chapter 11: IT and pharmtherapeutics

Question 1

1. Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to:
2. Search for information using the most common search engines
3. Serve as content experts in developing, implementing, and evaluating information systems
4. Write programs to assure the integrity of health information
5. Use information technology to prescribe drugs

Answer 1

2. Serve as content experts in developing, implementing, and evaluating information systems

Question 2

2. You are going to prescribe a drug and the electronic health record (EHR) alerts you that there is a potential drug–drug interaction. The alert is generated by:
3. The Food and Drug Administration MedWatch system
4. TOXNET, the National Institutes of Health alert system
5. The EHR clinical decision support system
6. Lexicomp, a commercial medication alert system

Answer 2

3. The EHR clinical decision support system

Question 3

3. Which of the following is a primary benefit of the use of computerized provider order entry for patient medications?
4. Reduces time that prescribing drugs takes
5. Eliminates the need to chart drugs prescribed
6. Decreases prescribing and transcription errors
7. Helps keep the number of drugs prescribed to a minimum

Answer 3

3. Decreases prescribing and transcription errors

Question 4

4. A number of barriers and concerns exist before the goals of a safe and efficient information technology (IT) system can be realized. Which of the following is NOT a barrier to adoption and use of IT in prescribing drugs?
5. Cost of initial setup
6. Access to highly skilled experts
7. Compatibility between systems
8. Patient confidentiality risks

Answer 4

2. Access to highly skilled experts

Question 5

5. EHRs:
6. Are being discouraged by the Centers for Medicare and Medicaid Services due to cost issues
7. Allow for all patient data to be centralized in one location for access by multiple providers
8. Use macros and templates to individualize care
9. Use standardized software to facilitate interoperability between systems

Answer 5

2. Allow for all patient data to be centralized in one location for access by multiple providers

Question 6

6. Factors that facilitate keeping patient information confidential in an electronic health record (EHR) system include:
7. Designing software so that only those who need the information can gain access
8. Requiring providers to log off at the end of the clinical day
9. Keeping a file of the login and password information for each provider in a secure place
10. Having patients sign informed consent documents to have their data on an EHR

Answer 6

1. Designing software so that only those who need the information can gain access

Question 7

7. Decision support systems often provide medication alerts that tell the prescriber:
8. Patient history data with a summary of their diagnoses
9. The usual dosage for the drug being prescribed
10. The patient’s latest laboratory values, such as potassium levels
11. Potential drug-to-drug interactions with other medications the patient is taking

Answer 7

4. Potential drug-to-drug interactions with other medications the patient is taking

Question 8

8. Prescribers have been shown to override a medication alert about a patient’s allergies when:
9. The history showed that the patient had tolerated the medication in the past
10. The benefit outweighed the risk
11. The medication was therapeutically appropriate and needed
12. All of the above

Answer 8

4. All of the above

Question 9

9. The use of information technology for quality improvement in pharmacotherapeutics includes:
10. Incorporating the use of “apps” into all patient encounters
11. Tracking data trends within the practice via the electronic health record database
12. Informing patients that they have access to their medication list via the Internet
13. Using macros for individualizing patient care management

Answer 9

2. Tracking data trends within the practice via the electronic health record database

Question 10

10. The advantage of using information technology for patient education includes:
11. The ability to track the number of times you have given the patient the same instructions regarding their medication
12. Standardized and individualized patient education that is simultaneously recorded into the patient record
13. Easy access to private patient information specific to populations with a similar diagnosis
14. The ability to download and interpret patient information in multiple languages, easily and accurately

Answer 10

2. Standardized and individualized patient education that is simultaneously recorded into the patient record

Question 11

11. One barrier to use of the Internet for both prescribing and for patient teaching is:
12. Lack of free public access to the Internet
13. Age, with older adults rarely understanding how to use a computer
14. Web pages and hyperlinks may change, be deleted, or be replaced
15. Few Web sites with information about drugs are free

Answer 11

3. Web pages and hyperlinks may change, be deleted, or be replaced

Question 12

12. Information technology can be a time-saving device in a busy practice if it is used wisely. One way to make it a help rather than a hindrance is to:
13. Prioritize what is needed information and avoid spending time reading “interesting” information not central to the problem at hand
14. Integrate professional and personal searching so that the same browser does not need to be accessed repeatedly
15. Check e-mail frequently so that patient questions can be addressed promptly
16. Check for viruses, spyware, and malware

Answer 12

1. Prioritize what is needed information and avoid spending time reading “interesting” information not central to the problem at hand

Question 13

13. Data in the electronic health record that the provider reviews prior to a patient encounter varies with the clinic setting. In an urgent care clinic, the provider should review:
14. The patient’s current diagnosis and history
15. Drugs the patient is currently taking
16. Any recent previous encounter for the same problem as this visit and what was done
17. All of the above

Answer 13

4. All of the above

Question 14

14. Information technology (IT) can also be used to interact with a patient between encounters. Which of the following statements about such interactions is true?
15. Patients feel the provider does not care about them if they are not seen in a face-to-face encounter.
16. Data collected from patients between encounters via IT is less accurate and complete.
17. Collecting data between encounters via IT may mean a more efficient face-to-face encounter.
18. Between encounters is a good time to collect screening data.

Answer 14

3. Collecting data between encounters via IT may mean a more efficient face-to-face encounter.

Question 15

15. Discharge summaries using information technology have several advantages. They can:
16. Replace the need for oral instruction because the patient has printed material to read at home
17. Be filed with the patient’s chart to document patient teaching
18. Both 1 and 2
19. Neither 1 nor 2

Answer 15

2. Be filed with the patient’s chart to document patient teaching

Question 16

16. Information technology can also be used for patient teaching during the encounter and after it. The provider can help patients and their families become savvy consumers of health-care information by:
17. Warning them about the questionable quality of health information online
18. Identifying easily used “apps” that patients can use to manage their medications
19. Teaching them how to identify high-quality Web sites and “red flags” signaling inaccurate content
20. All of the above

Answer 16

3. Teaching them how to identify high-quality Web sites and “red flags” signaling inaccurate content

Question 17

17. Incorporating information technology (IT) into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by:
18. Turning the screen around so the patient can see material being recorded
19. Not placing the computer screen between the provider and the patient
20. Both 1 and 2
21. Neither 1 nor 2

Answer 17

3. Both 1 and 2