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CBIC Certified Infection Control Exam Sample Questions (Q70-Q75):

NEW QUESTION # 70
Which of the following procedures has NOT been documented to contribute to the development of postoperative infections in clean surgical operations?

A. The use of iodophors for preoperative scrubs
B. Shaving the site on the day prior to surgery
C. Prolonged length of the operations
D. Prolonged preoperative hospital stay

Answer: A

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 # 71
Which of the following represents a class II surgical wound?

A. Old traumatic wounds with retained devitalized tissue.
B. Incisions in which acute, nonpurulent inflammation are seen.
C. Incisional wounds following nonpenetrating (blunt) trauma.
D. Incisions involving the biliary tract, appendix, vagina, and oropharynx.

Answer: B

Explanation:
Surgical wounds are classified by the Centers for Disease Control and Prevention (CDC) into four classes based on the degree of contamination and the likelihood of postoperative infection. This classification system, detailed in the CDC's Guidelines for Prevention of Surgical Site Infections (1999), is a cornerstone of infection prevention and control, aligning with the Certification Board of Infection Control and Epidemiology (CBIC) standards in the "Prevention and Control of Infectious Diseases" domain. The classes are as follows:
* Class I (Clean): Uninfected operative wounds with no inflammation, typically closed primarily, and not involving the respiratory, alimentary, genital, or urinary tracts.
* Class II (Clean-Contaminated): Operative wounds with controlled entry into a sterile or minimally contaminated tract (e.g., biliary or gastrointestinal), with no significant spillage or infection present.
* Class III (Contaminated): Open, fresh wounds with significant spillage (e.g., from a perforated viscus) or major breaks in sterile technique.
* Class IV (Dirty-Infected): Old traumatic wounds with retained devitalized tissue or existing clinical infection.
Option A, "Incisions in which acute, nonpurulent inflammation are seen," aligns with a Class II surgical wound. The presence of acute, nonpurulent inflammation suggests a controlled inflammatory response without overt infection, which can occur in clean-contaminated cases where a sterile tract (e.g., during elective gastrointestinal surgery) is entered under controlled conditions. The CDC defines Class II wounds as those involving minor contamination without significant spillage or infection, and nonpurulent inflammation fits this category, often seen in early postoperative monitoring.
Option B, "Incisional wounds following nonpenetrating (blunt) trauma," does not fit the Class II definition.
These wounds are typically classified based on the trauma context and are more likely to be considered contaminated (Class III) or dirty (Class IV) if there is tissue damage or delayed treatment, rather than clean- contaminated. Option C, "Incisions involving the biliary tract, appendix, vagina, and oropharynx," describes anatomical sites that, when surgically accessed, often fall into Class II if the procedure is elective and controlled (e.g., cholecystectomy), but the phrasing suggests a general category rather than a specific wound state with inflammation, making it less precise for Class II. Option D, "Old traumatic wounds with retained devitalized tissue," clearly corresponds to Class IV (dirty-infected) due to the presence of necrotic tissue and potential existing infection, which is inconsistent with Class II.
The CBIC Practice Analysis (2022) emphasizes the importance of accurate wound classification for implementing appropriate infection prevention measures, such as antibiotic prophylaxis or sterile technique adjustments. The CDC guidelines further specify that Class II wounds may require tailored interventions based on the observed inflammatory response, supporting Option A as the correct answer. Note that the phrasing in Option A contains a minor grammatical error ("inflammation are seen" should be "inflammation is seen"), but this does not alter the clinical intent or classification.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for Prevention of Surgical Site Infections, 1999.

NEW QUESTION # 72
Which water type is suitable for drinking yet may still be a risk for disease transmission?

A. Distilled water
B. Grey water
C. Purified water
D. Potable water

Answer: D

Explanation:
To determine which water type is suitable for drinking yet may still pose a risk for disease transmission, we need to evaluate each option based on its definition, treatment process, and potential for contamination, aligning with infection control principles as outlined by the Certification Board of Infection Control and Epidemiology (CBIC).
* A. Purified water: Purified water undergoes a rigorous treatment process (e.g., reverse osmosis, distillation, or deionization) to remove impurities, contaminants, and microorganisms. This results in water that is generally safe for drinking and has a very low risk of disease transmission when properly handled and stored. However, if the purification process is compromised or if contamination occurs post-purification (e.g., due to improper storage or distribution), there could be a theoretical risk.
Nonetheless, purified water is not typically considered a primary source of disease transmission under standard conditions.
* B. Grey water: Grey water refers to wastewater generated from domestic activities such as washing dishes, laundry, or bathing, which may contain soap, food particles, and small amounts of organic matter. It is not suitable for drinking due to its potential contamination with pathogens (e.g., bacteria, viruses) and chemicals. Grey water is explicitly excluded from potable water standards and poses a significant risk for disease transmission, making it an unsuitable choice for this question.
* C. Potable water: Potable water is water that meets regulatory standards for human consumption, as defined by organizations like the World Health Organization (WHO) or the U.S. Environmental Protection Agency (EPA). It is treated to remove harmful pathogens and contaminants, making it safe for drinking under normal circumstances. However, despite treatment, potable water can still pose a risk for disease transmission if the distribution system is contaminated (e.g., through biofilms, cross- connections, or inadequate maintenance of pipes). Outbreaks of waterborne diseases like Legionnaires' disease or gastrointestinal infections have been linked to potable water systems, especially in healthcare settings. This makes potable water the best answer, as it is suitable for drinking yet can still carry a risk under certain conditions.
* D. Distilled water: Distilled water is produced by boiling water and condensing the steam, which removes most impurities, minerals, and microorganisms. It is highly pure and safe for drinking, often used in medical and laboratory settings. Similar to purified water, the risk of disease transmission is extremely low unless contamination occurs after distillation due to improper handling or storage. Like purified water, it is not typically associated with disease transmission risks in standard use.
The key to this question lies in identifying a water type that is both suitable for drinking and has a documented potential for disease transmission. Potable water fits this criterion because, while it is intended for consumption and meets safety standards, it can still be a vector for disease if the water supply or distribution system is compromised. This is particularly relevant in infection control, where maintaining water safety in healthcare facilities is a critical concern addressed by CBIC guidelines.
References:
* CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain III:
Prevention and Control of Infectious Diseases, which highlights the importance of water safety and the risks of contamination in potable water systems.
* CBIC Examination Content Outline, Domain IV: Environment of Care, which includes managing waterborne pathogens (e.g., Legionella) in potable water supplies.

NEW QUESTION # 73
Hand-hygiene audits in a long-term care facility have demonstrated consistently low levels of staff compliance. An infection preventionist is planning an education program to try to improve hand-hygiene rates. Regarding assessment of the effectiveness of the education program, which of the following is true?

A. Repeated observations of staff will be required in order to demonstrate that the program has been effective.
B. A summative evaluation will accurately reflect the extent to which participants will change their hand- hygiene practices.
C. A change between pre- and post-test scores correlates well with the expected change in hand-hygiene compliance.
D. An evaluation of the program is not required if the program is mandatory.

Answer: A

Explanation:
The correct answer is B, "Repeated observations of staff will be required in order to demonstrate that the program has been effective," as this statement is true regarding the assessment of the effectiveness of the education program. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, evaluating the impact of an education program on hand-hygiene compliance in a long-term care facility requires ongoing monitoring to assess sustained behavior change. Repeated observations provide direct evidence of staff adherence to hand-hygiene protocols over time, allowing the infection preventionist (IP) to measure the program's effectiveness beyond initial training (CBIC Practice Analysis, 2022, Domain IV: Education and Research, Competency 4.2 - Evaluate the effectiveness of educational programs). This method aligns with the World Health Organization (WHO) and CDC recommendations for hand-hygiene improvement, which emphasize continuous auditing to ensure lasting improvements in compliance rates.
Option A (a summative evaluation will accurately reflect the extent to which participants will change their hand-hygiene practices) is incorrect because a summative evaluation, typically conducted at the end of a program, assesses overall outcomes but does not predict future behavior changes or account for long-term compliance, which is critical in this context. Option C (a change between pre- and post-test scores correlates well with the expected change in hand-hygiene compliance) is misleading; while pre- and post-tests can measure knowledge gain, they do not reliably correlate with actual practice changes, as knowledge does not always translate to behavior without observation. Option D (an evaluation of the program is not required if the program is mandatory) is false, as mandatory programs still require evaluation to verify effectiveness, especially when addressing low compliance, per CBIC and quality improvement standards.
The focus on repeated observations aligns with CBIC's emphasis on data-driven assessment to improve infection prevention practices, ensuring that the education program leads to sustained hand-hygiene improvements and reduces healthcare-associated infections (CBIC Practice Analysis, 2022, Domain II:
Surveillance and Epidemiologic Investigation, Competency 2.4 - Evaluate the effectiveness of infection prevention and control interventions).
References: CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.4 - Evaluate the effectiveness of infection prevention and control interventions; Domain IV:
Education and Research, Competency 4.2 - Evaluate the effectiveness of educational programs. WHO Guidelines on Hand Hygiene in Health Care, 2009. CDC Hand Hygiene in Healthcare Settings, 2019.

NEW QUESTION # 74
A microbiology laboratory plays a pivotal role in both endemic and epidemic epidemiology. Which of the following should be investigated FIRST?

A. Two blood isolates of coagulase-negative staphylococci in the oncology unit.
B. One blood isolate of Streptococcus agalactiae in the nursery.
C. Three respiratory isolates of multi-drug resistant Klebsiella pneumoniae in the medical ICU.
D. Two isolates of Staphylococcus aureus in postoperative surgical sites.

Answer: C

Explanation:
Multi-drug resistant (MDR) Klebsiella pneumoniae in a high-risk area like the ICU requires urgent investigation because:
* It spreads rapidly via contaminated hands or equipment.
* It poses a serious risk to immunocompromised patients.
* An outbreak could lead to severe hospital-acquired infections (HAIs).
Why the Other Options Are Incorrect?
* A. One blood isolate of Streptococcus agalactiae in the nursery - Single cases are not indicative of an outbreak.
* B. Two isolates of Staphylococcus aureus in postoperative surgical sites - Common post-surgical pathogen; requires monitoring but not immediate outbreak investigation.
* D. Two blood isolates of coagulase-negative staphylococci in the oncology unit - Common contaminants in blood cultures and not immediately alarming.
CBIC Infection Control Reference
APIC guidelines prioritize investigating MDR pathogens in high-risk units, such as ICU, to prevent transmission.

NEW QUESTION # 75
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