FFICM Safety and Infection Control 2 — Questions and Answers
Question 1: Which catheter-related bloodstream infection (CRBSI) prevention bundle element has the strongest evidence?
- Daily chlorhexidine bathing
- Maximal sterile barrier precautions during insertion (Correct answer)
- Antibiotic-impregnated catheters for all patients
- Routine catheter changes every 72 hours
Correct answer: Maximal sterile barrier precautions during insertion
Maximal sterile barrier precautions (cap, mask, gown, gloves, full drape) during central line insertion is a core evidence-based bundle element reducing CRBSI.
Question 2: A patient develops fever on day 5 post-intubation. Ventilator-associated pneumonia (VAP) is suspected. Which criterion is required for VAP diagnosis?
- Temperature >38°C alone
- New or progressive radiographic infiltrate plus clinical signs of infection (Correct answer)
- Positive sputum culture only
- Elevated CRP with tachycardia
Correct answer: New or progressive radiographic infiltrate plus clinical signs of infection
VAP diagnosis requires new or progressive pulmonary infiltrate on imaging combined with at least two of: fever, leukocytosis, and purulent secretions.
Question 3: In a patient with a suspected healthcare-associated infection (HAI), what is the preferred specimen timing for blood cultures?
- After antibiotics are started to assess efficacy
- Immediately before initiating empirical antibiotics (Correct answer)
- Only during high fever spikes >39°C
- 48 hours after suspected onset
Correct answer: Immediately before initiating empirical antibiotics
Blood cultures should be drawn before antibiotics are given to maximize yield and avoid false-negative results.
Question 4: Which isolation precaution is required for a patient colonized with carbapenem-resistant Enterobacteriaceae (CRE)?
- Droplet precautions
- Airborne precautions
- Contact precautions (Correct answer)
- Reverse isolation only
Correct answer: Contact precautions
CRE is transmitted via direct or indirect contact, so contact precautions (gloves and gown) are required.
Question 5: What is the primary benefit of chlorhexidine gluconate (CHG) daily bathing in ICU patients?
- Eradicates MRSA nasal carriage
- Reduces healthcare-associated bloodstream infections (Correct answer)
- Prevents ventilator-associated pneumonia directly
- Eliminates Clostridium difficile spores on skin
Correct answer: Reduces healthcare-associated bloodstream infections
Daily CHG bathing reduces skin bacterial burden and is associated with decreased rates of central line-associated bloodstream infections (CLABSIs).
Question 6: Which intervention is MOST effective in preventing catheter-associated urinary tract infections (CAUTIs)?
- Using silver-alloy catheters routinely
- Maintaining a closed sterile drainage system and daily catheter need review (Correct answer)
- Irrigating the catheter with antiseptic solutions daily
- Changing urinary catheters every 72 hours
Correct answer: Maintaining a closed sterile drainage system and daily catheter need review
Maintaining a closed drainage system and performing daily review to remove unnecessary catheters is the most effective CAUTI prevention strategy.
Question 7: A nurse notices that the alcohol hand rub dispenser is empty during a busy shift. According to hand hygiene guidelines, what is the appropriate action?
- Use gloves as a substitute until refilled
- Use soap and water as an equivalent alternative for all moments
- Report and replace the dispenser; use soap and water as interim (Correct answer)
- Skip hand hygiene if gloves will be worn
Correct answer: Report and replace the dispenser; use soap and water as interim
Dispensers must be replaced promptly; soap and water is an acceptable interim substitute, and hand hygiene must not be omitted.
FFICM Safety and Infection Control 2
Which catheter-related bloodstream infection (CRBSI) prevention bundle element has the strongest evidence?