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| Section | Weight | Objectives |
|---|---|---|
| Cleaning, Sterilization, Disinfection, Asepsis | 10-13% | |
| Surveillance and Epidemiologic Investigation | 22-26% | |
| Management and Communication | 10-13% | |
| Preventing/Controlling the Transmission of Infectious Agents | 17-19% | |
| Identification of Infectious Disease Processes | 17-19% | |
| Education and Research | 6-9% | |
| Employee/Occupational Health | 10-13% | |
| Environment of Care | 10-13% |
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NEW QUESTION # 164
A patient with meningococcal meningitis experiences cardiac arrest. A nurse administers mouth-to-mouth breathing during CPR. Which of the following actions should the nurse take immediately?
Answer: B
Explanation:
The CBIC Certified Infection Control Exam Study Guide (6th edition) identifies Neisseria meningitidis as a highly transmissible organism spread through respiratory droplets and direct contact with oral secretions.
Healthcare personnel who have unprotected, close exposure-such as mouth-to-mouth resuscitation-to a patient with meningococcal meningitis are considered high-risk contacts.
In this scenario, the nurse had direct exposure to respiratory secretions during CPR, which constitutes a significant risk for transmission. The Study Guide emphasizes that postexposure chemoprophylaxis is indicated as soon as possible, ideally within 24 hours of exposure, to prevent invasive meningococcal disease.
Recommended prophylactic agents include rifampin, ciprofloxacin, or ceftriaxone, depending on contraindications and institutional protocols.
Option A is incorrect because chlorhexidine oral rinse does not eliminate systemic infection risk. Option B is inappropriate because quarantine is not required for exposed healthcare workers who receive appropriate prophylaxis. Option D is insufficient, as monitoring alone does not adequately reduce the risk of developing disease following high-risk exposure.
Rapid initiation of chemoprophylaxis is a critical infection prevention intervention and a high-yield CIC exam concept. Early action protects the exposed healthcare worker and prevents secondary transmission within the healthcare setting.
NEW QUESTION # 165
The cleaning and disinfection process that is appropriate for a particular surgical instrument depends on
Answer: D
Explanation:
The correct answer is C, "the device manufacturer's written instructions for use," as this is the factor that determines the appropriate cleaning and disinfection process for a particular surgical instrument. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the reprocessing of surgical instruments must follow the specific instructions provided by the device manufacturer to ensure safety and efficacy. These instructions account for the instrument's material, design, and intended use, specifying the appropriate cleaning agents, disinfection methods, sterilization techniques, and contact times to prevent damage and ensure the elimination of pathogens (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). This is also mandated by regulatory standards, such as those from the Food and Drug Administration (FDA) and the Association for the Advancement of Medical Instrumentation (AAMI), which require adherence to manufacturer guidelines to maintain device integrity and patient safety.
Option A (all surgical instruments are cleaned and sterilized in the same manner) is incorrect because different instruments have unique characteristics (e.g., materials like stainless steel vs. delicate optics), necessitating tailored reprocessing methods rather than a one-size-fits-all approach. Option B (instruments contaminated with blood must be bleach cleaned first) is a misconception; while blood contamination requires thorough cleaning, bleach is not universally appropriate and may damage certain instruments unless specified by the manufacturer. Option D (the policies of the sterile processing department) may guide internal procedures but must be based on and subordinate to the manufacturer's instructions to ensure compliance and effectiveness.
The emphasis on manufacturer instructions aligns with CBIC's focus on evidence-based reprocessing practices to prevent healthcare-associated infections (HAIs) and protect patients (CBIC Practice Analysis,
2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). Deviating from these guidelines can lead to inadequate sterilization or instrument damage, increasing infection risks.
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 ST79:2017, Comprehensive guide to steam sterilization and sterility assurance in health care facilities.
NEW QUESTION # 166
An infection preventionist is asked to recommend a product for disinfection of bronchoscopes. Which of the following agents would be appropriate?
Answer: C
Explanation:
The correct answer is D, "Peracetic acid," as this agent is appropriate for the disinfection of bronchoscopes.
According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, bronchoscopes are semi-critical devices that require high-level disinfection (HLD) to eliminate all microorganisms except high levels of bacterial spores, as they come into contact with mucous membranes but not sterile tissues. Peracetic acid is recognized by the Centers for Disease Control and Prevention (CDC) and the Association for the Advancement of Medical Instrumentation (AAMI) as an effective high-level disinfectant for endoscopes, including bronchoscopes, due to its broad-spectrum antimicrobial activity, rapid action, and compatibility with the delicate materials (e.g., optics and channels) of these devices (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). It is commonly used in automated endoscope reprocessors, ensuring thorough disinfection when combined with proper cleaning and rinsing protocols.
Option A (iodophor) is typically used for intermediate-level disinfection and skin antisepsis, but it is not sufficient for high-level disinfection of bronchoscopes unless specifically formulated and validated for this purpose, which is uncommon. Option B (alcohol) is effective against some pathogens but evaporates quickly, fails to penetrate organic material, and is not recommended for HLD of endoscopes due to potential damage to internal components and inadequate sporicidal activity. Option C (phenolic) is suitable for surface disinfection but lacks the efficacy required for high-level disinfection of semi-critical devices like bronchoscopes, as it does not reliably eliminate all microbial threats, including mycobacteria.
The selection of peracetic acid aligns with CBIC's emphasis on evidence-based reprocessing practices to prevent healthcare-associated infections (HAIs) associated with endoscope use (CBIC Practice Analysis,
2022, Domain III: Infection Prevention and Control, Competency 3.4 - Implement environmental cleaning and disinfection protocols). This choice ensures patient safety by adhering to manufacturer and regulatory guidelines, such as those in AAMI ST91 (AAMI ST91:2015, Flexible and semi-rigid endoscope processing in health care facilities).
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.3 - Ensure safe reprocessing of medical equipment, 3.4 - Implement environmental cleaning and disinfection protocols. AAMI ST91:2015, Flexible and semi-rigid endoscope processing in health care facilities. CDC Guidelines for Disinfection and Sterilization in Healthcare Facilities, 2019.
NEW QUESTION # 167
The infection preventionist observed a caregiver entering a room without performing hand hygiene.The BEST response would be to
Answer: A
Explanation:
Immediate feedback is a best practice in behavior correction and performance improvement. In hand hygiene non-compliance, real-time intervention allows for immediate correction, education, and reinforcement of infection prevention policies.
* TheAPIC/JCR Workbookrecommends:
"Provide simulation training... that provides immediate feedback-for example, how to properly insert a urinary catheter or perform hand hygiene." This supports behavior change and staff learning.
* TheAPIC Textemphasizes that real-time, direct feedback is more effective than passive measures like signage or delayed education campaigns.
References:
APIC/JCR Infection Prevention and Control Workbook, 4th Edition, Chapter 6 - Clinical Strategies
NEW QUESTION # 168
A patient with a non-crusted rash has boon diagnosed with Sarcoptes scabiei. The patient is treated with 5% permethrin and precautions are started. The precautions can be stopped
Answer: C
Explanation:
For Sarcoptes scabiei (scabies), Contact Precautions should remain in place until 24 hours after effective treatment has been completed. The first-line treatment is 5% permethrin cream, which is applied to the entire body and left on for 8-14 hours before being washed off.
Why the Other Options Are Incorrect?
* A. When the treatment cream is applied - The mite is still present and infectious until treatment has fully taken effect.
* B. When the bed linen is changed - While changing linens is necessary, it does not indicate that the infestation has cleared.
* D. 24 hours after the second treatment - Most cases require only one treatment with permethrin, though severe cases may need a second dose after a week.
CBIC Infection Control Reference
According to APIC guidelines, Contact Precautions can be discontinued 24 hours after effective treatment has been administered.
NEW QUESTION # 169
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