D220 CPT Questions and Answers Review Guide

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 initiate contact precautions is driven by objective, verifiable evidence within the electronic medical record (EMR). The most influential data element is a prior laboratory culture confirming MRSA colonization or infection. A documented positive MRSA culture provides definitive proof of transmissible risk and aligns with infection prevention protocols designed to limit the spread of multidrug-resistant organisms within healthcare settings.

Other EMR components, while clinically relevant for overall patient care, do not independently justify contact precautions. Notes describing wound care techniques, such as wet-to-dry dressings, are not specific to MRSA management. Medication administration records may show antibiotic therapy, but without organism-specific confirmation, they cannot establish MRSA risk. Similarly, nursing documentation of localized symptoms may reflect non-MRSA-related conditions.

Option	Source of EMR Data	Relevance to MRSA Contact Precautions	Rationale
A	History and physical notes	Not relevant	Dressing types are not organism-specific.
B	History and physical notes (duplicate)	Not relevant	Repetition does not add clinical justification.
C	Medication administration record	Indirect relevance	Antibiotics may target various infections.
D	Laboratory report	Highly relevant	Confirms MRSA presence and transmission risk.
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?

Radiology findings indicating lung consolidation are the most compelling trigger for droplet precautions. Consolidation commonly reflects infectious pneumonia, a condition known to spread through respiratory droplets. This objective diagnostic evidence supports immediate infection control interventions to protect staff and other patients.

Other EMR findings provide supportive context but lack specificity. A history of asthma reflects a chronic, noninfectious condition. Elevated white blood cell counts suggest infection but do not identify transmission route. Wheezing, while respiratory in nature, does not confirm a contagious etiology.

Option	EMR Data Source	Indicator for Droplet Precautions	Rationale
A	Complete health history (asthma)	No	Asthma is non-contagious.
B	Radiology impression	Yes	Consolidation suggests infectious pneumonia.
C	Complete blood count	No	Nonspecific indicator of infection.
D	Nursing flowsheet (wheezing)	No	Does not confirm droplet transmission.

What EMR data supports an influenza diagnosis in a patient with fever, chills, and muscle aches?

Laboratory test results documenting influenza virus detection provide definitive diagnostic confirmation. Rapid antigen testing or polymerase chain reaction (PCR) assays recorded in the EMR allow clinicians to distinguish influenza from other viral or bacterial illnesses, enabling timely antiviral therapy and appropriate isolation measures.

Symptom documentation and imaging studies can strengthen clinical suspicion but are insufficient for diagnosis without laboratory validation.

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 primary purpose of a CDS alert identifying obstructive sleep apnea risk is to improve patient safety. Sleep apnea significantly increases perioperative risks, including airway compromise and anesthetic complications. Early identification enables clinicians to modify anesthesia plans, enhance monitoring, and reduce adverse surgical outcomes.

Although regulatory compliance and risk reduction are secondary benefits, the central goal remains prevention of patient harm.

What should a nurse assess to evaluate a newly diagnosed heart failure patient’s ability to engage in care and education?

A comprehensive assessment of barriers to engagement is essential. Nurses should evaluate cognitive function, language proficiency, health literacy, financial limitations, and social determinants that may affect the patient’s capacity to understand and adhere to treatment recommendations. These factors directly influence the effectiveness of education and self-management strategies.

Motivation and family involvement are valuable but do not fully represent the patient’s functional ability to participate in care.

Which low-cost marketing method should a rural hospital use to educate its community and promote patient engagement?

Social media platforms represent the most cost-effective outreach strategy for rural hospitals. They allow rapid dissemination of health information, enable two-way communication, and reach broad audiences without the expense associated with traditional advertising. Digital engagement also supports timely updates and targeted health education initiatives.

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 initial step should involve direct engagement with staff through interviews or observations. Understanding why clinicians rely on printed materials helps identify workflow inefficiencies, usability concerns, or training gaps within the EHR. Addressing root causes fosters safer, sustainable practice changes compared to immediate punitive or restrictive measures.

Who should be included in a committee tasked with reviewing and updating hospital order sets?

An interdisciplinary committee ensures clinical accuracy, usability, and regulatory alignment. Diverse expertise supports evidence-based updates and system-wide adoption.

Role	Primary Contribution
Informatics specialists	System functionality and technical integrity
Providers	Clinical evidence and practice standards
Nurses	Workflow practicality and patient care insights
Nursing leadership	Governance, oversight, and resource support

How should an informatics nurse determine the best mobile workstation device for nursing staff?

Direct observation of nursing workflows is the most effective method for determining appropriate device selection. Understanding how nurses interact with technology during patient care ensures that devices enhance efficiency, reduce documentation burden, and support clinical decision-making. Cost, security, and infection control considerations should follow workflow analysis.

Which nurse comment about hospital information systems (HIS) indicates a misunderstanding needing correction?

The statement that automated systems increase nursing errors reflects a misconception. Hospital information systems are designed to reduce errors through standardization, automation, and real-time clinical decision support. Properly implemented HIS improve accuracy, efficiency, and patient safety rather than undermine them.

What is the top priority security concern when using virtualized storage in clinical trial matching tools at an ambulatory oncology facility?

The foremost concern is the potential for unauthorized access or data breaches involving sensitive patient health information. Oncology data are particularly sensitive, requiring robust cybersecurity safeguards to ensure confidentiality, integrity, and compliance with privacy regulations.

What is the advantage of using standardized terminology in healthcare data reporting?

Standardized terminology enables reliable benchmarking and comparison of outcomes across healthcare organizations. Consistent data definitions support quality improvement initiatives, regulatory reporting, interoperability, and population health analysis, ultimately contributing to improved patient outcomes.

How can an informatics nurse specialist appropriately use knowledge discovery in databases (KDD) within healthcare?

Knowledge discovery in databases allows informatics nurse specialists to analyze large datasets to identify trends, correlations, and outcome patterns related to nursing practice. These insights inform evidence-based improvements, policy development, and quality initiatives, complementing clinical judgment rather than replacing it.

What time frame does CMS use to define repeat patient admissions under the Hospital Readmissions Reduction Program (HRRP)?

The Centers for Medicare & Medicaid Services defines repeat admissions as those occurring within 30 days of discharge. This standardized time frame supports national benchmarking and incentivizes hospitals to improve transitional care and reduce preventable readmissions.

What is the scope of practice for nursing informatics?

Nursing informatics integrates nursing science with information and analytical sciences to manage and communicate data, information, knowledge, and wisdom in nursing practice. The specialty focuses on optimizing health information systems, supporting clinical decision-making, and improving patient outcomes through effective use of technology.

References

Centers for Disease Control and Prevention. (2023). Infection control guidance for healthcare professionals.

HealthIT.gov. (2023). 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.

U.S. Centers for Medicare & Medicaid Services. (2023). Hospital Readmissions Reduction Program (HRRP).

World Health Organization. (2023). Standardization of terminology in health data.