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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Cleaning, Sterilization, Disinfection, Asepsis | 10-13% | |
| Topic 2: Surveillance and Epidemiologic Investigation | 22-26% | |
| Topic 3: Environment of Care | 10-13% | |
| Topic 4: Preventing/Controlling the Transmission of Infectious Agents | 17-19% | |
| Topic 5: Identification of Infectious Disease Processes | 17-19% | |
| Topic 6: Employee/Occupational Health | 10-13% | |
| Topic 7: Management and Communication | 10-13% | |
| Topic 8: Education and Research | 6-9% |
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質問 # 58
The degree of infectiousness of a patient with tuberculosis correlates with
正解：B
解説：
The infectiousness of tuberculosis (TB) is directly related to the number of Mycobacterium tuberculosis organisms expelled into the air by an infected patient.
Step-by-Step Justification:
* TB Transmission Mechanism:
* TB spreads through airborne droplet nuclei, which remain suspended for long periods.
* Factors Affecting Infectiousness:
* High bacterial load in sputum: Smear-positive patients are much more infectious.
* Coughing and sneezing frequency: More expelled droplets increase exposure risk.
* Environmental factors: Poor ventilation increases transmission.
Why Other Options Are Incorrect:
* A. Hand hygiene habits: TB is airborne, not transmitted via hands.
* B. Presence of acid-fast bacilli (AFB) in blood: TB is not typically hematogenous, and blood AFB does not correlate with infectiousness.
* C. Tuberculin skin test (TST) >20 mm: TST indicates prior exposure, not infectiousness.
CBIC Infection Control References:
* APIC Text, "Tuberculosis Transmission and Control Measures".
質問 # 59
The infection preventionist recognizes that facility renovation projects are associated with risk for healthcare- associated infections (HAIs). What is the primary rationale for this risk?
正解：B
解説：
The Certification Study Guide (6th edition) identifies environmental dispersal of microorganisms as the primary reason healthcare construction and renovation activities increase the risk of healthcare-associated infections (HAIs). Construction activities such as demolition, drilling, and ceiling penetration disturb dust and building materials that may harbor fungal spores and other microorganisms, particularly Aspergillus species.
Once aerosolized, these organisms can spread through airflow to patient care areas if containment and ventilation controls are inadequate.
The study guide emphasizes that immunocompromised patients-such as those in oncology units, transplant units, and intensive care settings-are especially vulnerable to infections caused by airborne fungi released during construction. Numerous outbreaks of invasive aspergillosis have been linked directly to renovation and construction projects that lacked appropriate infection control risk assessment (ICRA) measures.
The incorrect options describe secondary or contributory issues but are not the primary mechanism of infection risk. While increased personnel traffic, hand hygiene training, and waste handling are important considerations, they do not represent the central hazard posed by construction. The fundamental risk is airborne dissemination of microorganisms from disrupted environmental reservoirs.
CIC exam questions frequently test knowledge of construction-related infection risks and the importance of engineering controls such as negative pressure containment, HEPA filtration, and dust barriers. Recognizing environmental dispersal as the primary risk underscores why rigorous planning and infection control oversight are essential during renovation projects.
Reference: Certification Study Guide (CBIC/CIC Exam Study Guide), 6th edition, Chapter 9: Environment of Care.
質問 # 60
A city has a population of 150.000. Thirty new cases of tuberculosis (TB) were diagnosed in the city last year.
These now cases brought the total number of active TB cases in the city last year to 115. Which of the following equations represents the incidence rate tor TB per 100.000 in that year?
正解：A
解説：
The incidence rate is calculated using the formula:
Why the Other Options Are Incorrect?
* B. (30 ÷ 150,000) × 100 = X - Incorrect multiplier (should be 100,000 for standard incidence rate).
* C. (115 ÷ 150,000) × 100,000 = X - 115 represents total cases (prevalence), not incidence.
* D. (115 ÷ 100,000) × 100 = X - Uses the wrong denominator and multiplier.
CBIC Infection Control Reference
APIC defines the incidence rate as the number of new cases per population unit, typically per 100,000 people.
質問 # 61
When a Staphylococcus aureus outbreak is suspected, cultures of which of the following sites will MOST likely identify carriers?
正解：A
解説：
The CBIC Certified Infection Control Exam Study Guide (6th edition) identifies the anterior nares (nose) as the most common and reliable site for colonization with Staphylococcus aureus, including methicillin- resistant Staphylococcus aureus (MRSA). During suspected outbreaks, culturing the nares is the most effective method for identifying persistent carriers, particularly among healthcare personnel or patients who may serve as reservoirs for transmission.
Nasal carriage of S. aureus is well established in epidemiologic literature and infection prevention practice.
Individuals may be persistent carriers, intermittent carriers, or non-carriers, with persistent nasal carriers posing the highest risk for transmission and subsequent infection. The Study Guide emphasizes that nasal colonization strongly correlates with both endogenous infection risk and spread to others, making it the preferred screening site during outbreak investigations.
Hands (Option B) may transiently harbor S. aureus, but hand contamination is temporary and highly variable, making it less useful for identifying long-term carriers. Throat (Option C) and rectum (Option D) are not primary colonization sites for S. aureus and are not routinely used in outbreak screening unless specifically indicated by epidemiologic data.
For CIC exam purposes, this question reinforces a core infection prevention principle: the anterior nares are the primary reservoir for Staphylococcus aureus, and nasal cultures are the most effective method for identifying carriers during outbreak investigations.
質問 # 62
The Sterile Processing Deportment alerts an infection preventionist that a load of surgical Instruments sterilized with high temperature steam:moist heat needs to be recalled. Which of the following Is the MOST likely reason for the recall?
正解：C
解説：
The most likely reason for the recall of a steam-sterilized load is the failure of the biological indicator (BI), specifically Geobacillus stearothermophilus, which is used to monitor high-temperature steam (moist heat) sterilization processes. This organism is the biological indicator of choice because it has high resistance to moist heat and thus serves as a reliable marker for sterilization efficacy.
The APIC Text and AAMI ST79 guidelines confirm that Geobacillus stearothermophilus is used for steam sterilization and that a failed BI indicates a failure in the sterilization process, which requires immediate action, including recalling all items sterilized since the last negative BI and reprocessing them. This is a crucial aspect of ensuring patient safety and preventing the use of potentially non-sterile surgical instruments.
According to the APIC Text:
"BIs are the only process indicators that directly monitor the lethality of a given sterilization process. [...] Geobacillus stearothermophilus spores are used to monitor steam sterilization..." The CIC Study Guide (6th ed.) also specifies that:
"Evidence of sterilization failures (e.g., positive biological indicators) is the most common reason for a recall." Additionally, it is noted:
"With steam sterilization, the instrument load does not need to be recalled for a single positive biological indicator test, with the exception of implantable objects." However, multiple positive BIs or BI failure confirmation does require a recall.
The incorrect options explained:
A). Bacillus subtilis - This is not used in steam sterilization but rather in dry heat or EO processes.
C). Placement of the biological indicator on the bottom shelf over the drain - While incorrect placement can lead to test failure, the recall is prompted by BI failure, not just placement.
D). Incorrect placement of instruments - This can cause sterilization failure but is not the direct trigger for a recall unless it leads to a failed BI.
References:
CIC Study Guide, 6th Edition, Chapter 10 - Cleaning, Sterilization, Disinfection, Asepsis, Pages 211, 236 APIC Text, 4th Edition, Chapter 106 - Sterile Processing ANSI/AAMI ST79:2017, cited throughout APIC Text and APIC 4 for sterilization monitoring protocols.
質問 # 63
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