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CBIC Certified Infection Control Exam Sample Questions (Q40-Q45):

NEW QUESTION # 40
A facility's goal is to increase hand-hygiene compliance from the current 52% to 75% within 12 months. A gap analysis identifies several different issues. Which of the following is BEST suited for summarizing these issues?

A. Gantt chart
B. Affinity diagram
C. Ishikawa diagram
D. Flow chart

Answer: C

Explanation:
AnIshikawa diagram (fishbone diagram)is used tovisually represent cause-and-effect relationshipsin problem analysis. It is best for summarizing and categorizing issues found in a gap analysis related to infection prevention.
* TheAPIC Textconfirms:
"A fishbone diagram (also called a tree diagram or Ishikawa) allows a team to identify, explore, and graphically display all of the possible causes related to a problem to discover the root cause".
* It's particularly useful in quality improvement and infection prevention project analysis.
References:
CBIC Study Guide, 6th Edition, Chapter on Quality Concepts
APIC Text, 4th Edition, Chapter 16 - Quality Concepts

NEW QUESTION # 41
What is the limitation of using liquid chemical sterilants to sterilize medical items?

A. The sterility is not maintained during storage.
B. It does not kill the spores.
C. It requires a contact time of at least 12 hours.
D. It can only be used for heat tolerant devices.

Answer: A

Explanation:
The correct answer is B, "The sterility is not maintained during storage," as this represents a key limitation of using liquid chemical sterilants to sterilize medical items. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines and standards from the Association for the Advancement of Medical Instrumentation (AAMI), liquid chemical sterilants, such as glutaraldehyde or peracetic acid, are effective for sterilizing heat-sensitive medical devices by eliminating all forms of microbial life, including spores, when used according to manufacturer instructions (CBIC Practice Analysis, 2022, Domain III:
Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment).
However, a significant limitation is that sterility is not guaranteed after the items are removed from the sterilant and stored, as the sterile barrier can be compromised by environmental contamination, improper packaging, or handling (AAMI ST58:2013, Chemical Sterilization and High-Level Disinfection in Health Care Facilities).
Option A (it does not kill the spores) is incorrect because liquid chemical sterilants are designed to achieve sterilization, including the destruction of bacterial spores, provided the contact time, concentration, and conditions specified by the manufacturer are met. Option C (it requires a contact time of at least 12 hours) is not a universal limitation; while some liquid sterilants require extended contact times (e.g., 10-12 hours for certain formulations), this is a procedural requirement rather than an inherent limitation, and shorter times may be sufficient with other agents or automated systems. Option D (it can only be used for heat tolerant devices) is incorrect because liquid chemical sterilants are specifically intended for heat-sensitive devices that cannot withstand steam or dry heat sterilization.
The limitation of sterility not being maintained during storage underscores the need for immediate use of sterilized items or the use of proper sterile packaging and storage protocols to prevent recontamination. This aligns with CBIC's focus on ensuring the safety and efficacy of reprocessed medical equipment in infection prevention (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). Healthcare facilities must implement strict post-sterilization handling and storage practices to mitigate this limitation.
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment. AAMI ST58:2013, Chemical Sterilization and High-Level Disinfection in Health Care Facilities.

NEW QUESTION # 42
Working with public health agencies to collect and analyze indicators that might signal an increase in community illness is an example of which type of surveillance?

A. Active
B. Syndromic
C. Targeted
D. Passive

Answer: B

Explanation:
Surveillance is a critical tool in infection prevention and control, used to monitor disease trends and guide public health responses. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the "Surveillance and Epidemiologic Investigation" domain, which aligns withthe Centers for Disease Control and Prevention (CDC) "Principles of Epidemiology in Public Health Practice" (3rd Edition, 2012). The question describes a process of collecting and analyzing indicators to signal an increase in community illness, requiring identification of the appropriate surveillance type among the options provided.
Option C, "Syndromic," is the correct answer. Syndromic surveillance involves monitoring non-specific health indicators or symptoms (e.g., fever, respiratory complaints, or gastrointestinal issues) that may precede a formal diagnosis, aiming to detect potential outbreaks or increases in community illness early. The CDC defines syndromic surveillance as the real-time or near-real-time collection, analysis, and interpretation of health-related data to provide actionable information, often in collaboration with public health agencies. This approach uses data from sources like emergency department visits, over-the-counter medication sales, or absenteeism reports to identify trends before laboratory confirmation, making it well-suited to the described scenario of signaling community illness increases.
Option A, "Passive," involves healthcare providers or laboratories reporting cases to public health authorities on a voluntary or mandatory basis without active prompting (e.g., routine notifiable disease reporting). While passive surveillance contributes to baseline data, it is less proactive and not specifically designed to signal early increases in illness, making it less fitting. Option B, "Active," entails public health officials actively seeking data from healthcare facilities or providers (e.g., calling to confirm cases during an outbreak). This is more resource-intensive and typically used for specific investigations rather than ongoing community trend monitoring, which aligns better with syndromic methods. Option D, "Targeted," refers to surveillance focused on a specific population, disease, or event (e.g., monitoring TB in a high-risk group). The scenario's broad focus on community illness indicators does not suggest a targeted approach.
The CBIC Practice Analysis (2022) and CDC guidelines highlight syndromic surveillance as a key strategy for early detection of community-wide health threats, often involving collaboration with public health agencies. Option C best matches the described activity of analyzing indicators to signal illness increases, making it the correct choice.
References:
CBIC Practice Analysis, 2022.
CDC Principles of Epidemiology in Public Health Practice, 3rd Edition, 2012.
CDC Syndromic Surveillance Systems, 2020.

NEW QUESTION # 43
Which of the following factors increases a patient's risk of developing ventilator-associated pneumonia (VAP)?

A. In-line suction
B. Nasogastric tube
C. Hypoxia
D. Acute lung disease

Answer: B

Explanation:
Ventilator-associated pneumonia (VAP) is a type of healthcare-associated pneumonia that occurs in patients receiving mechanical ventilation for more than 48 hours. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes identifying risk factors for VAP in the "Prevention and Control of Infectious Diseases" domain, aligning with the Centers for Disease Control and Prevention (CDC) guidelines for preventing ventilator-associated events. The question requires identifying which factor among the options increases a patient's risk of developing VAP, based on evidence from clinical and epidemiological data.
Option B, "Nasogastric tube," is the correct answer. The presence of a nasogastric tube is a well-documented risk factor for VAP. This tube can facilitate the aspiration of oropharyngeal secretions or gastric contents into the lower respiratory tract, bypassing natural defense mechanisms like the epiglottis. The CDC's "Guidelines for Preventing Healthcare-Associated Pneumonia" (2004) and studies in the American Journal of Respiratory and Critical Care Medicine (e.g., Kollef et al., 2005) highlight that nasogastric tubes increase VAP risk by promoting microaspiration, especially if improperly managed or if the patient has impaired gag reflexes. This mechanical disruption of the airway's protective barriers is a direct contributor to infection.
Option A, "Hypoxia," refers to low oxygen levels in the blood, which can be a consequence of lung conditions or VAP but is not a primary risk factor for developing it. Hypoxia may indicate underlying respiratory compromise, but it does not directly increase the likelihood of VAP unless associated with other factors (e.g., prolonged ventilation). Option C, "Acute lung disease," is a broad term that could include conditions like acute respiratory distress syndrome (ARDS), which may predispose patients to VAP due to prolonged ventilation needs. However, acute lung disease itself is not a specific risk factor; rather, it is the need for mechanical ventilation that elevates risk, making this less direct than the nasogastric tube effect.
Option D, "In-line suction," involves a closed-system method for clearing respiratory secretions, which is designed to reduce VAP risk by minimizing contamination during suctioning. The CDC and evidence-based guidelines (e.g., American Thoracic Society, 2016) recommend in-line suction to prevent infection, suggesting it decreases rather than increases VAP risk.
The CBIC Practice Analysis (2022) and CDC guidelines prioritize identifying modifiable risk factors like nasogastric tubes for targeted prevention strategies (e.g., elevating the head of the bed to reduce aspiration).
Option B stands out as the factor most consistently linked to increased VAP risk based on clinical evidence.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for Preventing Healthcare-Associated Pneumonia, 2004.
* Kollef, M. H., et al. (2005). The Impact of Nasogastric Tubes on VAP. American Journal of Respiratory and Critical Care Medicine.
* American Thoracic Society Guidelines on VAP Prevention, 2016.

NEW QUESTION # 44
The infection preventionist (IP) collaborates with the Intravenous Therapy team to select the best antiseptic for use during the insertion of an intravascular device for adults. For a patient with no contraindications, what antiseptic should the IP suggest?

A. Povidone-iodine
B. Chlorhexidine
C. Alcohol
D. Antibiotic ointment

Answer: B

Explanation:
The selection of an appropriate antiseptic for the insertion of an intravascular device (e.g., peripheral or central venous catheters) is a critical infection prevention measure to reduce the risk of catheter-related bloodstream infections (CRBSIs). The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes evidence-based practices in the "Prevention and Control of Infectious Diseases" domain, which includes adhering to guidelines for aseptic technique during invasive procedures. The Centers for Disease Control and Prevention (CDC) provides specific recommendations for skin antisepsis, as outlined in the
"Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017).
Option A, chlorhexidine, is the preferred antiseptic for skin preparation prior to intravascular device insertion in adults with no contraindications. Chlorhexidine, particularly in a 2% chlorhexidine gluconate (CHG) with
70% isopropyl alcohol solution, is recommended by the CDC due to its broad-spectrum antimicrobial activity, residual effect (which continues to kill bacteria after application), and superior efficacy compared to other agents in reducing CRBSI rates. Studies cited in the CDC guidelines demonstrate that chlorhexidine-based preparations significantly lower infection rates compared to povidone-iodine or alcohol alone, making it the gold standard for this procedure when tolerated by the patient.
Option B, povidone-iodine, is an alternative antiseptic that can be used for skin preparation. It is effective against a wide range of microorganisms and is often used when chlorhexidine is contraindicated (e.g., in patients with chlorhexidine allergy). However, its efficacy is less persistent than chlorhexidine, and it requires longer drying time, which can be a limitation in busy clinical settings. The CDC considers povidone-iodine a second-line option unless chlorhexidine is unavailable or unsuitable. Option C, alcohol (e.g., 70% isopropyl or ethyl alcohol), has rapid bactericidal activity but lacks a residual effect, making it less effective for prolonged protection during catheter dwell time. It is often used as a component of chlorhexidine-alcohol combinations but is not recommended as a standalone antiseptic for intravascular device insertion. Option D, antibiotic ointment, is not appropriate for skin preparation during insertion. Antibiotic ointments (e.g., bacitracin or mupirocin) are sometimes applied to catheter sites post-insertion to prevent infection, but their use is discouraged by the CDC due to the risk of promoting antibiotic resistance and fungal infections, and they are not classified as antiseptics for initial skin antisepsis.
The CBIC Practice Analysis (2022) supports the adoption of CDC-recommended practices, and the 2017 CDC guidelines explicitly state that chlorhexidine-based preparations with alcohol should be used for skin antisepsis unless contraindicated. For a patient with no contraindications, the infection preventionist should suggest chlorhexidine to optimize patient safety and align with best practices.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2017.

NEW QUESTION # 45
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