D220 CPT Questions and Answers Review Guide
Student Name
Western Governors University
D220 Information Technology in Nursing Practice
Prof. Name
Date
D220 CPT Questions and Answers Review Guide
How did the data in the electronic medical record (EMR) inform the decision to place a patient with a history of methicillin-resistant Staphylococcus aureus (MRSA) on contact precautions?
The decision to implement contact precautions for a patient with a history of MRSA primarily relies on specific, confirmatory data found in the EMR. The most crucial piece of information is the laboratory report from the patient’s previous hospitalization showing a positive culture for MRSA. This result provides direct evidence of MRSA colonization or infection, justifying the use of contact precautions to prevent the spread of this resistant organism.
Other documentation, such as history and physical notes mentioning wet-to-dry dressing changes, does not specifically relate to MRSA management. Similarly, medication administration records indicating antibiotic use do not clarify whether the antibiotics were for MRSA or another infection. Nursing flowsheets documenting a swollen elbow with drainage could indicate other issues unrelated to MRSA.
| Option | Source of EMR Data | Relevance to MRSA Contact Precautions | Explanation |
|---|---|---|---|
| A | History and physical notes | Not relevant | Wet-to-dry dressings are nonspecific to MRSA. |
| B | History and physical notes (repeat) | Not relevant | Duplicate of A with no impact. |
| C | Medication administration record | Indirect relevance | Antibiotics may be for other infections. |
| D | Laboratory report | Highly relevant | Confirms MRSA presence; supports precautions. |
| E | Nursing flowsheets | Not relevant | Symptoms may be unrelated to MRSA. |
Which EMR data would prompt a nurse to implement droplet precautions for a patient reporting shortness of breath, productive cough, and fatigue?
The radiology impression revealing lung consolidation is the most significant finding prompting droplet precautions. Lung consolidation typically indicates pneumonia, an infection that can spread via respiratory droplets, thereby necessitating droplet precautions to protect healthcare workers and other patients.
While other findings such as a history of asthma, elevated white blood cell count, or wheezing support the presence of respiratory issues, they do not directly indicate the need for droplet precautions. Asthma is a chronic, non-infectious condition; elevated white blood cells are a general marker of infection; and wheezing alone does not confirm a contagious illness.
| Option | EMR Data Source | Indicator for Droplet Precautions | Explanation |
|---|---|---|---|
| A | Complete health history (asthma) | No | Asthma is non-contagious. |
| B | Radiology impression | Yes | Consolidation suggests infectious pneumonia. |
| C | Complete blood count | No | Infection marker, not specific for droplet spread. |
| D | Nursing flowsheet (wheezing) | No | Wheezing is nonspecific for infectious spread. |
What EMR data supports an influenza diagnosis in a patient with fever, chills, and muscle aches?
Laboratory specimen collection results within the EMR provide definitive confirmation of influenza. Rapid antigen or polymerase chain reaction (PCR) testing can detect the influenza virus, enabling appropriate treatment decisions and isolation precautions.
Although radiology reports, nursing notes, and history can document symptoms and support clinical suspicion, they do not confirm influenza diagnosis.
What is the purpose of a clinical decision support (CDS) alert in the EMR warning of high risk for obstructive sleep apnea before surgery?
The clinical decision support tool aims primarily to enhance patient safety by identifying risk factors such as obstructive sleep apnea before surgery. This condition increases perioperative risks like airway obstruction and complications with anesthesia. The alert encourages clinicians to take preventive measures, such as modifying anesthesia plans and increasing monitoring.
While compliance with regulations and reducing reportable incidents are beneficial outcomes, the immediate and foremost goal is to prevent patient harm.
What should a nurse assess to evaluate a newly diagnosed heart failure patient’s ability to engage in care and education?
The nurse should evaluate barriers that may hinder the patient’s engagement. These include cognitive impairments, language barriers, health literacy levels, and socioeconomic challenges that affect understanding and adherence to treatment plans. Although willingness to engage and family support contribute to overall engagement, they do not fully determine the patient’s ability. Simply having access to education is insufficient without addressing these barriers.
Which low-cost marketing method should a rural hospital use to educate its community and promote patient engagement?
Social media platforms are the most cost-effective and efficient way to disseminate information in rural areas. They allow rapid communication with a wide audience and encourage interactive engagement. Traditional media like radio, newspapers, and billboards are typically more expensive and less targeted, often yielding lower impact in rural communities.
What is the first action an informatics nurse should take when staff use printed information from a new electronic health record (EHR) as a “worklist,” creating unsafe practice?
The nurse should initially conduct interviews with staff to understand why they rely on printed reports. This approach helps identify underlying workflow challenges or usability issues within the EHR system that lead to this behavior. Addressing root causes through collaboration and education is more effective than immediately restricting printing or escalating the issue.
Who should be included in a committee tasked with reviewing and updating hospital order sets?
A multidisciplinary team is ideal for this responsibility to ensure comprehensive review and evidence-based updates. Recommended members include:
| Staff Role | Contribution |
|---|---|
| Informatics staff | Technical support and database management |
| Healthcare providers | Clinical expertise and evidence-based input |
| Nurses | Practical insights on patient care and workflow |
| Leadership (e.g., CNO) | Oversight, guidance, and resource allocation |
How should an informatics nurse determine the best mobile workstation device for nursing staff?
The nurse should observe end users directly to understand their workflow, preferences, and technical needs. This ensures that the selected devices align with clinical tasks, enhance efficiency, and support patient care. While factors like device disinfectability, budget, and security are important, these come after assessing user requirements.
Which nurse comment about hospital information systems (HIS) indicates a misunderstanding needing correction?
The comment, “With automated machines and computers, the number of nurses who encounter errors has increased,” is inaccurate. HIS are designed to reduce errors by automating routine tasks, standardizing documentation, and supporting clinical decision-making. Other comments correctly recognize HIS benefits such as improved inventory management, real-time data access, and enhanced community care coordination.
What is the top priority security concern when using virtualized storage in clinical trial matching tools at an ambulatory oncology facility?
The primary threat is the risk of data breaches compromising sensitive patient medical information stored virtually. Protecting confidentiality and preventing unauthorized access are critical due to the sensitive nature of oncology patient data. Other challenges like user resistance or workflow delays are secondary and manageable with proper training.
What is the advantage of using standardized terminology in healthcare data reporting?
Standardization enables consistent benchmarking and performance comparison across healthcare organizations. Uniform terminology and data formats facilitate quality improvement, regulatory compliance, and data sharing, which ultimately improve patient outcomes. While visual data presentation tools are useful, the core benefit lies in comparability and benchmarking.
How can an informatics nurse specialist appropriately use knowledge discovery in databases (KDD) within healthcare?
An informatics nurse specialist can leverage KDD to analyze large datasets related to nursing practice to identify trends, outcomes, or areas needing improvement. This process supports evidence-based practice and enhances patient care. Tasks like limiting treatments or creating care plans require clinical judgment and other decision-making frameworks beyond KDD.
What time frame does CMS use to define repeat patient admissions under the Hospital Readmissions Reduction Program (HRRP)?
CMS uses a 30-day period to define repeat admissions. This metric measures hospital readmission rates to incentivize hospitals to reduce avoidable readmissions and improve quality of care.
What is the scope of practice for nursing informatics?
Nursing informatics integrates nursing science with information and analytical sciences to manage data, information, knowledge, and wisdom in nursing practice. It supports clinical decision-making and enhances patient outcomes by optimizing information systems and communication. This scope excludes data engineering or behavioral health sciences as primary roles but focuses on applying informatics principles within nursing.
References
Centers for Disease Control and Prevention. (2023). Infection control guidance for healthcare professionals about coronavirus (COVID-19). https://www.cdc.gov/infectioncontrol/guidelines/index.html
HealthIT.gov. (2023). Clinical decision support. https://www.healthit.gov/topic/safety/clinical-decision-support
D220 CPT Questions and Answers Review Guide
Institute of Medicine. (2011). Health IT and patient safety: Building safer systems for better care. The National Academies Press.
National Institute of Nursing Research. (2022). Nursing informatics: The intersection of nursing science, computer science, and information science. https://www.ninr.nih.gov/researchandfunding/spotlight-on-nursing-research/nursing-informatics
U.S. Centers for Medicare & Medicaid Services. (2023). Hospital Readmissions Reduction Program (HRRP). https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program
World Health Organization. (2023). Standardization of terminology in health data. https://www.who.int/standards/classifications