New Practice Test for the CPPS Exam with 120
Questions and Correct Answers with Rationales/
CPPS - Certified Professional in Patient Safety Practice
Exam 2026
1. A patient safety professional is leading a process improvement team to enhance
communication hand-offs between hospital units. Which of the following 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?"
2. On studying the results of a root cause analysis, it is recognized that an RN missed
steps in a protocol. The RN is regarded as highly competent by colleagues and unit
leaders. The patient safety professional should determine the RN's behavior in this
error to be considered
A. workaround.
B. reckless.
C. high risk.
D. drift. - ANSWER- D. drift.
3. A practitioner reads a groundbreaking study on a condition seen frequently 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
4. While investigating a near miss medication event, a manager identifies a pattern of
workarounds 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
substitution test.
5. 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 feature of the culture
of safety did they practice?
A. activation of transfer protocols
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
healthcare workers adapting to changes.
6. A patient safety professional notes an increase in safety events involving insulin.
Which of the following strategies is most likely to result in improvement?
A. The quality committee requires monthly progress rep01ts on departmental
insulin safety plans.
B. The pharmacy and therapeutics committee introduces two insulin products to the
formulary.
, C. The pharmacy educates on insulin safety by distributing a tip sheet to nursing and
providers.
D. The medication safety committee monitors report on insulin administration errors.
- ANSWER-A. The quality committee requires monthly progress reports on
departmental insulin safety plans.
7. Of the following steps, which should be done first when conducting an FMEA?
A. Identify a high-risk process to evaluate.
B. Formulate solutions for a high-risk process.
C. Develop a ranking method to prioritize actions.
D. Facilitate error management strategies. - ANSWER-A. Identify a high-risk
process to evaluate.
A. Reach out to subject matter experts to gain insight on different compliance
issues.
B. Work with info1mation technology (IT) to build antibiotic indication and time-
out screens.
C. Partner with key stakeholders to perfo1m a gap analysis of current state to ideal
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 current
state to ideal state.
8. After implementing a new product recall system, a hospital was alerted to a
high- risk medication recall. This medication is in stock in the emergency
department and oncology unit. To ensure the effectiveness of the new system, a
patient safety professional should:
A. require individual departments to verify that a search for the recalled medication
was performed.
B. ensure an on-site visit verifies that the recalled medication was sequestered.
, C. reconcile the number of doses administered to the number of doses purchased.
D. notify the affected units via fax to remove recalled meds and to post recall
notices in the units - ANSWER-B. ensure an on-site visit verifies that the recalled
medication was sequestered.
9. A patient safety professional is analyzing data from a newly implemented barcode
medication administration (BCMA) system. They notice a sharp decline in reported
"wrong patient" errors but a significant increase in "workaround" alerts where nurses
bypass the system. What is the most appropriate initial action?
A. Discipline the nurses involved in the workarounds to reinforce the importance of the
technology.
B. Conduct a time-motion study to see if the BCMA system is slowing down workflow.
C. Convene a focus group with frontline nurses to understand the reasons for the
workarounds.
D. Disable the alert function for workarounds, as the primary goal of reducing wrong-
patient errors has been achieved.
o ANSWER-C. Convene a focus group with frontline nurses to understand the
reasons for the workarounds.
o Rationale: Workarounds are often a symptom of a poorly designed system that doesn't
support frontline workflow. Disciplining staff (A) ignores the system issue. While a time-
motion study (B) might provide data, it doesn't explore the "why" as effectively as direct
conversation. Disabling the alert (D) would eliminate the ability to track this important
proxy for system usability issues. Understanding the root cause of the workarounds from
the nurses' perspective is the first step to improving both safety and efficiency.
10. A root cause analysis (RCA) team is investigating a wrong-site surgery. The surgeon
states, "The site was marked, but the patient was turned on the table, and I just didn't
re-confirm the mark before making the incision." The patient safety professional
facilitating the RCA should recognize this statement as an example of:
A. A reckless behavior that requires disciplinary action.
B. A latent safety hazard related to the surgical consent process.
C. An active error (sharp end) that occurred at the point of care.
D. A perfect example of why the universal protocol is unnecessary.
o ANSWER-C. An active error (sharp end) that occurred at the point of care.
o Rationale: Active errors are the immediate, visible actions (or inactions) by frontline
personnel that lead to an adverse event. The surgeon's failure to re-verify the site is an
active error. The team's job in the RCA is to look beyond this active error to understand
the latent conditions (e.g., workflow, communication, training) that may have made this
error more likely.
Questions and Correct Answers with Rationales/
CPPS - Certified Professional in Patient Safety Practice
Exam 2026
1. A patient safety professional is leading a process improvement team to enhance
communication hand-offs between hospital units. Which of the following 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?"
2. On studying the results of a root cause analysis, it is recognized that an RN missed
steps in a protocol. The RN is regarded as highly competent by colleagues and unit
leaders. The patient safety professional should determine the RN's behavior in this
error to be considered
A. workaround.
B. reckless.
C. high risk.
D. drift. - ANSWER- D. drift.
3. A practitioner reads a groundbreaking study on a condition seen frequently 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
4. While investigating a near miss medication event, a manager identifies a pattern of
workarounds 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
substitution test.
5. 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 feature of the culture
of safety did they practice?
A. activation of transfer protocols
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
healthcare workers adapting to changes.
6. A patient safety professional notes an increase in safety events involving insulin.
Which of the following strategies is most likely to result in improvement?
A. The quality committee requires monthly progress rep01ts on departmental
insulin safety plans.
B. The pharmacy and therapeutics committee introduces two insulin products to the
formulary.
, C. The pharmacy educates on insulin safety by distributing a tip sheet to nursing and
providers.
D. The medication safety committee monitors report on insulin administration errors.
- ANSWER-A. The quality committee requires monthly progress reports on
departmental insulin safety plans.
7. Of the following steps, which should be done first when conducting an FMEA?
A. Identify a high-risk process to evaluate.
B. Formulate solutions for a high-risk process.
C. Develop a ranking method to prioritize actions.
D. Facilitate error management strategies. - ANSWER-A. Identify a high-risk
process to evaluate.
A. Reach out to subject matter experts to gain insight on different compliance
issues.
B. Work with info1mation technology (IT) to build antibiotic indication and time-
out screens.
C. Partner with key stakeholders to perfo1m a gap analysis of current state to ideal
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 current
state to ideal state.
8. After implementing a new product recall system, a hospital was alerted to a
high- risk medication recall. This medication is in stock in the emergency
department and oncology unit. To ensure the effectiveness of the new system, a
patient safety professional should:
A. require individual departments to verify that a search for the recalled medication
was performed.
B. ensure an on-site visit verifies that the recalled medication was sequestered.
, C. reconcile the number of doses administered to the number of doses purchased.
D. notify the affected units via fax to remove recalled meds and to post recall
notices in the units - ANSWER-B. ensure an on-site visit verifies that the recalled
medication was sequestered.
9. A patient safety professional is analyzing data from a newly implemented barcode
medication administration (BCMA) system. They notice a sharp decline in reported
"wrong patient" errors but a significant increase in "workaround" alerts where nurses
bypass the system. What is the most appropriate initial action?
A. Discipline the nurses involved in the workarounds to reinforce the importance of the
technology.
B. Conduct a time-motion study to see if the BCMA system is slowing down workflow.
C. Convene a focus group with frontline nurses to understand the reasons for the
workarounds.
D. Disable the alert function for workarounds, as the primary goal of reducing wrong-
patient errors has been achieved.
o ANSWER-C. Convene a focus group with frontline nurses to understand the
reasons for the workarounds.
o Rationale: Workarounds are often a symptom of a poorly designed system that doesn't
support frontline workflow. Disciplining staff (A) ignores the system issue. While a time-
motion study (B) might provide data, it doesn't explore the "why" as effectively as direct
conversation. Disabling the alert (D) would eliminate the ability to track this important
proxy for system usability issues. Understanding the root cause of the workarounds from
the nurses' perspective is the first step to improving both safety and efficiency.
10. A root cause analysis (RCA) team is investigating a wrong-site surgery. The surgeon
states, "The site was marked, but the patient was turned on the table, and I just didn't
re-confirm the mark before making the incision." The patient safety professional
facilitating the RCA should recognize this statement as an example of:
A. A reckless behavior that requires disciplinary action.
B. A latent safety hazard related to the surgical consent process.
C. An active error (sharp end) that occurred at the point of care.
D. A perfect example of why the universal protocol is unnecessary.
o ANSWER-C. An active error (sharp end) that occurred at the point of care.
o Rationale: Active errors are the immediate, visible actions (or inactions) by frontline
personnel that lead to an adverse event. The surgeon's failure to re-verify the site is an
active error. The team's job in the RCA is to look beyond this active error to understand
the latent conditions (e.g., workflow, communication, training) that may have made this
error more likely.
