CIC EXAM REVIEW SOLVED QUESTIONS COMPLETE ANSWERS GRADED A PLUS
CIC Practice EXAM 2026/2027 Questions Answers
Questions and Answers Verified Solutions Latest
Update
Question:
2. Which of the following is an example of the criterion of "Strength of the Association" from Hill's
criteria for causation? a. In a study of the association between antibiotic exposure and development
of C. difficile infection, the odds ratio was 2:3 b. In a study of the association between antibiotic
exposure and development of C. difficile infection, the authors' conclusions are consistent with
those of three other studies c. In a study of the association between antibiotic exposure and
development of C. difficile infection, antibiotic therapy began an average of 3 weeks before C.
difficile infection developed d. In a study of the association between antibiotic exposure and
development of C. difficile infection, prolonged antibiotic therapy was a greater risk factor for C.
difficile infection than short-term antibiotic therapy.
Answer:
In a study of the association between antibiotic exposure and development of C. difficile infection,
the odds ratio was 2:3 Rationale: Causal associations exist when evidence indicates that one factor is
clearly shown to increase the probability of the occurrence of a disease. In a causal relationship, the
reduction or diminution of a factor decreases the frequency of the disease being studied. The criteria
currently used for causality were developed by Austin Bradford Hill and are known as Hill's criteria.
These criteria use modern epidemiological methods to determine whether a factor is causal for a
given disease. Strength of association is the first criterion: The incidence of disease should be higher
in those who are exposed to the factor under consideration than in those who are not exposed; that
is, the stronger the association between an exposure and a disease, the more likely the exposure is to
be causal. The odds ratio is a statistical measure that gives us an indication of how strongly the risk
factor is associated with the disease outcome. Reference: APIC Text, 4th edition, Chapter 10
Question:
3. Which of the following rules should be followed when collecting a stool sample for C. difficile
testing? 1) Stool sample should be freshly passed within 1-2 hours 2) 10-20rnL. of formed stool
should be collected 3) Stool should be passed into a clean, dry container 4) Specimens should be
obtained before antimicrobial agents have been administered a. 1,2 b. 2,3 c. 1,3 d. 1,4.
Answer:
,1, 3 1) Stool sample should be freshly passed within 1-2 hours 3) Stool should be passed into a
clean, dry container Rationale: The accuracy of all tests depends on proper specimen handling and
transport. The following rules should be followed when collecting samples for C. difficile testing:
Stool samples should be freshly passed within 1-2 hours 10-20 mL of watery, soft, or unformed
stool should be collected Stool should be passed into a clean, dry container Reference: APIC Text,
4th edition, Chapter 72
Question:
4. What type of meningitis would be most consistent with the following cerebrospinal fluid (CSF)
report result: ++++++++++++++++++++++++++++++++++++++++++++++++++++
+++++++++++ Glucose: decreased Protein: elevated WBC: 1,000/mm(3)
++++++++++++++++++++++++++++++++++++++++++++++++++++ +++++++++++ a.
Bacterial b. Viral c. Fungal d. Tuberculosis.
Answer:
Bacterial Rationale: Culture of blood and CSF are indicated for patients with suspected invasive
meningococcal disease. The CSF of- patients with untreated meningococcal meningitis is usually:
cloudy pleocytosis (>WBC in CSF) with a predominance of neutrophils, low glucose, high protein
levels In most of the cases, the organisms are seen on Gram stain or can be identified using latex
agglutination assays. The culture is almost invariably positive as long as the samples was obtained
before the administration of antibiotics. Reference: APIC Text, 4th edition, Chapter 74 - Central
Nervous System Infection
Question:
5. The following blood culture result should be considered a potential contaminant: a. A positive
result of coagulase-negative staphylococci from two sets, 2 days apart, without symptoms b. A
positive result of S. aureus from one bottle in a patient with a temperature of 38.6°C c. A positive
result of E. coli from one bottle in an afebrile patient with diarrhea d. A positive result of Candida
albicans in a fungal blood culture in a patient with a urinary tract infection.
Answer:
A positive result of coagulase negative staphylococci from two sets, 2 days apart without symptoms
Rationale: According to the CDC CLABSI criteria, common commensals (such as
coagulase-negative staphylococci) meet the criteria for a CLABSI if there are two positive cultures
from two or more sets of blood cultures drawn " less than 2 days apart" and the patient has
symptoms (fever greater than 38°C, chills, or hypotension). CDC CLABSI criteria: Patient has at
least one of the following signs or symptoms: fever (greater than 38°C), chills, or hypotension and
positive laboratory results are not related an infection at another site. And the same common
,commensal (i.e., diphtheroids [Corynebacterium spp. not C. diphtheriae], Bacillus spp. [not B.
anthracis], Propionibacterium spp., coagulase-negative Staphylococci.[inclyding S. epidermidis],
viridans group streptococci, Aerococcus spp., and Micrococcus spp.) is cultured from two or more
blood cultures drawn on separate Occasions. Criterion elements must occur within a time frame that
does not exceed a gap of 1 calendar day between two adjacent elements.
Question:
6. Which of the following organisms have been associated with the transmission of infections after
body piercing? 1) Atypical Mycobacterium species 2) Staphylococcus species 3) Pseudomonas
species 4) Haemophilus species a. 1,2,3 b. 2,3,4 c. 1,3,4 d. 1,2,4.
Answer:
1, 2, 3 Not Haemophilus species Rationale: Body piercing activities can transmit infectious diseases.
Bacterial infections may result from improper initial piercing technique or from poor hygiene. The
organisms involved in most earlobe-piercing infections are often considered normal skin flora,
including Staphylococcus and Streptococcus species. Higher ear piercings in the ear cartilage have
been associated with more pathogenic organisms, including Pseudomonas species. Multiple cases of
atypical Mycobacterium infections after piercing have been reported. Mastitis due to
Mycobacterium abscesses has been reported after a nipple piercing; Mycobacterium flavescens has
been reported after an eyebrow piercing, and Mycobacterium chelonae has been reported after a
navel piercing. There are case reports of infective endocarditis that required treatment with
intravenous antibiotics, and in some cases surgical intervention to replace heart valves; the
infections resulting from navel, earlobe, and nipple piercings. There has also been a case report of
tetanus after a naval piercing. Reference: APIC Text, 4th edition, Chapter 123 Body Piercing,
Tattoos, and Electrolysis
Question:
7. The Director of the Operating Room (OR) requests that the OR surfaces be routinely
environmentally cultured. The IP's best response should be: a. A schedule for routine culturing of
the OR should be arranged so that each room is cultured at a set interval b. Routine culturing of the
OR should be done in the absence of any epidemiologic investigations in that area C. Routine
culturing should not be done because it is too expensive d. Routine environmental culturing should
not be considered unless an epidemiologic investigation is being conducted.
Answer:
d. Routine environmental culturing should not be considered unless an epidemiologic investigation
is being conducted Rationale: Microbiological environmental testing is not generally recommended.
Environmental culturing can be costly and may require special laboratory procedures. Additionally,
, in most cases no standards for comparison exist. Because of the lack of standards, environmental
testing may generate inconclusive data that could result in the implementation of unnecessary
procedures or treatment. Rationale for special environmental monitoring should be carefully
planned and limited to epidemiological investigations. In limited situations, "routine" environmental
sampling may be indicated. Reference: APIC Text, 4th edition, Chapter 24 - Microbiology Basics
Question:
8. All of the following may be indications of a heating, ventilation, and air conditioning (HVAC)
malfunction except: a. An increase in the postoperative surgical site infection (SSI) rates b. A single
case of aspergillosis in a severely immunosuppressed patient c. Healthcare-associated varicella
infections d. An outbreak of ventilator-associated Acinetobacter infections in the Intensive Care
Unit (ICU).
Answer:
d. An outbreak of ventilator- associated Acinetobacter infections in the Intensive Care Unit (ICU)
Rationale: Detection and identification of certain HAls may suggest HVAC malfunction (e.g.,
healthcare-associated tuberculosis, single case of aspergillosis in a severely immunosuppressed
patient, healthcare-associated varicella infections). Analysis of postoperative SSI rates and
associated infectious agents may offer important clues to problems in the OR air system(s). HVAC
systems are usually not the immediate cause of device associated HAls. Reference: APIC Text, 4th
edition, Chapter 114 - Heating, Ventilation, and Air Conditioning
Question:
9. A patient who underwent intraocular surgery was diagnosed with a noninfectious endopthalmitis
after the procedure. The IP initiates an investigation to identify the possible cause. Which of the
following factors should be considered? 1) Improper handling, cleaning, and rinsing of the
instruments 2) Improper labeling of the solutions 3) Gloves and powder 4) Prophylactic antibiotics
administered 2 hours before the procedure a. 1,3 b. 1,2 c. 3,4 d. 2,4.
Answer:
1,3 1) Improper handling, cleaning, and rinsing of the instruments 3) Gloves and powder Rationale:
Endophthalmitis is an inflammatory condition of the intraocular cavities (aqueous and/or vitreous
humor) usually caused by infection. Noninfectious (sterile) endophthalmitis may result from various
causes such as retained native lens material after an operation or from toxic agents. Improper
cleaning and rinsing of surgical instruments can leave a residue, which can irritate the eye and cause
an inflammation. Gloves, especially those with powder, can also cause inflammation of the eye
during surgery. Only a few organisms can penetrate the intact epithelium of the conjunctiva or
cornea. Among these are Neisseria gonorrhoeae, Neisseria meningitidis, Streptococcus pneumoniae,
CIC Practice EXAM 2026/2027 Questions Answers
Questions and Answers Verified Solutions Latest
Update
Question:
2. Which of the following is an example of the criterion of "Strength of the Association" from Hill's
criteria for causation? a. In a study of the association between antibiotic exposure and development
of C. difficile infection, the odds ratio was 2:3 b. In a study of the association between antibiotic
exposure and development of C. difficile infection, the authors' conclusions are consistent with
those of three other studies c. In a study of the association between antibiotic exposure and
development of C. difficile infection, antibiotic therapy began an average of 3 weeks before C.
difficile infection developed d. In a study of the association between antibiotic exposure and
development of C. difficile infection, prolonged antibiotic therapy was a greater risk factor for C.
difficile infection than short-term antibiotic therapy.
Answer:
In a study of the association between antibiotic exposure and development of C. difficile infection,
the odds ratio was 2:3 Rationale: Causal associations exist when evidence indicates that one factor is
clearly shown to increase the probability of the occurrence of a disease. In a causal relationship, the
reduction or diminution of a factor decreases the frequency of the disease being studied. The criteria
currently used for causality were developed by Austin Bradford Hill and are known as Hill's criteria.
These criteria use modern epidemiological methods to determine whether a factor is causal for a
given disease. Strength of association is the first criterion: The incidence of disease should be higher
in those who are exposed to the factor under consideration than in those who are not exposed; that
is, the stronger the association between an exposure and a disease, the more likely the exposure is to
be causal. The odds ratio is a statistical measure that gives us an indication of how strongly the risk
factor is associated with the disease outcome. Reference: APIC Text, 4th edition, Chapter 10
Question:
3. Which of the following rules should be followed when collecting a stool sample for C. difficile
testing? 1) Stool sample should be freshly passed within 1-2 hours 2) 10-20rnL. of formed stool
should be collected 3) Stool should be passed into a clean, dry container 4) Specimens should be
obtained before antimicrobial agents have been administered a. 1,2 b. 2,3 c. 1,3 d. 1,4.
Answer:
,1, 3 1) Stool sample should be freshly passed within 1-2 hours 3) Stool should be passed into a
clean, dry container Rationale: The accuracy of all tests depends on proper specimen handling and
transport. The following rules should be followed when collecting samples for C. difficile testing:
Stool samples should be freshly passed within 1-2 hours 10-20 mL of watery, soft, or unformed
stool should be collected Stool should be passed into a clean, dry container Reference: APIC Text,
4th edition, Chapter 72
Question:
4. What type of meningitis would be most consistent with the following cerebrospinal fluid (CSF)
report result: ++++++++++++++++++++++++++++++++++++++++++++++++++++
+++++++++++ Glucose: decreased Protein: elevated WBC: 1,000/mm(3)
++++++++++++++++++++++++++++++++++++++++++++++++++++ +++++++++++ a.
Bacterial b. Viral c. Fungal d. Tuberculosis.
Answer:
Bacterial Rationale: Culture of blood and CSF are indicated for patients with suspected invasive
meningococcal disease. The CSF of- patients with untreated meningococcal meningitis is usually:
cloudy pleocytosis (>WBC in CSF) with a predominance of neutrophils, low glucose, high protein
levels In most of the cases, the organisms are seen on Gram stain or can be identified using latex
agglutination assays. The culture is almost invariably positive as long as the samples was obtained
before the administration of antibiotics. Reference: APIC Text, 4th edition, Chapter 74 - Central
Nervous System Infection
Question:
5. The following blood culture result should be considered a potential contaminant: a. A positive
result of coagulase-negative staphylococci from two sets, 2 days apart, without symptoms b. A
positive result of S. aureus from one bottle in a patient with a temperature of 38.6°C c. A positive
result of E. coli from one bottle in an afebrile patient with diarrhea d. A positive result of Candida
albicans in a fungal blood culture in a patient with a urinary tract infection.
Answer:
A positive result of coagulase negative staphylococci from two sets, 2 days apart without symptoms
Rationale: According to the CDC CLABSI criteria, common commensals (such as
coagulase-negative staphylococci) meet the criteria for a CLABSI if there are two positive cultures
from two or more sets of blood cultures drawn " less than 2 days apart" and the patient has
symptoms (fever greater than 38°C, chills, or hypotension). CDC CLABSI criteria: Patient has at
least one of the following signs or symptoms: fever (greater than 38°C), chills, or hypotension and
positive laboratory results are not related an infection at another site. And the same common
,commensal (i.e., diphtheroids [Corynebacterium spp. not C. diphtheriae], Bacillus spp. [not B.
anthracis], Propionibacterium spp., coagulase-negative Staphylococci.[inclyding S. epidermidis],
viridans group streptococci, Aerococcus spp., and Micrococcus spp.) is cultured from two or more
blood cultures drawn on separate Occasions. Criterion elements must occur within a time frame that
does not exceed a gap of 1 calendar day between two adjacent elements.
Question:
6. Which of the following organisms have been associated with the transmission of infections after
body piercing? 1) Atypical Mycobacterium species 2) Staphylococcus species 3) Pseudomonas
species 4) Haemophilus species a. 1,2,3 b. 2,3,4 c. 1,3,4 d. 1,2,4.
Answer:
1, 2, 3 Not Haemophilus species Rationale: Body piercing activities can transmit infectious diseases.
Bacterial infections may result from improper initial piercing technique or from poor hygiene. The
organisms involved in most earlobe-piercing infections are often considered normal skin flora,
including Staphylococcus and Streptococcus species. Higher ear piercings in the ear cartilage have
been associated with more pathogenic organisms, including Pseudomonas species. Multiple cases of
atypical Mycobacterium infections after piercing have been reported. Mastitis due to
Mycobacterium abscesses has been reported after a nipple piercing; Mycobacterium flavescens has
been reported after an eyebrow piercing, and Mycobacterium chelonae has been reported after a
navel piercing. There are case reports of infective endocarditis that required treatment with
intravenous antibiotics, and in some cases surgical intervention to replace heart valves; the
infections resulting from navel, earlobe, and nipple piercings. There has also been a case report of
tetanus after a naval piercing. Reference: APIC Text, 4th edition, Chapter 123 Body Piercing,
Tattoos, and Electrolysis
Question:
7. The Director of the Operating Room (OR) requests that the OR surfaces be routinely
environmentally cultured. The IP's best response should be: a. A schedule for routine culturing of
the OR should be arranged so that each room is cultured at a set interval b. Routine culturing of the
OR should be done in the absence of any epidemiologic investigations in that area C. Routine
culturing should not be done because it is too expensive d. Routine environmental culturing should
not be considered unless an epidemiologic investigation is being conducted.
Answer:
d. Routine environmental culturing should not be considered unless an epidemiologic investigation
is being conducted Rationale: Microbiological environmental testing is not generally recommended.
Environmental culturing can be costly and may require special laboratory procedures. Additionally,
, in most cases no standards for comparison exist. Because of the lack of standards, environmental
testing may generate inconclusive data that could result in the implementation of unnecessary
procedures or treatment. Rationale for special environmental monitoring should be carefully
planned and limited to epidemiological investigations. In limited situations, "routine" environmental
sampling may be indicated. Reference: APIC Text, 4th edition, Chapter 24 - Microbiology Basics
Question:
8. All of the following may be indications of a heating, ventilation, and air conditioning (HVAC)
malfunction except: a. An increase in the postoperative surgical site infection (SSI) rates b. A single
case of aspergillosis in a severely immunosuppressed patient c. Healthcare-associated varicella
infections d. An outbreak of ventilator-associated Acinetobacter infections in the Intensive Care
Unit (ICU).
Answer:
d. An outbreak of ventilator- associated Acinetobacter infections in the Intensive Care Unit (ICU)
Rationale: Detection and identification of certain HAls may suggest HVAC malfunction (e.g.,
healthcare-associated tuberculosis, single case of aspergillosis in a severely immunosuppressed
patient, healthcare-associated varicella infections). Analysis of postoperative SSI rates and
associated infectious agents may offer important clues to problems in the OR air system(s). HVAC
systems are usually not the immediate cause of device associated HAls. Reference: APIC Text, 4th
edition, Chapter 114 - Heating, Ventilation, and Air Conditioning
Question:
9. A patient who underwent intraocular surgery was diagnosed with a noninfectious endopthalmitis
after the procedure. The IP initiates an investigation to identify the possible cause. Which of the
following factors should be considered? 1) Improper handling, cleaning, and rinsing of the
instruments 2) Improper labeling of the solutions 3) Gloves and powder 4) Prophylactic antibiotics
administered 2 hours before the procedure a. 1,3 b. 1,2 c. 3,4 d. 2,4.
Answer:
1,3 1) Improper handling, cleaning, and rinsing of the instruments 3) Gloves and powder Rationale:
Endophthalmitis is an inflammatory condition of the intraocular cavities (aqueous and/or vitreous
humor) usually caused by infection. Noninfectious (sterile) endophthalmitis may result from various
causes such as retained native lens material after an operation or from toxic agents. Improper
cleaning and rinsing of surgical instruments can leave a residue, which can irritate the eye and cause
an inflammation. Gloves, especially those with powder, can also cause inflammation of the eye
during surgery. Only a few organisms can penetrate the intact epithelium of the conjunctiva or
cornea. Among these are Neisseria gonorrhoeae, Neisseria meningitidis, Streptococcus pneumoniae,
