Free CHSP Infection Prevention and Control Questions and Answers 1 — Questions and Answers
Question 1: A patient is admitted with suspected pulmonary tuberculosis (TB). To protect healthcare workers and other patients, which of the following infection control measures is the MOST critical to implement immediately?
- Placing the patient in a negative-pressure Airborne Infection Isolation Room (AIIR). (Correct answer)
- Requiring all staff to wear standard surgical masks when in the patient's room.
- Implementing Droplet Precautions for the patient.
- Initiating environmental cleaning with a sporicidal disinfectant.
Correct answer: Placing the patient in a negative-pressure Airborne Infection Isolation Room (AIIR).
According to CDC guidelines, patients with suspected or confirmed infectious pulmonary tuberculosis must be placed in an AIIR. This specialized room has monitored negative pressure relative to surrounding areas, preventing airborne infectious particles from escaping the room. Staff must use, at a minimum, an N95 respirator, as standard surgical masks do not protect against inhalation of small airborne droplet nuclei. TB is transmitted via the airborne route, not by droplets, and it is not a spore-forming organism, making sporicidal agents unnecessary.
Question 2: A hospital is planning a major renovation project in an area adjacent to the neonatal intensive care unit (NICU). To proactively manage the risks of healthcare-associated infections from construction dust and debris, the safety professional should facilitate which formal process before work begins?
- A Root Cause Analysis (RCA).
- An Infection Control Risk Assessment (ICRA). (Correct answer)
- A Failure Mode and Effects Analysis (FMEA).
- A Hazard Vulnerability Analysis (HVA).
Correct answer: An Infection Control Risk Assessment (ICRA).
An Infection Control Risk Assessment (ICRA) is a mandatory, multidisciplinary process used in healthcare facilities to evaluate the potential risk of infection from construction, renovation, or maintenance activities. The ICRA process determines the specific infection control measures required (e.g., barriers, negative air pressure, HEPA filtration) based on the type of construction and the risk level of the adjacent patient population. An RCA is a reactive process used after an event, FMEA analyzes potential process failures, and HVA is a broader assessment for emergency management planning.
Question 3: According to Spaulding's classification system, a flexible endoscope that will be used for a colonoscopy is considered which type of medical device and requires what minimum level of reprocessing?
- Non-critical; requires low-level disinfection.
- Critical; requires sterilization.
- Semi-critical; requires high-level disinfection. (Correct answer)
- Non-critical; requires cleaning and intermediate-level disinfection.
Correct answer: Semi-critical; requires high-level disinfection.
A flexible endoscope is classified as a semi-critical device because it comes into contact with mucous membranes. According to Spaulding's classification, semi-critical items must, at a minimum, undergo high-level disinfection to eliminate all microorganisms except for high numbers of bacterial spores. Critical items enter sterile tissue and require sterilization, while non-critical items touch only intact skin and need low-level disinfection.
Question 4: A healthcare worker receives a needlestick from a contaminated sharp used on a source patient whose infectious status is unknown. After providing immediate first aid, what is the employer's primary responsibility to the employee under OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030)?
- Discipline the employee for an unsafe act to prevent recurrence.
- Require the employee to begin post-exposure prophylaxis (PEP) within two hours.
- Report the incident to the state health department within 24 hours.
- Make a confidential medical evaluation and follow-up available at no cost. (Correct answer)
Correct answer: Make a confidential medical evaluation and follow-up available at no cost.
OSHA's Bloodborne Pathogens standard (29 CFR 1910.1030) explicitly requires employers to make a confidential medical evaluation and follow-up available to an employee who has experienced an exposure incident. This must be provided at no cost to the employee and at a reasonable time and place. This process includes documentation, testing the source individual (with consent), testing the exposed employee (with consent), counseling, and post-exposure prophylaxis if medically indicated.
Question 5: A nurse is caring for a patient with profuse diarrhea confirmed to be caused by *Clostridioides difficile*. In addition to wearing a gown and gloves (Contact Precautions), which hand hygiene practice is required after removing PPE?
- Using an alcohol-based hand rub with at least 60% alcohol.
- Performing a surgical hand scrub with an antiseptic agent.
- Placing the patient in an Airborne Infection Isolation Room (AIIR).
- Washing hands vigorously with soap and water. (Correct answer)
Correct answer: Washing hands vigorously with soap and water.
*C. difficile* produces spores that are resistant to the killing effects of alcohol-based hand sanitizers. The CDC recommends washing hands with soap and water after caring for a patient with *C. difficile*. The physical friction of washing and rinsing is necessary to remove the spores from the hands. Contact precautions, including a gown and gloves, are also essential, but the specific hand hygiene method is critical for preventing transmission.
Question 6: A hospital's quality improvement team is implementing an evidence-based bundle to reduce Central Line-Associated Bloodstream Infections (CLABSIs). Which of the following interventions is a core component of a standard CLABSI prevention bundle?
- Changing the central line dressing every 24 hours regardless of condition.
- Daily review of line necessity with prompt removal when no longer needed. (Correct answer)
- Administering prophylactic systemic antibiotics during the life of the catheter.
- Routinely replacing the central line every 72 hours.
Correct answer: Daily review of line necessity with prompt removal when no longer needed.
A key component of the Institute for Healthcare Improvement (IHI) and CDC CLABSI prevention bundles is the daily review of line necessity. Minimizing the duration a central line is in place is one of the most effective strategies to reduce the risk of infection. Other core components include hand hygiene, maximal barrier precautions during insertion, chlorhexidine skin antisepsis, and optimal site selection.
Free CHSP Infection Prevention and Control Questions and Answers 1
A patient is admitted with suspected pulmonary tuberculosis (TB).
To protect healthcare workers and other patients, which of the following infection control measures is the MOST critical to implement immediately?