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CBIC Certified Infection Control Exam Sample Questions (Q159-Q164):NEW QUESTION # 159
The primary source of organisms that cause surgical silo infections is the
- A. operating room personnel.
- B. operating room environment.
- C. healthcare personnel's hands.
- D. patient's endogenous flora
Answer: D
Explanation:
The primary source of organisms causing surgical site infections (SSIs) is the patient's own endogenous flora. Bacteria from the skin, mucous membranes, or gastrointestinal tract contaminate the surgical site, leading to infection. Common pathogens include Staphylococcus aureus, coagulase-negative staphylococci, and Enterobacteriaceae.
Why the Other Options Are Incorrect?
* A. Operating room environment - While environmental contamination can contribute, it is not the primary source.
* B. Operating room personnel - Infection control measures (hand hygiene, gloves, masks) reduce transmission from personnel.
* D. Healthcare personnel's hands - Although hand contamination is a risk, it is secondary to the patient's endogenous flora.
CBIC Infection Control Reference
According to APIC guidelines, the patient's own flora is the primary source of SSIs.
NEW QUESTION # 160
A patient with suspected active tuberculosis is being transferred from a mental health facility to a medical center by emergency medical services. Which of the following should an infection preventionist recommend to the emergency medical technician (EMT)?
- A. Place an N95 respirator on both the patient and the EMT.
- B. Place a surgical mask on both the patient and the EMT.
- C. Place a surgical mask on the patient and an N95 respirator on the EMT.
- D. Place an N95 respirator on the patient and a surgical mask on the EMT.
Answer: D
Explanation:
Active tuberculosis (TB) is an airborne disease transmitted through the inhalation of droplet nuclei containing Mycobacterium tuberculosis. Effective infection control measures are critical during patient transport to protect healthcare workers, such as emergency medical technicians (EMTs), and to prevent community spread. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the use of appropriate personal protective equipment (PPE) and source control as key strategies in the " revention and Control of Infectious Diseases" domain, aligning with guidelines from the Centers for Disease Control and Prevention (CDC).
For a patient with suspected active TB, the primary goal is to contain the infectious particles at the source (the patient) while ensuring the EMT is protected from inhalation exposure. Option C, placing an N95 respirator on the patient and a surgical mask on the EMT, is the most appropriate recommendation. The N95 respirator on the patient serves as source control by filtering the exhaled air, reducing the dispersion of infectious droplets. However, fitting an N95 respirator on the patient may be challenging, especially in an emergency setting or if the patient is uncooperative, so a surgical mask is often used as an alternative source control measure. For the EMT, a surgical mask provides a basic barrier but does not offer the same level of respiratory protection as an N95 respirator. The CDC recommends that healthcare workers, including EMTs, use an N95 respirator (or higher-level respiratory protection) when in close contact with a patient with suspected or confirmed active TB, unless an airborne infection isolation room is available, which is not feasible during transport.
Option A is incorrect because placing a surgical mask on both the patient and the EMT does not provide adequate respiratory protection for the EMT. Surgical masks are not designed to filter small airborne particles like those containing TB bacilli and do not meet the N95 standard required for airborne precautions. Option B is impractical and unnecessary, as placing an N95 respirator on both the patient and the EMT is overly restrictive and logistically challenging, especially for the patient during transport. Option D reverses the PPE roles, placing the surgical mask on the patient(insufficient for source control) and the N95 respirator on the EMT (appropriate for protection but misaligned with the need to control the patient's exhalation). The CBIC and CDC guidelines prioritize source control on the patient and respiratory protection for the healthcare worker, making Option C the best fit.
This recommendation is consistent with the CBIC's emphasis on implementing transmission-based precautions (CDC, 2005, Guideline for Preventing the Transmission of Mycobacterium tuberculosis in Healthcare Settings) and the use of PPE tailored to the mode of transmission, as outlined in the CBIC Practice Analysis (2022).
References:
CBIC Practice Analysis, 2022.
CDC Guideline for Preventing the Transmission of Mycobacterium tuberculosis in Healthcare Settings, 2005.
NEW QUESTION # 161
A surgeon is beginning a new procedure in the facility within the next two weeks and requires loaner instruments. Infection prevention processes should ensure that
- A. staff education related to loaner instrument reprocessing has occurred.
- B. the planning process takes place after the instruments have arrived.
- C. instruments are able to be used prior to the biological indicator results.
- D. items arrive in time for immediate use steam sterilization.
Answer: A
Explanation:
The correct answer is D, "staff education related to loaner instrument reprocessing has occurred," as this is the infection prevention process that should be ensured when a surgeon is beginning a new procedure requiring loaner instruments within the next two weeks. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, loaner instruments-those borrowed from external sources for temporary use-pose unique infection prevention challenges due to potential variability in reprocessing standards and unfamiliarity among staff. Ensuring that staff are educated on proper reprocessing protocols (e.g., cleaning, sterilization, and handling per manufacturer instructions and AAMI ST79) is critical to prevent healthcare- associated infections (HAIs) (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). This education should cover the specific requirements for loaner instruments, including documentation and verification of sterilization, and should occur proactively before the instruments are used to ensure competency and compliance.
Option A (items arrive in time for immediate use steam sterilization) is a logistical consideration, but it does not address the infection prevention process itself; timely arrival is necessary but insufficient without proper reprocessing validation. Option B (instruments are able to be used prior to the biological indicator results) is unsafe, as biological indicators are essential to confirm sterilization efficacy, and using instruments before results are available violates infection control standards. Option C (the planning process takes place after the instruments have arrived) is impractical, as planning (e.g., coordinating with vendors, assessing reprocessing needs) must occur in advance to ensure readiness and safety, not as a reactive step.
The focus on staff education aligns with CBIC's emphasis on preparing healthcare personnel to handle loaner instruments safely, reducing the risk of contamination and ensuring patient safety (CBIC Practice Analysis,
2022, Domain IV: Education and Research, Competency 4.1 - Develop and implement educational programs).
This proactive measure is supported by AAMI and CDC guidelines, which stress the importance of training for reprocessing complex or unfamiliar devices.
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment; Domain IV: Education and Research, Competency 4.1 - Develop and implement educational programs. AAMI ST79:2017, Comprehensive guide to steam sterilization and sterility assurance in health care facilities.
NEW QUESTION # 162
What is a characteristic of immediate-use steam sterilization?
- A. Performed in emergencies where cleaning is the most critical step.
- B. Can be used for the following surgery if properly stored.
- C. Substitute for maintaining sufficient amounts of sterile instruments.
- D. Alternative to purchasing expensive instrument sets.
Answer: C
Explanation:
The correct answer is C, "Substitute for maintaining sufficient amounts of sterile instruments," as this is a characteristic of immediate-use steam sterilization (IUSS). According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, IUSS, formerly known as flash sterilization, is a process designed to rapidly sterilize items that are needed urgently when pre-sterilized inventory is unavailable or insufficient. It serves as a temporary solution to address gaps in sterile instrument availability, such as during unexpected surges in surgical demand or equipment shortages, provided strict protocols are followed (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). However, IUSS is not a routine practice and should be minimized due to its limitations, including the lack of immediate biologic indicator results.
Option A (alternative to purchasing expensive instrument sets) is incorrect because IUSS is not intended as a cost-saving measure or a replacement for acquiring necessary equipment; it is a contingency process. Option B (can be used for the following surgery if properly stored) is misleading, as IUSS items are intended for immediate use and not for storage or use in subsequent procedures, which requires standard sterilization cycles with proper packaging and validation. Option D (performed in emergencies where cleaning is the most critical step) overemphasizes cleaning and mischaracterizes IUSS; while cleaning is a critical initial step, the process is defined by its rapid sterilization for emergency use, not solely by cleaning priority.
The characteristic of substituting for insufficient sterile instruments aligns with CBIC's focus on ensuring safe reprocessing practices while acknowledging the practical challenges in healthcare settings (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). This is supported by AAMI ST79, which outlines IUSS as a last-resort measure to maintain surgical readiness (AAMI ST79:2017).
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.3 - Ensure safe reprocessing of medical equipment, 3.5 - Evaluate the environment for infection risks. AAMI ST79:2017, Comprehensive guide to steam sterilization and sterility assurance in health care facilities.
NEW QUESTION # 163
A patient with shortness of breath and a history of a tuberculin skin test (TST) of 15 mm induration was admitted to a semi-private room. The infection preventionist's FIRST action should be to
- A. contact the roommate's physician to initiate TST.
- B. transfer the patient to an airborne infection isolation room and initiate appropriate isolation for tuberculosis (TB).
- C. review the patient's medical record to determine the likelihood of pulmonary tuberculosis (TB).
- D. report the findings to the Employee Health Department to initiate exposure follow-up of hospital staff.
Answer: C
Explanation:
Before initiating airborne precautions, theinfection preventionist must first confirm the clinical suspicion of active TB.
Step-by-Step Justification:
* Confirming Active TB:
* Apositive tuberculin skin test (TST) alone does not indicate active disease.
* A review ofchest X-ray, symptoms, and risk factorsis needed.
* Medical Record Review:
* Past TB history, imaging, and sputum testingare key to diagnosis.
* Not all TST-positive patients require isolation.
Why Other Options Are Incorrect:
* A. Contact the roommate's physician to initiate TST remature, asno confirmation of active TB existsyet.
* C. Report findings to Employee Health for staff follow-up:Should occuronly after TB confirmation
.
* D. Transfer to airborne isolation immediately:Airborne isolation is necessaryonly if active TB is suspected based on clinical findings.
CBIC Infection Control References:
NEW QUESTION # 164
......
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