CBIC Employee Health 4 — Questions and Answers
Question 1: Under OSHA's Bloodborne Pathogen Standard, employers must offer hepatitis B vaccination to at-risk employees:
- At no cost to the employee, within 10 working days of assignment (Correct answer)
- Within 30 days, with a co-pay allowed
- Only after a documented exposure incident
- After a 90-day probationary period
Correct answer: At no cost to the employee, within 10 working days of assignment
OSHA mandates that employers provide hepatitis B vaccination at no cost within 10 working days of initial assignment for at-risk employees.
Question 2: A healthcare worker declines the influenza vaccine due to personal beliefs. The facility's most effective response to protect patients is:
- Require the worker to wear a surgical mask throughout the flu season (Correct answer)
- Document the declination and take no further action
- Terminate the employee
- Reassign permanently to non-patient-care areas
Correct answer: Require the worker to wear a surgical mask throughout the flu season
Many accrediting bodies and health departments support masking requirements for unvaccinated HCWs during influenza season as an alternative protective measure.
Question 3: Which of the following is the MOST important element in preventing occupational transmission of bloodborne pathogens?
- Use of safety-engineered sharps devices and proper disposal (Correct answer)
- Wearing double gloves for all procedures
- Annual blood testing of all healthcare workers
- Restricting HIV-positive patients to private rooms
Correct answer: Use of safety-engineered sharps devices and proper disposal
Engineering controls such as safety-engineered sharps devices are the hierarchy's first line of defense against bloodborne pathogen exposure.
Question 4: A healthcare worker is newly diagnosed with varicella (chickenpox). When may they return to work?
- When all lesions have fully crusted over (Correct answer)
- After 5 days from rash onset
- After completing a 7-day antiviral course
- After a negative PCR for VZV
Correct answer: When all lesions have fully crusted over
Varicella is contagious until all lesions are completely crusted; return to work is permitted only after this milestone.
Question 5: Which baseline laboratory test is routinely recommended at the time of hire for healthcare workers to establish immunity to hepatitis B?
- Hepatitis B surface antibody (anti-HBs) titer (Correct answer)
- Hepatitis B core antibody (anti-HBc)
- Hepatitis B surface antigen (HBsAg)
- HBV viral load by PCR
Correct answer: Hepatitis B surface antibody (anti-HBs) titer
Anti-HBs titer testing confirms protective immunity from prior vaccination or infection at the time of employment.
Question 6: An employee health program is evaluating a healthcare worker who is a non-responder to three doses of hepatitis B vaccine. The next step should be:
- Administer a second 3-dose series and retest anti-HBs titer (Correct answer)
- Test for HBsAg to rule out chronic infection
- Offer hepatitis B immune globulin prophylaxis
- Accept non-immune status and document declination
Correct answer: Administer a second 3-dose series and retest anti-HBs titer
CDC recommends a second 3-dose series followed by anti-HBs retesting for workers who do not respond to the initial series.
Question 7: When must an employer in the United States record a needlestick or sharps injury on the OSHA 300 log?
- Always, as needlestick injuries are automatically recordable (Correct answer)
- Only if the worker requires medical treatment beyond first aid
- Only if the source patient is known to be infected
- Only if the worker is hospitalized overnight
Correct answer: Always, as needlestick injuries are automatically recordable
Under OSHA's Recordkeeping Rule, all needlestick and sharps injuries involving contamination are automatically recordable regardless of treatment needed.
CBIC Employee Health 4
Under OSHA's Bloodborne Pathogen Standard, employers must offer hepatitis B vaccination to at-risk employees: