Q&A Hero

Q: For many years the EMR applied to a single encounter with no ability, or very limited ability, to carry information from one visit to another within a care delivery system. That situation has changed; it is now possible to bring information forward from prior visits within the organization or delivery system. Which of the following answers are basic components of the EMR system? Standard Text: Select all that apply. 1. Clinical messaging and e-mail 2. Results reporting 3. Decision support 4. Clinical documentation 5. Order entry

Q: Which of the following statements about meaningful use is correct? 1. Meaningful use will provide invaluable information that will define the numbers of staff members needed at the bedside. 2. Meaningful use will provide invaluable information that will improve patient outcomes and population health changing many current practices as we transform our health care delivery system. 3. Meaningful use is an ongoing process and not an issue associated with the EHR. 4. Meaningful use is an issue that must be addressed before implementing any upgrade.

Q: Which of the following is a major component of the computer-based patient record (CPR)? 1. Results reporting including unstructured data reports 2. Legal record created in hospitals and ambulatory environments 3. Support for links to local or remote information resources 4. Integration of all pertinent patient information into one record

Q: The computer-based patient record (CPR) is a comprehensive lifetime record that includes all information from all specialties. Most of the data included in the CPR is which of the following? 1. Structured data 2. Unstructured data 3. Fragmented data 4. Complete data

Q: The Bush administration called for the adoption of the electronic health record (EHR) by 2014 as a means to help transform U.S. health care. Who owns the individual client record when an EHR is used? 1. The client 2. Ownership is unclear 3. The institution at which the record is created 4. The health care providers who enter the data

Q: Which of the following are major impediments to the development of an electronic health record (EHR)? Standard Text: Select all that apply. 1. Development of an electronic infrastructure 2. Confidentiality 3. Cost 4. Lack of a common vocabulary 5. Information system vendors

Q: Which of the following statements is true about the benefits of the electronic health record (EHR)? 1. It improves the quality of health care. 2. Health care executives have developed strong organizational structures around the EHR. 3. The EHR fosters continuity of health care. 4. Little scientific evidence now exists on what benefits are actually delivered.

Q: Healthcare Information and Management Systems Society (HIMSS) has defined and described the term electronic Personal Health Record (ePHR). Which of the following are included in the HIMSS definition and description? Standard Text: Select all that apply. 1. Universally accessible 2. Owned and managed by the individual (or legal proxy) 3. Usually considered a legal record 4. Common data set of electronic health information 5. Lifelong tool for managing relevant health information

Q: Consumers are the primary source of information about their health history and medications. The patient-carried record (PCR) addresses this. Which of the following are potential problems associated with the PCR? Standard Text: Select all that apply. 1. Loss of the record 2. Legibility 3. Portability 4. Privacy 5. Liability

Q: What is a computer program that tells two different systems how to exchange data? 1. An interface 2. Request for proposal 3. Syntactic operability 4. HL7

Q: What uses archetypes (clinical models of content and process) as a means of exchanging clinical documents between systems? 1. Service oriented architecture 2. HL7 3. Open EHR 4. Semantic interoperability

Q: Which of the following is a classification system for surgical, diagnostic, and therapeutic procedures and is used for hospital billing and payer reimbursement? 1. NOC 2. CPT-4 3. NIC 4. NANDA

Q: Nurses must be involved in identifying and defining data elements that an interface may be able to supply. One way to ensure participation is to recruit staff nurses to do which of the following? 1. Provide input during the interface design. 2. Be a member of the technology committee 3. Participate in the creation of a RFP. 4. Define language needed for interoperability.

Q: The role of the nurse in the system integration efforts should include which of the following? Standard Text: Select all that apply. 1. Ensuring that data will be collected in only one system and shared as needed among others 2. Involvement in the formation and maintenance of the electronic health record 3. Promoting the development and maintenance of archetypes 4. Determining measures to assure the quality of data 5. Identifying and defining data elements

Q: ____________________ and Internet technology were seen as a means to provide access to data from disparate information systems. Standard Text:

Q: One step in the integration process is the development of a uniform definition of terms, or language. The American Nurses Association sponsors the Congress of Nursing Practice Steering Committee on Databases. Which of the following is a primary goal of this steering committee? 1. Categorize interventions that nurses carry out. 2. Measure client outcome position. 3. Develop a mapping system to link various classification schemes. 4. Identify client care problems that nurses treat independently.

Q: A hospital client sees the nurse documenting information into the computer. She asks the nurse why the computer is better than the "old patient chart like hospitals have always used." Which of the following points would be accurate to say about an electronic medical record? Standard Text: Select all that apply. 1. It captures the information needed for billing purposes. 2. It is more secure than a paper record. 3. More than one person can access the record at any given time. 4. The record is available when and where needed. 5. Data are in real-time, as things happen.

Q: Web-based tools can provide benefits of an alternative method for obtaining patient information from diverse information systems. Which of the following is accurate regarding recent advances toward interoperability? 1. The framework has been built and is in place. 2. National priorities will be set within the next five years. 3. Data exchange standards need to be developed. 4. Interoperability of electronic health data will be costly.

Q: Which of the following topics must be addressed when giving a presentation to physicians on the benefits of the electronic medical record (EMR)? Standard Text: Select all that apply. 1. Easier access to previous documented encounters 2. Facilitation of clinical pathways 3. Chart access speed 4. Trends and graphics are not available on demand 5. Reduced liabilities through accurate documentation

Q: Interface engines work in the background and are not seen by the user. This technology allows applications to interact with hardware and other applications. Which of the following are considered benefits associated with the use of interface engines? Standard Text: Select all that apply. 1. Improves timeliness and availability of critical administrative and clinical data 2. Improves data quality because of data mapping and consistent use of terms 3. Allows clients to select the best system for their needs 4. Preserves institutional investment in existing systems 5. Preserves institutional investment in existing systems

Q: While most hospitals have some level of automation, few have attained a fully electronic environment. Health care Information and Management Systems Society (HIMSS) analytics created an EMR adoption model that identifies eight levels of EMR capabilities. Your hospital has been designated as a Stage 3 facility. Which of the following is accurate about an organization at Stage 3 level? 1. Computerized provider order entry (CPOE) and better EBP clinical decision support is available. 2. Some clinical automation exists. 3. Basic clinical documentation is required. 4. Major ancillary clinical systems are all installed (laboratory, pharmacy, and radiology systems).

Q: Integration is a massive project within institutions and enterprises. It generally requires more time and effort than originally projected. Which of the following are factors that may slow down the integration process? Standard Text: Select all that apply. 1. Unrealistic institutional timetable 2. Lack of agreement among merged institution 3. Insufficient documentation 4. Changing user specifications 5. Lack of vendor support

Q: The U.S. Department of Health and Human Services indicated that the ________________ is a digital collection of patient's medical history. Standard Text:

Q: Nursing can reap significant benefits from integration. Which of the following integration statements is accurate for nursing? 1. Trends in client care data and cost analysis can be used to justify nursing staffing levels. 2. Nursing should be sure that data will be collected in several systems for sharing. 3. The use of a data dictionary can interfere with system integration processes. 4. Nursing involvement is unnecessary so long as I.S. staff members are given requirements.

Q: The clinical data repository provides data definition consistency through which of the following? 1. Mapping 2. Interface engine 3. Point-to-point interface 4. Clinical data warehouse

Q: _______________________ uses XML (Extensible Markup Language) for storage and movement of clinical documents between systems. Standard Text:

Q: ______________________________ interoperability is the ability to exchange the structure of the data, but not necessarily the meaning of the data. It is also referred to as functional interoperability. Web pages built with HTML illustrate this type of interoperability. Standard Text:

Q: Which of the following supports the development of an EHR by classifying and categorizing nursing data? 1. North American Nursing Diagnosis Association (NANDA) 2. HL7 3. Service oriented architecture (SOA) 4. SNOMED

Q: The use of HL7 standards in individual applications can improve the integration of applications with other applications or systems through the use of which of the following? 1. Digital imaging and communications in medicine (DICOM) 2. Interface engine 3. Radiology information system (RIS) 4. Current procedural terminology (CPT) codes

Q: The lack of which of the following has long been a barrier to effective data reporting and analysis? 1. Knowledge 2. Interoperability 3. Resources 4. Information technology

Q: Using what kind of strategy will permit data exchange within each hospital and across health care networks or enterprises? 1. Integration 2. Syntactic interoperability 3. Semantic interoperability 4. Using a clinical data repository

Q: Which of the following is the protection of information against threats to its integrity, inadvertent disclosure, or availability? 1. Information security 2. Survivability 3. Confidentiality 4. Privacy

Q: Which of the following answers are factors that slow systems integration? Standard Text: Select all that apply. 1. Vendors' false claims that their information systems are interoperable with other systems 2. Unrealistic institutional timetable set due to a lack of understanding of the complexity of the integration process. 3. Vendors who do not provide enough support and assistance to facilitate the integration efforts. 4. Existing systems are insufficiently documented. 5. Merged institutions do not agree on which systems to use.

Q: During an attempted carjacking, the female victim slams a car door on the male assailant's hand, possibly causing serious injuries. The assailant runs away. Local police contact the emergency department of a local hospital to determine if anyone matching the assailant's description has been treated for a hand injury. The hospital reveals that they currently have such a patient. The police ask the nurse manager to reveal the identity of the patient. It is noted that no court order has been issued. The nurse manager asks the patient to sign a consent form that allows the hospital to reveal his name and does mention the police. If the patient signs the consent form, what would it be considered? 1. Informed consent 2. Consent 3. HIPAA violation 4. Breech of privacy

Q: A female client goes to the clinic's office complaining of a cough and fever. She gives her name and date of birth at the admitting registration desk. The registration clerk verifies her current address and asks if she is still covered by IVY insurance. Client responds yes, is given a chart with the number 3948JAV04830 on it, and is directed to the physician's exam room. The physician orders a chest x-ray. The client is sent to the radiology department and checks in with the registration desk. The registration clerk verifies her current address and asks if she is still covered by IVY insurance. The client responds yes and is given an order sheet with the number 3948JAV04830 on it. The admitting office for the clinic and the radiology office use different information systems. The process depicted in this scenario illustrates the use of which of the following? 1. Uniform language 2. Master patient index 3. Data dictionary 4. Clinical data repository

Q: Which of the following is a state of mind, a specific place, freedom from intrusion, or control over the exposure of self or of personal information? 1. Privacy 2. Confidentiality 3. Security 4. HIPAA

Q: Which of the following is not a clue that spyware has infected a computer? 1. Ability to SKYPE 2. Appearance of pop-ups 3. Random error messages 4. Poor system performance

Q: The security of any information system is part of the strategic planning process. Information system security is planned for with the intention of achieving which of the following goals? Standard Text: Select all that apply. 1. Patient confidentiality protection 2. Information integrity protection 3. Timely availability protection 4. Cybercrime prevention 5. HIT compliance

Q: Which of the following is true about effective security? 1. Assessment of security resources enables organizational personnel to devise methods to protect information systems data. 2. Assessment of security resources provides super users with in depth access knowledge. 3. Assessment of security resources enables organizational personnel to alter the flow of information. 4. Assessment of security resources enables organizational personnel to define terms in the data dictionary.

Q: ______________________________ is the process of determining whether someone is who he or she professes to be. This usually involves a username and a password, but can include other methods of proving identity, such as a smart card, retina scan, voice recognition, or fingerprints. Standard Text:

Q: Which of the following best depicts the impact that Internet technology has on the security of health related information? 1. Health information on the Internet requires the same types of safeguards provided for information found in private offices and information systems. 2. Health information on the Internet does not require the same types of safeguards provided for information found in private offices and information systems. 3. Health information on the Internet requires more types of safeguards than what are provided for information found in private offices and information systems. 4. Health information on the Internet requires fewer safeguards than what are provided for information found in private offices and information systems.

Q: The Health Insurance Portability and Accountability Act (HIPAA) requires organizations to determine threats and appropriate protective measures for information, not only in electronic formats, but in all formats. Which of the following measures cannot be incorporated by organizations to secure all data? 1. Creation of authentication policies 2. Specific software 3. Spyware 4. Firewall

Q: What is the primary purpose of system integration in a health care facility? 1. Provide reliable flow of information between facility and physician offices 2. Offer seamless data exchange among disparate information systems 3. Prevent system data errors via large scale electronic exchanges 4. Customize information systems within a department

Q: The timely flow of information is critical to institutional survival. Which of the following statements about interfaces is accurate? 1. Interfaces use an open systems technology provided by the vendor. 2. Interfaces require installation of a Health Level Seven (HL7) device. 3. Interface connections between different information systems are invisible to the user. 4. Interfaces physically join two or more disparate information systems.

Q: Health Level Seven (HL7) standards are not the only standards that are evolving to fit the changing health care model. What other organizations are instrumental in supporting the development of standards and helping to define data exchange? Standard Text: Select all that apply. 1. Department of Defense 2. Centers for Medicare and Medicare Services 3. National Science Foundation 4. Institute of Medicine 5. American Medical Informatics Association

Q: The master patient index (MPI) is a database that lists all identifiers assigned to one client in all the information systems used within an enterprise. It assigns a global identification number for each client and allows clients to be identified by demographic information provided at the point of care. When the MPI cannot match a client's record based on demographic data, what is provided to the user? 1. The data dictionary resources 2. Non-citizen information so that the user may find a different identifier 3. All possible matches so that the user may view and select 4. The Social Security number

Q: The master patient index (MPI) saves work because vital information can be obtained from the database rather than rekeyed with each client visit. This decreases the possibility of making a mistake and eliminates the inadvertent creation of duplicate records. Which of the following are key features of an effective MPI? Standard Text: Select all that apply. 1. It is flexible enough to allow inclusion of additional identification. 2. It facilitates the evaluation of client care. 3. It locates records in real time for timely retrieval of information. 4. It is easily reconfigured to accommodate network changes. 5. It can grow to fit an organization of any size.

Q: The term interoperability is used when discussing the large scale electronic exchange of health care information across enterprises for the purpose of accessing and maintaining longitudinal health records. The term interoperability is understood to mean which of the following? Standard Text: Select all that apply. 1. Has the ability to exchange the structure of the data, but not the meaning of data 2. Has the ability to exchange the structure of data and meaning of data 3. Has the ability to exchange the meaning of data, but not the structure of data 4. Is the ability of two entities, whether human or machine, to exchange and use data 5. It is accurate to use the term interoperabilityinterchangeably with the term interface

Q: Which of the following measures are recommended for enhancing information security? Standard Text: Select all that apply. 1. File deletion software is used to overwrite hard disk files, using meaningless information. 2. Storage media that has been erased is disposed of in the dumpster. 3. Individuals routinely witness and record the destruction of records. 4. Papers such as prescriptions, laboratory specimen labels, and identification bracelets are disposed of in the dumpster. 5. Each page of output is assigned a serial number and the numbers are recorded when documents are destroyed.

Q: What are the benefits of data integration? Standard Text: Select all that apply. 1. Potential for improved remote access of clinical data from various systems 2. Trend analysis of financial and clinical data 3. Encouraging the use of systems customized to meet department specifications 4. Development of a computer-based patient record 5. Facilitation of data collection for accreditation purposes

Q: Which of the following best represents the purpose of training evaluation? 1. Training should be evaluated after the fifth session. 2. Training evaluation is necessary after the class. 3. Training evaluation alters methodology. 4. All super users have the opportunity to evaluate the training process.

Q: The cost of a new or upgraded system can be burdensome on an organization from a budgetary perspective. Which of the following statements can be considered a return on investment? 1. Employees express satisfaction with their jobs and turnover rate is low. 2. Staff with IT skills is more marketable and have greater job flexibility. 3. The newly trained individual can be granted work release time to train new staff members. 4. After the training, the objectives have not been met.

Q: The best time to train an end-user is which of the following? 1. Before the system goes live 2. Upon notice that there will be an upgrade 3. After the system goes live 4. As soon as the vendor has been selected

Q: Which of these is accurate about the Health Insurance Portability and Accountability Act (HIPAA) Security Rule and the use of technology? 1. Does not specify the use of particular technology 2. Refers to the Joint Commission standards for technology 3. Specifies the utilization of HIPAA approved technology 4. Provides a monthly Web-based list of approved technology

Q: During the course of client care, the 21-year-old client tells the nurse that she had an abortion last year but that no one in her family knows. Which of these terms best describes the situation? 1. Consent 2. Privacy 3. Security 4. Confidentiality

Q: An overlay occurs when one individual is assigned in the master patient index to another individual's health record. A health care facility has discovered that an overlay has occurred resulting in invalid data being stored in key identifying fields. Which of the following information security areas does this breach affect? 1. Survivability 2. Integrity 3. Availability 4. Inadvertent disclosure

Q: Survivability is the capability of a system as a whole to fulfill its mission, in a timely manner, in the presence of attacks, failures, or accidents. United States Hospitals (USH) is a large national hospital corporation with processing centralized at their headquarters. USH is reviewing their information security plan. Part of their mission is to provide emergency services to each regional area during catastrophic events. Which of the following indicate that survivability has been specifically considered in the plan? Standard Text: Select all that apply. 1. One hospital in each regional area has multiple sources of communication with USH central processing. 2. Emergency power generators for all associate hospitals are tested and serviced each week 3. Each night the system at USH central processing is backed up and stored in a remote location. 4. One hospital in each regional area has an emergency protocol in place for communicating directly with the Department of Homeland Security. 5. One hospital in each regional area is especially prepared to maintain information system functionality for the emergency, operating room, lab, and pharmacy units.

Q: Which one of the following passwords provides the most information and system security? 1. StJohns3821 2. p#3J24q7 3. p#5N24p7#hN5 4. p#3J24q7?hN5

Q: E-mail is an efficient means of disseminating information quickly and inexpensively. However, HIPAA regulations affect e-mail use and routing infrastructures. When may potentially sensitive information be sent via e-mail? 1. Client's consent was obtained to send information via e-mail 2. Recipient is known to the sender 3. E-mail is sent encrypted. 4. Organization's e-mail system has appropriate firewalls

Q: A nurse practitioner (NP) approaches a computer terminal at the local health care facility. In order to gain access to client information, the NP must first slide a smartcard through a card reader and then place a finger on a scanner. Which authentication measures were used to verify the NP's authorization to access client data? Standard Text: Select all that apply. 1. Appearance of the user's name on a screen 2. Biometric authentication 3. Picture authentication package 4. Proximity radio authentication 5. Encrypted pass key authentication

Q: Software that tracks system access by users, creates a(n) ____ that can reveal unusual activity or inappropriate use of information. Standard Text:

Q: Which of the following methods can be incorporated when planning training programs that may alleviate anxiety among the staff? Standard Text: Select all that apply. 1. Hands-on demonstration 2. Bulletin board messages 3. Use of tent cards 4. Review of newsletter articles 5. Administrative role modeling

Q: Why do most breaches of confidentiality occur? 1. Malicious behavior 2. System hacking 3. Intent 4. Carelessness

Q: How can the trainer create an environment in which the staff will retain the information? 1. Train when employees do not have clinical duties 2. Train immediately before a clinical shift 3. Plan training to begin after clinical shifts 4. Plan training for employees' days off

Q: A certified nursing assistant (CNA) at a local nursing home logs on to the facility's clinical information system. The CNA can only see information about the clients that were assigned by the registered nurse for that day. The CNA cannot see financial data regarding any of the assigned clients. This situation is an example of which of the following? 1. Password protection 2. Computer forensics 3. Access levels 4. User authentication

Q: _______________ are generated by an information system to warn of missing information or data entry errors. Standard Text:

Q: A(n) ____________________ is one of the greatest threats that may come from inside sources, namely employees, contractors, consultants, outsourced services, and vendors who view information inappropriately, disrupt information availability, or corrupt data integrity. Standard Text:

Q: ___________________ refers to a situation where the end-user is logged in to the information system but is unable to enter or process data. Standard Text:

Q: Passwords are a common means to authenticate access to automated records. Which of the following are recommendations for password selection and use? Standard Text: Select all that apply. 1. Using software to test and eliminate easily compromised passwords 2. Using the browser "password save" feature 3. Deleting and replacing all system user passwords when an employee is terminated 4. Storing passwords in a file on the computer 5. Using the same password for access to all sites or systems

Q: The _________________ of an information systems training evaluation strategy is to collect subjective participant feedback about the learning experience, identify pre- and post-training skill gaps, and measure knowledge and performance of the stated learning objectives. Standard Text:

Q: A trainer uses the following learning plan: An e-mail push is used for the announcement, a Webinar (Web-based seminar) is used for an overview session, simulations are used for self-paced learning, instant messaging is used for query resolution, a Web meeting is used for demonstration, simulation is used for practice, e-mail is used for feedback, another Webinar is used for a closing session, and a Web-based test is used for evaluation. Identify which training strategy was used for the learning plan. 1. Mixed learning 2. Blended learning 3. Comprehensive learning 4. Flexible learning

Q: Which of the following are specific factors to consider when selecting a training method? Standard Text: Select all that apply. 1. Time required to develop program 2. Cost of development and training 3. Application training strategies 4. Learning styles of trainees 5. Learning retention strategies

Q: Which of the following topics should be included in training class content? Standard Text: Select all that apply. 1. Computer-related policies 2. Access privileges 3. Computer literacy 4. Error correction 5. System idiosyncrasies

Q: Which of the following is not a factor to consider when selecting a trainer? 1. Teaching skills 2. Ability to interact 3. Experience with process outcomes 4. Educational approach

Q: Which of the following factors should be considered when selecting a training site? Standard Text: Select all that apply. 1. Classroom cost 2. Network connectivity 3. Classroom capacity 4. Training environment 5. Cabling and wiring

Q: Which of the following describes the philosophical differences between the trainer's and educator's role? 1. Trainers are concerned with outcomes only whereas educators are concerned strictly with the educational process. 2. Trainers focus on behavior change through skill acquisition while concentrate on learning, thinking, and problem solving as a way to change behavior. 3. Any employee can be a trainer whereas an individual must have an advanced degree to be an educator. 4. Trainers rely on skill acquisition through learning, thinking, and problem solving as a way to change behavior, while educators rely on behavioral psychology which focuses on behavior change.

Q: End-user training classes should be created for which of the following? 1. Physicians, residents, nurse practitioners, and physician assistants 2. Physicians and nurse practitioners only 3. Point-of-care staff only 4. Physicians and staff nurses only

Q: Which of the following defines project scope? 1. Project scope encompasses the entire life cycle. 2. Project scope describes the details of the system functionality that is slated for automation. 3. Project scope is part of the system implementation process. 4. Project scope is defined by the super users.

Q: Which form of training would best fit the needs of a night shift worker (11 p.m. to 7 a.m.)? 1. An online tutorial that can be accessed when it fits worker's time off 2. A Listserv set up for e-mail comments and questions 3. A three-hour video that can be run during the worker's shift 4. A full-day workshop that starts shortly after the end of the shift

Q: Which of the following statements is true about blended learning? 1. The use of blended learning should be appropriate for the content. 2. The use of blended learning is not appropriate for super user training. 3. Blended learning is too complicated for training sessions. 4. Blended learning should only be used for point-of-care staff.