,NURS 4107 Patient Safety and Quality
Improvement Exam Prep — Comprehensive Review
+ Practice MCQs — Walden University 2025/2026
1. Which report published by the Institute of Medicine in 1999 brought national attention to the prevalence of
medical errors in healthcare?
A. *Crossing the Quality Chasm*
B. *To Err Is Human*
C. *The Future of Nursing*
D. *Health Professions Education: A Bridge to Quality*
Correct Answer: B
Rationale: The IOM’s *To Err Is Human* (1999) highlighted medical errors as a leading cause of death and
catalyzed the modern patient safety movement. It shifted the focus from individual blame to system failures.
2. The primary goal of patient safety initiatives is to:
A. Increase hospital revenue
B. Prevent harm to patients from medical errors and adverse events
C. Reduce nursing staff
D. Expand facility size
Correct Answer: B
Rationale: Patient safety initiatives aim to prevent harm by reducing medical errors and adverse events
through system design, standardization, and a culture of safety.
,3. According to the Donabedian Model, quality is measured through which three components?
A. Assessment, Planning, Implementation
B. Structure, Process, Outcomes
C. Input, Output, Feedback
D. Safety, Quality, Efficiency
Correct Answer: B
Rationale: The Donabedian Model is a foundational framework for evaluating healthcare quality. Structure
refers to the attributes of the care setting (e.g., staffing, facilities), process refers to how care is delivered, and
outcomes refer to the results of care.
4. A nurse is analyzing whether the hospital has adequate nurse-to-patient ratios. This is an example of which
Donabedian component?
A. Outcome measure
B. Process measure
C. Structural measure
D. Benchmark measure
Correct Answer: C
Rationale: Structural measures refer to the attributes of the settings in which care occurs, such as staffing
ratios, facility resources, and organizational characteristics. Nurse-to-patient ratio is a structural measure.
, 5. Which quality improvement model uses the Plan-Do-Study-Act (PDSA) cycle?
A. Six Sigma
B. The Model for Improvement / Deming Model
C. Lean
D. Root Cause Analysis
Correct Answer: B
Rationale: The PDSA cycle, developed by W. Edwards Deming, is a core tool for continuous quality
improvement. It involves planning a change, implementing it on a small scale, studying the results, and acting
on what is learned.
6. Which methodology focuses primarily on reducing process variation and defects?
A. Lean
B. Six Sigma
C. PDSA
D. Root Cause Analysis
Correct Answer: B
Rationale: Six Sigma focuses on reducing variation and defects in processes to improve quality. It uses
statistical methods to identify and eliminate sources of error.
Improvement Exam Prep — Comprehensive Review
+ Practice MCQs — Walden University 2025/2026
1. Which report published by the Institute of Medicine in 1999 brought national attention to the prevalence of
medical errors in healthcare?
A. *Crossing the Quality Chasm*
B. *To Err Is Human*
C. *The Future of Nursing*
D. *Health Professions Education: A Bridge to Quality*
Correct Answer: B
Rationale: The IOM’s *To Err Is Human* (1999) highlighted medical errors as a leading cause of death and
catalyzed the modern patient safety movement. It shifted the focus from individual blame to system failures.
2. The primary goal of patient safety initiatives is to:
A. Increase hospital revenue
B. Prevent harm to patients from medical errors and adverse events
C. Reduce nursing staff
D. Expand facility size
Correct Answer: B
Rationale: Patient safety initiatives aim to prevent harm by reducing medical errors and adverse events
through system design, standardization, and a culture of safety.
,3. According to the Donabedian Model, quality is measured through which three components?
A. Assessment, Planning, Implementation
B. Structure, Process, Outcomes
C. Input, Output, Feedback
D. Safety, Quality, Efficiency
Correct Answer: B
Rationale: The Donabedian Model is a foundational framework for evaluating healthcare quality. Structure
refers to the attributes of the care setting (e.g., staffing, facilities), process refers to how care is delivered, and
outcomes refer to the results of care.
4. A nurse is analyzing whether the hospital has adequate nurse-to-patient ratios. This is an example of which
Donabedian component?
A. Outcome measure
B. Process measure
C. Structural measure
D. Benchmark measure
Correct Answer: C
Rationale: Structural measures refer to the attributes of the settings in which care occurs, such as staffing
ratios, facility resources, and organizational characteristics. Nurse-to-patient ratio is a structural measure.
, 5. Which quality improvement model uses the Plan-Do-Study-Act (PDSA) cycle?
A. Six Sigma
B. The Model for Improvement / Deming Model
C. Lean
D. Root Cause Analysis
Correct Answer: B
Rationale: The PDSA cycle, developed by W. Edwards Deming, is a core tool for continuous quality
improvement. It involves planning a change, implementing it on a small scale, studying the results, and acting
on what is learned.
6. Which methodology focuses primarily on reducing process variation and defects?
A. Lean
B. Six Sigma
C. PDSA
D. Root Cause Analysis
Correct Answer: B
Rationale: Six Sigma focuses on reducing variation and defects in processes to improve quality. It uses
statistical methods to identify and eliminate sources of error.
