Free CBIC CIC Practice Exam with Questions & Answers

Perioperative normothermia maintenance reduces SSI rates by improving immune function and tissue perfusion​.

Routine wound irrigation (B) has no strong evidence supporting SSI prevention.

Prolonged antibiotic use (C) increases antibiotic resistance without added benefit.

Extended use of wound dressings (D) does not reduce SSI rates.

CBIC Infection Control References:

APIC Text, "SSI Prevention in Surgery," Chapter 12​.

Glove Contamination and SSI Risk:

Failure to change contaminated gloves increases the risk of surgical site infections (SSIs)​.

Double-gloving with an outer glove change reduces contamination.

Why Other Options Are Incorrect:

B. Alcohol-based hand rubs: Are FDA-approved alternatives to traditional scrubs and effective​.

C. Delayed antibiotics: Increases infection risk, but immediate correction reduces harm.

D. Airflow disruption: Can increase SSI risk, but glove contamination poses a more direct threat.

CBIC Infection Control References:

APIC-JCR Workbook, "Surgical Infection Prevention," Chapter 6​.

The scenario involves a surgical patient with a purulent abdominal wound culture growing Staphylococcus aureus, a common pathogen in surgical site infections (SSIs). The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes accurate interpretation of culture results and antibiotic therapy in the "Identification of Infectious Disease Processes" and "Prevention and Control of Infectious Diseases" domains, aligning with the Centers for Disease Control and Prevention (CDC) guidelines for managing SSIs. The question requires assessing the sensitivity pattern and current treatment to determine the correct statement.

Option B, "The current therapy is not effective," is true. The wound culture shows Staphylococcus aureus resistant to oxacillin, indicating methicillin-resistant S. aureus (MRSA). The sensitivity pattern lists resistance to penicillin, oxacillin, cephalothin, and erythromycin, with susceptibility to clindamycin and vancomycin. Cefazolin, a first-generation cephalosporin, is ineffective against MRSA because resistance to oxacillin (a penicillinase-resistant penicillin) implies cross-resistance to cephalosporins like cefazolin due to altered penicillin-binding proteins (PBPs). The CDC’s "Guidelines for the Prevention of Surgical Site Infections" (2017) and the Clinical and Laboratory Standards Institute (CLSI) standards confirm that MRSA strains are not susceptible to cefazolin, meaning the current therapy is inappropriate and unlikely to resolve the infection, supporting Option B.

Option A, "The wound is not infected," is incorrect. The presence of purulent drainage, a clinical sign of infection, combined with a positive culture for S. aureus, confirms an active wound infection. The CBIC and CDC define purulent discharge as a key indicator of SSI, ruling out this statement. Option C, "Droplet Precautions should be initiated," is not applicable. Droplet Precautions are recommended for pathogens transmitted via respiratory droplets (e.g., influenza, pertussis), not for S. aureus, which is primarily spread by contact. The CDC’s "Guideline for Isolation Precautions" (2007) specifies Contact Precautions for MRSA, not Droplet Precautions, making this false. Option D, "This is a methicillin-sensitive S. aureus (MSSA) strain," is incorrect. Methicillin sensitivity is determined by susceptibility to oxacillin, and the resistance to oxacillin in the culture result classifies this as MRSA, not MSSA. The CDC and CLSI use oxacillin resistance as the defining criterion for MRSA.

The CBIC Practice Analysis (2022) and CDC guidelines stress the importance of aligning antimicrobial therapy with sensitivity patterns to optimize treatment outcomes. The mismatch between cefazolin and the MRSA sensitivity profile confirms that Option B is the correct statement,indicating ineffective current therapy.

Antimicrobial stewardship is the most effective strategy to reduce C. difficile infections (CDI) by limiting the use of broad-spectrum antibiotics​.

Quaternary ammonium disinfectants (A) are ineffective against C. difficile spores; bleach-based disinfectants are preferred.

Routine screening (C) is not cost-effective for prevention.

Alcohol-based hand rubs (D) do not kill C. difficile spores; soap and water should be used.

CBIC Infection Control References:

APIC Text, "C. difficile Prevention Strategies," Chapter 9​.

The infection preventionist’s (IP) best conclusion, based on the provided evidence, is that the evidence at this time fails to support the nurse's claim of acquiring hepatitis A virus (HAV) infection through occupational exposure. This conclusion is grounded in the clinical and epidemiological understanding of HAV, as aligned with the Certification Board of Infection Control and Epidemiology (CBIC) guidelines. Hepatitis A typically has an incubation period ranging from 15 to 50 days, with an average of approximately 28-30 days, following exposure to the virus (CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competency 1.3 - Apply principles of epidemiology). The reported 5-day interval between exposure and symptom onset in the nurse is significantly shorter than the expected incubation period, making it inconsistent with HAV transmission. Additionally, the presence of immunoglobulin G (IgG) antibodies in the source patient indicates past exposure or immunity to HAV, rather than an active or recent infection, which would typically be associated with immunoglobulin M (IgM) antibodies during the acute phase.

Option A (the nurse should be given hepatitis A virus immunoglobulin) is not supported because post-exposure prophylaxis with HAV immunoglobulin is recommended only within 14 days of exposure to a confirmed case with active infection, and the evidence here does not confirm a recent exposure or active case. Option C (the patient has serologic evidence of recent hepatitis A viral infection) is incorrect because IgG antibodies signify past infection or immunity, not a recent infection, which would require IgM antibodies. Option D (the 5-day incubation period is consistent with hepatitis A virus transmission) is inaccurate due to the mismatch with the known incubation period of HAV.

The IP’s role includes critically evaluating epidemiological data to determine the likelihood of transmission events. The discrepancy in the incubation period and the serologic status of the patient suggest that the nurse’s claim may not be substantiated by the current evidence, necessitating further investigation rather than immediate intervention or acceptance of the claim. This aligns withCBIC’s emphasis on accurate identification and investigation of infectious disease processes (CBIC Practice Analysis, 2022, Domain I: Identification of Infectious Disease Processes, Competency 1.2 - Investigate suspected outbreaks or exposures).

The interaction between pathogens and the human body can take various forms, each with distinct immunological and clinical implications. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes understanding these states within the "Identification of Infectious Disease Processes" domain to guide infection prevention strategies. The question describes a scenario where pathogens are present, can be cultured (indicating viable organisms), but do not trigger a response from the body’s defense mechanisms, such as inflammation or immune activation. This requires identifying the appropriate microbiological state.

Option A, "Colonization," is the correct answer. Colonization occurs when microorganisms are present on or in the body (e.g., skin, mucous membranes, or gut) without causing harm or eliciting an immune response. These pathogens can be cultured, as they are alive and replicating, but they exist in a commensal or symbiotic relationship with the host, not provoking symptoms or defense mechanisms. Examples include normal flora like Staphylococcus epidermidis on the skin or Streptococcus salivarius in the oral cavity. The Centers for Disease Control and Prevention (CDC) defines colonization as the presence of microbes without tissue invasion or damage, distinguishing it from infection (CDC, "Principles of Epidemiology in Public Health Practice," 3rd Edition, 2012).

Option B, "Infection," is incorrect because it involves the invasion and multiplication of pathogens in body tissues, leading to an immune response, such as inflammation, fever, or antibody production. This contrasts with the question’s description of no defense mechanism response. Option C, "Latency," refers to a state where a pathogen (e.g., herpes simplex virus or Mycobacterium tuberculosis) remains dormant in the body after initial infection, capable of reactivation but not eliciting an active immune response during dormancy. However, latency implies a prior infection with a latent phase, whereas the question suggests a current, non-responsive state without prior infection context. Option D, "Contamination," describes the unintended presence of pathogens on inanimate objects or surfaces (e.g., medical equipment), not within the body, and does not align with the scenario of living, culturable pathogens in a host.

The CBIC Practice Analysis (2022) and CDC guidelines highlight colonization as a key concept in infection control, particularly in settings like hospitals where colonized patients can serve as reservoirs for potential infections. The absence of an immune response, as specified, aligns with the definition of colonization, making Option A the most accurate answer.

The correct answer is D, "Study," as this is the step in the Shewhart/Deming cycle (commonly known as the Plan-Do-Study-Act [PDSA] cycle) where the results of the interventions are compared with the original goal. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the PDSA cycle is a systematic approach to quality improvement, widely used in infection control programs to test and refine interventions. The cycle consists of four stages: Plan (designing the intervention and setting goals), Do (implementing the intervention on a small scale), Study (analyzing the data and comparing outcomes against the original goal), and Act (standardizing successful changes or adjusting based on findings) (CBIC Practice Analysis, 2022,Domain IV: Education and Research, Competency 4.2 - Evaluate the effectiveness of educational programs). The Study phase is critical for assessing whether the intervention achieved the intended reduction in infection rates or other performance metrics, providing evidence to guide the next steps.

Option A (Do) involves the execution of the planned intervention, focusing on implementation rather than evaluation, so it does not include comparing results. Option B (Act) is the final step where successful interventions are implemented on a broader scale or adjustments are made, but it follows the comparison made in the Study phase. Option C (Plan) is the initial stage of setting objectives and designing the intervention, which occurs before any results are available for comparison.

The emphasis on the Study phase aligns with CBIC’s focus on using data to evaluate the effectiveness of infection prevention strategies, ensuring that performance improvement projects are evidence-based and goal-oriented (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.4 - Evaluate the effectiveness of infection prevention and control interventions). This step enables the infection preventionist to determine if the original goal—such as reducing healthcare-associated infections—was met, facilitating continuous improvement.

To determine the infection rate per 100 procedures for total hip replacements, use the following formula:

A white paper with black text and numbers AI-generated content may be incorrect.

Thus, the correct answer isB. 2.9per 100 procedures.

CBIC Infection Control Reference

The methodology of calculating SSI rates aligns with guidelines from theNational HealthcareSafety Network (NHSN)and standardized infection ratio (SIR) models used for hospital-specific SSI rates​.

Tuberculosis (TB), caused by Mycobacterium tuberculosis, is an airborne disease that poses a significant risk in healthcare settings, particularly through exposure to infectious droplets. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the "Prevention and Control of Infectious Diseases" domain, which includes developing exposure control plans, aligning with the Centers for Disease Control and Prevention (CDC) "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Healthcare Settings" (2005). The question seeks the most important aspect of an exposure control plan to prevent TB exposure, requiring a prioritization of preventive strategies.

Option B, "Identification of a potentially infectious patient," is the most important aspect. Early identification of individuals with suspected or confirmed TB (e.g., through symptom screening like persistent cough, fever, or weight loss, or diagnostic tests like chest X-rays and sputum smears) allows for timely isolation and treatment, preventing further transmission. The CDC guidelines stress that the first step in an exposure control plan is to recognize patients with signs or risk factors for infectious TB, as unrecognized cases are the primary source of healthcare worker and patient exposures. The Occupational Safety and Health Administration (OSHA) also mandates risk assessment and early detection as foundational to TB control plans.

Option A, "Placement of the patient in an airborne infection isolation room," is a critical control measure once a potentially infectious patient is identified. Airborne infection isolation rooms (AIIRs) with negative pressure ventilation reduce the spread of infectious droplets, as recommended by the CDC. However, this step depends on prior identification; placing a patient in an AIIR without knowing their infectious status is inefficient and not the initial priority. Option C, "Prompt initiation of chemotherapeutic agents," is essential for treating active TB and reducing infectiousness, typically within days of effective therapy, per CDC guidelines. However, this follows identification and diagnosis (e.g., via acid-fast bacilli smear or culture), making it a secondary action rather than the most important preventive aspect. Option D, "Use of personal protective equipment," such as N95 respirators, is a key protective measure for healthcare workers once an infectious patient is identified, as outlined by the CDC and OSHA. However, PPE is a reactive measure that mitigates exposure after identification and isolation, not the foundational step to prevent it.

The CBIC Practice Analysis (2022) and CDC guidelines prioritize early identification as the cornerstone of TB exposure prevention, enabling all subsequent interventions. Option B ensures that the exposure control plan addresses the source of transmission at its outset, making it the most important aspect.

Thegold standard specimenfor diagnosingpertussis (Bordetella pertussis infection)is anasopharyngeal culturebecause:

B. pertussis colonizes the nasopharynx, making it the best site for detection.

Aproperly collected nasopharyngeal swab or aspirateincreases diagnostic sensitivity.

This method is recommended forculture, PCR, or direct fluorescent antibody testing.

Why the Other Options Are Incorrect?

A. Cough plate– Not commonly used due tolow sensitivity.

B. Nares culture– Thenares are not a primary sitefor pertussis colonization.

C. Sputum culture–B. pertussis does not commonly infect the lower respiratory tract.

CBIC Infection Control Reference

APIC confirms thatnasopharyngeal culture is the preferred method for diagnosing pertussis​.