Practice exam 2

Question 1

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.

Answer 1

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

Question 2

A classic sign of measles is:

a. Kaposi Sarcoma
b. Stiff neck
c. Koplik spots
d. Bull’s eye rash

Answer 2

Koplik spots

Communicable Diseases Manual Identification of Infectious Disease Processes

Question 3

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.

Answer 3

HCP with artificial nails are more likely to have more Gram-negative bacteria under their nails than HCP with natural nails.

APIC Hand Hygiene

Question 4

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

Answer 4

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.

Question 5

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

Answer 5

Place a surgical mask on the patient

Question 6

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

Answer 6

Surgical mask placed on the patient during transport.

APIC Tuberculosis and Other Mycobacteria

Question 7

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

Answer 7

The licensed practical nurse who did not have direct contact with the patient’s oral secretions.

Question 8

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

Answer 8

February 9

Question 9

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

Answer 9

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

Question 10

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.

Answer 10

The medical record is complete and easy to access.

APIC Surveillance

Question 11

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.

Answer 11

Daily use of a biological indicator in the sterilizer.

APIC Sterile Processing

Question 12

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

Answer 12

IgM anti HAV

APIC Hepatitis

Question 13

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

Answer 13

Discuss, explain, and paraphrase

Question 14

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

Answer 14

24 hours

APIC Identification of Infectious Disease Processes

Question 15

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

Answer 15

The boxes may harbor dust, bacteria, and insects

Question 16

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

Answer 16

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

Question 17

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.

Answer 17

Present case studies describing family members’ noncompliance with Isolation Precaution to initiate discussion of the problem and possible solutions.

Question 18

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.

Answer 18

The popularity of tattooing the body piercing has made it more socially acceptable.

APIC Body Piercing, tattoos, and electrolysis

Question 19

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

Answer 19

Performance improvement

APIC Quality Concepts

Question 20

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

Answer 20

1,2

1) Hand washing with soap and water
2) Environmental cleaning and disinfection

APIC Clostridium difficle infections and Pseudo-membranous Colitis.

Question 21

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.

Answer 21

Cleaning of endoscopes is essential before manual or automated disinfection.

APIC Endoscopy

Question 22

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.

Answer 22

Number of blood collection devices used or purchased.

Occupational HealthEmployee/Occupational Health

Question 23

Point-source epidemics usually occur on the basis of:

a. A vector
b. A vehicle
c. Person-to-person transmission
d. Droplet infection

Answer 23

b. A vehicle

APIC Outbreak Investigations

Question 24

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

Answer 24

$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

Question 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.

Answer 25

The colonization rate for distal water sites in the hospital is greater than 30%.

APIC Legionella pneumonia

Question 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

Answer 26

Compare the new IP’s knowledge and skills to benchmarks based on set competencies

APIC Education and Training

Question 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

Answer 27

Vibrio cholerae

APIC Infectious Disease Disasters: Bioterrorism, emerging infections and Pandemics.

Question 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

Answer 28

Disinfect the system

APIC Dialysis

Question 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

Answer 29

Development of an educational program that effectively targets with most common causes of SOI in the facility.

APIC Surveillance

Question 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

Answer 30

Productivity

APIC Qualitative

Question 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.

Answer 31

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.

Question 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

Answer 32

Surveillance definitions may be different from those used for diagnosis and treatment

APIC Surveillance

Question 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

Answer 33

1,3

1) Assume a facilitator role
3) Incorporate an interactive approach

APIC Education and Training

Question 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

Answer 34

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

Question 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

Answer 35

Determine goals and objectives for the following year.

APIC Infection Prevention and Control Programs

Question 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

Answer 36

Universal Precautions and Body Substance Isolation.

APIC Standard Precautions

Question 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

Answer 37

Test A, because it has higher sensitivity.

APIC Use of statistics

Question 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

Answer 38

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

Question 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

Answer 39

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

Question 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

Answer 40

Cluster

Out break investigations Surveillance and Epidemiologic Investigation

Question 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%

Answer 41

92.5%

Negative predictive value = TN/(FN+TN)
500/ (40+500)
500/ (540)
= 0.92.5%

APIC Use of Statistics

Question 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

Answer 42

No mask is needed

APIC Isolation precautions

Question 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.

Answer 43

A negative result will be more accurate than a positive.

APIC Use of Statistics

Question 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.

Answer 44

Equipment is immersed in enzymatic cleaner that is discarded every 24 hours.

APIC Endoscopy

Question 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.

Answer 45

Methodologies should be flexible and evolve in response to changes in healthcare delivery, use of data, disease prevalence, and populations served.

Question 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

Answer 46

34.

a. 1,2,3
1) Diptheria
2) Varicella
3) Pertussis

APIC Occupational Health

Question 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.

Answer 47

A measure that is based on a definition that can easily be understood and applied in a facility.

APIC Performance measures

Question 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.

Answer 48

The number of Clostridium difficle patients in the hospital on any given day.

APIC General Principles of Epidemiology

Question 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

Answer 49

Agar plates used for testing sputum samples in the microbiology lab

APIC Waste management.

Question 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

Answer 50

Cleaning followed by high-level disinfection

APIC Cleaning and Disinfection, sterilization
Preventing and controlling the transmission of Infectious Agents

Question 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.

Answer 51

Staff are discussing strategies to increase PPE use at the monthly staff meeting.

APIC Infection Prevention and Behavioral Interventions

Question 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

Answer 52

p value of 0.50 means that the probability that the observation occurred by chance alone is 1 in 20

Question 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

Answer 53

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

Question 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

Answer 54

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

Question 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

Answer 55

Reduce central line-associated bloodstream infections (CLABSIs) by 50%.

APIC Quality Concepts

Question 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.

Answer 56

Blood samples should be obtained in pairs (two sets) from different peripheral sites.

Question 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

Answer 57

1,2

1) SDVs lack antimicrobial preservatives
2) Inappropriate use of SDVs can lead to contamination

Ambulatory Care

Question 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

Answer 58

Anthrax

Question 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

Answer 59

He should place absorbent material over the spill and pour the correct dilution of disinfectant over the material for the recommended contact time.

Question 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

Answer 60

on days 3-7

Question 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

Answer 61

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

Question 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

Answer 62

OPA does not require activation

Question 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

Answer 63

you should prepare food that is in unpowered refrigerators first

Question 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

Answer 64

Pseudomonas species

Question 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

Answer 65

118°F or 48°C for one hour

Question 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

Answer 66

the packing wrapper is intact
the item has not gotten wet
the storage area is well-ventilated, dry and free of dust and insects

Question 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

Answer 67

24 hours

Question 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

Answer 68

she should investigate potential sources of special cause variation

Question 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

Answer 69

Mycobacterium tuberculosis

Pseudomonas aeruginosa

Question 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

Answer 70

gravity displacement steam sterilizer

Question 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

Answer 71

Candida albicans

Question 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

Answer 72

Prohibiting live plants and dried or fresh flowers in rooms of HSCT patients

Avoiding items that collect or trap dust

Question 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

Answer 73

annual vaccination

Question 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

Answer 74

10 to the negative 6 power

Question 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

Answer 75

replacing floor strippers and finishes that contain heavy metals and asthmagens

employing carcinogen-free carpet cleaners

introducing high-filtration vacuum cleaners

Question 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

Answer 76

fever greater than 38°C

a positive dipstick for leukocyte esterase

a positive urine culture with 104 CFU/ml of E. coli

Question 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

Answer 77

rare outcomes or out comes that develop over a long time after exposure.

Question 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

Answer 78

an incidence of disease that is clearly in excess of that expected

Question 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

Answer 79

Rendered safe for handling without protective attire

Question 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

Answer 80

Move immediately to the doffing area to assess the exposure

Question 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

Answer 81

Range and standard deviation

Question 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

Answer 82

Colonization of the catheter hub

Question 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

Answer 83

When required by State and Regional regulations

After counsel from an expert review panel is sought

Question 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

Answer 84

Compromised air quality

Contaminated water

Question 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

Answer 85

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

Question 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

Answer 86

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

Question 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

Answer 87

The achievements and activities of the program

Stress the value of the program to the organization

Question 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

Answer 88

Gram-negative

Question 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

Answer 89

An airborne infection Isolation (AII) room

Question 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%

Answer 90

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%

Question 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

Answer 91

The IP provides essential input into preventing hazardous risks to patients, HCP, and visitors during design and construction projects

Question 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

Answer 92

Viruses use the host’s cell to replicate

Question 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

Answer 93

Run chart

Question 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

Answer 94

Pasturella

Question 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

Answer 95

Determine the instruments to be used and the processing to be done

Question 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

Answer 96

Neisseria gonorrhea

Clostridium difficile

Question 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

Answer 97

Use indirect communication

Question 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.

Answer 98

The ages and genders of the people for whom the intervention is being designed.

Question 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

Answer 99

They should use the standard terminal cleaning protocol

Question 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

Answer 100

Place all colonized or infected CRE patients on Contact Precautions

Minimize invasive devices

Communicate results to healthcare providers

Question 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

Answer 101

This vial of medication may not be used on multiple patients

Question 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

Answer 102

antigenic drift of the viruses

Question 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

Answer 103

Contact Environmental Services and request that the air vents be cleaned as soon as the room is available

Establish a monthly cleaning schedule

Question 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

Answer 104

Pulsed-field gel electrophoresis

Question 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

Answer 105

Evidence of infestation such as pruitic cutaneous rash

Question 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

Answer 106

Retrieve unused items from the load

Question 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

Answer 107

is less time consuming and less expensive

Question 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

Answer 108

They are more likely to transfer knowledge to practice if education sessions are interactive

Question 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

Answer 109

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.

Question 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

Answer 110

No. the patient cannot be removed from Airborne Precautions, because the sample collection was not sufficient to rule out pulmonary TB

Question 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

Answer 111

Should be discarded

Question 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

Answer 112

Respiratory hygiene/cough etiquette

Question 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

Answer 113

An evaluation of the surveillance program providing an assessment of its usefulness to the healthcare facility in preventing and controlling infections

Question 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

Answer 114

Case-control study

Question 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

Answer 115

Plan the educational offering by developing goals and objectives and determining the teaching method to use

Question 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

Answer 116

Inoculum of bacteria

Question 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)

Answer 117

Root cause analysis (RCA)

Question 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

Answer 118

2.25

x/y x k
18/800 x 100 = 2.25
x = numerator 
y = denominator
k = the constant as in this case

Question 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

Answer 119

The patient might be infected with measles

Question 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

Answer 120

Preparing a line list and epidemic curve

Notifying key partners about the investigation

Question 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

Answer 121

Outline the major points of the educational program, and ask the audience to work together to identify culturally appropriate examples of the major points

Question 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

Answer 122

Delphi technique

Question 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

Answer 123

Herd immunity

Question 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.

Answer 124

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

Question 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

Answer 125

Enrichment

Nutrient broth

Question 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.

Answer 126

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.

Question 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

Answer 127

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