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CBIC Certified Infection Control Exam Sample Questions (Q109-Q114):

NEW QUESTION # 109
A patient with pertussis can be removed from Droplet Precautions after

A. the patient has been given pertussis vaccine.
B. five days of appropriate antibiotic therapy.
C. the paroxysmal stage has ended.
D. direct fluorescent antibody and/or culture are negative.

Answer: B

Explanation:
A patient with pertussis (whooping cough) should remain on Droplet Precautions to prevent transmission.
According to APIC guidelines, patients with pertussis can be removed from Droplet Precautions after completing at least five days of appropriate antimicrobial therapy and showing clinical improvement.
Why the Other Options Are Incorrect?
* A. Direct fluorescent antibody and/or culture are negative - Laboratory results may not always detect pertussis early, and false negatives can occur.
* C. The patient has been given pertussis vaccine - The vaccine prevents but does not treat pertussis, and it does not shorten the period of contagiousness.
* D. The paroxysmal stage has ended - The paroxysmal stage (severe coughing fits) can last weeks, but infectiousness decreases with antibiotics.
CBIC Infection Control Reference
According to APIC guidelines, Droplet Precautions should continue until the patient has received at least five days of antimicrobial therapy.

NEW QUESTION # 110
In the current year, cases of tuberculosis (TB) among foreign-born persons accounted for the majority of new TB cases in the United States. The number of states with greater than 50% of cases among foreign-born persons increased from four cases ten years ago to 22 cases in the current year. This information can BEST be used to
* heighten awareness among Emergency Department staff.
* inform staff who are foreign-born.
* educate patients and visitors.
* review the TB exposure control plan.

A. 2 and 3 only.
B. 1 and 4 only.
C. 3 and 4 only.
D. 1 and 2 only.

Answer: B

Explanation:
The correct answer is B, "1 and 4 only," indicating that the information can best be used to heighten awareness among Emergency Department (ED) staff and review the TB exposure control plan. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, tuberculosis (TB) remains a significant public health concern, particularly with the increasing proportion of cases among foreign-born persons in the United States. The data showing a rise from four to 22 states with over 50% of TB cases among foreign-born individuals highlights an evolving epidemiological trend that warrants targeted infection prevention strategies (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.1 - Conduct surveillance for healthcare-associated infections and epidemiologically significant organisms).
Heightening awareness among ED staff (option 1) is critical because the ED is often the first point of contact for patients with undiagnosed or active TB, especially those from high-prevalence regions. Increased awareness can improve early identification, isolation, and reporting of potential cases. Reviewing the TB exposure control plan (option 4) is equally important, as it allows the infection preventionist to assess and update protocols-such as ventilation, personal protective equipment (PPE) use, and screening processes-to address the heightened risk posed by the growing number of cases among foreign-born individuals (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents).
Option 2 (inform staff who are foreign-born) is not the best use of this data, as the information pertains to patient demographics rather than staff risk, and targeting staff based on their origin could be inappropriate without specific exposure evidence. Option 3 (educate patients and visitors) is a general education strategy but less directly actionable with this specific epidemiological data, which is more relevant to healthcare worker preparedness and facility protocols. Combining options 1 and 4 aligns with CBIC's emphasis on using surveillance data to guide prevention and control measures, ensuring a proactive response to the increased TB burden (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.5 - Use data to guide infection prevention and control strategies).
References: CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competencies 2.1 - Conduct surveillance for healthcare-associated infections and epidemiologically significant organisms, 2.5 - Use data to guide infection prevention and control strategies; Domain III:
Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents.

NEW QUESTION # 111
What rate is expressed by the number of patients who acquire infections over a specified time period divided by the population at risk of acquiring an infection during that time period?

A. Point prevalence
B. Period prevalence
C. Incidence rate
D. Disease specific

Answer: C

Explanation:
The incidence rate measures new cases of infection in a population over a defined time period using the formula:

Why the Other Options Are Incorrect?
* B. Disease specific - Refers to infections caused by a particular pathogen, not the general rate of new infections.
* C. Point prevalence - Measures existing cases at a specific point in time, not new cases.
* D. Period prevalence - Includes both old and new cases over a set period, unlike incidence, which only considers new cases.
CBIC Infection Control Reference
APIC defines incidence rate as the number of new infections in a population over a given period.

NEW QUESTION # 112
On January 31, the nursing staff of a long-term care facility reports that five out of 35 residents have developed high fever, nasal discharge, and a dry cough. The BEST diagnostic tool to determine the causative agent is:

A. Nasopharyngeal swab
B. Legionella serology
C. Blood culture
D. Sputum culture

Answer: A

Explanation:
The scenario describes a cluster of five out of 35 residents in a long-term care facility developing high fever, nasal discharge, and a dry cough, suggesting a potential respiratory infection outbreak. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the "Identification of Infectious Disease Processes" and "Surveillance and Epidemiologic Investigation" domains, which require selecting the most appropriate diagnostic tool to identify the causative agent promptly. The Centers for Disease Control and Prevention (CDC) provides guidance on diagnostic approaches for respiratory infections, particularly in congregate settings like long-term care facilities.
Option C, "Nasopharyngeal swab," is the best diagnostic tool in this context. The symptoms-high fever, nasal discharge, and a dry cough-are characteristic of upper respiratory infections, such as influenza, respiratory syncytial virus (RSV), or other viral pathogens common in congregate settings. A nasopharyngeal swab is the gold standard for detecting these agents, as it collects samples from the nasopharynx, where many respiratory viruses replicate. The CDC recommends nasopharyngeal swabs for molecular testing (e.g., PCR) to identify viruses like influenza, RSV, or SARS-CoV-2, especially during outbreak investigations in healthcare facilities. The dry cough and nasal discharge align with upper respiratory involvement, making this sample type more targeted than alternatives. Given the potential for rapid spread among vulnerable residents, early identification via nasopharyngeal swab is critical to guide infection control measures.
Option A, "Blood culture," is less appropriate as the best initial tool. Blood cultures are used to detect systemic bacterial infections (e.g., bacteremia or sepsis), but the symptoms described are more suggestive of a primary respiratory infection rather than a bloodstream infection. While secondary bacteremia could occur, blood cultures are not the first-line diagnostic for this presentation and are more relevant if systemic signs (e.
g., hypotension) worsen. Option B, "Sputum culture," is useful for lower respiratory infections, such as pneumonia, where productive cough and sputum production are prominent. However, the dry cough and nasal discharge indicate an upper respiratory focus, and sputum may be difficult to obtain from elderly residents, reducing its utility here. Option D, "Legionella serology," is specific for diagnosing Legionella pneumophila, which causes Legionnaires' disease, typically presenting with fever, cough, and sometimes gastrointestinal symptoms, often in association with water sources. While possible, the lack of mention of pneumonia or water exposure, combined with the upper respiratory symptoms, makes Legionella serology less likely as the best initial test. Serology also requires time for antibody development, delaying diagnosis compared to direct sampling.
The CBIC Practice Analysis (2022) and CDC guidelines for outbreak management in long-term care facilities (e.g., "Prevention Strategies for Seasonal Influenza in Healthcare Settings," 2018) prioritize rapid respiratory pathogen identification, with nasopharyngeal swabs being the preferred method for viral detection. Given the symptom profile and outbreak context, Option C is the most effective and immediate diagnostic tool to determine the causative agent.
References:
* CBIC Practice Analysis, 2022.
* CDC Prevention Strategies for Seasonal Influenza in Healthcare Settings, 2018.
* CDC Guidelines for the Prevention and Control of Outbreaks in Long-Term Care Facilities, 2015.

NEW QUESTION # 113
What is the correct order of steps for reprocessing critical medical equipment?

A. Disinfect, sterilize
B. Clean, sterilize
C. Disinfect, clean, sterilize
D. Clean, sterilize, disinfect

Answer: B

Explanation:
The correct answer is D, "Clean, sterilize," as this represents the correct order of steps for reprocessing critical medical equipment. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, critical medical equipment-items that enter sterile tissues or the vascular system (e.g., surgical instruments, implants)-must undergo a rigorous reprocessing cycle to ensure they are free of all microorganisms, including spores. The process begins with cleaning to remove organic material, debris, and soil, which is essential to allow subsequent sterilization to be effective. Sterilization, the final step, uses methods such as steam, ethylene oxide, or hydrogen peroxide gas to achieve a sterility assurance level (SAL) of 10##, eliminating all microbial life (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). Disinfection, while important for semi-critical devices, is not a step in the reprocessing of critical items, as it does not achieve the sterility required; it is a separate process for non-critical or semi-critical equipment.
Option A (clean, sterilize, disinfect) is incorrect because disinfecting after sterilization is unnecessary and redundant, as sterilization already achieves a higher level of microbial kill. Option B (disinfect, clean, sterilize) reverses the logical sequence; cleaning must precede any disinfection or sterilization to remove bioburden, and disinfection is not appropriate for critical items. Option C (disinfect, sterilize) omits cleaning and incorrectly prioritizes disinfection, which is insufficient for critical equipment requiring full sterility.
The focus on cleaning followed by sterilization aligns with CBIC's emphasis on evidence-based reprocessing protocols to prevent healthcare-associated infections (HAIs), ensuring that critical equipment is safe for patient use (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.4 - Implement environmental cleaning and disinfection protocols). This sequence is supported by standards such as AAMI ST79, which outlines the mandatory cleaning step before sterilization to ensure efficacy and safety.
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.3 - Ensure safe reprocessing of medical equipment, 3.4 - Implement environmental cleaning and disinfection protocols. AAMI ST79:2017, Comprehensive guide to steam sterilization and sterility assurance in health care facilities.

NEW QUESTION # 114
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