Grohar-Murray TIF
Chapter 17: Informatics in Nursing
Learning Objective 1
Define Informatics.
1. The nurses are discussing how nursing informatics can be used to assist nurses with their
work. Which of the following statements indicates that a nurse requires more education about
this subject?
1. “I can quickly go online to help answer questions that I have about specific client
issues that are occurring on the unit.”
2. “I can use the computers to input data that I have collected about the number of
clients with central lines on this unit.”
3. “I’ve been monitoring the number of nosocomial infections that have been tracked
back to this unit for the last 3 years.”
4. “I can ask the computer to analyze the data and tell me specifically what to do about
an issue.”
2. The nurses do not have consistent online access to clinical practice guidelines due to a poor
connection to the Internet. The novice nurse is caring for a postoperative thyroidectomy client
during the night shift. The other nurses on the unit are inexperienced, and are unable to offer
advice about how to care for this type of client. Which of the following could occur as a result?
Select all that apply.
1. The nurse does not monitor the client for signs and symptoms of hypocalcemia.
2. The nurse ambulates the client three times during the first postoperative day.
3. The nurse carefully listens for bowel sounds in all four quadrants.
4. The nurse does not ensure that the incision site and the client’s neck are maintained
in a “straight” unbent position.
5. The client falls in the bathroom.
3. The nurses are planning the nursing informatics system for the new hospital. Which of the
following items would be appropriate to include for nurses to routinely use in client care areas?
Select all that apply.
1. Supercomputers
2. Personal digital assistants
3. Mainframes
4. Central computer housed in Data Processing
5. Laptop computer
4. Several nurses are discussing how computers work to assist nurses with storing client
information. One of the nurses asked a designated superuser nurse about how items are stored in
the computer. Which of the following is the superuser nurse’s best response?
1. “Random–access memory is how the computer stores specific programs.”
2. “The operating system allows us to save and print documents.”
3. “Read-only memory is how we store specific client documents.”
4. “The motherboard controls the hard drive and disk drives.”
5. The nurses are discussing nursing informatics and how it affects their ability to perform their
jobs. Which of the following statements indicates the need for further education?
1. “I think it’s great that we’re all on the same page because with nursing informatics,
everyone is using the same language.”
2. “It helped when we wanted to implement the new ventilator-associated pneumonia-
prevention guidelines because we had real client outcome data to support using the
new interventions.”
3. “The nurse manager was quickly able to determine that the average length of stay has
decreased to 3.2 days from 3.7 days.”
4. “We haven’t been trained yet on the new documentation system, but we should go
ahead and use it anyway.”
6. The nurses are discussing how nursing informatics has changed their lives. Which of the
following statements indicates that the nurse is least likely to be utilizing nursing informatics?
1. “I don’t have to attend classes at the college. I can do the work to get my graduate
degree from my den.”
2. “If a tornado came through, all of our records would be lost.”
3. “The computer notified me that I was about to give the client an ordered medication
to which the client is allergic.”
4. “I printed off some new information about controlling hypertension for my client.”
7. The nurses are discussing the recent sighting of a tornado in their small community, and how
the health care organization could be affected. In which of the following ways could nursing
informatics be useful in this situation? Select all that apply.
1. Telehealth could be utilized to help diagnose and treat victims of a natural disaster.
2. All volunteers, regardless of medical training, will be able to quickly understand how
to use nursing informatics to help victims.
3. After victims are identified, the electronic health record could be accessed to help
discover pre-existing conditions that might be helpful to understand prior to planning
treatment modalities.
4. Online clinical practice guidelines could be accessed to ensure proper treatment of
victims.
5. Nursing informatics provides easily used security measures to prevent people from
looking at unauthorized data from electronic health records.
8. The home health nurse is discussing the client’s inability to control serum glucose levels
adequately. Which of the following actions should the nurse do to best help the client?
1. The nurse should visit www.aace.com to access the newest guidelines regarding
diabetes mellitus.
2. The nurse should develop a research study aimed at determining which interventions
could help the client reduce serum glucose levels most effectively.
3. The nurse should report the increased serum glucose levels to the administrator of the
home health organization.
4. The nurse should visit www.nhlbi.nih.gov to access the newest clinical practice
guidelines regarding diabetes mellitus.
9. The nurse is visiting the home of the client in response to the client’s blood pressure, which
has risen to 196/102. The home health care nurse has lost wireless connection to the Internet
because the client lives in a rural area. What is a consequence of the lack of access to the
Internet?
1. The nurse will be unable to assist the ambulance personnel as they try to navigate
their way to the client’s house.
2. The nurse will be unable to access the National Institutes of Health hypertension
treatment guidelines.
3. The nurse will be unable to charge the client the appropriate amount for providing
treatment.
4. The nurse’s manager will be unable to use the client’s information in a research study
about hypertension.
10. The health care organization’s computers have not been linked via networks in the
appropriate manner, and do not transmit timely data well between users or easily between
networks. Which of the following statements indicates a real consequence of this type of system?
1. “I have had to enter the information about suctioning my client in three different
places in the documentation system.”
2. “I think this electronic health record is no longer a legal document.”
3. “The security of the personal health information in the system is poor.”
4. “This computer system will no longer flag drug allergies for the client.”
11. The nurses are discussing the use of electronic health records. Which of the following
statements indicates the need for further education?
1. “It is really inexpensive for the health care organization to implement new systems.”
2. “The system can flag potential drug interactions that my client could experience.”
3. “I only have to document the bath in one place.”
4. “Anyone can develop the system, but nurses have to use it, so it’s better if practicing
nurses have input.”
12. The nurses are discussing ethical issues in relation to nursing informatics. Which of the
following ethical issues might develop as a result of nursing informatics? Select all that apply.
1. The Medical Records Department employee informed one of his friends about a
hospitalized client’s address. The house was burglarized while the client was
hospitalized.
2. The insurance company denied coverage to a client due to an undiagnosed pre-
existing condition. The insurance company deduced that the client had diabetes
mellitus after the client’s glucose levels were consistently above 140 mg/dL during
hospitalization.
3. A computer hacker stole information from the hospital’s computerized billing system
and used the information to obtain a credit card in a client’s name.
4. The client’s sister–in-law is an employee in the laboratory at the hospital, and
discovered that the client had been admitted. The employee told the client’s brother
about the admission and specific laboratory results that indicated that the client was
HIV-positive.
5. The information from the client’s admission was used in research by the nurse
manager to reduce the unit’s average length of stay and increase quality of care.
13. Nursing informatics will continue to shape changes in nursing. Which of the following could
occur as a result of continued advances in this field?
1. Interdisciplinary communication could become easier.
2. Nursing education programs could return to classroom settings.
3. Paper records could be required among all health care facilities to document client
care.
4. Confidentiality issues could decrease with advancements in this field.
14. The novice nurse is questioning a designated superuser about advancements in nursing
informatics and how they might affect research in nursing. Which of the following is the
superuser nurse’s best response?
1. “It will continue to be difficult to show the relationship between client outcomes and
staffing ratios.”
2. “Nursing interventions will be more easily evaluated to see how they affect client
outcomes.”
3. “There still will be no way to adequately prove that an increase in nurses’ educational
levels translates to better client outcomes.”
4. “There is still a certain amount of statistical work that will need to be performed with
paper and pencil, even with advancements in nursing informatics.”
15. The nurse manager notes that there has been a significant increase in the number of clients
who have been given the wrong medication on the unit during the last 4 months. The nurse
manager uses nursing informatics to formulate rationale for why the problem is occurring. Which
of the following questions should the nurse manager answer using nursing informatics? Select all
that apply.
1. Was there a specific nurse who was involved in these incidents?
2. How many clients in the health care organization were given a wrong medication
during the last month?
3. At what time of day did each of the incidents occur?
4. What is the average length of stay on the unit?
5. What was the nurse-to-client ratio during the shifts when the incidents occurred?
