Q&A Hero

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: Unlike other health records the _____________________is patient-centered, presenting a more-balanced view of an individual's health history. Standard Text:

Q: The computer-based patient record (CPR) is a comprehensive lifetime record that includes all information from all specialties. The Institute of Medicine (IOM) identified major components of the CPR that are considered to be the "gold standard" attributes. Which of the following are CPR components? Standard Text: Select all that apply. 1. Lack of confidentiality 2. Direct entry for physicians will be available 3. Tools cannot measure cost 4. Provides sporadic access to data 5. Provides a patient problem list

Q: An emerging technology related to electronic health record (EHR) progress is the use of the personal health record (PHR). PHRs store client information that will eventually contribute to the development of a comprehensive, longitudinal record. Which of the following are found in a PHR but not found in the EHR? Standard Text: Select all that apply. 1. Periodic risk assessment survey results 2. Herbal supplements 3. Legal documentation created in a hospital 4. Decision support 5. Health status parameters such as exercise

Q: Which of the following are found with the electronic health record (EHR) but are not found with the computer-based patient record (CPR)? Standard Text: Select all that apply. 1. Evidence-based decision support 2. Assists with the work of planning and delivering evidence-based care 3. Quality management 4. Public health disease surveillance and reporting 5. Comprehensive lifetime record that includes all information from all specialties

Q: Personal health record (PHR) security issues relate to HIPAA and physical security of data. HIPAA only covers PHRs provided by covered entities such as health plans, health care clearinghouses, and providers. No governmental coverage exists for other sites unless it is at the state level. To avoid these types of breaches, the American Health Information Community's consumer empowerment working group made a recommendation. Which of the following was recommended for PHRs in order to avoid breaches? 1. Deletion of sensitive data 2. Educating the general consumer about PHRs 3. Restricting the number of authorized users 4. A PHR certification process

Q: The EHR offers benefits to nurses, physicians, and other health care providers, the health care enterprise, and most importantly, the consumer. Much must be done before the benefits associated with the EHR can be realized. Which of the following is one action that has been proposed by experts? 1. Health care professionals should institute major changes in the way they work. 2. Consumers need education to choose providers based upon appropriate financial and insurance considerations. 3. Individual consumers should have lesser responsibility for data. 4. Government intervention should promote information exchange among software vendors and health care systems.

Q: The electronic health record (EHR) has the potential to integrate all pertinent patient information into one record. It also has potential to improve the quality of health information, patient safety, and productivity, contain costs, support research, decrease wait time for treatment and contribute to the body of health care knowledge. Which of the following are reasons why traditional paper records on clients no longer meet the needs of today's health care industry? Standard Text: Select all that apply. 1. Paper records are episode-oriented with a separate record for each client visit. 2. Key information may be lost from one episode to the next, jeopardizing patient safety. 3. Only one person can access a paper record at any given time. 4. Different versions of the same information may be stored in several places. 5. Paper records cannot incorporate diagnostic studies that include images and sound.

Q: Electronic medical record (EMR) result reporting and data repository components include unstructured data. Which of the following are examples of unstructured data? Standard Text: Select all that apply. 1. Automated laboratory results 2. History and physical 3. Consultation findings 4. Magnetic resonance imaging 5. A social services text report

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: 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: 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 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: 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: 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: 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.

Q: Which statement regarding the training approach is true? 1. Users may choose online multimedia or online tutorials to enhance retention. 2. Computer-based training should be used whenever data entry is required. 3. Blended learning is popular because it is appropriate for almost any content need. 4. Instructor-led training is still the best approach even though it is now less prevalent.

Q: Which of the following describes the use of an advanced organizer? 1. The use of an advanced organizer is a way to guide the instruction, manage time, and allow for logical breaks in the classroom instruction. 2. The use of an advanced organizer is a methodological approach to patient care. 3. The use of an advanced organizer is a tethered health information systems. 4. The use of an advanced organizer is an excellent way to prepare novice nurses for their role at the point of care.

Q: The most essential knowledge for a staff nurse end-user are which of the following? Standard Text: Select all that apply. 1. Basic equipment troubleshooting procedures 2. Backing up the computer system at the end of each shift 3. Error message content recognition 4. Protocol for dealing with system "freezes" and "crashes" 5. Data entry error log review

Q: ____________________ are employees who are proficient in the use of the information system and can serve as mentors to other end-users in their department. Standard Text:

Q: Among the following computer-related policies, which of the following are appropriate? Standard Text: Select all that apply. 1. A nursing student shared confidential lab results obtained from the system at the request of one of the student's relatives. The policy is to dismiss the student from the clinical site. 2. Both students and employees sign documents that explain the consequence of termination for misuse of the system. 3. Access codes are assigned to authenticate each individual user's identity and may not be shared with anyone. 4. A radiology student makes a copy of a client's MRI report to prepare for the next days clinical. The copy is accidentally left in the waiting room and found by a staff member. The policy is to dismiss the student from the clinical site. 5. Once trained and entered into the system, employees may sign other users in under their access code for documentation purposes when necessary.

Q: Among the following, which defines the process for determining health care worker information systems training needs? Standard Text: Select all that apply. 1. User classes are used to refine the types of training courses needed for system implementation. 2. End-users are identified and grouped by job class responsibilities. 3. Training needs of each job class are determined according to what functions each end-user will perform. 4. Training is delivered based upon what administrators decide to automate first. 5. User class is defined and categorized as the personnel who perform similar functions.

Q: Which of the following are considered steps for identifying training needs? Standard Text: Select all that apply. 1. Identify user needs 2. Determine content 3. Establishing learning objectives 4. Deciding teaching approach 5. Create evaluation strategy

Q: Among the following, which indicate that an organization has identified and is managing human factors in the work environment? Standard Text: Select all that apply. 1. Classroom question and answer periods are regularly kept to a strict limit of five minutes. 2. Tent cards with name and unit of trainees are placed in the classroom at each meeting. 3. Administrators meet with unit supervisors and not staff for fear of intimidating them during the critical implementation phase. 4. A series of noon meetings (lunch provided) called "LunchBytes" are offered for demonstrations and discussion sessions. 5. An article announcing the implementation of the new system and recognizing the staff appears in the local paper.