CPPS IHI PRACTICE EXAM
1. When processing an order for diagnostic imaging of a patient's left foot, the
nurse remembered changing the dressing on the right foot. The nurse called the
provider to confirm the laterality, and the order was corrected.Whichcritical feature of
the culture of safety did the nurse practice?
A. measurement of patient safety
B. ensuring all orders are carried out
C. awareness of health education
D. detection of a near miss
Answer: D. detection of a near miss
2. Which of the following is an example of a high reliability principle?
A. individual accountability
B. sensitivity to operations
C. executive patient safety rounds
D. adoption of cutting edge technology
Answer: B. sensitivity to operations
3. Despite pre-procedure screening for scheduled MRIs, patients with im- planted
devices presented for scheduled MRI procedures.Technicians identified the hazards
and prevented patients from entering the suite. The most effective action for the
patient safety professional is to recommend
A. using track and trend reports for repeat occurrences.
B. suspending provider MRI ordering privileges for repetitive noncompliance.
C. requiring providers and staff to complete a safety training program.
D. collaborating with providers and staff to strengthen the screening process.-
Answer: D. collaborating with providers and staff to strengthen the screening
process.
4. Which of the following statements about root cause analysis (RCA) isaccurate?
A. The goal of performing an RCA is to find the one underlying root cause.
B. RCAs are not subject to outcome or hindsight biases.
C. RCAs may be subject to political highjack, resulting in poor risk controls.
D. RCAs are as effective in healthcare as they are in other high-risk industries.-
Answer: C. RCAs may be subject to political highjack, resulting in poor risk
controls.
5. Which of the following is accurate when a patient has back-to-back procedures,
and the person performing each procedure changes?
A. No staff changes may occur between procedures.
,B. One time-out at the beginning of the first surgery is sufficient for eachprocedure.
C. Another time-out needs to be performed before starting each procedure.
D. No additional sponge count is needed between surgeries.
Answer: C. Anothertime-out needs to be performed before starting each procedure.
6. Which of the following is most useful in illustrating inefficiency and wastein a
process?
A. fishbone diagram
B. control chart
C. spaghetti chart
D. Pareto diagram
Answer: C. spaghetti chart
7. Measurement of hospital-acquired pressure injuries would be an exampleof
A. an outcome measure.
B. a process measure.
C. a balance measure.
D. an evidence-based measure.
Answer: A. an outcome measure.
8. What type of organization recognizes and respects that information can come
from any source within the organization and that each reporter has a valuable
perspective?
A. highly reliable
B. diverse
C. patient-centered
D. interdisciplinary
Answer: A. highly reliable
9. From a human factors engineering perspective, which of the followingshould
beknown about identifying and eliminating diagnostic errors?
A. Diagnostic errors are the result of cognitive biases and failures by clinicians.
B. Partnership with scientists in cognition, perception, and decision makingis
needed.
C. An effective strategy to reduce diagnostic errors is the use of checklists.
D. Attribution of diagnostic errors is not subject to either hindsight or outcome
biases.
Answer: B. Partnership with scientists in cognition, perception, and decision making
is needed.
10. Which of the following would best demonstrate non-random process vari-ation
,over time?
A. histogram
B. control chart
C. run chart
D. pie chart
Answer: B. control chart
11. A patient safety professional is leading a process improvement team to enhance
communication hand-offs between hospital units. Which of the fol-lowing is the best
question to ask at the first team meeting?
A. "What process change should be the focus?"
B. "When should direct observations begin?"
C. "What are we trying to accomplish?"
D. "When should we spread best practices?"
Answer: C. "What are we trying to accomplish?"
12. Which of the following is most important in building a culture of safety?
A. measuring safety outcomes
B. addressing burnout
C. establishing shared values
D. utilizing electronic health records
Answer: C. establishing shared values
13. A practitioner reads a groundbreaking study on a condition seen frequent-ly in
their practice. Coincidentally, the next patient that the practitioner sees has
symptoms commonly seen with that condition. Which of the following biases or
heuristics best describes this phenomena?
A. anchoring
B. availability
C. premature closure
D. risk aversion
Answer: B. availability
14. While investigating a near miss medication event, a manager identifies a pattern
of work arounds by a clinician that violates policies and procedures. To determine
accountability, the manager's next step should be to
A. conduct a focus group with work area staff.
B. perform a substitution test.
C. escalate the workarounds to leadership.
D. amend procedures to support the workarounds.
Answer: B. perform a substitutiontest.
, 15. A physician is planning to discharge a patient. The nurse knew that the patient
needed additional equipment at home.Together they reached out to the
social worker and discharge planner for a safe care transition. Which featureof the
culture of safety did they practice?
A. activation of transfer protocols
B. utilization of open communication
C. measurement of patient safety
D. ensuring health literacy
Answer: B. utilization of open communication
16. From a human factors standpoint, which of the following is true about
harmduring healthcare?
A. It is either due to system errors or intentional human choice.
B. It would not occur if healthcare workers followed rules.
C. It is prevented by healthcare workers adapting to changes.
D. It is always preventable; the goal is zero harm.
Answer: C. It is prevented by healthcareworkers adapting to changes.
17. A patient safety professional notes an increase in safety events involvinginsulin.
Which of the following strategies is most likely to result in improvement?
A. The quality committee requires monthly progress reports on departmentalinsulin
safety plans.
B. The pharmacy and therapeutics committee introduces two insulin productsto the
formulary.
C. The pharmacy educates on insulin safety by distributing a tip sheet tonursing and
providers.
D. The medication safety committee monitors reports on insulin administration
errors.
Answer: A. The quality committee requires monthly progress reports on
departmental insulin safety plans.
18. In preparation for new antimicrobial stewardship regulatory
requirements,a hospital is creating an antimicrobial stewardship committee.
What should be thefirst step in supporting this new patient safety initiative?
A. Reach out to subject matter experts to gain insight on different complianceissues.
B. Work with information technology (IT) to build antibiotic indication andtime-out
screens.
C. Partner with key stakeholders to perform a gap analysis of current state toideal
state.
D. Review the past year's data to identify the most commonly grown pathogens.
Answer: C. Partner with key stakeholders to perform a gap analysis of currentstate
to ideal state.
1. When processing an order for diagnostic imaging of a patient's left foot, the
nurse remembered changing the dressing on the right foot. The nurse called the
provider to confirm the laterality, and the order was corrected.Whichcritical feature of
the culture of safety did the nurse practice?
A. measurement of patient safety
B. ensuring all orders are carried out
C. awareness of health education
D. detection of a near miss
Answer: D. detection of a near miss
2. Which of the following is an example of a high reliability principle?
A. individual accountability
B. sensitivity to operations
C. executive patient safety rounds
D. adoption of cutting edge technology
Answer: B. sensitivity to operations
3. Despite pre-procedure screening for scheduled MRIs, patients with im- planted
devices presented for scheduled MRI procedures.Technicians identified the hazards
and prevented patients from entering the suite. The most effective action for the
patient safety professional is to recommend
A. using track and trend reports for repeat occurrences.
B. suspending provider MRI ordering privileges for repetitive noncompliance.
C. requiring providers and staff to complete a safety training program.
D. collaborating with providers and staff to strengthen the screening process.-
Answer: D. collaborating with providers and staff to strengthen the screening
process.
4. Which of the following statements about root cause analysis (RCA) isaccurate?
A. The goal of performing an RCA is to find the one underlying root cause.
B. RCAs are not subject to outcome or hindsight biases.
C. RCAs may be subject to political highjack, resulting in poor risk controls.
D. RCAs are as effective in healthcare as they are in other high-risk industries.-
Answer: C. RCAs may be subject to political highjack, resulting in poor risk
controls.
5. Which of the following is accurate when a patient has back-to-back procedures,
and the person performing each procedure changes?
A. No staff changes may occur between procedures.
,B. One time-out at the beginning of the first surgery is sufficient for eachprocedure.
C. Another time-out needs to be performed before starting each procedure.
D. No additional sponge count is needed between surgeries.
Answer: C. Anothertime-out needs to be performed before starting each procedure.
6. Which of the following is most useful in illustrating inefficiency and wastein a
process?
A. fishbone diagram
B. control chart
C. spaghetti chart
D. Pareto diagram
Answer: C. spaghetti chart
7. Measurement of hospital-acquired pressure injuries would be an exampleof
A. an outcome measure.
B. a process measure.
C. a balance measure.
D. an evidence-based measure.
Answer: A. an outcome measure.
8. What type of organization recognizes and respects that information can come
from any source within the organization and that each reporter has a valuable
perspective?
A. highly reliable
B. diverse
C. patient-centered
D. interdisciplinary
Answer: A. highly reliable
9. From a human factors engineering perspective, which of the followingshould
beknown about identifying and eliminating diagnostic errors?
A. Diagnostic errors are the result of cognitive biases and failures by clinicians.
B. Partnership with scientists in cognition, perception, and decision makingis
needed.
C. An effective strategy to reduce diagnostic errors is the use of checklists.
D. Attribution of diagnostic errors is not subject to either hindsight or outcome
biases.
Answer: B. Partnership with scientists in cognition, perception, and decision making
is needed.
10. Which of the following would best demonstrate non-random process vari-ation
,over time?
A. histogram
B. control chart
C. run chart
D. pie chart
Answer: B. control chart
11. A patient safety professional is leading a process improvement team to enhance
communication hand-offs between hospital units. Which of the fol-lowing is the best
question to ask at the first team meeting?
A. "What process change should be the focus?"
B. "When should direct observations begin?"
C. "What are we trying to accomplish?"
D. "When should we spread best practices?"
Answer: C. "What are we trying to accomplish?"
12. Which of the following is most important in building a culture of safety?
A. measuring safety outcomes
B. addressing burnout
C. establishing shared values
D. utilizing electronic health records
Answer: C. establishing shared values
13. A practitioner reads a groundbreaking study on a condition seen frequent-ly in
their practice. Coincidentally, the next patient that the practitioner sees has
symptoms commonly seen with that condition. Which of the following biases or
heuristics best describes this phenomena?
A. anchoring
B. availability
C. premature closure
D. risk aversion
Answer: B. availability
14. While investigating a near miss medication event, a manager identifies a pattern
of work arounds by a clinician that violates policies and procedures. To determine
accountability, the manager's next step should be to
A. conduct a focus group with work area staff.
B. perform a substitution test.
C. escalate the workarounds to leadership.
D. amend procedures to support the workarounds.
Answer: B. perform a substitutiontest.
, 15. A physician is planning to discharge a patient. The nurse knew that the patient
needed additional equipment at home.Together they reached out to the
social worker and discharge planner for a safe care transition. Which featureof the
culture of safety did they practice?
A. activation of transfer protocols
B. utilization of open communication
C. measurement of patient safety
D. ensuring health literacy
Answer: B. utilization of open communication
16. From a human factors standpoint, which of the following is true about
harmduring healthcare?
A. It is either due to system errors or intentional human choice.
B. It would not occur if healthcare workers followed rules.
C. It is prevented by healthcare workers adapting to changes.
D. It is always preventable; the goal is zero harm.
Answer: C. It is prevented by healthcareworkers adapting to changes.
17. A patient safety professional notes an increase in safety events involvinginsulin.
Which of the following strategies is most likely to result in improvement?
A. The quality committee requires monthly progress reports on departmentalinsulin
safety plans.
B. The pharmacy and therapeutics committee introduces two insulin productsto the
formulary.
C. The pharmacy educates on insulin safety by distributing a tip sheet tonursing and
providers.
D. The medication safety committee monitors reports on insulin administration
errors.
Answer: A. The quality committee requires monthly progress reports on
departmental insulin safety plans.
18. In preparation for new antimicrobial stewardship regulatory
requirements,a hospital is creating an antimicrobial stewardship committee.
What should be thefirst step in supporting this new patient safety initiative?
A. Reach out to subject matter experts to gain insight on different complianceissues.
B. Work with information technology (IT) to build antibiotic indication andtime-out
screens.
C. Partner with key stakeholders to perform a gap analysis of current state toideal
state.
D. Review the past year's data to identify the most commonly grown pathogens.
Answer: C. Partner with key stakeholders to perform a gap analysis of currentstate
to ideal state.
