Question 1
On its own, the number 190 is an example of:
Selected
Answer:
c.
data.
Response
Feedback: The number 190 could refer to anything such as a person’s weight, blood
glucose level, or systolic blood pressure reading and therefore has no
meaning by itself.
Question 2
2 out of 2 points
Knowing when and how to use knowledge is referred to as:
Selected
Answer:
c.
wisdom.
Response
Feedback: Wisdom is defined as the appropriate use of knowledge in managing or
solving human problems. It is knowing when and how to use knowledge
in managing patient need(s) or problem(s).
Question 3
2 out of 2 points
A facility calls in experts to review evidence developed in research and develop
guidelines for clinical practice. Which stage of EBP is represented?
Selected
Answer:
b.
Translation to guidelines
Response
Feedback: In the third stage of EBP, translation, experts are called on to consider
the evidence summary, fill in gaps with consensus expert opinion, and
merge research knowledge with expertise to produce clinical practice
guidelines (CPGs).
Question 4
2 out of 2 points
The migration of informatics and telehealth toward uHealth means:
Selected
Answer:
c.
ecosystems of interoperable technologies and services organized to
meet global patients’ needs in a ubiquitous manner.
Response
Feedback: The migration of informatics and telehealth toward uHealth means
ecosystems of interoperable technologies and services will be organized
to meet global patients’ needs in a ubiquitous manner.
Question 5
2 out of 2 points
The supply item master is:
Selected
Answer:
d.
a list of all items available to order in the
organization.
Response The supply item master is the master list of supplies available to
Feedback: order in the organization.
Question 6
2 out of 2 points
The ________ is one of the oldest—and still widely used—methods for building and
implementing software applications in IT arena.
Selected
Answer:
b.
SDLC
Response
Feedback: Though it’s been through a number of iterations and adjustments, the
software development life cycle remains the tested and tried-and-true
method for studying, building, implementing, and maintaining a health
information system.
Question 7
2 out of 2 points
As EHR adoption expands to include data from multiple healthcare entities, more
opportunities for error exist. Which process can affect data integrity?
Selected
Answer:
d.
System failure
Response
Feedback: Data integrity refers to the accuracy and consistency of stored and
transmitted data that can be compromised when information is entered
incorrectly, deliberately altered, or the system protections are not
working correctly or suddenly fail.
Question 8
2 out of 2 points
Your organization hires you to conduct a formative evaluation of a new informatics
intervention. Which areas would you focus on in a formative evaluation?
Selected
Answer:
d.
Intervention fidelity, implementation quality, and types of personnel
Response
Feedback
:
A formative evaluation is an assessment of how well a program is being
implemented. Intervention fidelity, implementation quality, and types of
personnel are areas that would be focused on in formative evaluation.
Results of the formative evaluation are used as feedback to the program
for continuous improvement.
Question 9
2 out of 2 points
What is the primary difference between an open and closed system?
Selected
Answer:
d.
An open system has a semipermeable boundary and therefore will filter
both inputs and outputs when interacting with the environment.
Response
Feedback: With an open system the boundary is semipermeable, thereby
controlling what will be accepted as input and what will be permitted to
leave the system.
Question 10
2 out of 2 points
For healthcare infrastructures with many communicating systems, an interface
engine is helpful because:
Selected
Answer:
c.
it decreases the number of interfaces that must be maintained and
lessens complexity.
Response
Feedback
:
An interface engine is helpful because it decreases the number of
interfaces that must be maintained and lessens complexity. The other
choices do not accurately describe the use of an interface engine, the
ability to connect systems, or regulatory requirements.
Question 11
2 out of 2 points
All of the following are core functions of public health except:
Selected
Answer:
d.
treatment.
Response
Feedback: Public health is focused on prevention and the health of populations
before they are injured or ill; clinical care, not public health, involves
treating individuals.
Question 12
2 out of 2 points
A university hospital wants to implement a closed-loop medication management
system. Current systems include registration, computerized provider order entry,
electronic medication administration record, laboratory, radiology, and pharmacy.
Which system is needed to complete the loop?
Selected
Answer:
d.
Barcoding system
Response
Feedback: A closed-loop medication management system would connect the
pharmacy system to the CPOE, eMAR, and barcoding systems.
Question 13
2 out of 2 points
Which payer is the largest for home health services?
Selected
Answer:
b.
Medicare
Response
Feedback: As the largest payer, Medicare, through its Conditions of Participation,
represents the standard for the services provided by home health
agencies and the payment for these services by many commercial
insurance payers and state Medicaid programs.
Question 14
2 out of 2 points
Dr. James, in studying patient safety in U.S. hospitals, found that the number of
preventable adverse events leading to serious harm fell in the approximate range of
____________ to _____________ cases per year.
Selected
Answer:
d.
4.4 million; 8.8 million
Response
Feedback: Dr. James found some 440,000 cases of lethal harm each year and
estimated that the incidence of serious (but not lethal) harm was 10 to
20 times that figure.
Question 15
2 out of 2 points
Which are the three general types of learned behaviors?
Selected
Answer:
a.
Cognitive, affective, and psychomotor
Response
Feedback
:
Learning is defined as an increase in knowledge, a change in attitude or
values, or the development of new skills. Learned behaviors can be
cognitive (intellectual skills), affective (values and attitudes), or
psychomotor (the integration of cognitive and motor skills).
Question 16
2 out of 2 points
As the United States moves toward the implementation of an interoperable EHR,
which statement about the future “ownership” of the patient record is appropriate?
Selected
Answer:
c.
Ownership may be driven by who has control and access to the
data.
Response
Feedback
:
Traditional medical records have always been the property of the service
institution, but this may not be true in the future. Consumer consent is
required for health professionals to retrieve or share patient records to
ensure personal information is not accessed inappropriately. Ultimately,
ownership may be driven by who has control and access to the data.
Question 17
2 out of 2 points
You have altered the menu of food items served to your patients. However, the
change has greatly expanded the number of refrigerated items needed on hand. You
need to buy a new refrigerator, but the electric circuit in the kitchen cannot handle the
extra load and needs to be upgraded at significant expense. This set of unintended
consequences down the line, produced by an initial change, is called:
Selected
Answer:
d.
reverberation.
Response
Feedback: Change within any part of a system will be reflected across the total
system through a process termed reverberation. Reverberation can be
intended or unintended consequences of change.
Question 18
2 out of 2 points
Which incentive has the strongest potential to spur the nationwide adoption of
advanced CDS?
Selected
Answer:
c.
Shift of healthcare payment from a fee-for-service model to approaches
rewarding the delivery of better quality and outcomes at lower cost
Response
Feedback
:
All of these are important elements encouraging nationwide adoption of
advanced CDS. However, as discussed in the chapter, the shift of
healthcare payment from a fee-for-service model to approaches
rewarding the delivery of better quality and outcomes at lower cost
appears to have the strongest potential for change.
Question 19
2 out of 2 points
Financial reporting is a vital part of decision making in healthcare organizations.
Which report would be used to show a snapshot of the bottom line?
Selected
Answer:
d.
Income statement or statement of operations
Response
Feedback: Income statements reflect the following formula: revenue – expenses =
profit. This is often referred to as the bottom line. The balance sheet, on
the other hand, reflects an organization’s assets, liability, and equity.
Question 20
2 out of 2 points
Which statement describes the measurement of information as defined by the
Shannon and Weaver model?
Selected
Answer:
a.
The amount of information is measured by the extent the message
decreases entropy.
Response
Feedback: By decreasing entropy one decreases uncertainty. Shannon, a telephone
engineer, sought to overcome the technical problems of moving
information across communication channels by determining how to
minimize entropy.
Question 21
2 out of 2 points
What are the two overarching types of telehealth technologies?
Selected
Answer:
d.
Synchronous and asynchronous
Response
Feedback: Synchronous and asynchronous are the two overarching types of
telehealth technologies. The remaining responses are components of
telehealth.
Question 22
2 out of 2 points
What are the two important purposes of the OASIS dataset?
Selected d.
Answer: Determine payment and measure quality and outcomes
Response
Feedback
:
OASIS, or the Outcome and Information Set, is a standardized dataset
with two important purposes: it is the basis for determining payment for
each 60-day episode of care, and it measures the quality and outcomes
of services delivered by home health agency clinicians.
Question 23
2 out of 2 points
The “butterfly effect” describes a situation in which a minor change in input (eg, a
butterfly flapping its wings in one part of the world) can have a major effect on output
(eg, a windstorm developing in another part of the world). This aspect of chaotic
systems illustrates their property of:
Selected
Answer:
b.
the reiterative feedback loop.
Response
Feedback: Chaotic systems are dynamic systems with reiterative feedback loops. A
minor change in input can create a major change in output. This is often
described as the butterfly effect. A butterfly’s flapping wings in California
can over time become a hurricane in New York.
Question 24
2 out of 2 points
Materials management in the healthcare environment involves all of the following
EXCEPT:
Selected
Answer:
b.
logistics management and pipelines.
Response
Feedback
:
Materials management is a subset within supply chain management that
focuses on the storage, inventory and quality control, and operational
management of supplies, pharmaceuticals, equipment, and other items
used in the delivery of patient care or managing the patient care system.
Logistics involves the flow of goods and services from the point of origin
to the point of consumption and thus falls outside the realm of materials
management.
Question 25
2 out of 2 points
Which group would have a financial incentive to implement CDS?
Selected
Answer:
a.
Depends on CDS and healthcare payment model
Response
Feedback: Whether a particular stakeholder group has a financial incentive to
implement CDS depends on the specific CDS under consideration and
the governing healthcare payment model in place.
Question 26
2 out of 2 points
Which item is an example of information we might find in an EHR’s clinical data
repository?
Selected
Answer:
a.
The result of a patient’s microbiology lab test
Response
Feedback: The result of a patient’s microbiology lab test is an example of
information we would find in a CDR. The other items would be found in
other administrative databases.
Question 27
2 out of 2 points
The Health Information Management Systems Society (HIMSS) developed an EMR
adoption model that includes eight stages toward creating a paperless patient record
environment. All application capabilities within each stage must be operational before
the next stage can be achieved. Your organization has implemented systems for
Stages 1 and 2. Which system should your organization consider as Stage 3
adoption?
Selected
Answer:
a.
Nursing/clinical documentation (flow sheets) and clinical decision
support
Response
Feedback
:
Stage 1 includes the installation of ancillaries (lab, radiology, pharmacy).
Stage 2 includes clinical data repository (CDR), controlled medical
vocabulary, and clinical decision support system (CDSS) and may also
include document imaging and health information exchange. Stage 3
would require clinical documentation (flow sheets), CDSS (error
checking), and a picture archiving system (PACS) available outside
radiology.
Question 28
2 out of 2 points
Knowledge is the point of convergence across the areas of:
Selected
Answer:
d.
evidence-based practice, improvement, and
informatics.
Response
Feedback: Knowledge is the point of convergence across the areas of evidence-
based practice, informatics, and improvement. None of the other
answers include all of these aspects.
Question 29
2 out of 2 points
A vendor master file is:
Selected
Answer:
c.
a list of suppliers used by the organization.
Response
Feedback: The terms vendor and supplier are synonymous, so a vendor master
file is a list of suppliers used by the organization.
Question 30
2 out of 2 points
Which is a significant challenge to technical infrastructures in healthcare
environments?
Selected
Answer:
a.
Implementing a data repository that will be able to handle unanticipated
new information and advances in medicine
Response
Feedback
:
A significant challenge to technical infrastructure in healthcare
environments is implementing a data repository that will grow with
changes in medicine and the information needed to be stored. The other
choices describe usability, user training, and organizational policy.
Question 31
2 out of 2 points
A method for exchanging patient data among healthcare organizations that is
endorsed by the federal government is:
Selected
Answer:
c.
implementing a secure internet connection using components of the
eHealth Exchange.
Response
Feedback
:
The eHealth Exchange (formerly the Nationwide Health Information
Network) is a method for exchanging data endorsed by the federal
government and used by organizations from all 50 states as well as four
federal agencies. The other methods listed are not considered safe and
confidential, and the federal government does endorse health information
sharing.
Question 32
2 out of 2 points
A financial information system (FIS) includes:
Selected
Answer:
c.
accounts receivable management, accounts payable management, and
fiscal reporting management.
Response
Feedback: FISs are not involved with the clinical management of care. Accounts
receivable management, accounts payable management, and fiscal
reporting management are financial management processes and
included in an FIS.
Question 33
2 out of 2 points
The top three uses of the U.S. Army’s telehealth network include all of the following
EXCEPT ________________.
Selected
Answer:
d.
otolaryngology
Response
Feedback: The biggest use of the U.S. Army’s telehealth network is for behavioral
telehealth, followed by cardiology and dermatology. While telemedicine
is making inroads in otolaryngology, it is not among the top three uses
for the U.S. Army.
Question 34
2 out of 2 points
UTAUT is a theory of:
Selected
Answer:
b.
acceptance and use of technology.
Response
Feedback: The unified theory of acceptance and use of technology (UTAUT)
assesses factors associated with effective use.
Question 35
2 out of 2 points
Return on investment (ROI) in financial information systems (FISs) is challenging
because:
Selected
Answer:
d.
patient accounting is considered an intangible
asset.
Response
Feedback
:
Decision makers may have a more challenging time realizing the return
on investment or understanding the importance of the investment in
FISs, since information technology software applications, such as patient
accounting or revenue, are considered intangible assets.
Question 36
2 out of 2 points
The primary characteristics used to analyze an open system include:
Selected
Answer:
a.
structure, purpose, and functions.
Response
Feedback: Using these three characteristics, one can determine why the system
exists, what functions it performs to achieve its purpose, and how it is
structured to achieve its purpose.
Question 37
2 out of 2 points
In a social network analysis, each node is usually a(n):
Selected
Answer:
a.
individual or unit of analysis.
Response
Feedback: The patterns of connection between people in a social network analysis
(SNA) are displayed as a visual network of nodes and lines. Nodes are
individuals, and lines are interactions between them.
Question 38
2 out of 2 points
Of the following, which of these steps in the CDC’s six-step program evaluation
framework comes first?
Selected
Answer:
b.
Engage stakeholders
Response
Feedback: The CDC’s six-step program evaluation framework is (1) engage
stakeholders; (2) describe the program; (3) focus the evaluation design;
(4) gather credible evidence; (5) justify conclusions; and (6) ensure use
and share lessons learned.
Question 39
2 out of 2 points
You are asked to justify the creation of the first public health informatics (PHI)
program in your jurisdiction by emphasizing its actual benefits. One such benefit is
that:
Selected
Answer:
d.
current PHI can enhance public health surveillance such as identifying
clusters of diseases.
Response
Feedback: While all four options are relevant issues in PHI, only the fact that PHI
can identify and target clusters of diseases for treatment and action is an
actual benefit (or “plus”) to the community of adding this new program.
Question 40
2 out of 2 points
Which system is recommended as a method to address patient safety and reduce
errors that occur during the actual administration of medicines?
Selected
Answer:
a.
Barcode medication administration
(BCMA)
Response
Feedback
:
Barcode medication administration (BCMA) is a method used to address
patient safety and reduce errors that occur during the actual
administration of medicines. CPOE is used to decrease transcription
errors during the ordering process. ePrescribing is also used by the
physician to order the medication (not administer). The eMAR is used to
document the medications that are given.
Question 41
2 out of 2 points
Why have most clinical decision support (CDS) systems not shown to significantly
impact patient outcomes in clinical trials, despite the fact that a majority of systems
have been shown to significantly improve care processes?
Selected
Answer:
a.
Many CDS system evaluation trials are underpowered to detect
changes in care outcomes.
Response
Feedback: The sample sizes of many CDS system evaluation studies were too
small or conducted with too short of a time period to detect changes in
care outcomes.
Question 42
2 out of 2 points
When did formalized home health and community-based systems originate in the
United States?
Selected a.
Answer: 1800s
Response
Feedback
:
Early home health services originated in the United States in the 1800s
and were based on the district nursing model developed in England.
Often, initial programs evolved into visiting nurse associations. Home
health services increased and changed considerably after Medicare was
enacted in 1965.
Question 43
2 out of 2 points
Public health differs from clinical practice in important ways. Which statement reflects
the differences?
Selected
Answer:
d.
Public health is focused on the prevention and health of populations
before they are ill.
Response
Feedback: Public health is concerned with the health of populations and
communities rather than the individual, and therefore its focus is on the
health and prevention of illness of populations.
Question 44
2 out of 2 points
Public health systems have implemented vocabulary and messaging standards, are
used to make public health decisions in a clinical setting, and provide data for public
health policy. One of the best examples of a public health system that does all of
these is:
Selected
Answer:
a.
immunization information systems.
Response
Feedback
:
Immunization information systems exemplify public health systems that
implement vocabulary and messaging standards, that are used to make
public health decisions in a clinical setting, and that provide data for
public health policy. The others lack one or more of the stated elements.
Question 45
2 out of 2 points
Which two hurdles does the STAR Model address in employing evidence-based
practice?
Selected
Answer:
a.
The volume and form of knowledge
Response
Feedback: The STAR Model addresses two major hurdles in employing evidence-
based practice (EBP). These two hurdles are the volume of current
professional knowledge and the form of knowledge that healthcare
professionals attempt to apply in practice.
