SMQT Infection Prevention and Control 4 — Questions and Answers
Question 1: A surveyor observes that a facility is using a disinfectant on a surface before the required contact time has elapsed. Why is this a concern?
- It wastes cleaning supplies and increases costs
- Premature removal prevents the disinfectant from achieving its full antimicrobial efficacy (Correct answer)
- It may damage the surface material permanently
- It violates hazardous chemical labeling requirements
Correct answer: Premature removal prevents the disinfectant from achieving its full antimicrobial efficacy
Disinfectants require a specific dwell (contact) time to kill target organisms; wiping off early renders the disinfectant ineffective.
Question 2: Which of the following is a CDC-recommended Tier 2 transmission-based precaution used when caring for a resident with active tuberculosis?
- Contact precautions
- Droplet precautions
- Airborne precautions in an AIIR (Correct answer)
- Standard precautions with gown only
Correct answer: Airborne precautions in an AIIR
Active pulmonary tuberculosis requires airborne precautions, including placement in an airborne infection isolation room (AIIR) with negative pressure.
Question 3: A surveyor reviews a facility's cleaning and disinfection log for high-touch surfaces. The log shows surfaces are cleaned once daily. What is the BEST practice recommendation?
- Once daily is sufficient if the product label is followed
- High-touch surfaces should be cleaned and disinfected at least twice daily and after each use (Correct answer)
- High-touch surfaces only need to be cleaned when visibly soiled
- Weekly deep cleaning replaces the need for daily high-touch surface disinfection
Correct answer: High-touch surfaces should be cleaned and disinfected at least twice daily and after each use
High-touch surfaces such as call lights, bed rails, and doorknobs require more frequent cleaning to reduce the microbial burden and transmission risk.
Question 4: Which criterion is MOST important when evaluating whether a facility appropriately manages a resident with scabies?
- Whether the resident was transferred to the hospital immediately
- Whether contact precautions were initiated and close contacts were identified and treated (Correct answer)
- Whether the resident's room was painted after diagnosis
- Whether dietary staff were informed about the diagnosis
Correct answer: Whether contact precautions were initiated and close contacts were identified and treated
Scabies management requires contact precautions and treatment of all close contacts simultaneously to prevent ongoing transmission.
Question 5: A facility's infection control log shows a spike in gastrointestinal illness among residents and staff during a one-week period. Which pathogen should the surveyor FIRST suspect and inquire about?
- Staphylococcus aureus
- Norovirus (Correct answer)
- Pseudomonas aeruginosa
- Aspergillus fumigatus
Correct answer: Norovirus
Norovirus is the most common cause of acute gastroenteritis outbreaks in long-term care settings, often affecting both residents and staff simultaneously.
Question 6: Under CMS regulations, which staff group MUST receive infection prevention and control training?
- Only nursing staff who perform direct patient care
- Only environmental services and housekeeping staff
- All facility staff, including volunteers and contractors, upon hire and annually (Correct answer)
- Only licensed clinical staff with patient-facing roles
Correct answer: All facility staff, including volunteers and contractors, upon hire and annually
CMS requires infection control training for all staff — clinical, non-clinical, volunteers, and contractors — to ensure the entire workforce supports safe practices.
Question 7: Which action BEST demonstrates a facility's commitment to a 'just culture' approach in its infection prevention program?
- Disciplining every staff member observed not washing hands
- Encouraging staff to report near-misses and infection events without fear of blame (Correct answer)
- Publishing individual hand hygiene compliance rates publicly
- Requiring staff to sign a behavior contract after any infection event
Correct answer: Encouraging staff to report near-misses and infection events without fear of blame
A just culture promotes psychological safety so staff report issues, enabling the facility to identify systemic failures rather than blaming individuals.
SMQT Infection Prevention and Control 4
A surveyor observes that a facility is using a disinfectant on a surface before the required contact time has elapsed.
Why is this a concern?