ADM Safety & Infection Control 2 — Questions and Answers
Question 1: Which bloodborne pathogen poses the highest risk of transmission following a needlestick injury from an infected source?
- HIV
- Hepatitis C virus (HCV)
- Hepatitis B virus (HBV) (Correct answer)
- Hepatitis D virus (HDV)
Correct answer: Hepatitis B virus (HBV)
HBV has the highest transmission risk per needlestick at 6–30%, compared to HCV at 1.8% and HIV at 0.3%.
Question 2: A patient in an opioid treatment program reports sharing injection equipment last week. What is the recommended initial action?
- Initiate HIV post-exposure prophylaxis immediately
- Perform baseline HIV, HBV, and HCV testing (Correct answer)
- Refer the patient to an infectious disease specialist
- Prescribe a 28-day course of antiretrovirals
Correct answer: Perform baseline HIV, HBV, and HCV testing
Baseline serologic testing for HIV, HBV, and HCV is the first step to establish the patient's current infection status before any further intervention.
Question 3: Standard precautions in addiction medicine settings require gloves when performing which of the following tasks?
- Taking a patient's blood pressure
- Performing a venipuncture for lab draw (Correct answer)
- Conducting a motivational interview
- Reviewing a patient's prescription history
Correct answer: Performing a venipuncture for lab draw
Gloves are required for any procedure involving potential contact with blood or body fluids, such as venipuncture.
Question 4: A patient with active pulmonary tuberculosis is admitted to an inpatient detoxification unit. What isolation precaution is required?
- Contact precautions only
- Droplet precautions
- Airborne precautions with negative-pressure room (Correct answer)
- Protective environment
Correct answer: Airborne precautions with negative-pressure room
Active pulmonary TB requires airborne precautions, including placement in a negative-pressure room and N95 respirator use by staff.
Question 5: Which needle safety practice is most effective in preventing needlestick injuries among clinicians providing addiction medicine services?
- Recapping needles with two hands after use
- Using needles with engineered sharps injury protection (ESIP) (Correct answer)
- Wearing double gloves during all injections
- Bending needles before disposal
Correct answer: Using needles with engineered sharps injury protection (ESIP)
Engineered sharps injury protection devices are the most effective intervention for preventing needlestick injuries.
Question 6: Which of the following infections is most commonly associated with skin-popping (subcutaneous injection) of illicit drugs?
- Infective endocarditis
- Wound botulism
- Necrotizing fasciitis (Correct answer)
- Septic arthritis
Correct answer: Necrotizing fasciitis
Necrotizing fasciitis is a severe soft tissue infection particularly associated with subcutaneous and intramuscular injection of illicit drugs.
Question 7: What is the primary rationale for offering hepatitis A and B vaccination to patients with substance use disorder?
- These infections are curable if caught early
- Patients with SUD have elevated risk due to behaviors and comorbidities (Correct answer)
- Vaccination prevents all liver disease in this population
- Insurance mandates vaccination for SUD patients
Correct answer: Patients with SUD have elevated risk due to behaviors and comorbidities
Patients with SUD are at elevated risk for HAV and HBV due to behaviors such as injection drug use, homelessness, and sexual risk factors.
ADM Safety & Infection Control 2
Which bloodborne pathogen poses the highest risk of transmission following a needlestick injury from an infected source?