CBIC Test 4 — Questions and Answers
Question 1: When performing a root cause analysis (RCA) after an HAI cluster, which tool is most useful for systematically identifying contributing factors?
- Pareto chart
- Run chart
- Fishbone (Ishikawa) diagram (Correct answer)
- Scatter plot
Correct answer: Fishbone (Ishikawa) diagram
A fishbone diagram organizes potential causes into categories (e.g., people, process, equipment) and helps teams systematically identify root causes.
Question 2: Which reprocessing method achieves the highest level of microbial kill, including destruction of all bacterial spores?
- Pasteurization
- High-level disinfection
- Sterilization (Correct answer)
- Intermediate-level disinfection
Correct answer: Sterilization
Sterilization destroys all forms of microbial life including bacterial endospores, making it the highest level of microbial kill.
Question 3: A new nurse asks which body fluids require standard precautions. Which response is most accurate?
- Only blood and visibly bloody fluids
- All body fluids, secretions, and excretions except sweat (Correct answer)
- Only fluids from known HIV-positive patients
- Blood, semen, and vaginal secretions only
Correct answer: All body fluids, secretions, and excretions except sweat
Standard precautions apply to all body fluids, secretions, and excretions (except sweat), non-intact skin, and mucous membranes regardless of known infection status.
Question 4: Which organization publishes the National Healthcare Safety Network (NHSN) surveillance protocols used as the US standard for HAI reporting?
- The Joint Commission (TJC)
- Centers for Disease Control and Prevention (CDC) (Correct answer)
- Occupational Safety and Health Administration (OSHA)
- Centers for Medicare & Medicaid Services (CMS)
Correct answer: Centers for Disease Control and Prevention (CDC)
The CDC develops and maintains NHSN, the nation's most widely used HAI tracking system used by healthcare facilities across the country.
Question 5: A community hospital reports a cluster of post-cesarean SSIs caused by a single strain of Staphylococcus aureus. Which approach is the priority first step in the investigation?
- Close the operating room immediately
- Review the case line list and compare case demographics, procedures, and staff involved (Correct answer)
- Mandate universal decolonization of all surgical patients
- Replace all surgical instruments
Correct answer: Review the case line list and compare case demographics, procedures, and staff involved
Constructing a line list to identify commonalities among cases is the priority first step to generate hypotheses about the source and transmission route.
Question 6: Which factor most directly increases a patient's susceptibility to infection during hospitalization?
- Being in a private room
- Presence of an indwelling urinary catheter (Correct answer)
- Having a family member visit daily
- Receiving oral rather than IV medications
Correct answer: Presence of an indwelling urinary catheter
Indwelling urinary catheters bypass host defenses by providing a direct portal of entry for microorganisms into the bladder, significantly increasing UTI risk.
Question 7: Which contact time (wet contact time) is required for a disinfectant to achieve its labeled efficacy?
- The surface must remain visibly wet for the full contact time specified on the label (Correct answer)
- A quick wipe is sufficient as long as the surface appears clean
- Any contact time between 15 and 60 seconds is acceptable for all products
- Contact time requirements only apply to high-touch surfaces
Correct answer: The surface must remain visibly wet for the full contact time specified on the label
The surface must remain visibly wet for the full contact time stated on the EPA-registered label for the disinfectant to achieve its claimed kill.
CBIC Test 4
When performing a root cause analysis (RCA) after an HAI cluster, which tool is most useful for systematically identifying contributing factors?