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CBIC Certified Infection Control Exam Sample Questions (Q70-Q75):

NEW QUESTION # 70
The BEST roommate selection for a patient with active shingles would be a patient who has had

A. varicella vaccine.
B. treatment with acyclovir
C. a history of herpes simplex.
D. varicclla zoster immunoglobulin

Answer: A

Explanation:
A patient with active shingles (herpes zoster) is contagious to individuals who have never had varicella (chickenpox) or the varicella vaccine. The best roommate selection is someone who has received the varicella vaccine, as they are considered immune and not at risk for contracting the virus.
Why the Other Options Are Incorrect?
* B. Treatment with acyclovir - Acyclovir treats herpes zoster but does not prevent transmission to others.
* C. A history of herpes simplex - Prior herpes simplex virus (HSV) infection does not confer immunity to varicella-zoster virus (VZV).
* D. Varicella zoster immunoglobulin (VZIG) - VZIG provides temporary immunity but does not offer long-term protection like the vaccine.
CBIC Infection Control Reference
APIC guidelines recommend placing patients with active shingles in a room with individuals immune to varicella, such as those vaccinated.

NEW QUESTION # 71
A patient has an oral temperature of 101° F (38.33 C). Erythema and tenderness arc noted at the central line site. Blood samples are submitted for culture and intravenous vancomycin is ordered. This is an example of which of the following forms of antibiotic treatment?

A. Empiric
B. Prophylactic
C. Broad spectrum
D. Experimental

Answer: A

Explanation:
Empiric antibiotic therapy is the immediate initiation of antibiotics based on clinical judgment before laboratory confirmation of an infection. In this case, the presence of fever, erythema, and tenderness at the central line site suggests a possible bloodstream infection, prompting empiric treatment with vancomycin.
Step-by-Step Justification:
* Initiation Before Lab Confirmation:
* Empiric therapy starts treatment based on symptoms while awaiting culture results.
* Prevents Complications:
* Delayed treatment in central line-associated bloodstream infections (CLABSI) can lead to sepsis.
* Common in High-Risk Situations:
* Empiric treatment is used in cases where waiting for lab results could worsen the patient's condition.
Why Other Options Are Incorrect:
* B. Prophylactic:
* Prophylactic antibiotics are given to prevent infection, not to treat an existing one.
* C. Experimental:
* Experimental treatment refers to clinical trials or unproven therapies, which does not apply here.
* D. Broad spectrum:
* Broad-spectrum antibiotics cover multiple bacteria, but empiric therapy may be narrow- spectrum based on suspected pathogens.
CBIC Infection Control References:
* APIC Text, Chapter on Antimicrobial Stewardship and Empiric Therapy.

NEW QUESTION # 72
Which of the following BEST demonstrates the effectiveness of a program targeted at reducing central-line associated bloodstream infections (CLABSIs) in an intensive care unit (ICU)?

A. A 25% decrease in the length of stay in the ICU related to CLABSIs
B. A 30% reduction in the use of antibiotic-impregnated central catheters over 6 months
C. A 30% decrease in total costs related to treatment of CLABSIs over 12 months
D. A 25% reduction in the incidence of CLABSIs over 6 months

Answer: D

Explanation:
Evaluating the effectiveness of a program to reduce central-line associated bloodstream infections (CLABSIs) in an intensive care unit (ICU) requires identifying the most direct and relevant measure of success. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes outcome-based assessment in the "Performance Improvement" and "Surveillance and Epidemiologic Investigation" domains, aligning with the Centers for Disease Control and Prevention (CDC) guidelines for infection prevention. The primary goal of a CLABSI reduction program is to decrease the occurrence of these infections, with secondary benefits including reduced length of stay, costs, and resource use.
Option B, "A 25% reduction in the incidence of CLABSIs over 6 months," is the best demonstration of effectiveness. The incidence of CLABSIs-defined by the CDC as the number of infections per 1,000 central line days-directly measures the program's impact on the targeted outcome: preventing bloodstream infections associated with central lines. A 25% reduction over 6 months indicates a sustained decrease in infection rates, providing clear evidence that the intervention (e.g., improved insertion techniques, maintenance bundles, or staff education) is working. The CDC's "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017) and the National Healthcare Safety Network (NHSN) protocols prioritize infection rate reduction as the primary metric for assessing CLABSI prevention programs.
Option A, "A 25% decrease in the length of stay in the ICU related to CLABSIs," is a secondary benefit.
Reducing CLABSI-related length of stay can improve patient outcomes and bed availability, but it is an indirect measure dependent on infection incidence. A decrease in length of stay could also reflect other factors (e.g., improved discharge planning), making it less specific to program effectiveness. Option C, "A 30% decrease in total costs related to treatment of CLABSIs over 12 months," reflects a financial outcome, which is valuable for justifying resource allocation. However, cost reduction is a downstream effect of decreased infections and may be influenced by variables like hospital pricing or treatment protocols, diluting its direct link to program success. Option D, "A 30% reduction in the use of antibiotic-impregnated central catheters over 6 months," indicates a change in practice but not necessarily effectiveness. Antibiotic-impregnated catheters are one prevention strategy, and reducing their use could suggest improved standard practices (e.g., chlorhexidine bathing), but it could also increase infection rates if not offset by other measures, making it an ambiguous indicator.
The CBIC Practice Analysis (2022) and CDC guidelines emphasize that the primary measure of a CLABSI prevention program's success is a reduction in infection incidence, as it directly addresses patient safety and the program's core objective. Option B provides the most robust and specific evidence of effectiveness over a defined timeframe.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2017.
* NHSN CLABSI Surveillance Protocol, 2021.

NEW QUESTION # 73
An infection control manager is training a new infection preventionist. In discussing surveillance strategies, which of the following types of hospital infection surveillance usually provides maximum benefit with minimum resources?

A. High-risk patient focus
B. Antibiotic monitoring
C. Prevalence surveys
D. Nursing care plan review

Answer: A

Explanation:
A high-risk patient focus maximizes benefits while minimizing resource use in infection surveillance.
Step-by-Step Justification:
* Efficiency of High-Risk Surveillance:
* Targeting ICU, immunocompromised patients, or surgical units helps detect infections where the risk is highest, leading to earlier interventions.
* Resource Allocation:
* Full hospital-wide surveillance is resource-intensive; focusing on high-risk groups is more efficient.
* Why Other Options Are Incorrect:
* B. Antibiotic monitoring:
* Important for stewardship, but not the primary focus of infection surveillance.
* C. Prevalence surveys:
* Snapshot data only; does not provide ongoing monitoring.
* D. Nursing care plan review:
* Less direct in identifying infection trends.
CBIC Infection Control References:
* APIC Text, "Surveillance Strategies for Infection Prevention".

NEW QUESTION # 74
A nurse claims to have acquired hepatitis A virus infection as the result of occupational exposure. The source patient had an admitting diagnosis of viral hepatitis. Further investigation of this incident reveals a 5-day interval between exposure and onset of symptoms in the nurse. The patient has immunoglobulin G antibodies to hepatitis A. From the evidence, the infection preventionist may correctly conclude which of the following?

A. The evidence at this time fails to support the nurse's claim.
B. The 5-day incubation period is consistent with hepatitis A virus transmission.
C. The patient has serologic evidence of recent hepatitis A viral infection.
D. The nurse should be given hepatitis A virus immunoglobulin.

Answer: A

Explanation:
The infection preventionist's (IP) best conclusion, based on the provided evidence, is that the evidence at this time fails to support the nurse's claim of acquiring hepatitis A virus (HAV) infection through occupational exposure. This conclusion is grounded in the clinical and epidemiological understanding of HAV, as aligned with the Certification Board of Infection Control and Epidemiology (CBIC) guidelines. Hepatitis A typically has an incubation period ranging from 15 to 50 days, with an average of approximately 28-30 days, following exposure to the virus (CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competency 1.3 - Apply principles of epidemiology). The reported 5-day interval between exposure and symptom onset in the nurse is significantly shorter than the expected incubation period, making it inconsistent with HAV transmission. Additionally, the presence of immunoglobulin G (IgG) antibodies in the source patient indicates past exposure or immunity to HAV, rather than an active or recent infection, which would typically be associated with immunoglobulin M (IgM) antibodies during the acute phase.
Option A (the nurse should be given hepatitis A virus immunoglobulin) is not supported because post- exposure prophylaxis with HAV immunoglobulin is recommended only within 14 days of exposure to a confirmed case with active infection, and the evidence here does not confirm a recent exposure or active case.
Option C (the patient has serologic evidence of recent hepatitis A viral infection) is incorrect because IgG antibodies signify past infection or immunity, not a recent infection, which would require IgM antibodies.
Option D (the 5-day incubation period is consistent with hepatitis A virus transmission) is inaccurate due to the mismatch with the known incubation period of HAV.
The IP's role includes critically evaluating epidemiological data to determine the likelihood of transmission events. The discrepancy in the incubation period and the serologic status of the patient suggest that the nurse's claim may not be substantiated by the current evidence, necessitating further investigation rather than immediate intervention or acceptance of the claim. This aligns with CBIC's emphasis on accurate identification and investigation of infectious disease processes (CBIC Practice Analysis, 2022, Domain I:
Identification of Infectious Disease Processes, Competency 1.2 - Investigate suspected outbreaks or exposures).
References: CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competencies 1.2 - Investigate suspected outbreaks or exposures, 1.3 - Apply principles of epidemiology.

NEW QUESTION # 75
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