Contemporary Nursing Issues Trends and Management 5th Edition Cherry Jacob Test Bank
|ISBN-13: 978-0323069533||ISBN-13: 978-0323069533|
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Cherry: Contemporary Nursing, 5th Edition
Chapter 14: Information Technology in the Clinical Setting
- Consumers are concerned with security issues related to their confidential health information when placed in an electronic health record (EHR). However, when the security of the EHR is compared with that of paper-and-pencil records, the EHR is:
|d.||not comparable with the paper-and-pencil record.|
Computer-based patient record systems, such as EHRs, provide better protection than paper-based systems. The EHR allows only authorized users to view data, and access to records can be audited for inappropriate use.
Paper-and-pencil medical records have no means of limiting who views the health information or determining how often confidentiality is breached.
The EHR must comply with strict laws and regulations related to confidentiality, as well as to the aforementioned security functions.
The paper-and-pencil record cannot ensure the same level of security as found in computer-based systems.
DIF: Comprehension REF: Page 299
- When patient-focused clinical information systems (CISs) are compared with department-focused CISs:
|a.||the nurse who wishes to review how a patient’s plan of care deviated from the established criteria would use the patient-focused CIS.|
|b.||the patient-focused CIS would stand alone because of confidentiality.|
|c.||order entry always is done with the department-focused CIS.|
|d.||results reporting is done with the department-focused CIS.|
The patient-focused CIS includes order entry, results reporting, clinical documentation, care planning, and clinical pathways.
Early billing systems stood alone and were a type of department-focused CIS; the department-focused CIS also must protect and maintain confidentiality.
Order entry is included in the patient-focused CIS, along with care plans and clinical guidelines.
Results reporting is patient specific and is part of the patient-focused CIS.
DIF: Knowledge REF: Page 295
- During a search for the term informatics, when the nurse finds the domain “.edu,” the site is affiliated with a(n):
|d.||Internet service provider.|
The domain of an educational institution is .edu.
The domain of a government site is .gov.
The domain of a commercial site is .com.
The domain of an Internet service provider is .net.
DIF: Knowledge REF: Page 312
- When paper-and-pencil medical records are compared with computer-based records:
|a.||paper-and-pencil records provide controls to determine who has viewed the health information.|
|b.||information contained in a paper-and-pencil record has the capability of being more in-depth than that found in computer-based records.|
|c.||patients have the right to know that the confidentiality of their records is strictly maintained, regardless of the type of medical record used.|
|d.||patients must sign for each item of information released on the computer record.|
Regardless of the type of record used, the Health Insurance Portability and Accountability Act (HIPAA) protects the confidentiality of the patient’s medical information and imposes legal consequences for those who breech confidentiality.
The computer-based record has security controls that limit or prohibit entry by unauthorized users and that track attempts to access the record.
Information in the computer-based record is more comprehensive than that found in a linear paper record.
Patients may sign a release one time for information to be released to entities such as an insurance company.
DIF: Application REF: Pages 298, 302
- A nurse is preparing a scholarly publication on the prevalence of hepatitis A worldwide. The most efficient and effective means of conducting an Internet search to gather information for this publication is to use:
|a.||a search engine such as Google or Yahoo.|
|b.||a consumer health website.|
|c.||a decision support system.|
MEDLINE is one of the scientific and research scholarly databases, and it would be most appropriate for use in gathering information for a scholarly publication.
If the information is broad and general, one would use a search engine such as Google or Yahoo.
If the nurse is collecting data that are to be presented to the consumer, one would use a consumer health website.
A decision support system allows for the input of data such as clinical manifestations and medications and, with the use of a link to a knowledge software system, is able to produce a decision.
DIF: Application REF: Page 310
- A nurse who is majoring in informatics learns that clinical information systems (CISs) can be department focused rather than patient focused. Department-focused CIS would include:
|a.||a multidisciplinary tool that prescribes routine interventions for a group of patients with similar diagnoses; it includes expected outcomes at each stage.|
|b.||Promethazine (Phenergan) 12.5 mg intravenously every 4 hours as needed for pain.|
|c.||Blue Cross/Blue Shield, point of service #TN09874.|
|d.||“Risk for injury related to altered mobility.”|
Department-focused CIS contains information on a particular department, in this case, the billing department.
A multidisciplinary tool that prescribes routine interventions for a group of patients with similar diagnoses is a critical pathway that is patient-focused.
Physician orders are patient specific and are part of the patient-focused CIS.
“Risk for injury related to altered mobility” is a nursing diagnosis that is patient focused.
DIF: Analysis REF: Page 295
- A consumer is learning about electronic health records at a local health fair and states, “I am worried that someone can read my health information and I really don’t understand the difference between privacy and confidentiality.” The nurse explains that an example of confidentiality is as follows:
|a.||a pledge states, “I will hold matters pertaining to my patients in strict intimacy.”|
|b.||a patient does not tell the physician that he has been treated for a sexually transmitted disease.|
|c.||a teenager sustains a broken arm and in the emergency department withholds information about her use of recreational drugs.|
|d.||medical records are locked in cabinets to prevent unauthorized users from accessing patient information.|
Confidentiality is keeping private the personal information that was given to a health care provider, unless others have a legitimate need to know.
The right of an individual to keep information about himself or herself from being disclosed to anyone else, including the health care provider, is known as privacy.
The patient has chosen not to divulge personal information to the health care provider; this is privacy.
Locking medical records in cabinets pertains to controlled access, which is security.
DIF: Application REF: Page 299
- A physician has installed a computer-based patient records system. An outside care provider who requests medical information must obtain the patient’s signed consent and then is assigned a password to gain access to the medical information. A monthly audit is conducted to determine for whom and for what purpose patient records have been accessed. This protection is referred to as:
Security is the limitation of access to health care information through passwords and other precautions.
Privacy is the right of the patient or individual to not divulge personal information to the health care provider or others.
Confidentiality is keeping personal matters of a patient private from those who do not have a legitimate need to know.
Data capture refers to collecting and entering data into a computer system.
DIF: Application REF: Page 299
- A nurse walks up to a computer in the hallway and presses the index finger to the sensor, thereby gaining access to patient data. A few moments later another nurse performs the same steps and is granted access. A visitor who is watching from a room walks over and places the index finger on the sensor, only to receive an “error and access denied” message. Security is being maintained by:
Biometric fingerprint identification uses personal characteristics to allow access to health information.
Robot technology includes the delivery of simulation for rehabilitation, couriers, and language translators and even can be used to interview and examine patients at a distance.
Telehealth involves providing health care for patients located a distance from the provider.
Ubiquitous computing refers to the era when computers are so immersed in everyday life that they become invisible to users.
DIF: Application REF: Page 303
- A nurse who is teaching a class to introduce telehealth to the staff would include which example?
|a.||A robot performs menial housekeeping chores for an invalid patient.|
|b.||A computer software program alerts the nurse or physician who is reviewing orders that an order for a new drug can cause synergy of the theophylline inhaler.|
|c.||A physician speaks into a computer, and the admission history is recorded and saved in the patient file.|
|d.||A nurse watches remotely from California while a patient in Wyoming performs peritoneal dialysis to ensure that all steps are being followed correctly.|
Telehealth is the delivery of care to a patient who is at a distance from the health care provider.
Robotic technology involves the delivery of sensorimotor simulation for rehabilitation; language translators can be used to interview and examine patients at distance.
Point-of-care drug references and alerts that can be downloaded into PDAs and laptops may decrease drug errors but are not considered a component of telehealth. Voice communication systems, which include voice recognition, provide security through recognition of voice in dictation of histories, physicals, and notes related to patient progression.
DIF: Application REF: Page 303
- An advanced practice nurse inputs into a computer software program the following clinical manifestations: open wound with tibia exposed, petechial hemorrhage, and temporary loss of consciousness. The computer diagnosis of fat emboli is generated by a system known as:
Decision support systems are computer-based information systems that include knowledge-based systems designed to support clinical decision making.
Telehealth allows the provider to treat patients from a distance through electronic submission of data.
Robotic technology includes the delivery of sensorimotor simulation for rehabilitation, language translators, and technology to interview and examine patients at a distance.
Biometric technology is the use of personal characteristics such as fingerprints and hair to gain access to a secure site that contains patient information.
DIF: Application REF: Pages 294, 298-299
- A nurse is preparing a presentation using different websites to collect information. The nurse is concerned that contact information and the author’s credentials are not listed for one of the websites reviewed. Which criterion required to establish a reputable website is missing?
Authority is the criterion that is related to an author’s credentials and background that have prepared him or her to publish on the subject.
Objectivity is the criterion that is related to the site’s purpose, intended audience, and sponsorship and to whether the information is fact or opinion.
Usability is the criterion that is related to the maneuverability and overall arrangement of the website.
Currency is the criterion that is related to updated information required because of the dynamic state of health care.
DIF: Application REF: Pages 310-312
- A nurse is interested in locating reliable information concerning noninvasive blood glucose monitoring. Information is located, and the author is a scientist who conducted studies within the last year on the effectiveness of a particular noninvasive blood glucose monitor. The scientist received funding from a pharmaceutical company to support the studies. The URL indicates the pharmaceutical company site.com. The nurse is concerned about this information’s:
Sites sponsored by organizations such as pharmaceutical companies may influence the content.
The author, in this case the researcher for the pharmaceutical company, has authority on the topic.
Research studies are referenced.
The study was conducted within the last year.
DIF: Application REF: Pages 310-312
- Software programs that process data to produce or recommend valid choices are known as ____________________.
decision support systems
Decision support systems use software programs that process data to produce or recommend decisions by linking with an electronic knowledge base.
DIF: Knowledge REF: Pages 294, 298-299
- In the future, when computers have become so commonplace that they are unnoticed but are essential to everyday living, we will have entered the era of ____________________ computing.
In phase 3, the ubiquitous phase, computers will be involved in every aspect of life, making users unaware of their presence.
DIF: Comprehension REF: Page 304