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CBIC Certified Infection Control Exam Sample Questions (Q64-Q69):
NEW QUESTION # 64
A nurse claims to have acquired hepatitis A virus infection as the result of occupational exposure. The source patient had an admitting diagnosis of viral hepatitis. Further investigation of this incident reveals a 5-day interval between exposure and onset of symptoms in the nurse. The patient has immunoglobulin G antibodies to hepatitis A. From the evidence, the infection preventionist may correctly conclude which of the following?
- A. The patient has serologic evidence of recent hepatitis A viral infection.
- B. The evidence at this time fails to support the nurse's claim.
- C. The 5-day incubation period is consistent with hepatitis A virus transmission.
- D. The nurse should be given hepatitis A virus immunoglobulin.
Answer: B
Explanation:
The infection preventionist's (IP) best conclusion, based on the provided evidence, is that the evidence at this time fails to support the nurse's claim of acquiring hepatitis A virus (HAV) infection through occupational exposure. This conclusion is grounded in the clinical and epidemiological understanding of HAV, as aligned with the Certification Board of Infection Control and Epidemiology (CBIC) guidelines. Hepatitis A typically has an incubation period ranging from 15 to 50 days, with an average of approximately 28-30 days, following exposure to the virus (CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competency 1.3 - Apply principles of epidemiology). The reported 5-day interval between exposure and symptom onset in the nurse is significantly shorter than the expected incubation period, making it inconsistent with HAV transmission. Additionally, the presence of immunoglobulin G (IgG) antibodies in the source patient indicates past exposure or immunity to HAV, rather than an active or recent infection, which would typically be associated with immunoglobulin M (IgM) antibodies during the acute phase.
Option A (the nurse should be given hepatitis A virus immunoglobulin) is not supported because post- exposure prophylaxis with HAV immunoglobulin is recommended only within 14 days of exposure to a confirmed case with active infection, and the evidence here does not confirm a recent exposure or active case.
Option C (the patient has serologic evidence of recent hepatitis A viral infection) is incorrect because IgG antibodies signify past infection or immunity, not a recent infection, which would require IgM antibodies.
Option D (the 5-day incubation period is consistent with hepatitis A virus transmission) is inaccurate due to the mismatch with the known incubation period of HAV.
The IP's role includes critically evaluating epidemiological data to determine the likelihood of transmission events. The discrepancy in the incubation period and the serologic status of the patient suggest that the nurse's claim may not be substantiated by the current evidence, necessitating further investigation rather than immediate intervention or acceptance of the claim. This aligns with CBIC's emphasis on accurate identification and investigation of infectious disease processes (CBIC Practice Analysis, 2022, Domain I:
Identification of Infectious Disease Processes, Competency 1.2 - Investigate suspected outbreaks or exposures).
References: CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competencies 1.2 - Investigate suspected outbreaks or exposures, 1.3 - Apply principles of epidemiology.
NEW QUESTION # 65
A Quality Improvement Committee is trying to decrease catheter-associated urinary tract infections (CAUTIs) in the hospital. Which of the following would be an outcome measure that would help to show a reduction in CAUTIs?
- A. Rate of patients receiving daily indwelling urinary catheter care
- B. Percentage of patients with indwelling urinary catheters
- C. Percentage of staff trained to insert indwelling urinary catheters
- D. Rate of CAUTI per 1000 indwelling urinary catheter days
Answer: D
Explanation:
Anoutcome measuretracks the end result of healthcare processes. TheCAUTI rate per 1,000 catheter days directly measures the frequency of infections, making it an ideal outcome metric.
* From theAPIC Text:
"An incidence rate (i.e., the number of new cases during a time period, such as the rate of patients with urinary catheters who get a CAUTI) is a frequently used outcome performance measure."
* Other choices like care compliance or training areprocess measures, not outcomes.
References:
APIC Text, 4th Edition, Chapter 17 - Performance Measures
NEW QUESTION # 66
Which of the following is included in an effective respiratory hygiene program in healthcare facilities?
- A. Community educational brochures campaign
- B. Separate entrance for symptomatic patients and visitors
- C. Mask availability at building entrance and reception
- D. Temperature monitoring devices at clinical unit entrance
Answer: C
Explanation:
An effective respiratory hygiene program in healthcare facilities aims to reduce the transmission of respiratory pathogens, such as influenza, COVID-19, and other droplet- or airborne infectious agents, by promoting practices that minimize the spread from infected individuals. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the importance of such programs within the "Prevention and Control of Infectious Diseases" domain, aligning with guidelines from the Centers for Disease Control and Prevention (CDC). The CDC's "Guideline for Isolation Precautions" (2007) and its respiratory hygiene/cough etiquette recommendations outline key components, including source control, education, and environmental measures to protect patients, visitors, and healthcare workers.
Option B, "Mask availability at building entrance and reception," is a core element of an effective respiratory hygiene program. Providing masks at entry points ensures that symptomatic individuals can cover their mouth and nose, reducing the dispersal of respiratory droplets. This practice, often referred to as source control, is a primary strategy to interrupt transmission, especially in high-traffic areas like entrances and receptions. The CDC recommends that healthcare facilities offer masks or tissues and no-touch receptacles for disposal as part of respiratory hygiene, making this a practical and essential inclusion.
Option A, "Community educational brochures campaign," is a valuable adjunct to raise awareness among the public about respiratory hygiene (e.g., covering coughs, hand washing). However, it is an external strategy rather than a direct component of the facility's internal program, which focuses on immediate action within the healthcare setting. Option C, "Separate entrance for symptomatic patients and visitors," can enhance infection control by segregating potentially infectious individuals, but it is not a universal requirement and depends on facility resources and design. The CDC suggests this as an optional measure during outbreaks, not a standard element of every respiratory hygiene program. Option D, "Temperature monitoring devices at clinical unit entrance," is a useful screening tool to identify febrile individuals, which may indicate infection.
However, it is a surveillance measure rather than a core hygiene practice, and its effectiveness is limited without accompanying interventions like masking.
The CBIC Practice Analysis (2022) and CDC guidelines prioritize actionable, facility-based interventions like mask provision to mitigate transmission risks. The availability of masks at key entry points directly supports the goal of respiratory hygiene by enabling immediate source control, making Option B the most appropriate answer.
References:
* CBIC Practice Analysis, 2022.
* CDC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, 2007.
NEW QUESTION # 67
Operating room records indicate that 130 joint replacements have been performed. These include 70 total hip replacements, 55 total knee replacements, and 5 shoulder replacements. Two postoperative surgical site infections (SSIs) were identified in total hip replacements. What is the infection rate/100 procedures for total hip replacements?
- A. 3.3
- B. 2.9
- C. 1.5
- D. 3.6
Answer: B
Explanation:
To determine the infection rate per 100 procedures for total hip replacements, use the following formula:
A white paper with black text and numbers AI-generated content may be incorrect.
Thus, the correct answer isB. 2.9per 100 procedures.
CBIC Infection Control Reference
The methodology of calculating SSI rates aligns with guidelines from theNational HealthcareSafety Network (NHSN)and standardized infection ratio (SIR) models used for hospital-specific SSI rates.
NEW QUESTION # 68
A healthcare facility has installed a decorative water fountain in their lobby for the enjoyment of patients and visitors. What is an important issue for the infection preventionist to consider?
- A. Children getting Salmonella enteritidis
- B. Cryptosporidium growth in the fountain
- C. Aerosolization of Legionella pneumophila
- D. Growth of Acinetobacter baumannii
Answer: C
Explanation:
The installation of a decorative water fountain in a healthcare facility lobby introduces a potential environmental hazard that an infection preventionist must evaluate, guided by the Certification Board of Infection Control and Epidemiology (CBIC) principles and infection control best practices. Water features can serve as reservoirs for microbial growth and dissemination, particularly in settings with vulnerable populations such as patients. The key is to identify the most significant infection risk associated with such a water source. Let's analyze each option:
* A. Children getting Salmonella enteritidis: Salmonella enteritidis is a foodborne pathogen typically associated with contaminated food or water sources like poultry, eggs, or untreated drinking water.
While children playing near a fountain might theoretically ingest water, Salmonella is not a primary concern for decorative fountains unless they are specifically contaminated with fecal matter, which is uncommon in a controlled healthcare environment. This risk is less relevant compared to other waterborne pathogens.
* B. Cryptosporidium growth in the fountain: Cryptosporidium is a parasitic protozoan that causes gastrointestinal illness, often transmitted through contaminated drinking water or recreational water (e.
g., swimming pools). While decorative fountains could theoretically harbor Cryptosporidium if contaminated, this organism requires specific conditions (e.g., fecal contamination) and is more associated with untreated or poorly maintained water systems. In a healthcare setting with regular maintenance, this is a lower priority risk compared to bacterial pathogens spread via aerosols.
* C. Aerosolization of Legionella pneumophila: Legionella pneumophila is a gram-negative bacterium that thrives in warm, stagnant water environments, such as cooling towers, hot water systems, and decorative fountains. It causes Legionnaires' disease, a severe form of pneumonia, and Pontiac fever, both transmitted through inhalation of contaminated aerosols. In healthcare facilities, where immunocompromised patients are present, aerosolization from a water fountain poses a significant risk, especially if the fountain is not regularly cleaned, disinfected, or monitored. The CBIC and CDC highlight Legionella as a critical concern in water management programs, making this the most important issue for an infection preventionist to consider.
* D. Growth of Acinetobacter baumannii: Acinetobacter baumannii is an opportunistic pathogen commonly associated with healthcare-associated infections (e.g., ventilator-associated pneumonia, wound infections), often found on medical equipment or skin. While it can survive in moist environments, its growth in a decorative fountain is less likely compared to Legionella, which is specifically adapted to water systems. The risk ofAcinetobacter transmission via a fountain is minimal unless it becomes a direct contamination source, which is not a primary concern for this scenario.
The most important issue is C, aerosolization of Legionella pneumophila, due to its potential to cause severe respiratory infections, its association with water features, and the heightened vulnerability of healthcare facility populations. The infection preventionist should ensure the fountain is included in the facility's water management plan, with regular testing, maintenance, and disinfection to prevent Legionella growth and aerosol spread, as recommended by CBIC and CDC guidelines.
:
CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain IV:
Environment of Care, which addresses waterborne pathogens like Legionella in healthcare settings.
CBIC Examination Content Outline, Domain III: Prevention and Control of Infectious Diseases, which includes managing environmental risks such as water fountains.
CDC Toolkit for Controlling Legionella in Common Sources of Exposure (2021), which identifies decorative fountains as a potential source of Legionella aerosolization.
NEW QUESTION # 69
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