Patient Safety & Quality Improvement USMLE Step 1 Practice Questions
53 board-style USMLE Step 1 questions in Biostatistics & Behavioral Science. Each question shows the correct answer; create a free account for the full explanation and adaptive practice.
- USMLE Step 1 · hard1. A 400-bed community hospital implements a computerized double-verification protocol for high-risk medications (insulin, anticoagulants, chemotherapy) requiring two independent n…
- USMLE Step 1 · medium2. A 45-year-old woman presents to the emergency department with fever (38.9°C), hypotension (88/52 mmHg), tachycardia (118 bpm), and altered mental status. Blood cultures are draw…
- USMLE Step 1 · medium3. A 62-year-old man undergoes elective total hip arthroplasty. On postoperative day 5, he develops fever (38.9°C), tachycardia (HR 102 bpm), and purulent drainage from the surgica…
- USMLE Step 1 · medium4. A 250-bed community hospital implements a new computerized physician order entry (CPOE) system with real-time drug interaction alerts to reduce medication errors in the intensiv…
- USMLE Step 1 · hard5. A 54-year-old hospitalist implements a mandatory 8-week simulation-based crisis resource management (CRM) training program in a 24-bed medical ICU. The curriculum includes high-…
- USMLE Step 1 · medium6. A 67-year-old man with atrial fibrillation has been taking warfarin for 18 months. He presents to the emergency department with severe epistaxis, hemoptysis, and a 2-day history…
- USMLE Step 1 · medium7. A 78-year-old man with hypertension and depression presents to the emergency department with acute dizziness and near-syncope. Vital signs are BP 145/88 mmHg, HR 92 bpm, RR 16/m…
- USMLE Step 1 · medium8. A cardiac surgery center's quality improvement team identifies post-operative mortality rates ranging from 5% to 12% across six surgeons performing similar procedures in compara…
- USMLE Step 1 · easy9. A 67-year-old man with atrial fibrillation is anticoagulated with warfarin. He visits three different clinics for medication refills and has labs drawn at each site, but results…
- USMLE Step 1 · medium10. A 450-bed teaching hospital implements a rapid sepsis recognition protocol in the emergency department, which includes automated EHR alerts for lactate >2 mmol/L and systemic in…
- USMLE Step 1 · medium11. A 35-year-old primigravida at 34 weeks gestation presents to the emergency department with sudden onset severe abdominal pain and vaginal bleeding. Vital signs show BP 145/92 mm…
- USMLE Step 1 · hard12. A 40-year-old man with acute myocardial infarction is admitted to a community hospital's cardiac care unit. He receives timely reperfusion therapy and is discharged after an unc…
- USMLE Step 1 · easy13. A 73-year-old woman with mild cognitive impairment and limited English proficiency is discharged from the hospital after treatment for community-acquired pneumonia. She is presc…
- USMLE Step 1 · hard14. A 400-bed teaching hospital implements a new hand hygiene compliance program in July. The hospital epidemiology team uses standardized direct observation methods to assess compl…
- USMLE Step 1 · medium15. A 55-year-old man with type 2 diabetes mellitus is started on metformin 1000 mg twice daily by his primary care physician for glycemic control. His baseline serum creatinine is…
- USMLE Step 1 · medium16. A 28-year-old woman presents to the emergency department with fever, hypotension, and altered mental status. Blood cultures are drawn and empiric broad-spectrum antibiotics are…
- USMLE Step 1 · medium17. A 45-year-old woman with a history of hypertension presents to her primary care physician reporting symptoms of headaches and fatigue over the past 3 months. Review of her elect…
- USMLE Step 1 · hard18. A 67-year-old male with newly diagnosed atrial fibrillation is prescribed dabigatran 150 mg twice daily in the outpatient clinic. The electronic health record contains recent la…
- USMLE Step 1 · medium19. A 34-year-old woman at 32 weeks gestation presents to the obstetric unit with a chief complaint of headache and blurred vision for 6 hours. Vital signs are: BP 158/102 mmHg, HR…
- USMLE Step 1 · medium20. A 42-year-old man with type 2 diabetes mellitus presents for routine follow-up. His current HbA1c is 8.2% despite metformin monotherapy. The endocrinology team initiates a quali…
- USMLE Step 1 · easy21. A 55-year-old woman with no significant past medical history presents to the emergency department with acute right lower quadrant pain, fever, and elevated WBC. CT imaging confi…
- USMLE Step 1 · medium22. A 71-year-old man is hospitalized with pneumonia. During his stay, he develops hospital-acquired pressure ulcers despite nursing documentation indicating repositioning every 2 h…
- USMLE Step 1 · hard23. A 28-year-old primigravida at 32 weeks gestation presents for routine prenatal care. Vital signs: BP 158/95 mmHg, HR 92/min, RR 16/min, Temp 37.2°C. Laboratory results reveal pr…
- USMLE Step 1 · medium24. A 52-year-old man with chest pain presents to the emergency department. His electrocardiogram shows nonspecific ST changes. A high-sensitivity troponin I is drawn and results at…