ANCC Nursing Informatics Certification Review Questions
During the analysis phase of the systems development lifecycle, which of the following occurs?
workflows and business practices are examined
In a formal plan for implementation and testing it is not necessary to include:
Crisis coaches. Formal Plan must include: - Staff - Team members - Vendors - Executive staff - External resources
Parallel installation defined:
occurs when old and new system are implemented simultaneously, and the 2 systems run simultaneously (i.e. paper and electronic, "old" system and "new" system).
An advantage of an identity and access management (IAM) system is that the IAM system:
provides HIPAA-required encryption for PHI
The waterfall SDLC model is:
sequential
Which of the following is NOT part of documentation testing?
subscriber color preferences.
Data can be represented by all EXCEPT:
text
When utilizing a prioritization matrix to prioritize activities as a project manager, the informatics nurse must first establish:
the informatics nurse must first establish criteria and a rating scale. The criteria includes those factors that are utilized to determine how important each project is; for example, a project mandated by regulations is more important than a project that may improve customer satisfaction. A rating scale for each project should be established with numeric values (such as 1 to 10) used to demonstrate how effective the project is in meeting the criteria. A typical prioritization matrix may have up to a dozen criteria.
Wisdom is :
the recognition of patterns in data
The next step in complexity above information is:
. knowledge
Nursing terminology is:
A body of the terms used in nursing
A domain is:
A copy of the software system, or environment, in a particular state. Rationale: A domain is a copy of the software system, or environment, in a particular state. For example, test system (or domain); development system (or domain), training system and production system.
The field of science that attempts to create intelligent technologies and then apply these technologies to the field of informatics is:
AI - Artificial Intelligence. Researchers in artificial intelligence must engineer general intelligence and reasoning skills into the artificial intelligence programs as well as the ability to develop and learn from experiences and errors and to process natural language. One example of an artificial intelligence program is Siri®, which responds to verbal queries and is found on Apple devices, such as the iPhone and iPad.
"Bugs" in computer language are not really insects, but
Abberancies
What kind of information might be included in a clinical practice guideline?
All of the above: Rationale: a CPG is typically written as a narrative text providing background material and evidence. The strength of that evidence is ranked.
The human-technology interface (HTI):
Allows user interaction with technology.
Data mining in knowledge data discovery (KDD) allows providers to:
Apply algorithms for extracting patterns that are not typically apparent to human decision makers
All of the following are ways to determine the best type of system implementation for your organization EXCEPT:
Avoid combining strategies
What type of information should be included in the clinical practice guideline?
Background material and evidence ranking of strength of evidence
The organization has agreed to be the first major test site in which software will be installed. This site is known as a/an:
Beta site testing is the final stage of testing (usually before commercial release). Primary and secondary sites are not the appropriate terms and alpha site is an initial phase of testing often used in development of software.
Benchmarking is:
Both B & C. Benchmarking is defined as a way of finding best practices and then comparing ones organization against another.
Work flow:
Changes in many ways including culture, productivity, and clinical practice during an implementation
Decision making involves:
Cognitive processing that results in selecting a choice
The nurse informaticist (NI) is working on the implementation of a replacement laboratory system. One major consideration in order to have a fully operational system is:
Data Conversion - All responses are important, but in order to move from one system to another the data needs to be moved.
What are the techniques that apply algorithms for extracting patterns from data stored in data warehouses that are typically not apparent to human decision makers are known as:
Data mining or knowledge discovery in databases
What is the difference between a data warehouse and a data mart?
Data warehouses are large collections of data from several different sources and data marts are smaller collections that could be from a single department.
Which of the following use a knowledge base and set of rules to analyze data and provide recommendations?
Decision Support Systems (DSS)
The Informatics Nurse is concerned with user support. Procedure manuals will be developed that will:
Describe how to perform business tasks while using the system
While caring for a 40-year old patient with terminal cancer, the key area of the clinical practice guideline is to:
Encourage best practice, eliminate errors and reduce unjustified practice variations
There is no examples of wisdom in nursing practice, as it is merely a theoretical concept. True False
FALSE.
HIPPA only applies to organizations that have electronic health records. True False
False
Which is NOT a type of maintenance?
Flexible
Which of the following is not a mechanism for protecting the security of health data:
Having one password per nursing unit.
_____________ is a teaching strategy for educating staff that involves face-to-face and online learning.
Hybrid learning
Which of the following lists the steps of the planning structure in the correct order, starting with the first step?
Identify a planning need, determine preliminary resource list, establish goals and timeline. ???
Financial evaluation should:
Include both tangible and intangible costs
One set of vital signs is an example of:
Information
What is knowledge?
Information that is synthesized so that relationships are identified and formalized
A clinical information system contains the following process:
Input, processing, outputs
The Informatics Nurse Specialist is developing a test scenario to determine if the admissions, discharge, and transfer application will work with the clinical documentation and laboratory results reporting modules of a larger electronic health record. This is known as:
Integration testing is testing between systems. Unit testing only tests one discrete function and acceptance testing occurs when users test entire system to determine if the system meets the specified requirements of the design.
Quality Monitoring:
Is part of system performance maintenance strategies.
The Informatics nurse is involved with measure to protect the security and confidentiality of patient data because:
It is regulated by HIPPA Legislation and The Major cause of security breeches is human error.
The key to interpreting data is:
It must be organized so that patterns and relationships are apparent
What is the foundation of wisdom?
Knowledge
The network that connects the departments in an organization is likely a(n):
LAN
Adult learners who repeatedly cancel attending classes on the new computer system could be classified as which type of adopter?
Late Adopters
When an institution is transitioning to a CPOE, a primary role of the informatics nurse is that of:
Liason - When an institution is transitioning to a CPOE, a primary role of the informatics nurse is that of liaison to promote multidisciplinary collaboration and cooperation among the various members of the healthcare team, including nurses, physicians, and IT specialists, to ensure that the end-product has the functionality that is needed for workflow and that it meets the requirements for safety and security. Needs regarding both hardware and software must be clearly communicated to IT personnel.
If the informatics nurse is concerned that a computer system may not function well during peak times of access the type of testing needed is:
Load Volume Testing
Things to consider related to disaster planning include:
Must have a solid communication plan during disaster and recover.
What is the foundational process that a nurse uses in care of patients?
Nursing Science
Nursing informatics is a specialty that integrates which of the following into nursing practice?
Nursing science with multiple information management and analytical sciences
Which of the following standardized nursing terminologies is comprised of (1) a problem classification scheme, (2) an intervention scheme, and (3) a problem rating scale for outcomes?
OMAHA is standardized nursing terminology that is comprised of (1) a problem classification scheme, (2) an intervention scheme, and (3) a problem rating scale for outcome. OMAHA was developed by the Visiting Nurse Association in Omaha, Nebraska, in the 1970s and was later developed further through research projects funded by the US Department of Health and Human Services. OMAHA is in the public domain but must be used as published (as opposed to modified).
Information science is concerned with:
Obtaining, gathering, organizing, manipulating, managing, storing, retrieving, recapturing, disposing of, distributing or broadcasting information
Which of the following is NOT a major phase in implementation and testing?
Operations and language barriers Rationale: Operations and Language Barriers are not a major phase in implementation and testing.
Metastructures are:
Overarching concepts used in theory and science
Which is NOT true about backup and recovery:
Perform backups on Wednesdays during peak use
Which of the following may be a legal issue involved in telehealth?
Practitioner licenses may not allow for care when the patient is in another state
The transformation and analysis of information must go through validation before being used. What is information validation?
Process to ensure information in data warehouse is correct, reliable and consistent
PHI stands for :
Protected Health Information
The HITECH act and HIPAA Privacy and Security rules are intended to:
Provide patients with greater access and control over their PHI ???
Which resource for evidence-based research is provided by the National Library of Medicine?
PubMed is a resource for evidence-based research that is provided by the National Library of Medicine, which was developed by the National Center for Biotechnology Information (NCBI). PubMed provides access to numerous databases with 24 million citations from MEDLINE (the National Library of Medicine's bibliographic database with references to life sciences and biomedical sciences), life science journals, and electronic books with links to full text when it is available.
Which of the following is a feature of system enhancement?
Requested by staff or informatics
One of the steps in creating a clinical practice guideline is to:
Review evidence-based studies
Evaluation and support:
Should be outlined in the original project plan as an ongoing process.
ICD-10, The Omaha System, and Clinical Care Classification (CCC) are all examples of which of the following?
Standardized terminologies
Information in a data warehouse can be used to:
Support decision support systems and executive information systems
Some examples of physical security for healthcare data are fences, walls, locks, safes, vaults, armed guards, sensors, alarms. True False
TRUE
Benchmarking is:
Taking information and comparing it to another's data to identify strengths and weaknesses
In an organization, the CTO is responsible for:
Technologic research and development within the organization.
What are three clinical decision systems areas in which decision assistance can be found?
Test solutions, monitoring actions, change in condition
Integration testing involves:
Testing the flow of data across all interfaces
The major difference between Decision support systems (DSS) and expert systems (ES) is:
That a DSS leaves the ultimate decision to the decision maker and the ES selects the best solution.
Usability refers to:
The efficiency and effectiveness of an application
During the feasibility stage of the SDLC, which of the following occurs?
The project plan and estimated budgets are determined
When the SDLC is done correctly:
There is a formal change management process throughout to address new information as it comes to light. Change management is vital to the installation of a system. There may be several phases, particularly during a phased approach and end-users do not have final say on all aspects of the project and not all steps are done in order for all areas.
How is wisdom defined by Nursing Informatics: Scope and Standards of Practice?
Understanding data and knowledge and applying the knowledge with compassion
Which is NOT considered a factor that makes nursing informatics a professional discipline in nursing?
Varied definitions about scope of practice
Which of the following is NOT one of the approaches to the system development life cycle?
Waterfall
What is one metastructure to help organize information management and knowledge generation specific to nursing informatics?
Wisdom conceptual framework, knowledge, information and data
Workflow is:
a process from start to end
During the evaluation phase which of the following tools are used for construction and consistency?
all of the above
What are the pieces that require ongoing evaluation?
all of the above. Ongoing evaluation is needed on all aspects of the system - hardware, software, interfaces and integrations (which are software), and support. Support can include training as well as help desk operations.
What is data?
alphanumeric characters
One way to track the activity that is occurring in a system is:
an audit trail
An audit trail is :
an electronic tool that can track system access by individual user who viewed a specific client record.
Controls to protect data privacy and integrity are both logical and:
analytical
The smallest possible piece of data utilized in computer processing is the:
bit (binary digit), which comprises zeros (off) and ones (on). Four bits equal one nibble, eight bits equal one byte, 1024 bytes equal one kilobyte, 1024 kilobytes equal one megabyte, and 1024 megabytes equal one gigabyte.
CDSS stands for:
clinical decision support systems
When considering transitioning to cloud storage and assessing vendors, the most critical assessment relates to:
compliance with regulatory requirements because if the vendor cannot verify that the company meets HIPAA requirements and satisfies the Code of Federal Regulations Title 21, Part 11 (which provides regulations regarding electronic records and electronic signatures), then security of patient data may be inadequate. Other important considerations include cost analysis (including cost of implementation and ongoing costs), monitoring mechanisms, and interoperability.
What is information?
data that are interpreted, organized and structured.
Communication software is most commonly used for:
e-mail and IM.
When utilizing a prioritization matrix to prioritize activities as a project manager, the informatics nurse must first establish:
first establish criteria and a rating scale. The criteria includes those factors that are utilized to determine how important each project is; for example, a project mandated by regulations is more important than a project that may improve customer satisfaction. A rating scale for each project should be established with numeric values (such as 1 to 10) used to demonstrate how effective the project is in meeting the criteria. A typical prioritization matrix may have up to a dozen criteria.
In an EHR with CPOE and CDS, allergy alerts should be triggered:
in response to contraindicated drug order.
System and Functional Testing:
includes multiple subsystems and phases of testing. Rationale: Systems are usually made up of subsystems and all must be tested. System and Functional Testing must include security testing and must be structured and controlled. Cultural impacts of new processes is not an aspect of testing.
What is the foundation of knowledge?
information
These come together in decision support systems:
information and knowledge
What is Load Volume Testing?
is a non-functional testing for reliability that assesses the ability of the system to function under various loads, such as at peak times when multiple users in multiple departments are accessing the system. The purpose of load/volume testing is to determine the maximum load capacity and to identify the load at which problems begin to occur. Testing is done at both the safe working load (SWL) and above the SWL.
In preparation for the workflow redesign necessitated for implementation of an EHR, the first step should be to
map the current workflow
An advantage of an identity and access management (IAM) system is that the IAM system:
meets HIPAA's Security Rule requirements regarding access to PHI through identity management. An IAM system provides, captures, updates, and records user IDs and provides appropriate access privileges, preventing "privilege creep," which increases risks to security. The IAM system should provide authentication (single sign-in and session management), authorization (based on roles, rules, and attributes), user management (provisioning and password management), and a central directory.
The implementation team has determined that the conversion to the new system will occur department by department, with two weeks in between each installation. This is known as:
- Phased installation is when the implementation is done in stages, where one phase leads to another.
