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CIC Test Torrent and CIC Preparation Materials: CBIC Certified Infection Control Exam - CIC Practice Test
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CBIC Certified Infection Control Exam Sample Questions (Q33-Q38):
NEW QUESTION # 33
Peripherally inserted central catheter (PICC)-associated bloodstream infections (BSIs) have been increasing over the past four months. Which of the following interventions is MOST likely to have contributed to the increase?
- A. Use of chlorhexidine skin antisepsis during insertion of the PICC
- B. Replacement of the intravenous administration sets every 72 hours
- C. Use of a positive pressure device on the PICC
- D. Daily bathing adult intensive care unit patients with chlorhexidine
Answer: B
Explanation:
Peripherally inserted central catheter (PICC)-associated bloodstream infections (BSIs) are a significant concern in healthcare settings, and identifying factors contributing to their increase is critical for infection prevention. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the
"Surveillance and Epidemiologic Investigation" and "Prevention and Control of Infectious Diseases" domains, which align with the Centers for Disease Control and Prevention (CDC) guidelines for preventing intravascular catheter-related infections. The question asks for the intervention most likely to have contributed to the rise in PICC-associated BSIs over four months, requiring an evaluation of each option based on evidence-based practices.
Option C, "Replacement of the intravenous administration sets every 72 hours," is the most likely contributor to the increase. The CDC's "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017) recommend that intravenous administration sets (e.g., tubing for fluids or medications) be replaced no more frequently than every 72-96 hours unless clinically indicated (e.g., contamination or specific therapy requirements). Frequent replacement, such as every 72 hours as a routine practice, can introduce opportunities for contamination during the change process, especially if aseptic technique is not strictly followed. Studies cited in the CDC guidelines, including those by O'Grady et al. (2011), indicate that unnecessary manipulation of catheter systems increases the risk of introducing pathogens, potentially leading to BSIs. A change to a 72- hour replacement schedule, if not previously standard, could explain the observed increase over the past four months.
Option A, "Use of chlorhexidine skin antisepsis during insertion of the PICC," is a recommended practice to reduce BSIs. Chlorhexidine, particularly in a 2% chlorhexidine gluconate with 70% alcohol solution, is the preferred skin antiseptic for catheter insertion due to its broad-spectrum activity and residual effect, as supported by the CDC (2017). This intervention should decrease, not increase, infection rates, making it an unlikely contributor. Option B, "Daily bathing adult intensive care unit patients with chlorhexidine," is another evidence-based strategy to reduce healthcare-associated infections, including BSIs, by decolonizing the skin of pathogens like Staphylococcus aureus. The CDC and SHEA (Society for Healthcare Epidemiology of America) guidelines (2014) endorse chlorhexidine bathing in intensive care units, suggesting it should lower, not raise, BSI rates. Option D, "Use of a positive pressure device on the PICC," aims to prevent catheter occlusion and reduce the need for frequent flushing, which could theoretically decrease infection risk by minimizing manipulation. However, there is no strong evidence linking positive pressure devices to increased BSIs; if improperly used or maintained, they might contribute marginally, but this is less likely than the impact of frequent tubing changes.
The CBIC Practice Analysis (2022) and CDC guidelines highlight that deviations from optimal catheter maintenance practices, such as overly frequent administration set replacements, can increase infection risk.
Given the four-month timeframe and the focus on an intervention's potential negative impact, Option C stands out as the most plausible contributor due to the increased manipulation and contamination risk associated with routine 72-hour replacements.
References:
CBIC Practice Analysis, 2022.
CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2017.
O'Grady, N. P., et al. (2011). Guidelines for the Prevention of Intravascular Catheter-Related Infections.
Clinical Infectious Diseases.
SHEA Compendium, Strategies to Prevent Central Line-Associated Bloodstream Infections, 2014.
NEW QUESTION # 34
An outbreak of Candida auris is suspected in the infection preventionist's (IP) facility. The IP's investigation must be conducted in a standard method and communication is critical. Which first step is MOST important?
- A. Notify facility administration
- B. Plan to prevent future outbreaks
- C. Conduct environmental cultures
- D. Perform analytical studies
Answer: A
Explanation:
In an outbreak investigation, the first critical step is to notify facility administration and other key stakeholders. This ensures the rapid mobilization of resources, coordination with infection control teams, and compliance with regulatory reporting requirements.
Why the Other Options Are Incorrect?
* A. Conduct environmental cultures - While environmental sampling may be necessary, it is not the first step. The outbreak must first be confirmed and administration alerted.
* B. Plan to prevent future outbreaks - Prevention planning happens later after the outbreak has been investigated and controlled.
* D. Perform analytical studies - Data analysis occurs after case definition and initial response measures are in place.
CBIC Infection Control Reference
APIC guidelines state that the first step in an outbreak investigation is confirming the outbreak and notifying key stakeholders.
NEW QUESTION # 35
When implementing a multimodal strategy (or bundle) for improving hand hygiene, the infection preventionist should focus on Calculator
- A. availability of gloves in the patient care area
- B. institutional assessment of significant barriers.
- C. cost effectiveness of hand hygiene products.
- D. signage for hand hygiene reminders.
Answer: B
Explanation:
When implementing a multimodal strategy (or bundle) for hand hygiene, the infection preventionist should first assess barriers to compliance before implementing solutions.
Step-by-Step Justification:
* Understanding Barriers First:
* Identifying barriers (e.g., lack of access to sinks, high workload, or poor compliance culture) is critical for effective intervention.
* APIC Guidelines on Hand Hygiene Improvement:
* Strategies must be tailored based on the institution's specific challenges.
* Why Other Options Are Incorrect:
* A. Signage for hand hygiene reminders:
* Signage alone is insufficient without addressing systemic barriers.
* B. Cost-effectiveness of hand hygiene products:
* While important, cost analysis comes after identifying compliance barriers.
* C. Availability of gloves in the patient care area:
* Gloves do not replace hand hygiene and may lead to lower compliance.
CBIC Infection Control References:
* APIC/JCR Workbook, "Hand Hygiene Compliance and Institutional Barriers".
* APIC Text, "Hand Hygiene Improvement Strategies".
NEW QUESTION # 36
Which of the following procedures has NOT been documented to contribute to the development of postoperative infections in clean surgical operations?
- A. Prolonged length of the operations
- B. Shaving the site on the day prior to surgery
- C. Prolonged preoperative hospital stay
- D. The use of iodophors for preoperative scrubs
Answer: D
Explanation:
Postoperative infections in clean surgical operations, defined by the Centers for Disease Control and Prevention (CDC) as uninfected operative wounds with no inflammation and no entry into sterile tracts (e.g., gastrointestinal or respiratory systems), are influenced by various perioperative factors. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes identifying and mitigating risk factors in the "Prevention and Control of Infectious Diseases" domain, aligning with CDC guidelines for surgical site infection (SSI) prevention. The question focuses on identifying a procedure not documented as a contributor to SSIs, requiring an evaluation of evidence-based risk factors.
Option C, "The use of iodophors for preoperative scrubs," has not been documented to contribute to the development of postoperative infections in clean surgical operations. Iodophors, such as povidone-iodine, are antiseptic agents used for preoperative skin preparation and surgical hand scrubs. The CDC's "Guideline for Prevention of Surgical Site Infections" (1999) and its 2017 update endorse iodophors as an effective method for reducing microbial load on the skin, with no evidence suggesting they increase SSI risk when used appropriately. Studies, including those cited by the CDC, show that iodophors are comparable to chlorhexidine in efficacy for preoperative antisepsis, and their use is a standard, safe practice rather than a risk factor.
Option A, "Prolonged preoperative hospital stay," is a well-documented risk factor. Extended hospital stays prior to surgery increase exposure to healthcare-associated pathogens, raising the likelihood of colonization and subsequent SSI, as noted in CDC and surgical literature (e.g., Mangram et al., 1999). Option B,
"Prolonged length of the operations," is also a recognized contributor. Longer surgical durations are associated with increased exposure time, potential breaches in sterile technique, and higher infection rates, supported by CDC data showing a correlation between operative time and SSI risk. Option D, "Shaving the site on the day prior to surgery," has been documented as a risk factor. Preoperative shaving, especially with razors, can cause microabrasions that serve as entry points for bacteria, increasing SSI rates. The CDC recommends avoiding shaving or using clippers immediately before surgery to minimize this risk, with evidence from studies like those in the 1999 guideline showing higher infection rates with preoperative shaving.
The CBIC Practice Analysis (2022) and CDC guidelines focus on evidence-based practices, and the lack of documentation linking iodophor use to increased SSIs-coupled with its role as a preventive measure-makes Option C the correct answer. The other options are supported by extensive research as contributors to SSI development in clean surgeries.
References:
* CBIC Practice Analysis, 2022.
* CDC Guideline for Prevention of Surgical Site Infections, 1999, updated 2017.
* Mangram, A. J., et al. (1999). Guideline for Prevention of Surgical Site Infection. Infection Control and Hospital Epidemiology.
NEW QUESTION # 37
Following an outbreak of Hepatitis A, the water supply is sampled. A high count of which of the following isolates would indicate that the water was a potential source?
- A. Pseudomonads
- B. Legionella
- C. Acinetobacter
- D. Coliforms
Answer: D
Explanation:
Coliform bacteria are indicators of fecal contamination in water, making them a critical measure of water safety. Hepatitis A is a virus primarily transmitted via the fecal-oral route, often through contaminated food or water.
Step-by-Step Justification:
* Fecal Contamination and Hepatitis A:
* Hepatitis A virus (HAV) spreads through ingestion of water contaminated with fecal matter. High coliform counts indicate fecal contamination and increase the risk of HAV outbreaks.
* Use of Coliforms as Indicators:
* Public health agencies use total coliforms and Escherichia coli (E. coli) as primary indicators of water safety because they signal fecal pollution.
* Waterborne Transmission of Hepatitis A:
* Hepatitis A outbreaks have been traced to contaminated drinking water, ice, and improperly treated wastewater. Coliform detection signals a need for immediate action.
Why Other Options Are Incorrect:
* B. Pseudomonads:
* Pseudomonads (e.g., Pseudomonas aeruginosa) are environmental bacteria but are not indicators of fecal contamination.
* C. Legionella:
* Legionella species cause Legionnaires' disease through inhalation of contaminated aerosols, not through fecal-oral transmission.
* D. Acinetobacter:
* Acinetobacter species are opportunistic pathogens in healthcare settings but are not indicators of waterborne fecal contamination.
CBIC Infection Control References:
* APIC Text, "Water Systems and Infection Control Measures".
* APIC Text, "Hepatitis A Transmission and Waterborne Outbreaks".
NEW QUESTION # 38
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