a-IPC Exam Study Guide (Practice Test -1) Questions and Complete Solutions Graded A+

a-IPC Exam Study Guide (Practice Test #1) Questions and Complete Solutions Graded A+ The bacterium most likely to be transmitted from mother to infant during labor and cause neonatal sepsis is: a. Escherichia coli b. Staphylococcus aureus c. Group B Streptococcus d. Group A Streptococcus - Answer: c. Group B Streptococcus 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: a. In a study of the association between antibiotic exposure and development of C. difficile infection, the odds ratio was 2:3 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) 10-20mL. 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: c. 1, 3 What type of meningitis would be most consistent with the following cerebrospinal fluid (CSF) report result: Glucose= Decreased; Protein= Elevated; WBC counts= 1,000/mm3 a. Bacterial b. Viral c. Fungal d. Tuberculosis - Answer: a. Bacterial 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. A positive result of coagulase-negative staphylococci from two sets, 2 days apart, without symptoms 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: a. 1, 2, 3 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 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) 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: a. 1, 3 Sensitivity may be defined as: a. The ability of a test to detect true positives (persons with the disease) when applied to a population with the disease b. The ability of a test to detect the true negatives (persons without the disease) when applied to a population without the disease c. The ability of a test to detect true positives (persons with disease) when applied to a population without the disease d. The percentage of persons with true positive results when the test is applied to persons without the disease - Answer: a. The ability of a test to detect true positives (persons with the disease) when applied to a population with the disease The IP is monitoring blood work in order to differentiate between bacterial or viral infection in a newly admitted ICU patient. Which of the following components of a complete blood count (CBC) should the IP examine in order to determine this information? a. Hematocrit b. White blood cell count c. Platelet (thrombocyte count) d. Red blood cell indices - Answer: b. White blood cell count A nurse manager from a Rehabilitation Unit is requesting that aerators be installed on the sinks in the patient rooms on her unit. The IP should explain that: a. Aerators should be placed on all sinks in the ICU only b. Aerators are more effective when combined with an ultraviolet water disinfection method c. Aerators increase the risk of HAIs d. Low-flow aerators are suitable for use with this population - Answer: c. Aerators increase the risk of HAIs Herpes simplex virus (HSV) keratitis is suspected in an oncology patient. Aerobic eye cultures are negative to date. A single serum sample is sent for enzyme-linked immunosorbent assay (ELISA) antibody testing. The following titers are reported: HSV titer 1:128, cytomegalovirus (CMV) titer <1:8, Epstein-Barr virus (EBV) titer <1:8. These results indicate: a. Immunity to HSV b. Confirmation of acute HSV infection c. Presumptive identification of HSV infection d. Immunity to CMV and EBV - Answer: c. Presumptive identification of HSV infection A patient is suspected of having Pertussis. A nasopharyngeal aspirate is collected for direct fluorescent antibody (DFA) testing and for culture eight hours after antimicrobial therapy is started. The DFA test is negative but the culture test is positive. Does this patient have Pertussis? a. No, because the DFA test is highly specific and it was negative b. No, because culture of Bordatella pertussis has very low sensitivity c. No, because all testing is unreliable if antimicrobial therapy has been initiated prior to specimen collection d. Yes, because the culture test is 100 percent specific for identification of Bordatella pertussis - Answer: d. Yes, because the culture test is 100 percent specific for identification of Bordatella pertussis An ambulatory clinic will be transporting equipment to the local hospital for sterilization. The IP at the clinic has been askedto write a policy to ensure safe handling of the equipment by staff. The policy should include which of the following points on handling the instruments at the point of use? 1) Devices are to be cleaned before biofilm can form 2) Keep instrumentation moist to prevent bio-burden from drying 3) Instruments with lumens should be flushed with saline 4) Contaminated devices are to be placed in a sealed container to prevent exposure to staff and patients a. 1, 3, 4 b. 2, 3, 4 c. 1, 2, 4 d. 1, 2, 3 - Answer: c. 1, 2, 4 A patient is admitted for a skin infection after swimming in the ocean. Which of the following organisms is the most likely cause? a. Mycobacterium marinum b. Mycobacterium avium c. Mycobacterium leprae d. Mycobacterium tuberculosis - Answer: a. Mycobacterium marinum What is the probability of committing a Type I error if the p value is 0.10? a. 1 in 10 b. 1 in 100 c. 1 in 5 d. 1 in 20 - Answer: a. 1 in 10 Which of the following is an example of the principle of emergency management called "mitigation?" a. Implementation of the hospital's emergency management plan during a hurricane b. Recovery efforts after a major flood has subsided c. A facility-wide bioterrorism disaster drill d. Funding a program that will provide ring vaccination of exposed people against smallpox during an outbreak - Answer: d. Funding a program that will provide ring vaccination of exposed people against smallpox during an outbreak The purpose of the antibiogram is to: a. Provide a monthly report on new and emerging antimicrobials b. Give IPs another metric to track c. Provide information on antimicrobial usage and resistance patterns in the community d. Give hospitals information needed for reporting data through the National Healthcare Safety Network (NHSN) - Answer: c. Provide information on antimicrobial usage and resistance patterns in the community The most common organism associated with pneumonia in school-aged children and young adults is: a. Neisseria meningitidis b. Streptococcus pneumoniae c. Staphylococcus aureus d. Mycoplasma pneumoniae - Answer: d. Mycoplasma pneumoniae The purpose of a root cause analysis is to: a. Determine which individual made an error so that the employee may be disciplined or terminated b. Review the basic processes that are in place and then turn that review over to a unit-specific team so that they can determine how they should modify their practices c. Provide a process that requires little time or training but allows employees to identify culpability after an adverse event d. Include participants from diverse areas of the organization to delve into the cause of an error or systems failure and identify changes in practice and/or policy that will prevent a repeat of that error or event - Answer: d. Include participants from diverse areas of the organization to delve into the cause of an error or systems failure and identify changes in practice and/or policy that will prevent a repeat of that error or event A pediatric patient has been diagnosed with pediculosis. What is the most appropriate follow-up to prevent it from spreading to other patients or healthcare professionals? a. Place the patient on Contact Precautions until 24 hours after appropriate treatment has been initiated b. Require all visitors and HCP who enter the room to wear a disposable scrub cap for any patient contact c. Use an insecticidal spray in the room after the patent is discharged d. Prophylactically treat all family members and anyone with close physical contact with the patient - Answer: a. Place the patient on Contact Precautions until 24 hours after appropriate treatment has been initiated An employee has experienced an accidental needlestick injury while providing care to a patient. All of the following lab tests would be appropriate for the source patient except: a. Human immunodeficiency virus (HIV) b. Hepatitis B antibody c. Hepatitis B surface antigen d. Hepatitis C Antibody (Anti-HCV) - Answer: b. Hepatitis B antibody The IP receives a call from a physician who is concerned that there is an outbreak of Acinetobacter baumannii, because he has cared for four patients in the past week who are infected with the organism. What is the IP's first step in responding to this call? a. Contact the lab to ask them to create an alert for any A. baumannii cases b. Contact hospital administration to request additional resources to investigate the outbreak c. Confirm that there is an outbreak by using her own surveillance data and lab records to compare the rates of Acinetobacter baumannii over the past year d. Initiate a case-control study to determine risk factors for A. baumanii infection - Answer: c. Confirm that there is an outbreak by using her own surveillance data and lab records to compare the rates of Acinetobacter baumannii over the past year The IP receives a call from the Food and Drug Administration (FDA) with an official request for private health information (PHI) about a patient who was admitted to the facility with botulism. How should the IP respond to this call? a. Tell the FDA officer that she cannot share PHI with the FDA due to Health Insurance Portability and Accountability Act (HIPAA) regulations b. Ask the FDA to contact the local health department to obtain information about the patient c. Provide the FDA officer with the minimum amount of information necessary related to the patient d. Transfer the call to the Risk Management Department - Answer: c. Provide the FDA officer with the minimum amount of information necessary related to the patient A measles exposure from a patient in a clinic was identified and an exposure workup was initiated. A staff exposure was defined as "nonimmune HCP with more than 5 minutes of same-room contact or face-to-face contact with the index patient." Forty- eight HCP were identified as possible exposures. Of these, 44 had documented immunity to measles. Of the remaining HCP, three did not have the same room or face-to-face contact. How many HCP were at risk of developing measles because of this exposure? a. 4 b. 45 c. 1 d. 48 - Answer: c. 1 Which of the following recommendations related to disinfection and sterilization in healthcare facilities is a CDC category 1A recommendation? 1) "Before use on each patient, sterilize critical medical and surgical devices and instruments that enter normally sterile tissue or the vascular system or through which a sterile body fluid flows" 2) "Meticulously clean patient-care items with water and detergent, or with water and enzymatic cleaners before high-level disinfection or sterilization procedures" 3) "In hospitals, perform most cleaning, disinfection, and sterilization of patient-care devices in a central processing department in order to more easily control quality" 4) "Perform low-level disinfection for noncritical patient-care surfaces (e.g., bedrails, over-the-bed table) and equipment (e.g., blood pressure cuff) that touch intact skin" a. 1 b. 1, 3 c. 1, 2, 4 d. 1, 2, 3, 4 - Answer: a. 1 Vaginal probes with probe covers require which type of disinfection: a. Low-level disinfection b. Intermediate-level disinfection c. High-level disinfection d. Sterilization - Answer: c. High-level disinfection The IP is reviewing the facility's performance measures, which are used to benchmark against national data. The IP ensures that each performance measure includes which of the following characteristics: 1) Measure is reliable 2) Measure targets improvement in a health population 3) Measure is defined according to physician preference 4) Measure can be easily interpreted by the users of the data a. 1, 2, 3 b. 1, 2, 4 c. 2, 3, 4 d. 1, 3, 4 - Answer: b. 1, 2, 4 A preliminary microbiology report states that a patient's blood culture grew aerobic, Gram-negative bacilli. Which of the following is the most likely genus and species of the organism: a. Enterococcus faecalis b. Bacteroides fragilis c. Acinetobacter baumanii d. Neisseria meningitides - Answer: c. Acinetobacter baumanii Urinary tract infections in the postpartum period have three important risk factors. Which of the following is not one of them: a. Induction of labor b. Tocolysis c. Cesarean delivery d. Twin births - Answer: d. Twin births If chance is a likely explanation for the difference between a sample statistic and the corresponding null hypothesis population value, then: a. The difference is not statistically significant b. The sample results are not compatible with the null hypothesis c. The difference is statistically significant d. The null hypothesis can be rejected - Answer: a. The difference is not statistically significant Noninfectious postoperative endophthalmitis is most often associated with: a. Wearing contact lens b. Toxic anterior segment syndrome (TASS) c. Conjunctivitis d. Keratitis - Answer: b. Toxic anterior segment syndrome (TASS) 34. An acute care facility experiences an outbreak of Serratia marcescens bloodstream infections. After the outbreak is under control and no new cases are being reported, the IP wants to find the source of the outbreak. The most appropriate epidemiology study design to use is: a. Retrospective cohort study b. Prospective cohort study c. Case-control study d. Cross-sectional study - Answer: c. Case-control study To calculate the catheter-associated urinary tract infection (CAUTI) rate for a unit for one month, the denominator should be: a. The number of patient days for the unit for the month b. The number of admissions for the unit for the month c. The number of patients with urinary catheters for the month d. The number of urinary catheter insertions for the month - Answer: c. The number of patients with urinary catheters for the month Which of the following is an example of surveillance on a process indicator? a. The incidence rate of Clostridium difficile in the Bone Marrow Transplant Unit b. The rate of hand hygiene compliance in the Bone Marrow Transplant Unit c. The number of sharp object injuries in the month of May in the Bone Marrow Transplant Unit d. The prevalence of vancomycin-resistant enterococci (VRE) in the Bone Marrow Transplant Unit - Answer: b. The rate of hand hygiene compliance in the Bone Marrow Transplant Unit Which of the following is not an advantage of a case-control study? a. It takes less time than a cohort study b. It requires fewer subjects c. The data are more accurate because it is prospective d. It is generally considered less expensive - Answer: c. The data are more accurate because it is prospective You are working with the antimicrobial stewardship program in your facility to educate providers on appropriate use of antimicrobials. Which of the following would be an accurate recommendation from your group? a. Metronidazole is an effective antimicrobial to use for MRSA skin infections b. Consistent use of broad-spectrum antimicrobials regardless of susceptibility results will help reduce antimicrobial resistance in the facility c. It is not always necessary to maintain antimicrobial concentration in the body above the level of the minimum inhibitory concentration of the pathogen being targeted d. Cefepime is only useful for gram-negative bacterial infections - Answer: c. It is not always necessary to maintain antimicrobial concentration in the body above the level of the minimum inhibitory concentration of the pathogen being targeted As a time-saving measure, hospital administrators in your facility have suggested that endocavitary probes do not need to undergo high-level disinfection because they are used with probe covers. How would you respond to this suggestion? a. Agree, because the probe cover prevents contact with mucous membranes and non-intact skin b. Disagree, because the probe covers are not 100 percent reliable c. Agree, because even without covers the probes don't contact mucous membranes and non-intact skin during use d. Disagree, because switching from high-level disinfection to low-level disinfection will not save time - Answer: b. Disagree, because the probe covers are not 100 percent reliable After reviewing the quarterly report, the manager of the adult ICU contacts the IP for assistance to create a plan to reduce central line infections. Which of the following should the IP recommend: a. Wait for the next report to see if the rate has decreased b. Create an Intravascular Team c. Develop a multidisciplinary team to review and implement best practices d. Send a referral to Medical Affairs for peer review - Answer: c. Develop a multidisciplinary team to review and implement best practices Important considerations regarding blood culture specimens include: 1) Collect prior to the initiation of antimicrobial therapy 2) Collect from a central venous catheter whenever possible 3) Ensure that the volume of the specimen collected is sufficient 4) Culture of specific sites is not recommended for surveillance a. 1, 3 b. 2, 4 c. 1, 4 d. 3, 4 - Answer: a. 1, 3 An IP subscribes to several peer-reviewed journals. As she reviews published articles describing research findings, what question should she ask before incorporating the conclusions/findings of the article into the infection prevention program: a. Was the appropriate study design used and are the conclusions reasonable? b. Is the author well known and well published? c. Does the article state how to contact the author(s) with questions? d. Are the findings described in tables or graphs and easily understandable? - Answer: a. Was the appropriate study design used and are the conclusions reasonable? Which of the following is an accurate statement regarding the antibiogram for Staphylococcus isolates shown below? Total # of Isolates ClindamycinTetracycline Trimeth/ Sulfa Vancomycin Staphylococcus aureus MRSA Staphylococcus, coagulasenegative 98 100 1) 50 percent of Staphylococcus aureus isolates were resistant to Vancomycin 2) 12 percent of MRSA isolates were resistant to Trimeth/Sulfa 3) Clindamycin should not be used for coagulase-negative Staphylococcus infections in this facility because 100% of isolates were resistant to it 4) There were no cases of Vancomycin-resistant Staphylococcus aureus in this facility a. 2 b. 2, 4 c. 1, 2, 4 d. 1, 2, 3, 4 - Answer: b. 2, 4 Which of the following scenarios would be most appropriate for immediate-use sterilization: a. The vendor brings the instrument for the procedure the morning of the surgery, which does not allow for the full sterilization process b. The instrument used for the procedure is dropped on the floor of the operating room and another instrument is not available c. The turnaround time between procedures does not allow enough time for the full sterilization process d. The OR does not have the needed instruments to meet the demand of surgeries so the instruments are flashed between procedures - Answer: b. The instrument used for the procedure is dropped on the floor of the operating room and another instrument is not available The Director of the Infection Prevention and Control Department has assigned one of her IPs to cofacilitate in a root cause analysis of an adverse event in collaboration with the Performance Improvement team. The IP plans to use process improvement tools and techniques during the analysis. Which of the following methods would best outline the possible causes of the event? a. Brainstorming b. Affinity diagrams c. Fishbone diagram d. Pareto chart - Answer: c. Fishbone diagram Which of the following is not an infection prevention objective of an occupational health program? a. Contain costs by preventing infectious diseases that result in absenteeism and disability b. Provide care to personnel for work-related illnesses or exposures c. Educate patients about the principles of infection prevention d. Collaborate with the Infection Prevention Department in monitoring and investigating potentially harmful infectious exposures and outbreaks - Answer: c. Educate patients about the principles of infection prevention The biological indicator that was included in a steam sterilization load of non-implantable instruments has shown a positive result, as have biological indicators used in two additional follow-up tests of the sterilizer. The chemical indictor in the original load was reactive, as were the chemical indicators used in the follow-up tests. The log of all the runs indicates that the run conditions (temperature and time) were appropriate for the instrument load and there were no abnormalities in steam supply or electrical supply. Which of the following should be done next: a. The load should be released for use in the facility b. The sterilizer should be tested again with paired biological indicators from two different manufacturers c. The items from the load should be immediately recalled and reprocessed d. All items that were processed in that sterilizer since the time of the last negative biological indicator shoul - Answer: b. The sterilizer should be tested again with paired biological indicators from two different manufacturers What action is indicated when the IP is asked to help determine if a worker has experienced occupational acquisition of an infectious agent or disease in order to receive workers' compensation benefit? a. Provide enough information to prove or disprove the employee's claim b. Notify the facility's attorney immediately c. Review the workers' compensation system in place d. Perform a root cause analysis to investigate - Answer: c. Review the workers' compensation system in place The safe temperature range for cold food storage is: a. 41°F/5°C or lower b. 42°F to 50°F/5.6°C to 10°C c. 50°F to 55°F/10°C to 12.8°C d. Less than 60°F/15.6°C - Answer: a. 41°F/5°C or lower A robust Performance Improvement team should perform all of the following except: a. Observational audits b. Benchmark comparisons c. Root cause analyses d. Housewide infection rates - Answer: d. Housewide infection rates Toys used for inpatient pediatric patients should ideally be all of the following except: a. New b. Nonporous c. Plush d. Single-patient use - Answer: c. Plush Which of the following would be an appropriate method to evaluate the quality of an infection prevention program? a. The total number of areas where surveillance was carried out in the past year b. The average amount of time that elapsed between receiving reports from the lab about patients with multidrug-resistant infections and placing those patient on appropriate Isolation Precautions c. The number of IPs in the program per the number of beds d. The average amount of money spent on isolation gowns this year as compared to last year - Answer: b. The average amount of time that elapsed between receiving reports from the lab about patients with multidrug-resistant infections and placing those patient on appropriate Isolation Precautions On September 1, there were 30 surgical patients in the hospital. Two of these were postop patients with SSIs. A total of 75 surgeries were performed in September. Six additional SSIs occurred in patients who had surgery in September. What was the numerator for an incidence rate in September? a. 30 b. 6 c. 8 d. 75 - Answer: b. 6 An employee is exposed to blood and body fluids from a patient whose baseline testing revealed positive results in a rapid HIV test. The most appropriate follow-up test for the patient would be: a. Western Blot b. Viral Load c. HIV polymerase chain reaction d. CD4 - Answer: a. Western Blot Which is an example of actions taken during the Study phase of the "Plan, Do, Study, Act" Performance Improvement Model? a. Identifying goals for the project b. Performing staff education sessions c. Trending and benchmarking of data collected d. Tweaking the program based on results - Answer: c. Trending and benchmarking of data collected An infant in the Neonatal ICU (NICU) has been diagnosed with Malassezia furfur fungemia. What is the most likely source of the infection? a. Intravenous lipid infusions b. A healthcare worker's false fingernails c. Commercial powdered infant formula d. Respiratory transmission from a colonized family member or healthcare worker - Answer: a. Intravenous lipid infusions Which U.S. agency requires a respiratory program for HCP? a. Food and Drug Administration (FDA) b. The Joint Commission (TJC) c. Centers for Disease Control and Prevention (CDC) d. Occupational Safety and Health Administration (OSHA) - Answer: d. Occupational Safety and Health Administration (OSHA) Which of the following must be reprocessed by high-level disinfection? a. Non-critical items b. Semi-critical items c. Critical items d. Non patient-care items - Answer: b. Semi-critical items Which of the following are CDC requirements for storing endoscopes? 1) Store them coiled in the original case 2) Store them in a bin 3) Store hanging in a vertical position to facilitate drying 4) Store in a manner that protects the scope from contamination a. 1, 4 b. 1, 2 c. 2, 3 d. 3, 4 - Answer: d. 3, 4 The following data on incidence rates of VAP in the Surgical ICU (SICU) were collected: The best interpretation of the data in the graph is: a. The number of cases of VAP was higher in January than in May b. The number of cases of VAP was the same in January and February c. Prevalence of VAP was lowest in June d. The incidence rate of VAP was highest in February - Answer: d. The incidence rate of VAP was highest in February 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 - Answer: c. May require a long follow-up period Program evaluation is necessary to measure change and growth in the learner. The following program elements should be evaluated in order to demonstrate efficacy and impact. 1) Appropriateness of the program design 2) Adequacy of the teaching and instructional resources 3) Knowledge, skills, and attitudes learned by the participants 4) Assessing the educational needs of the attendees a. 1, 2, 3 b. 1, 3, 4 c. 2, 3, 4 d. 1, 2, 4 - Answer: a. 1, 2, 3 An early-level (novice) IP in your department has set a goal of advancing to achieve middle-level (proficient) competency within the next year. Which of the following activities would be the most appropriate to include on her personal development plan for the year: 1) Nominating herself for the President-elect position of the local APIC chapter 2) Taking the Certification in Infection Control exam within six months 3) Requesting information about a Master of Science in Epidemiology degree 4) Learning the basics of CAUTI surveillance a. 1 b. 1, 2 c. 1, 2, 3 d. 1, 2, 3, 4 - Answer: c. 1, 2, 3 Improved hydrogen peroxide contains: a. Anionic and/or nonionic surfactants b. Glutaraldehyde c. Peracetic acid d. Chlorine - Answer: a. Anionic and/or nonionic surfactants The director of critical care has expressed a concern that there seems to be an increase in contaminated blood culture results in the ICU. An acceptable contamination level for blood cultures is: a. Less than 10 percent b. Greater than 3 percent c. Greater than 5 percent d. Less than 3 percent - Answer: d. Less than 3 percent Which of the following Transmission-based Precautions category requires a negative airflow room? a. Contact Precautions b. Airborne Precautions c. Droplet Precautions d. Standard Precautions - Answer: b. Airborne Precautions A pregnant healthcare worker is concerned because she has been NOTES assigned to take care of a patient who has cytomegalovirus (CMV) infection. How should an IP respond to this concern? a. Reassign her to another patient b. Place the patient on Contact Precautions while the healthcare worker cares for him c. Advise her that following Standard Precautions while caring for the patient will prevent transmission d. Advise her that she is likely already infected with CMV and should not worry about transmission - Answer: c. Advise her that following Standard Precautions while caring for the patient will prevent transmission In a published report on the risk of VRE infection in ICUs of a major teaching hospital, the authors report that the relative risk of infection is 1.9 for the Cardiac ICU (CICU) when compared to the SICU, and they conclude that a stay in the CICU is a risk factor for VRE infection. The authors have not controlled for age in their study despite the fact that their CICU patients average 20 years older than their SICU patients, and older age is a risk factor for VRE infection. The IP is concerned about the conclusions of this study because he suspects which of the following? a. The study is affected by selection bias b. The study is affected by standard error c. The study is affected by confounding d. The study is affected by causation - Answer: c. The study is affected by confounding Inadequate refrigeration of food may permit the growth of potentially harmful microbes. Interventions to prevent the growth of pathogens due to inadequate refrigeration include: 1) Train personnel to recognize and implement safe maintenance of refrigerators 2) Establish a method to record temperature on a regular basis 3) Make daily rounds to ensure that the freezer and refrigerator are clean 4) Schedule and perform regular preventive maintenance of freezer and refrigerator a. 1, 2, 3 b. 1, 2, 4 c. 2, 3, 4 d. 1, 3, 4 - Answer: b. 1, 2, 4 Which of the following patient care units would be the best choice for conducting surveillance on wound infections with drug- resistant Gram-negative rod bacteria to prevent outbreaks? a. The Burn Unit b. The Orthopedic Medical/Surgical Unit c. The CICU d. The General Medical/Surgical Unit - Answer: a. The Burn Unit While reviewing blood culture reports, you notice a note indicating that the specimen was received in the lab 3 hours after it was collected. You confirm with the microbiology supervisor. The acceptable transport time is: a. Place specimen on ice and transport within one hour of collection b. Within 24 hours of collection at room temperature c. Equal to or less than 2 hours at room temperature d. Equal to or greater than 4 hours if refrigerated - Answer: c. Equal to or less than 2 hours at room temperature The "epidemiologic triangle" model for disease causation does not include: a. Agent b. Host c. Time d. Environment - Answer: c. Time 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 - Answer: d. You will need at least 25 gallons of water per patient per day to maintain care Patients with mycoplasma pneumonia should be cared for NOTES in which type of precautions? 1) Standard Precautions 2) Airborne Precautions 3) Droplet Precautions 4) Contact Precautions a. 1, 2 b. 3, 4 c. 1, 3 d. 1, 4 - Answer: c. 1, 3 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 - Answer: b. 1, 3 Epidemic keratoconjunctivitis (EKC) is a viral conjunctivitis caused by a group of adenoviruses. EKC is highly contagious and can be problematic in ambulatory surgery settings. Recommended measures for control of these infections include: 1) Disinfection of tonometer tips in 3 percent hydrogen peroxide 2) Sterilize ophthalmoscopes between uses 3) Disinfection of the environment 4) Frequent hand hygiene a. 2, 3, 4 b. 1, 2, 4 c. 1, 3, 4 d. 2, 3, 4 - Answer: c. 1, 3, 4 All of the 72 patients in a chronic hemodialysis center were tested for Hepatitis C virus (HCV). Eight of the patients were identified as HCV positive. During the following year, two of the dialysis center's patients who previously tested negative for HCV converted to HCV positive. What was the incidence for that year? a. 2.8 percent b. 3.1 percent c. 13.8 percent d. 7.2 percent - Answer: b. 3.1 percent The manufacturer of a wound dressing product has notified the hospital's Purchasing Department of possible contamination of one lot of dressings. The dressings were recently approved by the Product Standardization Committee and are used in all patient care areas. Which of the following actions should the IP take? a. Instruct the Purchasing Department to remove all the manufacturer's dressings and like products from the hospital b. Notify discharged patients who were using the product while in the hospital to be alert for signs of infection and notify their physician and the Infection Prevention and Control Department c. Identify where the dressings are in the hospital, check the lot number and return them to the manufacturer, and assess the patients who used the product for signs of infection d. Notify the Health Department of the recall and provide the names of the patients who used the product - Answer: c. Identify where the dressings are in the hospital, check the lot number and return them to the manufacturer, and assess the patients who used the product for signs of infection An IP has completed the investigation of an increase in postdischarge SSIs following ambulatory surgical procedures. He identified some corrective measures that will require monitoring. Which of the following actions should the Infection Prevention team take? a. Monitor the cleaning of the surgical suites b. Ensure the effectiveness of the ventilation system c. Revise the facility's surveillance plan d. Ensure that patient care equipment is adequately cleaned - Answer: c. Revise the facility's surveillance plan All of the 72 patients in a chronic hemodialysis center were tested for Hepatitis C virus (HCV). Eight of the patients were identified as HCV positive. What is the prevalence? a. 0.9 percent b. 9 percent c. 1 percent d. 11 percent - Answer: d. 11 percent The heating, ventilation, and air conditioning system will need to be shut down in one patient care unit of your hospital for repairs that are anticipated to take two hours. Which of the following protocols should be followed for this event? a. Relocate all patients to other units while the shut down is in progress b. Require all patients to wear a surgical mask while the shut-down is in progress c. Relocate immunocompromised patients if necessary and provide emergency back up ventilation or portable units for other rooms d. No protocol needs to be followed as the short shut down period will not affect any patients - Answer: c. Relocate immunocompromised patients if necessary and provide emergency back up ventilation or portable units for other rooms An IP is asked to participate in the selection of a company to reprocess single-use devices (SUDs). Before a decision is made on which reprocessing company will be used, the IP reviews available information from a variety of resources to assist with the decision making. Which of the following activities should the IP recommend the hospital undertake? a. Talk to other infection preventionists about which sterilizing methods to use on the SUDs b. Visit reprocessing companies under consideration c. Create quality control records for the SUDs d. Identify the patients on which the reprocessed SUDs, as opposed to new devices, will be used - Answer: b. Visit reprocessing companies under consideration What is the first action HCP should take after a needlestick exposure? a. Contact the supervisor b. Contact Occupational Health c. Squeeze or milk the site d. Wash the affected area - Answer: d. Wash the affected area An IP collected the following data from the ICU for the month of March. How would she calculate the CAUTI rate the month of March? March 2014 6 CAUTIs 240 patient days 180 catheter days a. (6 ÷ 240) × 1,000 = 25 per 1,000 patient days b. (6 ÷ 180) × 1,000 = 33.3 per 1,000 catheter days c. (180 ÷ 240) × 1,000 = 750 per 1,000 patient days d. (240 ÷ 180) × 1,000 = 1333.3 per 1,000 catheter days - Answer: b. (6 ÷ 180) × 1,000 = 33.3 per 1,000 catheter days The Director of Infection Prevention and Control is developing an educational program to provide annual bloodborne pathogen training to healthcare personnel in her facility. There are approximately 7,500 employees who need annual training, and her team of five IPs has to provide and document this training while still carrying out all other department duties. What is the best method of delivery for this training? a. Web-based training sessions b. Educational cart c. Group lecture sessions d. Role play training sessions - Answer: a. Web-based training sessions Important elements of surveillance programs include: 1) Tracking diseases associated with the healthcare environment 2) Environmental sampling 3) Reviewing microbiology reports for antibiotic resistant organisms 4) Tracking and reporting HAIs as mandated by state/local public health requirements a. 1, 2, 4 b. 1, 3, 4 c. 1, 2, 3 d. 2, 3, 4 - Answer: b. 1, 3, 4 Which of the following air filtration methods has the highest filtering efficiency compared to the others? a. Diffusion b. Straining c. Impingement d. Interception - Answer: a. Diffusion 88. The CDC has categorized bioterrorism agents according to priority. A disease that meets the criteria listed under Category B is: a. Anthrax b. Typhus c. Hantavirus d. Measles - Answer: b. Typhus Nursing Administration has announced the opening of a simulation lab at an acute care facility. The IP has been asked to develop a simulation setting dedicated to teaching infection prevention best practices. Which of the following is as example of a simulation activity? a. Creating an isolation room to practice use of Isolation Precautions b. Modeling proper hand hygiene techniques and having participants model back c. Showing an interactive video of cleaning procedures and asking participants to identify correct and incorrect elements d. Setting up a display of education materials concerning influenza vaccinations - Answer: a. Creating an isolation room to practice use of Isolation Precautions The IP at a long-term acute care (LTAC) facility is reviewing her surveillance data. Due to the high-risk nature of the LTAC's patient population, infection control data include a large number of outliers. Which measure of central tendency is least affected by outliers? a. Proportions that include the population in the numerator and a subset of the population in the denominator b. Proportions that include the population in the denominator and a subset of the population in the numerator c. Arithmetic mean d. Median - Answer: d. Median What is the acceptable upper limit for relative humidity in a facility to prevent fungal growth? a. 40 percent b. 50 percent c. 60 percent d. 70 percent - Answer: c. 60 percent A staff nurse informs the IP that a patient with confirmed multidrug-resistant TB requires an immediate bronchoscopy. In which of the following rooms must the procedure be performed? a. The operating room under positive pressure b. Standard procedure room in the endoscopy suite c. The ICU with direct exhaust to the outside d. Airborne infection isolation room - Answer: d. Airborne infection isolation room In a Gram stain procedure, Gram-positive bacteria stain purple because: a. They have a lipopolysaccharide layer in their cell wall that is decolorized with alcohol b. Their cell walls contain long-chain fatty acids that take up crystal violet easily c. They have a thick peptidoglycan cell wall that retains the primary stain during the alcohol decolorization d. Gram-staining is simple staining so the only stain used is crystal violet - Answer: c. They have a thick peptidoglycan cell wall that retains the primary stain during the alcohol decolorization Hepatitis A is diagnosed by the presence of: a. Immunoglobulin G (IgG) for anti-Hepatitis D virus (HDV) b. Hepatitis A virus (HAV) Immunoglobulin M (IgM) c. Increase in anti-Hepatitis B virus (HBV)-related to previous Hepatitis B infection d. HAV IgG - Answer: b. Hepatitis A virus (HAV) Immunoglobulin M (IgM) When using a medication vial that is intended to be discarded after a single procedure, it is acceptable to reuse the same syringe that was just used to access that vial and give that patient medication if: a. The needle is replaced with a new needle b. The medication vial is a single-use vial c. The vial is only going to be used for that patient d. It is not acceptable to reuse the syringe - Answer: d. It is not acceptable to reuse the syringe Which method of face-to-face instruction is a useful option when large numbers of staff must be educated over a relatively short span of time? a. Role play b. Mentoring c. Case studies d. Train the trainer - Answer: d. Train the trainer An IP conducts an audit of the OR cleaning process. The action that would be most concerning would be: a. The operating room is terminally cleaned at the end of each business day b. The decontamination process starts on the floor of the OR and works upward toward the lighting c. The cleaning solutions are prepared daily d. A wet vacuum and microfiber mop head are used to clean the OR floors - Answer: b. The decontamination process starts on the floor of the OR and works upward toward the lighting Strategies to prevent infection of a dialysis access site include the following: 1) Utilize an arteriovenous (AV) graft if a fistula cannot be established 2) Use a tunneled cuffed catheter for acute dialysis if use will be more than 3 weeks 3) Subclavian access is preferred over jugular options 4) Use femoral catheters only in bedbound patients for no more than 5 days a. 1, 3, 4 b. 1, 2, 4 c. 2, 3, 4 d. 1, 2, 3 - Answer: b. 1, 2, 4 Fifteen persons were infected with Salmonella at a picnic where 75 ate egg salad sandwiches. What was the attack rate of Salmonella among those who ate the egg salad sandwiches? a. 15 percent b. 0.20 percent c. 18 percent d. 20 percent - Answer: d. 20 percent A patient has been admitted with a wound infection. The lab reports that the stain of the wound culture is positive for AFB and the culture is positive for Mycobacterium marinum. Which of the following is the correct follow-up of this lab report? a. No further follow-up is needed b. Place the patient on airborne isolation c. Contact the local health department to report the Mycobacterium infection d. Place the patient on Contact Precautions - Answer: a. No further follow-up is needed Examples of efforts to improve patient safety in the healthcare setting include: 1) Encouraging patients to ask their healthcare providers if they have washed their hands 2) Medication safety programs that report medication errors and inform staff of efforts to prevent repeated errors 3) Encouraging patients to ask questions about their treatments and medications 4) Emphasizing punitive reactions to mistakes a. 1, 2, 4 b. 1, 2, 3 c. 2, 3, 4 d. 1, 3, 4 - Answer: b. 1, 2, 3 Which short-term central lines are associated with a higher risk of infection? 1) Peripherally-inserted central venous catheters (PICC) 2) Femoral lines 3) Subclavian lines 4) Jugular lines a. 1, 2 b. 2, 3 c. 2, 4 d. 1, 4 - Answer: c. 2, 4 A technician finds out after obtaining an EKG on a patient that the patient may have varicella-zoster (shingles) on a dermatome on the upper body. The Occupational Health Nurse checks the employee's records and realizes that the employee was never tested for varicella on hire. The first thing the Occupational Health Nurse should do is: a. Determine if the patient actually has an active case of varicella-zoster by involving the IP or checking with the patient's physician to verify the diagnosis b. Test the employee for varicella immunity and, if not immune, exclude from work from day 10 through day 21 after the exposure c. Give the varicella vaccine to the employee d. Give varicella-zoster immune globulin (VZIG) to the employee - Answer: a. Determine if the patient actually has an active case of varicella-zoster by involving the IP or checking with the patient's physician to verify the diagnosis 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 - Answer: c. She should remove the scrub top by using scissors to cut it off and discard it in a biohazard-labeled container There was contamination of a healthcare facility's potable water system with sewer water and there is high concern for the presence of Cryptosporidium. Which of the following should you recommend for corrective decontamination of the system? a. Use chlorination to disinfect the system b. Use high-temperature flushing to disinfect the system c. Use fluoridation to flush the system d. Use ultraviolet light to flush the system - Answer: b. Use high-temperature flushing to disinfect the system During environmental rounds, the IP observes an environmental service worker cleaning up a blood spill on the floor. The best choice for cleaning blood and body fluids is: a. Alcohol b. Quaternary ammonium compound c. Phenolic d. Bleach - Answer: d. Bleach The Standardized Infection Ratio (SIR) for CLABSIs in the ICU is 0.8. Which of the following is correct? a. There were more CLABSIs in the ICU than expected b. There were fewer CLABSIs in the ICU than expected c. There were about the same number of CLABSIs in the ICU as the national baseline d. There was a 20% increase in CLABSI rates from the baseline period - Answer: b. There were fewer CLABSIs in the ICU than expected Which of the following quality concepts will identify a pattern of observation points above and below the mean level? a. Fishbone diagram b. Run chart c. Pareto chart d. Process flow chart - Answer: b. Run chart Which agency or agencies has regulatory authority over some aspects of healthcare facility design, construction, and renovation related to Infection Prevention and Control? 1) Occupational Health and Safety Administration (OSHA) 2) National Institute for Occupational Safety and Health (NIOSH) 3) National Institutes of Health (NIH) 4) Centers for Disease Control and Prevention (CDC) a. 1 b. 1, 2 c. 2, 3, 4 d. 1, 2, 3, 4 - Answer: a. 1 You are the IP in an ambulatory surgery center. During rounds, you discover that staff are using a single bag of saline to prepare saline flushes for multiple patients. Your immediate response is: a. Clarify that saline bags must be labeled with time of use and discarded within 24 hours b. Explain that single dose bottles of sterile water should be used to flush IVs c. Remove the bag and send a follow-up email to the staff explain your actions d. Remove the bag and teach staff how to follow safe injection practices - Answer: d. Remove the bag and teach staff how to follow safe injection practices An outbreak of Hepatitis C has occurred in the endoscopy clinic. Single-dose vials of medication are used in the clinic and observation of practice shows that the rubber stopper of each vial is wiped with alcohol before access. Medication is drawn up with a needle and syringe and administered to the patient. If an added dose is needed, the needle is replaced on the syringe and more medication is drawn up from the vial. If medication remains in the vial, then it is stored at the recommended temperature for use on another patient. HCP in the clinic had a 40 percent overall compliance with recommended hand hygiene practices. Which practice is the most likely cause of the outbreak? a. Use of a single-dose mediation vial for more than one patient b. Poor hand hygiene practices c. Contamination of medication through the rubber stopper d. Inadequate cleaning and disinfection of endoscopes - Answer: a. Use of a single-dose mediation vial for more than one patient What is an advantage of experimental studies when identifying approaches to successfully interrupt the chain of infection? a. Experimental studies can identify causative disease factors retrospectively b. Experimental studies can establish association and causality if host factors such as disease susceptibility and other variables are strictly controlled c. Experimental studies avoid the need to manipulate the independent variable, and therefore ethical issues associated with exposure to disease d. Experimental studies do not require randomization, which is difficult to achieve in the healthcare environment - Answer: b. Experimental studies can establish association and causality if host factors such as disease susceptibility and other variables are strictly controlled The IP wants to calculate the surgeon-specific rate of infections NOTES associated with spinal fusion surgeries in the facility. Which of the following data elements will he need? 1) Number of spinal fusion procedures within the designated time frame 2) Number of spinal fusion SSIs within the designated time frame 3) Number of spinal fusion surgeries performed by each surgeon within the designated time frame 4) Number of spinal fusion infections for each surgeon within the designated time frame a. 1, 2 b. 1, 4 c. 2, 3 d. 3, 4 - Answer: d. 3, 4 114. 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 - Answer: a. Establish a method to recognize spills or leaks 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 - Answer: b. Legionella and Aspergillus An outbreak of norovirus in an LTCF would most likely have an epidemiological curve (EPI curve) that: a. Indicated a common source of infection b. Indicated a propagated source of infection c. Indicated a point source of infection d. Indicated a common vehicle of infection - Answer: b. Indicated a propagated source of infection What is the term for an unexpected occurrence involving death or serious physical or psychological injury, or the risk there of? a. Error b. Adverse event c. Near miss d. Sentinel event - Answer: d. Sentinel event The incubation period for meningococcal meningitis is: a. 10 to 14 days b. 7 to 21 days c. 2 to 10 days d. 1 to 2 days - Answer: c. 2 to 10 days A patient in has been diagnosed with Legionnaires' disease that was possibly acquired during his stay in the hospital. What is the recommended first response to this incident? a. All water sites in the healthcare facility to which the patient was exposed should be cultured for L. pneumophila b. The patient should be placed on respiratory isolation until 24 hours after treatment has started c. The water system should be superheated and flushed immediately d. All patients should immediately be provided with bottled water for drinking - Answer: a. All water sites in the healthcare facility to which the patient was exposed should be cultured for L. pneumophila Properly written instructional objectives include: a. Statements that communicate the intent of the curriculum b. Directions and plans for the educational session c. Learner outcomes in measurable terms using action verbs d. Measures of change and growth in the learner - Answer: c. Learner outcomes in measurable terms using action verbs The key to cleaning and disinfection of environmental surfaces is the: a. Use of specific antiseptics for each surface b. Physical removal of visible dirt, organic material, and debris c. Assignment of trained staff to each department d. Maintenance of equipment used for cleaning - Answer: b. Physical removal of visible dirt, organic material, and debris What key strategy should the IP use to meet the administrative challenges of outpatient settings that are geographically dispersed? a. Standardized measurement and definitions for HAIs consistent with those used for inpatient settings b. HAI comparison with external benchmarks for all sites c. Development of communication networks between sites, hospitals, and health departments d. Standardized infection prevention policies and procedures - Answer: c. Development of communication networks between sites, hospitals, and health departments 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 - Answer: d. Single-use items can be reprocessed in a third-party facility if FDA guidelines are followed Which of the following need to be considered when updating the annual infection risk assessment? 1) An evaluation of the previous year's goals and objectives 2) An identification of risks based on geographic location, community, and population served 3) Risks related to the type of services that the facility provides 4) A broad assessment of all risks identified in the facility a. 1, 2, 4 b. 1, 2, 3 c. 2, 3, 4 d. 1, 3, 4 - Answer: b. 1, 2, 3 In 2013, 565 persons died from influenza-related illness in a large metropolitan area with a population of 1.8 million. What was the cause-specific mortality rate? a. 31 per 100,000 b. 53 per 100,000 c. 31 percent d. 0.03 percent - Answer: a. 31 per 100,000 Which of the following would be considered biomedical waste? a. Diaper soiled with feces b. Blood-tinged suctioned fluids c. Wound dressing that is not saturated d. Isolation gown worn to deliver food tray - Answer: b. Blood-tinged suctioned fluids You are presenting an in-service to the Environmental Services group in your facility. Which of the following recommendations should you make related to mopping of patient rooms? 1) Standard mop heads should be disinfected with a disinfectant weekly 2) Floors should be mopped using the "S" stroke 3) Mop water should be changed after two hours of use. 4) The mops should never be redipped into the mopping solution. a. 1, 2 b. 2, 3 c. 3, 4 d. 2, 4 - Answer: d. 2, 4 The local Health Department informs the IP that a nurse in the CICU has been diagnosed with measles immediately after returning from a trip to Europe. His symptoms began 2 days ago, and he last worked in the unit 9 days ago. The incubation period for measles is 8 to 12 days, and the period of contagion is 1 to 2 days prior to onset of symptoms. How should the IP follow up on this report? a. Determine the susceptibility to measles of all HCP and patients who had contact with the nurse in the past 12 days b. Place all susceptible patients who were cared for by the nurse in Airborne Isolation c. Inform Occupational Health about the infection so that they can furlough the employee for the appropriate amount of time d. The IP does not need to conduct any follow-up - Answer: c. Inform Occupational Health about the infection so that they can furlough the employee for the appropriate amount of time A patient who had neurosurgery was exposed to Creutzfeldt-Jakob disease (CJD) prions through surgical instruments that were not correctly processed after having been previously used on an infected patient. As a result, she has developed the disease herself. This is an example of which mode of infection? a. Familial CJD b. Iatrogenic CJD c. Spontaneous CJD d. Mutational CJD - Answer: b. Iatrogenic CJD List the following diseases in order of resistance of the disease agents to disinfection and sterilization, from high resistance to low resistance. 1) Staphylococcus aureus 2) Clostridium difficile 3) Creutzfeldt-Jakob Disease 4) Polio a. 1, 2, 3, 4 b. 2, 3, 4, 1 c. 3, 4, 2, 1 d. 3, 2, 4, 1 - Answer: d. 3, 2, 4, 1 When considering occupational health issues in healthcare settings, which individuals are covered under the term "healthcare personnel"? 1) All paid persons working in healthcare settings who have the potential for exposure to infectious materials 2) All paid and unpaid persons working in healthcare settings who have the potential for exposure to infectious materials 3) Any individual who has the potential to acquire or transmit infectious agents during the course of his or her work in healthcare 4) All paid and unpaid persons who work in healthcare settings and encounter patients 5) All workers employed by the healthcare organization a. 1, 5 b. 2, 3 c. 1, 4 d. 4, 5 - Answer: b. 2, 3 What is the positive predictive value of the following data? True Disease Positive Test Result: Positive 100 True Disease Positive Test Result: Negative 40 True Disease Negative Test Result: Positive 3 True Disease Negative Test Result: Negative 500 a. 97.0 percent b. 92.5 percent c. 96.2 percent d. 99.4 percent - Answer: a. 97.0 percent All of the following would be considered prevention strategies to reduce the transmission of infections in a healthcare setting except: a. Implementing an influenza vaccine program for employees b. Educating staff members in PPE usage c. Decolonization of MRSA-positive patients prior to surgery d. Instituting use of bleach for cleaning C. difficile patient rooms - Answer: c. Decolonization of MRSA-positive patients prior to surgery Which of the following parameters affect(s) the effectiveness of ethylene oxide (ETO) sterilization? 1) Gas concentration 2) Temperature 3) Relative humidity 4) Exposure time a. 1, 2 b. 1, 3, 4 c. 1, 2, 3, 4 d. 1, 4 - Answer: c. 1, 2, 3, 4 Which of the following could be a result of a descriptive study on C. difficile in the healthcare setting? a. The average age of a patient with C. difficile b. The association between proton pump inhibitors and C. difficile c. The likelihood of having C. difficile and being placed on a specific unit d. The lack of hand hygiene by staff resulting in C. difficile acquisition - Answer: a. The average age of a patient with C. difficile