SMQT Infection Prevention and Control 2 — Questions and Answers
Question 1: During a survey, you observe that staff are wearing the same gloves while moving between resident rooms. Which infection control principle is being violated?
- Hand hygiene protocol
- Glove change between patients to prevent cross-contamination (Correct answer)
- Personal protective equipment storage
- Isolation precaution signage
Correct answer: Glove change between patients to prevent cross-contamination
Gloves must be changed between patients and hand hygiene performed to prevent transferring pathogens from one resident to another.
Question 2: A nursing home resident has been diagnosed with Clostridioides difficile (C. diff). What is the MOST appropriate isolation precaution?
- Airborne precautions with negative pressure room
- Droplet precautions with surgical mask
- Contact precautions with gown and gloves (Correct answer)
- Standard precautions only
Correct answer: Contact precautions with gown and gloves
C. diff is transmitted via the fecal-oral route through spores on surfaces, requiring contact precautions including gown and gloves.
Question 3: Which hand hygiene agent is NOT effective against Clostridioides difficile spores?
- Alcohol-based hand sanitizer (Correct answer)
- Chlorhexidine gluconate scrub
- Soap and water with friction
- Antimicrobial soap
Correct answer: Alcohol-based hand sanitizer
Alcohol-based hand sanitizers do not kill C. diff spores; soap and water with friction is required to physically remove them.
Question 4: A surveyor identifies that a facility's MDRO (multidrug-resistant organism) surveillance program lacks active surveillance cultures. What is the PRIMARY concern?
- Increased supply costs
- Failure to identify colonized residents who can transmit the organism (Correct answer)
- Non-compliance with dietary requirements
- Inadequate documentation of vital signs
Correct answer: Failure to identify colonized residents who can transmit the organism
Without active surveillance cultures, colonized but asymptomatic residents may go unidentified, allowing silent transmission of MDROs.
Question 5: Under the CMS infection control regulations, what is required when a resident is placed on transmission-based precautions?
- Immediate transfer to a hospital
- Notification of the resident's family within 24 hours
- Education of the resident about their precaution status and the reason (Correct answer)
- Restriction of all visitation indefinitely
Correct answer: Education of the resident about their precaution status and the reason
Residents have the right to know why precautions are being used, and education must be provided to support their understanding and cooperation.
Question 6: Which of the following practices BEST demonstrates appropriate respiratory hygiene and cough etiquette in a long-term care setting?
- Requiring all visitors to wear N95 respirators
- Providing tissues, waste receptacles, and hand sanitizer at the entrance (Correct answer)
- Isolating all coughing residents immediately
- Prohibiting staff from working if they have any cough
Correct answer: Providing tissues, waste receptacles, and hand sanitizer at the entrance
Providing tissues, no-touch waste disposal, and hand hygiene supplies at points of entry is the recommended approach for respiratory hygiene.
Question 7: A surveyor reviews a facility's antibiotic stewardship program. Which element is MOST critical to evaluate first?
- Cost of antibiotics purchased in the last quarter
- Whether a physician reviews and documents clinical indication for each antibiotic order (Correct answer)
- Number of antibiotic courses dispensed per month
- Brand versus generic antibiotic usage rates
Correct answer: Whether a physician reviews and documents clinical indication for each antibiotic order
Antibiotic stewardship requires documented clinical justification for each order to ensure antibiotics are prescribed only when appropriate.
SMQT Infection Prevention and Control 2
During a survey, you observe that staff are wearing the same gloves while moving between resident rooms.
Which infection control principle is being violated?