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CBIC Certified Infection Control Exam Sample Questions (Q45-Q50):

NEW QUESTION # 45
Which of the following operating suite design features is LEAST important for the prevention of infection?

A. Placement of sinks for surgical scrubs
B. Control of traffic and traffic flow patterns
C. Type of floor material
D. Positive pressure air handling

Answer: C

Explanation:
The correct answer is A, "Type of floor material," as it is the least important operating suite design feature for the prevention of infection compared to the other options. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the design of operating suites plays a critical role in infection prevention, particularly for surgical site infections (SSIs). While the type of floor material (e.g., vinyl, tile, or epoxy) can affect ease of cleaning and durability, its impact on infection prevention is secondary to other design elements that directly influence air quality, hygiene practices, and personnel movement (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). Modern flooring materials are generally designed to be non-porous and easily disinfected, mitigating their role as a primary infection risk factor when proper cleaning protocols are followed.
Option B (positive pressure air handling) is highly important because it prevents the influx of contaminated air into the operating suite, reducing the risk of airborne pathogens, including those causing SSIs. This is a standard feature in operating rooms to maintain a sterile environment (AORN Guidelines for Perioperative Practice, 2023). Option C (placement of sinks for surgical scrubs) is critical for ensuring that surgical staff can perform effective hand and forearm antisepsis, a key step in preventing SSIs by reducing microbial load before surgery. Option D (control of traffic and traffic flow patterns) is essential to minimize the introduction of contaminants from outside the operating suite, as excessive or uncontrolled movement can increase the risk of airborne and contact transmission (CDC Guidelines for Environmental Infection Control in Healthcare Facilities, 2019).
The relative unimportance of floor material type stems from the fact that infection prevention relies more on consistent cleaning practices and the aforementioned design features, which directly address pathogen transmission routes. This aligns with CBIC's focus on evaluating environmental risks based on their direct impact on infection control (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.4 - Implement environmental cleaning and disinfection protocols).
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.4 - Implement environmental cleaning and disinfection protocols, 3.5 - Evaluate the environment for infection risks. AORN Guidelines for Perioperative Practice, 2023. CDC Guidelines for Environmental Infection Control in Healthcare Facilities, 2019.

NEW QUESTION # 46
Some pathogens live in the body and can be cultured, but do NOT elicit any response from the body's defense mechanisms. This state is called:

A. Latency
B. Contamination
C. Colonization
D. Infection

Answer: C

Explanation:
The interaction between pathogens and the human body can take various forms, each with distinct immunological and clinical implications. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes understanding these states within the "Identification of Infectious Disease Processes" domain to guide infection prevention strategies. The question describes a scenario where pathogens are present, can be cultured (indicating viable organisms), but do not trigger a response from the body's defense mechanisms, such as inflammation or immune activation. This requires identifying the appropriate microbiological state.
Option A, "Colonization," is the correct answer. Colonization occurs when microorganisms are present on or in the body (e.g., skin, mucous membranes, or gut) without causing harm or eliciting an immune response.
These pathogens can be cultured, as they are alive and replicating, but they exist in a commensal or symbiotic relationship with the host, not provoking symptoms or defense mechanisms. Examples include normal flora like Staphylococcus epidermidis on the skin or Streptococcus salivarius in the oral cavity. The Centers for Disease Control and Prevention (CDC) defines colonization as the presence of microbes without tissue invasion or damage, distinguishing it from infection (CDC, "Principles of Epidemiology in Public Health Practice," 3rd Edition, 2012).
Option B, "Infection," is incorrect because it involves the invasion and multiplication of pathogens in body tissues, leading to an immune response, such as inflammation, fever, or antibody production. This contrasts with the question's description of no defense mechanism response. Option C, "Latency," refers to a state where a pathogen (e.g., herpes simplex virus or Mycobacterium tuberculosis) remains dormant in the body after initial infection, capable of reactivation but not eliciting an active immune response during dormancy.
However, latency implies a prior infection with a latent phase, whereas the question suggests a current, non- responsive state without prior infection context. Option D, "Contamination," describes the unintended presence of pathogens on inanimate objects or surfaces (e.g., medical equipment), not within the body, and does not align with the scenario of living, culturable pathogens in a host.
The CBIC Practice Analysis (2022) and CDC guidelines highlight colonization as a key concept in infection control, particularly in settings like hospitals where colonized patients can serve as reservoirs for potential infections. The absence of an immune response, as specified, aligns with the definition of colonization, making Option A the most accurate answer.
References:
* CBIC Practice Analysis, 2022.
* CDC Principles of Epidemiology in Public Health Practice, 3rd Edition, 2012.

NEW QUESTION # 47
Which of the following statements is true about the microbial activity of chlorhexidine soap?

A. Persistent activity with a broad spectrum effect
B. Poor against gram positive bacteria
C. Can be used with any hand lotion
D. As fast as alcohol

Answer: A

Explanation:
Chlorhexidine soap is a widely used antiseptic agent in healthcare settings for hand hygiene and skin preparation due to its effective antimicrobial properties. The Certification Board of Infection Control and Epidemiology (CBIC) underscores the importance of proper hand hygiene and antiseptic use in the
"Prevention and Control of Infectious Diseases" domain, aligning with guidelines from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Understanding the microbial activity of chlorhexidine is essential for infection preventionists to recommend its appropriate use.
Option D, "Persistent activity with a broad spectrum effect," is the true statement. Chlorhexidine exhibits a broad spectrum of activity, meaning it is effective against a wide range of microorganisms, including gram- positive and gram-negative bacteria, some fungi, and certain viruses. Its persistent activity is a key feature, as it binds to the skin and provides a residual antimicrobial effect that continues to inhibit microbial growth for several hours after application. This residual effect is due to chlorhexidine's ability to adhere to the skin's outer layers, releasing slowly over time, which enhances its efficacy in preventing healthcare-associated infections (HAIs). The CDC's "Guideline for Hand Hygiene in Healthcare Settings" (2002) and WHO's
"Guidelines on Hand Hygiene in Health Care" (2009) highlight chlorhexidine's prolonged action as a significant advantage over other agents like alcohol.
Option A, "As fast as alcohol," is incorrect. Alcohol (e.g., 60-70% isopropyl or ethyl alcohol) acts rapidly by denaturing proteins and disrupting microbial cell membranes, providing immediate kill rates within seconds.
Chlorhexidine, while effective, has a slower onset of action, requiring contact times of 15-30 seconds or more to achieve optimal microbial reduction. Its strength lies in persistence rather than speed. Option B, "Can be used with any hand lotion," is false. Chlorhexidine's activity can be diminished or inactivated by certain hand lotions or creams containing anionic compounds (e.g., soaps or moisturizers with high pH), which neutralize its cationic properties. The CDC advises against combining chlorhexidine with incompatible products to maintain its efficacy. Option C, "Poor against gram positive bacteria," is incorrect. Chlorhexidine is highly effective against gram-positive bacteria (e.g., Staphylococcus aureus) and is often more potent against them than against gram-negative bacteria due to differences in cell wall structure, though it still has broad-spectrum activity.
The CBIC Practice Analysis (2022) supports the use of evidence-based antiseptics like chlorhexidine, and its persistent, broad-spectrum activity is well-documented in clinical studies (e.g., Larson, 1988, Journal of Hospital Infection). This makes Option D the most accurate statement regarding chlorhexidine soap's microbial activity.
References:
* CBIC Practice Analysis, 2022.
* CDC Guideline for Hand Hygiene in Healthcare Settings, 2002.
* WHO Guidelines on Hand Hygiene in Health Care, 2009.
* Larson, E. (1988). Guideline for Use of Topical Antimicrobial Agents. Journal of Hospital Infection.

NEW QUESTION # 48
Following recent renovations on an oncology unit, three patients were identified with Aspergillus infections.
The infections were thought to be facility-acquired. Appropriate environmental microbiological monitoring would be to culture the:

A. Carpet
B. Aerators
C. Air
D. Ice

Answer: C

Explanation:
The scenario describes an outbreak of Aspergillus infections among three patients on an oncology unit following recent renovations, with the infections suspected to be facility-acquired. Aspergillus is a mold commonly associated with environmental sources, particularly airborne spores, and its presence in immunocompromised patients (e.g., oncology patients) poses a significant risk. The infection preventionist must identify the appropriate environmental microbiological monitoring strategy, guided by the Certification Board of Infection Control and Epidemiology (CBIC) and CDC recommendations. Let's evaluate each option:
* A. Air: Aspergillus species are ubiquitous molds that thrive in soil, decaying vegetation, and construction dust, and they are primarily transmitted via airborne spores. Renovations can disturb these spores, leading to aerosolization and inhalation by vulnerable patients. Culturing the air using methods such as settle plates, air samplers, or high-efficiency particulate air (HEPA) filtration monitoring is a standard practice to detect Aspergillus during construction or post-renovation in healthcare settings, especially oncology units where patients are at high risk for invasive aspergillosis. This aligns with CBIC's emphasis on environmental monitoring for airborne pathogens, making it the most appropriate choice.
* B. Ice: Ice can be a source of contamination with bacteria (e.g., Pseudomonas, Legionella) or other pathogens if improperly handled or stored, but it is not a typical reservoir for Aspergillus, which is a mold requiring organic material and moisture for growth. While ice safety is important in infection control, culturing ice is irrelevant to an Aspergillus outbreak linked to renovations and is not a priority in this context.
* C. Carpet: Carpets can harbor dust, mold, and other microorganisms, especially in high-traffic or poorly maintained areas. Aspergillus spores could theoretically settle in carpet during renovations, but carpets are not a primary source of airborne transmission unless disturbed (e.g., vacuuming). Culturing carpet might be a secondary step if air sampling indicates widespread contamination, but it is less direct and less commonly recommended as the initial monitoring site compared to air sampling.
* D. Aerators: Aerators (e.g., faucet aerators) can harbor waterborne pathogens like Pseudomonas or Legionella due to biofilm formation, but Aspergillus is not typically associated with water systems unless there is significant organic contamination or aerosolization from water sources (e.g., cooling towers). Culturing aerators is relevant for waterborne outbreaks, not for an Aspergillus outbreak linked to renovations, making this option inappropriate.
The best answer is A, culturing the air, as Aspergillus is an airborne pathogen, and renovations are a known risk factor for spore dispersal in healthcare settings. This monitoring strategy allows the infection preventionist to confirm the source, assess the extent of contamination, and implement control measures (e.g., enhanced filtration, construction barriers) to protect patients. This is consistent with CBIC and CDC guidelines for managing fungal outbreaks in high-risk units.
References:
* CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain IV:
Environment of Care, which recommends air sampling for Aspergillus during construction-related outbreaks.
* CBIC Examination Content Outline, Domain III: Prevention and Control of Infectious Diseases, which includes environmental monitoring for facility-acquired infections.
* CDC Guidelines for Environmental Infection Control in Healthcare Facilities (2022), which advocate air culturing to detect Aspergillus post-renovation in immunocompromised patient areas.

NEW QUESTION # 49
Which of the following strategies is MOST effective in reducing surgical site infections (SSI) in orthopedic procedures?

A. Routine intraoperative wound irrigation with povidone-iodine.
B. Administration of prophylactic antibiotics postoperatively for 48 hours.
C. Use of sterile adhesive wound dressings for 10 days postoperatively.
D. Perioperative normothermia maintenance.

Answer: D

Explanation:
* Perioperative normothermia maintenance reduces SSI rates by improving immune function and tissue perfusion.
* Routine wound irrigation (B) has no strong evidence supporting SSI prevention.
* Prolonged antibiotic use (C) increases antibiotic resistance without added benefit.
* Extended use of wound dressings (D) does not reduce SSI rates.
CBIC Infection Control References:
* APIC Text, "SSI Prevention in Surgery," Chapter 12.

NEW QUESTION # 50
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