Realizing Benefits of Prefixes, Word Roots, and Suffixes

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Which of the following is a prefix?
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hyper
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Which of the following is a word root
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nephr
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The term for above the kidney
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suprarenal
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Macro is a ..
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prefix
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in 'thermmometer \"meter\" is
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suffix
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which word part provides the general meaning of the word?
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word root
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toward the head or above the structure
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superior
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In order to realize all the benefits of electronic health records, which of the following represents a common medical language that allows data to be shared?
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Classifications and Terminiologies
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Which of the following utilizes a computer technology that allows physicians to use handheld or personal computer devices to access drug and formularies and transmit prescriptions to a printer or local pharmacy?
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E-Prescribing
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The term used to describe the mobilization of healthcare information electronically across organizations within a region, community or hospital systems is:
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HIE Health Information Exchange
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The purpose of providing guidelines to health professionals and hospitals on how to adopt and use electronic health record technology is to improve the
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quality , safety, and effieciency
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Which of the following agencies is responsible for oversight of the HITECH initiatives to promote meaningful use of electronic health records?
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ONC
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Which is NOT a goal of the American Recovery and Reinvestment Act?
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Improve Access to healthcare in rural areas
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Following the five rights of information management ensures that
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clinicians always have the information they need to make a decision regarding patient care.
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Which of the following is NOT true about the paper medical record?
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Those accessing can be easily tracked
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\"An electronic record of patient health information containing care received in all health facilities\" is the definition of
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EHR
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A friend of a patient asks the nurse if the patient is HIV positive. If the nurse provides this information, what is he or she guilty of?
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Confidentiality
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Access codes, passwords, and key cards are examples of:
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authentication
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Which of the following best describes a firewall?
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Hardware and software that forms a barrier between systems or parts of systems
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You are asked to select the type of type of computer network that best suits your organizational needs. What factors should you take consideration when making this choice?
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Purpose of system, type of hardware, type of organization Budget, type of information sytem, purpose of system End user work flow, purpose of system, available infrastructure All of the above
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Which of the following is true about a standardized healthcare language?
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It facilitates the measure of patient outcomes.
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Health Language 7 (HL7. is an information model that is used to help systems
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share information between information systems.
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Which of the following supports the development of electronic health records across the lifespan?
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Standardized healthcare languages
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CDS Systems are designed to..
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Assist the clinician in making decisions
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Which of the following activities supports global healthcare networking?
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interoperable clinical information systems
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A computer is:
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A system with a processor, memory, storage, keyboard, mouse and monitor. A person who computes. An electronic programmable device that inputs, processes and outputs data. An electronic device that is embedded in objects and that controls the object based on certain inputs. All of the above.
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Which of the following are example(s) of personal computers? Select all that apply.
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Desktop Supercomputer Laptop Smartphone
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Which of the following is an input device for a personal computer?
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Mouse
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Where are programs stored when they are running?
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Memory
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What is the most important software that runs on your computer?
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OS
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Which of the following are important factors to consider when selecting a computer?
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Budget Storage needs Application requirements Type of user Mobility needs All of the above
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Where can you find up to date information about current computing systems?
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Recent online reviews Current issues of computer magazines
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What was the oldest tool used for counting and calculations?
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Tally Stick
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What technology was used in the first general purpose electronic computers?
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Mechanical gears
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When was the World Wide Web first developed?
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1989
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What was the first personal computer?
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Altair
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What was the first use of electronic medical records?
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Storing dental records
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All computers have a keyboard, mouse and monitor.
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False
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Dishwasher has an embedded computer?
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True
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Speakers are an example of a computer output device.
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True
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Solid state drives are now being used on some laptops because solid state drives have moving parts and generate more heat than traditional hard disk drives.
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False
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Personal computers were first developed in the 1970s.
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True
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The ____ is a global system of computer networks that communicate using TCP/IP and is a large network made up of many smaller networks.
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Internet
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The Internet began because ____.
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the U. S. government wanted to be able to communicate, even in the event of a nuclear attack
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In 1995 it is estimated that ____ people were using the Internet.
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16,000,000
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The ____ is a collection of interconnected documents and other resources, linked by hyperlinks and URLs.
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World Wide Web
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The WWW was created in ____ by Dr. Tim Berners-Lee and others with the introduction of the Web browser and Web page coding.
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1989
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A(n) ____ is a software program that lets a user use Web server resources over the Internet.
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browser
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A browser uses ____ to communicate with Web servers.
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HTTP
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A Web server sends ____ back to the browser, which translates it for display on a monitor.
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HTML
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HTML is a(n) ____.
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Web page programming language
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HTTP is a(n) ____.
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Internet protocol used to communicate with Web servers
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The Internet is owned by ____.
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nobody
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What is required for a device to communicate over the Internet?
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An IP address and subnet mask.
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Select a valid IP address and subnet mask from below:
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10.10.10.1 and 255.255.255.224
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The Domain Naming System maps a(n) ____ to a domain name.
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IP address
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A domain name is a(n) ____ that defines a realm of authority on the Internet, based on the DNS.
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Identification label
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The slowest type of Internet connection is the ____ connection type.
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dialup
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The global standard governing wireless technologies is the ____ standard.
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802.11
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Home networks usually connect to the Internet through the use of the services provided by a(n) ____.
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ISP
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A typical home network connecting to the Internet uses ____ IP addressing
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public and private
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An IP address that that may change when you reboot your cable modem router is referred to as a(n) ____ address.
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Dynamic
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Search engines search ____ using a proprietary algorithm.
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web pages
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A(n) ____ is a set of instructions set out logically to solve a problem.
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algorithm
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How does a search engine provide you with a result set?
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Searches its indexed data based on your search criteria.
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A(n) ____ is also known as a query.
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search phrase
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Examples of Boolean operators include the terms ____.
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NOT, AND, or
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You search the Web using the term health and informatics not education. What result below best matches your search?
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Health Informatics
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What does it mean when a Web site is at the top of a search results list?
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Keywords on that site best matched the search terms used.
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A router is a device that ____.
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sends traffic from a private network to the Internet sends traffic from the Internet to a private network
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Installing ____ updates is important to securing your operating system from attack.
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critical
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Antivirus software works by recognizing ____ and stopping those things from causing harm to your computer.
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patterns of bad behavior
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What is the preferred method to use when closing a suspicious Web site popup window?
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alt +F4
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____ permit(s) or deny a computer the ability to connect to another computer.
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Firewalls
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Some experts recommend ____ first party, ____ third party, and ____ session cookies.
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accepting, rejecting, allowing
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A complex password should include at least ____ characters.
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6
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____ permit you to determine who uses your computer
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User Accounts
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You receive an e-mail without an attachment. The e-mail subject line reads \"Bank login required as soon as possible\". What type of e-mail did you receive?
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phishing
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One big difference between a virus and a worm is that the virus ____.
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usually cannot replicate itself
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Macro viruses are usually associated with ____ files.
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Microsoft Office files
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You receive an e-mail with the subject line \"Win a prize by forwarding this email\" and you decide not to forward this to your friends and family. Why did you take this course of action?
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Hoax
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Another student informs you that you can purchase a completed research paper online and avoid doing the work yourself. This is an example of ____.
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plagiarism
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Another student informs you that you can purchase software online and avoid paying the full retail price. This is an example of ____.
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pirating intellectual property
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Privacy is to ____ as confidentiality is to ____.
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people, data
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HIPAA requires that health care providers, insurance companies, and employers ____.
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abide by privacy and security standards
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One difference between PHRs and EHRs is that PHRs are ____.
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generally maintained by individuals
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Patient medical records should be send electronically in a(n) ____ format.
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encrypted
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According to HIPAA rules, who can view your medical information without a signed release?
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Primary care physician
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The hospital reports that a patient arrived at the hospital with a bullet injury. Can the hospital be forced to reveal this patient's medical records?
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Yes
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The main function of a computer is to ____.
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Execute Instructions
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The motherboard is made up of circuitry and thousands of copper wires known as ____.
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buses
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The motherboard contains ____ slots, into which device expansion cards are inserted.
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PCI
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Today's computers connect the mouse and keyboard via a(n) ____ slot.
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USB
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The ____ monitor port replaces the VGA port in today's computer systems.
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DVI
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A serial port, also known as a ____ port, can be used to connect to and manage a network device.
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DB-9
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Hard disk storage is known as ____ storage.
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Secondary
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The operating system is stored ____.
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n RAM when the computer is running on the hard disk
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What is a CT scan?
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An x-ray, using specialized equipment, that takes cross-sectional pictures of the body.
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What is a PET scan?
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A nuclear medicine imaging device that produces a 3-D image.
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What is an MRI?
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Magnetic imaging equipment that uses a radio frequency pulse to create an image.
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A binary digit value of one (1) indicates that electricity is ____.
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on
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In the binary number \"01011010\", the rightmost value of \"0\" is a placeholder for ____.
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2 0
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1024 bytes x 1024 x 1024 = ____.
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1 GB
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Microsoft Word, running on a computer, is an example of a(n) ____.
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process
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How does data differ from information?
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Data has no meaning on its own merit.
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Roughly how much storage does a chest x-ray require?
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20megs
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There are two types of software: application and _________ software.
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System
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Which of the following is NOT a form of software that is free?
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Packaged
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Which of the following is NOT an example of word processing software?
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Open office Impress
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Select all of the following that are examples of communications applications
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E-mail Web browsers Blog Wiki
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Select all of the following that are examples of healthcare software.
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EHRs and EMRs Health Information Systems Imaging
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Which of the following is NOT true about an operating system?
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There is only one operating system available for all computers.
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A ________ interface is one where the user types in all the commands.
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Command Line
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When do you need a new device driver? Select all of the following that are reasons you might need a new driver.
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You install a new printer. You do a major upgrade of your OS. You buy a new computer and want to use your old printer. Your driver was corrupted
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You buy a new computer and want to use your old printer. Your driver was corrupted
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Virtual Memory
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What is the latest version of Microsoft Windows OS?
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Windows 7
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A(n) ________ is a way of organizing files and their data.
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File System
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The file _______ can be used to identify the file type.
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Extension
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Which of the following are examples of file utilities? Select all that apply.
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Search File compression Backup
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When a hard disk drive is being accessed, the _______ spins and the _____ moves until the head is over the proper location on the disk.
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Platter , Arm
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Disks are formatted into _____, which make up tracks.
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sectors
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Files that are stored in non-contiguous clusters are called __________ files.
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Fragmented
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Which of the following operating systems support the NTFS file system? Select all that apply.
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Microsoft Windows Vista Microsoft Windows 7 Microsoft Windows XP
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The code used in an application is the same as the database.
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False
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The device driver for your printer will probably need to be updated when you do a major upgrade of your operating system.
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true
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Programming languages have __________ , just like natural languages.
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syntax
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Algorithms are written using _________________.
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psuedocode
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___________ is an example of a third generation programming language.
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fortran
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The C programming language uses the _____________ programming paradigm.
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procedural
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The ________________ programming language is an example of a compiled language.
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c
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_______________ are programming constructs that store data.
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variables
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The _________ data type in Java is used for storing whole numbers
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int
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Which of the following operators is the OR operator in Java?
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II
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_________________ are simple data structures that store multiple pieces of data together.
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arrays
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In Object Oriented Programming, __________ and ___________ are stored together.
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data, methods
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___________________ provides information hiding in Object Oriented Programming.
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encapsulation
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Algorithms are a sequence of steps that describe how a task is performed.
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true
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Machine code includes English words for basic computer commands.
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false
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SQL is an example of a third generation programming language.
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false
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Assembly language is unique to a particular type of computer.
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true
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LISP is a programming language that follows the functional paradigm.
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True
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Perl is a scripting language developed for web browsers.
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False
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MIIS is a language that was developed for healthcare applications.
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True
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A computer program that is compiled must be compiled separately for each different computer.
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True
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Java uses a hybrid approach of compiling and interpreting.
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True
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A variable's value cannot be changed.
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False
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In Java, variable declarations do not have to include data types.
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false
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The equal sign is the assignment operator in Java.
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true
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In expression evaluation, multiplication has higher precedence than subtraction
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true
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When the condition of an if statement is false, the body of the if statement executes.
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False
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Python is an example of an Object Oriented Programming language
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True
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Classes and objects are exactly the same things.
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false
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UML is an example of a design tool for Object Oriented Programs
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True
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Encapsulation and modularity are important features of Object Oriented Programming.
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true
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Typically, instance variables are declared to be private.
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true
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The purposes of a database include all of the following EXCEPT . . .
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Data is never repeated.
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An attribute is a synonym in database terminology for which of the following?
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column
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What database term involves connecting two or more tables together when a user needs data from more than one table in the database?
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relationship
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A natural key is . . .
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A well-known attribute value that uniquely determines a row in a table.
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A foreign key is . . .
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A unique key from another table.
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What language is used to store and retrieve data from a database?
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sql
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Which part of the database ER-diagram becomes a table in the implemented database?
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Entities
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Relationships in the database are carried out with the use of which of the following?
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Primary key to foreign key matches
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Attributes that contain more than one piece of data such as Address are called . .
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composite
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Primary keys are most efficient for data retrieval when they are which of the following?
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short and numeric
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An example of a one-to-one relationship is which of the following?
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Patient to Hospital wrist band ID
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An example of a one-to-many relationship is which of the following?
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Insured to dependents
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An example of a many-to-many relationship is which of the following
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Hospital medical procedure to patient
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SQL commonly produces or projects which of the following?
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record sets
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Which of the following is involved in data modeling
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ER- Diagram
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Constraints ensure that____________.
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attribute values follow rules
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Which normal form is commonly considered to be all that is necessary for most database situations?
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3rd normal form
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SQL is used to create tables (True or False).
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true
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The SQL statement used to retrieve data from a database is which of the following?
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SELECT
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\"Order By\" is which of the following?
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clause
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\"Count\" is which of the following?
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function
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The term used for the process of getting data out of more than one table is which of the following?
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Join
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In transaction processing changes to the database can be retracted before the end of the transaction is reached (true or false).
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true
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HITECH addresses which of the following barriers to using health information technology?
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There is a shortage of health IT support staff.
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Which of the following is an example of HITECH's concept of \"meaningful use\" of health IT?
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A primary care physician electronically exchanging a patient's laboratory data with a medical specialist
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What kind of job role is likely to be a part of a REC?
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Implementation manager
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HITECH's Workflow Process and Redesign specialists address which of the following problems?
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Electronic health records have to fit in with a practice's workflow.
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Which of the following barriers to health information exchange are NOT addressed by HITECH?
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Hospitals may lose competitive advantage if they exchange information with others.
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Which of the following is a major part of the HITECH vision?
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Increased transparency and efficiency
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The incentives for health IT are focused on getting
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physicians to use health IT to improve healthcare quality
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A major challenge in developing and implementing an e-prescribing system is
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the need for workflow re-engineering
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CPOE adoption has been low among hospital based physicians because
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the ordering process has been traditionally developed to be as convenient to the doctor as possible, and CPOE is not always convenient.
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In what way are CPOE and e-prescribing systems SIMILAR?
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can eliminate incomplete or lost information
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According to the lecture, the e-prescribing system first used in 1977 did not \"catch on\" in many organizations because
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data entry, while efficient for experienced users, was cumbersome for many people
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In 2000, the Leapfrog Group was launched. What exactly was this group?
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A conglomerate of health insurance purchasers
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According to the presentation, which of the following BEST describes why CHINs failed in the 1990s?
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A lack of focus on community stakeholders resulted in competitors being unable to agree on key issues.
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Which of the following statements BEST describes the current state of the National Health Information Network (NHIN.?
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NHIN is in its early developmental stages.
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According to the lecture, which of the following is the most common form of health information exchange today?
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fax
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What is the MAJOR difference between the RHIOs of the 2000s and the CHINs of the 1990s? RHIOs focus on
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quality rather than cost savings
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According to the lecture, a 2006 failure of a prominent RHIO caused a major uproar in the HIT community. Where was this RHIO located?
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Santa Barbara, CA
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Which of the following is likely to result in significant progress towards realizing the goals of HIE in the US?
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The broad federal support for HIE outlined in HITECH
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Which of the following was NOT a csecurity principle for health information proposed in the 1997 \"For the Record\" report?
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Avoid storage on portable drives
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Allowing cancer researchers to use the existing data in hospital systems, without asking each patient for permission, illustrates which of the following principles underlying the HIPAA privacy rule?
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Public Responsibility
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The 1996 HIPAA legislation related to
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portability of health insurance across state lines.
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Which of the following is the strongest example of authentication?
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Using both a password and a device with changing unique numbers
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Why did Congress fail to pass privacy legislation in 1999?
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The legislators could not agree among themselves about what to propose
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Before the HIPAA Privacy Rule was implemented, state laws were
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very variable.
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Which of the following was NOT one of the factors that led to changes in HIPAA as a result of the HITECH Act?
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Which of the following was NOT one of the factors that led to changes in HIPAA as a result of the HITECH Act?
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Which of the following was a change with the HITECH Privacy Regulations?
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Tracking disclosures for TPO was now required.
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What is the major challenge with the changes to HIPAA in the HITECH Act?
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They will require major changes in work processes.
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The recommendations for sanctions for privacy or security violations relates to which principle
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Accountability
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Which of the following is an example of \"competent human intervention\" as described in the 1989 FDA policy?
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A physician deciding not to follow the advice of a clinical decision support system
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Which organization was already an EHR certification organization prior to the establishment of the current ONC Authorized Testing and Certification Bodies?
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CCHIT
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What was one of the recommendations from the 1996 FDA workshop on regulating clinical software
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Software quality audits
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HITECH mandates certification of EHRs to assure that
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EHRs include functionality for meaningful use
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FDA regulation of EHRs is UNLIKELY to reduce errors due to
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implementation flaws.
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Which of the following best describes a process?
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A series of actions or operations that produce work
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Process analysis includes which of the following?
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Knowledge of process components and relationships between them Identification of opportunities for improvement BOTH
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Process redesign includes which of the following?
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A change in a process Anticipation of a good outcome
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A workflow is a Process,
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true
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Workflow analysis includes which of the following?
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Knowledge of process components and relationships between them Identification of opportunities for improvement
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Which of the following is NOT considered knowledge?
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Beliefs that may be true
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Which of the following is NOT one of the IOM characteristics of quality healthcare?
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Provider centered
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Which of the following is NOT a characteristic of Meaningful Use of Health IT?
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Has been in legislation for over 20 years
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Which of the following is NOT a Meaningful Use requirement? Choose the best answer:
answer
Greater than or equal to 90% of eligible pneumonia patients received antibiotics within 12 hours of an office visit.
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Which of the following are activities stated in the scenario?
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Identify out-of-range results
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Which of the following roles participate in the scenario?
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Patient
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Which of the following pieces of information are needed by the medical assistant in the scenario?
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Patient's contact information and provider
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Which of the following decisions are made in the scenario?
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Whether or not the results are out-of-range
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At which point in the scenario could more than one path be taken?
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When the lab results are reviewed.
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Mark the symbols that are common flowchart symbols:
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Arrow
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What symbol should be used to diagram the following process step: \"If the patient is a new patient ...\"
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Diamond
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Which of the following is used to indicate that a flowchart continues on another page?
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Circle connector
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Which of the following should be used t diagram the following text: \"...the new patient intake form is received, the information is confirmed with the patient, then entered into the EMR
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Document symbol, then two sequential process boxes
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An analyst needs to show the context in which a process operates. Which of the following methodologies is the most appropriate?
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Yourdon
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An analyst needs to show information movement and the order of the steps. Which of the following diagram notations should be used?
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Data flow diagram
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An analyst needs to show information content. Which of the following notations would be appropriate?
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E-R diagram
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An analyst needs to show detailed process steps. Which of the following diagrams is the most appropriate?
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ISO data flow diagram
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Indicate which statement is true:
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Information flow and process flow can be shown on a flowchart
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ndicate which statement is true:
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Multiple process aspects may be represented on some diagrams
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Which shape is used to mean different things in a UML activity diagram and basic flowchart?
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Circle
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A terminal symbol in a flowchart is used to represent which of the following?
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start and stop
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Which symbol would be used in flowchart notation to represent the following text? \"If the lab results are not within normal limits, call the patient.\"
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Diamond
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Which symbol would be used in flowchart notation to represent the following text? \"The patient called the office to schedule an appointment.\"
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Rectangle
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Which best describes the goal of Knowledge Acquisition (KA)?
answer
To gather and capture process knowledge
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Which of the following is true for Knowledge Acquisition (KA) in support of EMR adoption?
answer
Clinics will acquire knowledge through process analysis
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Which of the following types of knowledge is the easiest for organizations to share with others?
answer
Coded knowledge
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Which of the following CMM levels best describes the following organization: \"There are standard operating procedures, and performance is fairly consistent. When adapted to new situations, the process performance is not predictable, and sometimes results are substandard.\"
answer
Level 3
question
clinic that you are working with is at CMM level \"Managed\". Which of the following methodologies should be used to obtain process information?
answer
Reading available procedures
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A clinic that you are working with is at CMM level \"Repeatable\". Which of the following methodologies should be used to obtain process information?
answer
Interviews and process walkthroughs
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A context diagram is important for what reasons?
answer
Facilitates checking information with practice providers and staff Depicts major functions and processes
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A process inventory is developed from which of the following?
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A list of clinic services
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Which of the following categories of processes will likely be deemed important enough to analyze?
answer
Processes impacting patient care b. Processes that can be improved through Health IT c. High volume processes
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Which of the following processes would you find in most clinics?
answer
Appointment scheduling Receiving documentation
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According to the scenario, which of the following are process participants?
answer
Patient Nurse
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Which of the following would you interview or observe to acquire process information?
answer
Nurse
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A Knowledge Acquisition Plan should include which of the following?
answer
Process inventory
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Which of the following is true about Knowledge Acquisition for Health IT adoption?
answer
KA requires assimilating information.
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Complete the sentence: Knowledge Acquisition ________.
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Is constrained by available time and resources
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Which of the following are NOT steps in process analysis as described in this unit?
answer
Conduct process redesign.
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What is the correct order of steps for Process Analysis?
answer
1-Create process inventory 2-Report analysis findings 3-Identify variations and exceptions 4-Identify needed EHR functionality1,3,4,2
question
Choose the answer that best describes a process inventory
answer
Identifying and recording processes
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Which of the following processes does NOT occur at most clinics?
answer
Surgery
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Which of the following processes varies most by clinical specialty?
answer
Diagnostic tests
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Which of the following would be variations of a Diagnostic test process?
answer
Test is conducted by referral to an external facility
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Which of the following would be variations of an appointment scheduling process?
answer
Online appointment scheduling
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Which of the following would be exceptions in a prescription process?
answer
Potential drug interaction identified by pharmacy.
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Which of the following is NOT a primary goal of healthcare clinic process redesign as described in this unit?
answer
Making changes in the practice
question
According to Deming, which would be a good approach to address a medical error in a clinic?
answer
Investigate possible process changes to prevent such errors
question
Which of the following are examples of unproductive work? 1 - A patient waiting for a clinic appointment 2 - A provider spending time talking with a patient 3 - A billing manager correcting and re-filing denied claims 4 - Providers scheduling patient appointments
answer
1, 3, and 4
question
Which of the following would be an exception to a document receiving process?
answer
receipt of documents with no patient identifiers
question
Which of the following may indicate needed EHR functionality?
answer
a. Generic processes used by a clinic b. Process variations used by a clinic c. Process exceptions likely encountered by a clinic d. All of the above
question
Which of the following EHR functionality is indicated by the scenario?
answer
Clinical documentation.
question
Which of the following process variations should be further investigated, i.e., there is not enough information in the scenario to determine which variation(s) may be in use?
answer
Billing performed in practice management system.
question
Which of the following is NOT a primary goal of the implementation decision-making meeting as described in this unit?
answer
Selecting an EHR system for implementation
question
Which of the following is NOT a suggested approach to leading the implementation decision-making meeting?
answer
Use Brainstorming to generate ideas for process redesign
question
Which of the following are examples of the meeting facilitator's role? 1 - Establish Group Norms 2 - Manage Time 3 - Incorporate changes in the Process Diagrams 4 - Provide feedback and evaluation of all changes suggested
answer
1, 2, and 3
question
There is only one method that has proven to be successful in developing group consensus through group facilitation.\"
answer
false
question
Identifying processes that are ripe for improvement can be facilitated by which of the following?
answer
Reviewing \"Best Practices\" in other Health care facilities b. Some health care providers can show how much a change can improve services in specific areas and integration c. Focusing on processes that can increase satisfaction, compliance, and meaningful use of health IT ALL THE ABOVE is the ANSWER
question
The wrap-up / debriefing part of the meeting is designed to?
answer
Secure management \"Buy-in\"
question
Which of the following should be included in the implementation decision making meeting report?
answer
Complete documentation of all results Results or plans from the meeting Persons interviewed
question
Which of the following is not included in the Agenda for the Implementation decision making meeting?
answer
Brainstorming
question
BRAND is a mnemonic for remembering the steps of making a decision used in the health care field.\"
answer
true
question
Which of the following identify processes as \"Ripe for improvement\"?
answer
a. Processes that can increase satisfaction b. Increase Meaningful Use of health IT c. Appeal to patients
question
Which of the following is not a part of Quality Improvement methods in Health care?
answer
Focused on the individual patient
question
According to Goethe, it is sufficient to know the approximate number of people who die annually in U. S. due to medical errors.
answer
False
question
The Plan-Do-Study-Act cycle of Quality Improvement:
answer
Can be traced back to Shewhart Was described by Deming
question
Leadership involvement is essential for successful Quality Improvement. Which of the following is not a way leaders can support QI activities?
answer
hiring more people
question
Which of the following methods are based on Deming's PDSA?
answer
API FOCUS-PDCA Six Sigma
question
According to Ovretveit, failing to learn and plan for sustaining the improvement is which category of mistake in Quality Improvement?
answer
Mistake in transition and implementation
question
Mistakes in Purpose & Preparation include:
answer
Choosing a subject which is too difficult or which a collaborative is not appropriate b. Participants not defining their objectives and assessing their capacity to benefit from the collaborative. c. Not defining roles or making clear what is expected of individuals taking part in the QI
question
Which of the following tools is NOT appropriate for use in the early information collection stage of a QI project?
answer
Priorities matrix
question
Define, Measure, Analyze, Improve, Control in Six Sigma is used for what ?
answer
To reduce variation
question
Transitioning to flow thinking causes changes in how people perceive their roles in the organization.
answer
true
question
Pick the best explanation for the meaning of the following Chinese proverb: \"...show me and I may remember; involve me and I will understand.\"
answer
Most people comprehend best what they are engaged in.
question
In a meeting to discuss the new practice management system, it becomes clear that the front desk receptionist hasn't heard anything about the implementation planned for the next day. Application of which of the following key change concepts could have improved this situation?
answer
Transparency
question
A physician leader in a small practice has chosen and purchased an EMR without telling anyone in the practice. He has arranged for the vendor to install the system and explain it to the staff in two weeks. Application of which of the following key change concepts could have improved this situation?
answer
Engagement gap
question
Which of the following best matches the most likely reason for the providers, nurses and medical office assistants reaction to the new system in the scenario?
answer
They didn't understand the purpose for the extra work
question
For the situation in the scenario, application of which of the following change concepts may have alleviated the concerns?
answer
Engagement gap
question
In the scenario, what did Support Specialist Sam do that helped the situation?
answer
Pointed out the reason for the extra fields
question
An analyst is preparing for the initial meeting with practice leadership and staff which of the following should the analyst have ready for the meeting?
answer
An agenda for the meeting
question
True or False: It is just as important to engage leadership as it is to engage practice staff.
answer
true
question
True or False: Special meetings should be held to engage people not directly involved with the design.
answer
true
question
In a practice that uses paper medical records, to capture information for performance measures, providers and nurses have to record data on a special data collection form in addition to regular documentation in the chart. In moving to an EMR, application of which change concept would improve completeness of data collected?
answer
Design the system to run down-hill
question
Providers are more likely to view health care quality as
answer
Use of computerized decision support to facilitate evidence-based practice
question
Patients and families are more likely to view quality as
answer
how well the provider communicates
question
An example of a structure used to evaluate quality of health care information technology is
answer
A policy describing the prescriber's role and responsibilities with respect to provider order entry.
question
A policy describing the prescriber's role and responsibilities with respect to provider order entry.
answer
Innovation
question
What quality improvement measures must eligible providers report in 2011 to quality for meaningful use incentive payments?
answer
Must report on blood pressure, tobacco status, and adult weight screening as well as three additional measures from a list of metrics.
question
In your own words, explain the Institute of Healthcare Improvement's triple quality aim model and describe examples of how HIT can help to further these aims.
answer
Answer: The student's answer should include reference to the fact that the triple aim is designed to optimize health, health care experience, and costs for populations. That is, to provide the best care, for the whole population at the lowest cost. The answer should include at least three ways in which HIT can help to achieve the triple aim, such as introducing information tools into clinical practice, using information tools to personalize care delivery, electronically connecting clinicians, or advancing surveillance and population health reporting.
question
In your own words, describe the goals of meaningful use of electronic health records.
answer
Answer: The student's answer should include the five goals of meaningful use of electronic health. These goals are: to use health records in a way that improves quality, safety, & efficiency of care, engages patients and families in their care, improves coordination of care, improves population and public health and reduces disparities; and ensure privacy and security protections for all.
question
One example of how HIT can enhance patient-centeredness is:
answer
Tailor care plan to individual needs through clinical decision support
question
An example of a workaround that can result in unintended consequences is
answer
Having nurses enter prescriber orders because the prescriber is too busy
question
Man-made tools that aid or enhance the user's thinking abilities are called:
answer
Artifacts
question
The following is a basic principle of the science of safety
answer
The system is perfectly designed to deliver the results it gets.
question
The premise behind the Swiss Cheese Model is that
answer
There are ―holes,‖ vulnerabilities, or hazards in the health care environment that have an impact on medical error
question
One of the following is not a system factor that has an impact on patient safety
answer
Time factors
question
The following is not a principle of safe design
answer
Add steps
question
An example of an independent check is
answer
Car alarm sounds when passenger fails to put on seatbelt
question
Health care work should primarily be geared around
answer
Patients
question
An example of an independent check is:
answer
Requiring two signatures on high alert medications
question
An example of standardization is:
answer
Using a checklist before doing a procedure
question
The following indicate system factors that have an impact on patient safety:
answer
Patient and provider characteristics task characteristics and the work environment Institutional factors
question
HIT teams make wise decisions
answer
When there is diverse and independent input.
question
Reliability science allows organizations to improve the consistent and standard delivery of high quality, safe healthcare through each of the following except
answer
Using processes that perform as intended function under favorable conditions
question
The three-tier IHI framework for reliability begins with
answer
Preventing failure
question
The following are traits of high reliability organizations, except
answer
rely on the leaders for final decisions
question
Five concepts that create a sense of mindfulness within the context of reliability are sensitivity to operations, preoccupation with failure, deference to expertise, resilience and
answer
reluctance to simplify
question
The blame game leads to a cycle that includes which one of the following
answer
less is learned
question
Each of the following describes a high-reliability organization except
answer
Single authoritative decision-maker
question
Describe ways in which HIT teams in high reliability organizations are sensitive to operations.
answer
Answer: The student's answer should include examples in which the HIT team supports more than just checks of patient identity, vital signs, and medications. It includes awareness by staff, supervisors, and management of broader issues that can affect patient care, ranging from issues of human-computer interface, to the availability of needed supplies, to potential distractions.
question
Describe ways in which HIT teams operate within ultra-safe organizations
answer
Answer: The student's answers should include such things as learning to recognize potentially risky situations and speaking up if you see that something is not right so that action can be taken to reduce risk. The answer could also include promoting a blame-free culture, being preoccupied with failure, and viewing near misses as opportunities to improve HIT design.
question
Illustrate how teams make wise decisions by describing how teams can learn from honey bees.
answer
Answer: The student's answer should describe how bees can teach us a lot about teamwork and a culture of safety. Bees work exceptionally well in teams and are considered some of the best decision makers alive. They have grasped the concept that shared wisdom is imperative to making good decisions. Advocating for usability testing by users is one way that HIT professionals gather shared wisdom.
question
Deference to expertise supports recognizing
answer
a family member's contribution to decision-making
question
Human factors is:
answer
The study of the interactions of humans and other elements of a system
question
Describe problems that can arise with the design of HIT that relate to human factors
answer
Answer: The student's answer should include such things as problems that arise from mismatches among the 5 elements of a system: persons (e.g., doctors, nurses, patient), task and job design (e.g. medication prescribing, dispensing, administering), tools and technology (CPOE, flow sheets, task lists). environment (inpatient, outpatient, school), and/or organizational characteristics (structure, nursing practice model, policies).
question
Cognitive ergonomics is concerned with
answer
Mental processes
question
The following is relevant to physical ergonomics
answer
Workplace layout
question
The following is a relevant to organizational ergonomics
answer
Mental workload
question
A ―person approach‖ to error
answer
Blames the individual
question
The following statement is true about systems
answer
The system is responsible for about 95% of the cause of the outcome; the human only 5%.
question
Active failures
answer
Occur at the sharp end and their effects are felt almost immediately
question
An example of a latent error is
answer
a design flaw that causes alerts to fire inappropriately
question
Describe use of the SEIPPS model of work system design in the context of HIT.
answer
Answer: The student's answer should describe the SEIPPS model. This could include defining the acronym for System Engineering Initiative for Patient Safety as a model of work system and patient safety. It could include: a detailed model of work systems leading to processes which lead to outcomes and specification of the components and elements of the model to include the person, the environment and the organization as well as the technologies, tools, and tasks that are used. The student could discuss these components with respect to any of a wide variety of HIT applications, including patient portal, CPOE, notes, flow sheets, clinical summaries, to name a few.
question
Care coordination
answer
Has been identified as the top priority for national action
question
The following is not an example of a transition of care
answer
Change in patient room without change in providers
question
Hand-offs
answer
Are transfers of care from one provider to another provider
question
Studies show that the following is true about most hospital discharges
answer
Direct communication between hospital and primary care providers is low
question
A technique that examines relations among providers and looks to see patterns among groups to inform information technology decision making is
answer
Social Network Analysis
question
The following is an example of a social function meaning to a speech act
answer
―It's crowded in here means ―I want to leave‖
question
Describe three types of barriers to communication and identify how HIT design can actually enhance barriers.
answer
Answer: The student's answer should include ways that HIT design can contribute to at leas t three of the following barriers: perceptual differences, cultural differences, language barriers, information overload, organizational complexity, inattention/memory limits, time pressures, distraction/noise, interruptions, and emotions. Examples include: alert designs that are not consistent with work flow, computer systems that do not interact with each other leading to gaps in information, or designs that do not take into account the types of communications that are needed to ensure safe delivery of care
question
Describe the differences between synchronous and asynchronous communication, how these types of communication can hinder effective communication, and examples of each.
answer
Answer: The student's answer could address the fact that synchronous communication, such as face-to-face discussion and telephone communication, occurs simultaneously and places the speaker at risk for interruption and distraction due to the disruptive health care environment. Frequent interruptions during communication increase the likelihood that the message will be misinterpreted or lost. Asynchronous communication, which occurs at different times, such as voice mail, email, and computerized records, fails to provide the opportunity for questions and clarification, potentially rending communication ineffective.
question
Describe what is meant by basic components and processes of communication (encoding, communication channels, decoding) in the health care setting and how the message can get lost in translation. Discuss how HIT can help to alleviate these barriers.
answer
Answer: The student's answer should include the concepts of encoding by the person who initiates the message, barriers that occur in the channels through which that message is conveyed via verbal, written, or electronic means and decoding by the recipient of the message. Attention should be paid to the problems created by background noise, either external noise such as the paging system, alarms, cluttered work spaces (which are a form of visual noise and can be just as distracting as auditory noise) OR internal noise, such as the provider's own mental state that can make message transmission unclear. Examples of ways HIT can help to alleviate these barriers are: judicious use of alerts, electronic whiteboards, clinical summaries, automated notifications, hand-off notes, and discharge summaries.
question
Explain how at least three HIT tools can be used to facilitate multi-disciplinary rounding.
answer
Answer: The student's answer could include patient-centric information tools such as patient health records, variance tracking forms, progress notes, flow sheets, bedside monitoring devices; process oriented tools, such as rounding lists, sign-out tools, daily goals form, or discharge assessment tools; or decision support tools such as electronic evidence resources, clinical pathways, or graphic dislay of test results. Multi-disciplinary rounds allow the diverse members of the patient's care team to meet and communicate, coordinate patient care, make joint decisions, and manage their work.
question
Which one of the following is not an example of clinical decision support?
answer
The computer system times out after a period of inactivity
question
A clinician has been using a system that has a reminder system. When the clinician performs an action even when not prompted by the reminder system, this response is called
answer
spillover
question
Which one of the following is not a right of clinical decision support?
answer
Right dose
question
The following statement is a myth regarding clinical decision support:
answer
Clinicians will use stand-alone decision-support tools.
question
Which of the following is NOT a recommendation of the consensus panel for effective use of clinical decision support.
answer
Maximizing the use of active data capture
question
Clinical decision support is most appropriate for
answer
a. Inpatient settings b. Ambulatory care settings c. Public health settings
question
The following is a decision support rule that can enhance efficiency
answer
Rules that trigger alerts for high cost drugs and suggest lower cost alternatives
question
All of the following statements are correct EXCEPT:
answer
Alerts should never be overridden
question
Basic medication order guidance is
answer
an alert that provides dosing information with default dosing being the most appropriate initial dosing.
question
Describe at least two important considerations that should be taken into account prior to CDSS implementation
answer
Answer: The student's answer should include one of the following: workflow integration, such as ensuring that structure and work system features and processes support care; data entry and output considerations such as who enters the data and who receives the CDSS advice; standards and transferability such as whether the CDSS is ready to be used ―off the shelf‖ or needs to have some degree of local customization; and knowledge maintenance, such as maintaining accuracy by ensuring that imbedded knowledge is kept current.
question
Clinical decision-making is a systematic way to handle data and clinical algorithms to
answer
decide on the best course of action
question
A step-by-step procedure for solving a problem is
answer
an algorithm
question
Each of the following is a type of uncertainty in clinical decision-making EXCEPT:
answer
Contextual: the clinician does not know when to document in the EHR
question
An example of direct use of HIT to deal with uncertainty is:
answer
establishing what is known about best practice and incorporating this into ―smart order sets‖
question
The initial phase of HIT development in a human-centered design cycle is:
answer
specify context of use
question
An example of a quantitative workflow analysis method is
answer
video recording
question
Describe the types of information to be collected during the observation of current work flow processes when planning to implement HIT.
answer
Answer: The student's answer should include most of the following types of information: name of process, process owner, process output/product, who is involved in delivering the process, who cares about the process, extent of the process to be mapped, activities to define the process, start and end points of the process, waster (non-value-added time), bottlenecks, redundancies, points of dissatisfaction, and inefficient use of workforce skills.
question
There are four phases of human- centered design cycle (specify context of use, analyze requirements, design prototype and evaluate prototype). Discuss the concept of workflow and describe qualitative and quantitative methods of workflow analysis.
answer
Answer: The student's answer should include a discussion of the two main components of the workflow integration matrix, current and future workflow. The student should also discuss the concept of workflow as a description of sequenced activities performed by various clinicians and staff. The answer should include a description of at least one qualitative (ethnographic observation, shadowing, surveys) and one quantitative ( sensor technologies, video recordings) method of workflow analysis
question
A rectangle is used in a process flow chart to depict.
answer
an action or instruction
question
Mapping of current processes should include all of the following except:
answer
process redesign recommendations
question
Change
answer
Is situational whereas transition is a psychological process
question
The following is an important structural characteristic of effective teams:
answer
Appropriate culture
question
Effective implementation teams learn from mistakes. The following is essential to support teams in learning from mistakes.
answer
Culture of transparency
question
There are a number of strategies used by implementation teams to manage go-live support. Describe one way and indicate the benefits and potential risks of this method.
answer
Answer: The student's answer should include use of either external or internal consultants Mention should be made of the role that these consultants play during go-live, and any risks or benefits to the selection of this particular support strategy. Discussion should include such things as their expertise in use of the software application, their experience on go-live teams, their knowledge of specific organizational policies and work flow, and their cost.
question
Effective change and transition management are critical to effective implementation planning. Each of the following strategies ensures effective change and transition management EXCEPT:
answer
Ensuring that professionals work side-by-side
question
There are a variety of strategies for effective implementation planning. The following is a limitation of the single vendor strategy:
answer
If it fails, the organization can incur significant losses
question
To enhance implementation team effectiveness,
answer
Regular meetings should be scheduled and a standard agenda set
question
One of the advantages of ―best of breed‖ approaches over single vendor options is that
answer
Massive process reengineering is avoided
question
Two approaches that have been used successfully for HIT implementations are the big bang and staggered, or incremental, approaches. The following correctly depicts big bang implementation strategies
answer
High risk, high anxiety
question
The following is true of incremental implementation strategies
answer
They have higher training costs.
question
Efforts to improve patient safety over the past decade have been largely competitive, rather than cooperative. One success story involves an initiative that improved central line blood stream infections. The reason for its success was largely due to:
answer
Using a simple checklist to remind people of best practices.
question
Use of the central line BSI checklist was an example of the application of the science of safety to improve health care quality. Each of the following strategies is promoted as principles of the science of safety except
answer
Individualizing care
question
A proven effective strategy to ensure that best practices in central line insertion are standardized throughout organization is:
answer
Including use of a central line cart to increase compliance with the checklist
question
This module describes the experiences of a research team trying to implement best practices. When the team began its work on central line blood stream infections, it experienced:
answer
A culture that did not allow questioning physicians
question
One key premise of failure in HIT quality improvement initiatives is that the reason for failure is:
answer
because they fail in the adaptive component
question
Describe why the central line blood stream infection story is relevant to HIT work. Include reference to principles of the science of safety in your explanation. Give an example of how using these principles in HIT design or implementation can lead to success.
answer
Answer: The student's answer reflects an understanding that the principles of the science of safety (standardize, eliminate steps, independent redundancies, culture of safety) are relevant to all quality improvement work, including HIT work. Examples can include such things as: use of alerts, imbedding evidence-based practice recommendations in order sets, standardizing the way in which hand-offs are documented in the EHR.
question
Most transitions
answer
require the entire team
question
Ensuring a culture of safety
answer
applies to all teams regardless of clinical or technical roles
question
The following is essential to decoding resistance:
answer
Frequent, clear communication
question
People do not generally fear change; they fear
answer
Loss of the old ways of doing
question
In the absence of a valid and transparent measurement system, most people.
answer
Are over-confident in their performance
question
A valid model for reporting and measuring quality and safety in health care includes attention to structure, process, and outcome measures. An example of a structural measure in health care is the:
answer
percentage of time providers spend with patients
question
Donebidian's model of structure- process-outcome addresses each of the following except:
answer
dynamic interdependencies among structure, process, and outcome
question
An example of an outcome measure is:
answer
The percentage of patients with central lines who develop a blood stream infection
question
In order to calculate a fall rate, you need to have:
answer
a clear definition of the population that is at risk for falls
question
An example of something that we put forth in health care as a rate that is not really a rate is:
answer
Medication error rate
question
Although selection bias is often associated with research methodologies, this concept is also appropriate for quality improvement since organizations often seek to generalize results of quality improvement studies to other areas within the organization. Selection bias is highly dependent on
answer
who is in the sample that is being measured
question
The following is true of ―missing data‖
answer
It is important to account for missing data before communicating results of analyses.
question
HIT design can facilitate the collection and reporting of both rate- and non-rate based quality measures. Give an example of how HIT design can facilitate the collection and reporting of quality measures such as central line blood stream infection rates or hospital acquired pressure ulcer rates.
answer
Answer: The student's answer should include the collection of observations such as dates and times of central line placement, central line care or other parameters that indicate the continued presence of central lines, or date/time of central line discontinuation, blood culture values, whether or not a pressure ulcer was present on admission, documentation of pressure ulcer assessments, etc. The answer should also discuss reporting of these measures through analysis of EHR data.
question
When looking at rates of urinary catheter- related urinary tract infections the denominator would be
answer
the number of patients that had a urinary catheter
question
The customer service of healthcare professionals can be measured by
answer
the results of customer satisfaction surveys.
question
What two departments share a similar customer base in the healthcare setting?
answer
Physician's offices and hospitals
question
The culture of healthcare IT can be described primarily as __________
answer
service.
question
Customer service-driven EHR implementation success factors differ by customer role and include
answer
for administration, a return on their investment.
question
The definition of customer service, in terms of the assistance and courtesy granted to those who patronize a business, includes the word
answer
degree.
question
An important goal of understanding contextual norms is
answer
An important goal of understanding contextual norms is
question
A professional appearance is an important part of professionalism. The goal of maintaining a professional appearance can best be described as
answer
ensuring that the focus is on your work and message
question
Information technology staff's role in healthcare is to
answer
develop, implement and maintain electronic medical records.
question
To be successful in their roles, the most important thing IT professionals need to do is
answer
exhibit professional demeanor and deportment
question
The purpose of maintaining a professional appearance is
answer
that it allows others to know how to behave toward you.
question
Using an emotional tone in communications is a good idea when
answer
you are talking to a distressed user
question
What is the most important method for preventing the spread of infection?
answer
Frequent hand washing with soap or alcohol gel
question
The goal of infection control is to
answer
prevent the spread of infection from you to others and from others to you.
question
A Hospital Acquired Condition (HAC) means that
answer
the healthcare organization must absorb the cost of care for the HAC.
question
Standard precautions means
answer
all human body fluids should be treated as if they are infected
question
Sharing your computer access codes with a co-worker is
answer
unacceptable under any circumstance.
question
HIPAA is a federal law that protects patient privacy and prevents unauthorized release of medical Information. HIPAA includes which rule?
answer
Security Rule
question
Infection control is the responsibility of
answer
all healthcare workplace professionals
question
Penalties you may experience for breaching HIPAA include
answer
civil penalties such as a fine.
question
One of your co-workers, while reviewing electronic medical records, sees the record of his ex-spouse and wants you to look at it. You should respond,
answer
\"Remember that showing that to anyone or talking about it is a HIPAA violation.\"
question
You are in the Emergency Department working with a nurse on a problem with her EHR menu. During your time there, the rescue squad brings in a neighbor. When you get home, your spouse says, \"Did they bring Bill to the Emergency Department today? I saw an ambulance at his house.\" You should respond,
answer
You know that I am not allowed to answer you.\"
question
What are the three perspectives that support the conflict stool?
answer
Personal, interpersonal, social
question
Which of the following are ways of distinguishing major types of conflict?
answer
Content issues and relationship issues
question
The preferred way to resolve conflict is to use
answer
win-win strategies.
question
Which one of the following statements is true?
answer
The first step in Filley's model addresses antecedent conditions
question
In conflict resolution, which of the following is often used?
answer
Win-lose strategies
question
Which of the following refers to a conflict resolution approach?
answer
Relates to the outcome of the resolution process
question
Which of the following statements is correct?
answer
Conflict creates a need for change and conflict also occurs as a result of change.
question
Identify the developer of conflict resolution theory and the number of steps it contains.
answer
Filley, 6
question
Ethics are considered to be
answer
behaviors based on social standards
question
Policing smoking behavior in enclosed environments for public health reasons would be an ethical practice based on which of the following approaches?
answer
Utilitarian
question
Which of the following is NOT a major role of the medical ethics committee?
answer
Disciplinary action
question
Which of the following is considered an external or secondary diversity dimension?
answer
Income
question
The following statement is TRUE with respect to diversity
answer
Diversity can be leveraged with the appropriate leadership.
question
__________________ represents a preference for one's own culture that results in critical evaluations of people from another culture.
answer
Ethnocentrism
question
An emphasis on family involvement in healthcare decision making is characteristic of
answer
collectivist cultures.
question
An emphasis on building relationships in communication is characteristic of
answer
high context cultures.
question
The Civil Rights Act of 1964 prohibits discrimination based on
answer
religion
question
All of the following represent important elements of cultural competency EXCEPT
answer
Ethnocentric care
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