CIC Practice Test 1
A blood spill contaminated a pneumatic tube system and its
contents. The leak was not identified for a period of time. After
remediation of the contamination, the IP recommended the
following to prevent a future incident:
a. Establish a method to recognize spills or leaks
b. Perform a hazard vulnerability analysis
c. Contract with an outside vendor to clean and
maintain system
d. Restrict the use of pneumatic tube to nonhazardous
material - ANS-A. Establish a method to recognize spills or leaks
Blood/body fluid (e.g., from specimens due to spill or leak) may
contaminate transport system pathways (e.g., pneumatic tube system), receiver
stations, transport carts, dumbwaiters, or elevators. Disruption caused by these
spills can delay specimen transport and processing until the area is cleaned
and disinfected. Personnel may also be exposed to bloodborne pathogens,
other microbes (e.g., sputum specimen, tissue specimen), or chemicals
(pharmaceuticals; preservatives such as formaldehyde). Establish a method
to recognize spills or leaks; include communication protocol (e.g., notification
to sender, system shutdown, alternative methods of transport), cleaning and
decontamination, retrieval of "stuck" items, and restoration of system.
A case of healthcare-associated Mycobacterium chelonae
respiratory infection has been identified in a patient. Of the
following exposures that the patient had in the facility, which
should be investigated as a potential source of the infection?
1) Bronchoscopes
2) Dialysis
3) Hydrotherapy pool
4) Ice from tap water used during surgery
a. 1
b. 1, 3
c. 1, 3, 4
d. 1, 2, 3, 4 - ANS-B. 1, 3
Mycobacterium chelonae belongs to the family of nontuberculous
mycobacteria (NTM) classified in the rapidly growing mycobacteria (RGM),
,Runyon group IV. M chelonae are ubiquitous in the environment and have
been isolated from both natural and potable freshwater sources, soil,
contaminated solutions, and reptiles. The organism can grow in distilled
and unsupplemented water. Likely sources of healthcare-related exposure
may occur from bronchoscopes that were processed with tap water or from
exposure to a hydrotherapy pool.
A healthcare facility is undergoing extensive renovation.
Surveillance for which of the following organisms would be
particularly important during any construction or renovation
project in a healthcare facility?
a. MRSA, VRE, and other MDROs
b. Legionella and Aspergillus
c. Gram-negative bacilli
d. Mycobacterium abscessus - ANS-B. Legionella and Aspergillus
The risk of HAIs increases significantly when hospitals are
undergoing construction and renovation. Dust particles contaminated with
bacteria and fungi are dispersed and pose a health risk for patients, staff, and
visitors. Construction-related HAIs are primarily caused by fungi, and to a
lesser extent by bacteria. The most common etiological agent is Aspergillus,
in particular, A. fumigatus, A. flavus, A. niger, and A. terreus. A. fumigatus is
considered the most pathogenic species and is responsible for more than
90 percent of all Aspergillus infections. The most common group of bacteria
associated with construction-related nosocomial infections are Legionella
species, including L. pneumophila. Legionella bacteria have been isolated
from soil and dust but are more often associated with aquatic environments.
Typical water sources in hospitals supporting colonization with Legionella
bacteria are cooling towers, evaporative condensers, heated potable water
systems, and heating and air conditioning systems. During construction and
renovation processes, water systems are often disrupted. Potable water can
become contaminated with Legionella when the water supply is restored.
The introduction of contaminated soil into the plumbing system, as well as
optimized growth conditions for bacteria in stagnant water, may increase the
number of Legionella bacteria.
A healthcare worker has had her uniform scrub top contaminated
by a large blood spill that has penetrated the fabric. Choose her
best option for follow-up from the choices below.
a. She should be sent home immediately to take a shower
,b. She should remove the top by carefully pulling it over her
head and then launder it in a washing machine with hot
water and bleach
c. She should remove the scrub top by using scissors to
cut it off and discard it in a biohazard-labeled container
d. She should remove the top by pulling it over her head
and then discard it in the trash - ANS-C. S he should remove the scrub top by using
scissors to cut it off and discard it in a biohazard-labeled container
A scrub top that has been thoroughly soiled with blood should be
removed immediately. If the scrub top is soiled through the top layer, there is
potential for further exposure through contamination of mucus membranes if
the employee pulls it over her head. She should use scissors to carefully cut
off the top.
A hospital administrator has proposed that single-use
angiography catheters be reprocessed and reused to cut
costs. What is the best response to this request?
a. Single-use items are not allowed to be reprocessed
b. A cost-benefit analysis should be done before a
decision is made
c. Single-use items can be reprocessed in the facility as long
as administration, Risk Management, Legal Counsel, Supply
Chain Administrator, and Infection Control representatives
say it is allowable
d. Single-use items can be reprocessed in a third-party facility
if FDA guidelines are followed - ANS-D. Single-use items can be reprocessed in a
third-party facility
if FDA guidelines are followed
The decision to reprocess and reuse a single-use item should
be made by representatives from Administration, Risk Management, Legal
Counsel, the supply chain administrator, and Infection Control. Thirdparty
reprocessors must be FDA-licensed to reprocess single-use devices.
The reprocessing facility must maintain its own documentation, but it is
recommended that the IP also review all documentation and records.
A major difference between a prospective and a retrospective
study is that the prospective study:
a. Requires a relatively small number of subjects
, b. Is usually used for testing initial hypotheses
c. May require a long follow-up period
d. Is usually less costly - ANS-C. May require a long follow-up period
A retrospective study looks backwards and examines exposures
to suspected risk or protection factors in relation to an outcome that is
established at the start of the study. Retrospective studies may be undertaken
in a timelier and less-expensive manner than prospective cohort studies
because cases may be identified retrospectively, and at least some exposure
data are often available through medical record review.
A prospective cohort study watches for outcomes, such as the development
of a disease, during the study period and relates this to other factors such
as suspected risk or protection factor(s). The study usually involves taking
a cohort of subjects and watching them over a long period. Prospective
studies usually have fewer potential sources of bias and confounding than
retrospective studies.
A major hurricane is forecast for your area and you need to
plan for the possible contamination of potable water that is
supplied to your facility. Which of the following should be
included in your planning?
a. You should have at least one day's worth of back up
water supplies available
b. You will need one liter per day of drinking water
for all patients and healthcare workers
c. All back up water must be stored on site for easy access
d. You will need at least 25 gallons of water per patient
per day to maintain care - ANS-D. You will need at least 25 gallons of water per patient
per day to maintain care
In the event of a disaster, it is critical to ensure that there is a
reliable supply of water available for drinking and for patient care activities.
Individuals in the facility will need at least 2 liters of drinking water per day
per person, and additional water will be needed for bathing, flushing toilets,
dialysis, cooking, and other activities. It is estimated that a facility will need 25
gallons of water per patient per day to maintain these patient care activities.
Water may be stored on-site or off-site but it must be accessible in the event
of an emergency.
A measles exposure from a patient in a clinic was identified and
A blood spill contaminated a pneumatic tube system and its
contents. The leak was not identified for a period of time. After
remediation of the contamination, the IP recommended the
following to prevent a future incident:
a. Establish a method to recognize spills or leaks
b. Perform a hazard vulnerability analysis
c. Contract with an outside vendor to clean and
maintain system
d. Restrict the use of pneumatic tube to nonhazardous
material - ANS-A. Establish a method to recognize spills or leaks
Blood/body fluid (e.g., from specimens due to spill or leak) may
contaminate transport system pathways (e.g., pneumatic tube system), receiver
stations, transport carts, dumbwaiters, or elevators. Disruption caused by these
spills can delay specimen transport and processing until the area is cleaned
and disinfected. Personnel may also be exposed to bloodborne pathogens,
other microbes (e.g., sputum specimen, tissue specimen), or chemicals
(pharmaceuticals; preservatives such as formaldehyde). Establish a method
to recognize spills or leaks; include communication protocol (e.g., notification
to sender, system shutdown, alternative methods of transport), cleaning and
decontamination, retrieval of "stuck" items, and restoration of system.
A case of healthcare-associated Mycobacterium chelonae
respiratory infection has been identified in a patient. Of the
following exposures that the patient had in the facility, which
should be investigated as a potential source of the infection?
1) Bronchoscopes
2) Dialysis
3) Hydrotherapy pool
4) Ice from tap water used during surgery
a. 1
b. 1, 3
c. 1, 3, 4
d. 1, 2, 3, 4 - ANS-B. 1, 3
Mycobacterium chelonae belongs to the family of nontuberculous
mycobacteria (NTM) classified in the rapidly growing mycobacteria (RGM),
,Runyon group IV. M chelonae are ubiquitous in the environment and have
been isolated from both natural and potable freshwater sources, soil,
contaminated solutions, and reptiles. The organism can grow in distilled
and unsupplemented water. Likely sources of healthcare-related exposure
may occur from bronchoscopes that were processed with tap water or from
exposure to a hydrotherapy pool.
A healthcare facility is undergoing extensive renovation.
Surveillance for which of the following organisms would be
particularly important during any construction or renovation
project in a healthcare facility?
a. MRSA, VRE, and other MDROs
b. Legionella and Aspergillus
c. Gram-negative bacilli
d. Mycobacterium abscessus - ANS-B. Legionella and Aspergillus
The risk of HAIs increases significantly when hospitals are
undergoing construction and renovation. Dust particles contaminated with
bacteria and fungi are dispersed and pose a health risk for patients, staff, and
visitors. Construction-related HAIs are primarily caused by fungi, and to a
lesser extent by bacteria. The most common etiological agent is Aspergillus,
in particular, A. fumigatus, A. flavus, A. niger, and A. terreus. A. fumigatus is
considered the most pathogenic species and is responsible for more than
90 percent of all Aspergillus infections. The most common group of bacteria
associated with construction-related nosocomial infections are Legionella
species, including L. pneumophila. Legionella bacteria have been isolated
from soil and dust but are more often associated with aquatic environments.
Typical water sources in hospitals supporting colonization with Legionella
bacteria are cooling towers, evaporative condensers, heated potable water
systems, and heating and air conditioning systems. During construction and
renovation processes, water systems are often disrupted. Potable water can
become contaminated with Legionella when the water supply is restored.
The introduction of contaminated soil into the plumbing system, as well as
optimized growth conditions for bacteria in stagnant water, may increase the
number of Legionella bacteria.
A healthcare worker has had her uniform scrub top contaminated
by a large blood spill that has penetrated the fabric. Choose her
best option for follow-up from the choices below.
a. She should be sent home immediately to take a shower
,b. She should remove the top by carefully pulling it over her
head and then launder it in a washing machine with hot
water and bleach
c. She should remove the scrub top by using scissors to
cut it off and discard it in a biohazard-labeled container
d. She should remove the top by pulling it over her head
and then discard it in the trash - ANS-C. S he should remove the scrub top by using
scissors to cut it off and discard it in a biohazard-labeled container
A scrub top that has been thoroughly soiled with blood should be
removed immediately. If the scrub top is soiled through the top layer, there is
potential for further exposure through contamination of mucus membranes if
the employee pulls it over her head. She should use scissors to carefully cut
off the top.
A hospital administrator has proposed that single-use
angiography catheters be reprocessed and reused to cut
costs. What is the best response to this request?
a. Single-use items are not allowed to be reprocessed
b. A cost-benefit analysis should be done before a
decision is made
c. Single-use items can be reprocessed in the facility as long
as administration, Risk Management, Legal Counsel, Supply
Chain Administrator, and Infection Control representatives
say it is allowable
d. Single-use items can be reprocessed in a third-party facility
if FDA guidelines are followed - ANS-D. Single-use items can be reprocessed in a
third-party facility
if FDA guidelines are followed
The decision to reprocess and reuse a single-use item should
be made by representatives from Administration, Risk Management, Legal
Counsel, the supply chain administrator, and Infection Control. Thirdparty
reprocessors must be FDA-licensed to reprocess single-use devices.
The reprocessing facility must maintain its own documentation, but it is
recommended that the IP also review all documentation and records.
A major difference between a prospective and a retrospective
study is that the prospective study:
a. Requires a relatively small number of subjects
, b. Is usually used for testing initial hypotheses
c. May require a long follow-up period
d. Is usually less costly - ANS-C. May require a long follow-up period
A retrospective study looks backwards and examines exposures
to suspected risk or protection factors in relation to an outcome that is
established at the start of the study. Retrospective studies may be undertaken
in a timelier and less-expensive manner than prospective cohort studies
because cases may be identified retrospectively, and at least some exposure
data are often available through medical record review.
A prospective cohort study watches for outcomes, such as the development
of a disease, during the study period and relates this to other factors such
as suspected risk or protection factor(s). The study usually involves taking
a cohort of subjects and watching them over a long period. Prospective
studies usually have fewer potential sources of bias and confounding than
retrospective studies.
A major hurricane is forecast for your area and you need to
plan for the possible contamination of potable water that is
supplied to your facility. Which of the following should be
included in your planning?
a. You should have at least one day's worth of back up
water supplies available
b. You will need one liter per day of drinking water
for all patients and healthcare workers
c. All back up water must be stored on site for easy access
d. You will need at least 25 gallons of water per patient
per day to maintain care - ANS-D. You will need at least 25 gallons of water per patient
per day to maintain care
In the event of a disaster, it is critical to ensure that there is a
reliable supply of water available for drinking and for patient care activities.
Individuals in the facility will need at least 2 liters of drinking water per day
per person, and additional water will be needed for bathing, flushing toilets,
dialysis, cooking, and other activities. It is estimated that a facility will need 25
gallons of water per patient per day to maintain these patient care activities.
Water may be stored on-site or off-site but it must be accessible in the event
of an emergency.
A measles exposure from a patient in a clinic was identified and
