Practice exam 2 Flashcards
1
Q
The Product Evaluation Committee has asked the IP to assess a new preoperative skin preparation product that is less expensive than the one the facility is currently using. In researching the background information on the product, the IP reviews several sources of literature. Which of the following sources provides the best evidence for effectiveness of the product?
a. The vendor representative’s assurance that the new product has been tested and works at least as well as the product currently being used.
b. An independent, randomized trial that shows with statistical significance that the new products is comparable to the current product in preventing infections when used as a surgical skin prep.
c. The vendor-sponsored laboratory research showing that skin flora is reduced by the same magnitude with the new product as with the current product.
d. The testimonial of another IP whose hospital has been using the new product for 6 months.
A
An independent, randomized trial that shows with statistical significance that the new products is comparable to the current product in preventing infections when used as a surgical skin prep
APIC Product Evaluation
2
Q
A classic sign of measles is:
a. Kaposi Sarcoma
b. Stiff neck
c. Koplik spots
d. Bull’s eye rash
A
Koplik spots
Communicable Diseases Manual Identification of Infectious Disease Processes
3
Q
A healthcare worker has called the IP to ask the reasoning behind the policy that prohibits employees who have patient contact from wearing artificial fingernails. Which of the following reasons would she give to this employee?
a. There is strong evidence that artificial nails are associated with HAIs
b. HCP with artificial nails are more likely to have more Gram-negative bacteria under their nails than HCP with natural nails.
c. Artificial nails often puncture gloves, exposing the healthcare worker to blood and body fluids.
d. HCP with artificial nails do not perform hand hygiene as often as HCP with natural nails.
A
HCP with artificial nails are more likely to have more Gram-negative bacteria under their nails than HCP with natural nails.
APIC Hand Hygiene
4
Q
A patient from a long-term acute care (LTAC) facility is being transferred to an acute care facility for an outpatient procedure. The patient has a history of cryptococcal meningitis. The outpatient department asks the IP what type of Isolation Precautions the patient requires:
a. Airborne Precautions
b. Droplet Precautions
c. Standard Precautions
d. Contact Precautions
A
Standard Precautions
Cryptococcosis meningitis is caused by the fungus Cryptococcus neoformans. This fungus is found in soil around the world. Unlike bacterial meningitis, this form of meningitis comes on more slowly over a few days to a few weeks. Patients with Cryptococcus meningitis do not require isolation precautions. Standard precautions should be followed on all patients.
5
Q
A patient in Droplet Precautions is scheduled for a procedure in Endoscopy. In addition to following respiratory hygiene and cough etiquette, which of the following is the most appropriate method to reduce the transmission of infectious organisms during transportation of the patient?
a. Instruct patient to wear in N95 respirator
b. Cover or contain potentially infectious body fluids
c. Place a surgical mask on the patient
d. Provide respiratory protection for transport personnel
A
Place a surgical mask on the patient
6
Q
A patient is admitted to rule out TB. All of the following would be noted as a risk factor for transmission of infection to the staff EXCEPT:
a. Improper N95 respirator use by the staff.
b. Surgical mask placed on the patient during transport.
c. Acid-fast bacilli (AFB) smear positive sputum culture from the patient.
d. Patient placed in a regular exam room in the emergency room
A
Surgical mask placed on the patient during transport.
APIC Tuberculosis and Other Mycobacteria
7
Q
A patient was admitted to the Emergency Department with severe headache, fever, and photo-phobia. The results of the lumbar puncture are pending. A staff member who cared for the patient is requesting antibiotics because the patient may have meningitis. If meningococcal meningitis is confirmed, chemoprophylaxis would be indicated for all of the following individuals except:
a. The licensed practical nurse who did not have direct contact with the patient’s oral secretions.
b. The emergency medical technician who performed mouth-to-mouth resuscitation
c. The resident who did not war appropriate PPE during intubation
d. The registered nurse who suctioned the patient without wearing a mask
A
The licensed practical nurse who did not have direct contact with the patient’s oral secretions.
8
Q
A pregnant environmental services worker, who is non-immune to varicella, enters the room of a patient with confirmed varicella (chickenpox) before an isolation sign is posted. She spends 6 minutes in the room with the patient (who is not wearing a mask). This exposure happened on January 11. After giving the employee vericella-zoster immune globulin (VZIG), it is determined that she should be excluded from work. What day can she return to work?
a. January 31
b. February 1
c. February 8
d. February 9
A
February 9
9
Q
According to the CDC and the Advisory Committee on Immunization Practices (ACIP), which of the following groups should receive the Hepatitis B vaccine?
1) Unvaccinated adults receiving chemotherapy.
2) Residents and staff of facilities for developmentally delayed disabled persons
3) People with more than one sexual partner
4) Unvaccinated adults <60 years of age with diabetes mellitus
a. 1,2,3 b. 2,3,4 c. 1,3,4 d. 1,2,4
A
Residents and staff of facilities for developmentally delayed disabled persons
People with more than one sexual partner
Unvaccinated adults <60 years of age with diabetes mellitus
APIC Preventing / Controlling the Transmission of Infectious Agents
10
Q
All of the following are advantages of concurrent surveillance EXCEPT:
a. Immediate infection prevention measures may be instituted.
b. Outbreaks may be identified in more timely manner.
c. The medical record is complete and easy to access.
d. Caregivers and patients can be interviewed and provided accurate information.
A
The medical record is complete and easy to access.
APIC Surveillance
11
Q
An inspection of the Sterile Processing Department reveals several incorrect practices. Which of the following would be a CORRECT practice?
a. Ensuring hinged instruments are cleaned with the hinge closed.
b. Flushing instruments with saline.
c. Daily use of a biological indicator in the sterilizer.
d. Transporting contaminated instruments in a permeable container.
A
Daily use of a biological indicator in the sterilizer.
APIC Sterile Processing
12
Q
An IP is assisting local public health with a Hepatitis A outbreak in the community. She has been asked to contact the Health Department with any patients who are admitted to her facility with a test positive for Hepatitis A (HAV). Patients who test positive in the acute phase of the illness will have a positive:
a. IgG anti HAV
b. IgM anti HAV
c. IgA anti HAV
d. IgG, IgM anti HAV
A
IgM anti HAV
APIC Hepatitis
13
Q
An IP is writing instructional objectives for a learning module on catheter-associated bloodstream infections. He wants to focus on the cognitive level of “Analysis” from Bloom’s taxonomy. Which of the following choices contains the verbs he should use to describe his learning objectives?
a. Compare, discriminate, and differentiate
b. Define, identify, and select
c. Discuss, explain, and paraphrase
d. Judge, summarize and recommend
A
Discuss, explain, and paraphrase
14
Q
Contact Precautions for a patient with scabies can be discontinued when the patient has received effective treatment for:
a. 10 days
b. 7 days
c. 48 hours
d. 24 hours
A
24 hours
APIC Identification of Infectious Disease Processes
15
Q
During rounds in several patient care areas, the IP discovers several cardboard boxes being used to store patient care supplies. She informs the unit manager that another method of storing supplies must be implemented because:
a. The boxes cause clutter in the storeroom
b. Cardboard can only be used to store supplies in soiled utility rooms
c. The boxes may harbor dust, bacteria, and insects
d. The boxes are a fire hazard
A
The boxes may harbor dust, bacteria, and insects
16
Q
In 2013, 3,254 persons died of all causes in a large metropolitan area with a population of 1.8 million. What was the crude mortality rate?
a. 18 per 100,000
b. 18 per 1,000
c. 180 per 1,000
d. 180 per 100,000
A
180 per 100,000
Mortality rate = x/y x k
x = number of people
y = estimated population mid year
k = 1,000
APIC Use of Statistics in Infection Prevention
17
Q
In presenting an educational session to unit staff members, the IP wants to engage staff to discuss family member’s noncompliance with Isolation Precautions and identify possible solutions. Of the choices below, which educational method would be most effective?
a. Conduct personal interviews to determine staff and family.
b. Present case studies describing family members’ noncompliance with Isolation Precaution to initiate discussion of the problem and possible solutions.
c. Engage the staff in well-structured games that test their knowledge of Isolation Precautions
d. Utilize the “Train the Trainer” method to provide staff and family members with continuing education.
A
Present case studies describing family members’ noncompliance with Isolation Precaution to initiate discussion of the problem and possible solutions.
18
Q
Infection prevention challenges related to body piercings and tattooing include all of the following EXCEPT:
a. there have not been uniform licensure requirements for body art studios.
b. Reporting of infections to the Public Health Department is limited to bloodborne diseases.
c. The popularity of tattooing the body piercing has made it more socially acceptable.
d. Inspectors may not receive adequate training to conduct site inspections.
A
The popularity of tattooing the body piercing has made it more socially acceptable.
APIC Body Piercing, tattoos, and electrolysis
19
Q
Managing infection prevention outcomes, analyzing variance trends, and evaluating corrective actions taken to reduce infection risks are components of:
a. Case Management
b. Utilization review
c. Performance improvement
d. Medical review
A
Performance improvement
APIC Quality Concepts
20
Q
Methods to prevent the transmission of C. difficle infections include:
1) Hand washing with soap and water
2) Environmental cleaning and disinfection
3) Closing the unit for deep cleaning
4) Laundry and waste management controls
a. 1,2 b. 2,4 c. 1,3 d. 3,4
A
1,2
1) Hand washing with soap and water
2) Environmental cleaning and disinfection
APIC Clostridium difficle infections and Pseudo-membranous Colitis.
21
Q
Of the recommendations for reprocessing flexible gastrointestinal endoscopes listed below, the one that is most strongly supported by well-designed experimental, clinical, or epidemiologic studies is:
a. Cleaning of endoscopes is essential before manual or automated disinfection.
b. Brushes used to clean endoscopes should be thoroughly cleaned and disinfected or sterilized between uses.
c. Ultrasonic cleaning of reusable endoscopic components should be used to remove soil and organic material.
d. Routine environmental microbiological testing of endoscopes should be carried out.
A
Cleaning of endoscopes is essential before manual or automated disinfection.
APIC Endoscopy
22
Q
Phlebotomists within an organization are complaining that the new blood collection device introduced 6 months ago is difficult to use for blood draws and has resulted in an increase in needle-stick injuries. The IP is working with Occupational Health to evaluate the problem and would like to compare NHSN rates before and after implementation of the device.
Which of the following would be the MOST useful denominator in order to calculate useful data?
a. Phlebotomist employee hours at work (full-time equivalents)
b. Number of occupied beds (or licensed beds)
c. Number of patients (average daily census)
d. Number of blood collection devices used or purchased.
A
Number of blood collection devices used or purchased.
Occupational HealthEmployee/Occupational Health
23
Q
Point-source epidemics usually occur on the basis of:
a. A vector
b. A vehicle
c. Person-to-person transmission
d. Droplet infection
A
b. A vehicle
APIC Outbreak Investigations
24
Q
The annual education budge for the Infection Prevention Department is $1,650.00. In October, the IP manager allocated 20 percent of the department education budget towards resources for the annual flu shot program. However in November, the financial report indicates that only 15 percent was spent. How much of the budgeted amount remains unspent?
a. $330.00
b. $247.50
c. $82.50
d. $66.00
A
$82.50
20 percent of 1,650.00 (1,650.00 x 0.20 = 330.00) However only 15 percent (1,650.00 x 0.15 = 247.50 was spent.
$330.00 - $247.50 = $82.50
25
The Director of Facilities informs the IP that water testing of the hospital's hot water tanks and distal sites was positive for Legionella. The IP should consider disinfection of the hospital's water system if:
a. There have not had any prior cases of healthcare-associated legionellosis.
b. The IP conduct prospective surveillance of healthcare-associated legionellosis and there are no cases.
c. The colonization rate for distal water sites in the hospital is greater than 30%.
d. The hospital Risk Manager asks for the disinfection to be completed.
The colonization rate for distal water sites in the hospital is greater than 30%.
APIC Legionella pneumonia
26
The Director of Infection Prevention and Control has hired a new, entry-level IP. What is the best method to use to evaluate the training progress of this new IP?
a. Compare the new IP's knowledge and skill to the knowledge and skills of other IPs in the department
b. Compare the new IP's knowledge and skills to benchmarks based on set competencies
c. Training in infection control ideally occurs through experiential learning, and there is no need to evaluate this process at this time
.d. Compare the new IP's knowledge and skills to benchmarks based on the director's experience when he was new to infection control
Compare the new IP's knowledge and skills to benchmarks based on set competencies
APIC Education and Training
27
The Director of Infection Prevention and Control has just received information about a bioterrorist threat in her county with an agent spread primarily by contaminated food/water. Which of the following agents should she include in her emergency response plan?
a. Tularemia
b. Vibrio cholerae
c. Q fever
d. Brucellosis
Vibrio cholerae
APIC Infectious Disease Disasters: Bioterrorism, emerging infections and Pandemics.
28
The Hemodialysis Department at a hospital completes a monthly water culture testing. The results are over the limit for colony - forming unit (CFU)/mL. Which of the following actions should be done first?
a. Notify the physician
b. Initiate daily water culture testing
c. Disinfect the system
d. Notify the infection Control Department
Disinfect the system
APIC Dialysis
29
The Infection Control Manager is designing a surveillance program for sharp object injuries (SOIs) in his facility with the objective of reducing SOIs by 40% within a 1-year period. Which of the following is the most important element to the success of this surveillance program?
a. Identification of risk factors for SOI
b. Immediate notification about any SOI in the facility
c. Development of an educational program that effectively targets with most common causes of SOI in the facility.
d. Outcome of the SOI
Development of an educational program that effectively targets with most common causes of SOI in the facility.
APIC Surveillance
30
The Infection Prevention Manager is analyzing the department's overall performance. The ratio of output to input will produce a measure of the department's:
a. Productivity
b. Effectiveness
c. Quality control
d. Through put
Productivity
APIC Qualitative
31
The IP has been notified that three patients with possible pneumonic plague have been admitted to the Emergency Department. The IP recommends which of the following strategies?
a. A surgical mask worn within 3 feet of patient, door may be open
b. Negative pressure isolation room with use of N95 respirators
c. Normal ventilation, but door must remain closed and N95 respirator mask worn
d. No masks are required, but patient must be placed in private room and contacts should be treated for exposure.
A surgical mask worn within 3 feet of patient, door may be open
APIC Infectious Disease Disasters: Bio-terrorism, Emerging Infections, and Pandemics
Preventing and Controlling the Transmission of Infectious Agents.
32
The IP is asked to explain the discrepancy between the data reported by the facility to the NHSN and the patient diagnosis in the electronic medical record. What is the BEST explanation for the discrepancy?
a. Physicians often develop definitions to meet their preferred criteria.
b. Surveillance definitions may be different from those used for diagnosis and treatment
c. NHSN definitions should be used to establish clinical diagnoses
d. Clinical diagnoses are less sensitive than the NHSN definitions
Surveillance definitions may be different from those used for diagnosis and treatment
APIC Surveillance
33
The IP is planning an educational program for the nursing staff. The IP knows that in order to increase retention and motivate the nurses to change practice behaviors, she should do which of the following?
1) Assume a facilitator role
2) Utilize monologues to provide critical information
3) Incorporate an interactive approach
4) Use a computer-based learning module
a. 1,3 b. 1,4 c. 2,3 d. 1,2
1,3
1) Assume a facilitator role
3) Incorporate an interactive approach
APIC Education and Training
34
The IP on the Antimicrobial Stewardship Team is thinking of ways that he can support these efforts and add to the success of the team in decreasing antimicrobial resistance.
Some of the activities that he can do to help with the mission of the team include:
1) Calculate multidrug- resistant organism (MDRO) infection rates
2) Detect asymptomatic carriers using active surveillance cultures
3) Use molecular typing for investigating outbreaks
4) Collect environmental cultures of isolation rooms
a. 2,3.4 b. 1,3,4 c. 1,2,4 d. 1,2,3
1,2,3
1) Calculate multidrug- resistant organism (MDRO) infection rates
2) Detect asymptomatic carriers using active surveillance cultures
3) Use molecular typing for investigating outbreaks
APIC Antimicrobial and Resistance Prevention and controlling the transmission of infectious agents
35
The purpose of the annual infection prevention program risk assessment is to:
a. Determine goals and objectives for the following year.
b. Describe support requirements of the program.
c. Outline the achievements and activities of the program.
d. Document the facility's risks of infection
Determine goals and objectives for the following year.
APIC Infection Prevention and Control Programs
36
The term "Standard Precautions" is a synthesis of ____________ and __________.
a. Contact Precautions and Droplet Precautions.
b. Bloodborne Pathogen Precautions and Airborne Precautions.
c. Universal Precautions and Body Substance Isolation.
d. Airborne Precautions and Universal Precautions
Universal Precautions and Body Substance Isolation.
APIC Standard Precautions
37
There is a flu outbreak in a community, and the IP at the local hospital is interested in accurately identifying infected patients as quickly as possible so that they can be placed on Isolation Precautions. The IP has a choice between two rapid flu tests.
Test A has a sensitivity of 98% and a specificity of 85%.
Test B has a sensitivity of 92% and a specificity of 89%. Which test will be most accurate in correctly identify patients who are infected with flu?
a. Test A, because it has higher sensitivity.
b. Test A, because it has a higher predictive value negative.
c. Test B, because it has higher specificity.
d. Test B, because it has a higher predictive value negative
Test A, because it has higher sensitivity.
APIC Use of statistics
38
Using the reported data in the table, the IP and the facility leadership need to focus on what groups of patients? (need to be at least 90%).
Units Patients screened total # of patients
Pre-Op 180 194
ICU 237 268
Other Hosp 164 186
Previous dx 211 225
total 800 873
1. Preoperative patients for high-risk surgery.
2. Transfers into intensive Care Unit
3. Transfers from other facilities
4. Previous diagnosis
a. 1,2 b. 2,3 c. 1,3 d. 2,4
2,3
2. Transfers into intensive Care Unit
3. Transfers from other facilities
Divide the total number of screened patients by the total number of patients in each category divided by 100.
APIC use of statistics
39
Using the surgical risk index to stratify the identified infections for the previous quarter, an IP would report which of the following case(s) as having a higher risk for developing a surgical site infection?
1) An 80 year-old male with poor circulation who develops a donor site infection after a coronary artery bypass graft surgery that took 4 hours to perform.
2) A 30 year-old female who has knee surgery to repair a torn cruciate ligament after a skiing accident
3) A 90 year-old with insulin-dependent diabetes who has hip replacement surgery that takes 2.5 hours to perform
4) A 27 year-old male with Crohn's disease who has colon resection that takes more than 4 hours to perform due to adhesions.
a. 1,2 b. 2,3 c. 3,4 d. 1,4
3,4
3) A 90 year-old with insulin-dependent diabetes who has hip replacement surgery that takes 2.5 hours to perform
4) A 27 year-old male with Crohn's disease who has colon resection that takes more than 4 hours to perform due to adhesions.
APIC Surgical Site Infections Surveillance and Epidemiologic Investigation
40
What is the name given to an aggregation of cases in a given area over a particular period without regard to whether the number of cases is more than expected?
a. Pseudo-outbreak
b. Outbreak
c. Cluster
d. Epidemic
Cluster
Out break investigations Surveillance and Epidemiologic Investigation
41
What is the negative predictive value of the following data?
True disease True Disease Neg.
Test is positive 100 3
Test is Neg. 40 500
a. 82.9%
b. 83.3%
c. 92.5%
d. 71.4%
92.5%
Negative predictive value = TN/(FN+TN)
500/ (40+500)
500/ (540)
= 0.92.5%
APIC Use of Statistics
42
What recommendation should an IP give regarding mask use by a staff member who has documented immunity to varicella (chickenpox)?
a. Wear an N95 respirator whenever entering the room
b. Wear a regular surgical mask whenever entering the room
c. No mask is needed
d. The patient should don a surgical mask
No mask is needed
APIC Isolation precautions
43
When a test has a higher specificity than sensitivity, it means the test:
a. Will be more accurate when predicting who is ill
b. A negative result will be more accurate than a positive.
c. A positive results will be more accurate than a negative.
d. It should only be done as a secondary testing procedure to rule out disease.
A negative result will be more accurate than a positive.
APIC Use of Statistics
44
When performing an audit of the Endoscopy Department, the IP observes the following practices. Which one is cause for concern?
a. Single-use brushes are used to clean the scopes.
b. Equipment is immersed in enzymatic cleaner that is discarded every 24 hours.
c. Leak testing performed on scopes after each use.
d. Scopes stored vertically in a closed cabinet.
Equipment is immersed in enzymatic cleaner that is discarded every 24 hours.
APIC Endoscopy
45
Which of the following concepts is most important when determining what type of surveillance methodologies to use as part of the facility surveillance program?
a. Methodologies should be flexible and evolve in response to changes in healthcare delivery, use of data, disease prevalence, and populations served.
b. Methodologies must remain static due to the use of consistent definitions and criteria.
c. Methodologies should function to promote quality healthcare regardless of resources available.
d. Methodologies should focus exclusively on clinical outcomes but may interface with quality improvement or safety programs.
Methodologies should be flexible and evolve in response to changes in healthcare delivery, use of data, disease prevalence, and populations served.
46
Which of the following diseases are preventable by immunization?
1) Diptheria
2) Varicella
3) Pertussis
4) Cytomegalovirus
a. 1,2,3 b. 1,2,4 c. 1,4,5 d. 2,4,5
34.
a. 1,2,3
1) Diptheria
2) Varicella
3) Pertussis
APIC Occupational Health
47
Which of the following is an example of an effective performance measure?
a. A measure that has been developed based on observation of practices in a facility.
b. A measure that is based on a definition that can easily be understood and applied in a facility.
c. A measure that demonstrates a return on investment (ROI)
d. A measure that takes into consideration customer satisfaction.
A measure that is based on a definition that can easily be understood and applied in a facility.
APIC Performance measures
48
Which of the following is an example of disease prevalence?
a. The number of Clostridium difficle patients in the hospital on any given day.
b. The number of newly diagnosed TB cases for the year.
c. The number of CLABSIs identified in the third quarter.
d. The number of patients admitted with chickenpox in a 6-month time period.
The number of Clostridium difficle patients in the hospital on any given day.
APIC General Principles of Epidemiology
49
Which of the following is an example of infectious waste?
a. An unused syringe and needle that were discarded after accidentally being dropped on the floor.
b. A gauze pad with a small amount of blood on it.
c. Gloves that were worn to administer a Hepatitis B vaccine.
d. Agar plates used for testing sputum samples in the microbiology lab
Agar plates used for testing sputum samples in the microbiology lab
APIC Waste management.
50
Which of the following processes should be used for contaminated endotracheal blades?
a. Cleaning followed by high-level disinfection
b. Cleaning with chlorhexidine followed by soaking in an enzymatic solution for 20 minutes.
c. Cleaning followed by ultrasonic washer
d. Cleaning followed by alcohol disinfection
Cleaning followed by high-level disinfection
APIC Cleaning and Disinfection, sterilization
Preventing and controlling the transmission of Infectious Agents
51
Which of the following scenarios is an example of the preparation phase of the transtheoretical model?
a. Auditing reveals that staff compliance with personal protective equipment (PPE) use has increased in the last month.
b. Data is showing a 96% compliance rate for PPE use in the last 10 months.
c. Staff are discussing strategies to increase PPE use at the monthly staff meeting.
d. Staff are questioning why they need to wear PPE when caring for patients in isolation.
Staff are discussing strategies to increase PPE use at the monthly staff meeting.
APIC Infection Prevention and Behavioral Interventions
52
Which of the following statements, about testing for statistical significance is TRUE?
a. A p value of 0.50 means that the probability that the observation occurred by chance alone is 1 in 20
b. A p value of 0.50 increases the likelihood of making the Type 2 error
c. The size of the p value indicates the power of the results
d. The research hypothesis is the basis of significance
p value of 0.50 means that the probability that the observation occurred by chance alone is 1 in 20
53
Which of the following statements are TRUE regarding consent to immunization?
1) Some states allow personal belief exemptions
2) Federal regulations require informed consent
3) All states allow medical exemptions for persons with medical contraindications to vaccination
4) Vaccine recipients must receive Vaccine Information statements (VISs)
a. 1,2,3 b. 2,3,4 c. 1,3,4 d. 1,2,4
Some states allow personal belief exemptions
All states allow medical exemptions for persons with medical contraindications to vaccination
Vaccine recipients must receive Vaccine Information statements (VISs)
APIC Occupational Health
54
Which of the following statements is TRUE regarding an asymptomatic employee with a newly positive tuberculin skin test (TST) of 10 mm induration in a medium to high risk setting?
1) The employee has latent tuberculosis (TB) infection
2) The employee is capable of transmitting TB to others
3) The employee is not infectious
4) The employee has TB disease
a. 3,4 b. 2,4 c. 1,3 d. 1,2
1,3
1) The employee has latent tuberculosis (TB) infection
3) The employee is not infectious
Guidelines for preventing the transmission of Mycobacterium Tuberculosis in Health-care settings (2005 - Jensen PA, Lamber, LA, Ladermarco MF et al
55
Which of the following would be an appropriate goal for the Infection Prevention strategic plan?
a. Zero SSIs for the entire year.
b. Reducing healthcare-associated infections (HAIs).
c. Reduce central line-associated bloodstream infections (CLABSIs) by 50%.
d. Increase hand hygiene compliance
Reduce central line-associated bloodstream infections (CLABSIs) by 50%.
APIC Quality Concepts
56
While conducting rounds in the Intensive Care Unit (ICU), the IP is approached by a nurse who wants to know what the best practice standards are for drawing blood cultures from an existing central line. The correct response is:
a. Drawing blood cultures from and established central line reduces the contamination rate.
b. Blood samples should be obtained in pairs (two sets) from different peripheral sites.
c. The site is unimportant as long as the hub is cleaned thoroughly.
d. The tip of the catheter is also cultured if bacteremia is suspected.
Blood samples should be obtained in pairs (two sets) from different peripheral sites.
57
While rounding in an ambulatory care center, an IP discovers that healthcare personnel have been using single-dose vials of lidocaine for multiple patients. She informs the clinic manager that the practice must end immediately. Which of the following statements about SDV's should the IP include in her explanation to the clinic manager?
1) SDVs lack antimicrobial preservatives
2) Inappropriate use of SDVs can lead to contamination
3) A needless access device (spike) must be applied when reusing an SDV
4) All medications from an SDV must be prepared in a pharmacy
a. 1,2 b. 2,3 c. 3,4 d. 2,4
1,2
1) SDVs lack antimicrobial preservatives
2) Inappropriate use of SDVs can lead to contamination
Ambulatory Care
58
A 47 year old female bus driver is brought to the ED with a two day history of fever, shortness of breath, and chest pain. She is diaphoretic and appears acutely ill. She is confused as to place and time. Temperature is 38° C (100.4 ° F), blood pressure is 88/60 mm Hg, pulse rate is 110 /min, and respiration rate is 28 per min. Coarse bronchial breath sounds are heard. She has had no recent known contact with ill persons. The leukocyte count is 15,000/QL (15x109/L ). A chest X-ray shows a widened mediastinum and bilateral pleural effusions. Gram stain of a peripheral blood smear show box-car shaped Gram-positive bacilli. A bio-terrorism agent is suspected. Which of the following agents is most likely?
A. Typhus fever
B. Small pox
C. Tularemia
D. Anthrax
Anthrax
59
A new Environmental Services employee has been asked to clean up a large blood spill on the floor in the OR. How should he proceed?
A. He should mix an EPA-registered disinfectant with water in a bucket and mop up the spill
B. He should place absorbent material over the spill and pour the correct dilution of disinfectant over the material for the recommended contact time.
C. He should pour undiluted bleach directly on the blood spill, wait 10 minutes, and then mop up the spill
D. He should place absorbent material over the spill, dispose of the material after absorption, and then mop the floor with an EPA- registered disinfectant
He should place absorbent material over the spill and pour the correct dilution of disinfectant over the material for the recommended contact time.
60
A patient is admitted with measles and placed on Airborne Isolation. How many days after symptom onset would the characteristic blotchy red rash appear?
A. on day 1-2
B. on days 7-10
C. on days 3-7
D. on days 21 - 25
on days 3-7
61
Which of the following statements is correct regarding the efficacy of a disinfectant product on a microbe?
A. for all disinfectants, the greater the concentration of the disinfectant, the shorter the contact time is for effective cidal activity
B. for all disinfectants, the activity of the disinfectant increases as temperature increases
C. for all disinfectants, the greater the number of microbes on an object or surface, the greater the amount of time that's needed for a disinfectant to have effective cidal activity
D. for all disinfectants, the existence of a biofilm does not affect cidal activity
for all disinfectants, the greater the number of microbes on an object or surface, the greater the amount of time that's needed for a disinfectant to have effective cidal activity
62
Which of the following is an advantage of orthophthaladehyde (OPA) over glutaraldehyde?
A. OPA does not require activation
B. OPA is compatible with many more materials than glutaraldhyde
C. it does not stain skin
D. no personal protective equipment is needed to handle OPA
OPA does not require activation
63
In the event of a disaster with a prolonged power outage, how should you prioritize use of food stored in the facility?
A. you should continue to use food from a variety of refrigerators and freezers as usual
B. you should prepare food that is in unpowered refrigerators first
C. you should prepare food that is in unpowered freezers first
D. you should immediately use disaster reserve supplies
you should prepare food that is in unpowered refrigerators first
64
Which of the following organisms is most likely to be associated with contaminated disinfectants?
a. Pseudomonas species
b. Hepatitis C
c. Clostridium difficle
d. Cryptosporidium parvum
Pseudomonas species
65
When using heat to treat a room for bed bugs, the temperature must be:
A. 85°F or 29°C for one hour
B. 110°F or 43° C for 90 minutes
C. 125°F or 51°C for two hours
D. 118°F or 48°C for one hour
118°F or 48°C for one hour
66
Event-related storage of sterile items allows packaged, sterile items to be used any time after processing provided that:
1) the expiration date has not passed
2) the packing wrapper is intact
3) the item has not gotten wet
4) the storage area is well-ventilated, dry and free of dust and insects
a. 1
b. 1,2,3
c. 2,3,4
d. 1,2,3,4
the packing wrapper is intact
the item has not gotten wet
the storage area is well-ventilated, dry and free of dust and insects
67
Diluted bleach solutions stored in an open container must be changed every:
a. 30 days
b. 28 days
c. 24 hours
d. 12 hours
24 hours
68
An IP is evaluating her control chart and notices that several points in a row are above the mean line. This probably indicates:
a. the mean is incorrectly calculated
b. she should investigate potential sources of special cause variation
c. there is common cause variation in her process, and it requires no correction
d. she is using the incorrect type of control chart
she should investigate potential sources of special cause variation
69
Which of the following organisms are most likely to be the cause of outbreaks of healthcare-associated infections due to improper reprocessing of bronchoscopes?
1) Mycobacterium tuberculosis
2) Carbapenum-resistant Enterobacteriaceae
3) Pseudomonas aeruginosa
4) Staphylococcus aureus
a. 1,2,3,4
b. 1,3,4
c. 1,3
d. 2,4
Mycobacterium tuberculosis
Pseudomonas aeruginosa
70
This type of sterilizer works by forcing steam into the chamber from the top and pushing the air in the chamber out the bottom of the chamber:
a. steam sterilizer
b. ethylene oxide sterilizer
c. dynamic air removal steam sterilizer
d. gravity displacement steam sterilizer
gravity displacement steam sterilizer
71
Which of the following organisms is most likely to contaminate a urine specimen if the collection process is not done correctly:
a. Staphylococcus aureus
b. Pseudomonas aeruginosa
c. Candida albicans
d. Klebsiella pneumonia
Candida albicans
72
Which of the following environmental infection prevention measures are recommended for inpatient units that household hematopoietic stem cell transplant (HSCT) patients?
1) Providing sterile linens
2) Prohibiting live plants and dried or fresh flowers in rooms of HSCT patients
3) Avoiding items that collect or trap dust
4) Providing laminar air flow
a. 1,2
b. 3,4
c. 2,3
d. 1,3
Prohibiting live plants and dried or fresh flowers in rooms of HSCT patients
Avoiding items that collect or trap dust
73
Which of the following is the primary method to prevent influenza?
a. annual vaccination
b. hand washing
c. droplet precautions
d. promotion of respiratory hygiene/cough etiquette
annual vaccination
74
Which of the sterility assurance levels (SAL) listed below is appropriate for critical items?
a. zero
b. 10 to the negative 4 power
c. 10 to the negative 6 power
d. 10 to the negative 8 power
10 to the negative 6 power
75
Green cleaning is a new approach to environmental cleaning that aims at reducing harm to human health and the environments while maintaining or improving the hygiene of the healthcare environment. Which of the following green strategies would be appropriate to implement?
1) replacing floor strippers and finishes that contain heavy metals and asthmagens
2) substituting disinfectant room cleaners with less toxic detergents
3) employing carcinogen-free carpet cleaners
4) introducing high-filtration vacuum cleaners
a. 1,2,4
b. 2,3,4
c. 1,3,4
d. 1,24
replacing floor strippers and finishes that contain heavy metals and asthmagens
employing carcinogen-free carpet cleaners
introducing high-filtration vacuum cleaners
76
Which of the following would be evidence of CAUTI in an adult patient with an indwelling urinary catheter in place for more than 2 days?
1) fever greater than 38°C
2) a positive dipstick for leukocyte esterase
3) a positive urine culture with 104 CFU/ml of E. coli
4) a positive urinary catheter tip for E. coli
a. 1,3,4
b. 1,2,4
c. 1,2,3
d. 2,3,4
fever greater than 38°C
a positive dipstick for leukocyte esterase
a positive urine culture with 104 CFU/ml of E. coli
77
Case control studies are useful for studying;
a. rare outcomes or out comes that develop over a long time after exposure.
b. individuals with and without exposure to a potential risk factor.
c. specific exposure incidents
d. the availability of a risk exposure
rare outcomes or out comes that develop over a long time after exposure.
78
The existence of an outbreak is most often determined by:
a. the identification of more than 10 new cases per week
b. an incidence rate that is more than two standard deviations higher than the previous year
c. detection of a cluster of organisms within more than one population
d. an incidence of disease that is clearly in excess of that expected
an incidence of disease that is clearly in excess of that expected
79
Decontamination is the process by which an item is;
a. Cleaned of all soil and germs
b. Rendered free from all pathogens and infectious organisms
c. Sterilized and ready for reuse
d. Rendered safe for handling without protective attire
Rendered safe for handling without protective attire
80
While caring for an patient with suspected or confirmed Ebola, if during patient care a partial or total breach in PPE (gloves separate from sleeves leaving exposed skin, a tear develops in an outer glove, a needle stick) occur, the healthcare worker must;
a. Quickly remove PPE to reduce the risk of exposure
b. Immediately perform disinfection of gloved hands using an ABHR
c. Move immediately to the doffing area to assess the exposure
d. Immerse exposed areas with a bleach solution
Move immediately to the doffing area to assess the exposure
81
Measures of dispersion to consider for surveillance reporting include which of the following?
a. Rates
b. Ratios and proportions
c. Percentiles
d. Range and standard deviation
Range and standard deviation
82
Infection of short-term intravenous devices is associated with all of the following EXCEPT:
a. Precutaneous transmission during insertion
b. Colonization of the catheter hub
c. Extraluminal transmission
d. Contamination of intravenous (IV) fluids
Colonization of the catheter hub
83
Under what circumstances should human immunodeficiency virus (HIV) - infected HCP be placed under work restrictions?
1) When viral burden measurements of <5 x 102 GE/mL for HIV infection and techniques for eliminating transmission risks cannot be identified
2) No work restrictions necessary if Standard Precautions are followed
3) When required by State or Regional regulations
4) Whenever performing exposure-prone, noninvasive procedures
5) After counsel from an expert review panel is sought
a. 2,5
b. 1,3
c. 3,5
d. 4,5
When required by State and Regional regulations
After counsel from an expert review panel is sought
84
Poor planning during a construction project can lead to an increase risk of infection related to:
1) Construction delays
2) Compromised air quality
3) Contaminated water
4) Increase in construction-related traffic
a. 1,3
b. 2,4
c. 2,3
d. 4,5
Compromised air quality
Contaminated water
85
The following factors should be considered when preparing the environment for an educational program:
1) Providing an atmosphere of mutual respect and support
2) Establishing a comfortable environment conducive to learning
3) Encouraging interaction by arranging desk in straight rows
4) Having a person control and troubleshoot the environment as needed
a. 1,2,4
b. 2,3,4
c. 1,3,4
d. 1,2,3
Providing an atmosphere of mutual respect and support
Establishing a comfortable environment conducive to learning
Having a person control and troubleshoot the environment as needed
86
Which of the following is an example of syndromic surveillance?
1) Analyzing Emergency Department records for reports of influenza-like illness (ILI)
2) Monitoring sentinel chickens in the community for antibodies to arboviruses
3) Tracking all laboratory orders for respiratory cultures
4) Monitoring over-the-counter drug sales for cough medicine
a. 2,3,4
b. 1,2,4
c. 1,2,3
d. 1,3,4
Analyzing Emergency Department records for reports of influenza-like illness (ILI)
Tracking all laboratory orders for respiratory cultures
Monitoring over-the-counter drug sales for cough medicine
87
The IP is performing the annual evaluation of the infection prevention and control program. Components of this document should include:
1) The achievements and activities of the program
2) Results from the latest accreditation survey
3) Stress the value of the program to the organization
4) Satisfy the legal requirements for reporting infections
a. 1,2
b. 2,3
c. 1,3
d. 3,4
The achievements and activities of the program
Stress the value of the program to the organization
88
A bacterium that is decolorized with alcohol during a Gram stain and retains the counter stain is:
a. Gram-positive
b. Gram-negative
c. Stained purple
d. Acid-fast positive
Gram-negative
89
Which type of room would be the most appropriate to place a patient who is immunocompromised and has disseminated herpes zoster disease?
a. A shared, standard room
b. A private, standard room
c. An airborne infection Isolation (AII) room
d. A protective environment room
An airborne infection Isolation (AII) room
90
Seventy-five patients were admitted to the Medical-Surgical ICU. Forty were on the surgical service and 35 were on the medical service. Fifteen patients developed a healthcare-associated MRSA infection. Nine of the patients with MRSA infection were on the surgical service. There were 230 patient days in the ICU for the surgical patients in January, and 325 patient days for medical patients.
What was the over all MRSA attack rate?
a. 20%
b. 2%
c. 53%
d. 5%
20%
An attack rate is a special form of incidence rate.
The attack rate equals the number of new cases of disease (for a specified period of time) divided by the population at risk for the same period of time multiplied by 100.
in this example: 15/75 x 100 = 20%
91
The IP hears that one of the nursing units in his facility will soon be renovated. After verifying the information, he contacts the newly hired Director of Design and Construction to explain how important it is for the IP to be included in the planning and design of all renovation projects.
Which of the following is the most compelling argument?
a. The IP supplies necessary maintenance for critical utility.
b. The IP provides essential input into preventing hazardous risks to patients, HCP, and visitors during design and construction projects
c. The IP will ensure compliance with various compliance-regulatory standard, and guideline-setting agencies
d. The IP is responsible for facilitating the transport and approval for disposal of waste materials
The IP provides essential input into preventing hazardous risks to patients, HCP, and visitors during design and construction projects
92
Viral infections are difficult to treat because:
a. Viruses can suspend their metabolism in the presence of antivirals
b. Viruses use the host's cell to replicate
c. Synthesis of enzymes that inactivate the drug
d. Viruses may block viral mRNA transcription
Viruses use the host's cell to replicate
93
The Infection and Prevention Control Team has adopted the reduction of healthcare-associated MRSA as an annual goal. It has implemented improved processes and plans to monitor the effectiveness of these processes. Which of the following performance improvement tools will assist in identifying effectiveness?
a. Affinity diagram
b. Run chart
c. Process flow chart
d. Pareto chart
Run chart
94
A patient is admitted with skin and soft tissue injury from a cat bite. The most likely organism involved in the infection would be:
a. Pasturella
b. Psuedomonas
c. E. coli
d. Mycobacterium
Pasturella
95
The OR notifies the IP that a patient is scheduled for a brain biopsy. After reviewing the results of diagnostic tests, possible diagnosis, and the reason for biopsy, the IP assesses the patient to be high risk for Creutzfeldt-Jakob disease (CJD).
The next step is to:
a. Determine the instruments to be used and the processing to be done
b. Notify the staff to quarantine the patient after the procedure
c. Advise the OR staff to disinfect the instruments in the OR
d. Incinerate all equipment used to perform the biopsy
Determine the instruments to be used and the processing to be done
96
The CDC lists 18 drug-resistant threats to the United States. These threats are categorized based on level of concern: urgent, serious, and concerning.
Which of the following belong to the "Urgent" threat category?
1) Neisseria gonorrhea
2) Vancomycin-resistant Staphylococcus aureus
3) Drug-resistant Tuberculosis
4) Clostridium difficile
a. 1,2
b. 2,3
c. 1,4
d. 3,4
Neisseria gonorrhea
Clostridium difficile
97
The Infection Prevention Manager must apply principles of conflict resolution to resolve growing tension about how best to apply limited department resources in the coming year. For maximum success, the IP manager should use all of the following approaches EXCEPT:
a. Active listening
b. Accept responsibility
c. Use indirect communication
d. Identify points of agreement
Use indirect communication
98
The IP is designing a new hand hygiene intervention for HCP based on the Health Belief Model. According to that model, which of the following is/are examples of "modifying factors" in the hand hygiene intervention?
a. The ages and genders of the people for whom the intervention is being designed.
b. Signs posted in the unit that remind HCP to perform hand hygiene.
c. The perception of how much time it will take HCP to perform hand hygiene compared to the potential for hand hygiene to prevent infection in patients.
d. The belief among the target audience that they will be able to comply with hand hygiene 100 percent of the time.
The ages and genders of the people for whom the intervention is being designed.
99
A patient in your facility has been diagnosed with naturally-acquired inhalational Anthrax, and Environmental Services need to know how to terminally clean the patient's room.
Which protocol should they follow?
a. They should clean the room with a protocol similar to the one used for patients with C. difficile
b. they should only use an EPA - registered disinfectant with proven effectiveness against Anthrax
c. They should call the CDC to come clean the room
d. They should use the standard terminal cleaning protocol
They should use the standard terminal cleaning protocol
100
A healthcare facility is experiencing its first case of carbapenem-resistant Enterobacteriacease (CRE) infection. The IP plans to intensify the facility's MDRO control efforts and is implementing an active surveillance culture (ASC) program for CRE.
Which of the following strategies should the IP implement?
1) Screen all patients for CRE on admission
2) Place all colonized or infected CRE patients on Contact Precautions
3) Minimize invasive devices
4) Communicate results to healthcare providers
a. 1,2,3
b. 2,3,4
c. 1,3,4
d. 1,2,4
Place all colonized or infected CRE patients on Contact Precautions
Minimize invasive devices
Communicate results to healthcare providers
101
A patient is receiving eye drops to treat conjunctivitis. The drops are only available in a multi-dose vials. Which of the following is/are acceptable practices for this use of this medications?
1) This vial of medication may not be used on multiple patients
2) This vial of medication may be used on multiple patients if is has not come into contact with tears or the conjunctiva
3) This vial of medication may be used on multiple patients if it is used within 28 days of being opened
4) This vial of medication should be stored away from the patient care area
a. 1
b. 1,4
c. 2,3
d. 2,3,4
This vial of medication may not be used on multiple patients
102
The IP has just reviewed the current public health recommendations concerning influenza vaccines before developing an educational program for employees. The report indicates that the most important problem in developing a long-term vaccine for influenza is:
a. potential toxicity of the vaccine if the dosage is increased
b. lack of potency
c. antigenic drift of the viruses
d. short storage life of the vaccine
antigenic drift of the viruses
103
During routine infection prevention rounds in the Cardiac Catheterization Department, the IP notices that the air vents are dusty. The Nurse Manager is unsure of the cleaning schedule.
The best action to take is:
1) Contact Environmental Services and request that the air vents be cleaned as soon as the room is available
2) Ask the nurse caring for the patient to dust the vents immediately
3) Reduce the number of air exchanges per hour until vent has been cleaned
4) Establish a monthly cleaning schedule
a. 1,2
b. 1,4
c. 2,3
d. 3,4
Contact Environmental Services and request that the air vents be cleaned as soon as the room is available
Establish a monthly cleaning schedule
104
Five cases of prosthetic valve endocarditis caused by Staphylococcus epidermidis are observed in one hospital. Of the following available methods, which is best for determining whether all five isolates were derived from a single source?
a. Serotyping
b. Pulsed-field gel electrophoresis
c. Antimicrobial susceptibility testing
d. Bacteriophage typing
Pulsed-field gel electrophoresis
105
One of the units in an LTAC facility is experiencing an outbreak of crusted scabies. In this situation, when is HCP prophylaxis indicated?
a. Prolonged skin-to-skin contact with suspected and confirmed cases.
b. Evidence of infestation such as pruitic cutaneous rash
c. All staff, volunteers, and visitors who may have been exposed to a patient with crusted scabies
d. Treatment is indicated for all staff on affected units
Evidence of infestation such as pruitic cutaneous rash
106
A biological indicator from one of the sterilizers in Sterile Processing turns positive.
The first action should be:
a. Retrieve unused items from the load
b. Conduct surveillance of involved patients
c. Evaluate the sterilizer
d. Evaluate staff education of using the sterilizers
Retrieve unused items from the load
107
An advantage of case-control study over a cohort study is that a case-control study:
a. is considered less biased than a cohort study
b. provides stronger evidence for a causal association
c. is less time consuming and less expensive
d. is more valid
is less time consuming and less expensive
108
Which of the following statements is accurate about adult learners?
a. They do not readily speak out if their learning needs are not being met.
b. They have a preference for academic knowledge rather than practical knowledge
c. Most older adults have the same technological capabilities as younger adults
d. They are more likely to transfer knowledge to practice if education sessions are interactive
They are more likely to transfer knowledge to practice if education sessions are interactive
109
An IP has data on the number of bloodstream infections per central line days in the Cardiac ICU.
This is an example of which type of data?
1) Discrete data
2) Categorical data
3) Non-categorical data
4) continuous data
a. 1,2
b. 1,3
c. 1,4
d. 2,4
Discrete data
Non-categorical data
Discrete data contain whole numbers and are mutually exclusive e.g., infected or not infected, male or female.. etc.
Non-categorical the number at risk can be identified, but the actual number of " no infections" or "no falls" among those at risk cannot be identified.
110
A patient has been admitted to an acute care facility with a diagnosis of rule-out pulmonary TB. Below is the lab reports for the sputum testing on this patient.
3/4/20 @ 1143 is negative for AFB
3/4/20 @ 2026 is negative for AFB
3/5/20 @ 1113 is negative for AFB
Can this patient be removed from Airborne Precautions for rule-out pulmonary TB?
a. Yes, the patient cannot be removed from Airborne Precautions, as TB can be ruled out.
b. No, the patient cannot be removed from Airborne Precautions, because he is infectious
c. Yes, the patient can be removed from Airborne Precautions, as he has latent TB and is not infectious
d. No. the patient cannot be removed from Airborne Precautions, because the sample collection was not sufficient to rule out pulmonary TB
No. the patient cannot be removed from Airborne Precautions, because the sample collection was not sufficient to rule out pulmonary TB
111
Unused alcohol swabs that are placed on top of a dialysis machine in an active dialysis unit:
a. Should be discarded
b. May be returned to the common area
c. Must be cleaned before being used on another patient
d. Should only be used on patients with that dialysis machine
Should be discarded
112
Which interventions are designed to limit the spread of respiratory illnesses in outpatient settings?
a. Sterilization monitors
b. Aseptic technique
c. Respiratory hygiene/cough etiquette
d. Symptom-based evaluation
Respiratory hygiene/cough etiquette
113
In preparing for the first meeting of the year for the Infection Prevention and Control Committee, the IP develops an annual report to include HAI trends. Of the choices below, this report should also address:
a. A summary of injuries and risk factors for injuries in personnel during the previous year.
b. Staffing needs of the department to optimize efficiency
c. An evaluation of the surveillance program providing an assessment of its usefulness to the healthcare facility in preventing and controlling infections
d. A line list of all HAIs for the previous year and risk-reduction strategies
An evaluation of the surveillance program providing an assessment of its usefulness to the healthcare facility in preventing and controlling infections
114
The IP has identified a cluster of Candida bloodstream infections in two adjoining ICUs. She wants to look at risk factors that these patients may have had in common.
Which study design would she use?
a. Cross-sectional study
b. Cohort - study
c. Case-control study
d. Clinical trial
Case-control study
115
An IP is planning an educational program for hospital nursing staff to improve compliance with infection prevention strategies. Please choose the approach that should be used to ensure an effective learning experience for those who attend.
a. Provide food and drinks to all who attend as well as sufficient breaks and have a raffle to entice attendance
b. Plan the educational offering by developing goals and objectives and determining the teaching method to use
c. Use a slide presentation that periodically provides humor to the presentation to ensure attention
d. Provide continuing education credits and handouts for future reference
Plan the educational offering by developing goals and objectives and determining the teaching method to use
116
Which of the four clinical variables that determine the probability of infection would the IP be targeted when reviewing preoperative chlorhexidine glucontate (CHG)
bathing instructions that have been given to the preoperative patient population?
a. Inoculum of bacteria
b. Virulence of bacteria
c. Adjuvants in the micro-environment
d. Efficiency of host defenses
Inoculum of bacteria
117
Which of the following processes should take place after an adverse event has occurred?
a. Failure mode effect analysis (FMEA)
b. Root cause analysis (RCA)
c. Strengths - weakness- opportunities- threats analysis (SWOT)
d. Infection control risk assessment (ICRA)
Root cause analysis (RCA)
118
What is the annual sharps injury rate per 100 full-time equivalents (FTEs) in a facility that has 18 sharp injuries and 800 full-time employees?
a. 0.02
b. 0.23
c. 2.25
d. 22.5
2.25
```
x/y x k
18/800 x 100 = 2.25
x = numerator
y = denominator
k = the constant as in this case
```
119
An adult patient is admitted through the Emergency Department with a 1-day history of rash, fever, and cough. The attending physician is concerned that the patient has measles, as the patient cannot recall whether he has had measles disease or vaccine in the past. The serum sample does not contain measles-specific IgG or IgM antibodies.
What is the significance of this finding?
a. The patient does not have measles infection
b. The patient has had the measles vaccine in the past
c. The patient has a history of measles disease
d. The patient might be infected with measles
The patient might be infected with measles
120
Primary components of an initial outbreak investigation are:
1) Preparing a line list and epidemic curve
2) Notifying key partners about the investigation
3) Continuing case finding
4) Initiating an analytic study
a. 1,4
b. 2,3
c. 1,2
d. 3,4
Preparing a line list and epidemic curve
Notifying key partners about the investigation
121
An IP has been asked to present an educational program to a group of HCP who are culturally different from him. What is the best approach to developing an effective program in this case?
a. Develop the program without taking cultural diversity into account, but allow the learners to ask questions while he is teaching.
b. Be aware of potential cultural differences, but do not incorporate them into the program.
c. Outline the major points of the educational program, and ask the audience to work together to identify culturally appropriate examples of the major points
d. There is no need to take cultural diversity into account because that does not change the learning objectives of the educational program
Outline the major points of the educational program, and ask the audience to work together to identify culturally appropriate examples of the major points
122
The IP is helping develop a large-scale project to address SSI's. Which of the following tolls will the IP utilize that helps secure expert judgement prior to launching the project?
a. Delphi technique
b. Peer review
c. Fischer exact test
d. Meta - analysis
Delphi technique
123
The use of influenza vaccines in school - aged children to decrease the number of cases in the community uses the principle of:
a. Innate immunity
b. Passive immunity
c. Herd immunity
d. Epidemic immunity
Herd immunity
124
Several HCP have been exposed to a patient with untreated, active pulmonary TB. Which is the best option for follow up after this exposure?
a. TST's should be administered at the time of exposure; if these are negative, then no further follow-up is needed.
b. TST's should be administered at the time of exposure and repeated at 12 weeks post-exposure; converters with out symptoms should be excluded from work and treated immediately.
c. TST's should be administered at the time of exposure and repeated at 12 weeks post-exposure; converters with symptoms should follow up with a chest x-ray
d. TST's and chest x-rays should be administered at the time of exposure and repeated at 12 weeks post - exposure.
TST's should be administered at the time of exposure and repeated at 12 weeks post-exposure; converters with symptoms should follow up with a chest x-ray
125
Microorganisms are grown on culture media made of an agar base. Additives to media vary according to growth requirements of organisms and / or the desire to select out a specific organism. Fastidious organisms require __________ media and ___________ media are used to inhibit normal commensals.
1) Differential
2) Enrichment
3) Selective
4) Nutrient broth
5) Synthetic sheep blood agar
a. 1,3
b. 2,3
c. 3,4
d. 5, 1
Enrichment
Nutrient broth
126
A patient is concerned that there might be microbes int the facility that are resistant to the environmental disinfection products in use. How do you respond to this concern?
a. Inform her that while microbes can develop resistance to antimicrobials, they cannot become resistant to disinfectants.
b. Assure her that the disinfection products in use are ones that microbes have not developed resistance to yet.
c. Inform her that while reduced susceptibility of microbes to disinfectants can occur, the antimicrobial level of disinfectants used is still sufficient to inactivate those microbes.
d. Assure her that your facility uses special environmental disinfection procedures for all antimicrobial resistant organisms.
Inform her that while reduced susceptibility of microbes to disinfectants can occur, the antimicrobial level of disinfectants used is still sufficient to inactivate those microbes.
127
An IP has monitored the rate of hand hygiene compliance among different nursing units. She finds that the ICU staff's compliance is less than satisfactory even after providing conveniently located hand hygiene dispensers. She shares this feedback with the staff.
Of the choices below, what other information should be included in her discussion with the staff to improve hand hygiene compliance?
1) The number of patients on the unit during the monitoring period compared to the number of staff, as well as the nurse to patient ratio
2) information about hand contamination
3) Information about the association between hand hygiene practices and the transmission of infection
4) The effects of hand hygiene products on skin
a. 1,2,3
b. 2,3,4
c. 1,3,4
d. 1,2,4
information about hand contamination
Information about the association between hand hygiene practices and the transmission of infection
The effects of hand hygiene products on skin
