D220 CPT Questions and Answers Review Guide

D220 CPT Questions and Answers Review Guide

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Western Governors University

D220 Information Technology in Nursing Practice

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Date

D220 CPT Questions and Answers Review Guide

A patient with a history of methicillin-resistant Staphylococcus aureus (MRSA) is placed on contact precautions after being admitted to the hospital. How did data in the electronic medical record (EMR) inform this decision?

The decision to place the patient on contact precautions is primarily informed by specific data documented in the EMR. Among the options, the laboratory report from the patient’s last hospitalization that shows a positive specimen culture result for MRSA is the most direct and reliable source. This lab result confirms the presence of MRSA, justifying the use of contact precautions to prevent transmission.

Other EMR data such as the history and physical notes indicating wet-to-dry dressing changes are less relevant because wet-to-dry dressings are not specific to MRSA treatment. Similarly, the medication administration record indicating a course of antibiotics does not specify if these were for MRSA or another infection, and nursing flowsheets noting a swollen elbow with drainage may reflect other conditions not necessarily related to MRSA.

A patient reports shortness of breath, a productive cough, and fatigue. Which data in the electronic medical record (EMR) would inform a nurse to implement droplet precautions?

In determining the need for droplet precautions, the radiology impression report indicating consolidation in bilateral lungs is the most significant finding. Lung consolidation suggests pneumonia, which is commonly caused by infectious agents spread through respiratory droplets, necessitating droplet precautions to prevent disease transmission.

Other data such as a history of asthma, elevated white blood cells, or wheezing on auscultation provide supportive but less direct evidence. Asthma itself does not require droplet precautions, elevated white blood cells are a general marker of infection but not specific to droplet precautions, and wheezing alone does not indicate a contagious respiratory infection.

A patient is suspected of having influenza after presenting with reports of fever, chills, and muscle aches for five days. Which data in the electronic medical record (EMR) provides valuable information to support an influenza diagnosis?

The specimen collection results in the EMR provide the most definitive support for an influenza diagnosis. Laboratory testing can confirm the presence of the influenza virus, either by rapid antigen detection or PCR tests, which guide appropriate treatment and isolation measures.

Other data sources such as radiology impressions, nursing flowsheets, or history and physical notes may provide context or symptom documentation but do not confirm the diagnosis.

An alert pops up in a patient’s electronic medical record (EMR) that the patient is at high risk of obstructive sleep apnea prior to surgery, based on the pre-operative checklist documentation. What is the goal of the clinical decision support (CDS) tool in this scenario?

The primary goal of the CDS tool here is to prevent harm to the patient by identifying risk factors before surgery. Obstructive sleep apnea increases perioperative risks, such as airway obstruction or complications with anesthesia. The CDS alert prompts clinicians to take necessary precautions, such as enhanced monitoring or altered anesthesia plans, thereby improving patient safety.

While improving compliance with federal regulations or decreasing reportable events are important, they are secondary outcomes. The tool’s immediate aim is patient harm prevention.

A nurse is working with a recently hospitalized patient with a new heart failure diagnosis. What should the nurse assess in relation to the patient’s ability to engage?

To assess the patient’s ability to engage in care and education, the nurse should focus on identifying any barriers to the patient’s care. Barriers could include cognitive impairments, language differences, health literacy, or socioeconomic factors that affect understanding and participation in treatment.

While the patient’s willingness to engage and family support are important, they do not fully determine ability. Access to education alone also does not guarantee engagement.

A rural hospital is exploring marketing methods to educate the surrounding community on available services. Which low-cost method disseminates information and promotes patient engagement in today’s population?

Social media platforms offer a cost-effective and rapid method for disseminating information in rural areas. They allow hospitals to reach a broad audience quickly, encourage interaction, and promote patient engagement through targeted content.

In contrast, traditional methods like radio, newspapers, or billboards tend to be more expensive or less effective, particularly in rural settings with low traffic or limited reach.

After implementing a new electronic health record (EHR), an informatics nurse notices staff rely heavily on printed information from the EHR to use as a “worklist” throughout their shift. This is identified as an unsafe practice. What is the nurse’s first course of action in preventing this practice?

The nurse’s first step should be to interview staff to understand why printed reports are being used. This assessment can uncover workflow challenges, usability issues, or other reasons for reliance on printed materials. Addressing root causes is more effective than immediately restricting printing or reporting the issue.

Education on the risks of using printed data and collaboration with leadership would follow after understanding the underlying issues.

A facility uses order sets for common patient diagnoses. When reviewing, a nurse finds that several include outdated treatments. The nurse proposes forming a committee to review order set content yearly. Which staff does the nurse recommend for the order set review committee?

A multidisciplinary team is best suited for reviewing and updating order sets. This group would include healthcare providers, nurses, informatics staff, pharmacists, and possibly other stakeholders. Multidisciplinary input ensures that the most current and evidence-based treatments are incorporated, supporting safe, effective patient care.

A facility is planning to purchase new mobile workstations for nursing staff. An informatics nurse has been assigned to prepare a proposal for this purchase. Which action determines which mobile device is needed?

Observing end users to understand their workflow and device needs is essential. This direct observation helps identify what features and specifications are required, ensuring that the chosen devices enhance efficiency and meet clinical demands.

Other considerations like disinfectability, budget, and security features are important but should follow after identifying user needs.

 Which comment by a nurse on the clinical and hospital information system (HIS) indicates further teaching is required?

The statement “With automated machines and computers, the number of nurses who encounter errors has increased” reflects a misunderstanding. In fact, health information systems aim to reduce errors by automating processes, standardizing documentation, and providing clinical decision support.

Other comments correctly recognize improvements in inventory management, real-time access to records, and the positive impact of HIS on community-focused care.

A nursing leader in an ambulatory oncology facility is reviewing a clinical trial matching tool used for screening efficiency and patient recruitment. The key feature involves virtualized storage. Which threat should be a priority consideration?

The foremost concern is the potential risk of a data breach involving sensitive patient medical information stored virtually. Ensuring data security and confidentiality is critical, especially with virtualized systems that may be vulnerable to unauthorized access.

Other potential issues like resistance to new technology or delays in care are secondary and generally manageable with proper training and workflow design. Healthcare organizations are encouraged to use standard language in the data they report. What is the benefit of standardizing the data each organization reports?

Standardizing data enables organizations to benchmark performance effectively. Using uniform terminology and formats allows for meaningful comparison across institutions, facilitating quality improvement initiatives and regulatory compliance.

While visualization methods like scatterplots or fishbone diagrams are helpful, the key advantage of standardization lies in benchmarking and comparability.

 What is one way an informatics nurse specialist can use knowledge discovery in databases (KDD) appropriately within the healthcare field?

An informatics nurse specialist can use KDD to explore information and knowledge related to nursing practice. This includes analyzing large datasets to identify patterns, outcomes, or areas needing improvement, thereby supporting evidence-based practice and enhancing patient care.

Limiting treatments, creating individualized care plans, or writing clinical policies are better addressed through clinical judgment and other processes, rather than solely through KDD.

What is the time period CMS uses when defining repeat patient admissions according to the Hospital Readmissions Reduction Program (HRRP)?

The Centers for Medicare & Medicaid Services (CMS) uses a 30-day period to define repeat patient admissions under the HRRP. This window is used to measure hospital readmission rates, aiming to reduce avoidable readmissions and improve care quality.

What is the nursing informatics scope of practice?

Nursing informatics integrates nursing science with information and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice. This interdisciplinary field supports clinical decision-making and enhances patient outcomes by optimizing information management.

It does not include data engineering or behavioral health science as primary components, 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

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