Free CBIC CIC Practice Exam with Questions & Answers | Set: 2

The correct answer is A, "Type of floor material," as it is the least important operating suite design feature for the prevention of infection compared to the other options. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the design of operating suites plays a critical role in infection prevention, particularly for surgical site infections (SSIs). While the type of floor material (e.g., vinyl, tile, or epoxy) can affect ease of cleaning and durability, its impact on infection prevention is secondary to other design elements that directly influence air quality, hygiene practices, and personnel movement (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). Modern flooring materials are generally designed to be non-porous and easily disinfected, mitigating their role as a primary infection risk factor when proper cleaning protocols are followed.

Option B (positive pressure air handling) is highly important because it prevents the influx of contaminated air into the operating suite, reducing the risk of airborne pathogens, including those causing SSIs. This is a standard feature in operating rooms to maintain a sterile environment (AORN Guidelines for Perioperative Practice, 2023). Option C (placement of sinks for surgical scrubs) is critical for ensuring that surgical staff can perform effective hand and forearm antisepsis, a key step in preventing SSIs by reducing microbial load before surgery. Option D (control of traffic and traffic flow patterns) is essential to minimize the introduction of contaminants from outside the operating suite, as excessive or uncontrolled movement can increase the risk of airborne and contact transmission (CDC Guidelines for Environmental Infection Control in Healthcare Facilities, 2019).

The relative unimportance of floor material type stems from the fact that infection prevention relies more on consistent cleaning practices and the aforementioned design features, which directly address pathogen transmission routes. This aligns with CBIC’s focus on evaluating environmental risks based on their direct impact on infection control (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.4 - Implement environmental cleaning and disinfection protocols).

References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.4 - Implement environmental cleaning and disinfection protocols, 3.5 - Evaluate the environment for infection risks. AORN Guidelines for Perioperative Practice, 2023. CDC Guidelines for Environmental Infection Control in Healthcare Facilities, 2019.

The correct answer is A, "Pregnant persons," as they should be excluded from receiving the live attenuated influenza virus (LAIV) vaccine. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, which align with recommendations from the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP), the LAIV, commonly known as the nasal spray flu vaccine, contains a live attenuated form of the influenza virus. This vaccine is contraindicated in pregnant individuals due to the theoretical risk of the attenuated virus replicating and potentially harming the fetus, despite limited evidence of adverse outcomes (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents). Pregnant persons are instead recommended to receive the inactivated influenza vaccine (IIV), which is considered safe during pregnancy.

Option B (healthy persons aged 2 to 49) is incorrect because this group is generally eligible to receive LAIV, provided they have no other contraindications, as the vaccine is approved for healthy, non-pregnant individuals in this age range (CDC Immunization Schedules, 2024). Option C (persons with allergies to chicken feathers) is not a contraindication for LAIV; the vaccine is produced in eggs, and while egg allergy was historically a concern, current guidelines indicate that LAIV can be administered to persons with egg allergies if they can tolerate egg in their diet, with precautions managed by healthcare providers. Option D (persons simultaneously receiving an inactivated vaccine) is also incorrect, as LAIV can be co-administered with inactivated vaccines without issue, according to ACIP recommendations, as there is no significant interference between the two vaccine types.

The exclusion of pregnant persons reflects CBIC’s emphasis on tailoring infection prevention strategies, including vaccination programs, to protect vulnerable populations while minimizing risks (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.1 - Collaborate with organizational leaders). This decision is based on precautionary principles outlined in CDC and ACIP guidelines to ensure maternal and fetal safety (CDC Prevention and Control of Seasonal Influenza with Vaccines, 2023).

References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.1 - Collaborate with organizational leaders, 3.2 - Implement measures to prevent transmission of infectious agents. CDC Prevention and Control of Seasonal Influenza with Vaccines, 2023. CDC Immunization Schedules, 2024.

The correct answer is D, "Hepatitis B immune globulin (HBIG) and hepatitis B vaccine," as this is the recommended regimen for an HBsAb-negative employee with a percutaneous exposure to blood from an HBsAg-positive patient. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, which align with recommendations from the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP), post-exposure prophylaxis (PEP) for hepatitis B virus (HBV) exposure depends on the employee’s vaccination status and the source’s HBsAg status. For an unvaccinated or known HBsAb-negative individual (indicating no immunity) exposed to HBsAg-positive blood, the standard PEP includes both HBIG and the hepatitis B vaccine. HBIG provides immediate passive immunity by delivering pre-formed antibodies, while the vaccine initiates active immunity to prevent future infections (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents). The HBIG should be administered within 24 hours of exposure (preferably within 7 days), and the first dose of the vaccine should be given concurrently, followed by the complete vaccine series.

Option A (immune serum globulin and hepatitis B vaccine) is incorrect because immune serum globulin (ISG) is a general immunoglobulin preparation and not specific for HBV; HBIG, which contains high titers of anti-HBs, is the appropriate specific immunoglobulin for HBV exposure. Option B (hepatitis B immune globulin [HBIG] alone) is insufficient, as it provides only temporary passive immunity without initiating long-term active immunity through vaccination, which is critical for an unvaccinated individual. Option C (hepatitis B vaccine alone) is inadequate for immediate post-exposure protection, as it takes weeks to develop immunity, leaving the employee vulnerable in the interim.

The recommendation for HBIG and hepatitis B vaccine aligns with CBIC’s emphasis on evidence-based post-exposure management to prevent HBV transmission in healthcare settings (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.1 - Collaborate with organizational leaders). This dual approach is supported by CDC guidelines, which prioritize rapid intervention to reduce the risk of seroconversion following percutaneous exposure (CDC Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV, 2013).

References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.1 - Collaborate with organizational leaders, 3.2 - Implement measures to prevent transmission of infectious agents. CDC Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV, 2013.

Assessing the effectiveness of an infection control action plan is a critical responsibility of an infection preventionist (IP) to ensure that interventions reduce healthcare-associated infections (HAIs) and improve patient safety. The Certification Board of Infection Control and Epidemiology (CBIC) highlights this process within the "Surveillance and Epidemiologic Investigation" and "Performance Improvement" domains, emphasizing the need for ongoing evaluation and data-driven decision-making. The Centers for Disease Control and Prevention (CDC) and other guidelines stress that the ultimate goal of an action plan is to achieve measurable outcomes, such as reduced infection rates, which requires systematic monitoring and validation.

Option D, "Monitor and validate the related outcome and process measures," is the most important consideration. Outcome measures (e.g., infection rates, morbidity, or mortality) indicate whether the action plan has successfully reduced the targeted infection risk, while process measures (e.g., compliance with hand hygiene or proper catheter insertion techniques) assess whether the implemented actions are being performed correctly. Monitoring involves continuous data collection and analysis, while validation ensures the data’s accuracy and relevance to the plan’s objectives. The CBIC Practice Analysis (2022) underscores that effective infection control relies on evaluating both outcomes (e.g., decreased central line-associated bloodstream infections) and processes (e.g., adherence to aseptic protocols), making this a dynamic and essential step. The CDC’s "Compendium of Strategies to Prevent HAIs" (2016) further supports this by recommending regular surveillance and feedback as key to assessing intervention success.

Option A, "Re-evaluate the action plan every three years," suggests a periodic review, which is a good practice for long-term planning but is insufficient as the most important consideration. Infection control requires more frequent assessment (e.g., quarterly or annually) to respond to emerging risks or outbreaks, making this less critical than ongoing monitoring. Option B, "Update the plan before the risk assessment is completed," is illogical and counterproductive. Updating a plan without a completed risk assessment lacks evidence-based grounding, undermining the plan’s effectiveness and contradicting the CBIC’s emphasis on data-driven interventions. Option C, "Develop a timeline and assign responsibilities for the stated action," is an important initial step in implementing an action plan, ensuring structure and accountability. However, it is a preparatory activity rather than the most critical factor in assessing effectiveness, which hinges on post-implementation evaluation.

The CBIC Practice Analysis (2022) and CDC guidelines prioritize outcome and process monitoring as the cornerstone of infection control effectiveness, enabling IPs to adjust strategies based on real-time evidence. Thus, Option D represents the most important consideration for assessing an infection control action plan’s success.

References:

CBIC Practice Analysis, 2022.

CDC Compendium of Strategies to Prevent Healthcare-Associated Infections, 2016.

Meningococcal infections, such as Neisseria meningitidis, are transmitted via respiratory droplets. According to APIC and CDC guidelines, patients with meningococcal disease should be placed on Droplet Precautions upon admission. These precautions can be discontinued after 24 hours of effective antibiotic therapy.

Why the Other Options Are Incorrect?

B. Droplet precautions must continue – Droplet Precautions are not needed beyond 24 hours of appropriate therapy because treatment rapidly reduces infectiousness.

C. Airborne precautions may be discontinued after 24 hours of therapy – Meningococcal infection is not airborne, so Airborne Precautions are never required.

D. Airborne precautions must continue – Incorrect because meningococci do not transmit via airborne particles.

CBIC Infection Control Reference

According to APIC guidelines, Droplet Precautions should be maintained for at least 24 hours after effective antibiotic therapy initiation​.

The correct answer is A, "One dose of Tdap vaccine," as this is the recommended immunization for a 55-year-old nurse who received all childhood vaccinations. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, which align with recommendations from the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP), adults who have completed a primary series of childhood vaccinations (typically 5 doses of DTaP or DTP) should receive a single booster dose of Tdap if they have not previously received it. This is especially critical for healthcare personnel, such as a 55-year-old nurse, due to their increased risk of exposure to pertussis and the need to protect vulnerable patients (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents). The Tdap vaccine, which protects against tetanus, diphtheria, and pertussis, is recommended once between ages 11-64, with a preference for administration in early adulthood (e.g., 19-26 years) or as soon as feasible for older adults, including this 55-year-old nurse, to ensure immunity against pertussis, which wanes over time. For individuals aged 65 and older, Tdap is still recommended if not previously received, though Tdap is preferred over Td (tetanus and diphtheria only) for healthcare workers to address pertussis risk.

Option B (two doses of Tdap vaccine at least 14 days apart) and Option C (two doses of Tdap vaccine at least 28 days apart) are not standard recommendations for adults with a complete childhood vaccination history. Multiple doses are typically reserved for individuals with incomplete primary series or specific high-risk conditions, not for this scenario. Option D (no additional vaccination is recommended) is incorrect because, even with a complete childhood series, a Tdap booster is advised for healthcare workers to maintain protection, especially given the nurse’s occupational exposure risks (CDC Immunization Schedules, 2024). After receiving the Tdap booster, a Td booster every 10 years is recommended to maintain tetanus and diphtheria immunity, but the initial Tdap dose is the priority for this nurse.

The recommendation for one Tdap dose aligns with CBIC’s emphasis on evidence-based immunization policies to prevent transmission of vaccine-preventable diseases in healthcare settings (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.1 - Collaborate with organizational leaders). This ensures the nurse is protected and contributes to herd immunity, reducing the risk of pertussis outbreaks in the healthcare environment.

References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.1 - Collaborate with organizational leaders, 3.2 - Implement measures to prevent transmission of infectious agents. CDC Immunization Schedules, 2024. ACIP Recommendations for Tdap, 2011 (updated 2023).

Carbapenem-resistant Enterobacterales (CRE) colonization is most commonly found in the gastrointestinal (GI) tract. Therefore, rectal or peri-rectal cultures are recommended for active surveillance screening.

Why the Other Options Are Incorrect?

B. Nares or axillary cultures – CRE is not primarily found in the nasal or axillary region; this method is more relevant for detecting MRSA.

C. Abscess or blood cultures – While CRE may be present in clinical infections, these cultures are not used for screening asymptomatic carriers.

D. Throat or nasopharyngeal cultures – CRE does not commonly colonize the upper respiratory tract, so these are not ideal for active screening.

CBIC Infection Control Reference

The CDC and APIC guidelines emphasize rectal or peri-rectal swabbing as the most effective active surveillance method for CRE detection​.

The selection of an appropriate antiseptic for the insertion of an intravascular device (e.g., peripheral or central venous catheters) is a critical infection prevention measure to reduce the risk of catheter-related bloodstream infections (CRBSIs). The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes evidence-based practices in the "Prevention and Control of Infectious Diseases" domain, which includes adhering to guidelines for aseptic technique during invasive procedures. The Centers for Disease Control and Prevention (CDC) provides specific recommendations for skin antisepsis, as outlined in the "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017).

Option A, chlorhexidine, is the preferred antiseptic for skin preparation prior to intravascular device insertion in adults with no contraindications. Chlorhexidine, particularly in a 2% chlorhexidine gluconate (CHG) with 70% isopropyl alcohol solution, is recommended by the CDC due to its broad-spectrum antimicrobial activity, residual effect (which continues to kill bacteria after application), and superior efficacy compared to other agents in reducing CRBSI rates. Studies cited in the CDC guidelines demonstrate that chlorhexidine-based preparations significantly lower infection rates compared to povidone-iodine or alcohol alone, making it the gold standard for this procedure when tolerated by the patient.

Option B, povidone-iodine, is an alternative antiseptic that can be used for skin preparation. It is effective against a wide range of microorganisms and is often used when chlorhexidine is contraindicated (e.g., in patients with chlorhexidine allergy). However, its efficacy is less persistent than chlorhexidine, and it requires longer drying time, which can be a limitation in busy clinical settings. The CDC considers povidone-iodine a second-line option unless chlorhexidine is unavailable or unsuitable. Option C, alcohol (e.g., 70% isopropyl or ethyl alcohol), has rapid bactericidal activity but lacks a residual effect, making it less effective for prolonged protection during catheter dwell time. It is often used as a component of chlorhexidine-alcohol combinations but is not recommended as a standalone antiseptic for intravascular device insertion. Option D, antibiotic ointment, is not appropriate for skin preparation during insertion. Antibiotic ointments (e.g., bacitracin or mupirocin) are sometimes applied to catheter sites post-insertion to prevent infection, but their use is discouraged by the CDC due to the risk of promoting antibiotic resistance and fungal infections, and they are not classified as antiseptics for initial skin antisepsis.

The CBIC Practice Analysis (2022) supports the adoption of CDC-recommended practices, and the 2017 CDC guidelines explicitly state that chlorhexidine-based preparations with alcohol should be used for skin antisepsis unless contraindicated. For a patient with no contraindications, the infection preventionist should suggest chlorhexidine to optimize patient safety and align with best practices.

References:

CBIC Practice Analysis, 2022.

CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2017.

Reviewing compliance with VAP prevention bundles (e.g., head-of-bed elevation, oral care, sedation breaks) is the first step in outbreak control​.

Preemptive antibiotics (B) are not recommended due to antibiotic resistance risks.

Negative pressure rooms (C) are not required for VAP.

Ventilator circuit cultures (D) do not guide patient management.

CBIC Infection Control References:

APIC Text, "VAP Prevention Measures," Chapter 11​.

Measures of central tendency (mean, median, mode) and dispersion (standard deviation) are statistical tools used to summarize data, such as the duration of surgical procedures, which can help infection preventionists identify trends or risks for surgical site infections. The Certification Board of Infection Control and Epidemiology (CBIC) supports the use of data analysis in the "Surveillance and Epidemiologic Investigation" domain, aligning with epidemiological principles outlined by the Centers for Disease Control and Prevention (CDC). The question provides a data set of 2, 2, 3, 4, and 9, and requires determining the correct statement by calculating these measures.

Mean: The mean is the average of the data set, calculated by summing all values and dividing by the number of observations. For the data set 2, 2, 3, 4, and 9:(2 + 2 + 3 + 4 + 9) ÷ 5 = 20 ÷ 5 = 4. Thus, the mean is 4, making Option C correct.

Median: The median is the middle value when the data set is ordered. With five values (2, 2, 3, 4, 9), the middle value is the third number, which is 3. Option A states the median is 2, which is incorrect.

Mode: The mode is the most frequently occurring value. In this data set, 2 appears twice, while 3, 4, and 9 appear once each, making 2 the mode. Option B states the mode is 3, which is incorrect.

Standard Deviation: The standard deviation measures the spread of data around the mean. For a small data set like this, the calculation involves finding the variance (average of squared differences from the mean) and taking the square root. The mean is 4, so the deviations are: (2-4)² = 4, (2-4)² = 4, (3-4)² = 1, (4-4)² = 0, (9-4)² = 25. The sum of squared deviations is 4 + 4 + 1 + 0 + 25 = 34. The variance is 34 ÷ 5 = 6.8, and the standard deviation is √6.8 ≈ 2.61 (not 7). Option D states the standard deviation is 7, which is incorrect without further context (e.g., a population standard deviation with n-1 denominator would be √34 ≈ 5.83, still not 7).

The CBIC Practice Analysis (2022) and CDC guidelines encourage accurate statistical analysis to inform infection control decisions, such as assessing surgical duration as a risk factor for infections. Based on the calculations, the mean of 4 is the only correct statement among the options, confirming Option C as the answer. Note that the standard deviation of 7 might reflect a miscalculation or misinterpretation (e.g., using a different formula or data set), but with the given data, it does not hold.

References:

CBIC Practice Analysis, 2022.

CDC Principles of Epidemiology in Public Health Practice, 3rd Edition, 2012.