Practice Assessment: Nurse's Touch: Nursing Informatics and Technology Practice Assessment

A nurse is caring for a client who asks about measures the nurse takes to protect client privacy. Which of the following is an appropriate response by the nurse?

"I log off the computer between seeing clients." HIPAA establishes national standards for the protection of certain health information. The privacy rule addresses the use and sharing of individual's health information. This can be violated if a client's health information is on the computer screen and the nurse leaves this up while attending to other clients.

A nurse is teaching a client who has an ostomy about the proper use of Internet resources. Which of the following statements by the client indicates a need for further teaching?

"I will use social media for information about ostomy care." The nurse has a responsibility to be sure the patient can identify reliable and valid sources of information. Social media sites may be appropriate for support, but they may not provide credible information about ostomy care.

A nurse is caring for a client who has a new diagnosis of type two diabetes mellitus. The client tells the nurse that he is interested in doing research about diabetes online but that he has never used a computer. Which of the following responses by the nurse is appropriate?

"Let's take some time to look at Web sites about diabetes together." This response addresses the client's desire to learn how to use a computer and ensures the client receives credible information about diabetes.

A newly licensed nurse is concerned about the safety of a dosage for a prescribed medication. Which of the following resources is appropriate to promote evidence-based practice?

Pharmacological electronic resources Pharmacological electronic resources allow the nurse to access best evidence-based practice information, medication dosages, and safe medication administration guidelines.

A charge nurse is developing an in-service program on basic nursing informatics. Which of the following should the nurse include in the program?

Querying the electronic health record Accessing data from an electronic health record is used in nursing informatics and allows nurses to provide improved client care.

A nurse is caring for a client who has a pacemaker and requires telehealth monitoring. Which of the following is a benefit of this form of telehealth?

Downloads client rhythm data in real time Wireless technology allows cardiac data to be downloaded in real time from the client's pacemaker. This is a benefit of telehealth monitoring.

A nurse is observing a newly licensed nurse who is caring for a client. The client states, "How do I know that my information won't show up on the Internet?" Which of the following responses by the newly licensed nurse is appropriate?

"The hospital uses firewalls to protect records." Firewalls are a component of network security systems.

A nurse takes a photo of a client. After the client gives verbal approval, the nurse posts the photo to a social network site. Which of the following violations has occurred?

Breach of confidentiality The photo on the social network site could be used to identify the client. This is a HIPAA violation because the consent must be in writing.

A nurse is accessing clinical information systems while caring for a client. Which of the following is a benefit of using this technology?

Allows for an interdisciplinary approach when planning care for a client Clinical information systems allow for an interdisciplinary approach when planning care for a client by increasing the health care team's access to information.

A nurse is entering data in a client's electronic health record (EHR). Which of the following protects the integrity of the data in the EHR?

Authentication Login names and unique passwords ensure that only authorized individuals have access to read and make entries into the EHR.

A nurse is reinforcing teaching to a client about the use of the Internet to obtain credible information about a skin disorder. Which of the following is an appropriate statement by the nurse?

"You should check the hospital Web site for a list of relevant resources." In this situation, the nurse can refer the client to a list of resources that have been identified as credible and reliable by the hospital.

A nurse is asked whether she is proficient in the use of nursing informatics. Which of the following indicates competency?

Accessing Holter monitor data Accessing a client's Holter monitor data is an example of nursing informatics that includes using, managing, and communicating client electronic data in nursing practice.

A nurse educator is preparing an in-service program for nurses on the use of social media. Which of the following is an appropriate example of the use of social media?

Acknowledging a client's decision to post about her health care experience online A client has the right to disclose personal information on a social media site

Based on the nursing process approach to client care, assessment of medication compliance is the first action the nurse should take. A nurse is caring for a client who has a new diagnosis of asthma and is to be discharged. Which of the following should the nurse use to help ensure the client's medication compliance?

Ask the client to complete an online medication schedule. A weekly medication schedule allows the nurse to monitor the client's medication compliance, which is essential to preventative care and illness management.

A nurse on an acute-care unit enters the admission data on a client who has a history of developing a deep vein thrombosis (DVT). When coordinating the plan of care in the electronic health record (EHR), which of the following should the nurse expect?`

Automatic guidelines and alerts related to DVTs Guidelines and alerts supported by evidence-based practice should be expected by the nurse. This is a part of the clinical decision support system available through EHRs.

A nurse manager uses informatics technologies on her unit. Which of the following should the nurse use to reduce the incidence of medication errors?

Bar code scanning system Bar code scanning systems are used in medication administration and reduce medication errors.

A nurse manager wants to decrease the number of nosocomial urinary tract infections on her unit. Which of the following research databases should the nurse manager consult to obtain information on evidence-based practices?

CINAHL cumulative index CINAHL is an online evidence-based resource and information system that offers a multitude of online services, which include Web site link sources, CINAHL's online nursing and allied health database, document delivery, and search services. This is the appropriate database to find updated research for the nurse to use.

A nurse on a pediatric unit is caring for a client. The client's mother asks the nurse, "Can you turn off the alarm that seems to go off all the time?" Which of the following actions by the nurse is appropriate?

Check the alarm function. Checking the alarm function would include comparing alarm parameters to desired parameters to ensure they are appropriate.

A nurse is instructing a newly licensed nurse about obtaining client assignments. The newly licensed nurse states, "I will make copies of my client's electronic health records so I can complete the care plan at home." Which of the following responses by the nurse is appropriate?

Client information should remain in the hospital." Documents containing client information should remain in the facility due to the risk of a breach to client confidentiality.

A nurse is preparing to interview a client during a telehealth interaction. Which of the following is a client identifier?

Client's home phone number A client's home phone number is an acceptable identifier if it matches the electronic health record.

A nurse manager on a cardiac unit is using a clinical information system to measure the outcomes of clients who were treated using the facility's acute cardiac event protocol. Which of the following is integrated into the clinical information system to support clinical data access?

Coded entry system Use of standardized nursing terminologies, such as a coded entry system, in computerized reports enhances the ability to use the data for reporting and future research, such as measuring client outcomes.

A nurse is caring for a client who is involved in a clinical trial being conducted by researchers at the facility. Which of the following resources facilitates time management for the research team?

Databases that compile data sets from participants Databases that provide data sets facilitate time management for the research team.

A nurse manager is implementing an electronic health record program. Which of the following indicates that data security is effectively managed by the program?

Guidelines are available about printing client information.Policies on printing and duplicating client information are implemented for effectively managing data security.

A nurse is caring for a client who is scheduled to be discharged and sent home with a telehealth monitor. Which of the following actions should the nurse take first?

Have the client state what he knows about telehealth.Identifying client teaching needs is part of assessment, which is the first step the nurse should take according to the nursing process approach to client care.

A risk management nurse uses informatics research data to design an application to reduce the incidence of postoperative complications. Which of the following stages of nursing informatics competency describes the nurse?

Informatics innovatorThe highest level of competency is the informatics innovator. This level includes the design and development of new applications to improve client outcomes.

A nurse supervisor wants to review data on nurse-sensitive outcomes from other facilities related to falls. Which of the following is an appropriate resource to obtain this information?

National Database of Nursing Quality Indicators (NDNQI) NDNQI provides data from multiple facilities for profiling and comparison. This allows data to be analyzed and isolates issues that require attention.

A telehealth nurse is caring for a client who has a new prescription for an antihypertensive medication. The telehealth monitoring system reports the client's current blood pressure is 160/62. Which of the following actions should the nurse take first?

Obtain information about medication compliance.Based on the nursing process approach to client care, assessment of medication compliance is the first action the nurse should take. Obtain information about medication compliance

A nurse is accessing a client information system to implement a standardized plan of care for a client. Which of the following is a goal of this technology?

Optimizing client outcomes Using standardized care plans provides guidelines for treatments and interventions to optimize client outcomes.

A nurse manager is reviewing hospital policies related to information security with a newly licensed nurse. Which of the following actions by the newly licensed nurse requires intervention?

Paging a client by last name to return to therapy This would publicize a client identifier and violate confidentiality.

A nurse is discussing computerized provider order entry (CPOE) with a newly licensed nurse. Which of the following should the nurse identify as a benefit of this technology?

Provides a medication allergy alert CPOE provides medication allergy alerts to the provider and the nurse. This is a benefit of this technology.

A nurse is creating a social network as a support system for a group of clients. Which of the following practices would be appropriate in launching this site?

Providing clients with links to reference information Providing accurate and timely reference information would be an appropriate use of a social network.

A nurse is caring for a client who reports shortness of breath. Which of the following devices should the nurse use to obtain electronic data regarding the client's clinical manifestations?

Pulse oximeter A pulse oximeter permits the indirect measurement of oxygen saturation using a light-emitting diode. This information can be transmitted to the client's health care record.

A nurse in a primary care clinic completes a quality assurance project using the electronic health records of clients who have type one diabetes mellitus. Project findings reveal that clients had higher than expected capillary blood glucose levels following teaching by the clinic nurses. Which of the following conclusions should the nurse draw from these findings?

The development of clinical practice guidelines should be considered. The development of clinical guidelines incorporates best practices, promotes uniformity and consistency in education programs, and improves client outcomes.

A newly hired nurse is reviewing an institution's networking policy. Which of the following statements by the nurse indicates a need for further teaching?

These policies determine acceptable social networks for employee use." An institutional networking policy includes confidentiality, availability, and integrity, but it does not specifically address acceptable social networks for employee use.

A nurse is conducting a home health visit with a client who has a Holter monitor due to recent syncopal episodes. The client asks, "Why will telemonitoring be used?" Which of the following responses by the nurse is appropriate?

This data will assist your provider in making a diagnosis." Telemonitoring collects data that can assist the provider in making a medical diagnosis for a client experiencing syncopal episodes

A nurse is providing care for a client on a medical-surgical unit. Which of the following interventions involves the use of informatics?

Using a glucometer to obtain blood glucose level A glucometer is an electronic device that transmits and calculates client blood glucose level to a database. This involves the use of nursing informatics.

A charge nurse is reviewing confidentiality with a newly licensed nurse. Which of the following actions by the newly licensed nurse requires intervention?

Using the computer to search for information about a client from another unit The nurse should access information only about clients she is caring for.

A nurse receives a phone call from an individual requesting information about a client's status on the day of surgery. Which of the following actions should the nurse take?

Verify whether client information can be communicated over the phone. The nurse should determine the identity of the caller and the caller's right to the information as established by the client.

A nurse is reinforcing teaching with a client about the use of reputable Web sites to research osteoporosis. Which of the following guidelines should the nurse include in the teaching?

e Web site should include the author's contact information. A credible Web site includes the author's contact information to provide the opportunity for the client to seek verification of information.

A nurse is documenting a client's assessment in the electronic health record. A prompt to provide a specific nursing intervention displays on the screen. This is an example of which of the following

evidence-based practice Evidence-based practice is embedded in the clinical information system. Prompts may display on the screen as a reminder.

A community health nurse receives a report of an outbreak of a communicable disease using a computerized data collection method. How does accurate reporting of the disease improve the quality of client care?

information is analyzed to determine community treatment strategies. Early detection and reporting of a communicable disease promotes rapid response, case finding, and the development of appropriate treatment strategies.

A nurse is preparing an in-service on the use of informatics to improve client outcomes. Which of the following should the nurse include? (Select all that apply.)

Apply the use of standardized terminology is correct. The nurse should understand that new information management tools include the use of standardized terminology such as NANDA to document nursing-sensitive outcomes. Become an opponent in the technology implementation process is incorrect. The nurse should become an advocate, not an opponent, for new information management tools in order to create an environment for effective nursing practice. Apply principles of lifelong learning is correct. The nurse should apply principles of lifelong learning in order to understand information management tools, which creates an environment for effective nursing practice. Incorporate the use of Technology Informatics Guiding Education Reform (TIGER) is correct. The use of TIGER establishes a common goal for the incorporation of informatics in the use of nursing education and practice. Incorporate the use of Quality and Safety Education for Nurses (QSEN) is correct. QSEN incorporates key competencies into nursing informatics.

A nurse manager is giving an in-service presentation to a group of nurses about uniform taxonomies in nursing practice. The nurse should explain that which of the following taxonomies helps quantify nursing care based on costs specific to nursing?

Nursing Management Minimum Data Set (NMMDS) The NMMDS is a standardized nursing terminology that focuses on numerical data, such as cost analysis figures, and provides a framework of uniform entry and management of data.

A nurse is teaching a client about the identification of reliable Internet resources. Which of the following online resources should the nurse identify as the most reliable?

Web sites ending in ".gov" Web sites ending in ".gov" are governmental Web sites that include professional contact information and are the most reliable resource.

A nurse manager is implementing criteria that promote a culture of safety as defined by the Agency of Healthcare Research and Quality (AHRQ). Which of the following criteria are included in the AHRQ guidelines? (Select all that apply.)

*Encourage collaboration among disciplines to seek solutions to client safety problems is correct. Collaboration demonstrates the manager's commitment to client safety and is a guideline of the AHRQ. *Use state-of-the-art technology to determine high-risk activities within an organization is correct. Identification of high-risk activities is required to determine appropriate interventions to promote safety and is a guideline of the AHRQ. *Sustain a blame-free environment where staff is able to report errors without fear of reprimand is correct. A blame-free environment transfers the focus from blame to client safety and is a guideline of the AHRQ. *Integrate silent alarm systems to reduce noise pollution in the hospital environment is INCORRECT. Although noise pollution is a concern on a nursing unit, it does not take priority over client safety. *Encourage organizations to engage in root-cause analysis is correct. This analysis places focus on client safety and is a guideline of the AHRQ.

A nurse is teaching a newly licensed nurse about electronic health records (EHRs). Which of the following should the nurse include in the teaching?

An EHR helps to develop a plan of care.An EHR provides the information needed to develop a client's plan of care from admission to discharge. A charge nurse is orienting a newly licensed nurse to the unit and demonstrates how to access data from the hospital information system. Which of the following actions by the newly licensed nurse requires intervention by the charge nurse?` Reviewing the health record of a client on another unit with similar symptoms Accessing the health record of a client who is not under the nurse's direct care is a violation of the client privacy regulations under HIPAA.

A nurse is teaching a newly licensed nurse about the benefits of telehealth services. Which of the following is an example of a benefit of telehealth?

First responders transmit client data to the receiving facility The transmission of client data is a benefit of telehealth.

A charge nurse is teaching a seminar to other nurses about informatics and client care. Which of the following topics is appropriate for the charge nurse to include?

Reviewing trends of vital signs since admission Trending of vital signs allows nurses to identify emerging or developing client conditions and is a useful informatics tool to improve client care.

A nurse is caring for a patient who has a new diagnosis of asthma and is to be d/c home. Which of the following should the nurse use to help ensure the patient's medication compliance?

Send automated emails reminders for med administration. INCORRECT. Sending automated emails reminders does not monitor pt's compliance. Offer online tutorials regarding med mgt. INCORRECT. THis does not monitor pt's compliance. Ask the pt to complete an online medication schedule. CORRECT. A weekly med sch allows the nurse to monitor the pt's med compliance, which is essential for preventative care and illness.

A nurse is preparing to perform a dressing change on a client and is researching the appropriate technique to use. Which of the following should the nurse recognize as the source of information to use?

The facility's online procedure manual A facility's policy and procedure manual is the official governing collection of evidence-based practice used to provide current, safe, and effective client care within that facility.