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CBIC Certified Infection Control Exam Sample Questions (Q74-Q79):

NEW QUESTION # 74
The infection preventionist understands that the heating, ventilation and air conditioning (HVAC) systems in the facility can be a risk factor for healthcare-acquired infections. What is the MOST likely risk from the HVAC system for patients in a Pediatric Oncology unit?

A. Clostridioides difficile
B. Norovirus
C. Aspergillus spp.
D. Methicillin-resistant Staphylococcus aureus (MRSA)

Answer: C

Explanation:
Patients in pediatric oncology units are highly immunocompromised, making them particularly susceptible to opportunistic fungal infections such asAspergillusspp. HVAC systems, especially if improperly maintained or contaminated, can disseminate fungal spores into patient care areas.
* According to theAPIC Text (Chapter 116 - HVAC Systems), fungal spores such asAspergilluscan be transmitted via HVAC systems. These infections have been linked to contaminated air ducts, faulty air filters, and construction-related air disturbances. Outbreaks of aspergillosis are frequently associated with construction near patient care areas and are particularly dangerous for immunocompromised patients, including pediatric oncology patients.
* Additional data fromAPIC Text (Chapter 45 - Infection Prevention in Oncology Patients)reinforces thatAspergillusspp. infections in oncology and immunocompromised patients are primarily airborne and are most often disseminated via HVAC systems.
* Incorrect answer rationale:
* A. MRSA- Typically spread via direct contact, not HVAC.
* B. Norovirus- Spread via fecal-oral route and contaminated surfaces, not airborne HVAC.
* D.Clostridioides difficile- Spread via contact with spores on surfaces, not through the air.
References:
APIC Text, 4th Edition, Chapter 116 - Heating, Ventilation, and Air Conditioning APIC Text, 4th Edition, Chapter 45 - Infection Prevention in Oncology and Immunocompromised Patients

NEW QUESTION # 75
An 84-year-old male with a gangrenous foot is admitted to the hospital from an extended-care facility (ECF).
The ECF is notified that the wound grew Enterococcus faecium with the following antibiotic sensitivity results:
ampicillin - R
vancomycin - R
penicillin - R
linezolid - S
This is the fourth Enterococcus species cultured from residents within the same ECF wing in the past month.
The other cultures were from two urine specimens and a draining wound. The Infection Preventionist (IP) should immediately:

A. Notify the nursing administrator to close the wing to new admissions.
B. Conduct surveillance cultures for this organism in all residents.
C. Compare the four culture reports and sensitivity patterns.
D. Notify the medical director of the outbreak.

Answer: D

Explanation:
The scenario describes a potential outbreak of multidrug-resistant Enterococcus faecium in an extended-care facility (ECF) wing, indicated by four positive cultures (including the current case and three prior cases from urine and a draining wound) within a month. The organism exhibits resistance to ampicillin, vancomycin, and penicillin, but sensitivity to linezolid, suggesting a possible vancomycin-resistant Enterococcus (VRE) strain, which is a significant concern in healthcare settings. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the importance of rapid outbreak detection and response in the
"Surveillance and Epidemiologic Investigation" domain, aligning with Centers for Disease Control and Prevention (CDC) guidelines for managing multidrug-resistant organisms (MDROs).
Option A, "Notify the medical director of the outbreak," is the most immediate and critical action. Identifying an outbreak-defined by the CDC as two or more cases of a similar illness linked by time and place-requires prompt notification to the facility's leadership (e.g., medical director) to initiate a coordinated response. The presence of four Enterococcus cases, including a multidrug-resistant strain, within a single ECF wing over a month suggests a potential cluster, necessitating urgent action to assess the scope, implement control measures, and allocate resources. The CDC's "Management of Multidrug-Resistant Organisms in Healthcare Settings" (2006) recommends immediate reporting to facility leadership as the first step to activate an outbreak investigation team, making this the priority.
Option B, "Compare the four culture reports and sensitivity patterns," is an important subsequent step in outbreak investigation. Analyzing the antibiotic susceptibility profiles and culture sources can confirm whether the cases are epidemiologically linked (e.g., clonal spread of VRE) and guide treatment and control strategies. However, this is a detailed analysis that follows initial notification and should not delay alerting the medical director. Option C, "Conduct surveillance cultures for this organism in all residents," is a proactive measure to determine the prevalence of Enterococcus faecium, especially VRE, within the wing. The CDC recommends targeted surveillance during outbreaks, but this requires prior authorization and planning by the outbreak team, making it a secondary action after notification. Option D, "Notify the nursing administrator to close the wing to new admissions," may be a control measure to prevent further spread, as suggested by the CDC for MDRO outbreaks. However, closing a unit is a significant decision that should be guided by the medical director and infection control team after assessing the situation, not an immediate independent action by the IP.
The CBIC Practice Analysis (2022) and CDC guidelines prioritize rapid communication with leadership to initiate a structured outbreak response, including resource allocation and policy adjustments. Given the multidrug-resistant nature and cluster pattern, notifying the medical director (Option A) is the most immediate and appropriate action to ensure a comprehensive response.
References:
* CBIC Practice Analysis, 2022.
* CDC Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006.

NEW QUESTION # 76
Documentation of each steam sterilization cycle should include which of the following pieces of information?

A. Load contents
B. Date sterilizer was cleaned
C. Machine model number
D. Initials of the person who prepared the instrument set

Answer: A

Explanation:
Documentation of each steam sterilization cycle is a regulatory and quality requirement. It must includeload contents, thesterilizer ID,date,cycle number, and theperson who assembled the load. These details support traceability and quality assurance.
* TheAPIC Textstates:
"Each item or package should be labeled with a lot-control identifier that includes the sterilizer identification number or code, a detailed list of the contents, an identifier for the person who assembled the package, the date of sterilization, the cycle number..."
* Other options like themachine model numberordate sterilizer was cleanedare not routine documentation elements for every cycle.
References:
APIC Text, 4th Edition, Chapter 108 - Sterile Processing

NEW QUESTION # 77
Which of the following processes is MOST important for the infection preventionist (IP) to review when evaluating a third-party reprocessor for single-use devices?

A. Observe all steps for reprocessing.
B. Obtain feedback from other IPs who use the reprocessor.
C. Ensure air and water cultures are performed regularly.
D. Review the facility's blueprints and policies.

Answer: A

Explanation:
The correct answer is A, "Observe all steps for reprocessing," as this is the most important process for the infection preventionist (IP) to review when evaluating a third-party reprocessor for single-use devices.
According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the reprocessing of single-use devices (SUDs) by third-party entities must adhere to stringent infection control standards to ensure they are safe for reuse and do not contribute to healthcare-associated infections (HAIs).
Observing all steps-such as cleaning, disinfection, sterilization, packaging, and quality control-allows the IP to directly assess compliance with manufacturer instructions, regulatory requirements (e.g., FDA guidelines), and best practices (e.g., AAMI ST91) (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). This hands-on evaluation is critical because any deviation in the reprocessing chain can compromise device sterility and patient safety.
Option B (review the facility's blueprints and policies) provides context about the physical layout and procedural framework, but it is a preliminary step that does not directly verify the reprocessing process's effectiveness. Option C (ensure air and water cultures are performed regularly) is important for monitoring environmental contamination risks, particularly in sterile processing areas, but it is a supportive measure rather than the primary focus of evaluating the reprocessor's core activities. Option D (obtain feedback from other IPs who use the reprocessor) offers valuable peer insights, but it is subjective and secondary to direct observation, which provides firsthand evidence of compliance and performance.
The priority on observing reprocessing steps aligns with CBIC's emphasis on ensuring the safety and efficacy of reprocessed medical devices, a key responsibility for IPs when outsourcing to third-party reprocessors (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). This process enables the IP to identify specific weaknesses, validate adherence to standards, and make informed decisions about the reprocessor's suitability.
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 ST91:2015, Flexible and semi-rigid endoscope processing in health care facilities.

NEW QUESTION # 78
Therapeutic antimicrobial agents should be used when

A. Following identification of the pathogen and sensitives.
B. the infecting agent is unknown
C. the patient symptoms suggest likely pathogens.
D. the patient's illness warrants treatment prior to culture results

Answer: A

Explanation:
Therapeutic antimicrobial agentsshould ideally bepathogen-directedto minimizeresistance, side effects, and treatment failure. Once thecausative pathogen and its antimicrobial susceptibilities are known, the mostnarrow-spectrum, effectiveagent should be used.
Why the Other Options Are Incorrect?
* A. The infecting agent is unknown- Empiric therapy may be necessary initially, but definitive therapy should be based on pathogen identification.
* B. The patient's illness warrants treatment prior to culture results- This applies toempiric therapy
, but not todefinitive antimicrobial selection.
* C. The patient's symptoms suggest likely pathogens- Clinical presentation guidesempiric treatment
, butdefinitive therapy should follow culture and susceptibility testing.
CBIC Infection Control Reference
APIC emphasizes theimportance of selecting antimicrobials based on pathogen identification and susceptibility testingto preventantimicrobial resistance.

NEW QUESTION # 79
......

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