Information Technology in the Clinical Setting exams 2023 latest updated, Exams of Nursing

Download Information Technology in the Clinical Setting exams 2023 latest updated and more Exams Nursing in PDF only on Docsity! Information Technology in the Clinical Setting exams 2023 latest updated with right answered question  MULTIPLE CHOICE  Consumers are concerned with security issues related to their confidential health information being placed in an electronic health record (EHR). However, when the security of the EHR is compared with that of paper-and-pencil records, the EHR is:  more secure.  less secure.  equivalent.  not comparable with the paper- and-pencil record.  ANS: A  Computer-based patient record systems, such as EHRs, provide better protection than paper-based systems. The EHR allows only authorized users to view data, and access to records can be audited for inappropriate use.  A nurse is preparing a scholarly publication on the prevalence of hepatitis A worldwide. The most efficient and effective means of conducting an Internet search to gather information for this publication is to use:  a search engine such as Google or Yahoo.  a consumer health website.  a decision support system.  MEDLINE database.  ANS: D  MEDLINE is one of the scientific and research scholarly databases, and it would be the most appropriate for use in gathering information for a scholarly publication.  DIF: ComprehensionREF: p. 276  A consumer is learning about electronic health records at a local health fair and states, “I am worried that someone can read my health information and I really don’t understand the difference between privacy and confidentiality.” The nurse explains that an example of confidentiality would be:  a pledge that states, “I will hold matters pertaining to my patients in strict intimacy.”  a patient who does not tell the physician that he has been treated for a sexually transmitted disease.  a teenager who sustains a broken arm and in the emergency department and withholds information about her use of recreational drugs.  locking medical records in cabinets to prevent unauthorized users from accessing patient information.  ANS: A  Confidentiality is keeping private the personal information that was given to a health care provider, unless others have a legitimate need to know.  DIF: Application REF: p. 271  A physician has installed a computer-based patient records system. An outside care provider who requests medical information must obtain the patient’s signed consent and then is assigned a password to gain access to the medical information. A monthly audit is conducted to determine for whom and for what purpose patient records have been accessed. This protection is referred to as:  privacy.  confidentiality.  security.  data capture.  A nurse who is teaching a class to introduce telehealth to the staff would include which example?  A robot performs menial housekeeping chores for an invalid patient.  A computer software program alerts the nurse or physician who is reviewing orders that an order for a new drug can cause synergy of the theophylline inhaler.  A physician speaks into a computer, and the admission history is recorded and saved in the patient file.  While a patient in Wyoming performs peritoneal dialysis, a nurse watches remotely from California to ensure that all steps are being followed correctly.  ANS: D  Telehealth is the delivery of care to a patient who is at a distance from the health care provider.  DIF: Application REF: p. 273  An advanced practice nurse inputs into a computer software program the following clinical manifestations: open wound with tibia exposed, petechial hemorrhage, and temporary loss of consciousness. The computer diagnosis of fat emboli is generated by a system known as:  decision support.  telehealth.  robotic technology.  biometric technology.  ANS: A  Decision support systems are computer-based information systems that include knowledge- based systems designed to support clinical decision making.  DIF: ComprehensionREF: pp. 268-269  A nurse is preparing a presentation using different websites to collect information. The nurse is concerned that contact information and the author’s credentials are not listed for one of the websites reviewed. Which criterion required to establish a reputable website is missing?  Authority  Objectivity  Decision support  Patient support  Administrative support  ANS: B  Decision support provides reminders about preventive practices, such as immunizations, drug alerts for dosing and interactions, and clinical decision making.  DIF: ComprehensionREF: pp. 268-269  A nurse works on a unit where electronic health records (EHR) are being initiated and asks, “What is meant by ‘meaningful use’ standards that are in our education packet?” The best answer is that “meaningful use”:  identifies a set of EHR proficiencies and benchmarks that EHR systems must meet to be certain that they are functioning to their maximum capacity and meeting this standard allows companies/organizations to qualify for funds to defray cost of the EHR from Medicare.  refers to training competencies that all users must achieve to be able to access and transfer patient data/information.  refers to a requirement that at least 50% plus one of all patients have data entered  into the EHR.  the requirement that rigorous confidentiality security is in place to protect all patient information from sources which have no right to the data.  ANS: A  Meaningful use is “A defined set of EHR capabilities and standards that EHR systems must meet to ensure their full capacity is realized and for the users (hospitals and physician practices) to qualify for financial incentives from Medicare.”  DIF: Application REF: p. 271  A nurse is caring for a patient who is to receive an antibiotic drug that causes severe skin damage when infiltrated. The order reads, “infuse over 1 hour by portacath.” The nurse accesses the Personal Digital why doesn’t everyone just replace paper and pencil charts”? Barriers to a universal health information infrastructure include the fact that: (select all that apply)  competition from individual companies to build EMR prevent a universal infrastructure.  cost is prohibitive even with federal funding for larger health care systems.  preventive health reminders for immunizations and yearly screenings such as  mammograms are used in clinical decision making.  insurance companies have halted sharing of some patient data due to fear of law suits.  the full capacity of EHRs has not been realized with only Stage 1 of 3 nearing completion.  ANS: A, E  It has been recommended that only a federal-based EMR would provide an infrastructure that allows access to comprehensive patient information. The first stage, years 2011 and 2012, forms the foundation for electronic data capture and information sharing.  DIF: ComprehensionREF: p. 271  A nurse interested in quality improvement tools performed a search for cause and effect diagrams using www.ishikawa.com. A page opened that provided images and templates for performing fishbone diagrams. Which type of search did the nurse conduct?  Quick and dirty  Advanced  Brute force  Link searching  ANS: C  Brute force is a method of searching where you type in what you think might logically be a web address and see what happens.  DIF: ComprehensionREF: p. 275  COMPLETION  Software programs that process data to produce or recommend valid choices are known as  .  ANS: A  Every disaster response begins as a local event known as the preparedness phase, which consists of planning, preparedness, prevention, and warning.  DIF: ComprehensionREF: p. 285  A nurse at a school notices that several students have “blisters” on their bodies. Further investigation reveals that a terrorist incident has occurred, causing smallpox. If the chemical, biologic, radiologic, nuclear, and explosive (CBRNE) agent categories are used, this incident would be classified as:  chemical.  biologic.  radiologic.  nuclear.  ANS: B  The biologic category refers to diseases such as plague or smallpox.  DIF: ComprehensionREF: p. 284, Table 16-1  The Metropolitan Medical Response System (MMRS):  is totally financed by the federal government national disaster fund.  consists of responders who have obtained specialized training and equipment to deal with mass casualty events.  has a storehouse of medications and antidotes to be used during response in times of national emergencies.  arranges for patient admissions to federal hospitals.  ANS: B  The MMRS responds to disaster with trained individuals who have expertise in this type of situation and who have the equipment required to be effective.  DIF: ComprehensionREF: p. 286 nurse knows that:  the response of local hospitals will be dictated by the federal government.  the same ground rules practiced in other settings and during smaller crises will be applicable.  the least experienced nurses will be assigned to triage low-risk victims and victims who have no chance of survival.  multiple incident commanders ensure a quick, effective response.  ANS: B  The fundamentals of nursing applied to other settings and situations can be used in a disaster.  DIF: ComprehensionREF: p. 283  Nurses caring for the victims of a mass casualty incident:  determine the common terminology to be used by hospitals and participating agencies.  take charge of communicating with the news media.  determine whether there is a credible threat of a terrorist attack.  give priority for care to those with the greatest chance of survival rather than those most critically ill.  ANS: D  Care is shifted from categorizing patients at low, intermediate, and critical risk to using resources to serve those with the greatest likelihood of survival.  DIF: ComprehensionREF: p. 283  During a community health fair the disaster medical assistance team (DMAT) informs participants that every community must be ready to provide disaster care. A participant asks, “In a disaster, the local community cannot possibly be effective, so why not have a plan to call federal agencies immediately to provide relief?” The correct response by the DMAT is:  “Unless known terrorist activities involving mass destruction occur, the federal government does not become involved.”  “The community is essentially the ‘first responder’ to any disaster.”  “The preparedness phase of a disaster is the responsibility of the community, the relief response  Metropolitan Medical Response System (MMRS)  Commissioned Corps Readiness Force  National Disaster Medical System  ANS: B  The MMRS is concerned with deploying trained responders who are able to provide mental health care for victims and health care providers.  DIF: ComprehensionREF: p. 286  The crisis communication officer may first inform the public or health care facility of a disaster or an act of terrorism. This representative has the responsibility to:  contain the facts to within the administration group.  incite the public to quickly take cover and obtain emergency supplies.  provide understandable and straightforward facts about the event within the facility and possibly to the news media.  inform the public that no information can be released until it has been confirmed by state and federal agencies.  ANS: C  The crisis communication officer is the first contact for patients, families, and employees within the facility or news media, so they may better understand the situation and know how to react and protect themselves.  DIF: ComprehensionREF: p. 289  The disaster medical assistance team works quickly to contain contaminants from a chemical plant explosion. Afterward, personnel undergo a special process to remove harmful chemicals from equipment and supplies. This removal process is known as:  containment.  decontamination.  triage.  scene assessment.  ANS: B  Decontamination is the physical process of removing harmful substances from personnel, equipment, and supplies.  DIF: Knowledge REF: p. 280  A group of local volunteers respond to a tornado. Volunteers have completed an emergency response course and are able to  ANS: A  The National Disaster Medical System supplements care for casualties evacuated back to the United States from overseas and federally declared disasters including national disasters, major transportation accidents, technologic disasters, and acts of terrorism.  DIF: ComprehensionREF: pp. 286-287  A nurse is informed that the Federal Bureau of Investigation has determined that a bomb has been detected and is in the possession of a known terrorist group. The government buildings in the local community are the target. This situation is termed a(n):  all-hazards approach.  biologic event.  credible threat.  natural disaster.  ANS: C  A credible threat is a situation in which the Federal Bureau of Investigation (FBI) determines that a terrorist threat is probable and verifies the involvement of a weapon of mass destruction in the developing terrorist incident.  DIF: Comprehension REF: p. 280  The emergency response team responded to a terrorist attack where hundreds of people died following symptoms of chest tightness, palpations, seizures, and finally paralysis. A colorless odorless liquid known as Sarin (GB) was the agent, which is primarily inhaled with limited exposure through the skin. The concentration of Sarin has not been measured. What level is the minimum level of personal protection and safety equipment (PPE) that would be needed?  A  B  C  D  ANS: B  Level B requires a high level of respiratory protection, but less skin protection, providing a chemical splash–resistant suit with hood and self-contained breathing apparatus (SCBA). It provides maximum respiratory protection but less skin protection than level A equipment.  DIF: Analysis REF: p. 289  A state is devastated by a tornado killing many people, destroying disaster continuum is consistent with the evaluation step of the nursing process.  ANS: A  The preparedness phase requires assessing possible needs of the community and planning appropriate interventions and is consistent with the assessment and planning steps of the nursing process.  DIF: ComprehensionREF: p. 285  In the preparedness phase for disasters, the community plans for a possible terrorist attack using anthrax as the weapon of destruction. What treatments and/or preparations would be needed?  Vaccines and Level B Personal Protection Equipment (PPE)  Treatment for burns, decontamination, and Level A PPE  Social distance determination, decontamination for radioactive fallout  Identify and detect incendiary devices, treatment for burns and propellants  ANS: A  Anthrax is a biologic weapon and requires Level B protection since it is a known agent and can be carried in wind or surfaces. Timing of treatment is critical and vaccines are available.  DIF: Analysis REF: pp. 282-284, Table 16-1  MULTIPLE RESPONSE  Health care professionals have been activated to respond to a disaster, and the registered nurse who is coordinating the effort realizes that: (select all that apply)  in the event of a mass casualty incident, care is prioritized to those who have the greatest chance of surviving.  communities should use their own resources first to attempt to stabilize and organize the response.  state assistance occurs any time a disaster occurs, regardless of the community’s resources.  the emergency operating plan developed by one central agency rather than individual facilities should be put into operation.  strict protocols regarding the use of resources must be followed.  ANS: A, B within a well-defined area is .  ANS:  containment  Containment is correct because the focus is to prevent the agent that caused the disaster from spreading.  DIF: Knowledge REF: p. 280  The term used during a pandemic disaster that refers to the attempt to contain germs by limiting socialization and personal interactions is .  ANS:  social distancing  The term social distancing refers to the attempt to keep people as far apart as possible so as to limit the possibility of spreading germs.  DIF: Knowledge REF: p. 291  Chapter 17: Nursing Leadership and Management  Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 7th Edition   MULTIPLE CHOICE  In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees’ health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin’s planned change?  Unfreeze  Move  Refreeze  ANS: B  The nursing process, which is familiar to nurses who address patient care needs, can be applied to all management activities that require decision making and problem-solving. As in the nursing process and the problem-solving process, one must first gather information about the problem or situation.  DIF: ComprehensionREF: pp. 309-310  An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation?  Autocratic  Democratic  Laissez-faire  Referent  ANS: A  The dynamics of the situation demand that the leader take control and direct employees to specific actions in response to the emergency.  DIF: ComprehensionREF: p. 300, Box 17-3  An RN with excellent assessment and psychomotor skills would derive power on the basis of which source?  Rewards  Coercion  Expert  Legitimate  ANS: C  Seven primary sources of power are known. Expert power is based on knowledge, skills, and information.  DIF: ComprehensionREF: p. 297  Managers who exhibit an authoritative behavioral style are most likely to use which source of power?  Informal  Expert  Coercive  Reward  Leadership trait theory describes intrinsic traits of leaders and is based on the assumption that leaders were born with particular leadership characteristics. Other traits found to be associated with this leadership theory include intelligence, alertness, dependability, energy, drive, enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery.  DIF: ComprehensionREF: p. 298  A nurse manager is concerned with restocking the emergency cart, creating the staff schedule, requesting floor stock from pharmacy, and checking the orders on patient charts. Which type of leader accurately describes this nurse?  Transactional  Situational  Transformational  Contemporary  ANS: A  The transactional leader is concerned with the day-to-day operations of the facility.  DIF: ComprehensionREF: p. 298, Box 17-1  According to the unit’s policy for call-ins, a nurse is suspended for 3 days because of excessive call-ins that occur within 15 minutes of shift change. The nurse states, “You are unfair to me.” Which theory would disprove the nurse’s statement?  Authoritative  Closed systems  Open systems  Trait  ANS: A  Autocratic/authoritative management style revolves around the assumption that authority confers the right to issue commands within an organization on the basis of impersonal rules and rights, by virtue of the management position rather than any trait ascribed to the person who occupies that position. Other characteristics include the following: Impersonal rules govern the actions of superiors over subordinates, all personnel are chosen for their competence and are subject to strict rules that are applied impersonally and uniformly, and a system of procedures for dealing with work situations is in place.  Represents the systems theory of the organization.  Monitoring data from the quality management initiative related to the last three orientation programs  Developing a 5-year plan that will incorporate the clinical nurse leader as a part of all nursing units  ANS: D  A strategic plan is a written document that details organizational goals, allocates resources, assigns responsibilities, and determines time frames. The strategic plan generally looks 3 to 5 years into the future.  DIF: Application REF: pp. 301- 302  A hospital’s policy requires that all nurse managers must have a minimum of a bachelor’s degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to physicians and staff, “The new nurse manager has book sense but no leadership abilities.” What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit?  Send memos to all staff except the upset nurse to invite them to a luncheon.  Ask management to transfer the upset nurse to another unit.  Assign the upset nurse to committees that do not directly affect that nursing unit.  Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication.  ANS: D  The best way for the new nurse manager to communicate with this employee, who may be an informal leader, is to show respect for the individual’s clinical expertise and experience through clear and direct communication. The new nurse manager should attempt to identify the staff nurse’s power as an informal leader, should involve him and other staff members in decision- making and change-implementation processes, and should clearly communicate goals and work expectations to all staff members.  DIF: Application REF: pp. 297- 298  Transactional  Clinical consultant  Corporate supporter  Autocratic  ANS: C  The manager is embracing the mission of the organization by supporting achievement of goals noted in the mission statement.  DIF: ComprehensionREF: p. 311  A staff nurse provides care based on intuition and always seems to be in control of her personal and professional life—serving on the board of the state nurses association, serving as the nursing unit’s representative on the ethics committee, and coaching her daughter’s soft ball team. Many of the staff observes how she manages time and provides care. This nurse’s power comes from which type of power?  Referent  Legitimate  Information  Connection  ANS: A  Referent power comes from the followers’ identification with the leader. Referent leaders are admired and respected and able to influence other nurses because of their desire to emulate her.  DIF: ComprehensionREF: p. 297  A staff nurse states, “I really enjoyed having dinner with the Chief of Medical Staff and the President of the hospital. We hope to meet again soon.” Which source of power does this nurse possess?  Expert  Legitimate  Connection  Reward  ANS: C throughout the shift as part of best practices. Random visits are made to nursing units to ensure all nurses are participating and patients are interviewed for their involvement. This stage of Lewin’s change is:  unfreeze.  moving.  refreeze.  resistance.  ANS: C  In the refreezing stage, change becomes status quo and the agent reinforces until the change is part of the daily process as in the above situation.  DIF: ComprehensionREF: p. 311  A manager just finished the last annual performance review of the staff, reviews the unexpected expenditures for the month due to use of agency nurses, and shares the latest quality indicators with the staff nurses. This manager is performing which management function?  Directing  Planning  Organizing  Controlling  ANS: D  Controlling is the final management function. It includes performance evaluations, financial activities, and tracking outcomes of care to ensure quality.  DIF: ComprehensionREF: p. 307  MULTIPLE RESPONSE  Registered nurses who are entering the workforce will have expanded leadership responsibilities that include: (select all that apply)  serving on interdisciplinary care teams.  being competent to work in several areas independently when dictated by patient census.  attending a meeting to plan advanced training for unlicensed assistive personnel.  evaluating outcomes of care that are reported to a standing committee.  managing units with higher acuity, shorter length of stay, and more diverse patients and staff.  DIF: Application REF: pp. 296- 297  A nurse asks, “What is meant by ‘internal’ customers?” The correct response is: (select all that apply)  insurance companies  accreditors such as The Joint Commission  X-ray technicians  clinical pharmacist  chief financial officer  ANS: C, D, E  Internal customers are employees of an organization at all levels. An x-ray technician is an example of an internal customer. Internal customers are employees of an organization at all levels. A clinical pharmacist is an example of an internal customer. Internal customers are employees of an organization at all levels. A chief financial officer is an example of an internal customer. > DIF: Comprehension REF: p. 308 with Fall Watch electronic sensors that will detect when patients get out of bed. The manager will be involved in which type of budgeting to replace the beds?  Fiscal  Labor  Operational  Capital  ANS: D  Capital budgets are concerned with major purchases such as equipment paid for over several years.  DIF: ComprehensionREF: pp. 320-321  A nurse manager is preparing a budget that does not base annual budgets on the revenue and expenditures of the prior year and has the advantage that outdated information is not integrated into the budget. The manager is using which budget method?  Zero-based  Incremental  Labor  Operational  ANS: A  The zero-based method is based on the assumption of no volume and no resources assigned; it essentially starts each new budget period at zero rather than building from past budgets.  DIF: ComprehensionREF: p. 321  A nurse on the unit is heard saying, “I am not going to document that I used four catheters to start that IV; it doesn’t matter anyway.” What action can help the staff nurse understand the financial budget goals of the unit?  Have the nurse work in payroll for a week.  Enroll the staff in continuing education units (CEU) for personal finance.  Ask the nurse to represent the unit on the budget planning committee.  Make the nurse responsible for monitoring all disposable equipment and supplies.  ANS: C  Participating on the committee will give the nurse ownership of the the basis of unit-of-service  Providing qualitative analysis for variances in the capital budget  ANS: B  Nurse managers are often evaluated according to their success in managing nursing overtime costs and supply usage as reflected in the unit’s budget.  DIF: Application REF: p. 319  A primary function of the budgeting process is to provide managers with an opportunity to:  insist that salary increases for all nurses are included in the annual budget.  discuss concerns about resource allocation with leaders of the organization who are capable of resolving issues.  develop a mechanism for changing from zero-based budgeting to incremental  budgeting.  develop for all staff an educational program related to supply usage.  ANS: B  Coordination and communication are very important functions of budgeting that require many different groups within an organization to come together with organizational leaders to discuss the resources necessary to accomplish the goals of a business unit.  DIF: Application REF: p. 318  Organizations measure the effectiveness of their budgets by examining actual revenues and expenditures versus:  planned variances.  incremental budgets.  productivity metrics.  expected performance. emergency department equipment has been turned in for consideration by the hospital’s administrative team.  The patient census likely will increase during the next fiscal year because two large physician groups have transferred their admission privileges to this hospital.  The participatory budgeting approach instituted last year has been helpful in controlling supply costs.  Zero-based budgeting will help the managers to be more efficient in establishing next year’s budget.  ANS: B  Budget assumptions are future predictors of performance and include the stability of the price of supplies, the salary range needed to recruit and retain quality employees, new services offered by competitors, and the variability of the patient census.  DIF: Application REF: p. 322  The nurse manager meets with upper management to share strategic goals agreed upon by her staff for their individual nursing unit as the first step to begin budget negotiations. One strategic goal is that staff will have access to technology that will allow them to incorporate point-of-care devices for all RNs. The second goal is to improve RNs’ ability to recognize critical indicators that a patient’s health status is deteriorating through advanced health assessment skills. During the meeting the manager discusses the strategy options and selecting the one that works for the unit. Which type of budget development is used?  Iterative  Top-down  Participatory  Zero-based  ANS: C  In the participatory approach, the people responsible for achieving the budget goals are included in goal setting.  DIF: ComprehensionREF: p. 322  The nursing executive team met to review last year’s productivity metric to strategize for the upcoming year’s metric. The team