FFICM Safety and Infection Control 3 — Questions and Answers
Question 1: Which Candida species is inherently resistant to fluconazole and requires echinocandin treatment?
- Candida albicans
- Candida parapsilosis
- Candida krusei (Correct answer)
- Candida tropicalis
Correct answer: Candida krusei
Candida krusei has intrinsic resistance to fluconazole and should be treated with an echinocandin or amphotericin B.
Question 2: A healthcare worker sustains a needlestick injury from a patient with unknown HIV status. What is the first step?
- Start post-exposure prophylaxis (PEP) immediately without further steps
- Wash the site thoroughly with soap and water and report to occupational health (Correct answer)
- Test the healthcare worker for HIV and wait for results before acting
- Squeeze the wound to express blood, then apply iodine
Correct answer: Wash the site thoroughly with soap and water and report to occupational health
Immediate thorough washing with soap and water followed by prompt reporting to occupational health is the first step after needlestick injury.
Question 3: Which of the following is the most important factor in preventing surgical site infections (SSIs) in ICU patients returning from surgery?
- Prolonged prophylactic antibiotic courses postoperatively
- Maintaining normothermia and normoglycemia perioperatively (Correct answer)
- Applying topical antibiotics to all wounds
- Keeping wounds covered with occlusive dressings for 14 days
Correct answer: Maintaining normothermia and normoglycemia perioperatively
Normothermia and tight glycemic control are key evidence-based measures that significantly reduce SSI rates.
Question 4: In the context of ICU infection control, what does 'cohorting' mean?
- Grouping patients with the same infection or colonization together in a designated area (Correct answer)
- Assigning one nurse to all infected patients across the unit
- Placing all infected patients in negative-pressure rooms
- Transferring infected patients to a separate hospital
Correct answer: Grouping patients with the same infection or colonization together in a designated area
Cohorting involves grouping colonized or infected patients together and dedicating specific staff to care for them, reducing pathogen spread.
Question 5: What is the main mode of transmission of Clostridioides difficile in the ICU?
- Airborne droplet nuclei
- Fecal-oral route via contact with spore-contaminated surfaces and hands (Correct answer)
- Bloodborne exposure
- Respiratory secretions
Correct answer: Fecal-oral route via contact with spore-contaminated surfaces and hands
C. difficile spreads via spores on contaminated surfaces; transmission is fecal-oral through hand contact with these surfaces.
Question 6: Why is alcohol-based hand rub (ABHR) insufficient for Clostridioides difficile infection control?
- ABHR has poor coverage against gram-positive bacteria
- ABHR does not kill C. difficile spores (Correct answer)
- ABHR is inactivated by organic material only
- ABHR causes skin colonization with C. difficile
Correct answer: ABHR does not kill C. difficile spores
Alcohol does not destroy C. difficile spores; soap and water with mechanical friction is required to physically remove spores from hands.
Question 7: A ventilated patient's endotracheal tube cuff pressure should be maintained at what level to reduce VAP risk from microaspiration?
- 5–10 cmH2O
- 15–20 cmH2O
- 25–30 cmH2O (Correct answer)
- 35–40 cmH2O
Correct answer: 25–30 cmH2O
Maintaining cuff pressure between 25–30 cmH2O reduces microaspiration of subglottic secretions, a key mechanism in VAP development.
FFICM Safety and Infection Control 3
Which Candida species is inherently resistant to fluconazole and requires echinocandin treatment?