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CBIC CIC Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Environment of Care10%- Water and air quality management
- Facility design, construction, and renovation
- Safety and risk assessment
- Waste management and environmental services
Topic 2: Employee and Occupational Health10%- Health screening and surveillance
- Immunization programs
- Exposure management and post-exposure prophylaxis
- Workplace safety policies
Topic 3: Identification of Infectious Disease Processes19%- Epidemiologic principles
- Emerging and re-emerging pathogens
- Microbiology and pathogenesis
- Risk factors and transmission mechanisms
Topic 4: Surveillance and Epidemiologic Investigation24%- Surveillance system design and implementation
- Outbreak investigation and response
- Benchmarking and reporting
- Data collection, validation, and analysis
Topic 5: Prevention and Control of Transmission of Infectious Agents28%- Antimicrobial stewardship
- Isolation and patient placement
- Standard and transmission-based precautions
- Hand hygiene and aseptic techniques
- Cleaning, disinfection, and sterilization
Topic 6: Education, Research, and Quality Improvement9%- Development and delivery of education programs
- Performance measurement and quality improvement
- Regulatory and accreditation compliance
- Evidence-based practice and research application

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CBIC Certified Infection Control Exam Sample Questions (Q144-Q149):

NEW QUESTION # 144
Peripherally inserted central catheter (PICC)-associated bloodstream infections (BSIs) have been increasing over the past four months. Which of the following interventions is MOST likely to have contributed to the increase?

Answer: B

Explanation:
Peripherally inserted central catheter (PICC)-associated bloodstream infections (BSIs) are a significant concern in healthcare settings, and identifying factors contributing to their increase is critical for infection prevention. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the
"Surveillance and Epidemiologic Investigation" and "Prevention and Control of Infectious Diseases" domains, which align with the Centers for Disease Control and Prevention (CDC) guidelines for preventing intravascular catheter-related infections. The question asks for the intervention most likely to have contributed to the rise in PICC-associated BSIs over four months, requiring an evaluation of each option based on evidence-based practices.
Option C, "Replacement of the intravenous administration sets every 72 hours," is the most likely contributor to the increase. The CDC's "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017) recommend that intravenous administration sets (e.g., tubing for fluids or medications) be replaced no more frequently than every 72-96 hours unless clinically indicated (e.g., contamination or specific therapy requirements). Frequent replacement, such as every 72 hours as a routine practice, can introduce opportunities for contamination during the change process, especially if aseptic technique is not strictly followed. Studies cited in the CDC guidelines, including those by O'Grady et al. (2011), indicate that unnecessary manipulation of catheter systems increases the risk of introducing pathogens, potentially leading to BSIs. A change to a 72- hour replacement schedule, if not previously standard, could explain the observed increase over the past four months.
Option A, "Use of chlorhexidine skin antisepsis during insertion of the PICC," is a recommended practice to reduce BSIs. Chlorhexidine, particularly in a 2% chlorhexidine gluconate with 70% alcohol solution, is the preferred skin antiseptic for catheter insertion due to its broad-spectrum activity and residual effect, as supported by the CDC (2017). This intervention should decrease, not increase, infection rates, making it an unlikely contributor. Option B, "Daily bathing adult intensive care unit patients with chlorhexidine," is another evidence-based strategy to reduce healthcare-associated infections, including BSIs, by decolonizing the skin of pathogens like Staphylococcus aureus. The CDC and SHEA (Society for Healthcare Epidemiology of America) guidelines (2014) endorse chlorhexidine bathing in intensive care units, suggesting it should lower, not raise, BSI rates. Option D, "Use of a positive pressure device on the PICC," aims to prevent catheter occlusion and reduce the need for frequent flushing, which could theoretically decrease infection risk by minimizing manipulation. However, there is no strong evidence linking positive pressure devices to increased BSIs; if improperly used or maintained, they might contribute marginally, but this is less likely than the impact of frequent tubing changes.
The CBIC Practice Analysis (2022) and CDC guidelines highlight that deviations from optimal catheter maintenance practices, such as overly frequent administration set replacements, can increase infection risk.
Given the four-month timeframe and the focus on an intervention's potential negative impact, Option C stands out as the most plausible contributor due to the increased manipulation and contamination risk associated with routine 72-hour replacements.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2017.
* O'Grady, N. P., et al. (2011). Guidelines for the Prevention of Intravascular Catheter-Related Infections. Clinical Infectious Diseases.
* SHEA Compendium, Strategies to Prevent Central Line-Associated Bloodstream Infections, 2014.


NEW QUESTION # 145
An outbreak of carbapenem-resistant Klebsiella pneumoniae is linked to duodenoscopes. What is the infection preventionist's PRIORITY intervention?

Answer: A

Explanation:
* The CDC and FDA have identified duodenoscopes as high-risk devices due to inadequate reprocessing, leading to MDRO transmission.
* The first priority is enhancing reprocessing protocols and ensuring strict compliance with manufacturer instructions.
CBIC Infection Control References:
* APIC Text, "Endoscope Reprocessing and Infection Risk," Chapter 10.


NEW QUESTION # 146
The infection preventionist notes an increase in Clostridioides difficile infections (CDI) in the ICU. A Root Cause Analysis (RCA) is scheduled. What is the goal of a Root Cause Analysis?

Answer: A


NEW QUESTION # 147
An infection preventionist (IP) is notified that a patient who underwent an endoscopic brain biopsy the night before has been diagnosed with prion disease. Because the diagnosis was thought to be unlikely but possible at the time of the biopsy, the endoscope was sequestered. The endoscope manufacturer's instructions for reprocessing indicate that the endoscope can be reprocessed using high-level disinfection or low-temperature sterilization. The IP should recommend that the endoscope be:

Answer: C

Explanation:
The CBIC Certified Infection Control Exam Study Guide (6th edition) identifies prion diseases (such as Creutzfeldt-Jakob disease) as unique and extremely challenging from an infection prevention standpoint due to the extraordinary resistance of prions to conventional disinfection and sterilization methods. Prions are not destroyed by standard high-level disinfection, low-temperature sterilization, ethylene oxide, or hydrogen peroxide gas plasma, even when manufacturer instructions for use suggest these methods for routine pathogens.
Invasive neurologic procedures involving high-risk tissues (brain, spinal cord, posterior eye) pose the greatest transmission risk. When a reusable device such as an endoscope is used on high-risk tissue in a patient with known or suspected prion disease, and the device cannot tolerate validated prion-inactivation protocols, the Study Guide recommends removal from service and disposal.
While harsh chemical treatments such as 1N sodium hydroxide or high-concentration bleach combined with extended steam sterilization may be effective for heat-resistant surgical instruments, flexible endoscopes and similar devices cannot safely undergo these processes without damage. Therefore, reprocessing is not acceptable in this scenario.
Autoclaving alone and low-temperature sterilization methods are ineffective against prions. As a result, the safest and recommended action is to bag the device as biohazardous waste and discard it, preventing any risk of iatrogenic transmission.
For the CIC exam, this question tests recognition that manufacturer IFUs do not supersede prion-specific infection prevention guidance, and patient safety requires device destruction when prion exposure cannot be reliably mitigated.


NEW QUESTION # 148
During the last week in June, an emergency department log reveals numerous cases of profuse watery diarrhea in individuals 74 years of age and older. During the same time period, four immunocompromised patients were admitted with possible Cryptosporidium. Which of the following actions should the infection preventionist take FIKST?

Answer: B

Explanation:
When an outbreak of infectious disease is suspected, the first step is to conduct an epidemiologic investigation. This begins with characterizing the outbreak by person, place, and time to establish patterns and trends. This approach, known as descriptive epidemiology, provides critical insights into potential sources and transmission patterns.
Step-by-Step Justification:
* Identify Cases and Patterns:
* The infection preventionist should analyze patient demographics (person), locations of cases (place), and onset of symptoms (time). This helps in defining the outbreak scope and potential exposure sources.
* Create an Epidemic Curve:
* An epidemic curve helps determine whether the outbreak is a point-source or propagated event.
This can indicate whether the infection is spreading person-to-person or originating from a common source.
* Compare with Baseline Data:
* Reviewing historical data ensures that the observed cases exceed the expected norm, confirming an outbreak.
* Guide Further Investigation:
* Establishing basic epidemiologic patterns guides subsequent actions, such as laboratory testing, environmental sampling, and surveillance.
Why Other Options Are Incorrect:
* B. Increase surveillance facility-wide for additional cases:
* While enhanced surveillance is important, it should follow the initial characterization of the outbreak. Surveillance without a defined case profile may lead to misclassification and misinterpretation.
* C. Contact the laboratory to confirm stool identification results:
* Confirming lab results is essential but comes after defining the outbreak's characteristics. Without an epidemiologic link, testing may yield results that are difficult to interpret.
* D. Form a tentative hypothesis about the potential reservoir for this outbreak:
* Hypothesis generation occurs after sufficient epidemiologic data have been collected. Jumping to conclusions without characterization may result in incorrect assumptions and ineffective control measures.
CBIC Infection Control References:
* APIC Text, "Outbreak Investigations," Epidemiology, Surveillance, Performance, and Patient Safety Measures.
* APIC/JCR Infection Prevention and Control Workbook, Chapter 4, Surveillance Program.
* APIC Text, "Investigating Infectious Disease Outbreaks," Guidelines for Epidemic Curve Analysis.


NEW QUESTION # 149
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