Employee & Occupational Health Flashcards

A healthcare worker is found to have a positive IGRA test during annual TB screening. Her previous baseline IGRA was negative. The NEXT step in management is:

Answer: Obtain a chest radiograph to rule out active tuberculosis disease

A new positive IGRA (conversion) requires a chest X-ray to exclude active TB disease before treating for latent TB infection.

Which factor MOST increases the risk of HIV transmission following a percutaneous needlestick injury from an HIV-positive source patient?

Answer: Deep injury with a hollow-bore needle containing visible blood from a patient with high viral load

Deep injuries with hollow-bore needles contaminated with blood from high-viral-load patients carry the greatest transmission risk after percutaneous exposure.

Healthcare workers with which condition should generally be excluded from caring for severely immunocompromised patients?

Answer: Active herpes zoster (shingles) with uncovered, weeping lesions

Active herpes zoster with open lesions poses a transmission risk to immunocompromised patients through direct contact.

The MOST effective administrative control for reducing sharps injuries in a healthcare setting is:

Answer: Implementing a sharps safety device selection and evaluation program

Engineering controls such as safety-engineered sharps devices are more effective than behavioral interventions because they remove or reduce the hazard at the source.

Under which circumstance may a healthcare worker with active pulmonary tuberculosis return to work?

Answer: After three consecutive negative sputum smears and clinical improvement on effective therapy

Return-to-work requires clinical improvement, effective therapy, and three consecutive AFB-negative sputum smears to ensure non-infectiousness.

An employee health nurse is reviewing vaccination records for new hires. Which vaccine is recommended for all healthcare personnel who lack evidence of immunity, regardless of prior vaccination history?

Answer: Varicella vaccine

ACIP and CDC recommend varicella vaccination for all healthcare personnel without documented immunity, as varicella poses patient and worker risk.

A hospital implements a respiratory protection program. Who is responsible for ensuring that the written program is in place, respirators are selected appropriately, and fit testing is conducted?

Answer: The employer (hospital administration)

OSHA places the ultimate responsibility for the respiratory protection program — including written plans, proper respirator selection, and fit testing — on the employer.