1. Electronic medication safety solutions include:

• a. CPOE, tall man lettering, eMARs, and barcode scanning.
• b. Excluding look-alike/sound-alike drugs from the formulary.
• c. Physician voice-recognition software programs to prevent errors.
• d. Sending orders directly to nursing, bypassing the pharmacist.

2. Every hospital today uses:

• a. Voice recognition software to save money on transcription.
• b. Fingerprint recognition software to save time on log-in procedures.
• c. Bar-coded medication administration software to prevent errors.
• d. Whatever software has been deemed essential to its own unique needs.

3. Basic definitions used in the world of healthcare informatics are:

• a. Black and white.
• b. Evolving and can vary, depending on the context.
• c. Too complicated for the average clinician to learn.
• d. Not important to bedside clinicians.

4. The purpose of a network is to link computers and other devices together to:

• a. Prevent staff from accessing organizational information.
• b. Make it easier for staff to entertain themselves online during downtime.
• c. Share information the organization deems necessary to perform work.
• d. Make it easier for clinicians to fix their own computer problems by rebooting.

5. The purpose of a clinical information system is to:

• a. Increase the use of paper, which is good for the economy.
• b. Allow flexibility in the way information is collected and shared.
• c. Assist with decision making for adherence to research findings.
• d. Prevent patient care data from being seen by anyone except direct caregivers.

6. An example of decision support for physicians from a clinical information system is:

• a. Display of an alert for the physician in the event of a wrong diagnosis.
• b. Display of evidence-based practice guidelines for a selected diagnosis.
• c. Automated notice to the chief of staff in the event of a wrong diagnosis.
• d. Automated limitations on tests that can be ordered for the selected diagnosis.

7. An automated notification, which saves a clinician from making a phone call, is an example of:

• a. A safety tool.
• b. Information management.
• c. Evidence-based practice.
• d. Decision support.

8. Which one of the following types of information management is least structured?

• a. Requiring specific information on a specific form or screen
• b. Providing specific fields for specific pieces of data
• c. Providing the answer choices for a question
• d. Providing a general comment field where the user can type freely

9. Which one of the following is not an example of decision support for a clinician? The system:

• a. Calculates the fall-risk level after completion of the assessment tool.
• b. Displays evidence-based care strategies recommended to prevent falls.
• c. Sends an automated notice of high fall risk to the physical therapy department.
• d. Displays hospital policy relative to fall prevention.

10. Which one of the following statements about inpatient falls is true?

• a. Hospitals will be reimbursed for fall-related costs as long as they have implemented a fall prevention program.
• b. Hospitals will not be reimbursed for fall-related costs for patients with Medicare/Medicaid coverage.
• c. It is impossible to prevent falls because confused patients can't remember the safety instructions they've been given.
• d. Preventing falls is a Core Measure.

11. Evidence-based practice guidelines called Core Measures must be implemented:

• a. Only in teaching hospitals and level III trauma centers.
• b. In all hospitals that treat Medicare/Medicaid patients.
• c. For patients with diabetes, diverticulosis, and deep-vein thrombosis.
• d. After the patient is discharged from the hospital.

12. A progress note written in complete sentences is:

• a. Legally required on every patient on every shift by every caregiver.
• b. Legally required on every patient on every shift by the nurse and physician.
• c. Required in order to summarize care documented in computer fields.
• d. Not required but recommended when computer fields don't cover all important events.

13. Important events and observations I need to document on all patients, even if the computer doesn't prompt me for the information, include:

• a. Routine visits of friends and family.
• b. Departures from the inpatient unit and related information.
• c. How much TV the patient watches and what games he plays.
• d. Whether the patient was in bed or in a chair each time I saw her.

14. In addition to the electronic records of your own patients, you can justify looking at the records of:

• a. A patient about whom a colleague asks you to consult.
• b. Your children who are under 18 years of age.
• c. Patients on the mental health unit whom you cared for before they were transferred.
• d. Your friend who wants her CBC results without waiting for her next visit to the doctor.

15. Documenting everything in the computer and eliminating all printed worksheets:

• a. Can introduce unsafe practices into a process that was formerly working well.
• b. Is the best approach to safe and streamlined documentation.
• c. Is always an improvement over what was done on paper.
• d. Enables a healthcare facility to get along with fewer computers.

16. Waiting your turn to use a desktop or portable computer to document your work:

• a. Is normal in most facilities.
• b. Has a negative impact on your job satisfaction.
• c. Has no impact on patient care.
• d. Can be explained by the tremendous cost of hardware.

17. If equipment problems are keeping you from being efficient, which one of the following actions would not be helpful?

• a. Interviewing other staff to identify shared experiences and patterns
• b. Sending a letter of complaint to the IT director, with a copy to his administrative supervisor
• c. Starting a log of equipment problems with the manager's input
• d. Asking your manager to appoint a committee to make recommendations

18. With an EHR:

• a. Chart access problems are reduced.
• b. Records can be reviewed only from the computers on the same unit as the patient.
• c. There is no way to identify everyone who looked at the record.
• d. A medical assistant can't look at records using the physician's password.

19. Which one of the following processes does not need to be analyzed for potential efficiencies?

• a. Nurses place a phone call to the physician every time the lab posts a critical value.
• b. The speech therapist's discharge summary is printed, cut to size, and taped to a billing form by a secretary in the rehabilitation department.
• c. Physical therapists document goal-related information in three places in the chart.
• d. When the respiratory therapist documents a treatment, the related charge is posted to the patient's account by the computer.

20. Decision support structures in the clinical system:

• a. Ensure you won't be sued for giving the wrong care.
• b. Guarantee patient safety and make personal liability insurance unnecessary.
• c. Should prompt you to further investigate key clinical issues through reading.
• d. Are there to save you the time and inconvenience of reading any professional literature.

21. Because information management and decision support help reduce error and risk and can tell people what to do, step-by-step:

• a. You should never deviate from the computer's guidance.
• b. You can now perform care that was formerly outside your scope of practice.
• c. You won't be found guilty of negligence or incompetence if you are sued.
• d. It's important to use the system as it was designed so you don't side-step all the built-in assistance.

22. Workflow refers to:

• a. Patterns of activity in daily work and the processes that support them.
• b. Clinician:patient ratios and worker productivity, department by department.
• c. Changes in the way key processes are implemented.
• d. Organizational skills that must be developed by new graduates.

23. Teams that design online documentation may make the system too complicated because they:

• a. Have little experience with this type of design work.
• b. Know that staff want a system that is academically correct.
• c. Get carried away with making it perfectly comprehensive.
• d. Have clear directions from administration.

24. When trying to keep the documentation workload to a minimum, remember that:

• a. Even a single keystroke counts.
• b. The more answer choices, the better.
• c. It's still important to include all possible questions.
• d. It's easy to move from one screen to another.

25. Admission assessments completed by nursing tend to include questions:

• a. Only if they are important.
• b. That have been asked forever.
• c. Only if someone agrees to review and follow up on the information they collect.
• d. That are asked only of patients to whom they are pertinent.

26. Documentation systems that quickly have to be revised tend to:

• a. Include too many care plans and interventions.
• b. Lack enough different care plans to structure patient care.
• c. Be at such a simple level, they're an insult to staff.
• d. Show everything the clinician has to do on one screen.

27. Systems that use standardized languages:

• a. Are superior to those that do not.
• b. May enable staff to produce care plans that look academic and professional, if used as intended.
• c. Don't make a documentation more complex.
• d. Are easily understood by anyone.

28. Circumstances that can contribute to the design of a documentation system that's too complex include:

• a. Design choices by bedside staff.
• b. Inclusion of someone with too much design experience on the design team.
• c. Ability to differentiate between quantity and quality.
• d. Validation of the system by the team who designed it.

29. If clinicians are required to document the same thing in multiple places, it is probably due to:

• a. Federal regulations.
• b. Outdated software.
• c. In-house design or policy.
• d. Interfaces.