NPS Infection Prevention and Control 3

Question 1

A 28-week gestational age neonate develops candidemia. Which antifungal agent is the drug of choice, particularly given the risk of concurrent CNS involvement?

Accepted Answer

Amphotericin B (deoxycholate or liposomal formulation)

Answer

Oral fluconazole

Answer

Voriconazole

Answer

Micafungin

Question 2

Which intervention is most effective in preventing catheter-associated urinary tract infections (CAUTI) in neonates?

Accepted Answer

Removing urinary catheters as soon as they are no longer clinically necessary

Answer

Daily catheter irrigation with antiseptic solution

Answer

Routine prophylactic antibiotics during catheterization

Answer

Scheduled catheter changes every 48 hours

Question 3

Which of the following is NOT a component of the standard CLABSI prevention bundle?

Accepted Answer

Routine scheduled catheter replacement every 7 days

Answer

Hand hygiene before catheter insertion and maintenance

Answer

Maximal sterile barrier precautions at insertion

Answer

Chlorhexidine skin antisepsis at insertion site

Question 4

A mother with active, untreated pulmonary tuberculosis delivers a term neonate. What is the recommended approach regarding breastfeeding?

Accepted Answer

Breastfeeding should be deferred until the mother has received at least 2 weeks of effective anti-TB therapy and is non-infectious

Answer

Breastfeeding is safe and should begin immediately

Answer

Breastfeeding is permanently contraindicated with active TB

Answer

The mother should pump and discard milk until culture negativity is confirmed

Question 5

Which bundle component is most evidence-based for preventing ventilator-associated events (VAE) in mechanically ventilated neonates?

Accepted Answer

Closed suctioning systems combined with appropriate head-of-bed elevation when feasible

Answer

Routine instillation of normal saline before endotracheal suctioning

Answer

Prophylactic antibiotics throughout the duration of mechanical ventilation

Answer

Routine chest physiotherapy every 4 hours

Question 6

Which vaccination is specifically recommended for all healthcare workers in the NICU as part of a 'cocooning' strategy to protect neonates from pertussis?

Accepted Answer

Tdap (tetanus, diphtheria, acellular pertussis) booster

Answer

Annual influenza vaccine

Answer

MMR (measles, mumps, rubella) vaccine

Answer

Hepatitis B vaccine series

Question 7

A mother is found to have Group B Streptococcus (GBS) bacteriuria during the current pregnancy. What is the appropriate intrapartum management to protect the neonate?

Accepted Answer

Intrapartum antibiotic prophylaxis (IAP) with penicillin G administered to the mother

Answer

No prophylaxis is needed unless the neonate shows infection signs

Answer

Oral amoxicillin for 7 days postpartum given to the neonate

Answer

Immediate neonatal prophylaxis with ampicillin regardless of maternal treatment status