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CBIC Certified Infection Control Exam Sample Questions (Q84-Q89):

NEW QUESTION # 84
A nurse exposed to pertussis develops a mild cough 14 days later. What is the recommended action?

A. Continue working with a surgical mask.
B. Initiate post-exposure prophylaxis only if symptoms worsen.
C. Conduct serologic testing before deciding on work restrictions.
D. Exclude from patient care until five days after starting antibiotics.

Answer: D

Explanation:
* The CDC recommends exclusion of healthcare workers with pertussis until completing at least five days of antibiotic therapy.
CBIC Infection Control References:
APIC-JCR Workbook, "Occupational Health Considerations," Chapter 10

NEW QUESTION # 85
During the past week, three out of four blood cultures from a febrile neonate in an intensive care unit grew coagulase-negative staphylococci. This MOST likely indicates:

A. Laboratory error.
B. Infection.
C. Contamination.
D. Colonization.

Answer: C

Explanation:
The scenario involves a febrile neonate in an intensive care unit (ICU) with three out of four blood cultures growing coagulase-negative staphylococci (CoNS) over the past week. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes accurate interpretation of microbiological data in the
"Identification of Infectious Disease Processes" domain, aligning with the Centers for Disease Control and Prevention (CDC) guidelines for healthcare-associated infections. Determining whether this represents a true infection, contamination, colonization, or laboratory error requires evaluating the clinical and microbiological context.
Option B, "Contamination," is the most likely indication. Coagulase-negative staphylococci, such as Staphylococcus epidermidis, are common skin flora and frequent contaminants in blood cultures, especially in neonates where skin preparation or sampling technique may be challenging. The CDC's "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017) and the Clinical and Laboratory Standards Institute (CLSI) note that multiple positive cultures (e.g., two or more) are typically required to confirm true bacteremia, particularly with CoNS, unless accompanied by clear clinical signs of infection (e.g., worsening fever, hemodynamic instability) and no other explanation. The inconsistency (three out of four cultures) and the neonate's ICU setting-where contamination from skin or catheter hubs is common-suggest that the positive cultures likely result from contamination during blood draw rather than true infection. Studies, such as those in the Journal of Clinical Microbiology (e.g., Beekmann et al., 2005), indicate that CoNS in blood cultures is contaminated in 70-80% of cases when not supported by robust clinical correlation.
Option A, "Laboratory error," is possible but less likely as the primary explanation. Laboratory errors (e.g., mislabeling or processing mistakes) could occur, but the repeated growth in three of four cultures suggests a consistent finding rather than a random error, making contamination a more plausible cause. Option C,
"Colonization," refers to the presence of microorganisms on or in the body without invasion or immune response. While CoNS can colonize the skin or catheter sites, colonization does not typically result in positive blood cultures unless there is an invasive process, which is not supported by the data here. Option D,
"Infection," is the least likely without additional evidence. True CoNS bloodstream infections (e.g., catheter- related) in neonates are serious but require consistent positive cultures, clinical deterioration (e.g., persistent fever, leukocytosis), and often imaging or catheter removal confirmation. The febrile state alone, with inconsistent culture results, does not meet the CDC's criteria for diagnosing infection (e.g., at least two positive cultures from separate draws).
The CBIC Practice Analysis (2022) and CDC guidelines stress differentiating contamination from infection to avoid unnecessary treatment, which can drive antibiotic resistance. Given the high likelihood of contamination with CoNS in this context, Option B is the most accurate answer.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2017.
* Beekmann, S. E., et al. (2005). Coagulase-Negative Staphylococci in Blood Cultures. Journal of Clinical Microbiology.
* CLSI Guidelines on Blood Culture Interpretation, 2018.

NEW QUESTION # 86
A surgical team is performing a liver transplant. Which of the following represents the HIGHEST risk for transmission of a healthcare-associated infection?

A. Using alcohol-based hand rub instead of surgical scrub.
B. Airflow disruption due to personnel movement.
C. Failure to change surgical gloves after contamination.
D. Delayed administration of preoperative antibiotics.

Answer: C

Explanation:
* Glove Contamination and SSI Risk:
* Failure to change contaminated gloves increases the risk of surgical site infections (SSIs).
* Double-gloving with an outer glove change reduces contamination.
* Why Other Options Are Incorrect:
* B. Alcohol-based hand rubs: Are FDA-approved alternatives to traditional scrubs and effective.
* C. Delayed antibiotics: Increases infection risk, but immediate correction reduces harm.
* D. Airflow disruption: Can increase SSI risk, but glove contamination poses a more direct threat.
CBIC Infection Control References:
* APIC-JCR Workbook, "Surgical Infection Prevention," Chapter 6.

NEW QUESTION # 87
Which of the following is the BEST strategy for reducing bloodstream infections associated with central venous catheters?

A. Use of chlorhexidine-impregnated dressings.
B. Daily blood cultures for patients with central lines.
C. Routine replacement of central lines every 7 days.
D. Use of povidone-iodine instead of chlorhexidine for skin antisepsis.

Answer: A

Explanation:
* Chlorhexidine-impregnated dressings reduce central line-associated bloodstream infections (CLABSI) by preventing bacterial colonization.
* Routine catheter replacement (A) increases insertion risks without reducing infections.
* Daily blood cultures (C) are unnecessary and lead to false positives.
* Povidone-iodine (D) is less effective than chlorhexidine for skin antisepsis.
CBIC Infection Control References:
* APIC Text, "CLABSI Prevention Measures," Chapter 10.

NEW QUESTION # 88
Which of the following is an example of an outcome measure?

A. Hand hygiene compliance rate
B. Timing of preoperative antibiotic administration
C. Adherence to Environmental Cleaning
D. Rate of multi-drug resistant organisms acquisition

Answer: D

Explanation:
The correct answer is C, "Rate of multi-drug resistant organisms acquisition," as it represents an example of an outcome measure. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, outcome measures are indicators that reflect the impact or result of infection prevention and control interventions on patient health outcomes or the incidence of healthcare-associated infections (HAIs).
The rate of multi-drug resistant organisms (MDRO) acquisition directly measures the incidence of new infections caused by resistant pathogens, which is a key outcome affected by the effectiveness of infection control practices (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.4 - Evaluate the effectiveness of infection prevention and control interventions).
Option A (hand hygiene compliance rate) is an example of a process measure, which tracks adherence to specific protocols or practices intended to prevent infections, rather than the resulting health outcome. Option B (adherence to environmental cleaning) is also a process measure, focusing on the implementation of cleaning protocols rather than the end result, such as reduced infection rates. Option D (timing of preoperative antibiotic administration) is another process measure, assessing the timeliness of an intervention to prevent surgical site infections, but it does not directly indicate the outcome (e.g., infection rate) of that intervention.
Outcome measures, such as the rate of MDRO acquisition, are critical for evaluating the success of infection prevention programs and are often used to guide quality improvement initiatives. This aligns with CBIC's emphasis on using surveillance data to assess the effectiveness of interventions and inform decision-making (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.5 - Use data to guide infection prevention and control strategies). The focus on MDRO acquisition specifically highlights a significant healthcare challenge, making it a prioritized outcome measure in infection control.
References: CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competencies 2.4 - Evaluate the effectiveness of infection prevention and control interventions, 2.5 - Use data to guide infection prevention and control strategies.

NEW QUESTION # 89
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