NCAS Infection Control and Prevention 2 — Questions and Answers
Question 1: Which of the following is the MOST effective strategy to prevent health care-associated infections (HAIs) at the community health facility level?
- Consistent hand hygiene compliance by all health care workers (Correct answer)
- Antibiotic prophylaxis for all patients
- Universal patient isolation
- Daily facility fumigation
Correct answer: Consistent hand hygiene compliance by all health care workers
Hand hygiene compliance is the single most effective, evidence-based strategy for preventing health care-associated infections across all settings.
Question 2: A community nurse identifies a cluster of influenza cases in a school. The FIRST public health action should be:
- Report the cluster to the local health department and implement influenza prevention measures (Correct answer)
- Administer antiviral medication to all students without testing
- Immediately close all schools in the district
- Wait for laboratory confirmation before any action
Correct answer: Report the cluster to the local health department and implement influenza prevention measures
Reporting infectious disease clusters to the local health department is a mandatory public health duty, initiating official investigation and coordinated response.
Question 3: Which epidemiological concept describes the minimum proportion of a population that must be immune to prevent ongoing disease transmission?
- Herd immunity threshold (Correct answer)
- Attack rate
- Incubation period
- Case fatality rate
Correct answer: Herd immunity threshold
The herd immunity threshold is the proportion of a population that must be immune (through vaccination or prior infection) to prevent sustained disease transmission.
Question 4: A community health nurse is providing education about Lyme disease prevention in an endemic area. Which protective measure is MOST effective?
- Using EPA-registered insect repellents containing DEET and conducting daily tick checks (Correct answer)
- Avoiding all outdoor activities year-round
- Taking prophylactic antibiotics daily during summer
- Wearing light-colored clothing only, with no other measures
Correct answer: Using EPA-registered insect repellents containing DEET and conducting daily tick checks
DEET-based repellents and daily tick checks after outdoor exposure are the most effective primary prevention strategies for Lyme disease in endemic regions.
Question 5: Under which circumstances should a community health nurse implement droplet precautions?
- For patients with influenza, meningococcal meningitis, or pertussis (Correct answer)
- For patients with suspected TB only
- For all patients regardless of diagnosis
- Only for patients with HIV infection
Correct answer: For patients with influenza, meningococcal meningitis, or pertussis
Droplet precautions are used for infections spread by large respiratory droplets (>5 microns), including influenza, bacterial meningitis, and pertussis.
Question 6: A community nurse is counseling a patient who was exposed to hepatitis B through a needle stick. Which post-exposure prophylaxis is recommended for an unvaccinated individual?
- Hepatitis B immune globulin (HBIG) plus initiation of the hepatitis B vaccine series within 24 hours (Correct answer)
- Hepatitis B vaccine series alone started within 1 week
- Antiviral medications only
- Prophylactic antibiotics and observation only
Correct answer: Hepatitis B immune globulin (HBIG) plus initiation of the hepatitis B vaccine series within 24 hours
Unvaccinated individuals exposed to hepatitis B should receive HBIG for immediate passive immunity plus start the hepatitis B vaccine series within 24 hours of exposure.
NCAS Infection Control and Prevention 2
Which of the following is the MOST effective strategy to prevent health care-associated infections (HAIs) at the community health facility level?