SMQT TEST FINAL EXAM 2025 ACTUAL EXAM/150 COMPLETE EXAM
QUESTIONS WITH DETAILED VERIFIED ANSWERS PLUS RATIONALES
(100% CORRECT ANSWERS) /ALREADY GRADED A+
Question 1
Which appendix of the State Operations Manual contains the core guidance for determining if
Immediate Jeopardy exists?
A) Appendix A
B) Appendix G
C) Appendix P
D) Appendix Q
E) Appendix Z
Correct Answer: D) Appendix Q
Rationale: Appendix Q is the specific section of the CMS State Operations Manual that
provides the guidelines, definitions, and procedures for surveyors to use when identifying,
investigating, and citing Immediate Jeopardy.
Question 2
What are the three essential components that must be present for a situation to be cited as
Immediate Jeopardy?
A) Harm, Immediacy, and Noncompliance
B) Harm, Immediacy, and Culpability
C) Neglect, Abuse, and Harm
D) Culpability, Noncompliance, and Immediacy
E) Potential Harm, Actual Harm, and Immediacy
Correct Answer: B) Harm, Immediacy, and Culpability
Rationale: For a citation of Immediate Jeopardy to be valid, the surveyor must establish all
three components: 1) Harm (either actual or potential for serious harm), 2) Immediacy (the
harm is likely to occur in the very near future), and 3) Culpability (the facility's
noncompliance caused the situation).
Question 3
Which of the following situations is a specific trigger for considering Immediate Jeopardy under
the category of "Failure to protect from abuse"?
,[Type here]
A) A non-functioning call system without compensatory measures.
B) A pattern of repeated medication errors without intervention.
C) Staff striking or roughly handling an individual.
D) Failure to carry out physician's orders.
E) Inadequate supervision to prevent physical altercations between residents.
Correct Answer: C) Staff striking or roughly handling an individual.
Rationale: This is a direct act of physical abuse. The willful infliction of injury by staff is a
clear and immediate trigger for an Immediate Jeopardy investigation, as it represents a
direct threat of serious harm.
Question 4
A facility fails to provide supervision for a resident with known special needs, leading to a
serious fall. This situation is a trigger for considering Immediate Jeopardy under which category?
A) Failure to protect from abuse
B) Failure to prevent neglect
C) Failure to protect from psychological harm
D) Failure to safely administer medications
E) Failure to provide adequate nutrition
Correct Answer: B) Failure to prevent neglect
Rationale: Neglect is the failure to provide necessary goods and services. A lack of
supervision for an individual with known special needs (who requires supervision to be
safe) is a failure to provide a necessary service and directly falls under the category of
preventing neglect.
Question 5
A cognitively impaired resident is known to be at high risk for elopement. The facility fails to
provide adequate supervision, and the resident leaves the facility unnoticed. This is a trigger for
Immediate Jeopardy related to:
A) Failure to protect from abuse.
B) Failure to provide adequate nutrition.
C) Failure to protect from psychological harm.
,[Type here]
D) Failure to prevent neglect.
E) Failure to provide safety from fire.
Correct Answer: D) Failure to prevent neglect.
Rationale: Supervision is a critical service for a resident with a known elopement risk. The
facility's failure to provide this supervision, which places the resident at high risk of serious
harm or death, is a clear example of neglect.
Question 6
Staff members are observed repeatedly yelling at and demeaning a resident, causing the resident
to display fear and withdraw from social interaction. This is a trigger for considering Immediate
Jeopardy under which category?
A) Failure to protect from abuse
B) Failure to prevent neglect
C) Failure to protect from psychological harm
D) Failure to provide medications as prescribed
E) Failure to identify individuals correctly
Correct Answer: C) Failure to protect from psychological harm
Rationale: Psychological harm is as serious as physical harm. Staff behavior that is
threatening or demeaning and results in a resident showing fear or sudden behavioral
changes is a direct trigger for considering Immediate Jeopardy related to psychological
harm.
Question 7
A nurse administers penicillin to a resident whose chart clearly documents a known, severe
allergy to penicillin. This action is a trigger for considering Immediate Jeopardy under which
category?
A) Failure to prevent neglect
B) Failure to identify individuals correctly
C) Failure to provide medications as prescribed / protect from undue adverse consequences
D) Failure to protect from psychological harm
E) Failure to protect from abuse
, [Type here]
Correct Answer: C) Failure to provide medications as prescribed / protect from undue
adverse consequences
Rationale: Administering a medication to an individual with a known history of a severe
allergic reaction is a critical medication error that has the immediate potential to cause
serious harm or death (anaphylaxis). This is a primary trigger for an IJ investigation
related to medication administration.
Question 8
A facility has a pattern of repeated medication errors, such as administering the wrong dose or at
the wrong time, but has not taken any action to investigate the cause or implement corrective
measures. This situation is a trigger for considering Immediate Jeopardy related to:
A) Failure to prevent neglect.
B) Failure to protect from abuse.
C) Failure to protect from widespread nosocomial infections.
D) Failure to provide medications as prescribed.
E) Failure to provide adequate nutrition.
Correct Answer: D) Failure to provide medications as prescribed.
Rationale: A single medication error may not constitute Immediate Jeopardy, but a pattern
of repeated errors without any facility intervention demonstrates a systemic failure. This
lack of action (culpability) creates a high potential for a serious adverse event to occur,
meeting the criteria for IJ.
Question 9
A surveyor observes that a facility's food supply is clearly insufficient to meet the nutritional
needs of all its residents. This finding is a trigger for considering Immediate Jeopardy under
which category?
A) Failure to prevent neglect
B) Failure to provide adequate nutrition and hydration
C) Failure to protect from abuse
D) Failure to protect from environmental hazards
E) Failure to provide safety from fire
QUESTIONS WITH DETAILED VERIFIED ANSWERS PLUS RATIONALES
(100% CORRECT ANSWERS) /ALREADY GRADED A+
Question 1
Which appendix of the State Operations Manual contains the core guidance for determining if
Immediate Jeopardy exists?
A) Appendix A
B) Appendix G
C) Appendix P
D) Appendix Q
E) Appendix Z
Correct Answer: D) Appendix Q
Rationale: Appendix Q is the specific section of the CMS State Operations Manual that
provides the guidelines, definitions, and procedures for surveyors to use when identifying,
investigating, and citing Immediate Jeopardy.
Question 2
What are the three essential components that must be present for a situation to be cited as
Immediate Jeopardy?
A) Harm, Immediacy, and Noncompliance
B) Harm, Immediacy, and Culpability
C) Neglect, Abuse, and Harm
D) Culpability, Noncompliance, and Immediacy
E) Potential Harm, Actual Harm, and Immediacy
Correct Answer: B) Harm, Immediacy, and Culpability
Rationale: For a citation of Immediate Jeopardy to be valid, the surveyor must establish all
three components: 1) Harm (either actual or potential for serious harm), 2) Immediacy (the
harm is likely to occur in the very near future), and 3) Culpability (the facility's
noncompliance caused the situation).
Question 3
Which of the following situations is a specific trigger for considering Immediate Jeopardy under
the category of "Failure to protect from abuse"?
,[Type here]
A) A non-functioning call system without compensatory measures.
B) A pattern of repeated medication errors without intervention.
C) Staff striking or roughly handling an individual.
D) Failure to carry out physician's orders.
E) Inadequate supervision to prevent physical altercations between residents.
Correct Answer: C) Staff striking or roughly handling an individual.
Rationale: This is a direct act of physical abuse. The willful infliction of injury by staff is a
clear and immediate trigger for an Immediate Jeopardy investigation, as it represents a
direct threat of serious harm.
Question 4
A facility fails to provide supervision for a resident with known special needs, leading to a
serious fall. This situation is a trigger for considering Immediate Jeopardy under which category?
A) Failure to protect from abuse
B) Failure to prevent neglect
C) Failure to protect from psychological harm
D) Failure to safely administer medications
E) Failure to provide adequate nutrition
Correct Answer: B) Failure to prevent neglect
Rationale: Neglect is the failure to provide necessary goods and services. A lack of
supervision for an individual with known special needs (who requires supervision to be
safe) is a failure to provide a necessary service and directly falls under the category of
preventing neglect.
Question 5
A cognitively impaired resident is known to be at high risk for elopement. The facility fails to
provide adequate supervision, and the resident leaves the facility unnoticed. This is a trigger for
Immediate Jeopardy related to:
A) Failure to protect from abuse.
B) Failure to provide adequate nutrition.
C) Failure to protect from psychological harm.
,[Type here]
D) Failure to prevent neglect.
E) Failure to provide safety from fire.
Correct Answer: D) Failure to prevent neglect.
Rationale: Supervision is a critical service for a resident with a known elopement risk. The
facility's failure to provide this supervision, which places the resident at high risk of serious
harm or death, is a clear example of neglect.
Question 6
Staff members are observed repeatedly yelling at and demeaning a resident, causing the resident
to display fear and withdraw from social interaction. This is a trigger for considering Immediate
Jeopardy under which category?
A) Failure to protect from abuse
B) Failure to prevent neglect
C) Failure to protect from psychological harm
D) Failure to provide medications as prescribed
E) Failure to identify individuals correctly
Correct Answer: C) Failure to protect from psychological harm
Rationale: Psychological harm is as serious as physical harm. Staff behavior that is
threatening or demeaning and results in a resident showing fear or sudden behavioral
changes is a direct trigger for considering Immediate Jeopardy related to psychological
harm.
Question 7
A nurse administers penicillin to a resident whose chart clearly documents a known, severe
allergy to penicillin. This action is a trigger for considering Immediate Jeopardy under which
category?
A) Failure to prevent neglect
B) Failure to identify individuals correctly
C) Failure to provide medications as prescribed / protect from undue adverse consequences
D) Failure to protect from psychological harm
E) Failure to protect from abuse
, [Type here]
Correct Answer: C) Failure to provide medications as prescribed / protect from undue
adverse consequences
Rationale: Administering a medication to an individual with a known history of a severe
allergic reaction is a critical medication error that has the immediate potential to cause
serious harm or death (anaphylaxis). This is a primary trigger for an IJ investigation
related to medication administration.
Question 8
A facility has a pattern of repeated medication errors, such as administering the wrong dose or at
the wrong time, but has not taken any action to investigate the cause or implement corrective
measures. This situation is a trigger for considering Immediate Jeopardy related to:
A) Failure to prevent neglect.
B) Failure to protect from abuse.
C) Failure to protect from widespread nosocomial infections.
D) Failure to provide medications as prescribed.
E) Failure to provide adequate nutrition.
Correct Answer: D) Failure to provide medications as prescribed.
Rationale: A single medication error may not constitute Immediate Jeopardy, but a pattern
of repeated errors without any facility intervention demonstrates a systemic failure. This
lack of action (culpability) creates a high potential for a serious adverse event to occur,
meeting the criteria for IJ.
Question 9
A surveyor observes that a facility's food supply is clearly insufficient to meet the nutritional
needs of all its residents. This finding is a trigger for considering Immediate Jeopardy under
which category?
A) Failure to prevent neglect
B) Failure to provide adequate nutrition and hydration
C) Failure to protect from abuse
D) Failure to protect from environmental hazards
E) Failure to provide safety from fire
