CDCES Safety and Infection Control 3 — Questions and Answers
Question 1: A patient reports storing insulin pens in the refrigerator but notices the injection site burns severely. What is the MOST likely contributing factor?
- The insulin is past its expiration date
- Cold insulin is being injected directly from the refrigerator (Correct answer)
- The needle gauge is too large for the patient's skin thickness
- The patient is injecting too quickly
Correct answer: Cold insulin is being injected directly from the refrigerator
Injecting cold insulin can cause pain and tissue irritation; insulin should be brought to room temperature before injection.
Question 2: During a home visit, a CDCES observes a patient recapping used insulin pen needles and storing them for reuse. What is the PRIMARY safety concern with this practice?
- It increases the risk of air bubble formation in subsequent injections
- Residual insulin in the needle can crystallize and clog the device
- Repeated use increases needle trauma, skin flora introduction, and infection risk (Correct answer)
- It reduces the accuracy of dose delivery due to needle dead-space changes
Correct answer: Repeated use increases needle trauma, skin flora introduction, and infection risk
Reusing pen needles dulls the tip, damages the coating, and can introduce skin bacteria into the subcutaneous tissue, raising infection risk.
Question 3: What is the recommended minimum distance between insulin injection sites during site rotation to prevent lipohypertrophy?
- 0.5 cm (about 0.2 inches)
- 1 cm (about 0.4 inches)
- 2 cm (about 0.8 inches) (Correct answer)
- 5 cm (about 2 inches)
Correct answer: 2 cm (about 0.8 inches)
Injections should be spaced at least 1–2 cm apart within a region to avoid repeated trauma and lipohypertrophy formation.
Question 4: A CDCES is counseling a patient about insulin pump infusion set changes. How often should infusion sets typically be changed to minimize infection risk?
- Every 24 hours
- Every 2–3 days (Correct answer)
- Every 5–7 days
- Only when blood glucose becomes unexpectedly elevated
Correct answer: Every 2–3 days
Infusion sets should be changed every 2–3 days to prevent site infections, occlusions, and insulin degradation.
Question 5: A patient with diabetic peripheral neuropathy reports stepping on a nail but feeling minimal pain. What is the MOST important immediate action to teach?
- Apply hydrogen peroxide and a bandage, then reassess in three days
- Seek immediate medical evaluation regardless of pain level (Correct answer)
- Soak the foot in warm Epsom salt water for 30 minutes twice daily
- Monitor for redness and swelling and call if symptoms worsen over 48 hours
Correct answer: Seek immediate medical evaluation regardless of pain level
Any puncture wound in a person with diabetes and neuropathy requires immediate medical evaluation due to the high risk of rapid infection progression.
Question 6: Which of the following is a key element of standard precautions that a CDCES should teach to a patient performing home blood glucose monitoring?
- Wearing sterile gloves for every fingerstick procedure
- Washing hands thoroughly with soap and water before and after testing (Correct answer)
- Disinfecting the glucometer with bleach solution after each use
- Performing fingersticks only on the dominant hand to ensure consistency
Correct answer: Washing hands thoroughly with soap and water before and after testing
Hand hygiene before and after fingerstick testing is the cornerstone of infection prevention and also improves accuracy of blood glucose readings.
Question 7: A school nurse asks a CDCES about policies for students sharing glucose tablets during hypoglycemia emergencies. What is the best guidance?
- Sharing is acceptable in emergencies if the student has symptoms of hypoglycemia
- Each student should have their own personal supply of glucose tablets that are not shared (Correct answer)
- Glucose tablets can be shared if they are placed in the student's hand without direct contact
- Schools are required by law to maintain a shared community supply of glucose tablets
Correct answer: Each student should have their own personal supply of glucose tablets that are not shared
Each student with diabetes should have their own personal supply of glucose tablets to prevent cross-contamination and ensure access to treatment.
CDCES Safety and Infection Control 3
A patient reports storing insulin pens in the refrigerator but notices the injection site burns severely.
What is the MOST likely contributing factor?