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 · medium25. A 38-year-old woman with newly diagnosed atrial fibrillation presents to the anticoagulation clinic to initiate warfarin therapy. Vital signs are stable: BP 118/76, HR 102, RR 1…
- USMLE Step 1 · medium26. A 62-year-old man is admitted to the ICU with sepsis secondary to pneumonia. His hospital course is complicated by acute kidney injury requiring vasopressor support. On hospital…
- USMLE Step 1 · medium27. A hospital implements daily 30-minute safety huddles in its ICU and tracks patient outcomes over 6 months. During analysis of mortality data, the team notes that sicker patients…
- USMLE Step 1 · hard28. A 45-year-old hospitalist implements a new medication reconciliation training program across 200 residents. Six months later, medication error rates are lower in the interventio…
- USMLE Step 1 · easy29. A 400-bed hospital's quality improvement team identifies that medication errors occur at a rate of 12.3 per 1,000 doses during night shifts, compared to 3.1 per 1,000 doses duri…
- USMLE Step 1 · medium30. A 62-year-old man with no documented penicillin allergy undergoes elective colorectal surgery. Prophylactic cefazolin is not administered perioperatively. On postoperative day 3…
- USMLE Step 1 · hard31. A 45-year-old hospital epidemiologist is reviewing a 12-month control chart from a quality improvement initiative tracking nosocomial infection rates on the medical/surgical uni…
- USMLE Step 1 · medium32. A 68-year-old male with a history of hypertension and atrial fibrillation presents to the emergency department with palpitations and dizziness. Vital signs show heart rate 118 b…
- USMLE Step 1 · medium33. A 45-year-old woman presents to the emergency department with acute substernal chest pain. The initial EKG shows nonspecific ST-segment changes, and a troponin level is ordered.…
- USMLE Step 1 · easy34. A quality improvement team at a community hospital wants to reduce the rate of postoperative surgical site infections. They review recent data and find that the antibiotic timin…
- USMLE Step 1 · medium35. A 58-year-old hospitalization safety officer reviews 240 incident reports over 6 months and identifies that 60% involve verbal telephone orders, with dose miscommunication as th…
- USMLE Step 1 · hard36. A hospital measures the time from emergency department arrival to percutaneous coronary intervention for ST-elevation myocardial infarction patients. The target is a door-to-bal…
- USMLE Step 1 · medium37. A 28-year-old medical student observes an attending physician enter a patient's room without performing hand hygiene before examining a hospitalized 62-year-old male with pneumo…
- USMLE Step 1 · medium38. A clinic implements a new diabetes management protocol. They measure hemoglobin A1c levels for all diabetic patients at baseline and every 3 months. After 1 year, they want to p…
- USMLE Step 1 · easy39. A 68-year-old male with hemoglobin of 7.2 g/dL receives O-negative blood instead of his prescribed A-positive type due to specimen mislabeling in phlebotomy. Within 30 minutes,…
- USMLE Step 1 · hard40. A hospital infection control team implements a bundle to prevent catheter-associated urinary tract infections (CAUTI). The bundle includes using aseptic technique during inserti…
- USMLE Step 1 · easy41. A 52-year-old male presents with acute dyspnea, HR 118/min, BP 168/92, RR 28, SpO2 89%. Chest X-ray reveals pulmonary edema. During root cause analysis of a delayed diuretic adm…
- USMLE Step 1 · medium42. A 68-year-old man with systolic heart failure (EF 35%) presents with dyspnea, orthopnea, and 8-pound weight gain over two weeks. Vitals: BP 158/94, HR 108, RR 22, SpO2 92% on ro…
- USMLE Step 1 · hard43. A hospital transitions from a paper-based medication ordering system to computerized physician order entry (CPOE). Three months after implementation, a review shows that while t…
- USMLE Step 1 · easy44. A 52-year-old surgeon consistently performs procedures without preoperative surgical site marking, despite two informal conversations about the practice gap. The hospital's surg…
- USMLE Step 1 · medium45. A hospital's morbidity and mortality conference reviews a case in which a patient died after receiving a tenfold overdose of heparin. The investigation reveals that the pharmacy…
- USMLE Step 1 · medium46. A quality improvement team uses a Plan-Do-Study-Act (PDSA) cycle to reduce patient wait times in an outpatient clinic. In the Plan phase, they hypothesize that staggering appoin…
- USMLE Step 1 · hard47. A hospital implements a new hand hygiene monitoring system using electronic sensors at alcohol-based hand rub dispensers. After 6 months, the data show that hand hygiene complia…
- USMLE Step 1 · medium48. A nurse administers 10 units of regular insulin intravenously to a patient instead of the prescribed 10 units of regular insulin subcutaneously. The patient develops symptomatic…