CBIC Infection Prevention 5 — Questions and Answers
Question 1: When conducting an outbreak investigation, the CORRECT sequence of steps begins with:
- Implementing control measures, then confirming the diagnosis
- Confirming the outbreak exists and verifying the diagnosis before forming a case definition (Correct answer)
- Forming a hypothesis first, then confirming the diagnosis
- Notifying public health, then verifying the diagnosis
Correct answer: Confirming the outbreak exists and verifying the diagnosis before forming a case definition
The first steps of an outbreak investigation are to confirm that a true outbreak exists and verify the diagnosis through laboratory or clinical confirmation before proceeding.
Question 2: Which disinfectant is INEFFECTIVE against Clostridioides difficile spores and should NOT be used as the primary environmental disinfectant during a C. diff outbreak?
- Sodium hypochlorite (bleach) at 1:10 dilution
- Hydrogen peroxide vapor
- Quaternary ammonium compounds (quats) (Correct answer)
- Accelerated hydrogen peroxide
Correct answer: Quaternary ammonium compounds (quats)
Quaternary ammonium compounds are sporicidal-activity–deficient and do not kill C. difficile spores; EPA-registered sporicidal agents such as bleach or hydrogen peroxide vapor are required.
Question 3: An IP notices that CAUTI rates have increased significantly over the past quarter. Which bundle element, if missing, would have the GREATEST direct impact on catheter-associated UTI rates?
- Daily documentation of catheter insertion date
- Daily reassessment of catheter necessity with prompt removal when no longer indicated (Correct answer)
- Use of silver-alloy–coated catheters for all patients
- Routine catheter irrigation with antiseptic solutions
Correct answer: Daily reassessment of catheter necessity with prompt removal when no longer indicated
Daily review and prompt removal of unnecessary urinary catheters is the single highest-impact CAUTI prevention intervention because catheter dwell time is the primary risk factor.
Question 4: Under the OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030), employers are required to offer hepatitis B vaccination to covered employees:
- Only after a documented exposure incident
- Within 10 working days of initial assignment to a job with occupational exposure (Correct answer)
- Annually, with updated booster doses
- Only if the employee requests it in writing
Correct answer: Within 10 working days of initial assignment to a job with occupational exposure
OSHA requires that employers make hepatitis B vaccination available to all employees with occupational exposure within 10 working days of initial job assignment, at no cost to the employee.
Question 5: A critical care nurse is caring for a patient with pandemic influenza requiring enhanced respiratory precautions. When performing an aerosol-generating procedure (AGP), the recommended respirator is at minimum a:
- Surgical mask
- N95 filtering facepiece respirator (Correct answer)
- Powered air-purifying respirator (PAPR) only
- No respiratory protection is needed if gown and gloves are worn
Correct answer: N95 filtering facepiece respirator
AGPs that generate infectious aerosols require at least an N95 respirator (fit-tested), as surgical masks do not provide adequate filtration against small airborne particles.
Question 6: In epidemiology, the 'attack rate' is best defined as:
- The number of deaths divided by the number of cases
- The proportion of exposed persons who develop disease during an outbreak (Correct answer)
- The rate of new infections per 1,000 patient days
- The number of secondary cases caused by one primary case
Correct answer: The proportion of exposed persons who develop disease during an outbreak
Attack rate = (number of new cases ÷ number of persons exposed) × 100, and is commonly used during foodborne outbreak or point-source outbreak investigations.
Question 7: Which of the following is a key purpose of the Infection Control Risk Assessment (ICRA) matrix used during healthcare construction and renovation?
- To determine staffing ratios during construction periods
- To categorize the type of construction activity and patient population risk to select appropriate infection control measures (Correct answer)
- To assign budgets for infection prevention supplies during renovation
- To schedule cleaning frequencies for construction areas
Correct answer: To categorize the type of construction activity and patient population risk to select appropriate infection control measures
The ICRA matrix cross-references the type of construction/renovation activity with the risk level of surrounding patient populations to determine required barrier and ventilation controls.
CBIC Infection Prevention 5
When conducting an outbreak investigation, the CORRECT sequence of steps begins with: