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CPPS IHI PRACTICE EXAM QUESTIONS LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
CPPS IHI Practice Exam: Questions with Rationales
DOMAIN 1: CULTURE (Questions 1-60)
1. A patient safety professional is tasked with creating a dashboard for the Board of
Directors to oversee patient safety. Which of the following metrics would best
provide a high-level, balanced view of the organization's safety performance to
support effective governance?
A) The total number of incident reports filed per month
B) The hospital's current National Patient Safety Goals compliance rate
C) A composite score of proactive and reactive metrics, including culture survey results,
serious event rates, and high-reliability adoption
D) The percentage of staff who have completed mandatory patient safety training
Correct Answer: C - The most effective safety oversight dashboard provides a balanced
view of proactive (leading) and reactive (lagging) indicators, as well as culture metrics. A
composite view tells the Board about the state of the organization's culture, its current
harm rates, and how well it is adopting high-reliability behaviors, providing a more
comprehensive picture than any single metric .
2. A manager is preparing to have a conversation with a staff member who made a
serious error. The manager plans to start the conversation by saying, "I know you
feel terrible about this, but we need to review what happened." Which of the
following best describes why this opening should be revised to support a just
culture approach?
A) It assumes how the employee feels, which may be inaccurate and can feel
patronizing
B) It is too soft and may not convey the seriousness of the event to the employee
C) It does not clearly state that the purpose of the meeting is to assign blame
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D) It focuses on the employee's feelings rather than the systems that contributed to the
event
Correct Answer: A - Opening the conversation by telling the employee how they feel is a
coaching pitfall. It assumes the employee's emotional state, which can be inaccurate
and feel patronizing. The manager should focus on a systems-based review of the event,
not on the employee's feelings .
3. The free, uninhibited flow of information that is open to the scrutiny of others is
the definition of which of the following concepts that is fundamental to a strong
patient safety culture?
A) Just Culture
B) Transparency
C) Quality Care
D) High Reliability
Correct Answer: B - The Lucian Leape Institute defines transparency as the free,
uninhibited flow of information that is open to the scrutiny of others. This concept is
essential for a strong safety culture, enabling learning from errors and building trust .
4. In a just culture, which of the following responses is most appropriate for a staff
member who made a human error (a slip or lapse) that resulted in a patient safety
event?
A) Termination of employment to send a message about safety
B) Remediation and coaching focused on system improvements and reducing reliance
on memory
C) A formal disciplinary action with a written warning in the employee's file
D) Suspension pending a full investigation by the quality department
Correct Answer: B - In a just culture, human error (e.g., a slip or lapse) is managed by
consoling and coaching the individual, with a focus on improving the system and
reducing reliance on memory. Disciplinary action or termination is reserved for reckless
behavior or intentional violations, not simple human error .
5. An organization is working to improve its safety culture. Which of the following
leadership behaviors is most critical to fostering psychological safety among staff
and encouraging them to speak up about safety concerns?
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A) Discouraging questions to maintain efficiency and authority
B) Punishing staff who report errors to deter future mistakes
C) Actively seeking input from staff and responding non-punitively to concerns raised
D) Limiting communication to formal channels to prevent rumors
Correct Answer: C - Psychological safety is the belief that one will not be punished or
humiliated for speaking up with ideas, questions, concerns, or mistakes. Leaders foster
this by actively soliciting input and responding positively to staff who raise concerns .
6. A hospital is experiencing high rates of burnout among nursing staff. The patient
safety team is asked to evaluate the impact of burnout on safety. Which of the
following is the best description of the relationship between burnout and patient
safety?
A) Burnout is primarily a human resources issue and does not significantly impact
patient safety
B) Burnout leads to increased turnover, which indirectly increases costs but does not
affect clinical outcomes
C) Burnout is associated with decreased empathy and increased medical errors,
impacting both staff well-being and patient safety
D) Burnout only affects a small percentage of healthcare workers and is not a systemic
issue
Correct Answer: C - Burnout is associated with decreased empathy and increased
medical errors, impacting both staff well-being and patient safety. It is a significant
concern because exhausted, disengaged staff are more likely to make errors and less
likely to identify and report safety issues .
7. Which of the following is the most appropriate role of a patient safety officer
(PSO) in a healthcare organization's leadership structure?
A) The PSO is responsible for conducting all root cause analyses and implementing
action plans independently
B) The PSO serves as a member of the leadership team, setting priorities and allocating
resources for patient safety initiatives
C) The PSO's primary role is to investigate and discipline staff involved in patient safety
events
D) The PSO reports to the risk management department and focuses on minimizing
financial liability
Correct Answer: B - An effective Patient Safety Officer (PSO) is a member of the
organization's leadership team who helps set safety priorities, allocate resources, and
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champion a culture of safety. Leadership is crucial in establishing a culture of safety
and setting priorities for patient safety initiatives .
8. A healthcare organization is implementing a new safety reporting system. What
is the primary purpose of encouraging staff to report near misses and unsafe
conditions in addition to actual adverse events?
A) To identify staff members who are frequently involved in errors for performance
improvement
B) To create a complete record of all events for potential legal discovery
C) To learn from the gaps in the system that could lead to harm, allowing proactive
correction before an event occurs
D) To increase the number of reports to demonstrate regulatory compliance
Correct Answer: C - The primary purpose of reporting near misses and unsafe
conditions is to learn from the gaps in the system that could lead to harm. Analyzing
these reports allows the organization to correct problems before a patient is harmed,
shifting from a reactive to a proactive safety approach .
9. The "Swiss Cheese Model" of accident causation illustrates which of the
following concepts about how errors lead to patient harm in complex healthcare
systems?
A) Errors only occur when a single layer of defense fails, making the system vulnerable
B) Errors occur when multiple layers of defense (represented as slices of cheese) fail,
allowing hazards to pass through and lead to harm
C) Errors are random and unpredictable, and the model helps identify the specific
individual responsible for the error
D) Errors are caused by human carelessness, and the model shows how to discipline
the negligent party
Correct Answer: B - The Swiss Cheese Model illustrates how errors occur when
multiple layers of defense (represented as slices of cheese with holes) fail, allowing
hazards to pass through and lead to harm. This model emphasizes that errors are rarely
caused by a single failure but by the alignment of multiple vulnerabilities .
10. A patient safety professional is helping a department head who is about to have
a conversation with a staff member who made a serious error. Which of the
following is the most appropriate opening for the meeting, consistent with a just
culture approach?
CPPS IHI PRACTICE EXAM QUESTIONS LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
CPPS IHI Practice Exam: Questions with Rationales
DOMAIN 1: CULTURE (Questions 1-60)
1. A patient safety professional is tasked with creating a dashboard for the Board of
Directors to oversee patient safety. Which of the following metrics would best
provide a high-level, balanced view of the organization's safety performance to
support effective governance?
A) The total number of incident reports filed per month
B) The hospital's current National Patient Safety Goals compliance rate
C) A composite score of proactive and reactive metrics, including culture survey results,
serious event rates, and high-reliability adoption
D) The percentage of staff who have completed mandatory patient safety training
Correct Answer: C - The most effective safety oversight dashboard provides a balanced
view of proactive (leading) and reactive (lagging) indicators, as well as culture metrics. A
composite view tells the Board about the state of the organization's culture, its current
harm rates, and how well it is adopting high-reliability behaviors, providing a more
comprehensive picture than any single metric .
2. A manager is preparing to have a conversation with a staff member who made a
serious error. The manager plans to start the conversation by saying, "I know you
feel terrible about this, but we need to review what happened." Which of the
following best describes why this opening should be revised to support a just
culture approach?
A) It assumes how the employee feels, which may be inaccurate and can feel
patronizing
B) It is too soft and may not convey the seriousness of the event to the employee
C) It does not clearly state that the purpose of the meeting is to assign blame
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D) It focuses on the employee's feelings rather than the systems that contributed to the
event
Correct Answer: A - Opening the conversation by telling the employee how they feel is a
coaching pitfall. It assumes the employee's emotional state, which can be inaccurate
and feel patronizing. The manager should focus on a systems-based review of the event,
not on the employee's feelings .
3. The free, uninhibited flow of information that is open to the scrutiny of others is
the definition of which of the following concepts that is fundamental to a strong
patient safety culture?
A) Just Culture
B) Transparency
C) Quality Care
D) High Reliability
Correct Answer: B - The Lucian Leape Institute defines transparency as the free,
uninhibited flow of information that is open to the scrutiny of others. This concept is
essential for a strong safety culture, enabling learning from errors and building trust .
4. In a just culture, which of the following responses is most appropriate for a staff
member who made a human error (a slip or lapse) that resulted in a patient safety
event?
A) Termination of employment to send a message about safety
B) Remediation and coaching focused on system improvements and reducing reliance
on memory
C) A formal disciplinary action with a written warning in the employee's file
D) Suspension pending a full investigation by the quality department
Correct Answer: B - In a just culture, human error (e.g., a slip or lapse) is managed by
consoling and coaching the individual, with a focus on improving the system and
reducing reliance on memory. Disciplinary action or termination is reserved for reckless
behavior or intentional violations, not simple human error .
5. An organization is working to improve its safety culture. Which of the following
leadership behaviors is most critical to fostering psychological safety among staff
and encouraging them to speak up about safety concerns?
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A) Discouraging questions to maintain efficiency and authority
B) Punishing staff who report errors to deter future mistakes
C) Actively seeking input from staff and responding non-punitively to concerns raised
D) Limiting communication to formal channels to prevent rumors
Correct Answer: C - Psychological safety is the belief that one will not be punished or
humiliated for speaking up with ideas, questions, concerns, or mistakes. Leaders foster
this by actively soliciting input and responding positively to staff who raise concerns .
6. A hospital is experiencing high rates of burnout among nursing staff. The patient
safety team is asked to evaluate the impact of burnout on safety. Which of the
following is the best description of the relationship between burnout and patient
safety?
A) Burnout is primarily a human resources issue and does not significantly impact
patient safety
B) Burnout leads to increased turnover, which indirectly increases costs but does not
affect clinical outcomes
C) Burnout is associated with decreased empathy and increased medical errors,
impacting both staff well-being and patient safety
D) Burnout only affects a small percentage of healthcare workers and is not a systemic
issue
Correct Answer: C - Burnout is associated with decreased empathy and increased
medical errors, impacting both staff well-being and patient safety. It is a significant
concern because exhausted, disengaged staff are more likely to make errors and less
likely to identify and report safety issues .
7. Which of the following is the most appropriate role of a patient safety officer
(PSO) in a healthcare organization's leadership structure?
A) The PSO is responsible for conducting all root cause analyses and implementing
action plans independently
B) The PSO serves as a member of the leadership team, setting priorities and allocating
resources for patient safety initiatives
C) The PSO's primary role is to investigate and discipline staff involved in patient safety
events
D) The PSO reports to the risk management department and focuses on minimizing
financial liability
Correct Answer: B - An effective Patient Safety Officer (PSO) is a member of the
organization's leadership team who helps set safety priorities, allocate resources, and
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champion a culture of safety. Leadership is crucial in establishing a culture of safety
and setting priorities for patient safety initiatives .
8. A healthcare organization is implementing a new safety reporting system. What
is the primary purpose of encouraging staff to report near misses and unsafe
conditions in addition to actual adverse events?
A) To identify staff members who are frequently involved in errors for performance
improvement
B) To create a complete record of all events for potential legal discovery
C) To learn from the gaps in the system that could lead to harm, allowing proactive
correction before an event occurs
D) To increase the number of reports to demonstrate regulatory compliance
Correct Answer: C - The primary purpose of reporting near misses and unsafe
conditions is to learn from the gaps in the system that could lead to harm. Analyzing
these reports allows the organization to correct problems before a patient is harmed,
shifting from a reactive to a proactive safety approach .
9. The "Swiss Cheese Model" of accident causation illustrates which of the
following concepts about how errors lead to patient harm in complex healthcare
systems?
A) Errors only occur when a single layer of defense fails, making the system vulnerable
B) Errors occur when multiple layers of defense (represented as slices of cheese) fail,
allowing hazards to pass through and lead to harm
C) Errors are random and unpredictable, and the model helps identify the specific
individual responsible for the error
D) Errors are caused by human carelessness, and the model shows how to discipline
the negligent party
Correct Answer: B - The Swiss Cheese Model illustrates how errors occur when
multiple layers of defense (represented as slices of cheese with holes) fail, allowing
hazards to pass through and lead to harm. This model emphasizes that errors are rarely
caused by a single failure but by the alignment of multiple vulnerabilities .
10. A patient safety professional is helping a department head who is about to have
a conversation with a staff member who made a serious error. Which of the
following is the most appropriate opening for the meeting, consistent with a just
culture approach?
