CIC CERTIFICATION EXAM- SURVEILLANCE
AND EPIDEMIOLOGIC INVESTIGATION
EXAM NEWEST 2026
1. An IP is calculating the incidence rate of CLABSI on a 20-bed ICU. Over 30 days,
there were 4 new CLABSIs and 540 central line days. What is the rate per 1,000
central line days?
A) 4.2
B) 7.4
C) 13.5
D) 0.74
Correct Answer: B
Rationale: Incidence rate = (Number of new infections / Number of central line
days) x 1,000. () x 1,000 = 7.4 per 1,000 line days.
2. A hospital uses electronic health record alerts to monitor over-the-counter
antihistamine sales in the community to detect early signs of a bioterrorism
event. This is an example of:
A) Targeted surveillance
B) Syndromic surveillance
C) Active surveillance
D) Outcome surveillance
Correct Answer: B
Rationale: Syndromic surveillance uses pre-diagnostic data (e.g., medication sales,
ER fever visits) to identify potential outbreaks or bioterrorism events rapidly,
before lab confirmation.
3. During an outbreak of gastrointestinal illness, you calculate that 18 out of 22
people who ate the potato salad became ill. What is the attack rate?
,A) 81.8%
B) 22.2%
C) 40.9%
D) 18.2%
Correct Answer: A
Rationale: Attack rate = (Ill / Total exposed) x 100. () x 100 = 81.8%. This is a
classic point-source outbreak measure.
4. An IP reviews 500 charts and finds 20 existing cases of MRSA colonization on
admission. What is the prevalence of MRSA colonization in this population?
A) 2%
B) 4%
C) 10%
D) 20%
Correct Answer: B
Rationale: Prevalence = (Existing total cases / Total population) x 100. () x
100 = 4%. Prevalence measures the disease burden at a single point in time.
5. Which statistical test is most appropriate for comparing infection rates
between two small groups when the expected frequency in any cell is less than
5?
A) Chi-square test
B) Student's t-test
C) Fisher's exact test
D) ANOVA
Correct Answer: C
Rationale: Fisher's exact test is specifically designed for 2x2 contingency tables
with small sample sizes, unlike Chi-square which requires expected cell counts >5.
,6. In a control chart used for surveillance, a data point that falls outside the
upper control limit indicates:
A) Common cause variation
B) Expected seasonal variation
C) Special cause variation
D) A calculation error
Correct Answer: C
Rationale: Control charts distinguish between common cause (inherent to the
process) and special cause (due to an external factor). Points outside the control
limits signal special cause variation requiring investigation.
7. What is the first step an IP should take upon suspecting a healthcare-
associated outbreak?
A) Implement immediate isolation precautions for all patients
B) Notify the local public health department
C) Verify the existence of the outbreak and the diagnosis
D) Collect environmental cultures
Correct Answer: C
Rationale: Before expending resources, the IP must verify that an outbreak truly
exists by confirming diagnoses and ensuring the observed cases exceed the
baseline endemic rate.
8. Which measure of central tendency is most affected by extreme outliers in a
data set?
A) Median
B) Mode
C) Mean
D) Percentile
Correct Answer: C
Rationale: The mean (average) is highly sensitive to extreme values (skewed data).
The median is the preferred measure of central tendency for skewed distributions.
, 9. A surgeon has performed 50 hip replacements. Two patients developed deep
SSIs. What is the surgeon-specific infection rate?
A) 0.04%
B) 2%
C) 4%
D) 20%
Correct Answer: C
Rationale: Surgeon-specific rate = (Infections for that surgeon / Procedures
performed by that surgeon) x 100. (2/50) x 100 = 4%.
10. You are investigating a cluster of Aspergillus infections in transplant patients.
Which type of investigation is this primarily classified as?
A) Point-source outbreak
B) Common-vehicle outbreak
C) Propagated outbreak
D) Pseudo-outbreak
Correct Answer: B
Rationale: Aspergillus clusters in immunocompromised patients are often traced
to a common environmental source (e.g., hospital construction dust,
contaminated HVAC systems), making it a common-vehicle (point-source)
exposure.
11. Monitoring hand hygiene compliance rates among nursing staff is an
example of:
A) Outcome surveillance
B) Process surveillance
C) Syndromic surveillance
D) Sentinel surveillance
Correct Answer: B
AND EPIDEMIOLOGIC INVESTIGATION
EXAM NEWEST 2026
1. An IP is calculating the incidence rate of CLABSI on a 20-bed ICU. Over 30 days,
there were 4 new CLABSIs and 540 central line days. What is the rate per 1,000
central line days?
A) 4.2
B) 7.4
C) 13.5
D) 0.74
Correct Answer: B
Rationale: Incidence rate = (Number of new infections / Number of central line
days) x 1,000. () x 1,000 = 7.4 per 1,000 line days.
2. A hospital uses electronic health record alerts to monitor over-the-counter
antihistamine sales in the community to detect early signs of a bioterrorism
event. This is an example of:
A) Targeted surveillance
B) Syndromic surveillance
C) Active surveillance
D) Outcome surveillance
Correct Answer: B
Rationale: Syndromic surveillance uses pre-diagnostic data (e.g., medication sales,
ER fever visits) to identify potential outbreaks or bioterrorism events rapidly,
before lab confirmation.
3. During an outbreak of gastrointestinal illness, you calculate that 18 out of 22
people who ate the potato salad became ill. What is the attack rate?
,A) 81.8%
B) 22.2%
C) 40.9%
D) 18.2%
Correct Answer: A
Rationale: Attack rate = (Ill / Total exposed) x 100. () x 100 = 81.8%. This is a
classic point-source outbreak measure.
4. An IP reviews 500 charts and finds 20 existing cases of MRSA colonization on
admission. What is the prevalence of MRSA colonization in this population?
A) 2%
B) 4%
C) 10%
D) 20%
Correct Answer: B
Rationale: Prevalence = (Existing total cases / Total population) x 100. () x
100 = 4%. Prevalence measures the disease burden at a single point in time.
5. Which statistical test is most appropriate for comparing infection rates
between two small groups when the expected frequency in any cell is less than
5?
A) Chi-square test
B) Student's t-test
C) Fisher's exact test
D) ANOVA
Correct Answer: C
Rationale: Fisher's exact test is specifically designed for 2x2 contingency tables
with small sample sizes, unlike Chi-square which requires expected cell counts >5.
,6. In a control chart used for surveillance, a data point that falls outside the
upper control limit indicates:
A) Common cause variation
B) Expected seasonal variation
C) Special cause variation
D) A calculation error
Correct Answer: C
Rationale: Control charts distinguish between common cause (inherent to the
process) and special cause (due to an external factor). Points outside the control
limits signal special cause variation requiring investigation.
7. What is the first step an IP should take upon suspecting a healthcare-
associated outbreak?
A) Implement immediate isolation precautions for all patients
B) Notify the local public health department
C) Verify the existence of the outbreak and the diagnosis
D) Collect environmental cultures
Correct Answer: C
Rationale: Before expending resources, the IP must verify that an outbreak truly
exists by confirming diagnoses and ensuring the observed cases exceed the
baseline endemic rate.
8. Which measure of central tendency is most affected by extreme outliers in a
data set?
A) Median
B) Mode
C) Mean
D) Percentile
Correct Answer: C
Rationale: The mean (average) is highly sensitive to extreme values (skewed data).
The median is the preferred measure of central tendency for skewed distributions.
, 9. A surgeon has performed 50 hip replacements. Two patients developed deep
SSIs. What is the surgeon-specific infection rate?
A) 0.04%
B) 2%
C) 4%
D) 20%
Correct Answer: C
Rationale: Surgeon-specific rate = (Infections for that surgeon / Procedures
performed by that surgeon) x 100. (2/50) x 100 = 4%.
10. You are investigating a cluster of Aspergillus infections in transplant patients.
Which type of investigation is this primarily classified as?
A) Point-source outbreak
B) Common-vehicle outbreak
C) Propagated outbreak
D) Pseudo-outbreak
Correct Answer: B
Rationale: Aspergillus clusters in immunocompromised patients are often traced
to a common environmental source (e.g., hospital construction dust,
contaminated HVAC systems), making it a common-vehicle (point-source)
exposure.
11. Monitoring hand hygiene compliance rates among nursing staff is an
example of:
A) Outcome surveillance
B) Process surveillance
C) Syndromic surveillance
D) Sentinel surveillance
Correct Answer: B
