CIC Employee & Occupational Health 5 — Questions and Answers
Question 1: A healthcare worker receives a fingerstick from a patient's lancet. The source patient is unknown. What is the MOST appropriate initial action regarding HIV PEP?
- Always initiate PEP regardless of circumstances
- Assess the exposure risk and consider PEP based on facility protocol and clinical judgment (Correct answer)
- Never initiate PEP for lancet injuries
- Wait 24 hours for source patient identification before deciding
Correct answer: Assess the exposure risk and consider PEP based on facility protocol and clinical judgment
PEP decisions for unknown sources should be individualized using risk assessment, the nature of the exposure, and local HIV prevalence rather than automatic initiation or refusal.
Question 2: Which of the following is the BEST example of a work practice control to reduce bloodborne pathogen exposure?
- Using a sharps container with a self-closing lid
- Prohibiting recapping needles by a two-handed technique (Correct answer)
- Wearing double gloves during venipuncture
- Installing needle-free IV connection systems
Correct answer: Prohibiting recapping needles by a two-handed technique
Prohibiting two-handed recapping is a work practice control — it changes the behavior itself — whereas safety devices are engineering controls.
Question 3: A healthcare worker is diagnosed with pertussis (whooping cough). The recommended work exclusion period after starting appropriate antibiotic treatment is:
- Until completion of the full 5-day antibiotic course
- 5 days after starting effective antibiotic therapy (Correct answer)
- Until cough resolves completely
- 14 days regardless of treatment
Correct answer: 5 days after starting effective antibiotic therapy
Healthcare workers with pertussis may return to work 5 days after initiating effective antimicrobial therapy, as they are considered non-infectious by that point.
Question 4: An infection preventionist is evaluating sharps injury data. The highest rate of injuries is occurring during which phase of device use?
- During the procedure itself
- After use but before disposal — during recapping, passing, or cleanup (Correct answer)
- During disposal into sharps containers
- During device unpacking before use
Correct answer: After use but before disposal — during recapping, passing, or cleanup
Studies consistently show most sharps injuries occur after use and before or during disposal, particularly during recapping and transfer activities.
Question 5: A healthcare worker with a documented anti-HBs titer of 5 mIU/mL after completing the initial hepatitis B vaccine series should:
- Be considered immune and require no further action
- Receive a second complete 3-dose vaccine series and retest (Correct answer)
- Receive a single booster dose and retest in 1-2 months
- Be classified as a non-responder after retesting once
Correct answer: Receive a second complete 3-dose vaccine series and retest
Workers who do not respond adequately to the first series should receive a second 3-dose series followed by post-vaccination serologic testing.
Question 6: Which term describes a healthcare worker who has a positive TST or IGRA result but no symptoms, normal chest X-ray, and no evidence of active tuberculosis disease?
- Active tuberculosis case
- Latent tuberculosis infection (LTBI) (Correct answer)
- Tuberculosis converter
- Suspected tuberculosis
Correct answer: Latent tuberculosis infection (LTBI)
Latent TB infection is defined by immune sensitization to M. tuberculosis without clinical, bacteriological, or radiographic evidence of active disease.
Question 7: What is the primary purpose of an occupational health pre-placement evaluation for a new healthcare worker?
- To determine salary grade based on physical capabilities
- To establish a health baseline, assess immunity, and identify risks that may require job modification (Correct answer)
- To screen exclusively for communicable diseases
- To fulfill HIPAA documentation requirements
Correct answer: To establish a health baseline, assess immunity, and identify risks that may require job modification
Pre-placement evaluations establish baselines for future comparisons, assess vaccination immunity status, and identify conditions requiring accommodations or restrictions.
CIC Employee & Occupational Health 5
A healthcare worker receives a fingerstick from a patient's lancet.
The source patient is unknown.
What is the MOST appropriate initial action regarding HIV PEP?