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CBIC Certified Infection Control Exam Sample Questions (Q21-Q26):

NEW QUESTION # 21
Which of the following statements characterizes the proper use of chemical disinfectants?

A. The label on the solution being used must indicate that it kills all viable micro-organisms.
B. A chemical indicator must be used with items undergoing high-level disinfection.
C. The solution should be adaptable for use as an antiseptic.
D. All items to be processed must be cleaned prior to being submerged in solution.

Answer: D

Explanation:
The proper use of chemical disinfectants is a critical aspect of infection control, as outlined by the Certification Board of Infection Control and Epidemiology (CBIC). Chemical disinfectants are used to eliminate or reduce pathogenic microorganisms on inanimate objects, and their effective application requires adherence to specific protocols to ensure safety and efficacy. Let's evaluate each option based on infection control standards:
* A. All items to be processed must be cleaned prior to being submerged in solution.: This statement is a fundamental principle of disinfectant use. Cleaning (e.g., removing organic material such as blood, tissue, or dirt) is a prerequisite before disinfection because organic matter can inactivate or reduce the effectiveness of chemical disinfectants. The CBIC emphasizes that proper cleaning is the first step in the disinfection process to ensure that disinfectants can reach and kill microorganisms. This step is universally required for all levels of disinfection (low, intermediate, and high), making it a characterizing feature of proper use.
* B. The label on the solution being used must indicate that it kills all viable micro-organisms.: This statement is misleading. No disinfectant can be guaranteed to kill 100% of all viable microorganisms under all conditions, as efficacy depends on factors like contact time, concentration, and the presence of organic material. Disinfectant labels typically indicate the types of microorganisms (e.g., bacteria, viruses, fungi) and the level of disinfection (e.g., high-level, intermediate-level) they are effective against, based on standardized tests (e.g., EPA or FDA guidelines). Claiming that a solution kills all viable microorganisms is unrealistic and not a requirement for proper use; instead, the label must specify the intended use and efficacy, which varies by product.
* C. The solution should be adaptable for use as an antiseptic.: An antiseptic is a chemical agent used on living tissue (e.g., skin) to reduce microbial load, whereas a disinfectant is used on inanimate surfaces.
While some chemicals (e.g., alcohol) can serve both purposes, this is not a requirement for proper disinfectant use. The adaptability of a solution for antiseptic use is irrelevant to its classification or application as a disinfectant, which focuses on environmental or equipment decontamination. This statement does not characterize proper disinfectant use.
* D. A chemical indicator must be used with items undergoing high-level disinfection.: Chemical indicators (e.g., test strips or tapes) are used to verify that the disinfection process has met certain parameters (e.g., concentration or exposure time), particularly in sterilization or high-level disinfection (HLD). While this is a recommended practice for quality assurance in HLD (e.g., with glutaraldehyde or hydrogen peroxide), it is not a universal requirement for all chemical disinfectant use. HLD applies specifically to semi-critical items (e.g., endoscopes), and the need for indicators depends on the protocol and facility standards. This statement is too narrow and specific to characterize the proper use of chemical disinfectants broadly.
The correct answer is A, as cleaning prior to disinfection is a foundational and universally applicable step in the proper use of chemical disinfectants. This aligns with CBIC guidelines, which stress the importance of a clean surface to maximize disinfectant efficacy and prevent infection transmission in healthcare settings.
References:
* CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain IV:
Environment of Care, which mandates cleaning as a prerequisite for effective disinfection.
* CBIC Examination Content Outline, Domain III: Prevention and Control of Infectious Diseases, which includes protocols for the proper use of disinfectants, emphasizing pre-cleaning.
* CDC Guidelines for Disinfection and Sterilization in Healthcare Facilities (2021), which reinforce that cleaning must precede disinfection to ensure efficacy.

NEW QUESTION # 22
A patient with shortness of breath and a history of a tuberculin skin test (TST) of 15 mm induration was admitted to a semi-private room. The infection preventionist's FIRST action should be to

A. contact the roommate's physician to initiate TST.
B. review the patient's medical record to determine the likelihood of pulmonary tuberculosis (TB).
C. report the findings to the Employee Health Department to initiate exposure follow-up of hospital staff.
D. transfer the patient to an airborne infection isolation room and initiate appropriate isolation for tuberculosis (TB).

Answer: B

Explanation:
Before initiating airborne precautions, theinfection preventionist must first confirm the clinical suspicion of active TB.
Step-by-Step Justification:
* Confirming Active TB:
* Apositive tuberculin skin test (TST) alone does not indicate active disease.
* A review ofchest X-ray, symptoms, and risk factorsis needed.
* Medical Record Review:
* Past TB history, imaging, and sputum testingare key to diagnosis.
* Not all TST-positive patients require isolation.
Why Other Options Are Incorrect:
* A. Contact the roommate's physician to initiate TST:Premature, asno confirmation of active TB existsyet.
* C. Report findings to Employee Health for staff follow-up:Should occuronly after TB confirmation
.
* D. Transfer to airborne isolation immediately:Airborne isolation is necessaryonly if active TB is suspected based on clinical findings.
CBIC Infection Control References:

NEW QUESTION # 23
After defining and identifying cases in a possible cluster of infections, an infection preventionist should NEXT establish:

A. A hypothesis that will explain the majority of cases.
B. Whether observed incidence exceeds expected incidence.
C. The route of transmission.
D. An appropriate control group.

Answer: A

Explanation:
When investigating a possible cluster of infections, an infection preventionist (IP) follows a structured epidemiological approach to identify the cause and implement control measures. The Certification Board of Infection Control and Epidemiology (CBIC) outlines this process within the "Surveillance and Epidemiologic Investigation" domain, which aligns with the Centers for Disease Control and Prevention (CDC) guidelines for outbreak investigation. The steps typically include defining and identifying cases, formulating a hypothesis, testing the hypothesis, and implementing control measures. The question specifies the next step after defining and identifying cases, requiring an evaluation of the logical sequence.
Option C, "A hypothesis that will explain the majority of cases," is the next critical step. After confirming a cluster through case definition and identification (e.g., by time, place, and person), the IP should develop a working hypothesis to explain the observed pattern. This hypothesis might propose a common source (e.g., contaminated equipment), a mode of transmission (e.g., airborne), or a specific population at risk. The CDC's
"Principles of Epidemiology in Public Health Practice" (3rd Edition, 2012) emphasizes that formulating a hypothesis is essential to guide further investigation, such as identifying risk factors or environmental sources.
This step allows the IP to focus resources on testing the most plausible explanation before proceeding to detailed analysis or interventions.
Option A, "The route of transmission," is an important element of the investigation but typically follows hypothesis formulation. Determining the route (e.g., contact, droplet, or common vehicle) requires data collection and analysis to test the hypothesis, making it a subsequent step rather than the immediate next action. Option B, "An appropriate control group," is relevant for analytical studies (e.g., case-control studies) to compare exposed versus unexposed individuals, but this is part of hypothesis testing, which occurs after the hypothesis is established. Selecting a control group prematurely, without a hypothesis, lacks direction and efficiency. Option D, "Whether observed incidence exceeds expected incidence," is a preliminary step to define a cluster, often done during case identification using baseline data or statistical thresholds (e.g., exceeding the mean plus two standard deviations). Since the question assumes cases are already defined and identified, this step is complete, and the focus shifts to hypothesis development.
The CBIC Practice Analysis (2022) and CDC guidelines prioritize hypothesis formulation as the logical next step after case identification, enabling a targeted investigation. This approach ensures that the IP can efficiently address the cluster's cause, making Option C the correct answer.
References:
* CBIC Practice Analysis, 2022.
* CDC Principles of Epidemiology in Public Health Practice, 3rd Edition, 2012.

NEW QUESTION # 24
An outbreak of carbapenem-resistant Klebsiella pneumoniae is linked to duodenoscopes. What is the infection preventionist's PRIORITY intervention?

A. Implement immediate enhanced reprocessing procedures and audit compliance.
B. Perform targeted patient screening for Klebsiella pneumoniae.
C. Discontinue the use of duodenoscopes until further notice.
D. Conduct whole-genome sequencing of outbreak isolates.

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 # 25
In which of the following ways is human immunodeficiency virus similar to the Hepatitis B virus?

A. Needlestick exposure leads to a high frequency of healthcare worker infection
B. Transmission may occur from asymptomatic carriers
C. The risk of infection from mucous membrane exposure is the same
D. The primary mechanism of transmission for both is maternal-fetal

Answer: B

Explanation:
The human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) are both bloodborne pathogens that pose significant risks in healthcare settings, and understanding their similarities is crucial for infection prevention and control. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the importance of recognizing transmission modes and implementing appropriate precautions in the
"Prevention and Control of Infectious Diseases" domain, aligning with guidelines from the Centers for Disease Control and Prevention (CDC). Comparing these viruses involves evaluating their epidemiology, transmission routes, and occupational risks.
Option C, "Transmission may occur from asymptomatic carriers," is the correct answer. Both HIV and HBV can be transmitted by individuals who are infected but show no symptoms, making asymptomatic carriage a significant similarity. For HBV, chronic carriers (estimated at 257 million globally per WHO, 2019) can transmit the virus through blood, semen, or other bodily fluids without overt signs of disease. Similarly, HIV- infected individuals can remain asymptomatic for years during the latent phase, yet still transmit the virus through sexual contact, blood exposure, or perinatal transmission. The CDC's "Guidelines for Prevention of Transmission of HIV and HBV to Healthcare Workers" (1987, updated 2011) and "Epidemiology and Prevention of Viral Hepatitis" (2018) highlight this shared characteristic, underscoring the need for universal precautions regardless of symptom status.
Option A, "The primary mechanism of transmission for both is maternal-fetal," is incorrect. While maternal- fetal transmission (perinatal transmission) is a significant route for both HIV and HBV-occurring in 5-10% of cases without intervention for HBV and 15-45% for HIV without antiretroviral therapy-it is not the primary mechanism. For HBV, the primary mode is horizontal transmission through unprotected sexual contact or percutaneous exposure (e.g., needlesticks), accounting for the majority of cases. For HIV, sexual transmission and intravenous drug use are the leading modes globally, with maternal-fetal transmission being a smaller proportion despite its importance. Option B, "Needlestick exposure leads to a high frequency of healthcare worker infection," is partially true but not a precise similarity. Needlestick exposures carry a high risk for HBV (transmission risk ~30% if the source is HBeAg-positive) and a lower risk for HIV (~0.3%), but the frequency of infection among healthcare workers is significantly higher for HBV due to its greater infectivity and stability outside the host. This makes the statement more characteristic of HBV than a shared trait. Option D, "The risk of infection from mucous membrane exposure is the same," is false. The risk of HIV transmission via mucous membrane exposure (e.g., splash to eyes or mouth) is approximately 0.09%, while for HBV it is higher (up to 1-2% depending on viral load and exposure type), reflecting HBV's greater infectivity.
The CBIC Practice Analysis (2022) and CDC guidelines emphasize the role of asymptomatic transmission in shaping infection control strategies, such as routine testing and post-exposure prophylaxis. This shared feature of HIV and HBV justifies Option C as the most accurate similarity.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for Prevention of Transmission of HIV and HBV to Healthcare Workers, 2011.
* CDC Epidemiology and Prevention of Viral Hepatitis, 2018.
* WHO Hepatitis B Fact Sheet, 2019.

NEW QUESTION # 26
......

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CBIC Certified Infection Control Exam Sample Questions (Q21-Q26):

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