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CBIC Certified Infection Control Exam Sample Questions (Q82-Q87):

NEW QUESTION # 82
The cleaning and disinfection process that is appropriate for a particular surgical instrument depends on

A. the device manufacturer's written instructions for use.
B. the policies of the sterile processing department.
C. all surgical instruments are cleaned and sterilized in the same manner.
D. instruments contaminated with blood must be bleach cleaned first.

Answer: A

Explanation:
The correct answer is C, "the device manufacturer's written instructions for use," as this is the factor that determines the appropriate cleaning and disinfection process for a particular surgical instrument. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the reprocessing of surgical instruments must follow the specific instructions provided by the device manufacturer to ensure safety and efficacy. These instructions account for the instrument's material, design, and intended use, specifying the appropriate cleaning agents, disinfection methods, sterilization techniques, and contact times to prevent damage and ensure the elimination of pathogens (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). This is also mandated by regulatory standards, such as those from the Food and Drug Administration (FDA) and the Association for the Advancement of Medical Instrumentation (AAMI), which require adherence to manufacturer guidelines to maintain device integrity and patient safety.
Option A (all surgical instruments are cleaned and sterilized in the same manner) is incorrect because different instruments have unique characteristics (e.g., materials like stainless steel vs. delicate optics), necessitating tailored reprocessing methods rather than a one-size-fits-all approach. Option B (instruments contaminated with blood must be bleach cleaned first) is a misconception; while blood contamination requires thorough cleaning, bleach is not universally appropriate and may damage certain instruments unless specified by the manufacturer. Option D (the policies of the sterile processing department) may guide internal procedures but must be based on and subordinate to the manufacturer's instructions to ensure compliance and effectiveness.
The emphasis on manufacturer instructions aligns with CBIC's focus on evidence-based reprocessing practices to prevent healthcare-associated infections (HAIs) and protect patients (CBIC Practice Analysis,
2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). Deviating from these guidelines can lead to inadequate sterilization or instrument damage, increasing infection risks.
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.3 - Ensure safe reprocessing of medical equipment, 3.5 - Evaluate the environment for infection risks. AAMI ST79:2017, Comprehensive guide to steam sterilization and sterility assurance in health care facilities.

NEW QUESTION # 83
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. Coliforms
B. Acinetobacter
C. Pseudomonads
D. Legionella

Answer: A

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 # 84
Which humoral antibody indicates previous infection and assists in protecting tissue?

A. IgM
B. IgD
C. IgA
D. IgG

Answer: D

Explanation:
Humoral antibodies, or immunoglobulins, play distinct roles in the immune system, and their presence or levels can provide insights into infection history and ongoing immune protection. The Certification Board of Infection Control and Epidemiology (CBIC) recognizes the importance of understanding immunological responses in the "Identification of Infectious Disease Processes" domain, which is critical for infection preventionists to interpret diagnostic data and guide patient care. The question focuses on identifying the antibody that indicates a previous infection and assists in protecting tissue, requiring an evaluation of the functions and kinetics of the five major immunoglobulin classes (IgA, IgD, IgG, IgM, IgE).
Option C, IgG, is the correct answer. IgG is the most abundant antibody in serum, accounting for approximately 75-80% of total immunoglobulins, and is the primary antibody involved in long-term immunity. It appears in significant levels after an initial infection, typically rising during the convalescent phase (weeks to months after exposure) and persisting for years, serving as a marker of previous infection.
IgG provides protection by neutralizing pathogens, opsonizing them for phagocytosis, and activating the complement system, which helps protect tissues from further damage. The Centers for Disease Control and Prevention (CDC) and clinical immunology references, such as the "Manual of Clinical Microbiology" (ASM Press), note that IgG seroconversion or elevated IgG titers are commonly used to diagnose past infections (e.
g., measles, hepatitis) and indicate lasting immunity. Its ability to cross the placenta also aids in protecting fetal tissues, reinforcing its protective role.
Option A, IgA, is primarily found in mucosal secretions (e.g., saliva, tears, breast milk) and plays a key role in mucosal immunity, preventing pathogen adhesion to epithelial surfaces. While IgA can indicate previous mucosal infections and offers localized tissue protection, it is not the primary systemic marker of past infection or long-term tissue protection, making it less fitting. Option B, IgD, is present in low concentrations and is mainly involved in B-cell activation and maturation, with no significant role in indicating previous infection or protecting tissues. Option D, IgM, is the first antibody produced during an acute infection, appearing early in the immune response (within days) and indicating current or recent infection. However, its levels decline rapidly, and it does not persist to mark previous infection or provide long-term tissue protection, unlike IgG.
The CBIC Practice Analysis (2022) and CDC guidelines on serological testing emphasize IgG's role in assessing past immunity, supported by immunological literature (e.g., Janeway's Immunobiology, 9th Edition). Thus, IgG is the humoral antibody that best indicates previous infection and assists in protecting tissue, making Option C the correct choice.
References:
* CBIC Practice Analysis, 2022.
* Manual of Clinical Microbiology, ASM Press, 2019.
* Janeway's Immunobiology, 9th Edition, 2016.
* CDC Serologic Testing Guidelines, 2014.

NEW QUESTION # 85
A surgeon approaches an infection preventionist (IP) concerned that there are more surgical site infections (SSIs) in hysterectomies performed in the facility's stand-alone surgery center than in those performed in the acute-care operating room. The IP should

A. compare post-hysterectomy SSI rates in cases performed at the acute-care operating room with those performed at the surgery center.
B. initiate post-hysterectomy SSI surveillance in hysterectomy patients to verify accuracy of current surveillance methodology
C. compare the most recent post-hysterectomy SSI surveillance data from the surgery center with those of the previous 12 months.
D. initiate prospective surveillance for SSIs in hysterectomies performed at the stand-alone surgery center

Answer: A

Explanation:
The infection preventionist (IP) should start by comparing SSI rates between the acute-care operating room and the stand-alone surgery center. This direct comparison will help determine if there is a statistically significant difference in infection rates and guide further investigation.
Step-by-Step Justification:
* Identify Trends:
* Compare SSI rates between the two locations over a set period to identify patterns.
* Assess Contributing Factors:
* Look at factors such as patient population, antibiotic prophylaxis, surgical techniques, environmental controls, and adherence to infection prevention protocols.
* Validate Surveillance Data:
* Ensure that consistent SSI surveillance methodologies are used at both locations to avoid discrepancies.
Why Other Options Are Incorrect:
* A. Initiate prospective surveillance for SSIs in hysterectomies performed at the stand-alone surgery center:
* Prospective surveillance is beneficial but does not immediately answer the surgeon's concern about existing infections.
* B. Compare the most recent post-hysterectomy SSI surveillance data from the surgery center with those of the previous 12 months:
* This approach only looks at trends at the surgery center without comparing it to the acute-care setting.
* C. Initiate post-hysterectomy SSI surveillance in hysterectomy patients to verify accuracy of current surveillance methodology:
* This step is secondary. Before initiating new surveillance, a direct comparison should be made using existing data.
CBIC Infection Control References:
* APIC Text, "Surgical Site Infection Surveillance and Prevention Measures".

NEW QUESTION # 86
Which of the following options describes a correct use of personal protective equipment?

A. Gloves should be worn when handling or touching a cardiac monitor that has been disinfected.
B. Surgical masks should be worn during lumbar puncture procedures.
C. Personal eyeglasses should be worn during suctioning.
D. Eye protection should be worn when providing patient care it at risk of spreading respiratory disease after unprotected exposure.

Answer: B

Explanation:
According to CDC and APIC guidelines, a surgical mask is required when performing lumbar punctures to prevent bacterial contamination (e.g., meningitis caused by droplet transmission of oral flora).
Why the Other Options Are Incorrect?
* A. Personal eyeglasses should be worn during suctioning - Incorrect because eyeglasses do not provide adequate eye protection. Goggles or face shields should be used.
* C. Gloves should be worn when handling or touching a cardiac monitor that has been disinfected
- Not necessary unless recontamination is suspected.
* D. Eye protection should be worn when providing patient care after unprotected exposure - Eye protection should be used before exposure, not just after.
CBIC Infection Control Reference
APIC states that surgical masks must be worn for procedures such as lumbar puncture to reduce infection risk.

NEW QUESTION # 87
......

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CBIC Certified Infection Control Exam Sample Questions (Q82-Q87):

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