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CBIC Certified Infection Control Exam Sample Questions (Q112-Q117):

NEW QUESTION # 112
An infection preventionist is informed that there is a possible cluster of streptococcal meningitis in the neonatal intensive care unit. Which of the following streptococcal serogroops is MOST commonly associated with meningitis in neonates beyond one week of age?

A. Group C
B. Group B
C. Group A
D. Group D

Answer: B

Explanation:
Group B Streptococcus (Streptococcus agalactiae) is the most common cause of neonatal bacterial meningitis beyond one week of age.
Step-by-Step Justification:
* Group B Streptococcus (GBS) and Neonatal Infections:
* GBS is a leading cause of late-onset neonatal meningitis (occurring after 7 days of age).
* Infection typically occurs through vertical transmission from the mother or postnatal exposure.
* Neonatal Risk Factors:
* Premature birth, prolonged rupture of membranes, and maternal GBS colonization increase risk.
Why Other Options Are Incorrect:
* A. Group A: Rare in neonates and more commonly associated with pharyngitis and skin infections.
* C. Group C: Typically associated with animal infections and rarely affects humans.
* D. Group D: Includes Enterococcus, which can cause neonatal infections but is not the most common cause of meningitis.
CBIC Infection Control References:
* APIC Text, "Group B Streptococcus and Neonatal Meningitis".

NEW QUESTION # 113
An outbreak of Candida auris is suspected in the infection preventionist's (IP) facility. The IP's investigation must be conducted in a standard method and communication is critical. Which first step is MOST important?

A. Perform analytical studies
B. Plan to prevent future outbreaks
C. Notify facility administration
D. Conduct environmental cultures

Answer: C

Explanation:
In an outbreak investigation, the first critical step is to notify facility administration and other key stakeholders. This ensures the rapid mobilization of resources, coordination with infection control teams, and compliance with regulatory reporting requirements.
Why the Other Options Are Incorrect?
* A. Conduct environmental cultures - While environmental sampling may be necessary, it is not the first step. The outbreak must first be confirmed and administration alerted.
* B. Plan to prevent future outbreaks - Prevention planning happens later after the outbreak has been investigated and controlled.
* D. Perform analytical studies - Data analysis occurs after case definition and initial response measures are in place.
CBIC Infection Control Reference
APIC guidelines state that the first step in an outbreak investigation is confirming the outbreak and notifying key stakeholders.

NEW QUESTION # 114
An employee is presenting to Occupational Health for clearance prior to starting work at a healthcare facility.
They have a history of having received the Bacillus Calmette-Guérin (BCG) vaccination. What is the preferred methodology for pre-work clearance?

A. Referral to tuberculosis (TB) clinic
B. Interferon-gamma release assay
C. Two-step purified protein derivative-based Tuberculin skin test (TST)
D. Initial chest radiograph

Answer: B

Explanation:
The preferred methodology for pre-work clearance in this scenario is the interferon-gamma release assay (IGRA), making option C the correct choice. This conclusion is supported by the guidelines from the Certification Board of Infection Control and Epidemiology (CBIC), which align with recommendations from the Centers for Disease Control and Prevention (CDC) for tuberculosis (TB) screening in healthcare workers.
The employee's history of receiving the Bacillus Calmette-Guérin (BCG) vaccination, a vaccine commonly used in some countries to prevent severe forms of TB, is significant because it can cause false-positive results in the traditional Tuberculin skin test (TST) due to cross-reactivity with BCG antigens (CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competency 1.3 - Apply principles of epidemiology).
The IGRA, such as the QuantiFERON-TB Gold test, measures the release of interferon-gamma from T-cells in response to specific TB antigens (e.g., ESAT-6 and CFP-10) that are not present in BCG or most non- tuberculous mycobacteria. This makes it a more specific and reliable test for detecting latent TB infection (LTBI) in individuals with a history of BCG vaccination, avoiding the false positives associated with the TST.
The CDC recommends IGRA over TST for BCG-vaccinated individuals when screening for TB prior to healthcare employment (CDC Guidelines for Preventing Transmission of Mycobacterium tuberculosis, 2005, updated 2019).
Option A (referral to tuberculosis clinic) is a general action but not a specific methodology for clearance; it may follow testing if results indicate further evaluation is needed. Option B (initial chest radiograph) is used to detect active TB disease rather than latent infection and is not a primary screening method for pre-work clearance, though it may be indicated if IGRA results are positive. Option D (two-step purified protein derivative-based Tuberculin skin test) is less preferred because the BCG vaccination can lead to persistent cross-reactivity, reducing its specificity and reliability in this context. The two-step TST is typically used to establish a baseline in unvaccinated individuals with potential prior exposure, but it is not ideal for BCG- vaccinated individuals.
The IP's role includes ensuring accurate TB screening to protect both the employee and patients, aligning with CBIC's focus on preventing transmission of infectious diseases in healthcare settings (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents).
References: CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competency 1.3 - Apply principles of epidemiology; Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents. CDC Guidelines for Preventing Transmission of Mycobacterium tuberculosis, 2005, updated 2019.

NEW QUESTION # 115
Following recent renovations on an oncology unit, three patients were identified with Aspergillus infections.
The infections were thought to be facility-acquired. Appropriate environmental microbiological monitoring would be to culture the:

A. Air
B. Carpet
C. Ice
D. Aerators

Answer: A

Explanation:
The scenario describes an outbreak of Aspergillus infections among three patients on an oncology unit following recent renovations, with the infections suspected to be facility-acquired. Aspergillus is a mold commonly associated with environmental sources, particularly airborne spores, and its presence in immunocompromised patients (e.g., oncology patients) poses a significant risk. The infection preventionist must identify the appropriate environmental microbiological monitoring strategy, guided by the Certification Board of Infection Control and Epidemiology (CBIC) and CDC recommendations. Let's evaluate each option:
* A. Air: Aspergillus species are ubiquitous molds that thrive in soil, decaying vegetation, and construction dust, and they are primarily transmitted via airborne spores. Renovations can disturb these spores, leading to aerosolization and inhalation by vulnerable patients. Culturing the air using methods such as settle plates, air samplers, or high-efficiency particulate air (HEPA) filtration monitoring is a standard practice to detect Aspergillusduring construction or post-renovation in healthcare settings, especially oncology units where patients are at high risk for invasive aspergillosis. This aligns with CBIC's emphasis on environmental monitoring for airborne pathogens, making it the most appropriate choice.
* B. Ice: Ice can be a source of contamination with bacteria (e.g., Pseudomonas, Legionella) or other pathogens if improperly handled or stored, but it is not a typical reservoir for Aspergillus, which is a mold requiring organic material and moisture for growth. While ice safety is important in infection control, culturing ice is irrelevant to an Aspergillus outbreak linked to renovations and is not a priority in this context.
* C. Carpet: Carpets can harbor dust, mold, and other microorganisms, especially in high-traffic or poorly maintained areas. Aspergillus spores could theoretically settle in carpet during renovations, but carpets are not a primary source of airborne transmission unless disturbed (e.g., vacuuming). Culturing carpet might be a secondary step if air sampling indicates widespread contamination, but it is less direct and less commonly recommended as the initial monitoring site compared to air sampling.
* D. Aerators: Aerators (e.g., faucet aerators) can harbor waterborne pathogens like Pseudomonas or Legionella due to biofilm formation, but Aspergillus is not typically associated with water systems unless there is significant organic contamination or aerosolization from water sources (e.g., cooling towers). Culturing aerators is relevant for waterborne outbreaks, not for an Aspergillus outbreak linked to renovations, making this option inappropriate.
The best answer is A, culturing the air, as Aspergillus is an airborne pathogen, and renovations are a known risk factor for spore dispersal in healthcare settings. This monitoring strategy allows the infection preventionist to confirm the source, assess the extent of contamination, and implement control measures (e.g., enhanced filtration, construction barriers) to protect patients. This is consistent with CBIC and CDC guidelines for managing fungal outbreaks in high-risk units.
:
CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain IV:
Environment of Care, which recommends air sampling for Aspergillus during construction-related outbreaks.
CBIC Examination Content Outline, Domain III: Prevention and Control of Infectious Diseases, which includes environmental monitoring for facility-acquired infections.
CDC Guidelines for Environmental Infection Control in Healthcare Facilities (2022), which advocate air culturing to detect Aspergillus post-renovation in immunocompromised patient areas.

NEW QUESTION # 116
A nurse claims to have acquired hepatitis A virus infection as the result of occupational exposure. The source patient had an admitting diagnosis of viral hepatitis. Further investigation of this incident reveals a 5-day interval between exposure and onset of symptoms in the nurse. The patient has immunoglobulin G antibodies to hepatitis A. From the evidence, the infection preventionist may correctly conclude which of the following?

A. The evidence at this time fails to support the nurse's claim.
B. The 5-day incubation period is consistent with hepatitis A virus transmission.
C. The nurse should be given hepatitis A virus immunoglobulin.
D. The patient has serologic evidence of recent hepatitis A viral infection.

Answer: A

Explanation:
The infection preventionist's (IP) best conclusion, based on the provided evidence, is that the evidence at this time fails to support the nurse's claim of acquiring hepatitis A virus (HAV) infection through occupational exposure. This conclusion is grounded in the clinical and epidemiological understanding of HAV, as aligned with the Certification Board of Infection Control and Epidemiology (CBIC) guidelines. Hepatitis A typically has an incubation period ranging from 15 to 50 days, with an average of approximately 28-30 days, following exposure to the virus (CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competency 1.3 - Apply principles of epidemiology). The reported 5-day interval between exposure and symptom onset in the nurse is significantly shorter than the expected incubation period, making it inconsistent with HAV transmission. Additionally, the presence of immunoglobulin G (IgG) antibodies in the source patient indicates past exposure or immunity to HAV, rather than an active or recent infection, which would typically be associated with immunoglobulin M (IgM) antibodies during the acute phase.
Option A (the nurse should be given hepatitis A virus immunoglobulin) is not supported because post- exposure prophylaxis with HAV immunoglobulin is recommended only within 14 days of exposure to a confirmed case with active infection, and the evidence here does not confirm a recent exposure or active case.
Option C (the patient has serologic evidence of recent hepatitis A viral infection) is incorrect because IgG antibodies signify past infection or immunity, not a recent infection, which would require IgM antibodies.
Option D (the 5-day incubation period is consistent with hepatitis A virus transmission) is inaccurate due to the mismatch with the known incubation period of HAV.
The IP's role includes critically evaluating epidemiological data to determine the likelihood of transmission events. The discrepancy in the incubation period and the serologic status of the patient suggest that the nurse's claim may not be substantiated by the current evidence, necessitating further investigation rather than immediate intervention or acceptance of the claim. This aligns with CBIC's emphasis on accurate identification and investigation of infectious disease processes (CBIC Practice Analysis, 2022, Domain I:
Identification of Infectious Disease Processes, Competency 1.2 - Investigate suspected outbreaks or exposures).
References: CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competencies 1.2 - Investigate suspected outbreaks or exposures, 1.3 - Apply principles of epidemiology.

NEW QUESTION # 117
......

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CBIC Certified Infection Control Exam Sample Questions (Q112-Q117):

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