Infection Control (CIC) Exam
Q1. An infection preventionist is reviewing a positive blood culture for coagulase-negative
Staphylococcus from a single set. The patient is afebrile with no signs of infection. How should this
finding be interpreted?
A. True bloodstream infection requiring therapy
B. Contamination from skin flora
C. Colonization requiring isolation
D. Pseudo-infection from laboratory error
Correct Answer: Contamination from skin flora ✅
Rationale: Coagulase-negative staphylococci are common skin flora and frequent blood
culture contaminants, especially when only one set is positive without clinical signs. True infection
typically requires multiple positive sets and host response. Colonization refers to microorganisms on
a body surface without tissue invasion. Pseudo-infection is a false-positive laboratory finding without
clinical correlation. The key concept is that clinical correlation is essential when interpreting culture
results.
Q2. A patient with a urinary catheter has a urine culture growing >100,000 CFU/mL of E. coli but
reports no symptoms. Which term best describes this finding?
A. Infection
B. Colonization
C. Contamination
D. Bacteremia
Correct Answer: Colonization ✅
,Rationale: Asymptomatic bacteriuria represents colonization of the urinary tract without
tissue invasion or clinical signs. Infection requires symptoms such as fever, dysuria, or costovertebral
tenderness. Contamination refers to microorganisms introduced during specimen collection.
Bacteremia indicates bloodstream infection. The key concept is that asymptomatic bacteriuria
generally does not require treatment except in specific populations.
Q3. A patient develops fever, cough, and chest X-ray infiltrates. Sputum culture grows Streptococcus
pneumoniae. Which term most accurately describes this clinical picture?
A. Colonization
B. Contamination
C. Infection
D. Pseudo-infection
Correct Answer: Infection ✅
Rationale: Infection is defined by microbial invasion of body tissues with an associated
immune response and clinical signs. This patient has symptoms, radiographic evidence, and a
pathogen isolated from a normally sterile site. Colonization lacks clinical signs. Contamination
indicates specimen introduction of organisms. Pseudo-infection is a false-positive without clinical
correlation. The key concept is that infection requires clinical correlation with laboratory findings.
Q4. An infection preventionist is evaluating antimicrobial therapy initiated before culture results are
available. Which term describes this approach?
A. Prophylactic therapy
B. Empiric therapy
C. Targeted therapy
D. Directed therapy
Correct Answer: Empiric therapy ✅
Rationale: Empiric therapy is initiated based on clinical presentation and likely pathogens
before organism identification and susceptibility results. Prophylactic therapy prevents infection
,before it occurs. Targeted or directed therapy is based on confirmed culture and susceptibility
results. The key concept is that empiric therapy should be narrowed once culture data become
available.
Q5. A patient is scheduled for total hip arthroplasty and receives cefazolin within 60 minutes before
incision. Which type of antimicrobial use does this represent?
A. Empiric therapy
B. Prophylactic therapy
C. Targeted therapy
D. Therapeutic therapy
Correct Answer: Prophylactic therapy ✅
Rationale: Surgical antimicrobial prophylaxis is administered before incision to prevent surgical
site infection. Empiric therapy treats suspected infection before culture results. Targeted therapy
treats a confirmed organism based on susceptibility. Therapeutic therapy treats an established
infection. The key concept is that prophylactic antimicrobials should be discontinued within 24 hours
after surgery in most procedures.
Q6. Which statement accurately differentiates the cellular structure of bacteria from viruses?
A. Bacteria contain only RNA; viruses contain DNA and RNA
B. Bacteria are prokaryotic cells with both DNA and RNA and ribosomes; viruses are acellular and
require host cells for replication
C. Bacteria are acellular; viruses are prokaryotic cells
D. Bacteria require host cells to replicate; viruses replicate independently
Correct Answer: Bacteria are prokaryotic cells with both DNA and RNA and ribosomes; viruses are
acellular and require host cells for replication ✅
Rationale: Bacteria possess cellular structure including ribosomes, cell wall, and both DNA and
RNA, and replicate independently. Viruses are acellular, contain either DNA or RNA (not both), lack
ribosomes, and are obligate intracellular parasites. The other options incorrectly describe bacterial or
, viral biology. The key concept is that structural differences determine antimicrobial targets and
susceptibility.
Q7. An infection preventionist is evaluating a water main break that may have contaminated the
municipal supply. Which action should be taken first?
A. Notify emergency and admissions departments to report diarrhea cases
B. Review microbiology laboratory reports for enteric organisms from the past week
C. Contact employee health for case-finding collaboration
D. Review the emergency preparedness plan with engineering
Correct Answer: Review microbiology laboratory reports for enteric organisms from the past week ✅
Rationale: The first action in a potential waterborne outbreak is to review existing surveillance
data for evidence of impact. Notifying departments is important but follows initial data review.
Employee health collaboration supports case-finding but is not the first step. Reviewing the
preparedness plan is relevant once contamination is confirmed. The key concept is that surveillance
data guides outbreak response priorities.
Q8. During an outbreak of ventilator-associated pneumonia, which action should the infection
preventionist take first?
A. Implement preemptive antibiotics for all ventilated patients
B. Perform bacterial cultures from ventilator circuits
C. Review adherence to ventilator bundle elements
D. Isolate all ventilated patients in negative pressure rooms
Correct Answer: Review adherence to ventilator bundle elements ✅
Rationale: Reviewing compliance with VAP prevention bundles (head-of-bed elevation, oral
care, sedation breaks) is the first step in outbreak control because lapses in bundle adherence are
common causes. Preemptive antibiotics are not recommended and promote resistance. Ventilator
circuit cultures do not guide patient management. Negative pressure rooms are not required for VAP
Q1. An infection preventionist is reviewing a positive blood culture for coagulase-negative
Staphylococcus from a single set. The patient is afebrile with no signs of infection. How should this
finding be interpreted?
A. True bloodstream infection requiring therapy
B. Contamination from skin flora
C. Colonization requiring isolation
D. Pseudo-infection from laboratory error
Correct Answer: Contamination from skin flora ✅
Rationale: Coagulase-negative staphylococci are common skin flora and frequent blood
culture contaminants, especially when only one set is positive without clinical signs. True infection
typically requires multiple positive sets and host response. Colonization refers to microorganisms on
a body surface without tissue invasion. Pseudo-infection is a false-positive laboratory finding without
clinical correlation. The key concept is that clinical correlation is essential when interpreting culture
results.
Q2. A patient with a urinary catheter has a urine culture growing >100,000 CFU/mL of E. coli but
reports no symptoms. Which term best describes this finding?
A. Infection
B. Colonization
C. Contamination
D. Bacteremia
Correct Answer: Colonization ✅
,Rationale: Asymptomatic bacteriuria represents colonization of the urinary tract without
tissue invasion or clinical signs. Infection requires symptoms such as fever, dysuria, or costovertebral
tenderness. Contamination refers to microorganisms introduced during specimen collection.
Bacteremia indicates bloodstream infection. The key concept is that asymptomatic bacteriuria
generally does not require treatment except in specific populations.
Q3. A patient develops fever, cough, and chest X-ray infiltrates. Sputum culture grows Streptococcus
pneumoniae. Which term most accurately describes this clinical picture?
A. Colonization
B. Contamination
C. Infection
D. Pseudo-infection
Correct Answer: Infection ✅
Rationale: Infection is defined by microbial invasion of body tissues with an associated
immune response and clinical signs. This patient has symptoms, radiographic evidence, and a
pathogen isolated from a normally sterile site. Colonization lacks clinical signs. Contamination
indicates specimen introduction of organisms. Pseudo-infection is a false-positive without clinical
correlation. The key concept is that infection requires clinical correlation with laboratory findings.
Q4. An infection preventionist is evaluating antimicrobial therapy initiated before culture results are
available. Which term describes this approach?
A. Prophylactic therapy
B. Empiric therapy
C. Targeted therapy
D. Directed therapy
Correct Answer: Empiric therapy ✅
Rationale: Empiric therapy is initiated based on clinical presentation and likely pathogens
before organism identification and susceptibility results. Prophylactic therapy prevents infection
,before it occurs. Targeted or directed therapy is based on confirmed culture and susceptibility
results. The key concept is that empiric therapy should be narrowed once culture data become
available.
Q5. A patient is scheduled for total hip arthroplasty and receives cefazolin within 60 minutes before
incision. Which type of antimicrobial use does this represent?
A. Empiric therapy
B. Prophylactic therapy
C. Targeted therapy
D. Therapeutic therapy
Correct Answer: Prophylactic therapy ✅
Rationale: Surgical antimicrobial prophylaxis is administered before incision to prevent surgical
site infection. Empiric therapy treats suspected infection before culture results. Targeted therapy
treats a confirmed organism based on susceptibility. Therapeutic therapy treats an established
infection. The key concept is that prophylactic antimicrobials should be discontinued within 24 hours
after surgery in most procedures.
Q6. Which statement accurately differentiates the cellular structure of bacteria from viruses?
A. Bacteria contain only RNA; viruses contain DNA and RNA
B. Bacteria are prokaryotic cells with both DNA and RNA and ribosomes; viruses are acellular and
require host cells for replication
C. Bacteria are acellular; viruses are prokaryotic cells
D. Bacteria require host cells to replicate; viruses replicate independently
Correct Answer: Bacteria are prokaryotic cells with both DNA and RNA and ribosomes; viruses are
acellular and require host cells for replication ✅
Rationale: Bacteria possess cellular structure including ribosomes, cell wall, and both DNA and
RNA, and replicate independently. Viruses are acellular, contain either DNA or RNA (not both), lack
ribosomes, and are obligate intracellular parasites. The other options incorrectly describe bacterial or
, viral biology. The key concept is that structural differences determine antimicrobial targets and
susceptibility.
Q7. An infection preventionist is evaluating a water main break that may have contaminated the
municipal supply. Which action should be taken first?
A. Notify emergency and admissions departments to report diarrhea cases
B. Review microbiology laboratory reports for enteric organisms from the past week
C. Contact employee health for case-finding collaboration
D. Review the emergency preparedness plan with engineering
Correct Answer: Review microbiology laboratory reports for enteric organisms from the past week ✅
Rationale: The first action in a potential waterborne outbreak is to review existing surveillance
data for evidence of impact. Notifying departments is important but follows initial data review.
Employee health collaboration supports case-finding but is not the first step. Reviewing the
preparedness plan is relevant once contamination is confirmed. The key concept is that surveillance
data guides outbreak response priorities.
Q8. During an outbreak of ventilator-associated pneumonia, which action should the infection
preventionist take first?
A. Implement preemptive antibiotics for all ventilated patients
B. Perform bacterial cultures from ventilator circuits
C. Review adherence to ventilator bundle elements
D. Isolate all ventilated patients in negative pressure rooms
Correct Answer: Review adherence to ventilator bundle elements ✅
Rationale: Reviewing compliance with VAP prevention bundles (head-of-bed elevation, oral
care, sedation breaks) is the first step in outbreak control because lapses in bundle adherence are
common causes. Preemptive antibiotics are not recommended and promote resistance. Ventilator
circuit cultures do not guide patient management. Negative pressure rooms are not required for VAP
