1.

A hospital implements a new EHR, but nurses begin to record data inconsistently across
wards. What is the most likely root cause?
A. Lack of standardized terminologies
B. System hardware malfunction
C. Overtraining of users
D. Excessive security measures

2. When information is extracted, interpreted, and applied to improve nursing decisions, it

becomes:
A. Data
B. Information
C. Knowledge
D. Wisdom

3. A nurse manager uses monthly infection rate dashboards to justify staff training. Which level
of the DIKW model is being demonstrated?
A. Data
B. Information
C. Knowledge
D. Wisdom

4. In an EHR system, which function most directly supports clinical decision-making?

A. Clinical Decision Support System (CDSS)
B. Electronic Billing System
C. Master Patient Index
D. Inventory Module

5. A nurse downloads anonymized patient datasets for research but fails to encrypt them. This
compromises:
A. Data confidentiality
B. Data visualization
C. Data accuracy
D. Data accessibility

6. Which chart would best reveal patterns of patient readmissions over a 12-month period?
A. Line graph
B. Pie chart
C. Histogram
D. Tree map

7. In Rogers’ Diffusion of Innovation theory, which group is essential for translating pilot
successes into organizational change?
A. Early adopters
B. Innovators
C. Late majority
D. Laggards
8. Which ethical principle is most at risk when a nurse posts patient data on a secure hospital
intranet discussion forum?
A. Confidentiality
B. Autonomy
C. Non-maleficence
D. Justice

9. Which of the following best describes the wisdom level of the DIKW model?
A. Judging when and how to apply knowledge for patient care
B. Organizing data into meaningful categories
C. Summarizing numeric records
D. Cleaning data for accuracy

10. A nurse leader insists that any new technology must “talk” to existing systems. This
leadership concern emphasizes:
A. Interoperability
B. Privacy
C. Hardware durability
D. Interface color design

11. A nursing lecturer demonstrates how to use NVivo to identify recurring themes from
interviews. This software is used for:
A. Qualitative data analysis
B. Quantitative statistics
C. Data encryption
D. System configuration

12. When designing a dashboard for senior managers, the most appropriate visualization
principle is:
A. Simplicity and clarity
B. Overuse of 3D effects
C. Maximizing color saturation
D. Hiding outliers

13. In health informatics, “data cleaning” primarily ensures:

A. Accuracy and reliability of information
B. Confidentiality of records
C. Increase in system speed
D. Improved patient experience

14. A nurse finds that patient alerts from the CDSS are often ignored by staff. Which factor most
likely contributes?
A. Alert fatigue from excessive prompts
B. System downtime
C. Limited patient data
D. Software licensing
15. The nurse informaticist’s strategic role during EHR implementation is to:
A. Align system design with nursing workflows
B. Design hardware
C. Author hospital budgets
D. Manage human resources

16. Which chart best compares proportions of disease cases between age groups?
A. Bar chart
B. Line graph
C. Scatter plot
D. Histogram

17. A nurse leader decides to replace manual records with EHRs to improve accuracy and
accessibility. Which term best captures this process?
A. Digital transformation in healthcare
B. Process redundancy
C. Ethical modernization
D. Data aggregation

18. In the DIKW hierarchy, information differs from data because it:
A. Adds meaning and context to raw facts
B. Is always numerical
C. Cannot be stored electronically
D. Is less accurate

19. Which of the following is most likely to reduce data integrity during transfer?
A. Unencrypted email transmission
B. Use of verified identifiers
C. Data validation rules
D. Audit trails

20. A hospital system automatically cross-checks allergies before drug administration. This
function reflects:
A. Clinical Decision Support
B. Data encryption
C. Hardware automation
D. Data visualization

21. A nurse manager reviews colorful charts but struggles to extract meaning. Which
visualization error is likely present?
A. Cognitive overload due to poor design
B. Too few data points
C. Accurate scaling
D. Clear labeling

22. Which of the following is the most effective safeguard against data breaches in nursing
informatics?
A. Strong encryption and access control
B. Using shared login credentials
C. Posting updates publicly
D. Automatic screen-savers

23. The term “interoperability” in EHR systems means:

A. Seamless exchange of data between systems
B. High-speed processors
C. Offline data entry
D. Secured passwords only

24. A nurse educator notices students use Wikipedia instead of PubMed. The risk is mainly:
A. Low reliability and academic credibility
B. Open access
C. Free access cost
D. Large sample coverage

25. A nurse transfers patient data via USB without encryption. The violated ethical principle is:
A. Confidentiality
B. Fidelity
C. Autonomy
D. Justice

26. A nurse analyzes temperature trends of ICU patients. Which visualization method is best?
A. Line chart
B. Pie chart
C. Bar chart
D. Histogram

27. Which health informatics system helps track patients across multiple departments and
prevents duplication?
A. Master Patient Index
B. CDSS
C. E-prescribing
D. Finance module

28. Which factor most affects successful EHR adoption in low-resource hospitals?
A. Infrastructure and user training
B. High funding
C. Too many nurses
D. Government overregulation

29. When visualizing infection rates, the y-axis should typically represent:
A. Frequency or rate values
B. Time
C. Patient names
D. Unit codes
30. Which is the most reliable data visualization for showing distribution of patient waiting
times?
A. Histogram
B. Bar chart
C. Pie chart
D. Scatter plot

31. Which nursing informatics principle directly supports quality improvement?

A. Evidence-based data use
B. Data secrecy
C. Aesthetic documentation
D. Narrative charting

32. The difference between an HIS and an EHR is that an HIS:

A. Covers administrative and clinical subsystems
B. Is only for outpatient data
C. Stores paper records
D. Is purely financial

33. A data visualization showing staff performance by color intensity represents which type of
chart?
A. Heat map
B. Line chart
C. Histogram
D. Scatter plot

34. Which system is primarily used to analyze health data rather than to store it?
A. SAS or SPSS
B. EHR
C. MPI
D. Billing module

35. A CDSS recommends a drug the patient is allergic to. The nurse’s safest action is to:
A. Verify manually before administering
B. Trust the system
C. Disable alerts
D. Ignore reporting

36. In a telehealth consultation, the weakest link in maintaining confidentiality is:

A. Unsecured communication channel
B. Patient awareness
C. Time difference
D. Video resolution

37. The process of combining data from multiple systems for analysis is known as:
A. Data integration
B. Data encryption
C. Data validation
D. Data normalization

38. When the same data element is defined differently across systems, the issue is:
A. Semantic interoperability
B. Hardware failure
C. Visual bias
D. Logical integrity

39. The principle of “minimum necessary data” means:

A. Accessing only data required for a specific task
B. Collecting all patient information
C. Sharing all data for efficiency
D. Printing summaries

40. The accuracy of a predictive model depends MOST on:

A. Quality and completeness of input data
B. Size of visualizations
C. Font of dashboards
D. System password strength

41. A nurse viewing patient satisfaction by department over time would best use a:
A. Line chart with multiple series
B. Pie chart
C. Scatter plot
D. Word cloud

42. What’s the core difference between data security and data integrity?
A. Security prevents unauthorized access; integrity ensures correctness
B. Integrity hides data; security checks quality
C. They are identical
D. Security applies to offline data only

43. In a hospital network, maintaining frequent backups primarily enhances:

A. Data availability and recovery
B. Data confidentiality
C. System overload
D. Interoperability

44. Which advanced data visualization tool can integrate live dashboards with predictive
analytics?
A. Power BI
B. NVivo
C. Excel
D. Access

45. Which step comes first in implementing a new HIS?

A. Needs assessment and stakeholder analysis
B. Staff training
C. Policy writing
D. Maintenance schedule

46. When analyzing blood pressure data, outliers should be:

A. Evaluated, not automatically removed
B. Deleted immediately
C. Ignored
D. Averaged

47. Which ethical principle ensures patients voluntarily agree to digital data use?
A. Informed consent
B. Beneficence
C. Fidelity
D. Veracity

48. A nurse leader insists that system updates be communicated clearly before rollout. This
reflects:
A. Transparent change management
B. Financial accountability
C. Ethical neutrality
D. Power centralization

49. A scatter plot displaying BMI vs. blood glucose helps identify:
A. Correlation patterns between variables
B. Time trends
C. Categorical differences
D. Frequency distributions

50. In data visualization, excessive use of 3D effects can distort interpretation by:
A. Misrepresenting proportional relationships
B. Highlighting outliers
C. Clarifying scales
D. Improving accuracy
Cross-Match 1
Match the theory/framework in Column B with its correct description in Column A.
Column A Column B
_____Explains how innovation adoption spreads within a
A. Lewin’s Change Theory
social system.
_____Views information as a hierarchy progressing from
B. DIKW Framework
data to wisdom.
_____Describes how unfreezing and refreezing processes
C. Rogers’ Diffusion of Innovation
support informatics adoption.
_____Guides alignment of nursing science, computer
D. ANA Nursing Informatics Model
science, and information science.
_____Stresses ethical use of information and data-driven
E. Informatics Principles of Practice
decision-making.

Cross-Match 2
Match the system type in Column B with its correct scenario in Column A.
Column A (Scenario) Column B
____Used for analyzing statistical nursing data A. Master Patient
____Manages daily hospital operations B. CDSS
____Stores patient treatment records electronically C. HIS
____Assists in evidence-based medication alerts D. SAS / SPSS
____Links patient identifiers across departments E. HER

Cross-Match 3
Match the data visualization type in Column B with its correct use in Column A.
Column A Column B
____Compare infection rates across wards A. Pie Chart
____Show blood pressure trends over time B. Scatter Plot
____Display proportion of disease cases C. Bar Chart
____Display distribution of patient ages D. Line Graph
____Show correlation between BMI and glucose E. Histogram

Cross-Match 4
Match the data violated law/principle type in Column B with its correct breach in Column A.
Column A Column B
____Nurse posts patient photos online A. Ethical Misconduct
____Data lost due to missing backups B. Confidentiality Ethical
____Wrong patient record accessed C. Data Availability
____Incomplete data entry into system D. Privacy Violation
____System used for personal gain E. Data Accuracy
 Fill in the blanks/One-word Answer

1. The discipline that unites nursing science, computer science, and information science into
one field is called __________.
2. A conceptual representation that guides data use in clinical decision-making is known as
a __________.
3. The intangible set of instructions that directs hardware functions is termed __________.
4. A system that can be freely modified, redistributed, and improved by users is known as
__________.
5. The ethical principle ensuring technology use respects patient dignity and autonomy is
__________.

6. A digital system that manages patients’ clinical data within hospital wards is a
__________ system.
7. Technology-enabled delivery of health services across distances is known as
__________.
8. A technology platform that tracks outpatient encounters and follow-ups is an __________
system.
9. Using informatics tools to coordinate response to epidemics or disasters falls under
__________ informatics.
10. Devices and software that streamline administrative workflows are collectively called
__________ technologies.
11. A digitally generated document integrating nursing diagnoses, outcomes, and
interventions is a __________ plan.
12. A structured, time-bound sequence of care for a specific condition is called a __________
pathway.
13. Scholarly, peer-reviewed journals accessed only in digital format are called __________.
14. Authoritative recommendations for clinical decisions, derived from systematic reviews,
are known as __________.
15. The practice model integrating best evidence, clinical expertise, and patient preferences is
__________ practice.
16. The real-time audiovisual link that connects healthcare professionals across locations is
called __________.
17. The microblogging platform that limits posts to short character counts is __________.
18. Apple’s video communication application used for patient and team interaction is
__________.
19. The version of the web that allows user participation, collaboration, and content
generation is __________.
20. The digital method of saving frequently visited websites for easy retrieval is called a
__________.

Indicate whether the statement is True or False

 21. Nursing informatics is limited to the use of electronic health records in hospitals and does
not extend to community or research settings. ____________
22. Computer hardware refers to the collection of both physical and digital components that
make up a computer system. _____________________
23. In nursing informatics, frameworks and models are interchangeable terms that describe
the same conceptual structure. ______________________
24. Open-source software allows users to freely access and modify the source code, but
redistribution is prohibited. ___________________
25. Telehealth and telemedicine are identical concepts referring only to remote clinical
consultations. __________________
26. Netiquette rules exist to regulate copyright ownership of digital materials. ____________
27. Evidence-based nursing practice integrates clinical expertise and patient preferences but
excludes informatics-generated data. _______________________
28. Electronic Health Records (EHR) and Electronic Medical Records (EMR) are exactly the
same in scope and functionality. _______________________
29. The IT team in a healthcare setting is solely responsible for maintaining electronic
systems and is not part of the nursing informatics team. _____________________
30. In nursing research, tools like SPSS and SurveyMonkey serve identical purposes since
both are used for data analysis. ____________________

1. Kapiri Mposhi District Hospital recently introduced an Electronic Health Record (EHR)
system. However, most nurses have shown reluctance to use it due to lack of training, fear of
technology, and perceived increase in workload.

a) Define nursing informatics and explain its relevance in modern nursing practice. (15%)
b) List five major components of an Electronic Health Record (EHR) system used in hospitals.
(10%)
c) Explain how EHR systems enhance patient safety, continuity of care, and documentation
accuracy. (25%)
d) Discuss the challenges faced by nurses during the implementation of EHRs in Zambia. (25%)
e) Propose practical strategies a nurse leader can employ to promote acceptance and effective
utilization of EHRs among nursing staff. (25%)

2. A nurse at the University Teaching Hospital (UTH) posts a patient’s lab results and
photograph on a professional WhatsApp group for academic discussion without the patient’s
consent. The post spreads to the public, raising ethical concerns.
a) Define patient confidentiality and explain its importance in nursing informatics. (15%)
b) List the key ethical and legal principles violated in this scenario. (10%)
c) Explain the potential legal implications and professional consequences of breaching patient
confidentiality. (20%)
d) Discuss the relevance of “netiquette” in maintaining professional behavior online. (30%)
e) Propose strategies that nursing institutions in Zambia can use to instill ethical digital behavior
among students and practitioners. (25%)

3. You have been appointed as the Nursing Informatics Coordinator at a provincial hospital
tasked with implementing a telehealth program linking district hospitals and rural health centers.

a) Define the leadership role of a nurse in managing nursing informatics systems. (6%)
b) List four key leadership competencies required for effective informatics system management.
(8%)
c) Explain how collaboration between IT experts and the nursing team improves system
functionality and staff acceptance. (26%)
d) Discuss major challenges likely to be faced during telehealth implementation in Zambia.
(35%)
e) Propose practical leadership interventions that would ensure successful telehealth system
adoption and sustainability. (25%)

All The Best!!!