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CBIC Certified Infection Control Exam Sample Questions (Q136-Q141):

NEW QUESTION # 136
Assume the mean age of onset for patients with tuberculosis (TB) is 62 years, with one standard deviation of
5 years, and the age of onset follows a normal distribution. What is the percentage of patients expected to have the age of onset ranging from 57 to 67 years?

• A. 95%
• B. 34%
• C. 68%
• D. 99%

Answer: C

Explanation:
To determine the percentage of patients with an age of onset ranging from 57 to 67 years, we need to apply the properties of a normal distribution. In a normal distribution, the mean represents the central point, and the standard deviation defines the spread of the data. Here, the mean age of onset is 62 years, and the standard deviation is 5 years. The range of 57 to 67 years corresponds to one standard deviation below the mean (62 - 5
= 57) to one standard deviation above the mean (62 + 5 = 67).
In a normal distribution, approximately 68% of the data falls within one standard deviation of the mean (i.e., between # - # and # + #, where # is the mean and # is the standard deviation). This is a well-established statistical principle, often referred to as the 68-95-99.7 rule (or empirical rule) in statistics. Specifically, 34% of the data lies between the mean and one standard deviation above the mean, and another 34% lies between the mean and one standard deviation below the mean, totaling 68% for the range spanning one standard deviation on both sides of the mean.
Let's verify this:
* The lower bound (57 years) is exactly one standard deviation below the mean (62 - 5 = 57).
* The upper bound (67 years) is exactly one standard deviation above the mean (62 + 5 = 67).
* Thus, the range from 57 to 67 years encompasses the middle 68% of the distribution.
Option A (34%) represents the percentage of patients within one standard deviation on only one side of the mean (e.g., 62 to 67 or 57 to 62), not the full range. Option C (95%) corresponds to approximately two standard deviations from the mean (62 ± 10 years, or 52 to 72 years), which is wider than the given range.
Option D (99%) aligns with approximately three standard deviations (62 ± 15 years, or 47 to 77 years), which is even broader. Since the question specifies a range of one standard deviation on either side of the mean, the correct answer is 68%, corresponding to Option B.
In infection control, understanding the distribution of disease onset ages can help infection preventionists identify at-risk populations and allocate resources effectively, aligning with the CBIC's focus on surveillance and data analysis (CBIC Practice Analysis, 2022). While the CBIC does not directly address statistical calculations in its core documents, the application of normal distribution principles is a standard epidemiological tool endorsed in public health guidelines, which inform CBIC practices.
References:
* CBIC Practice Analysis, 2022.
* Public Health Epidemiology Guidelines, Normal Distribution and Empirical Rule (commonly accepted statistical standards).

 

NEW QUESTION # 137
A surgeon is beginning a new procedure in the facility within the next two weeks and requires loaner instruments. Infection prevention processes should ensure that

• A. staff education related to loaner instrument reprocessing has occurred.
• B. the planning process takes place after the instruments have arrived.
• C. items arrive in time for immediate use steam sterilization.
• D. instruments are able to be used prior to the biological indicator results.

Answer: A

Explanation:
The correct answer is D, "staff education related to loaner instrument reprocessing has occurred," as this is the infection prevention process that should be ensured when a surgeon is beginning a new procedure requiring loaner instruments within the next two weeks. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, loaner instruments-those borrowed from external sources for temporary use-pose unique infection prevention challenges due to potential variability in reprocessing standards and unfamiliarity among staff. Ensuring that staff are educated on proper reprocessing protocols (e.g., cleaning, sterilization, and handling per manufacturer instructions and AAMI ST79) is critical to prevent healthcare- associated infections (HAIs) (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). This education should cover the specific requirements for loaner instruments, including documentation and verification of sterilization, and should occur proactively before the instruments are used to ensure competency and compliance.
Option A (items arrive in time for immediate use steam sterilization) is a logistical consideration, but it does not address the infection prevention process itself; timely arrival is necessary but insufficient without proper reprocessing validation. Option B (instruments are able to be used prior to the biological indicator results) is unsafe, as biological indicators are essential to confirm sterilization efficacy, and using instruments before results are available violates infection control standards. Option C (the planning process takes place after the instruments have arrived) is impractical, as planning (e.g., coordinating with vendors, assessing reprocessing needs) must occur in advance to ensure readiness and safety, not as a reactive step.
The focus on staff education aligns with CBIC's emphasis on preparing healthcare personnel to handle loaner instruments safely, reducing the risk of contamination and ensuring patient safety (CBIC Practice Analysis,
2022, Domain IV: Education and Research, Competency 4.1 - Develop and implement educational programs).
This proactive measure is supported by AAMI and CDC guidelines, which stress the importance of training for reprocessing complex or unfamiliar devices.
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment; Domain IV: Education and Research, Competency 4.1 - Develop and implement educational programs. AAMI ST79:2017, Comprehensive guide to steam sterilization and sterility assurance in health care facilities.

 

NEW QUESTION # 138
The annual report for Infection Prevention shows a dramatic decrease in urinary catheter days, a decrease in the catheter utilization ratio, and a slight decrease in the number of catheter-associated urinary tract infections (CAUTIs). The report does not show an increase in the overall rate of CAUTI. How would the infection preventionist explain this to the administration?

• A. The rate is not affected by the number of catheter days.
• B. The rate may be higher if the denominator is very small.
• C. Decreasing catheter days will not have an effect on decreasing CAUTI.
• D. The rate is incorrect and needs to be recalculated.

Answer: B

Explanation:
The correct answer is B, "The rate may be higher if the denominator is very small," as this provides the most plausible explanation for the observed data in the annual report. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the CAUTI rate is calculated as the number of CAUTIs per 1,000 catheter days, where catheter days serve as the denominator. The report indicates a dramatic decrease in urinary catheter days and a slight decrease in the number of CAUTIs, yet the overall CAUTI rate has not increased. This discrepancy can occur if the denominator (catheter days) becomes very small, which can inflate or destabilize the rate, potentially masking an actual increase in the infection risk per catheter day (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.2 - Analyze surveillance data). A smaller denominator amplifies the impact of even a slight change in the number of infections, suggesting that the rate may be higher than expected or less reliable, necessitating further investigation.
Option A (the rate is incorrect and needs to be recalculated) assumes an error in the calculation without evidence, which is less specific than the denominator effect explanation. Option C (the rate is not affected by the number of catheter days) is incorrect because the CAUTI rate is directly influenced by the number of catheter days as the denominator; a decrease in catheter days should typically lower the rate if infections decrease proportionally, but the lack of an increase here suggests a calculation or interpretation issue. Option D (decreasing catheter days will not have an effect on decreasing CAUTI) contradicts evidence-based practice, as reducing catheter days is a proven strategy to lower CAUTI incidence, though the rate's stability here indicates a potential statistical artifact.
The explanation focusing on the denominator aligns with CBIC's emphasis on accurate surveillance and data analysis to guide infection prevention strategies, allowing the infection preventionist to advise administration on the need to review data trends or adjust monitoring methods (CBIC Practice Analysis, 2022, Domain II:
Surveillance and Epidemiologic Investigation, Competency 2.5 - Use data to guide infection prevention and control strategies). This insight can prompt a deeper analysis to ensure the CAUTI rate reflects true infection risk.
References: CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competencies 2.2 - Analyze surveillance data, 2.5 - Use data to guide infection prevention and control strategies.

 

NEW QUESTION # 139
Which of the following management activities should be performed FIRST?

• A. Assign responsibility for projects
• B. Evaluate project results
• C. Plan and organize activities
• D. Establish goals

Answer: D

Explanation:
To determine which management activity should be performed first, we need to consider the logical sequence of steps in effective project or program management, particularly in the context of infection control as guided by CBIC principles. Management activities typically follow a structured process, and the order of these steps is critical to ensuring successful outcomes.
* A. Evaluate project results: Evaluating project results involves assessing the outcomes and effectiveness of a project after its implementation. This step relies on having completed the project or at least reached a stage where outcomes can be measured. Performing this activity first would be premature, as there would be no results to evaluate without prior planning, goal-setting, and execution. Therefore, this cannot be the first step.
* B. Establish goals: Establishing goals is the foundational step in any management process. Goals provide direction, define the purpose, and set the criteria for success. In the context of infection control, as emphasized by CBIC, setting clear objectives (e.g., reducing healthcare-associated infections by a specific percentage) is essential before any other activities can be planned or executed. This step aligns with the initial phase of strategic planning, making it the logical first activity. Without established goals, subsequent steps lack focus and purpose.
* C. Plan and organize activities: Planning and organizing activities involve developing a roadmap to achieve the goals, including timelines, resources, and tasks. This step depends on having clear goals to guide the planning process. In infection control, this might include designing interventions to meet infection reduction targets. While critical, it cannot be the first step because planning requires a predefined objective to be effective.
* D. Assign responsibility for projects: Assigning responsibility involves delegating tasks and roles to individuals or teams. This step follows the establishment of goals and planning, as responsibilities need to be aligned with the specific objectives and organized activities. In an infection control program, this might mean assigning staff to monitor compliance with hand hygiene protocols. Doing this first would be inefficient without a clear understanding of the goals and plan.
The correct sequence in management, especially in a structured field like infection control, begins with establishing goals to provide a clear target. This is followed by planning and organizing activities, assigning responsibilities, and finally evaluating results. The CBIC framework supports this approach by emphasizing the importance of setting measurable goals as part of the infection prevention and control planning process, which is a prerequisite for all subsequent actions.
References:
* CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain V:
Management and Communication, which highlights the importance of setting goals as the initial step in managing infection control programs.
* CBIC Examination Content Outline, Domain V: Leadership and Program Management, which underscores the need for goal-setting prior to planning and implementation of infection control initiatives.

 

NEW QUESTION # 140
Peripherally inserted central catheter (PICC)-associated bloodstream infections (BSIs) have been increasing over the past four months. Which of the following interventions is MOST likely to have contributed to the increase?

• A. Use of a positive pressure device on the PICC
• B. Daily bathing adult intensive care unit patients with chlorhexidine
• C. Replacement of the intravenous administration sets every 72 hours
• D. Use of chlorhexidine skin antisepsis during insertion of the PICC

Answer: C

Explanation:
Peripherally inserted central catheter (PICC)-associated bloodstream infections (BSIs) are a significant concern in healthcare settings, and identifying factors contributing to their increase is critical for infection prevention. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the
"Surveillance and Epidemiologic Investigation" and "Prevention and Control of Infectious Diseases" domains, which align with the Centers for Disease Control and Prevention (CDC) guidelines for preventing intravascular catheter-related infections. The question asks for the intervention most likely to have contributed to the rise in PICC-associated BSIs over four months, requiring an evaluation of each option based on evidence-based practices.
Option C, "Replacement of the intravenous administration sets every 72 hours," is the most likely contributor to the increase. The CDC's "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017) recommend that intravenous administration sets (e.g., tubing for fluids or medications) be replaced no more frequently than every 72-96 hours unless clinically indicated (e.g., contamination or specific therapy requirements). Frequent replacement, such as every 72 hours as a routine practice, can introduce opportunities for contamination during the change process, especially if aseptic technique is not strictly followed. Studies cited in the CDC guidelines, including those by O'Grady et al. (2011), indicate that unnecessary manipulation of catheter systems increases the risk of introducing pathogens, potentially leading to BSIs. A change to a 72- hour replacement schedule, if not previously standard, could explain the observed increase over the past four months.
Option A, "Use of chlorhexidine skin antisepsis during insertion of the PICC," is a recommended practice to reduce BSIs. Chlorhexidine, particularly in a 2% chlorhexidine gluconate with 70% alcohol solution, is the preferred skin antiseptic for catheter insertion due to its broad-spectrum activity and residual effect, as supported by the CDC (2017). This intervention should decrease, not increase, infection rates, making it an unlikely contributor. Option B, "Daily bathing adult intensive care unit patients with chlorhexidine," is another evidence-based strategy to reduce healthcare-associated infections, including BSIs, by decolonizing the skin of pathogens like Staphylococcus aureus. The CDC and SHEA (Society for Healthcare Epidemiology of America) guidelines (2014) endorse chlorhexidine bathing in intensive care units, suggesting it should lower, not raise, BSI rates. Option D, "Use of a positive pressure device on the PICC," aims to prevent catheter occlusion and reduce the need for frequent flushing, which could theoretically decrease infection risk by minimizing manipulation. However, there is no strong evidence linking positive pressure devices to increased BSIs; if improperly used or maintained, they might contribute marginally, but this is less likely than the impact of frequent tubing changes.
The CBIC Practice Analysis (2022) and CDC guidelines highlight that deviations from optimal catheter maintenance practices, such as overly frequent administration set replacements, can increase infection risk.
Given the four-month timeframe and the focus on an intervention's potential negative impact, Option C stands out as the most plausible contributor due to the increased manipulation and contamination risk associated with routine 72-hour replacements.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2017.
* O'Grady, N. P., et al. (2011). Guidelines for the Prevention of Intravascular Catheter-Related Infections. Clinical Infectious Diseases.
* SHEA Compendium, Strategies to Prevent Central Line-Associated Bloodstream Infections, 2014.

 

NEW QUESTION # 141
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