products based on the patient’s Internet preferences, and mobile health-monitoring devices do not define Health 2.0.

DIF: Cognitive Level: Understand

REF: pp. 220-221

Chapter 14: Social Networking and Other Web-Based Applications in Healthcare Test Bank MULTIPLE CHOICE 1. A case manager wants to communicate with her clients on a regular basis by sending short messages that encourage health promotion tips. The tool best suited for this task is: a. Facebook. b. e-mail. c. microblogging. d. Second Life.

ANS: C

Clients may benefit from short, directed messages; thus microblogging (a form of short messages) is the most appropriate. The other choices (Facebook, e-mail, and Second Life) are not appropriate for sending short messages.

DIF: Cognitive Level: Apply

REF: p. 227

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 2. The percentage of adults using social media to seek healthcare information is: a. less than 10%. b. between 10% and 30%. c. between 40% and 60%. d. over 75%.

ANS: C

According to the Pew Internet Study of 2011, between 40% and 60% of adults use social media to seek healthcare information.

DIF: Cognitive Level: Remember

REF: p. 228

3. Which group is allowed to share personal health information on social media sites? a. Providers who monitor the social media site b. Healthcare providers on the site c. Patients/consumers d. Hospital registration clerks

ANS: C

Healthcare providers are not allowed to share this information, but patients/consumers are not restricted.

DIF: Cognitive Level: Remember

REF: pp. 229-230

4. Which is an example of apomediation? a. Healthcare providers tell patients not to use Facebook for healthcare advice. b. Healthcare providers direct patients to high-quality information on the web. c. Healthcare providers state that only their web portal should be used by patients. d. Healthcare providers direct patients to websites in which they have a financial interest.

ANS: B

Apomediation means standing by the patient rather than standing between the patient and the web.

DIF: Cognitive Level: Understand

REF: p. 233

5. Healthcare providers should friend patients only if: a. they have been their patients for at least 5 years. b. the patients ask them to be a friend. c. the patient has a chronic disease. d. they check their social media policy at work.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: D

There is no law prohibiting friending patients. Professional guidelines and social media policies should outline the instances when friending is possible.

DIF: Cognitive Level: Remember

REF: pp. 234-235

6. In the future, social media in healthcare is likely to be: a. nothing at all. It has gone too far already. b. minimally used only by “geeks.” c. widely used by everyone including those who are reluctant now. d. widely used but with some pockets of non-users such as those lacking Internet access or

choosing to be private.

ANS: D

Even as social media expands, some will not be able to or will choose not to use these applications.

DIF: Cognitive Level: Understand

REF: p. 235

7. Which social media site was developed by healthcare agencies? a. PatientsLikeMe b. CureTogether c. WrongDiagnosis.com d. Heart.org

ANS: D

Heart.org was developed by the American Heart Association. The others were developed by consumers.

DIF: Cognitive Level: Remember

REF: p. 226 | p. 229

MULTIPLE RESPONSE 8.

Social media tools include: (Select all that apply.) a. social networks and microblogging. b. wikis and blogs. c. desktop computers. d. video and picture sharing.

ANS: A, B, D

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Social media is focused on not only connecting and collaborating with others but also sharing user-generated material of all types. While a desktop computer may assist a person to discover social media tools, it is not a social media tool in itself.

DIF: Cognitive Level: Remember 9.

REF: pp. 225-226

Using social media tools for research purposes helps: (Select all that apply.) a. develop relationships between participants. b. recruit patients. c. identify new variables to study. d. provide insight into the patient’s experience.

ANS: B, C, D

Using social media tools for research purposes helps to recruit patients, identify new variables to study, and provide insight into the patient’s experience. Researchers should be cautious of allowing research participants to communicate and create relationships with social media as this may contaminate findings.

DIF: Cognitive Level: Understand

REF: pp. 228-229

10. Social media policies should contain: (Select all that apply.) a. guidance on acceptable behavior. b. methods for handling unacceptable behaviors. c. statement to promote ethical behaviors. d. penalties for misuse.

ANS: A, B, C

Social media polices should contain guidance on acceptable behavior, methods for handling unacceptable behaviors, and a statement that promotes ethical behavior. Imposing penalties for misuse should be discussed on a case-by-case basis.

DIF: Cognitive Level: Remember

REF: p. 229 | p. 236

Chapter 15: Personal Health Records (PHRs) Test Bank MULTIPLE CHOICE 1. What are the main types of PHR? a. Tethered, untethered, stand-alone, and networked b. Integrated, tethered, untethered, and stand-apart c. Tethered, de-tethered, stand-apart, and stand-together

Health Informatics-An Interprofessional Approach 2Ed(Staggers) d. USB-based, Web-based, and patient portals

ANS: A

The main types of PHRs are tethered, untethered, stand-alone, and networked. The other choices are terms that are associated with PHRs but are not general types.

DIF: Cognitive Level: Remember

REF: p. 248

2. What are the two most commonly owned personal computing devices? a. Game device and MP3 player b. Mobile phone and laptop c. Laptop and desktop computer d. Laptop and MP3 player

ANS: B

The two most commonly owned types of personal computing devices are mobile phones and laptop computers. The other choices are less commonly owned devices.

DIF: Cognitive Level: Remember

REF: pp. 245-246

3. Secure PHR messaging refers to the capacity to: a. send messages between healthcare providers within a single EHR. b. send messages between healthcare providers across healthcare systems. c. send messages from patients to providers via a tethered PHR. d. send messages from patients to providers via a stand-alone PHR.

ANS: C

Secure PHR messaging refers to the capacity to send messages from patients to providers via a tethered PHR. DIF: Cognitive Level: Remember

REF: p. 248

4. The most commonly used functions of personal health records are: a. viewing test results and secure messaging. b. reading patient education materials and renewing medication prescriptions. c. entering data (such as self-measured glucose and blood pressure) and watching educational

videos. d. online appointment scheduling and reading clinical notes.

ANS: A

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

The most commonly used functions of the PHR are viewing test results and secure messaging.

The other choices are PHR functions that are less commonly used.

DIF: Cognitive Level: Remember

REF: p. 251

5. The ONC (Office of the National Coordinator for Health Information Technology) is bestdescribed

as: a. the principal federal entity charged with coordination of nationwide efforts to implement

and use the most advanced health information technology and the electronic exchange of health information. b. the principal federal entity charged with promoting nationwide sales of advanced health information technology. c. a federal entity charged with increasing public awareness of the value of health information technology. d. a federal agency that regulates the contents and functions of health information technologies, including PHRs.

ANS: A

The ONC is described as the principal federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information.

DIF: Cognitive Level: Remember

REF: p. 245

6. Which statement is true regarding the continuity of care record (ASTM standard E2369-05e2)? a. It is an XML-based extract of the health record that allows for syntactically interoperable

records. b. It is an XML-based extract of the health record that allows for semantically interoperable records. c. It is a tab-delimited extract of the health record that specifies constraints on the controlled vocabularies used. d. It is a tab-delimited extract of the health record that paves the way for national health information exchange.

ANS: A

The continuity of care record (ASTM standard E2369-05e2) is an XML-based extract of the health record that allows for syntactically interoperable records.

DIF: Cognitive Level: Understand

REF: p. 252

7. The “digital divide” refers to: a. higher adoption and use of information technologies among individuals from ethnic

minorities, of lower socioeconomic status, and older age.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) b. the gap between current adoption of PHRs and their potential use. c. lower adoption and use of information technologies among individuals from ethnic

minorities, those of lower socioeconomic status, and older age. d. the difference between rates of overall cell phone ownership and “smart phone” ownership.

ANS: C

The digital divide refers to lower adoption and use of information technologies among individuals from ethnic minorities, those of lower socioeconomic status, and older age.

DIF: Cognitive Level: Remember

REF: p. 252

8. Which statement is true of Meaningful Use? a. These are criteria created by patient advocacy groups intended to ensure that patientfacing

technology is addressing users’ needs. b. These are criteria created by the ONC to determine eligibility for incentives for health information technology adoption and use. c. These are criteria created by Congress that delineate appropriate uses of health data for research purposes. d. These are criteria proposed by the Institute for Healthcare Improvement to suggest ways to use health information technology to improve healthcare in the United States.

ANS: B

Meaningful Use refers to criteria created by the ONC to determine eligibility for incentives for health information technology adoption and use.

DIF: Cognitive Level: Understand

REF: p. 246

9. Which statement is true of PHRs? a. They have been used in paper form for many years, and electronic versions offer the same

functionality. b. They were a new idea when proposed in the 1990s and are a now a well-established technology. c. Approximately 35% of the US population currently has one. d. They have been used in paper form for many years, but electronic versions offer new functionality.

ANS: D

PHRs have been used in paper form for many years, but electronic versions offer new functionality.

DIF: Cognitive Level: Understand

REF: p. 245

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

MULTIPLE RESPONSE 10. HIPAA (Health Information Portability and Accountability Act) requires that: (Select all that

apply.) a. healthcare records be available electronically by 2014. b. healthcare providers keep an audit trail of access to an individual’s record and provide copies of the individual’s record upon request. c. specific privacy and security measures must be used in all electronic health records. d. healthcare providers must be able to electronically exchange health records by 2014. e. healthcare providers must be able to electronically exchange lab data by 2014.

ANS: B, C

HIPAA requires that healthcare providers keep an audit trail of access to an individual’s record and provide copies of the individual’s record upon request and that specific privacy and security measures must be used in all electronic health records including PHRs. The other answers are either only partially correct or incorrect.

DIF: Cognitive Level: Understand

REF: p. 245

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chapter 16: Identifying and Selecting an Information System Solution Test Bank MULTIPLE CHOICE 1. Which category of objectives contains the need for the system to be intuitive and easy to use? a.

Patient care b. Information technology c. Efficiency d. Organization

ANS: C

Ease of system use and intuitiveness promote efficiency for the end user.

DIF: Cognitive Level: Apply

REF: pp. 261-262

2. Which is included in an RFP but not an RFI? a. Desired system components and functionality b. Financial considerations c. Description of the hospital or health system d. Goals of the organization

ANS: B

Pricing and financial considerations are part of an RFP but not part of an RFI. DIF: Cognitive Level: Analyze

REF: pp. 265-266

3. Which group is not a major information technology research firm? a. Forrester b. Gartner c. HIMSS d. KLAS

ANS: C

HIMSS does not provide comparative research information regarding various vendors.

DIF: Cognitive Level: Analyze MULTIPLE RESPONSE

REF: pp. 266-267

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 4.

What should be considered when identifying and selecting a healthcare information system?

(Select all that apply.) a. Strategic vision b. Strategic alignment c. Enterprise and information technology goals and objectives d. Operating system e. Vendor strategic planning

ANS: A, B, C

Having a strategic vision, strategic alignment, and enterprise and information technology goals and objectives should be considered when identifying and selecting a healthcare information system. Each of these items is critical to selecting an effective system that supports the organization’s goals and mission. The operating system and vendor strategic planning are not part of an organization’s goals and mission.

DIF: Cognitive Level: Analyze 5.

REF: pp. 259-260

Which methods will provide information useful in requirements identification? (Select all that apply.) a. Delphi method b. Survey c. Interview d. Direct observation e. Regression analysis

ANS: B, C, D

Methods useful in providing information for requirements identification include using surveys, interviews, and direct observation to collect data. A variety of data collection methods is necessary to define system requirements.

DIF: Cognitive Level: Analyze 6.

REF: pp. 260-261

A process of ongoing evaluation must be developed to: (Select all that apply.) a. identify areas of omission. b. validate appropriate responses. c. develop training plans for go-live. d. ensure adequate users. e. determine if any changes to the system are needed.

ANS: A, B, E

A process of ongoing evaluation must be developed to identify areas of omission, validate appropriate responses, and determine if any changes to the system are needed. Ongoing

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

evaluation provides the opportunity to evaluate the effectiveness of the system for current and future needs.

DIF: Cognitive Level: Analyze 7.

REF: pp. 259-260

Which considerations should be included in your system evaluation criteria? (Select all that apply.) a. Cost b. Vendor experience c. Organization devices d. Vendor’s market and industry understanding

ANS: A, B, D

It is important to include a variety of criteria, including cost, vendor experience, and the vendor’s market and industry understanding.

DIF: Cognitive Level: Analyze 8.

REF: pp. 265-266

Which costs should be considered in determining the total cost of information system ownership?

(Select all that apply.) a. User costs b. Supply costs c. Hardware costs d. Software costs e. Resource costs

ANS: C, D, E

The costs that should be considered in determining the total cost of information system ownership include hardware, software, and resource costs. The total cost of ownership includes all costs related to purchasing, implementing, and supporting an information system.

DIF: Cognitive Level: Apply 9.

REF: p. 267

Which of the following describe information system functionality? (Select all that apply.) a.

System response time b. Data validation c. Accuracy d. Ease of use for end users

ANS: A, C, D

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

System response, accuracy, and ease of use for end users describe information system functionality. Data validation is not part of functionality, although it is required in an assessment of an information system.

DIF: Cognitive Level: Understand

REF: p. 259

10. Which of the following are phases in the systems development life cycle (SDLC)? (Select all that

apply.) a. System selection b. Design c. Implementation d. Maintenance

ANS: B, C, D

Phases in the SDLC include design, implementation, and maintenance. The initial phase of the systems development life cycle is to identify requirements. System selection has already taken place.

DIF: Cognitive Level: Remember

REF: p. 260

Chapter 17: Implementing and Upgrading an Information System Solution Test Bank MULTIPLE CHOICE 1. Upon entering an order for two units of packed red blood cells into a computerized physician order

entry system, a dialog box is displayed stating that the patient is designated as “Bloodless,” meaning that the patient will refuse all blood products. This is an example of: a. clinical decision support. b. evidence-based medicine. c. Heisenberg Principle. d. minimal data set.

ANS: A

Evidence-based medicine is defined as best practices or the application of the results from the best research-based studies in clinical care in order to obtain the best results. The Heisenberg Principle is defined as the difficulty involved in explaining an existing phenomenon and predicting future phenomena when the domain being studied is always changing. A minimal data set is the state-approved resident assessment instrument, which contains a minimum set of data elements with uniform definitions and categories concerning the cost and quality of nursing care.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) DIF: Cognitive Level: Apply

REF: pp. 273-274

2. A large medical practice that specializes in cancer care is weighing the advantages and

disadvantages of implementing the most recent version of a commercial EHR or building its own homegrown system for its office. The staff selects a commercial EHR from a major vendor.

Which factor best supports this decision? a. A commercial product can be easily customized to accommodate the unique needs of the hospital. b. A homegrown system cannot be certified by the Certification Commission for Healthcare Information Technology. c. The commercial version is considered one of the “Best of Breed” products. d. A homegrown system is typically interfaced with the organization’s ADT system and downstream systems.

ANS: C

Commercial electronic health systems are more expensive than homegrown systems but also considered one of the “Best of Breed” products. A homegrown system can be certified through a Certification Commission for Healthcare Information Technology (CCHIT) program called EACH. Homegrown systems are usually fully integrated using a common database and not interfaced with other dissimilar applications.

DIF: Cognitive Level: Apply

REF: p. 277

3. A large medical center that specializes in high-risk pregnancies is implementing an entire suite of

clinical applications such as CPOE, barcode medication administration (BCMA), nursing documentation, data acquisition system to collect clinical data from cardiac and fetal monitors and ventilators, laboratory system, radiology system, PACS, and cardiology. It has a large, highly skilled, experienced IT team. The project team decided to go with a Big Bang go-live versus an incremental or phased approach. Which factor best supports this decision? a. The Big Bang approach decreases the possibility of errors. b. The incremental approach is best for hospitals with large IT departments. c. The Big Bang approach minimizes overall productivity loss. d. The incremental approach normally has lower implementation costs.

ANS: A

Big Bang decreases the possibility of errors because physicians do not have to use different workflows in different departments or units. Users also have high levels of support in the initial days. Big Bang will have a major impact on productivity initially with a gradual return to baseline. The incremental approach is best suited for organizations with small IT departments and minimal support personnel. It also typically will increase the overall costs of the project.

DIF: Cognitive Level: Apply

REF: pp. 284-285

4. An unintended consequence associated with the use of an electronic health system occurs when:

Health Informatics-An Interprofessional Approach 2Ed(Staggers) a. a physician places a medication order with an inappropriate drug dose for a pediatric patient

in a CPOE system. b. a physician enters orders on a patient who was incorrectly selected from a dropdown list of

the physician’s personal patient list. c. a nurse enters a telephone order from the attending physician into the electronic health system and fails to read back the order. d. a nurse enters PRN pain medication orders on a patient and fails to record the indications for each pain medication.

ANS: B

The physician entering orders on a patient who was incorrectly selected from a drop-down list of the physician’s personal patient list would be an example of an unintended consequence.

The other responses are examples of behaviors that are not unique to orders placed in an EHR and can occur in a paper system as well.

DIF: Cognitive Level: Apply

REF: pp. 275-276

5. Which activity or intervention should be avoided when implementing an EHR system? a. Public and unwavering support for the project by the organization’s leadership b. Building a large number of aliases for orders and alerts for select clinical scenarios c. Input from representatives from different disciplines over the course of the project d. Default clinical information and responses to order prompts on orders and fill in as much

as possible on order sets

ANS: B

Physicians will count clicks and do not want to be stopped during order entry unless it is necessary. An overuse of alerts will cause alert fatigue.

DIF: Cognitive Level: Analyze

REF: p. 281

6. The first country to implement ICD-10 codes was: a. Denmark. b. England. c. Canada. d. the United States.

ANS: A

Scandinavian countries were the first to implement ICD-10 codes between 1994 and 1997. The United States has not yet implemented ICD-10 codes.

DIF: Cognitive Level: Remember

REF: p. 274

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 7. Which activity or intervention is the biggest deterrent to the success of an EHR implementation? a. Schedule the go-live date for a Monday when vendor support staff is most available b. Anticipate user resistance and plan for it c. Possess an understanding that there is no finish line for EHR Maintenance d. Provide ample education to all users with opportunities for practice

ANS: A

It is best to avoid Monday as the go-live date because it is usually one of the busiest days for healthcare providers.

DIF: Cognitive Level: Apply

REF: p. 287

8. A system that incorporates evidence-based content and clinical decision support includes: a.

building multiple aliases. b. using Tall Man lettering for select medications. c. enforcing the use of only CMS-approved abbreviations. d. providing real-time updates to the order item master.

ANS: B

Using Tall Man lettering for select medication is the only example of clinical decision support.

Building multiple aliases, enforcing CMS-approved abbreviations, and providing real-time updates to the order item master are examples of building specific safety protocols into the EHR system.

DIF: Cognitive Level: Apply

REF: pp. 273-274 | p. 276

9. Which factor commonly interferes with the goal of successfully completing an EHR

implementation that is on time and within budget? a. Scope creep b. Big Bang go-live c. An integrated EHR system d. Delayed transition to ICD-10 codes

ANS: A

A Big Bang go-live, an integrated EHR system, and delayed transition to ICD-10 codes do not impact the success of completing an EHR implementation that is on time and within budget.

The only factor that impacts the success of completing an EHR implementation that is on time and within budget is scope creep.

DIF: Cognitive Level: Remember

REF: pp. 276-277

Health Informatics-An Interprofessional Approach 2Ed(Staggers) MULTIPLE RESPONSE 10. Which are the most significant financial reasons to implement an EHR or upgrade to the latest

version of the current EHR? (Select all that apply.) a. Transition from ICD-9 codes to ICD-10 codes b. Migration from HIPAA 4010 Standards to 5010 Standards c. Certification of EHRs by the Office of the National Coordinator (ONC) d. ARRA Meaningful Use requirements

ANS: B, D

The ARRA Meaningful Use requirements provide a financial incentive for EHR adoption and the migration from HIPAA 4010 Standards to 5010 Standards can financially benefit an organization with increased acceptance of claims. The other options are benefits that do not have financial implications.

DIF: Cognitive Level: Remember

REF: p. 272

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chapter 18: Health System Downtime and Disaster Recovery Test Bank MULTIPLE CHOICE 1. Which examples are natural disasters that could affect IT systems? a. Bomb, flood b. Earthquake, bomb, terrorist attack c. Flood, earthquake, hurricane d. Terrorist attack, hurricane, flood

ANS: C

Floods, earthquakes, and hurricanes are natural disasters. Bombs and terrorist attacks are manmade disasters.

DIF: Cognitive Level: Analyze

REF: p. 293; Table 18-1

2. Which examples are man-made disasters that could affect IT products? a. Cyberattack, nuclear incident, bomb b. Cyberattack, blizzard, nuclear incident c. Nuclear incident, bomb, tornado d. Tornado, blizzard

ANS: A

Cyberattacks, nuclear incidents, and bombs are examples of manmade disasters. Blizzards and tornados are examples of natural disasters.

DIF: Cognitive Level: Analyze

REF: p. 293; Table 18-1

3. Which system is an example of a core clinical application? a. Scheduling system b. Electronic health record c. Claim scrubber d. Physiologic monitoring system

ANS: B

The electronic health record is a core clinical application because it is used for every patient in every care situation. The scheduling system and claim scrubbers are revenue cycle applications.

The physiologic monitoring system is an ancillary or specialty area system.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) DIF: Cognitive Level: Apply

REF: p. 293; Table 18-2

4. Which system is an example of an ancillary service application? a. Keyless entry system b. PBX switchboard c. Email d. Radiology information system

ANS: D

The radiology information system is an ancillary service application used for ancillary clinical patient care. PBX switchboard, email, and keyless entry systems are business applications supporting the business operation but are not used for patient care.

DIF: Cognitive Level: Apply

REF: p. 293; Table 18-2

5. If the planned single system downtime is less than 1 hour in the middle of a Sunday night, which

downtime level should be assigned? a. Level 1 b. Level 2 c. Level 3 d. Level 4

ANS: A

A single system planned downtime at the least busy clinical time creates the lowest level of downtime risk, or level 1. Levels 2, 3, and 4 are all higher risk in this scenario.

DIF: Cognitive Level: Analyze

REF: p. 296; Table 18-5

6. If an unplanned total network outage occurs with all systems affected during the week at 1300

hours and there is no estimated time to recovery announced, which downtime level should be assigned? a. Level 1 b. Level 2 c. Level 3 d. Level 4

ANS: D

Unplanned outage of all systems and the network at the busiest time for the business and patient care is the highest risk outage for an organization, or level 4. Levels 1, 2, and 3 are all lower risk than level 4 in this scenario.

DIF: Cognitive Level: Analyze

REF: p. 296; Table 18-5

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 7. Which backup EHR downtime application is critical to avoid disrupting nurses’ care of patients? a. The billing system b. The registration system c. CPOE and the MAR (medication administration record) d. the SAN (storage area network)

ANS: C

CPOE and the MAR are crucial to nurses’ care of patients. The billing system, registration system, and SAN support other operational functions.

DIF: Cognitive Level: Analyze

REF: p. 299

8. What is the primary reason to back up data entered into electronic health records? a. In the event of a system failure, the EHR system can be recovered with accurate data. b. The work of physicians will be disrupted in the clinics if the system fails and there is no

backup. c. Administrators cannot continue to bill patients if the EHR fails and no backup exists. d. The interface engine will not be able to function if the EHR fails and no backup is available.

ANS: A

The key reason is that if a system fails and data is lost or data integrity is in question, available backups allow the system to be recovered with accurate and complete data. The work of physicians, billing, and the interface engine all depend on a complete and accurate recovered system but are single functions rather than the overarching, key reason to do complete backups.

DIF: Cognitive Level: Analyze

REF: p. 301; Table 18-6

MULTIPLE RESPONSE 9.

Which examples of essential information technology physical hardware infrastructure could cause a downtime if they fail? (Select all that apply.) a. Network cabling b. Network switches or hubs c. Financial applications d. Interface engine e. Email

ANS: A, B

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Network cables and switches are actual hardware components of infrastructure. They are physical pieces of IT equipment. Financial applications, the interface engine, and email are software.

DIF: Cognitive Level: Apply

REF: p. 293; Table 18-1

10. What are integral components of a downtime communication plan? (Select all that apply.) a. Who needs to know the details? b. Who has passed the annual charting review exam? c. What details are needed? d. What systems and workflows are impacted? e. Who is going to communicate the information? f. When is the next Joint Commission review scheduled to occur?

ANS: A, C, D, E

Who needs to know what details, what systems and workflows are impacted, and who is going to communicate the information are critical components of a downtime communication plan.

Which personnel have passed the annual charting exam would be communicated at a unit-based level to the employees and the unit management. A Joint Commission announcement would be a general announcement to all personnel but is not associated with downtime communications.

DIF: Cognitive Level: Analyze

REF: pp. 302-303

Chapter 19: Privacy, Confidentiality, Security, and Data Integrity Test Bank MULTIPLE CHOICE 1. Which definition most accurately describes privacy? a. The means to ensure health record privacy and confidentiality b. Accuracy and completeness of health information c. The rights of individuals to control access to their person or information about themselves d. An act that has the potential to cause harm to an informational asset

ANS: C

Privacy is the rights of individuals to control access to their person or information about themselves. Security is defined as the means to ensure health record privacy and confidentiality.

Data integrity is defined as the accuracy and completeness of health information. A threat is an act that has the potential to cause harm to an informational asset.

DIF: Cognitive Level: Remember

REF: p. 308

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 2. A healthcare provider forgets to update a patient’s medications. Which fair information principle

is being violated? a. Correction b. Openness and transparency c. Data quality and integrity d. Safeguards

ANS: C

By not keeping a patient’s records current and up to date, the healthcare provider is violating the fair information principle of data quality and integrity. Correction involves allowing individuals to dispute the accuracy of their information, openness and transparency involve keeping patients informed on policies regarding PHI, and safeguards are actions implemented to protect sensitive data.

DIF: Cognitive Level: Apply

REF: p. 309; Table 19-2

3. Which organization works on an international level to improve information privacy? a. Health and Human Services Office of Civil Rights b. Health Information Security and Privacy Collaboration (HISPC) c. Department of Health and Human Services (DHHS) d. Electronic Frontier Foundation (EFF)

ANS: D

The Electronic Frontier Foundation (EFF) maintains a website listing international privacyrelated accords and agreements. Health and Human Services Office of Civil Rights, Health Information Security and Privacy Collaboration (HISPC), and Department of Health and Human Services (DHHS) are all examples of federal and/or state organizations.

DIF: Cognitive Level: Understand

REF: p. 312

4. What is the difference between the safe harbor and expert determination methods of deidentifying

data? a. The safe harbor method involves removal of 18 types of identifiers, and the expert

determination method involves the application of statistical or scientific models. b. The safe harbor method involves the application of statistical or scientific models, and the

expert determination method involves removal of 18 types of identifiers. c. The safe harbor method involves removal of all identifiers, and the expert determination method involves the removal of 18 types of identifiers. d. The safe harbor method involves securing identifiers in an encrypted database, and the expert determination specifically determines the riskiest identifiers to remove.

ANS: A

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

The safe harbor method involves removal of 18 types of identifiers, and the expert determination method involves the application of statistical or scientific models to de-identify data. None of the other options accurately describe these two methods.

DIF: Cognitive Level: Apply

REF: p. 314; Figure 19-1

5. What is a negative impact of the increased use of mobile devices in transmitting health data? a. They support increased health data access for providers. b. They increase the risk of a security breach. c. They decrease productivity. d. They increase the number of medication errors.

ANS: B

The largest downfall to the increased use of mobile devices is the increased risk for a security breach. The increased access for providers is a positive impact. Mobile devices have been proven to increase productivity rather than decrease it, and there is no evidence supporting an increase in medication errors due to mobile devices.

DIF: Cognitive Level: Understand

REF: p. 316

6. Which example constitutes an internal security event? a. Servers containing clinical data were stolen from a facility. b. A person hacks into a facility’s server and steals PHI electronically. c. A person installs a malicious code past a facilities firewall. d. A system administrator installed a new server without any security measures.

ANS: D

Internal events are those perpetrated (usually accidentally) by people within an institution. A system administrator not taking proper security measures would be an example of this. The remaining examples are all external events.

DIF: Cognitive Level: Apply

REF: p. 316

7. An organization implements a policy on installing software service packs on all its computers. This

is an example of which type of control? a. Administrative b. Technical c. Physical d. Electronic

ANS: A

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Administrative controls include establishing and adhering to security policies and procedures as well as dedicating resources to security. Implementing a policy on installing and updating service packs would be an example of administrative controls. Physical controls are actual physical methods to protect inappropriate access to PHI. Technical controls are using technology to protect against inappropriate access to PHI. Electronic controls is not an accurate term.

DIF: Cognitive Level: Apply

REF: pp. 317-318

MULTIPLE RESPONSE 8.

What are some examples of indirect costs to organizations that have security breaches? (Select all that apply.) a. Lost productivity b. Expensive fines c. Damaged public trust d. Remediation costs

ANS: A, C, D

Indirect costs to an organization with security breaches are lost productivity, damaged public trust, and remediation costs. Fines are a direct penalty.

DIF: Cognitive Level: Understand 9.

REF: pp. 314-315

Which are examples of secondary use of health information? (Select all that apply.) a. Treatment b. Surveillance c. Research d. Marketing

ANS: B, C, D

The three most common secondary uses of personal health information include public health monitoring or surveillance, research, and marketing. Treatment for an illness would be a primary use of health information.

DIF: Cognitive Level: Understand

REF: p. 313

10. Which principles are included in IMIA’s Code of Ethics for informatics? (Select all that apply.) a. Information-Privacy and Disposition b. Openness c. Elimination of Threats d. Legitimate Infringement e. Accountability

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: A, B, D, E

IMIA’s Code of Ethics for informatics includes Information-Privacy and Disposition, Openness, Security, Access, Legitimate Infringement, Least Intrusive Alternative, and Accountability. While the principles of the code might be to eliminate threats, elimination of threats is not a specific principle.

DIF: Cognitive Level: Remember

REF: p. 309; Table 19-4

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chapter 20: Patient Safety and Quality Initiatives in Informatics Test Bank MULTIPLE CHOICE 1. An important component of the informatics infrastructure is: a. establishment and adoption of standards to support semantic interoperability. b. defined standard value sets, groupings, aligners, and attributes. c. organizations enabled to set individual standards for quality measurement and reporting. d. variation in the types of data used to populate the quality metrics.

ANS: A

Establishment and adoption of standards at multiple levels are important components of the informatics infrastructure. The standard quality metrics must define standard value sets, taxonomies, concept codes, attributes, and data structures. Organizations must adopt the same standards for quality measurements and reporting. Standard clinical content needs to be adopted and used in the electronic systems, and the content should be represented by standard data terminologies.

DIF: Cognitive Level: Remember

REF: pp. 324-326

2. When evaluating quality and patient safety, which approach defines the framework for Patient

Safety and Quality Research Design (PSQRD)? a. Outcomes are driven mainly by Meaningful Use directives. b. Consideration of current managerial processes has no effect on patient outcomes. c. Patient safety is best achieved by minimizing changes to existing processes. d. Quality and safety are based on organization structure, management and clinical processes, and their linkages to patient outcomes.

ANS: D

Quality is based on organizational structure, process, and their linkages to patient outcomes.

Consideration of current managerial processes in place has a latent effect on patient outcomes.

The framework for PSQRD builds upon Donabedian’s structure-process-outcome model to support evaluation of an intervention from the pre-implementation testing phase, through implementation, and evaluation. In the case of a health information technology (IT) intervention, the expanded framework supports understanding of where the health IT intervention is most likely to have an effect, within the organizational causal chain of quality and safety events. The PSQRD framework provides a means to categorize interventions according to areas of the causal chain targeted (e.g., the structure, the management or clinical processes, and the patient outcomes or throughput that are targeted by the intervention or that drive adoption and use of the intervention in clinical practice).

Health Informatics-An Interprofessional Approach 2Ed(Staggers) DIF: Cognitive Level: Remember

REF: pp. 327-328

3. Why is the PSQRD a useful framework for research and practice? a. It explains why using computer applications is the best way to support better patient

outcomes. supports implementation, performance improvement, and rigorous methodologies. c. It ensures successful implementation of a clinical process change. d. It increases communication among clinical staff. b. It

research

ANS: B

PSQRD is a useful framework for quality and safety projects whether or not they use health information technology as a tool. While the PSQRD framework may improve communication and implementation, a critical strength of this framework is its systems approach and comprehensive strategy for ongoing monitoring and evaluation. The PSQRD framework provides a means to introduce health IT interventions in a systematic way, and it serves as a reminder to incorporate measures of success across the causal chain. This approach supports implementation, performance improvement, and research projects with an appreciation for the effects and the limitations of health IT and other intervention components. Adoption of the PSQRD framework for both research and organizational implementations will provide a means to plan for successful implementation and to collect data on the structural and process factors that may affect adoption and use of health IT interventions and ultimately patient outcomes.

This type of measurement is appropriate for both research-based and operational implementations of health IT. DIF: Cognitive Level: Remember

REF: pp. 330-331

4. A nurse forgets to walk a patient during the nurse’s shift. This is an example of an error of: a.

commission. b. omission. c. condition. d. remission.

ANS: B

Forgetting to do something that is required for a patient would be considered an error of omission. Doing the wrong thing would be considered an error of commission. Condition and remission are not considered error types.

DIF: Cognitive Level: Apply

REF: p. 324

5. A nurse gives a patient the wrong drug. This is an example of an error of: a. commission. b. omission.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) c. condition. d. remission.

ANS: A

Doing the wrong thing would be considered an error of commission. Forgetting to do something that is required for a patient would be considered an error of omission. Condition and remission are not considered error types.

DIF: Cognitive Level: Apply

REF: p. 324

6. A hospital has an integrated clinical decision support system embedded in the EHR. According to

Donabedian’s model, this would be considered: a. structure. b. process. c. outcome. d. effectiveness.

ANS: A

The setting and its attributes (e.g., the physical structure of buildings, staffing rations, the equipment available within an organization, and the budget to support care provision) are all part of structure. The EHR with an embedded CDS system is part of the structure of an organization.

DIF: Cognitive Level: Apply

REF: p. 327

7. A nurse uses a CDS system to make an informed clinical decision regarding a drug dosage ordered for a patient. According to Donabedian’s model, this would be considered: a. structure. b. process. c. outcome. d. effectiveness.

ANS: B

The managerial and clinical processes in place to support the provision of care are all included under the process component. The use of a CDS system is considered process.

DIF: Cognitive Level: Apply

REF: p. 327

8. A unit has been experiencing a high rate of patient falls for the past three months. According to

Donabedian’s model, patient falls would be considered: a. structure. b. process. c. outcome.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) d. effectiveness.

ANS: C

The end results of the structures and processes are considered outcomes. These may include clinical outcomes. The measurement of patient falls is considered an outcome.

DIF: Cognitive Level: Apply

REF: p. 327

MULTIPLE RESPONSE 9.

To automatically track the quality of care, standardized quality measures are needed in order to: (Select all that apply.) a. use consistent metrics. b. benchmark. c. standardize data collection. d. ensure clinical efficiency.

ANS: A, B, C

To automatically track the quality of care, standardized quality measures are needed to ensure that all organizations are using consistent metrics for benchmarking and that organizations are using the same types of data to populate the quality metrics.

DIF: Cognitive Level: Understand

REF: p. 326

10. Which items are included in the IOM six aims for improvement? (Select all that apply.) a. safe b. patient-centered c. innovative d. effective

ANS: A, B, D

The six aims for improvement are safe, effective, patient-centered, timely, efficient, and equitable. Innovative is not one of the six aims for improvement.

DIF: Cognitive Level: Remember

REF: p. 324

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chapter 21: Improving the User Experience for Health Information Technology Products Test Bank MULTIPLE CHOICE 1. Your organization acknowledges that providers want to improve their user experience with health

information technology (IT) products. You want to raise awareness of the potential benefits to the organization. You could draw on stated benefits such as: a. improved productivity, patient safety, and decreased customer support costs. b. improved cognitive support, increased maintenance costs, and patient safety. c. decreased user errors, decreased customer support costs, and increased administrative overhead. d. decreased maintenance costs and increased training.

ANS: A

Improved productivity, patient safety, and decreased customer support costs will help you raise awareness of the potential benefits to your organization.

DIF: Cognitive Level: Remember

REF: pp. 335-337

2. Which of these best describes an example of usability? a. The IT department is surveying your unit to determine the placement of new computer

workstations. b. A researcher is conducting a study of how nurses interact with electronic documentation to

organize care handoffs. c. The leadership in your institution is asking for your help to determine oncology patient flow across regional institutions. d. The administration has asked you to take responsibility for orientation of new hires and the retraining of selected current employees on use of the automated medication administration system because there have been a consistent number of user errors.

ANS: B

An example of usability would be when a researcher is conducting a study of how nurses interact with electronic documentation to organize care handoffs. The other items describe ergonomics, non-HIT workflow, and education/training.

DIF: Cognitive Level: Analyze

REF: p. 338

3. National efforts to improve the user experience are under way in the U.S. One organization

involved with this effort is the: a. Office of Technology and Disasters. b. American Nurses Association.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) c. National Institute of Standards and Technology. d. National League for Nursing.

ANS: C

An organization involved in national efforts to improve the user experience is the National Institute of Standards and Technology. The Office of Technology and Disasters, American Nurses Association, and National League for Nursing are not involved with the user experience.

DIF: Cognitive Level: Remember

REF: p. 347

4. You are asked to perform a heuristic evaluation of the new orders management module of your

inpatient system. You discover that the flow of the orders is different than the way providers are taught in school. This is an example of: a. consistency and standards. b. match between system and world. c. informative feedback. d. ergonomics.

ANS: B

Match addresses the way health practitioners think and the design of systems.

DIF: Cognitive Level: Apply

REF: p. 342; Table 21-1

5. You want to make sure you consider crucial components as you design your first usability study.

One of these components is to consider users and their characteristics. Other components are: a. a developmental timeline, tasks, information, product, and context. b. tasks, information, projected errors, context, and interactions. c. information, a developmental timeline, context, and group interactions. d. information, testing, errors, and context.

ANS: A

Crucial components as you design your first usability study include a developmental timeline, tasks, information, product, and context. The HHCI describes elements to consider.

DIF: Cognitive Level: Remember

REF: p. 339

6. Your team developed a prototype for a mobile health (mhealth) device for diabetics to track their

glucose levels, insulin, and preventive care appointments. You want to assess whether the application includes the appropriate content for users (consumers). You plan to ask patients from an ambulatory clinic to participate. The kind of test you would plan is a(n): a. validation test. b. exploratory test. c. comparison test.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) d. assessment test.

ANS: B

The type of test that is appropriate is an exploratory test. Content issues are addressed in exploratory tests.

DIF: Cognitive Level: Apply

REF: p. 345

7. You are part of a knowledge management team that is interested in improving the user experience

for your organization. The team members know you have taken a course in informatics and ask your advice about how to get started with usability in the organization. You recommend: a. talking to the CEO about her ideas. b. examining the support call lists and system change requests. c. working with only physicians, since they have been the most vocal about issues with the EHR. d. hiring a consultant.

ANS: B

The first step is to understand the key users’ issues, and support call lists and change requests would give that information.

DIF: Cognitive Level: Apply

REF: p. 346

8. Nielsen coined the term “Discount Usability Testing” to indicate the design of tests that conserve

resources, including funding and time. One example is a reduced number of users who need to participate. He indicates that as few as how many users can find 80% of design issues? a. 3 b. 5 c. 10 d. 15

ANS: B

Nielsen’s work in the early 1990s noted that as few as 5 users can find 80% of design issues.

DIF: Cognitive Level: Remember

REF: p. 345

MULTIPLE RESPONSE 9.

Think aloud protocol is a method for generating rich data when users talk aloud as they use a product. This method is used: (Select all that apply.) a. during initial product development. b. during mature product design.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) c. after the product is released. d. after the product is used.

ANS: A, B, C

Think aloud protocol can be used during initial product development, during mature product design, and after the product is released.

DIF: Cognitive Level: Apply

REF: p. 341

10. Task analysis is a collection of many different techniques. You can use task analysis to: (Select

all that apply.) a. conduct the think aloud protocol. b. analyze users’ cognitive processes. c. observe workflow in a cardiology clinic. d. determine crucial errors with CPOE.

ANS: B, C, D

Task analysis addresses many issues in the user experience. These may include analyzing users’ cognitive processes, observing workflow in a cardiology clinic, and/or determining crucial errors with CPOE. DIF: Cognitive Level: Apply

REF: pp. 341-342

Chapter 22: Standards Test Bank MULTIPLE CHOICE 1. The NIC system includes: a. interventions for illness prevention. b. medication administration records (MARs). c. 30 domains with 7 classes each. d. nursing outcomes.

ANS: A

The NIC system includes interventions for illness prevention.

DIF: Cognitive Level: Understand

REF: p. 360

2. Which organization recognizes nursing terminologies as supporting nursing practice?

Health Informatics-An Interprofessional Approach 2Ed(Staggers) a. b. c. d.

NANDA-I International Health Terminology Standards Development Organization (IHTSDO) American Nurses Association (ANA) Alliance for Nursing Informatics (ANI)

ANS: C

The organization that recognizes nursing terminologies as supporting nursing practice is the American Nurses Association.

DIF: Cognitive Level: Remember

REF: p. 359

3. The NANDA-I classification is a: a. standardized classification of patient/client outcomes. b. set of nursing diagnoses of actual problems, risks, and health enhancement needs. c. standardized classification of interventions. d. unified nursing language system into which nursing terminologies can be crossmapped.

ANS: B

The NANDA-I classification is a set of nursing diagnoses of actual problems, risks, and health enhancement needs.

DIF: Cognitive Level: Remember

REF: p. 360

4. International Classification of Nursing Practice is a: a. standardized classification of patient/client outcomes. b. set of nursing diagnoses. c. standardized classification of interventions. d. unified nursing language system into which nursing terminologies can be crossmapped.

ANS: D

The ICNP is a unified nursing language system into which nursing terminologies can be crossmapped.

DIF: Cognitive Level: Remember

REF: pp. 359-360

5. Which terminology serves as a resource to represent domain knowledge of interest and thus facilitates data collection, processing, and aggregation using computer processing? a. Ontology b. Classification c. Reference terminology d. Nomenclature

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: C

Reference terminology serves as a resource to represent domain knowledge of interest and thus facilitates data collection, processing, and aggregation using computer processing.

DIF: Cognitive Level: Understand

REF: p. 352

6. ICD-9 and ICD-10 are examples of which category of terminology? a. Nursing terminology b. Billing code c. Clinical classification d. Multidiscipline terminology used for clinical coding within an EHR

ANS: B

ICD-9 and ICD-10 are examples of billing codes.

DIF: Cognitive Level: Remember

REF: p. 358

7. ISO 18104:2003, an international standard for integration of a reference terminology model for nursing, does not state specifically the nursing terminologies that should be used in systems. a.

True b. False

ANS: A

ISO 18104:2003, an international standard for integration of a reference terminology model for nursing, does not state specifically the nursing terminologies that should be used in systems.

DIF: Cognitive Level: Remember

REF: p. 354

MULTIPLE RESPONSE 8. Which terminology contains nursing problems? (Select all that apply) a. SNOMED b. Logical Observations Identifiers Names and Codes (LOINC) c. Omaha System d. NANDA

ANS: A, C, D

The terminologies that contain nursing languages include SNOMED, the Omaha System, and NANDA.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) DIF: Cognitive Level: Understand

REF: pp. 354-355

9. Which terminologies are recognized by the ANA? (Select all that apply.) a. ICNP b. NOC c. LOINC d. RxNorm

ANS: A, B, C

ANA-recognized nursing terminologies include ICNP, NOC, and LOINC. RxNorm is not a nursing terminology.

DIF: Cognitive Level: Remember

REF: p. 358

COMPLETION

and

10.

are ANA recognized “multidisciplinary” terminologies.

ANS:

SNOMED, LOINC SNOMED and LOINC are ANA recognized “multidisciplinary” terminologies.

DIF: Cognitive Level: Remember

REF: pp. 354-358

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chapter 23: Health Information Technology Governance Test Bank MULTIPLE CHOICE 1. Who “owns” health IT governance? a. The Chief Information Officer b. The Chief Medical Information Officer c. The Chief Executive Officer d. The type of institution

ANS: D

The ownership of health IT governance, as with other aspects of governance, depends on the institution.

DIF: Cognitive Level: Apply

REF: pp. 372-373

2. What is the first factor in deciding on an optimal health IT governance for an institution? a. The

EHR system in use b. The organizational culture c. The size of the IT budget d. Whether the organization is a for-profit or non-profit entity

ANS: B

Of the listed factors, an organization’s culture is the most important factor that needs to be considered.

DIF: Cognitive Level: Analyze

REF: p. 374

3. Why is it difficult to establish effective health IT governance? a. Fundamentally, effective governance means that some stakeholders’ informatics needs will

need to be de-prioritized. b. There is too much literature available on the topic, making it difficult to choose which

approach to follow. c. So few activities within a healthcare organization involve informatics. d. No stakeholder wants to have a say in how informatics resources are leveraged.

ANS: A

The fundamental reason for the difficulty of informatics governance is that there is more effort desired from informatics than resources allow.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

DIF: Cognitive Level: Apply

REF: pp. 371-372

4. A centralized health IT governance structure is always the most effective. a. True b. False

ANS: B

The optimal health IT governance structure depends on the organization.

DIF: Cognitive Level: Apply

REF: pp. 374-375

MULTIPLE RESPONSE 5.

Why is health IT governance needed? (Select all that apply.) a. It ensures the alignment of informatics resources with institutional priorities. b. It effectively prioritizes the use of informatics resources. c. It optimizes the return on investment on informatics investments. d. It encourages clinician involvement.

ANS: A, B, C

Health IT governance is needed as it ensures the alignment of informatics resources with institutional priorities, effectively prioritizes the use of informatics resources, and optimizes the return on investment on informatics investments. All three reasons are core to the need for health IT governance.

DIF: Cognitive Level: Apply 6.

REF: pp. 371-372

Which clinical initiatives require informatics to be optimally effective? (Select all that apply.) a.

Population health management b. IT governance c. Care pathways d. Reduction in care variability

ANS: A, C, D

Population health management, care pathways, and reduction in care variability require informatics to be optimally effective. All these initiatives have a significant information management component and require informatics support to be optimally effective.

DIF: Cognitive Level: Apply 7.

REF: pp. 371-372

Which components are necessary for effective health IT governance? (Select all that apply.) a. Organizational structures for clinical processes

Health Informatics-An Interprofessional Approach 2Ed(Staggers) b. Organizational structures responsible for clearly defining institutional priorities c. Organizational structures responsible for ensuring that informatics efforts are aligned with

institutional priorities and optimally utilized d. Accompanying processes to operationalize the governance

ANS: B, C, D

Effective health IT governance requires organizational structures responsible for clearly defining institutional priorities, organizational structures responsible for ensuring that informatics efforts are aligned with institutional priorities and optimally utilized, and accompanying processes to operationalize the governance.

DIF: Cognitive Level: Remember 8.

REF: p. 372

Which factors represent internal and external forces that require effective informatics governance? (Select all that apply.) a. Increasing demand for decision support and analytics b. Greater expectations for information access and transparency c. Clinician demand d. Meaningful Use and healthcare reform

ANS: A, B, D

Increasing demand for decision support and analytics, greater expectations for information access and transparency, and Meaningful Use and healthcare reform represent significant issues that increase the demand for informatics resources and subsequently require more effective health IT governance and prioritization.

DIF: Cognitive Level: Apply 9.

REF: p. 373

Which groups are relevant stakeholders for health IT governance? (Select all that apply.) a. IT department b. Quality department c. Health services researchers d. Housekeepers

ANS: A, B, C

Relevant stakeholders of IT governance include the IT department, the quality department, and health services researchers.

DIF: Cognitive Level: Understand

REF: pp. 371-372

10. Which activities represent dimensions of the National Health Service’s Informatics Capability

Maturity Model? (Select all that apply.)

Health Informatics-An Interprofessional Approach 2Ed(Staggers) a. b. c. d.

Clinical documentation Managing information Using business intelligence Aligning business and informatics

ANS: B, C, D

Managing information, using business intelligence, and aligning business and informatics are dimensions of the National Health Service’s Informatics Capability Maturity Model.

DIF: Cognitive Level: Remember

REF: p. 374

Chapter 24: Legal Issues, Federal Regulations, and Accreditation Test Bank MULTIPLE CHOICE 1. Which healthcare professional is eligible to participate in the Medicare EHR Incentive Program? a. Registered nurse b. Physician assistant c. Medical doctor d. Nurse practitioner

ANS: C

The medical doctor is the only healthcare provider listed who is eligible to participate in the Medicare EHR Incentive Program. The registered nurse, physician assistant, and nurse practitioner are all ineligible for this program.

DIF: Cognitive Level: Remember

REF: p. 380

2. Which President initiated the Office of National Coordinator? a. President William Clinton b. President Barack Obama c. President George W. Bush d. President George H.W. Bush

ANS: C

The Office of National Coordinator was implemented in 2004 when President George W. Bush was in office.

DIF: Cognitive Level: Remember

REF: p. 378

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

3. Which metrics give providers some flexibility in meeting Meaningful Use criteria? a. Menu

elements b. Core elements c. Primary elements d. Secondary elements

ANS: A

Because individual providers have different types of practices, the Health IT Policy and Health IT Standards Committees divided the Meaningful Use metrics into “core” required elements and “menu” elements. Permitting providers an opportunity to report on required core elements and then choose to report on a select few menu elements addresses the unique aspects of each provider’s practice/facility and adds flexibility to the financial incentive program.

DIF: Cognitive Level: Understand

REF: p. 381

4. When there is a breach of one unsecured patient record, it is necessary to notify: a. the patient. b. the Department of Health and Human Services. c. the media outlets. d. the Office of National Coordinator for Healthcare Information Technology.

ANS: A

If there is only a breach of one record versus a breach of more than 500 records, only the patient must be notified within sixty (60) days upon the discovery of the breach.

DIF: Cognitive Level: Apply

REF: pp. 381, 391

5. If a hospital loses its backup tapes containing 315,000 unencrypted records, it is necessary to

notify: a. the Office of National Coordinator for Healthcare Information Technology. b. the media

outlets. c. the Attorney General. d. the Department of Justice.

ANS: B

Pursuant to the HITECH breach notification requirements, because there is a breach of more than 500 unsecured records, the media must be notified to ensure patients are made aware of the breach. In addition to the media outlets, the Department of Health and Human Services Office of Civil Rights Agency must also be notified within sixty (60) days of discovering the breach.

DIF: Cognitive Level: Apply

REF: p. 391

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

6. A vendor provided all advanced practice registered nurses with free mobile devices to stimulate

referrals. Which regulation is being violated? a. The Anti-Kickback Statute b. The Stimulus Act c. The HITECH Act d. HIPAA

ANS: A

The Anti-Kickback Statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a federal health care program. Where remuneration is paid purposefully to induce or reward referrals of items or services payable by a federal health care program, the Anti-Kickback Statute is violated.

DIF: Cognitive Level: Apply

REF: pp. 388, 392

7. The Center for Medicare & Medicaid Innovation was created by: a. the American Recovery and Reinvestment Act of 2009. b. the Health Insurance Portability and Accountability Act. c. the Patient Protection and Affordable Care Act. d. the Health Information Technology for Education and Clinical Health Act.

ANS: C

The Patient Protection and Affordable Care Act of 2010 created the Center for Medicare & Medicaid Innovation (CMI) to help transform federal and state healthcare programs by changing and redesigning the healthcare system. Ultimately, CMI intends to develop better healthcare, improve health, and reduce costs for beneficiaries to enhance the delivery of care for all recipients.

DIF: Cognitive Level: Remember

REF: pp. 394-395

MULTIPLE RESPONSE 8.

Which entities have the authority to enforce penalties for a breach of PHI? (Select all that apply.) a. State attorney general b. Office of Civil Rights c. Office of Inspector General d. Centers for Medicare and Medicaid Services

ANS: A, B

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Pursuant to the enhanced enforcement authority granted under HITECH, both the Office of Civil Rights and the state attorney general have the authority to enforce penalties for the breach of the HIPAA laws that protect the privacy and security of PHI. DIF: Cognitive Level: Understand 9.

REF: pp. 390, 392

Which initiatives are a policy priority for Meaningful Use? (Select all that apply.) a. To engage patients and families b. To lower the cost of delivering healthcare services c. To improve care coordination d. To ensure adequate privacy and security of patient information

ANS: A, C, D

Engaging patients and families, improving care coordination, and ensuring privacy and security are all policy initiatives that were used as foundational elements of how the Health IT Policy Committee defined Meaningful Use to achieve the specific public policy goals. The policy initiatives created by the Health IT Policy Committee did not base the Meaningful Use measures upon the intention of lowering the costs.

DIF: Cognitive Level: Remember

REF: p. 381

10. Which safeguards are implementation specifications for security awareness and training?

(Select all that apply.) a. Security reminders b. Protection from malicious software c. Log-in monitoring d. Response and reporting

ANS: A, B, C

Security reminders, protection from malicious software, and log-in monitoring are implementation specifications for security awareness and training. Response and reporting are implementation safeguards for how to address a security incident and are not specifications of security awareness and training.

DIF: Cognitive Level: Understand

REF: p. 387

Chapter 25: Health Policy and Informatics Test Bank MULTIPLE CHOICE 1. The EHR incentive Meaningful Use criteria are adapted from work done by:

Health Informatics-An Interprofessional Approach 2Ed(Staggers) a. b. c. d.

the National Quality Forum. the National Priorities Partnership. the Joint Commission. the Institute of Medicine.

ANS: B

The EHR incentive program’s Stage 1 criteria for meeting Meaningful Use are divided into five initiatives adapted from work done by the National Priorities Partnership.

DIF: Cognitive Level: Remember

REF: p. 398

2. The ONC-sponsored Standards & Interoperability Framework completes its health IT standards

development initiatives using: a. consensus-based decision making through a moderated online wiki. b. monthly conference calls of volunteers working on each initiative. c. surveys sent out to provider organizations working on EHR implementation. d. face-to-face work teams assembled to work on each initiative.

ANS: A

The health IT standards work is done online through a moderated wiki with over 1,300 volunteers participating in the Standards & Interoperability Framework.

DIF: Cognitive Level: Remember

REF: p. 400

3. It is important to monitor and track unintended consequences of health IT implementation because: a. reporting is mandatory. b. not much is known and we need to learn more. c. the federal government is interested in this information. d. this is a prevalent issue.

ANS: B

Research in this area is just beginning, but even without knowing all the details, monitoring and tracking of the unplanned or unexpected consequences are important, so we can learn moreabout the issues to inform the future.

DIF: Cognitive Level: Remember

REF: p. 401

4. The Center to Champion Nursing in America envisions a healthcare system where: a. best practices need to be developed. b. quality care is increasing in targeted areas. c. nurses are expanding their capabilities.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) d. all Americans have access to high-quality care.

ANS: D

The Center to Champion Nursing in America envisions a healthcare system where all Americans have access to high-quality care, with nurses contributing to the full extent of their capabilities.

DIF: Cognitive Level: Understand

REF: p. 406

5. To achieve the goals of the HIMSS Nursing Informatics Position Statement, all nurses should: a.

draft health IT policy. b. run for political office. c. participate in advocacy and educational efforts directed to policymakers. d. develop innovative technologies.

ANS: C

The HIMSS Nursing Informatics Position Statement states that nurse leaders should be knowledgeable and well versed in current public policy initiatives and participate in advocacy and educational efforts directed to policymakers.

DIF: Cognitive Level: Apply

REF: p. 406

6. Meaningful Use refers to: a. receiving the EHR incentive payments for Meaningful Use. b. meeting all the Meaningful Use criteria. c. leveraging the EHR to facilitate practice and payment change for healthcare transformation. d. attesting to Meaningful Use.

ANS: C

Meaningful Use is determining how to leverage the EHR implementation to accomplish other goals in an organization beyond just meeting the Meaningful Use criteria. It is not just doing the minimum and checking the Meaningful Use criteria off, but using the implementation process to create other changes needed for healthcare reform.

DIF: Cognitive Level: Remember

REF: p. 401

7. When preparing to provide testimony or serve as an expert witness, the nurse should: a. prepare detailed written notes to read during the presentation. b. interview individuals who are knowledgeable in the topic area. c. prepare multiple questions to ask the committee chairperson. d. focus primarily on developing nursing-related content.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: B

Interviewing knowledgeable individuals, including board members and industry, organizational, or volunteer leaders, will add credibility to the testimony by broadening the scope of expertise and experience that can be leveraged.

DIF: Cognitive Level: Apply

REF: pp. 402-403

MULTIPLE RESPONSE 8.

Which strategies are required when nurses prepare to engage in public policy efforts? (Select all that apply.) a. Acquire knowledge of basic health policy and funding b. Demonstrate leadership skills c. Register as a lobbyist d. Leverage a professional network

ANS: A, B, D

Strategies required for nurses to engage in public policy efforts include acquiring knowledge of the basics of health policy funding, demonstrating leadership skills, and leveraging a professional network.

DIF: Cognitive Level: Apply 9.

REF: pp. 403-404

The IOM report, HIT and Patient Safety: Building Safer Systems for Better Care, documented that safe use of health IT relies on: (Select all that apply.) a. the interplay of people, process, and technology. b. vendors, users, and government. c. clinicians and patients. d. commercial interests

ANS: A, B, C

The safe use of HIT relies on many factors, including clinicians, patients, and socio-technical issues such as the interplay of people, process, and technology. Vendors, users, government, and the private sector all have roles to play.

DIF: Cognitive Level: Remember

REF: pp. 400-401

10. Well-defined policies are necessary to ensure that: (Select all that apply.) a. confidentiality of protected health information is safeguarded. b. accurate cost accounting occurs. c. data capture is being automated. d. clinical decision support is adopted.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: A, C, D

Well-defined policies are necessary to ensure that confidentiality of protected health information is safeguarded, data capture is being automated, and clinical decision support is adopted. Policymakers should leverage these opportunities to transform nursing practice through the use of new and existing technologies intended to support decision making and care delivery.

DIF: Cognitive Level: Apply

REF: p. 405

Chapter 26: Informatics in the Curriculum for Healthcare Professionals Test Bank MULTIPLE CHOICE 1.

Advocating for users’ needs and acting as a liaison between the users, the IT staff, and the vendor are competencies for a(n): a. generalist. b. advanced practice nurse. c. specialist. d. innovator.

ANS: C

Advocating for users’ needs and acting as a liaison between the users, the IT staff, and the vendor are competencies for the informatics nurse specialist (INS). The INS receives graduate training for this role.

DIF: Cognitive Level: Remember 2.

REF: pp. 420-421

A popular continuing education program that teaches informatics knowledge, skills, and attitudes is: a. TIGER. b. AMIA 10x10. c. HRSA. d. HIMSS.

ANS: B

A popular continuing education program that teaches informatics knowledge, skills, and attitudes is AMIA 10x10. TIGER, HRSA, and HIMSS are all organizations that advocate for continuing education but are not providers of informatics education.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

DIF: Cognitive Level: Remember 3.

REF: p. 413

The Health Information Technology for Economic and Clinical Health (HITECH) Act has influenced healthcare delivery because it is: a. a training program for informatics specialists. b. an organization that develops informatics competencies. c. an academic electronic health records software. d. federal legislation that promotes the use of electronic health records.

ANS: D

HITECH has influenced healthcare delivery because it is federal legislation that promotes the use of electronic health records. HITECH has not specifically addressed informatics training or education.

DIF: Cognitive Level: Remember 4.

REF: p. 412

The Quality and Safety Education in Nursing (QSEN) project developed competencies based on work completed by: a. HRSA. b. TIGER. c. IOM. d. AMIA 10x10.

ANS: C

The QSEN project developed competencies based on work completed by the Institute of Medicine (IOM). HRSA, TIGER, and AMIA 10x10 may address informatics competencies, but they did not provide the foundation for the QSEN project.

DIF: Cognitive Level: Remember 5.

REF: p. 420

The implementation specialist, practice workflow specialist, and health information exchange specialist are informatics roles identified and described by: a. the ANA Scope and Standards for Nursing Informatics. b. the Department of Labor’s Bureau of Labor Statistics. c. ONC’s HITECH Workforce Plan. d. the Department of Commerce’s Standard Occupation Codes.

ANS: C

The implementation specialist, practice workflow specialist, and health information exchange specialist are informatics roles identified and described by the ONC’s HITECH Workforce Plan. The ANA Scope and Standards for Nursing Informatics, Department of Labor’s Bureau

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

of Labor Statistics, and Department of Commerce’s Standard Occupation Codes do not delineate these positions.

DIF: Cognitive Level: Remember 6.

REF: pp. 417-418

Evaluating data from all relevant sources, including technology, to inform the delivery of care is a competency for a(n): a. generalist. b. advanced practice nurse. c. specialist. d. innovator.

ANS: A

Evaluating data from all relevant sources, including technology, to inform the delivery of care is a competency for a generalist. The generalist receives undergraduate training for this role.

DIF: Cognitive Level: Remember 7.

REF: pp. 420-421

Cognitive psychology claims that learning involves memory, motivation, thinking, reflection, and abstraction. Which question is instrumental in teaching critical thinking? a. What? b. How? c. Why? d. Who?

ANS: B

“Knowing how” involves memory, motivation, thinking, reflection, and abstraction. These skills are useful in teaching critical thinking. “Knowing what” represents behaviorism, and “knowing why” represents constructivism. “Knowing who” is not part of the learning theories discussed.

DIF: Cognitive Level: Remember 8.

REF: pp. 415-416

Educating students about informatics includes working with EHRs and: a. evidence-based practice (EBP). b. interprofessional teams. c. patient safety. d. communication tools.

ANS: D

Informatics deals primarily working with information and communicating information to others. Therefore communication tools are a necessary component of an informatics education.

While the EBP, interprofessional teams, and patient safety can be enhanced by the use of

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

informatics, they are not informatics knowledge, skills, or attitudes. Informatics is about information and communicating it to others.

DIF: Cognitive Level: Remember 9.

REF: p. 416

Incorporating usability principles into software configuration and implementation is a competency of: a. the generalist. b. the advanced practice nurse (APN). c. the nursing informatics specialist (INS). d. the implementation support specialist.

ANS: D

Incorporating usability principles into software configuration and implementation is a competency of the implementation support specialist. This is not a competency of the generalist, APN, or INS. DIF: Cognitive Level: Remember

REF: p. 421

10. Existing resources that promote meeting the challenge of teaching informatics in the health

professional curriculum are: a. sufficient number of trained faculty. b. readily available technical infrastructure. c. teaching materials and assignments. d. simulation and academic electronic health records (AEHRs) software.

ANS: C

QSEN and ONC have made freely available numerous teaching materials and assignments for teaching informatics. Insufficient faculty and lack of technical support are two major barriers to teaching informatics. The costs of simulation and AEHRs can be prohibitive.

DIF: Cognitive Level: Remember

REF: pp. 420-421

Chapter 27: Distance Education: Applications, Techniques, and Issues Test Bank MULTIPLE CHOICE 1.

Which two instrumental movements pushed correspondence courses forward? a. The Society to Encourage Studies at Home and Chautauqua College of Liberal Arts b. The invention of the television and cable services c. The development of Web 2.0 tools and the Internet

Health Informatics-An Interprofessional Approach 2Ed(Staggers) d. Fiber-optic cables and 2-way video communications

ANS: A

Phase one of distributive education historical developments was pushed forward by the establishment of the Society to Encourage Studies at Home and the Chautauqua College of Liberal Arts. The invention of the television and cable services, the development of Web 2.0 tools and the Internet, fiber-optic cables, and 2-way video communications relate to other events that further promoted distance education.

DIF: Cognitive Level: Remember 2.

REF: p. 425

Distributive education is: a. education that takes place in different settings and at different times. b. the use of electronic devices to deliver the instruction and by which the learners acquire their knowledge. c. customized, learner-centered education that uses technology to provide learner experiences where the learner is engaged in the learning activities that may or may not be at a distance. d. a version of distance education that requires the use of the Internet or Intranet to deliver the educational materials.

ANS: C

Distributive education is customized, learner-centered education that uses technology to provide learner experiences where the learner is engaged in the learning activities that may or may not be at a distance. The definition incorporates the main components of technology, engagement, customization, interaction, and individualization. The remaining choices are not complete enough or describe other terms like distance education, elearning, or online learning.

DIF: Cognitive Level: Understand 3.

REF: p. 426

What is the main difference between a portal approach and a proprietary course management system (CMS) approach in distance education? a. Portal-based systems can only be accessed by faculty of an institution, and proprietary CMS systems can be accessed by students and faculty. b. Portal-based systems can be accessed by students and faculty of an institution, and proprietary CMS systems can only be accessed by faculty. c. Portal-based systems are products purchased or licensed by a vendor, and proprietary CMS systems are developed and customized by the learning institution. d. Portal-based systems are developed and customized by the learning institution, and proprietary CMS systems are products purchased or licensed by a vendor.

ANS: D

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Portal-based systems are developed and customized by the learning institution, and proprietary CMS systems are products purchased or licensed by a vendor. Both systems allow access to students and faculty alike.

DIF: Cognitive Level: Understand 4.

REF: pp. 428-429

From a faculty perspective, the two critical criteria for a CMS/LMS are: a. ease of use and tool set. b. installed base and integration. c. cost and scalability. d. ease of use and installed base.

ANS: A

While all of these criteria are important for faculty, ease of use and tool set are the most important. The installed base and integration, cost and scalability, and ease of use and installed base are generally more important to the technology staff and administration.

DIF: Cognitive Level: Understand 5.

REF: pp. 431-432

Two examples of campus portal systems are: a. Moodle and Blackboard. b. Ellucian and Jenzabar e-Racer. c. Desire2Learn and Blackboard. d. Sakai and Ellucian.

ANS: B

Ellucian and Jenzabar e-Racer are portal systems. Blackboard and Desire2Learn are CMS, and Moodle and Sakai are open source examples.

DIF: Cognitive Level: Remember 6.

REF: pp. 428-429

For a successful distributive education program, the institution: a. must always offer students the option for distributed learning even if there is no faculty buyin. b. should move forward with an initiative to offer distributive learning in order to stay competitive even when resources may not be in place. c. must match the goals and objectives for a distributive education initiative to the mission and goals of the institution. d. should offer distributive education as a way of making money and lowering operating costs.

ANS: C

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Without matching goals and objectives of distributive education to the mission and goals of the institution, resources will not line up correctly, which is a recipe for failure. A successful program requires commitment from faculty and appropriate institutional resources and will cost money; it may or may not make money for the institution.

DIF: Cognitive Level: Remember 7.

REF: p. 427

In a distributed learning environment, faculty members should: a. take their face-to-face lectures and turn them into a podcast. b. teach the course the same way as the face-to-face course, as all sections of the course need to be the same. c. use the same activities as the on-campus courses; there is no need to adjust them. d. develop learning activities that engage the learner with relevant real-world activities.

ANS: D

In distributive education the instructor needs to empower the learners to take charge of their learning, to be engaged, and to have a comprehensive learning experience. Podcasts of lectures do not engage the learner, and using the same learning activities does not take advantage of the tools available to engage and empower the learner.

DIF: Cognitive Level: Remember 8.

REF: p. 426

To ensure student success and engagement, faculty members should: a. make evaluative comments in the discussion forum as to the quality of each student’s post so they can improve. b. administer multiple choice tests to measure students’ progress in learning the concepts. c. provide timely feedback to students using a grading rubric through the grading center. d. use their discretion as to the amount and frequency of their feedback to the students.

ANS: C

Providing students with how their learning will be evaluated though a rubric and when this will occur should keep the students engaged and successful. The Family Educational Rights and Privacy Act (FERPA) frowns on other students having access to evaluative comments of classmates. Multiple-choice questions do not necessarily keep the student engaged. Students should know what is required, when, and how soon they will receive feedback on their progress.

DIF: Cognitive Level: Apply 9.

REF: p. 433

Critical to a successful distributive education program are the student support services. The first thing one should do is: a. make sure the library has online access to its holdings through online lending, full text literature databases, and online access to the research librarian.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) b. arrange for tutoring services especially in the distribution courses such as probability and

statistics, college algebra, English, and sciences. c. arrange for the bookstore to provide delivery services for required textbooks. d. survey the students for what support services they expect from the school.

ANS: D

Faculty must determine or assess the needs of the students for support services before deciding what to provide; the other answers all relate to specific support services one might provide.

DIF: Cognitive Level: Apply

REF: p. 433

10. Faculty should clarify the intellectual property issues surrounding the creation of distributive

course materials because: a. these digital materials may have commercial value, and the institution may decide to sell them. Faculty members need to know if they share ownership and, therefore, profits. b. students may want to distribute materials to their family and friends and not have to pay for them. c. accreditation agencies, as a part of their criteria, require that ownership of these materials belongs to the faculty who developed them and must be clearly stated in intellectual property (IP) policies. d. if institutional resources were used to create these course materials, the materials belong to the institution.

ANS: A

With the digitization of class materials, there is a market for developed materials, and faculty members need to be aware of their rights to/ownership of these materials. The field is changing when it comes to ownership of materials developed to teach a course. Students distributing materials to their family and friends without paying for them relates to copyright issues.

Accreditation agencies requiring, as a part of their criteria, that ownership of these materials belongs to the faculty who developed them and must be clearly stated in IP policies is not relevant to who actually owns what and what that may mean to a faculty member. While it may be true that the institution owns the course materials if institutional resources were used to create them, this would need to be clarified as this statement has applied to patents and inventions.

DIF: Cognitive Level: Remember

REF: pp. 436-437

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chapter 28: Informatics Systems and Tools for Educating Health Professionals Test Bank MULTIPLE CHOICE 1. An example of a learning management system is: a. Blackboard. b. Merlot. c. Soarian. d. Smartboard.

ANS: A

Blackboard is one of the largest proprietary learning management systems in the world. Merlot is a collection of resources for faculty working in online learning. Soarian is an electronic health record application for acute care institutions. Smartboard is a white board with features such as a touch interface.

DIF: Cognitive Level: Remember

REF: p. 447

2. What is the process that faculty members at higher educational institutions must undergo to secure

a career position? a. Tenure b. Security c. Tension d. Freedom

ANS: A

Tenure is the process that faculty at higher educational institutions must go through to secure a career position. The other options (security, tension, and freedom) describe how faculty members may feel during the tenure process.

DIF: Cognitive Level: Remember

REF: p. 444

3. Which generic term describes the technology that replaced the traditional chalkboard in

classrooms? a. Interactive white board b. Smart chalk board c. Advanced chalk management d. The board

Health Informatics-An Interprofessional Approach 2Ed(Staggers) ANS: A

An interactive white board is the generic term that describes the technology that replaced the traditional chalkboard in classrooms. The other answers (smart chalk board, advanced chalk management, and the board) either do not fully describe the technology or are incorrect.

DIF: Cognitive Level: Remember

REF: p. 444

4. Which is the major application for virtual world creation and interaction? a. FirstWave b. Virtual Worldz c. Second Life d. World of Warcraft

ANS: C

Second Life is the major application for virtual world creation and interaction. Second Life was the original application created for interaction between users in a virtual world. FirstWave, Virtual Worldz, and World of Warcraft are incorrect choices.

DIF: Cognitive Level: Remember

REF: pp. 449-450

MULTIPLE RESPONSE 5. What are some software examples of eportfolio creation? (Select all that apply.) a. iClickr b. ePortfolio c. eInstruction d. Desire2Learn ePortfolio

ANS: B, D

Some software examples of eportfolio creation are ePortfolio and Desire2Learn ePortfolio. iClickr and eInstruction are audience response systems.

DIF: Cognitive Level: Remember

REF: p. 448

6. Which applications might be useful for recording reflective student clinical journals? (Select all

that apply.) a. Microsoft Word b. Microsoft Excel c. Twitter d. Blackboard

ANS: A, D

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Microsoft Word and Blackboard are both excellent tools for recording reflective journals for students and allow for ease of access to faculty. The functionality of Microsoft Excel makes this a poor choice for journaling, and the character limit of Twitter makes reflective journaling impossible.

DIF: Cognitive Level: Apply

REF: p. 449

7. Which examples represent proprietary applications suitable for real-time in-class student

responses? (Select all that apply.) a. iClickr b. TurningPoint c. TurnOff d. ClickMe

ANS: A, B iClickr and TurningPoint are applications currently marketed as audience response

systems. TurnOff and ClickMe are not examples of audience response systems.

DIF: Cognitive Level: Remember

REF: pp. 446-447

8. What are the limitations of employing a virtual environment as a teaching method? (Select all that

apply.) a. b. c. d.

Access Interface Creativity Cost

ANS: A, B, D

Access, interface, and cost are the most common reasons for not participating in or using this sort of technology in a course. Typically, cost is related to creation of a location in the virtual world. Interface is using a keyboard, mouse, and microphone to interact, and access relates to bandwidth available to the user.

DIF: Cognitive Level: Understand

REF: pp. 449-450

9. What are some reasons institutions are hesitant to adopt information management and

technology tools? (Select all that apply.) a. Prohibitive costs of purchasing technologies b. Fear of change among faculty and students c. Uncertainty about how to structure and determine costs of new courses d. Financial incentives from publishing companies to continue using traditional teaching materials

Health Informatics-An Interprofessional Approach 2Ed(Staggers) ANS: A, B, C

Reasons for the slowness of adoption of technology range from purchasing costs of technologies; dislike or fear of change from administration, staff, faculty, and students; a parochial view that traditional education will always be with us; and how to determine the cost of education based on something other than student credit hours (or seat time). Publishers are embracing technology and are not offering incentives for using traditional print materials.

DIF: Cognitive Level: Understand

REF: pp. 450-451

Chapter 29: Simulation in Healthcare Education Test Bank MULTIPLE CHOICE 1. The best practice starting point for developing a simulation scenario is: a. the equipment available. b. the goals or objectives to be achieved. c. the facilitator’s choice. d. the commercially based scenarios available.

ANS: B

Simulation Standard III: Participant Objectives of the Standards of Best Practice states simulations should be developed based on the goals or objectives to be achieved by the participants, not on the technology available.

DIF: Cognitive Level: Apply 2.

REF: p. 460

The purpose of the debriefing process is: a. to provide additional lecture time. b. to provide time for the facilitator to critique the student’s performance. c. to promote self-reflection. d. to provide time for participants to critique other participants’ performances.

ANS: C

Simulation Standard IV: Debriefing Process of the Standards of Best Practice states that debriefing is reflecting on one’s thoughts, performance, and actions. Self-reflection can be taught.

DIF: Cognitive Level: Understand

REF: p. 461

3. When SBAR communication is used, the B represents: a. baseline.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) b. breath sounds. c. bottom line. d. background.

ANS: D

SBAR stands for situation, background, assessment, and recommendation.

DIF: Cognitive Level: Remember

REF: p. 462

4. Which organization created the first set of published standards to guide simulation experiences? a. International Nursing Association for Clinical Simulation and Learning b. Society for Simulation in Healthcare c. National League for Nursing d. American Association for Colleges of Nursing

ANS: A

The Standards of Best Practice: Simulation was created by the International Nursing Association for Clinical Simulation and Learning (INACSL) in response to a growing need for standardization and guidelines related to simulation educational methodologies.

DIF: Cognitive Level: Remember

REF: p. 460

5. As a simulation facilitator, you develop a confidentiality form that all learners must sign prior to

simulation experiences. Which standard does this represent? a. Standard I: Terminology b. Standard II: Professional Integrity of the Participants c. Standard VI: The Debriefing Process d. Standard VII: Evaluation of Expected Outcomes

ANS: B

Asking all learners to sign a confidentiality form prior to simulation experiences ensures that all learners will receive the same opportunity for learning. This confidentiality form states that the learners will not share the details of the simulation experience with any other students and ensures the professional integrity of the participant.

DIF: Cognitive Level: Analyze

REF: p. 460

6. Which simulator model is most appropriate for learning to obtain an arterial blood gas? a.

Standardized patient b. Computer-controlled mannequin c. Arm model from elbow to fingers d. Computer model

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: C

Asking a learner to obtain an arterial blood gas is an example of a psychomotor skill. This skill can be practiced on an arm model. The arm model is the most realistic model to be used without placing the patient in any dangerous situation, such as the use of the standardized patient.

DIF: Cognitive Level: Analyze

REF: p. 455

7. The evaluation data collected after a simulation experience related to care of the heart failure

patient demonstrated a decrease in hospital admissions related to heart failure exacerbations. This type of evidence supports training outcomes in which level of Kirkpatrick’s Model? a. Level 1 b. Level 2 c. Level 3 d. Level 4

ANS: D

This type of training impact demonstrates the organizational impact (improved patient outcomes) related to a training experience. This is an example of a Kirkpatrick level 4 training outcome.

DIF: Cognitive Level: Analyze

REF: p. 456

MULTIPLE RESPONSE 8.

Which of the following are INACSL standards for best practice for simulation? (Select all that apply.) a. Terminology b. Debriefing process c. Facilitator objectives d. Facilitation methods

ANS: A, B, D

Terminology, debriefing process, and facilitation methods are INACSL standards for simulation best practice. The current INACSL standards address the participant objectives, not the facilitator objectives.

DIF: Cognitive Level: Remember 9.

REF: p. 460

What is the purpose for creating standards to guide simulation experiences? (Select all that apply.) a. To regulate all simulation activities nationwide b. To provide standardized experiences for the learners

Health Informatics-An Interprofessional Approach 2Ed(Staggers) c. To enhance quality of the simulation experience d. To ensure funding for simulation programs

ANS: B, C

Standards are necessary to create the foundational structure on which to build simulation experiences and ensure quality and control related to the scenarios.

DIF: Cognitive Level: Understand

REF: p. 460

10. Which categories of objectives can be met in a simulated clinical experience using a

computercontrolled high-fidelity mannequin? (Select all that apply.) a. Cognitive b. Sociocultural c. Psychomotor d. Affective

ANS: A, C, D

Objectives are designed to meet learning needs in the categories of cognition, psychomotor development, and affective, or emotional feelings. Sociocultural cues used within the simulated learning experience can help to achieve those objectives.

DIF: Cognitive Level: Remember

REF: p. 455

Chapter 30: International Efforts, Issues, and Innovations Test Bank MULTIPLE CHOICE 1. Which international organization organizes an international conference on nursing informatics? a. International Council of Nurses (ICN) b. International Medical Informatics Association – Nursing Informatics SIG (IMIA-

NI) c. Nursing Working Group of HL7 d. International Standard Organization (ISO)

ANS: B

The International Medical Informatics Association – Nursing Informatics SIG (IMIA-NI) organizes an international conference on nursing informatics. The ICN, HL7, and ISO do not organize an international conference on nursing informatics.

Health Informatics-An Interprofessional Approach 2Ed(Staggers) DIF: Cognitive Level: Remember

REF: p. 484

2. Which international organization develops and maintains a family of international classifications

such as the International Classification of Diseases? a. International Health Terminology Standards Development Organization (IHTSDO) b. World Health Organization (WHO) c. International Medical Informatics Association (IMIA) d. Health Level 7 (HL7)

ANS: B

The World Health Organization develops and maintains a family of international classifications such as the International Classification of Diseases. The IHTSDO, IMIA, and HL7 do not develop and maintain a family of international classifications.

DIF: Cognitive Level: Remember

REF: p. 482

3. Which region introduced ehealth initiatives such as epSOS and SEHGovIA for interoperability? a.

Asia-Pacific region b. Latin America and the Caribbean c. Europe d. Africa

ANS: C

Europe introduced ehealth initiatives such as epSOS and SEHGovIA for interoperability. The remaining choices (Asia-Pacific region, Latin America and Caribbean region, and African region) did not introduce these initiatives.

DIF: Cognitive Level: Remember

REF: pp. 474-475

4. Which issue is a deterrent to global interoperability? a. Multiple terminologies used in describing and documenting healthcare b. The development of an international standard clinical terminology c. The development of clinical data models such as HL7 CDA documents d. The use of openEHR Archetypes

ANS: A

Key barriers to global interoperability include issues related to the terminologies used in describing and documenting healthcare such as cost and accessibility; gaps in exhaustiveness; and lack of granularity. The remaining options are all efforts to solve the problem.

DIF: Cognitive Level: Understand

REF: p. 489

Health Informatics-An Interprofessional Approach 2Ed(Staggers) 5. Which international organization develops and maintains standards for data exchange? a. World Health Organization (WHO) b. Health Level 7 (HL7) c. International Health Terminology Standards Development Organization (IHTSDO) d. International Medical Informatics Association (IMIA)

ANS: B

Health Level 7 is an international organization that develops and maintains standards for data exchange. The WHO, IHTSDO, and IMIA do not develop and maintain standards for data exchange.

DIF: Cognitive Level: Remember

REF: p. 489

6. Which international organization deals with harmonization among standard development

organizations in healthcare? a. World Health Organization (WHO) b. Global Health Informatics Partnership (GHIP) c. Health Level 7 (HL7) d. International Standard Organization Technical Committee 215 (ISO/TC 215)

ANS: D

The International Standard Organization Technical Committee 215 (ISO/TC 215) is an international organization that deals with harmonization among standard development organizations in healthcare. The WHO, GHIP, and HL7 do not deal specifically with harmonization among standard development organizations in healthcare.

DIF: Cognitive Level: Remember

REF: p. 486

MULTIPLE RESPONSE 7. Which organizations have relationships with the Health Informatics Building Blocks Program aimed at health informatics workforce development in Africa? (Select all that apply.) a. Health

Level 7 (HL7) b. Health Informatics in Africa (HELINA) c. American Medical Informatics Association (AMIA) d. Global Health Informatics Partnership (GHIP)

ANS: B, C, D

The HELINA, AMIA, and GHIP organizations have relationships with the Health Informatics Building Blocks Program aimed at health informatics workforce development in Africa. The HL7 does not have a relationship with the Health Informatics Building Blocks Program.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

DIF: Cognitive Level: Remember

REF: pp. 480-481

8. Which international organizations develop terminology? (Select all that apply.) a. International Medical Informatics Association (IMIA) b. International Council of Nurses (ICN) c. World Health Organization (WHO) d. International Health Terminology Standards Development Organization (IHTSDO)

ANS: B, C, D

The ICN, WHO, and IHTSDO all develop terminologies. International Medical Informatics Association does not develop terminology.

DIF: Cognitive Level: Remember

REF: p. 482 | p. 484 | p. 489

9. Which international organizations develop international standards? (Select all that apply.) a. Health

Level 7 (HL7) b. International Health Terminology Standards Development Organization (IHTSDO) c. Global Health Informatics Partnership (GHIP) d. International Standard Organization (ISO)

ANS: A, B, D

Health Level 7 (HL7), International Health Terminology Standards Development Organization (IHTSDO), and the International Standard Organization (ISO) all develop international standards for informatics. The Global Health Informatics Partnership (GHIP) does not develop international standards for informatics.

DIF: Cognitive Level: Remember

REF: pp. 484-485 | p. 489

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

Chapter 31: Future Directions and Future Research in Health Informatics Test Bank MULTIPLE CHOICE 1.

Which two events led to the expansion of the field of nanotechnology? a. A lecture titled “There’s Plenty of Room at the Bottom” and development of carbon nanotubes b. Creation of the Project on Emerging Nanotechnologies and use of quantum dots c. Development of the subdisciplines of nanofabrication and nanomedicine d. Invention of the scanning tunneling microscope and the discovery of fullerenes

ANS: D

The invention of the scanning tunneling microscope and the discovery of fullerenes were the two events that led to the expansion of the field of nanotechnology.

DIF: Cognitive Level: Knowledge 2.

REF: pp. 502-503

Which term is analogous to futures research? a. Futuristics b. Futurology c. Foresightology d. Rationalistics

ANS: B

Futures research, or futurology, refers to the study of the future with the goal of identifying possible, probable, and preferable futures. The remaining terms do not exist.

DIF: Cognitive Level: Knowledge 3.

REF: p. 495

An agency has just implemented electronic medication administration records (eMARs). This would be an example of what level of change? a. First-level change b. Second-level change c. Third-level change d. No change

ANS: A

The implementation of eMARs is an example of a first-level change. Previously, medications were documented using a paper system, not an electronic system.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

DIF: Cognitive Level: Apply 4.

REF: pp. 496-497

A hospital has just implemented bar-coded medication administration (BCMA). This would be an example of what level of change? a. First-level change b. Second-level change c. Third-level change d. No change

ANS: B

Implementing BCMA would be a second-level change. The implementation of BCMA has not only changed how medications are documented, but it has actually changed the process of medication administration.

DIF: Cognitive Level: Apply 5.

REF: pp. 496-497

A nurse is asked by the nursing manager to review electronic comments left by patients on the unit’s Facebook page. The nurse examines the comments for common themes. This is an example of: a. trend analysis. b. scenarios. c. content analysis. d. backcasting.

ANS: C

This is an example of content analysis. The content of the comments left by the patients are examined for common themes.

DIF: Cognitive Level: Apply 6.

REF: pp. 497-499

Which description best defines nanofabrication? a. The study of controlling and altering matter at the atomic or molecular level b. The development of materials used in structures, electronics, and commercial products c. A subdiscipline of nanotechnology centering on the application of nanoparticles and nanoscience techniques to healthcare and clinical research d. The use of biomedical informatics techniques and tools for nanoparticle data and information to improve research in the field of nanotechnology

ANS: B

Nanofabrication is the development of materials used in structures, electronics, and commercial products. Nanotechnology is the study of controlling and altering matter at the atomic or

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

molecular level. Nanomedicine is a subdiscipline of nanotechnology centering on the application of nanoparticles and nanoscience techniques to healthcare and clinical research.

Nanoinformatics is the use of biomedical informatics techniques and tools for nanoparticle data and information to improve research in the field of nanotechnology.

DIF: Cognitive Level: Remember 7.

REF: pp. 503-504

An organization decides to utilize a silver nanoparticle in the production of a product in order to make the product antimicrobial. This is an example of: a. nanofabrication. b. nanomedicine. c. health information exchange. d. nanoinformatics.

ANS: A

The purpose and goal of nanofabrication is to utilize nanoparticles to improve existing structures, devices, products, etc.

DIF: Cognitive Level: Analyze 8.

REF: pp. 503-504

What is the primary goal of nanomedicine? a. The advancement of man through the modification of the human body with nanotechnology b. Development of nanomaterials used in electronics, structural materials, and commercial products c. Creation of materials, devices, and other structures at the nanoscale d. The use of nanotechnology for the prevention, diagnosis, and treatment of disease

ANS: D

The primary purpose of nanomedicine is the use of nanotechnology for the prevention, diagnosis, and treatment of disease. The advancement of man through the modification of the human body with nanotechnology; development of nanomaterials used in electronics, structural materials, and commercial products; and creation of materials, devices, and other structures at the nanoscale are not primary purposes of nanomedicine.

DIF: Cognitive Level: Remember 9.

REF: p. 504

Nanoparticles appear to have a very bright and meaningful future in the world; however, what is one potential issue with nanoparticles? a. Development of the field of nanoinformatics and nanomedicine is difficult. b. Creation of nanoparticles has not yet come to full fruition. c. There are cytotoxicity and ethical concerns regarding the use of nanoparticles. d. No methods exist to successfully combat cytotoxicity and clearance of nanoparticles.

Health Informatics-An Interprofessional Approach 2Ed(Staggers)

ANS: C

A potential issue with nanoparticles is that there are cytotoxicity and ethical concerns regarding the use of them. Development of the field of nanoinformatics and nanomedicine is difficult, creation of nanoparticles has not yet come to full fruition, and the lack of methods to successfully combat cytotoxicity and clearance of nanoparticles are not potential issues with nanoparticles.

DIF: Cognitive Level: Remember

REF: p. 505

10. Which goal applies to the field of nanoinformatics? a. Development of a publicly available database of nanoparticle information, nanoparticle

structure simulation tools, and data mining techniques for nanoparticle information b. Development of nanomaterials used in electronics, structural materials, and commercial products c. Creation of materials, devices, and other structures at the nanoscale d. The use of nanotechnology for the prevention, diagnosis, and treatment of disease

ANS: A

A goal that applies to the field of nanoinformatics is the development of a publicly available database of nanoparticle information, nanoparticle structure simulation tools, and data mining techniques for nanoparticle information. Nanofabrication is the development of nanomaterials used in electronics, structural materials, and commercial products. Nanotechnology is the creation of materials, devices, and other structures at the nanoscale. Nanomedicine is the use of nanotechnology for the prevention, diagnosis, and treatment of disease DIF: Cognitive Level: Remember

REF: p. 505