CIC - Certification in Infection Prevention and Control Employee & Occupational Health Questions and Answers — Questions and Answers
Question 1: A newly hired healthcare worker with a history of a previously positive Tuberculosis (TB) skin test provides a documented normal chest x-ray from one year ago. According to current CDC guidelines, what is the MOST appropriate next step for the pre-placement TB screening process?
- Repeat the chest x-ray to establish a new baseline.
- Perform a two-step Tuberculin Skin Test (TST) to check for boosting.
- Administer an Interferon-Gamma Release Assay (IGRA) blood test.
- Conduct a TB symptom screen and an individual risk assessment. (Correct answer)
Correct answer: Conduct a TB symptom screen and an individual risk assessment.
For healthcare personnel with a documented history of a positive TB test and a normal chest x-ray, repeat testing is not recommended. The focus shifts to screening for active disease. Current CDC guidelines state that these individuals should receive a baseline individual TB risk assessment and a TB symptom screen upon hire.
Question 2: An unvaccinated nurse sustains a needlestick injury from a hollow-bore needle used on a source patient who is known to be HBsAg-positive (chronic Hepatitis B infection). The nurse has not previously received the Hepatitis B vaccine. What is the most critical immediate post-exposure management step?
- Administer the first dose of the Hepatitis B vaccine only.
- Administer Hepatitis B Immune Globulin (HBIG) only.
- Administer both HBIG and the first dose of the Hepatitis B vaccine. (Correct answer)
- Draw blood for baseline serology and await results before treatment.
Correct answer: Administer both HBIG and the first dose of the Hepatitis B vaccine.
For an unvaccinated person exposed to a known HBsAg-positive source, post-exposure prophylaxis should include both Hepatitis B Immune Globulin (HBIG) for immediate passive immunity and the first dose of the Hepatitis B vaccine series for long-term active immunity. These should be administered as soon as possible, preferably within 24 hours.
Question 3: Which of the following scenarios requires implementation of work restrictions for an asymptomatic healthcare worker with no evidence of immunity?
- A brief, masked encounter with a patient later diagnosed with pertussis.
- An unprotected exposure to a patient with active pulmonary tuberculosis.
- Sharing a breakroom with a coworker who later developed influenza.
- An unprotected exposure to a patient with confirmed measles (rubeola). (Correct answer)
Correct answer: An unprotected exposure to a patient with confirmed measles (rubeola).
Measles is highly contagious. Asymptomatic, non-immune healthcare workers exposed to measles must be excluded from work, typically from day 5 after the first exposure through day 21 after the last exposure, to prevent potential transmission during the incubation period. For many other diseases like pertussis or tuberculosis, work restrictions for asymptomatic staff are not typically required if post-exposure prophylaxis is administered or they are monitored for symptoms.
Question 4: A hospital's Occupational Health department is updating its employee immunization policy to align with CDC recommendations for healthcare personnel. Which vaccine is considered essential and should be offered to all employees with potential exposure to blood or body fluids?
- Meningococcal (MenACWY)
- Hepatitis A
- Hepatitis B (Correct answer)
- Polio
Correct answer: Hepatitis B
The OSHA Bloodborne Pathogens standard mandates that employers make the Hepatitis B vaccination series available at no cost to all employees who have occupational exposure to blood or other potentially infectious materials. While other vaccines like MMR, Varicella, Tdap, and Influenza are also recommended for healthcare workers, the Hepatitis B vaccine is specifically required by OSHA for those with bloodborne pathogen exposure risk.
Question 5: A healthcare worker reports to occupational health with a fever and cough. The facility is experiencing a community-wide influenza outbreak. According to CDC guidelines for healthcare settings, what is the minimum recommended duration for work exclusion?
- For at least 5 days from symptom onset.
- Until the cough has completely resolved.
- For at least 24 hours after their fever resolves without the use of fever-reducing medications. (Correct answer)
- Until a negative influenza rapid antigen test is obtained.
Correct answer: For at least 24 hours after their fever resolves without the use of fever-reducing medications.
CDC guidelines recommend that healthcare personnel with influenza-like illness should be excluded from work for at least 24 hours after they are no longer febrile, without the aid of fever-reducing medicines like acetaminophen or ibuprofen.
Question 6: Under the OSHA Bloodborne Pathogens Standard, which of the following is a required component of an employer's Exposure Control Plan?
- A mandate for all employees to receive the influenza vaccine annually.
- A policy requiring post-exposure prophylaxis for all sharps injuries, regardless of source patient status.
- The identification and use of safer medical devices and needleless systems. (Correct answer)
- A requirement for N95 respirator fit-testing for all clinical staff.
Correct answer: The identification and use of safer medical devices and needleless systems.
The OSHA Bloodborne Pathogens Standard, as amended by the Needlestick Safety and Prevention Act, requires employers to establish an Exposure Control Plan. This plan must include the evaluation and implementation of safer medical devices, such as sharps with engineered sharps injury protections and needleless systems, to eliminate or minimize employee exposure.
CIC - Certification in Infection Prevention and Control Employee & Occupational Health Questions and Answers
A newly hired healthcare worker with a history of a previously positive Tuberculosis (TB) skin test provides a documented normal chest x-ray from one year ago.
According to current CDC guidelines, what is the MOST appropriate next step for the pre-placement TB screening process?