CIC Environment of Care 2 — Questions and Answers
Question 1: Which ventilation parameter is most critical for maintaining negative pressure in an airborne infection isolation room (AIIR)?
- Supply air volume exceeding exhaust air volume
- Exhaust air volume exceeding supply air volume (Correct answer)
- Equal supply and exhaust air volumes
- Recirculated air exceeding fresh air intake
Correct answer: Exhaust air volume exceeding supply air volume
Negative pressure rooms require exhaust airflow to exceed supply airflow so contaminated air flows inward rather than escaping to hallways.
Question 2: What is the recommended minimum number of air changes per hour (ACH) for a standard patient care room according to ASHRAE 170?
- 2 ACH
- 4 ACH
- 6 ACH (Correct answer)
- 12 ACH
Correct answer: 6 ACH
ASHRAE 170 recommends a minimum of 6 total air changes per hour for standard patient care rooms, with at least 2 being outdoor air.
Question 3: During construction in a healthcare facility, which method best controls fungal spore dispersal to protect immunocompromised patients?
- Placing HEPA air purifiers in patient rooms only
- Installing negative pressure anteroom barriers with HEPA filtration at the construction zone (Correct answer)
- Increasing hand hygiene frequency among construction workers
- Spraying antifungal agents on construction surfaces daily
Correct answer: Installing negative pressure anteroom barriers with HEPA filtration at the construction zone
Negative pressure barriers with HEPA filtration at the construction zone prevent Aspergillus and other fungal spores from migrating to patient care areas.
Question 4: Which surface in a patient room has consistently been identified as a high-touch surface with the greatest pathogen contamination burden?
- Window ledge
- Patient bed rail (Correct answer)
- Room light switch near the door
- IV pole
Correct answer: Patient bed rail
Bed rails are among the highest-touch surfaces in patient rooms and consistently harbor pathogens including MRSA, VRE, and C. difficile.
Question 5: A facility is upgrading its HVAC system. Which filter efficiency rating is required for areas housing severely immunocompromised patients such as bone marrow transplant recipients?
- MERV 8
- MERV 14
- MERV 17 (HEPA) (Correct answer)
- MERV 6
Correct answer: MERV 17 (HEPA)
HEPA filters (MERV 17 or higher, 99.97% efficiency at 0.3 microns) are required for protective environment rooms serving severely immunocompromised patients.
Question 6: When should terminal cleaning of a patient room occur?
- Only when the patient had a confirmed infection
- After every patient discharge regardless of infection status (Correct answer)
- Weekly during the patient's stay
- Only when visible soiling is present
Correct answer: After every patient discharge regardless of infection status
Terminal cleaning after every patient discharge removes potential pathogens left by any patient, not just those with known infections.
Question 7: Which water system problem in healthcare facilities is most directly associated with Legionella pneumophila outbreaks?
- Cold water stored below 10°C
- Hot water maintained above 60°C at the heater
- Water stagnation in low-flow areas and temperatures between 25–45°C (Correct answer)
- High chlorine residuals in distribution lines
Correct answer: Water stagnation in low-flow areas and temperatures between 25–45°C
Legionella thrives in water temperatures of 25–45°C and proliferates in stagnant areas such as seldom-used outlets, dead-end pipes, and cooling towers.
CIC Environment of Care 2
Which ventilation parameter is most critical for maintaining negative pressure in an airborne infection isolation room (AIIR)?