CIC Prevention Practices 3 — Questions and Answers
Question 1: Which surgical site infection (SSI) prevention measure is recommended for patients undergoing elective colorectal surgery?
- Routine bowel preparation with oral antibiotics alone
- Skin preparation with alcohol-based chlorhexidine gluconate (Correct answer)
- Hair removal with a razor the morning of surgery
- Maintaining normothermia only during wound closure
Correct answer: Skin preparation with alcohol-based chlorhexidine gluconate
Alcohol-based chlorhexidine gluconate is the preferred skin antiseptic agent for SSI prevention because it has superior residual activity compared to povidone-iodine alone.
Question 2: A healthcare worker has a needlestick exposure from an HIV-positive source patient with a detectable viral load. Within what time frame should post-exposure prophylaxis (PEP) ideally be initiated?
- Within 1 hour
- Within 72 hours (Correct answer)
- Within 7 days
- Within 14 days
Correct answer: Within 72 hours
PEP should ideally be started as soon as possible and within 72 hours of exposure for maximum effectiveness.
Question 3: When is it appropriate to use droplet precautions in addition to standard precautions?
- For patients with active pulmonary tuberculosis
- For patients with influenza (Correct answer)
- For patients with C. difficile diarrhea
- For patients with MRSA wound infections
Correct answer: For patients with influenza
Influenza spreads via respiratory droplets (>5 microns), requiring droplet precautions including a surgical mask within 3 feet of the patient.
Question 4: Which action BEST reduces the risk of surgical smoke inhalation hazards for OR personnel?
- Wearing a standard surgical mask during all laser and electrosurgical procedures
- Using a smoke evacuation system at the point of generation (Correct answer)
- Increasing room air exchanges during surgery
- Double-gloving for all laparoscopic cases
Correct answer: Using a smoke evacuation system at the point of generation
A smoke evacuation system captures surgical plume at the source, providing the most effective protection against chemical and biological hazards in surgical smoke.
Question 5: A patient is placed on droplet precautions for pertussis. Which mask should the patient wear when transported through the hospital?
- N95 respirator
- Surgical/procedure mask (Correct answer)
- Powered air-purifying respirator
- No mask is required for the patient
Correct answer: Surgical/procedure mask
Patients on droplet precautions should wear a surgical mask when leaving their room to contain respiratory secretions during transport.
Question 6: Which sterilization method is MOST appropriate for heat-sensitive flexible endoscopes?
- Steam autoclave at 132°C
- Dry heat oven at 170°C
- High-level disinfection with glutaraldehyde or peracetic acid (Correct answer)
- Ethylene oxide gas sterilization
Correct answer: High-level disinfection with glutaraldehyde or peracetic acid
Flexible endoscopes cannot withstand the heat of autoclave or dry heat and are routinely processed with high-level disinfection, which eliminates all organisms except high numbers of bacterial spores.
Question 7: During a point-prevalence survey, the infection preventionist identifies patients colonized with carbapenem-resistant Enterobacterales (CRE). Which intervention is MOST important to implement?
- Transfer all colonized patients to a single cohort unit
- Place colonized patients on contact precautions (Correct answer)
- Initiate decolonization with oral rifaximin
- Restrict antibiotic use facility-wide
Correct answer: Place colonized patients on contact precautions
Contact precautions are the cornerstone intervention to prevent horizontal transmission of CRE in healthcare settings.
CIC Prevention Practices 3
Which surgical site infection (SSI) prevention measure is recommended for patients undergoing elective colorectal surgery?