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CBIC Certified Infection Control Exam Sample Questions (Q47-Q52):

NEW QUESTION # 47
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?

A. Increase surveillance facility wide for additional cases
B. Contact the laboratory to confirm stool identification results
C. Characterize the outbreak by person, place, and time
D. Form a tentative hypothesis about the potential reservoir for this outbreak

Answer: C

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 # 48
Which of the following represents a class II surgical wound?

A. Incisions involving the biliary tract, appendix, vagina, and oropharynx.
B. Incisions in which acute, nonpurulent inflammation are seen.
C. Old traumatic wounds with retained devitalized tissue.
D. Incisional wounds following nonpenetrating (blunt) trauma.

Answer: B

Explanation:
Surgical wounds are classified by the Centers for Disease Control and Prevention (CDC) into four classes based on the degree of contamination and the likelihood of postoperative infection. This classification system, detailed in the CDC's Guidelines for Prevention of Surgical Site Infections (1999), is a cornerstone of infection prevention and control, aligning with the Certification Board of Infection Control and Epidemiology (CBIC) standards in the "Prevention and Control of Infectious Diseases" domain. The classes are as follows:
* Class I (Clean): Uninfected operative wounds with no inflammation, typically closed primarily, and not involving the respiratory, alimentary, genital, or urinary tracts.
* Class II (Clean-Contaminated): Operative wounds with controlled entry into a sterile or minimally contaminated tract (e.g., biliary or gastrointestinal), with no significant spillage or infection present.
* Class III (Contaminated): Open, fresh wounds with significant spillage (e.g., from a perforated viscus) or major breaks in sterile technique.
* Class IV (Dirty-Infected): Old traumatic wounds with retained devitalized tissue or existing clinical infection.
Option A, "Incisions in which acute, nonpurulent inflammation are seen," aligns with a Class II surgical wound. The presence of acute, nonpurulent inflammation suggests a controlled inflammatory response without overt infection, which can occur in clean-contaminated cases where a sterile tract (e.g., during elective gastrointestinal surgery) is entered under controlled conditions. The CDC defines Class II wounds as those involving minor contamination without significant spillage or infection, and nonpurulent inflammation fits this category, often seen in early postoperative monitoring.
Option B, "Incisional wounds following nonpenetrating (blunt) trauma," does not fit the Class II definition.
These wounds are typically classified based on the trauma context and are more likely to be considered contaminated (Class III) or dirty (Class IV) if there is tissue damage or delayed treatment, rather than clean- contaminated. Option C, "Incisions involving the biliary tract, appendix, vagina, and oropharynx," describes anatomical sites that, when surgically accessed, often fall into Class II if the procedure is elective and controlled (e.g., cholecystectomy), but the phrasing suggests a general category rather than a specific wound state with inflammation, making it less precise for Class II. Option D, "Old traumatic wounds with retained devitalized tissue," clearly corresponds to Class IV (dirty-infected) due to the presence of necrotic tissue and potential existing infection, which is inconsistent with Class II.
The CBIC Practice Analysis (2022) emphasizes the importance of accurate wound classification for implementing appropriate infection prevention measures, such as antibiotic prophylaxis or sterile technique adjustments. The CDC guidelines further specify that Class II wounds may require tailored interventions based on the observed inflammatory response, supporting Option A as the correct answer. Note that the phrasing in Option A contains a minor grammatical error ("inflammation are seen" should be "inflammation is seen"), but this does not alter the clinical intent or classification.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for Prevention of Surgical Site Infections, 1999.

NEW QUESTION # 49
A healthcare personnel has an acute group A streptococcal throat infection. What is the earliest recommended time that this person may return to work after receiving appropriate antibiotic therapy?

A. 48 hours
B. 24 hours
C. 72 hours
D. 8 hours

Answer: B

Explanation:
The correct answer is B, "24 hours," as this is the earliest recommended time that a healthcare personnel with an acute group A streptococcal throat infection may return to work after receiving appropriate antibiotic therapy. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, which align with recommendations from the Centers for Disease Control and Prevention (CDC), healthcare workers with group A Streptococcus (GAS) infections, such as streptococcal pharyngitis, should be treated with antibiotics (e.g., penicillin or a suitable alternative) to eradicate the infection and reduce transmission risk. The CDC and Occupational Safety and Health Administration (OSHA) guidelines specify that healthcare personnel can return to work after at least 24 hours of effective antibiotic therapy, provided they are afebrile and symptoms are improving, as this period is sufficient to significantly reduce the bacterial load and contagiousness (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency
3.2 - Implement measures to prevent transmission of infectious agents).
Option A (8 hours) is too short a duration to ensure the infection is adequately controlled and the individual is no longer contagious. Option C (48 hours) and Option D (72 hours) are longer periods that may apply in some cases (e.g., if symptoms persist or in outbreak settings), but they exceed the minimum recommended time based on current evidence. The 24-hour threshold is supported by studies showing that GAS shedding decreases substantially within this timeframe with appropriate antibiotic treatment, minimizing the risk to patients and colleagues (CDC Guidelines for Infection Control in Healthcare Personnel, 2019).
The infection preventionist's role includes enforcing return-to-work policies to prevent healthcare-associated infections (HAIs), aligning with CBIC's emphasis on timely and evidence-based interventions to control infectious disease transmission in healthcare settings (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.1 - Collaborate with organizational leaders). Compliance with this recommendation also supports occupational health protocols to balance staff safety and patient care.
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.1 - Collaborate with organizational leaders, 3.2 - Implement measures to prevent transmission of infectious agents. CDC Guidelines for Infection Control in Healthcare Personnel, 2019.

NEW QUESTION # 50
An infection preventionist in the role of educator is teaching risk reduction activities to patients and families.
For which of the following groups is the pneumococcal vaccine MOST appropriate?

A. Patients in behavioral health settings
B. Immunocompromised newborns
C. Asplenic patients
D. International travelers

Answer: C

Explanation:
The pneumococcal vaccine is designed to protect against infections caused by Streptococcus pneumoniae, a bacterium responsible for diseases such as pneumonia, meningitis, and bacteremia. The appropriateness of this vaccine depends on the population's risk profile, particularly their susceptibility to invasive pneumococcal disease (IPD). The Certification Board of Infection Control and Epidemiology (CBIC) highlights the role of infection preventionists as educators in promoting vaccination as a key risk reduction strategy, aligning with the "Education and Training" domain (CBIC Practice Analysis, 2022). The Centers for Disease Control and Prevention (CDC) provides specific guidelines on pneumococcal vaccination, recommending it for individuals at higher risk due to underlying medical conditions or immunologic status.
Option A, asplenic patients, refers to individuals who have had their spleen removed (e.g., due to trauma or disease) or have a nonfunctional spleen (e.g., in sickle cell disease). The spleen plays a critical role in clearing encapsulated bacteria like Streptococcus pneumoniae from the bloodstream. Without a functioning spleen, these patients are at significantly increased risk of overwhelming post-splenectomy infection (OPSI), with pneumococcal disease being a leading cause. The CDC and Advisory Committee on Immunization Practices (ACIP) strongly recommend pneumococcal vaccination, including both PCV15/PCV20 and PPSV23, for asplenic patients, making this group the most appropriate for the vaccine in this context. The infection preventionist should prioritize educating these patients and their families about the vaccine's importance and timing.
Option B, international travelers, may benefit from various vaccines depending on their destination (e.g., yellow fever or typhoid), but pneumococcal vaccination is not routinely recommended unless they have specific risk factors (e.g., asplenia or chronic illness) or are traveling to areas with high pneumococcal disease prevalence. This group is not inherently a priority for pneumococcal vaccination. Option C, immunocompromised newborns, includes infants with congenital immunodeficiencies or other conditions, who may indeed require pneumococcal vaccination as part of their routine immunization schedule (e.g., PCV15 or PCV20 starting at 2 months). However, newborns are generally covered under universal childhood vaccination programs, and the question's focus on "MOST appropriate" suggests a group with a more specific, elevated risk, which asplenic patients fulfill. Option D, patients in behavioral health settings, may have varied health statuses, but this group is not specifically targeted for pneumococcal vaccination unless they have additional risk factors (e.g., chronic diseases), making it less appropriate than asplenic patients.
The CBIC emphasizes tailoring education to high-risk populations, and the CDC's Adult and Pediatric Immunization Schedules (2023) identify asplenic individuals as a top priority for pneumococcal vaccination due to their extreme vulnerability. Thus, the infection preventionist should focus on asplenic patients as the group for whom the pneumococcal vaccine is most appropriate.
References:
* CBIC Practice Analysis, 2022.
* CDC Adult Immunization Schedule, 2023.
* CDC Pediatric Immunization Schedule, 2023.
* ACIP Recommendations for Pneumococcal Vaccination, 2022.

NEW QUESTION # 51
Which of the following stains is used to identify mycobacteria?

A. Methylene blue
B. Gram
C. India ink
D. Acid-fast

Answer: D

Explanation:
Mycobacteria, including species such as Mycobacterium tuberculosis and Mycobacterium leprae, are a group of bacteria known for their unique cell wall composition, which contains a high amount of lipid-rich mycolic acids. This characteristic makes them resistant to conventional staining methods and necessitates the use of specialized techniques for identification. The acid-fast stain is the standard method for identifying mycobacteria in clinical and laboratory settings. This staining technique, developed by Ziehl-Neelsen, involves the use of carbol fuchsin, which penetrates the lipid-rich cell wall of mycobacteria. After staining, the sample is treated with acid-alcohol, which decolorizes non-acid-fast organisms, while mycobacteria retain the red color due to their resistance to decolorization-hence the term "acid-fast." This property allows infection preventionists and microbiologists to distinguish mycobacteria from other bacteria under a microscope.
Option B, the Gram stain, is a common differential staining technique used to classify most bacteria into Gram-positive or Gram-negative based on the structure of their cell walls. However, mycobacteria do not stain reliably with the Gram method due to their thick, waxy cell walls, rendering it ineffective for their identification. Option C, methylene blue, is a simple stain used to observe bacterial morphology or as a counterstain in other techniques (e.g., Gram staining), but it lacks the specificity to identify mycobacteria.
Option D, India ink, is used primarily to detect encapsulated organisms such as Cryptococcus neoformans by creating a negative staining effect around the capsule, and it is not suitable for mycobacteria.
The CBIC's "Identification of Infectious Disease Processes" domain underscores the importance of accurate diagnostic methods in infection control, including the use of appropriate staining techniques to identify pathogens like mycobacteria. The acid-fast stain is specifically recommended by the CDC and WHO for the initial detection of mycobacterial infections, such as tuberculosis, in clinical specimens (CDC, Laboratory Identification of Mycobacteria, 2008). This aligns with the CBIC Practice Analysis (2022), which emphasizes the role of laboratory diagnostics in supporting infection prevention strategies.
References:
* CBIC Practice Analysis, 2022.
* CDC Laboratory Identification of Mycobacteria, 2008.
* WHO Guidelines for the Laboratory Diagnosis of Tuberculosis, 2014.

NEW QUESTION # 52
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CBIC Certified Infection Control Exam Sample Questions (Q47-Q52):

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