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

Anyevidence of moistureinside a sterilization package indicates acompromised sterilization process. The immediate action is torecall and reprocessthe entire affected load.

According toANSI/AAMI ST79and cited in theAPIC Text:

“Any items with packaging that appears to be wet should not be used.” These items must bereprocessedto ensure sterility is not compromised.

This is not a matter for education or monitoring—it requires direct corrective action to protect patient safety.

10% lipid emulsionsare themost likely to promote microbial growthbecause they provide an ideal environment forbacterial and fungal proliferation, especiallyStaphylococcus aureus, Pseudomonas aeruginosa, and Candida species. Lipids supportrapid bacterial multiplicationdue to theirhigh nutrient content.

Why the Other Options Are Incorrect?

A. 50% hypertonic glucose–High glucose concentrations inhibit bacterial growthdue toosmotic pressure effects.

B. 5% dextrose– While it can support some bacterial growth, it isless favorablethan lipid emulsions.

C. Synthetic amino acids– These solutionsdo not support microbial growth as well as lipid emulsions.

CBIC Infection Control Reference

APIC guidelines confirm that lipid-based solutions support rapid microbial growthand should be handled with strict aseptic technique​.

Epidemiologic Investigation:

The first step in an outbreak response is to characterize cases by person, place, and time​.

Identifying common exposures (e.g., ventilators, catheters, or contaminated surfaces) helps determine the source​.

Why Other Options Are Incorrect:

A. Universal contact precautions: Premature; precautions should be tailored based on transmission patterns.

C. Environmental sampling: Should be done after identifying epidemiologic links.

D. Decolonization protocols: Not routinely recommended for Acinetobacter outbreaks.

CBIC Infection Control References:

CIC Study Guide, "Epidemiologic Investigations in Outbreaks," Chapter 4​.

There isno strong evidence that isolating infected cases in a separate surgical suite reduces SSI risk.

Step-by-Step Justification:

SSI Prevention Strategies Supported by Evidence:

Preoperative hospital stay limitationreduces exposure to hospital-acquired pathogens​.

Antimicrobial preoperative scrubslower bacterial load on the skin​.

Adequate nutritionimproves immune function and wound healing​.

Why Designating a Separate Surgical Suite Is Not Effective:

Operating room environmental controls(e.g., laminar airflow, sterilization protocols) are more important than suite designation.

No significant reduction in SSIs has been observed bysegregating infected cases into specific OR suites​.

Why Other Options Are Correct:

A. Limiting preoperative hospital stay:Reducesnosocomial bacterial exposure.

B. Antimicrobial preoperative scrub:Decreasesskin flora contamination.

C. Assuring adequate patient nutrition:Enhancesimmune defense against infections.

CBIC Infection Control References:

APIC Text, "Surgical Site Infection Prevention Strategies"​.

When evaluating a new disinfectant, theinfection preventionist's primary concern must be the safety and effectiveness of the product. This includes ensuring the product is EPA-registered, effective against targeted pathogens, safe for both the environment and users, and compliant with regulatory guidelines.

From theAPIC/JCR Workbook, key considerations include:

“Organizations should evaluate each product to ensure that it can be used safely and include a review of dilutions, storage, shelf life, PPE needed, and disposal and ventilation requirements to ensure that OSHA, EPA, or local requirements are met”.

TheCBIC Study Guidereinforces that:

"Safety and efficacy are critical factors in evaluating new products, with particular emphasis on infection prevention and user safety".

The other options, while relevant, are not the most critical factors in determining product adoption from an infection control standpoint.

Postoperative infections in clean surgical operations, defined by the Centers for Disease Control and Prevention (CDC) as uninfected operative wounds with no inflammation and no entry into sterile tracts (e.g., gastrointestinal or respiratory systems), are influenced by various perioperative factors. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes identifying and mitigating risk factors in the "Prevention and Control of Infectious Diseases" domain, aligning with CDC guidelines for surgical site infection (SSI) prevention. The question focuses on identifying a procedure not documented as a contributor to SSIs, requiring an evaluation of evidence-based risk factors.

Option C, "The use of iodophors for preoperative scrubs," has not been documented to contribute to the development of postoperative infections in clean surgical operations. Iodophors, such as povidone-iodine, are antiseptic agents used for preoperative skin preparation and surgical hand scrubs. The CDC’s "Guideline for Prevention of Surgical Site Infections" (1999) and its 2017 update endorse iodophors as an effective method for reducing microbial load on the skin, with no evidence suggesting they increase SSI risk when used appropriately. Studies, including those cited by the CDC, show that iodophors are comparable to chlorhexidine in efficacy for preoperative antisepsis, and their use is a standard, safe practice rather than a risk factor.

Option A, "Prolonged preoperative hospital stay," is a well-documented risk factor. Extended hospital stays prior to surgery increase exposure to healthcare-associated pathogens, raising the likelihood of colonization and subsequent SSI, as noted in CDC and surgical literature (e.g., Mangram et al., 1999). Option B, "Prolonged length of the operations," is also a recognized contributor. Longer surgical durations are associated with increased exposure time, potential breaches in sterile technique, and higher infection rates, supported by CDC data showing a correlation between operative time and SSI risk. Option D, "Shaving the site on the day prior to surgery," has been documented as a risk factor. Preoperative shaving, especially with razors, can cause microabrasions that serve as entry points for bacteria, increasing SSI rates. The CDCrecommends avoiding shaving or using clippers immediately before surgery to minimize this risk, with evidence from studies like those in the 1999 guideline showing higher infection rates with preoperative shaving.

The CBIC Practice Analysis (2022) and CDC guidelines focus on evidence-based practices, and the lack of documentation linking iodophor use to increased SSIs—coupled with its role as a preventive measure—makes Option C the correct answer. The other options are supported by extensive research as contributors to SSI development in clean surgeries.

An effective respiratory hygiene program in healthcare facilities aims to reduce the transmission of respiratory pathogens, such as influenza, COVID-19, and other droplet- or airborne infectious agents, by promoting practices that minimize the spread from infected individuals. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the importance of such programs within the "Prevention and Control of Infectious Diseases" domain, aligning with guidelines from the Centers for Disease Control and Prevention (CDC). The CDC’s "Guideline for Isolation Precautions" (2007) and its respiratory hygiene/cough etiquette recommendations outline key components, including source control, education, and environmental measures to protect patients, visitors, and healthcare workers.

Option B, "Mask availability at building entrance and reception," is a core element of an effective respiratory hygiene program. Providing masks at entry points ensures that symptomatic individuals can cover their mouth and nose, reducing the dispersal of respiratory droplets. This practice, often referred to as source control, is a primary strategy to interrupt transmission, especially in high-traffic areas like entrances and receptions. The CDC recommends that healthcare facilities offer masks or tissues and no-touch receptacles for disposal as part of respiratory hygiene, making this a practical and essential inclusion.

Option A, "Community educational brochures campaign," is a valuable adjunct to raise awareness among the public about respiratory hygiene (e.g., covering coughs, hand washing). However, it isan external strategy rather than a direct component of the facility’s internal program, which focuses on immediate action within the healthcare setting. Option C, "Separate entrance for symptomatic patients and visitors," can enhance infection control by segregating potentially infectious individuals, but it is not a universal requirement and depends on facility resources and design. The CDC suggests this as an optional measure during outbreaks, not a standard element of every respiratory hygiene program. Option D, "Temperature monitoring devices at clinical unit entrance," is a useful screening tool to identify febrile individuals, which may indicate infection. However, it is a surveillance measure rather than a core hygiene practice, and its effectiveness is limited without accompanying interventions like masking.

The CBIC Practice Analysis (2022) and CDC guidelines prioritize actionable, facility-based interventions like mask provision to mitigate transmission risks. The availability of masks at key entry points directly supports the goal of respiratory hygiene by enabling immediate source control, making Option B the most appropriate answer.

Surgical wounds are classified by the Centers for Disease Control and Prevention (CDC) into four classes based on the degree of contamination and the likelihood of postoperative infection. This classification system, detailed in the CDC’s Guidelines for Prevention of Surgical Site Infections (1999), is a cornerstone of infection prevention and control, aligning with the Certification Board of Infection Control and Epidemiology (CBIC) standards in the "Prevention and Control of Infectious Diseases" domain. The classes are as follows:

Class I (Clean):Uninfected operative wounds with no inflammation, typically closed primarily, and not involving the respiratory, alimentary, genital, or urinary tracts.

Class II (Clean-Contaminated):Operative wounds with controlled entry into a sterile or minimally contaminated tract (e.g., biliary or gastrointestinal), with no significant spillage or infection present.

Class III (Contaminated):Open, fresh wounds with significant spillage (e.g., from a perforated viscus) or major breaks in sterile technique.

Class IV (Dirty-Infected):Old traumatic wounds with retained devitalized tissue or existing clinical infection.

Option A, "Incisions in which acute, nonpurulent inflammation are seen," aligns with a Class II surgical wound. The presence of acute, nonpurulent inflammation suggests a controlled inflammatory response without overt infection, which can occur in clean-contaminated cases where a sterile tract (e.g., during elective gastrointestinal surgery) is entered under controlled conditions. The CDC defines Class II wounds as those involving minor contamination without significant spillage or infection, and nonpurulent inflammation fits this category, often seen in early postoperative monitoring.

Option B, "Incisional wounds following nonpenetrating (blunt) trauma," does not fit the Class II definition. These wounds are typically classified based on the trauma context and are more likely to be considered contaminated (Class III) or dirty (Class IV) if there is tissue damage or delayed treatment, rather than clean-contaminated. Option C, "Incisions involving the biliary tract, appendix, vagina, and oropharynx," describes anatomical sites that, when surgically accessed, often fall into Class II if the procedure is elective and controlled (e.g., cholecystectomy), but the phrasing suggests a general category rather than a specific wound state with inflammation, making it less precise for Class II. Option D, "Old traumatic wounds with retained devitalized tissue," clearly corresponds to Class IV (dirty-infected) due to the presence of necrotic tissue and potential existing infection, which is inconsistent with Class II.

The CBIC Practice Analysis (2022) emphasizes the importance of accurate wound classification for implementing appropriate infection prevention measures, such as antibiotic prophylaxis or sterile technique adjustments. The CDC guidelines further specify that Class II wounds may require tailored interventions based on the observed inflammatory response, supporting Option A as the correct answer. Note that the phrasing in Option A contains a minor grammatical error ("inflammation are seen" should be "inflammation is seen"), but this does not alter the clinical intent or classification.

A patient withactive shingles (herpes zoster)is contagious to individuals who havenever had varicella (chickenpox) or the varicella vaccine.The best roommate selectionis someone who has received thevaricella vaccine, as they are consideredimmune and not at riskfor contracting the virus.

Why the Other Options Are Incorrect?

B. Treatment with acyclovir– Acyclovirtreatsherpes zoster but does notprevent transmissionto others.

C. A history of herpes simplex– Priorherpes simplex virus (HSV) infection does not confer immunity to varicella-zoster virus (VZV).

D. Varicella zoster immunoglobulin (VZIG)–VZIG provides temporary immunitybut does not offerlong-term protectionlike the vaccine.

CBIC Infection Control Reference

APIC guidelines recommendplacing patients with active shingles in a room with individuals immune to varicella, such as those vaccinated​.

The correct answer is B, "1 and 4 only," indicating that the information can best be used to heighten awareness among Emergency Department (ED) staff and review the TB exposure control plan. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, tuberculosis (TB) remains a significant public health concern, particularly with the increasing proportion of cases among foreign-born persons in the United States. The data showing a rise from four to 22 states with over 50% of TB cases among foreign-born individuals highlights an evolving epidemiological trend that warrants targeted infection prevention strategies (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.1 - Conduct surveillance for healthcare-associated infections and epidemiologically significant organisms).

Heightening awareness among ED staff (option 1) is critical because the ED is often the first point of contact for patients with undiagnosed or active TB, especially those from high-prevalence regions. Increased awareness can improve early identification, isolation, and reporting of potential cases. Reviewing the TB exposure control plan (option 4) is equally important, as it allows the infection preventionist to assess and update protocols—such as ventilation, personal protective equipment (PPE) use, and screening processes—to address the heightened risk posed by the growing number of cases among foreign-born individuals (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents).

Option 2 (inform staff who are foreign-born) is not the best use of this data, as the information pertains to patient demographics rather than staff risk, and targeting staff based on their origin could be inappropriate without specific exposure evidence. Option 3 (educate patients and visitors) is a general education strategy but less directly actionable with this specific epidemiological data, which is more relevant to healthcare worker preparedness and facility protocols. Combining options 1 and 4 aligns with CBIC’s emphasis on using surveillance data to guide prevention and control measures, ensuring a proactive response to the increased TB burden (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.5 - Use data to guide infection prevention and control strategies).