CBIC Infection Prevention 4 — Questions and Answers
Question 1: A patient on droplet precautions needs to be transported to radiology. Which action should the IP recommend?
- Transport is contraindicated until the patient is off precautions
- Place a surgical mask on the patient and notify receiving area in advance (Correct answer)
- The transporting staff wear N95 respirators and no mask on the patient is needed
- Transport only with a portable HEPA filtration unit
Correct answer: Place a surgical mask on the patient and notify receiving area in advance
For transport of patients on droplet precautions, a surgical mask is placed on the patient to contain respiratory secretions, and the receiving department is notified to prepare.
Question 2: Which element of the hierarchy of controls is considered most effective for preventing occupational exposure to infectious aerosols?
- Administrative controls such as training
- Personal protective equipment
- Engineering controls such as HEPA ventilation (Correct answer)
- Work practice controls
Correct answer: Engineering controls such as HEPA ventilation
Engineering controls (e.g., negative-pressure rooms, HEPA filtration, biosafety cabinets) are highest in the hierarchy because they eliminate or reduce hazards at the source without relying on worker behavior.
Question 3: An IP is investigating a cluster of MRSA infections in a neonatal ICU. Which specimen collection approach is used to identify colonized patients during an outbreak?
- Blood cultures from all neonates
- Active surveillance cultures from anterior nares and/or perirectal swabs (Correct answer)
- Routine urine cultures
- Wound cultures only from symptomatic patients
Correct answer: Active surveillance cultures from anterior nares and/or perirectal swabs
Active surveillance cultures (ASC) of anatomical sites such as the anterior nares detect MRSA colonization in asymptomatic patients, identifying the reservoir driving transmission.
Question 4: According to the CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC), which surface is considered a 'high-touch' environmental surface requiring frequent disinfection?
- Ceiling tiles
- Window sills
- Bed rails and call buttons (Correct answer)
- Floor drains
Correct answer: Bed rails and call buttons
High-touch surfaces such as bed rails, call buttons, and overbed tables are frequently contacted by patients and staff and serve as vehicles for pathogen transmission.
Question 5: Which formula correctly calculates incidence density rate for HAIs in a surveillance report?
- (Number of HAIs / Number of patients) × 1,000
- (Number of HAIs / Number of patient days) × 1,000 (Correct answer)
- (Number of HAIs / Number of admissions) × 100
- (Number of new cases / Population at risk) × 10,000
Correct answer: (Number of HAIs / Number of patient days) × 1,000
Incidence density rate divides the number of HAIs by the total patient days (device days for device-associated rates) and multiplies by 1,000 to account for varying lengths of stay.
Question 6: A healthcare worker who received the 2-dose hepatitis B vaccine series shows anti-HBs titer < 10 mIU/mL one to two months after completing the series. The recommended next step is:
- Declare the HCW a non-responder and take no further action
- Administer a second complete 3-dose series and retest (Correct answer)
- Administer HBIG immediately
- Repeat the titer in 6 months without further vaccination
Correct answer: Administer a second complete 3-dose series and retest
Non-responders to the initial hepatitis B series should receive a second full 3-dose series; approximately 50% of initial non-responders will respond to revaccination.
Question 7: Which of the following is a key principle of 'bare below the elbows' (BBE) policy in infection prevention?
- It replaces the need for gloves during patient care
- It removes wrist jewelry and long sleeves to improve hand hygiene effectiveness (Correct answer)
- It applies only to surgical personnel in the OR
- It is an optional add-on to standard hand hygiene policy
Correct answer: It removes wrist jewelry and long sleeves to improve hand hygiene effectiveness
BBE policies require removal of watches, rings, and rolled-up-sleeve barriers to ensure thorough hand and wrist decontamination during patient care.
CBIC Infection Prevention 4
A patient on droplet precautions needs to be transported to radiology.
Which action should the IP recommend?