CIC test 1 Flashcards
APIC
1
Q
Prior to designated surgical procedures, current guidelines for use of prophylactic antibiotics state that antibiotics are BEST given:
A. within 30 minutes prior to the incision
B. with in 2 hours prior to the incision
C. to achieve a bactericidal level in serum and tissue at the time of the incision
D. to achieve a constant therapeutic level throughout the intraoperative period
A
Prior to designated surgical procedures, current guidelines for use of prophylactic antibiotics state that antibiotics are BEST given:
to achieve a bactericidal level in serum and tissue at the time of the incision
2
Q
In an outbreak of hepatitis A, immune globulin (IG) was administered to close contacts of the cases. The control measure is an example of:
A. pre-exposed prophylaxis
B. passive immunization
C. activity immunization
D. producing herd immunity
A
In an outbreak of hepatitis A, immune globulin (IG) was administered to close contacts of the cases. The control measure is an example of:
passive immunization
3
Q
A medical director is concerned that a facility is seeing an increased number of patients infected with hepatitis A virus (HAV). The ICP/IP is asked to review HAV infection rates. The ICP/IP should focus on HAV:
A. cases reported to the Public Health department in the prior year
B. incidence rates reported in facility risk groups, such as Pediatrics and HIV clinics.
C. current prevalence data in the community served by the facility
D. attack rates in the facilities in other geographic locations
A
A medical director is concerned that a facility is seeing an increased number of patients infected with hepatitis A virus (HAV). The ICP/IP is asked to review HAV infection rates. The ICP/IP should focus on HAV:
current prevalence data in the community served by the facility
4
Q
- Guidelines for transporting specimens include:
1) Transport within 2 hours of collecting a specimen.
2) Transport in leak proof specimen containers and sealable leak proof bags.
3) Transport specimen in the syringe used to collect it.
4) Refrigerate all specimens prior to transport
a. 1,4; b. 2,3: c. 1,2: d. 3,4
A
C. 1,2 The appropriate selection, collection and transport of specimens to the diagnostic microbiology lab are essential parts in the accurate id of microorganisms.
5
Q
- A patient who was hospitalized for 2 days calls 3 days after discharge complaining that he has developed Healthcare associated scabies due to his recent inpatient stay. The IP know that his scabies infestation is not HA because:
a. Scabies is only transmitted through contaminated linens.
b. The incubation period for scabies is longer than 5 days.
c. The incubation period for scabies is shorter than 3 days.
d. Scabies is only transmitted through direct contact and none of the Health care personnel who cared for the patient are infected.
A
B. The incubation period for scabies is longer than 5 days. APIC - Parasites.
6
Q
An IP would like to compare a hosptial’s Coronary Artery Bypass Graft (CABG) surgical wound infection rate to the NHSN system stratum surgical site rate. Which of the following tests should be performed?
A. Use a Z-test to compare procedure risk stratum-specific wound infection rates.
B. use a T-test to compare procedure risk stratum-specific wound infection rates.
C. perform a Z-test. Calculate and compare risk stratum-specific surgical wound infection rates for all operations pooled.
D. perform a T-test. Calculate and compare risk startum-specific surgical wound infection rates for all operations pooled
A
An IP would like to compare a hosptial’s Coronary Artery Bypass Graft (CABG) surgical wound infection rate to the NHSN system stratum surgical site rate. Which of the following tests should be performed?
Use a Z-test to compare procedure risk stratum-specific wound infection rates.
7
Q
The manufacturer of an antibacterial soap has reported the isolation of Burkholderia cepacia in one lot of the soap. The soap had been evaluated and approved by the product evaluation committee 1 year ago and is currently in use in the acute care, extended care, and ambulatory care clinics. The IP should:
A. culture the soap of involved lots in use to confirm contamination
B. notify the purchasing department to initiate removal of the soap and order from another company
C. identify where the antibacterial soap is in use and stored, check the lot numbers, and return those to the manufacturer
D. screen the patients and employees for evidence of skin irritation.
A
The manufacturer of an antibacterial soap has reported the isolation of Burkholderia cepacia in one lot of the soap. The soap had been evaluated and approved by the product evaluation committee 1 year ago and is currently in use in the acute care, extended care, and ambulatory care clinics. The IP should:
identify where the antibacterial soap is in use and stored, check the lot numbers, and return those to the manufacturer
8
Q
Several patients who have undergone surgery in the past month have developed a post operative wound infection. Data indicate there are no common sources for the infections (e.g., different sites, different wound classifications, different ASA scores, different surgeons, different operating rooms, different days). Given these data, the IP should:
A. examine the operating room cleaning schedule.
B. conduct intensive surveillance in the operating room for 2 weeks.
C. review surgical antibiotic prophylaxis.
D. report this to the Chief of Surgery
A
Answer: review surgical antibiotic prophylaxis
9
Q
A patient is identified with Mycobacterium tuberculosis 6 days after admission. Antituberculous therapy is started immediately. The case manager contacts an IP for assistance in identifying appropriate patient needs for discharge planning purposes. Which of the following statements is MOST appropriate?
A. the patient should remain in airborne isolation until he has received 2 weeks of four-drug therapy. Directly observed therapy should be arranged before discharge
B. the patient may be discharged to home or a subacute care facility as soon as a sputum AFB smear becomes negative
C. if the patient requires long-term care placement, the receiving facility must have airborne isolation capabilities if discharged before receieving effective therapy and 3 consecutive negative AFB smears
D. the patient can be discharged as soon as fever has resolved. If additionsl care is required the Public Health Authorities should be contacted.
A
A patient is identified with Mycobacterium tuberculosis 6 days after admission. Antituberculous therapy is started immediately. The case manager contacts an IP for assistance in identifying appropriate patient needs for discharge planning purposes. Which of the following statements is MOST appropriate?
if the patient requires long-term care placement, the receiving facility must have airborne isolation capabilities if discharged before receieving effective therapy and 3 consecutive negative AFB smears
10
Q
The rate of complice with central line insertion protocols in the operating room is 45%. The operating room supervisor requests that the IP provide a review program for the staff. Which of the following is the NEXT step in providing this training?
A. provide reference documents regarding the protocols.
B. establish goals and objectives for the program.
C. present a program to the operating room employees.
D. outline the information to be covered in the program
A
The rate of complice with central line insertion protocols in the operating room is 45%. The operating room supervisor requests that the IP provide a review program for the staff. Which of the following is the NEXT step in providing this training?
establish goals and objectives for the program.
11
Q
Which of the following observations noted by the IP during routine environmental inspections is an appropriate practice?
A. Using isolation gowns not longer than duration of shift
B. Patient care staff cleaning infusion pumps between patients
C. High-level disinfection of eating utensils of patient in droplet precautions
D. Direct care provider using alcohol-hand gel on fingers of casted hand
A
Which of the following observations noted by the IP during routine environmental inspections is an appropriate practice?
Patient care staff cleaning infusion pumps between patients
12
Q
The best evidence-based published research studies are:
A. case-control studies
B. randomized clinical studies
C. cross-sectional studies
D. cohort studies
A
The best evidence-based published research studies are:
case-control studies
13
Q
One major advantage of collecting surveillance data retrospectively is that:
A. it enhances syndromic survillance
B. the effectiveness of interventions can be assessed
C. the medical record is more likely to be complete
D. it is easier to identify an outbreak
A
One major advantage of collecting surveillance data retrospectively is that:
the medical record is more likely to be complete
14
Q
Occupational health srevices is discussing with an ICP/IP that 15 employees with a diarrhea - like lillness had eaten in the cafeteria within the last 4 days. As part of the follow-up, which of the following should be done FIRST?
A. observe food handling practices of dietary personnel
B. interview employees to identify common food history
C. report symptoms to the Public Health department
D. ask the dietary manager if any department employees are ill
A
Occupational health srevices is discussing with an ICP/IP that 15 employees with a diarrhea - like lillness had eaten in the cafeteria within the last 4 days. As part of the follow-up, which of the following should be done FIRST?
report symptoms to the Public Health department
15
Q
An investigation at a hospital reveals a statistically significant increase in the quarterly incidence of medication errors. Such a finding is an example of:
A. proof of association
B. rejection of the null hypothesis
C. acceptance of the null hypothesis
D. error in the medication administration record
A
An investigation at a hospital reveals a statistically significant increase in the quarterly incidence of medication errors. Such a finding is an example of:
rejection of the null hypothesis
16
Q
A 17 year old patient is hospitalized with Listeria monocytogenes menigitis. Which of the following employees is an appropriate candidate for antibiotic prophylaxis?
A. intensive care unit nurse who suctioned the patient
B. pregnant laboratory technician who obtained blood specimens
C. physician who perfromed a lumbar puncture
D. prophylaxis is not necessary
A
A 17 year old patient is hospitalized with Listeria monocytogenes menigitis. Which of the following employees is an appropriate candidate for antibiotic prophylaxis?
prophylaxis is not necessary
17
Q
An IP is reviewing the basic principles to be followed in writing instructional objectives. Which of the following verbs is MOST appropriate for stating a behavioral objective?
A. understand
B. appreciate
C. know
D. define
A
An IP is reviewing the basic principles to be followed in writing instructional objectives. Which of the following verbs is MOST appropriate for stating a behavioral objective?
define
18
Q
A characteristic typically shared by adult learners is a:
A. perference to gain academic knowledge
B. need to be acquire new material
C. tendency to become more group-oriented
D. desire to attach greater value to personal experience
A
A characteristic typically shared by adult learners is a:
desire to attach greater value to personal experience
19
Q
To prevent the spread of multidrug-resistant organisms (MDRO) in an extended-care facility, which of the following is recommended by the Centers for Disease Control and Prevention?
A. screen residents on admission
B. use standard precautions for residents
C. restrict residents’ admission with acute infection
D. cohort residents with MDRO for meals and social activity
A
To prevent the spread of multidrug-resistant organisms (MDRO) in an extended-care facility, which of the following is recommended by the Centers for Disease Control and Prevention?
use standard precautions for residents
20
Q
An IP has been asked to investigate the epidemiological link among six ICU patients who developed acute respiratory illness over a 2-week period. The respiratory illness developed 24 to 72 hours post-aortofemoral bypass surgery. The FIRST action the IP should take is to:
A. Verify the diagnosis
B. Search for additional cases
C. Establish a hypothesis
D. Collect specimens
A
An IP has been asked to investigate the epidemiological link among six ICU patients who developed acute respiratory illness over a 2-week period. The respiratory illness developed 24 to 72 hours post-aortofemoral bypass surgery. The FIRST action the IP should take is to:
Verify the diagnosis
21
Q
A nursing unit has found to have six hospital-acquired urinary tract infections (UTIs) in the month of June. The census on the unit for the month of June is 100. During the month of April, there were 10 infections and a census of 150. During May, an in-service on preventing UTIs was presented by the IP. How is this change in the number of UTIs best interpreted.
A. The in-service resulted in a change in behavior, reducing the number of UTi’s
B. No conclusions can be obtained from this data
C. The change in UTIs is unrelated the in-service
D. The in-service caused a decrease in the number of UTIs
A
A nursing unit has found to have six hospital-acquired urinary tract infections (UTIs) in the month of June. The census on the unit for the month of June is 100. During the month of April, there were 10 infections and a census of 150. During May, an in-service on preventing UTIs was presented by the IP. How is this change in the number of UTIs best interpreted:
No conclusions can be obtained from this data
22
Q
An IP is asked to review the sorting of non-regulated and regulated medical waste. Each patient room has a sharps container, a container for infectious waste, and a regular waste container. Medical tubing, a patient dressing and IV bags are being placed in the Infectious waste containers. Paper towels and gloves are being placed in the regular trash. The IP’s recommendations should result in:
A. Changing the procedure for waste handling to incorporate current practices
B. Reducing over-classification of regulated medical waste
C. Increasing capability of onsite reprocessing
D. Centralizing regulated medical waste in soiled utility rooms
A
An IP is asked to review the sorting of non-regulated and regulated medical waste. Each patient room has a sharps container, a container for infectious waste, and a regular waste container. Medical tubing, patient dressing and IV bags are being placed in the Infectious waste containers. Paper towels and gloves are being placed in the regular trash. The IP’s recommendations should result in:
Reducing over-classification of regulated medical waste
23
Q
Based on the HICPAC Guidelines, a Category 1A means:
A. Strongly recommended and supported by clinical studies
B. Required for implementation for federal or state regulations
C. Suggested for implementation and supported by some studies
D. Suggested for implementation and supported by anecdotal citations
A
Based on the HICPAC Guidelines, a Category 1A means:
Strongly recommended and supported by clinical studies
24
Q
A 45-year-old patient is admitted to the burn unit with burns over 60% of the body surface. All of the following procedures will reduce the risk of acquiring a healthcare-associated infection EXCEPT:
A. Ambulating the patient as soon as medically advisable
B. Performing frequent surgical and/or mechanical debridement
C. Increasing caloric and nutritional intake
D. Instructing personnel and visitors to use scrub suits when in the patient’s room
A
A 45-year-old patient is admitted to the burn unit with burns over 60% of the body surface. All of the following procedures will reduce the risk of acquiring a healthcare-associated infection EXCEPT:
D. Instructing personnel and visitors to use scrub suits when in the patient’s room
25
Which of the following procedures is most likely to reduce the risk of catheter-associated urinary tract infections?
A. decreasing the length of catheterization
B. anchoring catheter to prevent trauma
C. obtaining urine culture on admission
D. collecting urine samples from sampling port
Which of the following procedures is most likely to reduce the risk of catheter-associated urinary tract infections?
decreasing the length of catheterization
26
In order to perform interhospital comparison of bloodstream infections related to central line devices, the BEST denominator to use is:
A. patient days
B. number of patients with central lines
C. number of bloodstream infections
D. central line days
In order to perform interhospital comparison of bloodstream infections related to central line devices, the BEST denominator to use is:
central line days
27
Which of the following practices should the IP recommend to reduce financial cost without negatively impacting clinical outcomes?
A. CHG impregnated patches on all central lines inserted in the operating room
B. Antibiotic impregnated catheters for all central lines for cardiac surgery patients
C. Reducing the frequency of environmental cultures to monthly
D. Changing peripheral IV tubing, dressing, and site care every 96 hours
Which of the following practices should the IP recommend to reduce financial cost without negatively impacting clinical outcomes?
Changing peripheral IV tubing, dressing, and site care every 96 hours
28
In preparing a report on surgical site infections, the IP should expect the largest percentage of the chart to be surgical site infections:
A. occurring within the initial surgical hospitalization
B. with associated secondary bacteremia
C. identified post discharge
D. associated with inappropriate antibiotic prophylaxis
In preparing a report on surgical site infections, the IP should expect the largest percentage of the chart to be surgical site infections:
identified post discharge
29
Recent surveillance data show that the incidence of healthcare-associated *Clostridium difficle* has increased. Which of the following is MOST likely to be contributing to the transmission?
A. Use of plain soap for hand hygiene instead of antimicrobial soap
B. Use of yogurt diet for patients receiving antibiotics
C. An increase in asymptomatic carriers
D. Conversion from ear to rectal thermometers
Recent surveillance data show that the incidence of healthcare-associated Clostridium difficle has increased. Which of the following is MOST likely to be contributing to the transmission?
Conversion from ear to rectal thermometers
30
A laboratory reports to the IP a series of 10 consecutive respiratory tract specimens from different patients. Of the 10 samples, eight sputum smears are positive for acid-fast bacilli, and two bronchial lavage specimens are negative. Which of the following BEST explains this unusual finding?
A. Laboratory contamination
B. Contaminated staining agent
C. Cross-contamination during specimen collection
D. An outbreak of tuberculosis or a related organism
A laboratory reports to the IP a series of 10 consecutive respiratory tract specimens from different patients. Of the 10 samples, eight sputum smears are positive for acid-fast bacilli, and two bronchial lovage specimens are negative. Which of the following BEST explains this unusual finding?
Laboratory contamination
31
A team approach is used to control the spread of disease and prevent outbreaks. The infection prevetionist (IP) should consult Risk Management for serious concerns regarding:
A. pre-employment health assessments
B. adverse infectious outcomes related to a specific medical device
C. ethical dilemmas involving patients rights for persons placed in isolation.
D. infection prevention and control standards
A team approach is used to control the spread of disease and prevent outbreaks. The infection prevetionist (IP) should consult Risk Management for serious concerns regarding:
adverse infectious outcomes related to a specific medical device
32
When evaluating a computer software system, which of the following attributes would be MOST valuable?
A. the software does not integrate with a mainfram hospital system, ensuring confidentiality
B. the software is designed specifically for infection control and fixed data-entry codes and report formats, ensuring consistency
C. the software is user-friendly and versatile, allowing use by personnel with limited computer training
D. the software is produced by the company that manufactures the hospital's mainframe system, allowing easy access to patient data.
When evaluating a computer software system, which of the following attributes would be MOST valuable?
the software is user-friendly and versatile, allowing use by personnel with limited computer training
33
An induration of 5 mm or greater is considered a positive tuberculin test reaction in:
A. persons who have fibrotic chest radiograph consistent with old TB
B. intravenous drug-users known to be HIV negative
C. persons with diabetes mellitus and chronic renal failure
D. migrant workers and homeless persons
An induration of 5 mm or greater is considered a positive tuberculin test reaction in:
persons who have fibrotic chest radiograph consistent with old TB
34
An ICP/IP has collected data concerning nosocomial urinary tract infections (UTIs) occurring in a cardiac surgery post operative care unit. The data are shown below:
Data. January. February. March
UTIs. 10. 20. 10
Catheter days. 100. 100. 100
Patient days. 300. 200. 280
Analysis of the data suggests that the UTI incidence is:
A. Similar in all months and further study is warranted at this time
B. Highest frequency in February, but since the number of catheter days is the same, no further study is warranted
C. Highest in February and may be a result of increased catheter use or duration and further study is warranted
D. Not important in cardiac surgery patients and further study is warranted to study median sternotomy wound infections
An ICP/IP has collected data concerning nosocomial urinary tract infections (UTIs) occurring in a cardiac surgery post operative care unit. The data are shown below:
Data. January. February. March
UTIs. 10. 20. 10
Catheter days. 100. 100. 100
Patient days. 300. 200. 280
Analysis of the data suggests that the UTI incidence is:
Highest in February and may be a result of increased catheter use or duration and further study is warranted
35
When developing an educational program, an IP should keep in mind that adults learn MOST effectively when:
A. internally motivated by personal need.
B. externally motivated by institutional mandate
C. participating in group activities
D. written materials are provided
When developing an educational program, an IP should keep in mind that adults learn MOST effectively when:
internally motivated by personal need.
36
Which of the following organisms is MOST likely to cause bacteremia in newborns?
A. group B streptococci
B. Haemophilus influenzae
C. group A streptococci
D. Listeria monocytogenes
Which of the following organisms is MOST likely to cause bacteremia in newborns?
group B streptococci
37
Infection Control receives the following from data from Employee Health for one month:
1. 2 HCWs with positive TB skin tests
2. 2 HCWs with needlestick injuries
3. 12 HCWs on one unit exposed to chickenpox
What kind of data does this represent?
A. a prevalence rate
B. an incidence rate
C. targeted surveillance
D. random surveillance
Infection Control receives the following from data from Employee Health for one month:
1. 2 HCWs with positive TB skin tests
2. 2 HCWs with needlestick injuries
3. 12 HCWs on one unit exposed to chickenpox
What kind of data does this represent?
targeted surveillance
38
An IP is consulted about an employee who intubated a patient with meningococcal meningitis in the emergency department. The employee was not wearing a mask. An acceptable antibiotic prophylaxis is:
A. ciprofloxacin
B. penicillin
C. cefazolin
D. trimethoprim-sulfamethoxazole
An IP is consulted about an employee who intubated a patient with meningococcal meningitis in the emergency department. The employee was not wearing a mask. An acceptable antibiotic prophylaxis is:
ciprofloxacin
39
A 23 year-old male is brought to the emergency department unconscious and unresponsive. Physical examination reveals a temperature of 103 degree F. (39 degrees C) and a blood pressure of 140/60 mm Hg. His neck is stiff. The cerebrospinal fluid is cloudy and contains 12,000 WBC/mm3 (12,000 x 10(9) /L) and 94% segmented neutrophils. A Gram stain of centrifuged cerebrospinal fluid reveals small Gram-negative bacilli. The MOST likely etiology agent is:
A. *Listeria monocytogenes*
B. *Neisseria meningitidis*
C. *Haemophilus influenaze*
D. *Streptococcus pneumonia*
A 23 year-old male is brought to the emergency department unconscious and unresponsive. Physical examination reveals a temperature of 103 degree F. (39 degrees C) and a blood pressure of 140/60 mm Hg. HIs neck is stiff. The cerebrospinal fluid is cloudy and contains 12,000 WBC/mm3 (12,000 x 10(9) /L) and 94% segmented neutrophils. A Gram stain of centrifuged cerebrospinal fluid reveals small Gram-negative bacilli. The MOST likely etiology agent is:
Haemophilus influenaze
40
A respiratory therapist cared for a patient with positive cytomegaloviris (CMV) IgM antibody. The therapist is 4 months pregnant and was treated for CMV antibodies 1 week afer exposure. The therapist's CMV IgG was positive. Which of the following is a true statement regarding these results?
A. The therapist has a history of CMV infection
B. The therapist acquired a primary CMV infection as a result of the exposure
C. The patient is immune to CMV and cannot be the source of the therapist's exposure
D. Viral testing is necessary to confirm the source of the therapist's infection
Answer: Viral testing is necessary to confirm the source of the therapist's infection
41
Four patients recently hospitalized on the medical/surgical unit are described as follows:
Patient A: sternal wound culture positive for *Staphyloccoccus aureus.*
Patient B: purulent drainage from a wound that is positive for *coagulate-positive staphylococci*
Patient C: wound culture positive for *Staphylococcus epidermidis*
Patient D: purulent drainage from a wound that is positive for *Staphylococcus aureus*
Which of the following scenarios is MOST likely?
A. All four patients had surgery
B. Patients A and D are the in the same room
C. All four patients have a hospital-acquired wound infection
D. There is insufficient information to draw any conclusions
Four patients recently hospitalized on the medical/surgical unit are described as follows:
Patient A: sternal wound culture positive for Staphyloccoccus aureus.
Patient B: purulent drainage from wound positive for coagulate-positive staphylococci
Patient C: wound culture positive for Staphylococcus epidermidis
Patient D: purulent drainage from wound positive for Staphylococcus aureus
Which of the following scenarios is MOST likely?
There is insufficient information to draw any conclusions
42
An IP met with the pulmonary function laboratory staff to discuss their infection control concerns regarding inpatients reporting to the laboratory with symptomatic *Clostridium difficle*. What action should the IP take FIRST?
A. discuss transmission risks with the unit manager
B. reschedule cases following 24 hours of antibiotic therapy
C. postpone testing of patients with active *C. difficile*
D. encourage liberal use of hand sanitizers
An IP met with the pulmonary function laboratory staff to discuss their infection control concerns regarding inpatients reporting to the laboratory with symptomatic *Clostridium difficle*. What action should the IP take FIRST?
discuss transmission risks with the unit manager
43
Which of the following statements regarding chickenpox and immunity is accurate?
A. a negative history of vericella infection is a reliable method of determining susceptibility
B. infection confers long-term immunity and second attacks are rare
C. immune adults who are exposed to varicella may develop shingels from exposure
D. Susceptible individuals should receive IG within 4 days after exposure.
Which of the following statements regarding chickenpox and immunity is accurate?
infection confers long-term immunity and second attacks are rare
44
An IP gives a pretest to all nurses on a surgical unit. Half of the nurses are then randomly assigned to attend a special class on wound management. A post-test is given 1 month later to all nurses on the unit. This practise illustrates what type of study?
A descriptive
B. experimental
C. retrospective
D. case-control
An IP gives a pretest to all nurses on a surgical unit. Half of the nurses are then randomly assigned to attend a special class on wound management. A post-test is given 1 month later to all nurses on the unit. This practise illustrates what type of study?
experimental
45
10. A nurse is concerned that a patient in the neurology ward has a prion disease after receiving a lab report stating that the patient had a positive nucleic acid test for John Cunningham virus (JCV) in the cerebrospinal fluid. What is the best response to give this nurse?
a. The test is positive for Creutzfeldt-jakob disease, which is a prion test.
b. The test is positive for Campholobactor jejuni, which is not a prion disease.
c. The test is positive for JCV (a polyomavirus), which is not a prion disease.
d. The test is positive for JCV ( a polyomavirus) which is a prion disease.
C. The test is positive for JCV (a polyomavirus), which is not a prion disease.
46
An 82-year-old patient is admitted to a hospital with *Proteus mirabilis bacteremia*. Which of the following is the MOST likely source of the bacteremia?
A. urinary tract
B. decubitus ulcer
C. gastroinestinal tract
D. lower respiratory tract
An 82-year-old patient is admitted to a hospital with *Proteus mirabilis bacteremia*. Which of the following is the MOST likely source of the bacteremia?
urinary tract
47
Which of the following practices is recommended to prevent food borne outbreaks in a hospital?
A. Processing food trays from isolation patients separately
B. Holding hot foods at a temperature of 140 degrees F. (60 C) or above
C. Routine culturing of food service workers
D. Sanitizing food preparation surfaces with a chlorine disinfectant
Which of the following practices is recommended to prevent food borne outbreaks in a hospital?
Holding hot foods at a temperature of 140 degrees F. (60 C) or above
48
Over the past 3 days, an Infection Preventionis (IP) notices an increased number of patients admitted with vomiting and diarrhea. The laboratory staff report that they have isolated Shigella sonnei from 20 different patients. Discussion with Public Health reveals that the usual incidence of Shigella sonnei is 50 cases per year in a town with a population of 200,000. What is the MOST likely source of this outbreak?
A. undercooked hamburgers
B. imported apples
C. infected foodhandler
D. raw oysters
Over the past 3 days, an Infection Preventionis (IP) notices an increased number of patients admitted with vomiting and diarrhea. The laboratory staff report that they have isolated Shigella sonnei from 20 different patients. Discussion with Public Health reveals that the usual incidence of Shigella sonnei is 50 cases per year in a town with a population of 200,000. What is the MOST likely source of this outbreak?
infected foodhandler
49
Which of the following is a measure of the frequency with which a new event occurs in a population over a defined time period?
A. Incidence
B. Baseline
C. Prevalence
D. Endemic
Which of the following relates is a measure of the frequency with which a new event occurs in a population over a defined time period?
Incidence
50
What percent of alcohol by weight is most effective for waterless hand-hygiene products?
A. 40% to 55%
B. 50% to 70%
C. 60% to 90%
D. 75% to 98%
What percent of alcohol by weight is most effective for waterless hand-hygiene products?
60% to 90%
51
6. The primary immune response after exposure to a communicable disease pathogen or vaccine is production of:
a. Immunoglobulin G (IgG)
b. Immunoglobulin M (IgM)
c. Immunoglobulin A (IgA)
d. Immunoglobulin C (IgC)
B. Immunoglobulin M (IgM)
52
An adult patient is hospitalized with an acute hepatitis B infection, Serologic tests will MOST likely reveal the presence of:
A. HBcAg and anti-HBs
B. Anti-HBs and anti-HBc
C. HBeAg and anti-HBcIgM
D. HBsAg and HBcAg
An adult patient is hospitalized with an acute hepatitis B infection, Serologic tests will MOST likely reveal the presence of:
HBeAg and anti-HBcIgM
53
An individual who is HIV positive presents to the emergency department complaining of soreness of the lips, buccal surfaces, tongue, and throat. Upon assessment, white plaque-like areas are noted. Which of the following organisms would MOST likely be found if these areas were scraped and cultured?
A. Candida albicans
B. Tourlopsis glabrata
C. herpes simplex
D. Neisseria gonorrhoeae
Answers: Tourlopsis glabrata
54
An IP is preparing a hospital tuberculosis policy. In planning for proper use of resources, the IP should consider the CDC's hierarchy of controls for tuberculosis. From MOST important to LEAST important, they are:
A. personal protection devices, engineering controls, administrative controls.
B. administrative controls, engineering controls, personal protection devices.
C. engineering controls, personal protection devices, administrative controls.
D. personal protection devices, administrative controls, engineering controls.
An IP is preparing a hospital tuberculosis policy. In planning for proper use of resources, the IP should consider the CDC's hierarchy of controls for tuberculosis. From MOST important to LEAST important, they are:
administrative controls, engineering controls, personal protection devices.
55
7. When are IgM antibodies to Hepatitis A virus (HAV) detectable in the blood?
a. 30 days after exposure.
b. 5-10 days after exposure.
c. 1-4 days after exposure.
d. 15-20 days after exposure.
B. 5-10 days after exposure.
56
Which of the following is the BEST method for confirming an infection in a pressure ulcer?
A. Culture of wound vac contents
B. Surface swab culture
C. Culture of wound aspirate
D. Semi quantitative wound culture
Which of the following is the BEST method for confirming an infection in a pressure ulcer?
Culture of wound aspirate
57
The IP receives a report of “encapsulated yeast in the India ink prep of cerebrospinal fluid.” The meningitis that is the MOST likely cause is which one of the following fungi?
A. *Candida tropicalis*
* B. Coxiella burnetii*
* C. Histoplasmosis capsulatum*
* D. Cryptococcus neoformans*
The IP receives a report of “encapsulated yeast in the India ink prep of cerebrospinal fluid.” The meningitis that is the MOST likely caused is which one of the following fungi?
Cryptococcus neoformans
58
In conducting an in-service program regarding group A streptococcus, the IP should include which of the following?
A. meningitis
B. urinary tract infection
C. necrotizing fascitis
D. gastroenteritis
In conducting an in-service program regarding group A streptococcus, the IP should include which of the following?
necrotizing fascitis
59
Which of the following factors should an IP consider First when establishing an annual surveillance plan for an infection control program?
A. Characteristics of the population at risk in the facility
B. The amount that could be saved from prevention of certain infections
C. How easy it is to prevent certain infections
D. The ease of obtaining the surveillance data
Which of the following factors should an IP consider First when establishing an annual surveillance plan for an infection control program?
Characteristics of the population at risk in the facility
60
In reviewing microbiology reports as part of surveillance activities, it is important for the IP to know which of the following regarding sputum specimen results?
A. Review of routine sputum culture results may be an effective and efficient means to conduct surveillance for unusual reportable respiratory infections (e.g., *Bordetella pertussis*, *Legionella sp.,* or *Mycobacterium tuberculosis*).
B. A microbiological report that includes information regarding the method of specimen collection provides greater predicatibility in depicting etiologic agents
C. A summary of positive sputum culture reports for a specified period of time may provide an excellent overview of respiratory pathogens
D. Only final sputum culture results can provide definitive information regarding lower respiratory tract pathogens
In reviewing microbiology reports as part of surveillance activities, it is important for the IP to know which of the following regarding sputum specimen results?
A microbiological report that includes information regarding the method of specimen collection provides greater predicatibility in depicting etiologic agents
61
One major advantage of collecting surveillance data retrospectively is that:
A. it enhances syndromic surveillance
B. effectiveness of interventions can be assessed
C. the medical record is more likely to be complete
D. it is easier to identify an outbreak
On major advantage of collecting surveillance data retrospectively is that:
the medical record is more likely to be complete
62
Which of the following patient characteristics MOST likely suggests the possibility of an intravenous catheter-related infection?
A. recent postoperative abdominal surgery
B. blood culture growing E. coli
C. peripheral catheter inserted within 24 hours
D. no identifiable localized infection on examination
Which of the following patient characteristics MOST likely suggests the possibility of an intravenous catheter-related infection?
blood culture growing E. coli
63
The measure of dispersion that reflects the variability in the values around the mean is the:
A. standard deviation
B. confidence interval
C. range
D. standard error
The measure of dispersion that reflects the variability in the values around the mean is the:
standard deviation
64
Which of the following is the BEST example of an IC quality /performance Improvement activity?
A. monitoring the cleanliness of the floors in the healthcare facility
B. measuring direct care providers' compliance with hand hygiene requirements
C. determing the number of patients who receive antimicrobials postoperatively
D. validating that all new employess are fit-tested to wear an N95 respirator
bring the surveillance data and the concerns ot the attention of the surgeon and /or hospital epidemiologist
measuring direct care providers' compliance with hand hygiene requirements
65
An IP is asked by employee health services to devise department-specific policies for screening and control of communicable diseases. Which of the following diseases is the MOST likely to be acquired by laboratory personnel?
A. Tuberculosis
B. Legionellosis
C. Measles
D. Herpes simplex
An IP is asked by employee health services to devise department-specific policies for screening and control of communicable diseases. Which of the following diseases is the MOST likely to be acquired by laboratory personnel?
Tuberculosis
66
8. The incubation period for pertussis in immunocompetent persons is usually:
a. 7-10 days
b. 3-5 days
c. 1-2 days
d. 2-4 days
A. 7-10 days - APIC Bordetella pertussis
67
MOST characteristic of intravenous fluids containing dextrose is the ability to:
A. support the growth of Candida albicans
B. support the growth of Staphylococcus aureus
C. support the growth of Enterobacter sp.
D. become turbid when contamination reaches 10(3) organisms per mL.
MOST characteristic of intravenous fluids containing dextrose is the ability to:
support the growth of Enterobacter sp.
68
For which of the following vaccines is recent receipt of blood products a contraindication?
A. MMR
B. Influenza
C. Hepatitis B
D. Tetanus
For which of the following vaccines is recent receipt of blood products a contraindication?
MMR
69
Which of the following organisms has been the MOST frequent cause of healthcare-associated endocarditis in patients undergoing valve replacement?
A. Serratia marcescens
B. Enterococcus faecalis
C. Pseudomonas aeruginosa
D. Staphylococcus epidermidis
Which of the following organisms has been the MOST frequent cause of healthcare-associated endocarditis in patients undergoing valve replacment?
Staphylococcus epidermidis
70
An IP has been told by several orthopedic surgeons that post operative patients with multidrug-resistant organisms (MDRO) should not be placed on the joint replacement / orthopedic unit. Hospital policy states that any patient colonzied or infected with a drug-resistant organism should receive contact precautions for the duration of their hosptial stay. Which of the following is the BEST action for the IP to take?
A. consult with nursing leadership regarding MDRO patient placement policy
B. have the staff follow contact precautions and hand hygiene guidelines in patient care
C. Report the orthopedic sugeons' requests to the chair of the Infection Control Committee
D. place the infected orthopedic patients on a medical unit to prevent transmission to other surgical patients
An IP has been told by several orthopedic surgeons that post operative patients with multidrug-resistant organisms (MDRO) should not be placed on the joint replacement / orthopedic unit. Hospital policy states that any patient colonzied or infected with a drug-resistant organism should receive contact precautions for the duration of their hosptial stay. Which of the following is the BEST action for the IP to take?
have the staff follow contact precautions and hand hygiene guidelines in patient care
71
5. A hospital has hired a new manager of Microbiology section of the laboratory. During the initial discussion with the manager about the infection prevention program the IP stresses the importance of collaboration between the departments in reducing HAI. Of the choices listed, which will best meet this goal.
a. The Microbiology staff's compliance with the annual flu vaccination program and TB skin testing.
b. The Microbiology staff's participation in the periodic infection prevention educational sessions for hospital staff.
c. Microbiology's prompt notification to the IP department of any organism's unusual resistance pattern.
d. The Microbiology manager's attendance at local/state and /or national IP educational conferences.
C. Microbiology's prompt notification to the IP department of any organism's unusual resistance pattern.
72
A nurse manager on a neurological unit asks an IP to consult with the staff about a problem of inconsistent glove use during endotracheal suctioning. If the IP wants the staff to solve the problem independently, the BEST approach is to:
A. provide a training program on glove use during suctioning
B. evaluate the suctioning technique of individual staff members and report findings to the nurse manager.
C. identify suctioning technique deficiencies, and recommend a way to solve the problems.
D. initiate staff discussion about the exposure risks associated with endotracheal suctioning.
A nurse manager on a neurological unit asks an IP to consult with the staff about a problem of inconsistent flove use during endotracheal suctioning. If the IP wants the staff to solve the problem independently, the BEST approach is to:
initiate staff discussion about the exposure risks associated with endotracheal suctioning.
73
An ICP/IP wants to display the last 5 years of central-line associated bacteremia rates in the dialysis unit. Which of the following types of charts is MOST appropriate for displaying the data?
A. control
B. bar
C. flow
D. pareto
An ICP/IP wants to display the last 5 years of central-line associated bacteremia rates in the dialysis unit. Which of the following types of charts is MOST appropriate for displaying the data?
bar
74
An IP noted an increase in sternal surgical site infections following CABG procedures performed in the IP's facility during the past four quarters. In order to investigate the SSI outcomes further, which of the following performance improvement process monitors should be reviewed by the IP in conjunction with the interdisciplinary team?
A. infusion of vancomycin mean time = 90 minutes
B. discontinuation of antibiotics 24 hours after surgery
C. mean glucose reading 6 am day 2 post operative =120 mg/dl
D. shave preps performed 1 hour before surgiery
An IP noted an increase in sternal surgical site infections following CABG procedures performed in the IP's facility during the past four quarters. In order to investigate the SSI outcomes further, which of the following performance improvement process monitors should be reviewed by the IP in conjunction with the interdisciplinary team?
discontinuation of antibiotics 24 hours after surgery
75
The HIV serologic study of a voluntary blood donor population has a 99% sensitivity and a 98% specificity. What percentage of positive HIV tests are false-positives?
A. 0.1%
B. 0.2%
C. 1.0%
D. 2.0%
The HIV serologic study of a voluntary blood donor population has a 99% sensitivity and a 98% specificity. What percentage of positive HIV tests are false-positives?
2.0%
76
When establishing diagnostic criteria for identifying a catheter-associated urinary tract infection (UTI) in a resident of a long-term care facility, all of the following are true EXCEPT?
A. Clinical symptoms such as fever, dysuria, and frequency are usually present
B. The presence of \>10 WBC /hpf in uncentrifuged urine may indicate an infection
C. The presence of 100,000 bacterial colony count usually indicates an infection in a resident with an indwelling urinary catheter
D. A positive (urine) nitrite by dipstick is an indication of bacteriuria
When establishing diagnostic criteria for identifying a catheter-associated urinary tract infection (UTI) in a resident of a long-term care facility, all of the following are true EXCEPT?
Clinical symptoms such as fever, dysuria, and frequency are usually present
77
Several infants recently discharged from a hospital nursery are readmitted with skin pustules and with presumptive methicillin-resistant *Staphylococcus aureus* infection. Which of the following should the IP do FIRST?
A. Recommend the nursery be temporarily closed
B. Culture hands and nares of direct care nursery staff
C. Culture other infants in the nursery
D. Review charts and microbiology reports
Several infants recently discharged from a hospital nursery are readmitted with skin pustules and with presumptive methicillin-resistant Staphylococcus aureus infection. Which of the following should the IP do FIRST?
Review charts and microbiology reports
78
An IP is reviewing a prospective study on a new tunneled dialysis catheter. The manufacturer claims the catheter will reduce central line-associated bacteremia. In the study, the dialysis patients requiring new central catheters are randomly assigned to have either the new catheter or the standard central catheter issued by the hospital. This is an example of what type of study?
A. desctriptive
B. experimental
C. case-control
D. point prevalence
An IP is reviewing a prospective study on a new tunneled dialysis catheter. The manufacturer claims the catheter will reduce central line-associated bacteremia. In the study, the dialysis patients requiring new central catheters are randomly assigned to have either the new catheter or the standard central catheter issued by the hospital. This is an example of what type of study?
experimental
79
A patient is diagnosed with vertebral osteomyelitis 6 months after diskectomy and placement of hardware. This condition is usually:
A. group A streptococcal cellulitis
B. group B streptococcal endometritis
C. pharyngitis
D. pyelonephritis
A patient is diagnosed with vertebral osteomyelitis 6 months after diskectomy and placement of hardware. This condition is usually:
pyelonephritis
80
The sterile processing department reports a positive spore test to the IP, the MOST appropriate initial action would be to:
A. recall any implantable devices from the affected load
B. recall all items processed since the last negative biological indicator
C. notify surgical physicians since the last negative biological indicator
D. consider spore strip defective and check results from next load
The sterile processing department reports a positive spore test to the IP, the MOST appropriate inital action would be to:
recall any implantable devices from the affected load
81
Established criteria to identify primary bacteremia in a geriatric patient should include:
A. a maculopapular rash
B. a single-positive blood culture of coagulase-negative staphylococci
C. an increasing systolic blood pressure of \>30 mm Hg from baseline
D. new hypothermia of 94 ° F (\<34.5° C).
Established criteria to identify primary bacteremia in a geriatric patient should include:
new hypothermia of 94 ° F (\<34.5° C).
82
Which of the following access methods for hemodialysis is associated with the lowest risk of infection?
A. Central arterial line
B. External arteriovenous shunt
C. Arteriovenous fistula graft
D. Temporary subclavian catheter
Which of the following access methods for hemodialysis is associated with the lowest risk of infection?
Arteriovenous fistula graft
83
The optimal time to collect a sputum specimen for acid-fast bacilli (AFB) testing to rule out TB would be:
a. First thing in the morning;
b. After a respiratory treatment:
c. Prior to the patient going to bed:
d. Prior to a respiratory treatment.
A. First thing in the morning
APIC - Tuberculosis and Other Mycobacteria
84
A home health agency has asked an IP for a recommendation on the use of antimicrobial household products such as cutting boards, toys, and hand lotion products in patients' homes. The IP should respond that these products:
A. will reduce the presence of bacteria
B. will be effective against virus transmission
C. have no proven infection prevention benefit
D. have caused allergic reactions
A home health agency has asked an IP for a recommendation on the use of antimicrobial household products such as cutting boards, toys, and hand lotion products in patients' homes. The IP should respond that these products:
have no proven infection prevention benefit
85
While making rounds on the orthopedic service, a nurse observes the surgeon removing a surgical dressing from a draining wound. The surgeon fails to wear gloves and does not wash her hands afterwards. The nurse is instructed to redress the wound while the surgeon proceeds to examine another patient. What intervention should the nurse use to correct this breach in infection control practice?
A. ask the IP to speak to the surgeon immediately
B. ignore the break in technique since the surgeon just came from the OR
C. the nurse should speak to the surgeon privately regarding the dressing change policy
D. The nurse should report the break in technique to the chief of surgical services
While making rounds on the orthopedic service, a nurse observes the surgeon removing a surgical dressing from a draining wound. The surgeon fails to wear gloves and does not wash her hands afterwards. The nurse is instructed to redress the wound while the surgeon proceeds to examine another patient. What intervention should the nurse use to correct this breach in infection control practice?
the nurse should speak to the surgeon privately regarding the dressing change policy
86
An IP is evaluating the infection control aspects of a hospital’s employee health program. In developing an institution-wide rubella screening program, which of the following would satisfactorily constitute rubella immunity?
1. Serological evidence of immunity
2. A clinical history of the disease
3. Physician confirmation of diagnosed disease
4. Proof of immunization with one dose of live virus vaccine without post vaccine serologic testing
A. 1 and 4 only
B. 3 and 4 only
C. 1, 2, and 3 only
D. 1, 2, 3 and 4
An IP is evaluating the infection control aspects of a hospital’s employee health program. In developing an institution-wide rubella screening program, which of the following would satisfactorily constitute rubella immunity?
1. Serological evidence of immunity
2. A clinical history of the disease
3. Physician confirmation of diagnosed disease
4. Proof of immunization with one dose of live virus vaccine without post vaccine serologic testing
1 and 4 only
87
Eight patients were diagnosed with health care-associated Legionella pneumonia. The locations of the patients were: four in the liver transplant unit, two in the trauma unit, and one each in the pediatric and psychiatric units. The infection preventionist (IP) should:
A. review the Engineering Department's schedule for changing HEPA filters.
B. discontinue the use of humidifiers on the affected units
C. focus surveillance on the liver transplant units
D. culture the water supply on all affected units
Eight patients were diagnosed with health care-associated Legionella pneumonia. The locations of the patients were: four in the liver transplant unit, two in the trauma unit, and one each in the pediatric and psychiatric units. The infection preventionist (IP) should:
culture the water supply on all affected units
88
Which of the following methods would BEST assist in IP when confirming a common source bacterial outbreak?
A. blood culture review
B. antibiogram results of isolates
C. environmental cultures
D. pulse field gel electrophoresis results
Which of the following methods would BEST assist in IP when confirming a common source bacterial outbreak?
pulse field gel electrophoresis results
89
In a patient with an arterial line device, microorganisms are MOST likely to enter the bloodstream at the:
A. Cannula-tubing junction
B. Insertion site
C. Transducer
D. Bottle/bag-tubing junction
In a patient with an arterial line device, microorganisms are MOST likely to enter the bloodstream at the:
Insertion site
90
To calculate the incidence of intravascular infiltrations associated with peripheral IVs, the most appropriate denominator is the total number of..
A. patients receiving peripheral intravascular fluids
B. line days for patients receiving peripheral IV therapy
C. peripheral IV sites used to administer intravascular fluids
D. vascular access sites used to administer intravascular fluids
To calculate the incidence of intravascular infiltrations associated with peripheral IVs, the most appropriate denominator is the total number of..
line days for patients receiving peripheral IV therapy
91
Two companies have submitted bids on an air-fluidized bed contract to the products/standards committee. The committee requests the IP to review both bids and make a recommendation. Which of the following should be the LEAST important infection prevention consideration?
A. Surface composition
B. Cost
C. Storage
D. Bead disinfection
Two companies have submitted bids on an air-fluidized bed contract to the products/standards committee. The committee requests the IP to review both bids and make a recommendation. Which of the following should be the LEAST important infection prevention consideration?
Cost
92
An IP is investigating an outbreak of healthcare-associated Legionella pneumonia. The organism in the hospital water supply is Legionella pneumophilia serogroup 1. Which of the following is the best method to quickly identify additional cases in the outbreak?
A. sputum culture
B. urinary antigen
C. culture of lung tissue
D. acute and convalencent serologies
An IP is investigating an outbreak of healthcare-associated Legionella pneumonia. The organism in the hospital water supply is Legionella pneumophilia serogroup 1. Which of the following is the best method to quickly identify additional cases in the outbreak?
urinary antigen
93
Which of the following is the preferred skin preparation to use prior to intravascular catheter insertion?
A. 70% alcohol
B. 2% chlorhexidine
C. Acetone
D. Tincture of iodine
Which of the following is the preferred skin preparation to use prior to intravascular catheter insertion?
2% chlorhexidine
94
An IP is developing a program of post-discharge surveillance for surgical site infection. A review of the literature on the subject should indicate which of the following?
A. There are published standard methods for conducting post-discharge surveillance
B. More than 50% of surgical site infections may be missed without a formal post-discharge surveillance system in place
C. Post-discharge surveillance that solicits direct feedback from patients yields data with the best specificity and sensitivity to identify true infection
D. The trend of shorter length of stay has not significantly impacted the rate of surgical site infections identified through inpatient surveillance programs
An IP is developing a program of post-discharge surveillance for surgical site infection. A review of the literature on the subject should indicate which of the following?
More than 50% of surgical site infections may be missed without a formal post-discharge surveillance system in place
95
An environmental service worker refuses to enter a patient's room because he suspects that the patient is infected. What is an IP's MOST appropriate response to this situation?
A. make certain a standard precautions placard is visible in the patient's room
B. inform the employee that the patient's diagnosis is confidential
C. arrange to have the worker reassigned
D. discuss with the employee his concerns about this situation
An environmental service worker refuses to enter a patient's room because he suspects that the patient is infected. What is an IP's MOST appropriate response to this situation?
discuss with the employee his concerns about this situation
96
A patient with a skin rash is admitted from another facility. Scabies is diagnosed and treated. Which of the following should be notifited?
A. the Department of Health, since this is a reportable disease
B. the previous facility so they can assess other patients and staff
C. coworkers who shared the same office space
D. exposed healthcare workers so they can be treated by Occupational health
Answer: the previous facility so they can assess other patients and staff.
97
Over a 3 month period, eight (8) patients were diagnosed with Healthcare associated Legionella pneumonia. Locations of the patients were: four (4) in the liver transplant unit: two (2) in the trauma unit: and one (1) each in the pediatric and psychiatric units. To investigate Legionella in this facility, the IP should?
A. review engineering department's schedule for changing HEPA filters
B. discontinue the use of humidifiers on the affected units
C. focus surveillance on the liver transplant unit
D. culture water supplies on all affected units
answer : culture water supplies on all affected units.
98
If an IP is asked to develop a mission and a vision statement, the mission statement should:
A. Define the purpose and focus of daily activities
B. Stand alone from the healthcare facility’s mission statement to avoid conflict
C. Includes the evaluation process for infection control program
D. Explain why the infection control program exists
If an IP is asked to develop a mission and a vision statement, the mission statement should:
Explain why the infection control program exists
99
The major focus of the annual infection control activities report shoud be:
A. a description of goals and objectives
B. the impact of the program on patient outcomes
C. the departmental mission statement
D. a line listing of nosocomial infections
The major focus of the annual infection control activities report shoud be:
the impact of the program on patient outcomes
100
Transparent dressings are being used as central venous catheter dressing. There is an increase in catheter-associated bacteremias, and an IP wants to determine whether gauze dressings should be substitued for the transparent dressing. Which of the following is the FIRST step in gathering information to make a decision?
A. perform a cost-benefit analysis
B. assess community standards
C. conduct a literature search on the efficacy of different dressing materials
D. observe practice and survey nursing personnel for product preference
Transparent dressings are being used as central venous catheter dressing. There is an increase in catheter-associated bacteremias, and an IP wants to determine whether gauze dressings should be substitued for the transparent dressing. Which of the following is the FIRST step in gathering information to make a decision?
conduct a literature search on the efficacy of different dressing materials
101
Which of the following is a primary factor when selecting an appropriate antimicrobial handwashing agent?
A. Cost of the product
B. Spectrum of the agent’s inactivity
C. Activation by organic material
D. Characteristics of the agent desired
Which of the following is a primary factor when selecting an appropriate antimicrobial handwashing agent?
Characteristics of the agent desired
102
3. Which is True about the tuberculin skin test (TST)?
a. Positive TST indicates active tuberculosis infection.
b. Negative TST rules out active TB.
c. Positive TST indicates past exposure to TB.
d. Negative TST indicates past exposure to TB.
C. Positive TST indicates past exposure to TB. TST involves injection of purified protein derived from the mycobacterial cell wall.
103
An IP is newly hired as the only IP for an ambulatory care facility. Highest priority should be given to:
A. Assessing the existing infection control program
B. Revising policies and procedures
C. Developing goals and objectives
D. Instituting infection surveillance
An IP is newly hired as the only IP for an ambulatory care facility. Highest priority should be given to:
Assessing the existing infection control program
104
Antibiotic therapy is started within 4 hours of admission on a patient suspected of having community acquired pneumonia. This type of treatment is know as:
A. synergistic
B. empiric
C. specific
D. prophylactic
Answer: empiric
105
A patient is admitted to a facility with community-acquired pneumonia. Sputum Gram stain shows faintly staining thin gram-negative rods, but no growth is seen on routine culture. Which of the following should be used to diagnose this patient's illness?
A. urinary antigen for *Legionella*
B. DFA stain for *Bordetella pertussis*
C. PCR testing for *Mycoplasma pneumoniae*
D. sputum culture specific for *Corynebacterium diphteriae*
A patient is admitted to a facility with community-acquired pneumonia. Sputum Gram stain shows faintly staining thin gram-negative rods, but no growth is seen on routine culture. Which of the following should be used to diagnose this patient's illness?
urinary antigen for *Legionella*
106
Five days after admission for pneumonia, a patient is diagnosed with activity cavitary pulmonary tuberculosis. Which of the following staff is MOST likely to have a TST conversion?
A. dietary employees who delivered the meal trays
B. the nursing assistant who fed the patient
C. housekeeping staff who mopped the floor in the patient's room
D. engineering staff who repaired the patient's call light
Five days after admission for pneumonia, a patient is diagnosed with activity cavitary pulmonary tuberculosis. Which of the following staff is MOST likely to have a TST conversion?
the nursing assistant who fed the patient
107
A surgeon has been reported to be noncompliant with pre-operative scrub procedures. Over the past 3 months, the surgeon's patients have had a significant increases in surgical site infections. Which of the following should the ICP/IP do?
A. bring the surveillance data and the concerns ot the attention of the surgeon and /or hospital epidemiologist
B. Initiate an outbreak investigation and determine the correlation between handwashing and infection outcomes
C. instruct the nursing staff to monitor the sugeon's pre-operative scrub and enforce compliance
D. ask the surgeon to switch to an alcohol - based hand product
A surgeon has been reported to be noncompliant with pre-operative scrub procedures. Over the past 3 months, the surgeon's patients have had a significant increses in surgical site infections. Which of the following should the ICP/IP do?
bring the surveillance data and the concerns ot the attention of the surgeon and /or hospital epidemiologist
108
Infection Control receives the following from data from Employee Health for one month:
1. 2 HCWs with positive TB skin tests
2. 2 HCWs with needlestick injuries
3. 12 HCWs on one unit exposed to chickenpox
The IP should recommend:
A. Collecting more information about the cases
B. Prophylaxis for the two employees who are TST/PPD positive
C. Prophylaxis for the two employees with needlestick injuries
D. Prophylaxis for the employee with chickenpox
Infection Control receives the following from data from Employee Health for one month:
1. 2 HCWs with positive TB skin tests
2. 2 HCWs with needlestick injuries
3. 12 HCWs on one unit exposed to chickenpox
The IP should recommend:
Collecting more information about the cases
109
An immunocompetent adult who is day 2 postoperative has a suspected Respiratory Synctial Virus (RSV) infection. Which of the following types of precaustion is MOST appropriate?
A. standard
B. droplet
C. airborne
D. contact
An immunocompetent adult who is day 2 postoperative has a suspected Respiratory Synctial Virus (RSV) infection. Which of the following types of precaustion is MOST appropriate?
contact
110
Nursing personnel are concerned about acquireing hepatitis B from hepatitis B surface antigen (HBsAg) positive postpartum patients. Which of the following provides the best protection for personnel?
A. screen patient care personnel annually for HBsAg and HBsAb
B. immunize personnel with hepatitis B vaccine and emphasize standard precautions
C. administer hepatitis B immune globulin to personnel with blood contact
D. screen postpartum mothers and infants for hepatitis B and place the infants in isolation precautions
Nursing personnel are concerned about acquireing hepatitis B from hepatitis B surface antigen (HBsAg) positive postpartum patients. Which of the following provides the best protection for personnel?
immunize personnel with hepatitis B vaccine and emphasize standard precautions
111
An ICP/IP reports changes in federal and state regulations to the affected departments, integrates pertinent regulations into the facility's policies and procedures, and ensures that these policies and procedures are disseminated to appropriate groups and individuals. In which APIC/CHICA Professional and Practice Standard is the ICP/IP demonstrating competence?
A. surveillance
B. education
C. consultation
D. performance improvement
An ICP/IP reports changes in federal and state regulations to the affected departments, integrates pertinent regulations into the facility's policies and procedures, and ensures that these policies and procedures are disseminated to appropriate groups and individuals. In which APIC/CHICA Professional and Practice Standard is the ICP/IP demonstrating competence?
consultation
112
An IP was asked to make a recommendation to Occupational Health and Administration on a volunteer who delivered mail to patients throughout the facility. After coughing for sevreal weeks, the volunteer was diagnosed with active pulmonary tuberculosis. After investigation, which of the following should the IP do first?
A. Notify potential contacts to initiate TB skin testing at baseline and in 3 months.
B. Provide contacts with TB media to alleviate any potential for TST/PPD conversaion
C. Notify Public Relations office of exposures and providing information.
D. Furlough volunteers and potentially exposed staff.
Answer: Notify potential contacts to initiate TB skin testing at baseline and in 3 months.
113
During environmental rounds on a maternity unit, an IP discovers pumped breast milk in the medication refrigerator, Which of the following actions should the IP take?
A. Require the breast milk be labeled and stored at a temperature of 38 degrees F. ( 4 degrees C.)
B. Require a dedicated refrigerator for storage of the patient’s breast milk.
C. Institute routine culturing of breast milk to ensure safe storage and identify contamination.
D. Prohibit pumping and storage of breast milk in the facility.
During environmental rounds on a maternity unit, an IP discovers pumped breast milk in the medication refrigerator, Which of the following actions should the IP take?
Require a dedicated refrigerator for storage of the patient’s breast milk.
114
Another name for crusted scabies is:
a. American scabies:
b. Norwegian scabies:
c. Canadian scabies:
d. English scabies.
B. Norwegian scabies is a severe form of scabies that can occur in individuals who may be immunocompromised, elderly, or debilitated.
APIC - parasites.
115
After an in service, which of the following is the best way to evaluate if newly learned behaviors are being integrated into practice?
A. unrelated to the surgical procedure
B. a hematogenous infection from bacterial endocarditis
C. secondary to postoperative trauma and vascular insufficiency
D. Observe participants' tecnique 6 months after inservice completion
After an in service, which of the following is the best way to evaluate if newly learned behaviors are being integrated into practice?
Observe participants' tecnique 6 months after inservice completion
116
Which of the following has the potential to increase healthcare-associated infections in hospitalized mental health patients?
A. sexually active while hospitalized
B. decreased susceptibility to infections while on psychotropic drugs
C. adequate hydration and nutrition
D. use of waterless hand cleansing agents by HCWs
Which of the following has the potential to increase healthcare-associated infections in hospitalized mental health patients?
Answer : sexually active while hospitalized
117
When comparing ortho-phthaladehyde (OPA) to 2% glutaraldehyde and peracetic acid sterilization, one unique advantage OPA has demonstrated in the area of superior antimicrobial activity is against:
A. cryptosporidium
B. hepatitis B
C. mycobacteria
D. CJD prions
Answer : mycobacteria
118
A performance improvement tool useful in identifying the root cause of a problem is a:
A. check sheet
B. control chart
C. fishbone diagram
D. pareto chart
Answer: fishbone diagram
119
A dead bat was found in a family home. Public Health post-exposure surveillance should include:
A. definitive diagnosis of Negri bodies in the bat's brain
B. a report to domestic animal control
C. observation of the family's for 30 days
D. alterting the neighborhood of potential risks of being bitten by a bat
Answer: a report to domestic animal control
120
An IP was asked to make a recommendation to Occupational Health and Administration on a volunteer who delivered mail to patients throughout the facility. After coughing for several weeks, the volunteer was diagnosed with active pulmonary tuberculosis. After investigation, which of the following should the IP do **first**?
A. notify potential contacts to initiate TB skin tesing at baseline and 3 months
B. provide contacts with TB meds to alleviate any potential for TST/PPD conversion
C. notify Public Relations office of exposures and providing information
D. furlough volunteers and potentially exposed staff
Answer: notify potential contacts to initiate TB skin tesing at baseline and 3 months
121
Which of the following teaching strategies promotes the highest degree of learning by participants on increasing compliance with barrier precaution?
A. showing a videotape on personal protective equipment
B. attending a lecture given by an authority on isolation
C. problem-solving using small work groups
D. providing a computer-based instructional module
Answer: problem-solving using small work groups
122
A patient was isolated on admission with respiratory failure and found to be smear positive for AFB. Without consulting the IP, isolation was discontinued after 10 days of treatment with a four-drug regimen. Which of the following should the IP do **first**?
A. place the patient in droplet isolation
B. consult the physician about anti-tuberculosis therapy
C. check with the public health department for previous tuberculosis history
D. review the patient's record for the clinical symptoms and microbiology report.
Answer: problem-solving using small work groups
123
Five days after admission for pneumonia, a patient is diagnosed with active cavitary pulmonary tuberculosis. Which of the following staff is **MOST** likely to have a skin test converstion?
A. dietary employee who delivered the meal trays
B. housekeeping staff who mopped the floor in the patient's room
C. engineering staff who repaired the patient's call light
D. the nursing assistant who fed the patient
Answer: the nursing assistant who fed the patient
124
An IP has been requested to provide instructions to a group of hospital voluneers regarding donning and removing isolation apparel. Which of the following instructional methods would be the most appropriate for this audience?
A. demonstrating the technique
B. delivering a lecture on types of isolation
C. providing a handout on the resistent organisms
D. showing a video about MRSA
Answer: demonstrating the technique
125
The careful description of events within populations and the carison of rates of events between groups is called?
A. demographics
B. epidemiology
C. prevalence study
D. case control study
Answer: epidemiology
126
An IP is notified tha environmental service workers were observed not using TB respirators upon entering TB isolation rooms. Educational records show classes were provided 3 weeks prior to the reported observations. The IP should do which of the following?
A. respond that this is not an educational issue
B. assess the appropriateness of the teaching method used
C. provide counseling for policy violators
D. complete incident reports for risk management
Answer: assess the appropriateness of the teaching method used
127
Which of the following can contribute to a foodborne illness outbreak?
A. using non-homogenized eggs in salad dressing
B. washing cutting boards after preparing raw chicken
C. regrigerating unused food within 2 hours of preparation
D. rinsing raw vegetables before use.
Answer: using non-homogenized eggs in salad dressing
128
An IP is consulted by the occupational health nurse regarding a new employee who ahs a hitory of receiving BCG as a child. The IP should advise the occupational health nurse to:
A. administer a PPD/TST as usual
B. defer further PPD/TST skin testing
C. record as a previously positive PPD/TST
D. administer a PPD/TST, but with half the dose
Answer: administer a PPD/TST as usual
129
