Free CBIC CIC Practice Exam with Questions & Answers | Set: 3

Qualitative studiesfocus on collectingsubjective data, including personal narratives, observations, and experiences. These data arenot numeric, and instead aim to explore themes and meaning from contextual, non-quantifiable information.

From theAPIC Text:

“Qualitative methods... Measures or data: Subjective, Unique, Differs over time, sample, and context.”

Theincidence ratemeasuresnew cases of infection in a population over a defined time periodusing the formula:

Why the Other Options Are Incorrect?

B. Disease specific– Refers to infectionscaused by a particular pathogen, not the general rate of new infections.

C. Point prevalence– Measuresexisting cases at a specific point in time, not new cases.

D. Period prevalence– Includesboth old and new cases over a set period, unlike incidence, which only considers new cases.

CBIC Infection Control Reference

APIC definesincidence rate as the number of new infections in a population over a given period​.

Chlorhexidine soap is a widely used antiseptic agent in healthcare settings for hand hygiene and skin preparation due to its effective antimicrobial properties. The Certification Board of Infection Control and Epidemiology (CBIC) underscores the importance of proper hand hygiene and antiseptic use in the "Prevention and Control of Infectious Diseases" domain, aligning with guidelines from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Understanding the microbial activity of chlorhexidine is essential for infection preventionists to recommend its appropriate use.

Option D, "Persistent activity with a broad spectrum effect," is the true statement. Chlorhexidine exhibits a broad spectrum of activity, meaning it is effective against a wide range of microorganisms, including gram-positive and gram-negative bacteria, some fungi, and certainviruses. Its persistent activity is a key feature, as it binds to the skin and provides a residual antimicrobial effect that continues to inhibit microbial growth for several hours after application. This residual effect is due to chlorhexidine’s ability to adhere to the skin’s outer layers, releasing slowly over time, which enhances its efficacy in preventing healthcare-associated infections (HAIs). The CDC’s "Guideline for Hand Hygiene in Healthcare Settings" (2002) and WHO’s "Guidelines on Hand Hygiene in Health Care" (2009) highlight chlorhexidine’s prolonged action as a significant advantage over other agents like alcohol.

Option A, "As fast as alcohol," is incorrect. Alcohol (e.g., 60-70% isopropyl or ethyl alcohol) acts rapidly by denaturing proteins and disrupting microbial cell membranes, providing immediate kill rates within seconds. Chlorhexidine, while effective, has a slower onset of action, requiring contact times of 15-30 seconds or more to achieve optimal microbial reduction. Its strength lies in persistence rather than speed. Option B, "Can be used with any hand lotion," is false. Chlorhexidine’s activity can be diminished or inactivated by certain hand lotions or creams containing anionic compounds (e.g., soaps or moisturizers with high pH), which neutralize its cationic properties. The CDC advises against combining chlorhexidine with incompatible products to maintain its efficacy. Option C, "Poor against gram positive bacteria," is incorrect. Chlorhexidine is highly effective against gram-positive bacteria (e.g., Staphylococcus aureus) and is often more potent against them than against gram-negative bacteria due to differences in cell wall structure, though it still has broad-spectrum activity.

The CBIC Practice Analysis (2022) supports the use of evidence-based antiseptics like chlorhexidine, and its persistent, broad-spectrum activity is well-documented in clinical studies (e.g., Larson, 1988, Journal of Hospital Infection). This makes Option D the most accurate statement regarding chlorhexidine soap’s microbial activity.

ForSarcoptes scabiei(scabies),Contact Precautionsshould remainin place until 24 hours after effective treatment has been completed. The first-line treatment is5% permethrin cream, which is applied to the entire body and left on for8–14 hoursbefore being washed off.

Why the Other Options Are Incorrect?

A. When the treatment cream is applied– Themite is still presentand infectiousuntil treatment has fully taken effect.

B. When the bed linen is changed–While changing linens is necessary, it doesnot indicate that the infestation has cleared.

D. 24 hours after the second treatment– Mostcases require only one treatmentwith permethrin, though severe cases may need a second dose after a week.

CBIC Infection Control Reference

According toAPIC guidelines,Contact Precautions can be discontinued 24 hours after effective treatmenthas been administered​.

The correct answer is D, "Cost benefit analysis and safety considerations," as this provides the best information to support the selection of a new catheter aimed at decreasing the rate of catheter-associated urinary tract infections (CAUTIs). According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, selecting medical devices like catheters for infection prevention involves a comprehensive evaluation that balances efficacy, safety, and economic impact. A cost-benefit analysis assesses the financial implications (e.g., reduced infection rates leading to lower treatment costs) against the cost of the new catheter, while safety considerations ensure the device minimizes patient risk, such as reducing biofilm formation or irritation that contributes to CAUTIs (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). This dual focus provides evidence-based data to justify the catheter’s adoption, aligning with the goal of improving patient outcomes and reducing healthcare-associated infections (HAIs).

Option A (staff member preference and product availability) is subjective and logistical rather than evidence-based, making it insufficient for a decision that impacts infection rates. Option B (product materials and vendor information) offers technical details but lacks the broader context of efficacy and cost-effectiveness needed for a comprehensive evaluation. Option C (value analysis and information provided by the manufacturer) includes a structured assessment of value, but it may be biased toward the manufacturer’s claims and lacks the independent safety and cost-benefit perspective critical for infection prevention decisions.

The emphasis on cost-benefit analysis and safety considerations reflects CBIC’s priority on using data-driven and patient-centered approaches to select interventions that enhance infection control (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.5 - Use data to guide infection prevention and control strategies). This approach ensures the catheter’s selection is supported by robust evidence, optimizing both clinical and economic outcomes in the prevention of CAUTIs.

The correct answer is C, "Rate of multi-drug resistant organisms acquisition," as it represents an example of an outcome measure. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, outcome measures are indicators that reflect the impact or result of infection prevention and control interventions on patient health outcomes or the incidence of healthcare-associated infections (HAIs). The rate of multi-drug resistant organisms (MDRO) acquisition directly measures the incidence of new infections caused by resistant pathogens, which is a key outcome affected by the effectiveness of infection control practices (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.4 - Evaluate the effectiveness of infection prevention and control interventions).

Option A (hand hygiene compliance rate) is an example of a process measure, which tracks adherence to specific protocols or practices intended to prevent infections, rather than the resulting health outcome. Option B (adherence to environmental cleaning) is also a process measure, focusing on the implementation of cleaning protocols rather than the end result, such as reduced infection rates. Option D (timing of preoperative antibiotic administration) is another process measure, assessing the timeliness of an intervention to prevent surgical site infections, but it does not directly indicate the outcome (e.g., infection rate) of that intervention.

Outcome measures, such as the rate of MDRO acquisition, are critical for evaluating the success of infection prevention programs and are often used to guide quality improvement initiatives. This aligns with CBIC’s emphasis on using surveillance data to assess the effectiveness of interventions and inform decision-making (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.5 - Use data to guide infection prevention and control strategies). The focus on MDRO acquisition specifically highlights a significant healthcare challenge, making it a prioritized outcome measure in infection control.

When reviewing the discussion section of an original article, an infection preventionist must focus on critically evaluating the interpretation of the study findings, their relevance to infection control, and their implications for practice. The discussion section typically addresses the meaning of the results, compares them to existing literature, and considers limitations or alternative interpretations. The appropriate question should align with the purpose of this section and reflect the infection preventionist's need to assess the validity and applicability of the research. Let’s analyze each option:

A. Was the correct sample size and analysis method chosen?: This question pertains to the methodology section of a research article, where the study design, sample size, and statistical methods are detailed. While these elements are critical for assessing the study's rigor, they are not the primary focus of the discussion section, which interprets results rather than re-evaluating the study design. An infection preventionist might ask this during a review of the methods section, but it is less relevant here.

B. Could alternative explanations account for the observed results?: The discussion section often explores whether the findings can be explained by factors other than the hypothesized cause, such as confounding variables, bias, or chance. This question is highly appropriate foran infection preventionist, as it encourages a critical assessment of whether the results truly support infection control interventions or if other factors (e.g., environmental conditions, patient factors) might be responsible. This aligns with CBIC's emphasis on evidence-based practice, where understanding the robustness of conclusions is key to applying research to infection prevention strategies.

C. Is the study question important, appropriate, and stated clearly?: This question relates to the introduction or background section of an article, where the research question and its significance are established. While important for overall study evaluation, it is not specific to the discussion section, which focuses on interpreting results rather than revisiting the initial question. An infection preventionist might consider this earlier in the review process, but it does not fit the context of the discussion section.

D. Are criteria used to measure the exposure and the outcome explicit?: This question is relevant to the methods section, where the definitions and measurement tools for exposures (e.g., a specific intervention) and outcomes (e.g., infection rates) are described. The discussion section may reference these criteria but focuses more on their implications rather than their clarity. This makes it less appropriate for the discussion section specifically.

The discussion section is where authors synthesize their findings, address limitations, and consider alternative explanations, making option B the most fitting. For an infection preventionist, evaluating alternative explanations is crucial to ensure that recommended practices (e.g., hand hygiene protocols or sterilization techniques) are based on solid evidence and not confounded by unaddressed variables. This critical thinking is consistent with CBIC's focus on applying research to improve infection control outcomes.

Thawingraw meat at room temperatureis amajor food safety violationbecause it allows bacteria to multiply rapidly within thetemperature danger zone(40–140°F or 4.4–60°C).Meat should always be thawed in the refrigerator, under cold running water, or in a microwave if cooked immediately.

Why the Other Options Are Incorrect?

B. Using a cutting board to cut vegetables– This issafeas long as proper cleaning and sanitation procedures are followed.

C. Maintaining hot food at 145°F (62.7°C) during serving–145°F is an acceptable minimum temperaturefor certain meats likebeef, fish, and pork.

D. Discarding most perishable food within 72 hours– Many perishable foods, especially leftovers, should be discardedwithin 3 days, making this an appropriate practice.

CBIC Infection Control Reference

The APIC guidelinesemphasize thatraw meat should never be thawed at room temperaturedue to the risk ofbacterial growth and foodborne illness​.

The correct answer is D, "Peracetic acid," as this agent is appropriate for the disinfection of bronchoscopes. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, bronchoscopes are semi-critical devices that require high-level disinfection (HLD) to eliminate all microorganisms except high levels of bacterial spores, as they come into contact with mucous membranes but not sterile tissues. Peracetic acid is recognized by the Centers for Disease Control and Prevention (CDC) and the Association for the Advancement of Medical Instrumentation (AAMI) as an effective high-level disinfectant for endoscopes, including bronchoscopes, due to its broad-spectrum antimicrobial activity, rapid action, and compatibility with the delicate materials (e.g., optics and channels) of these devices (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). It is commonly used in automated endoscope reprocessors, ensuring thorough disinfection when combined with proper cleaning and rinsing protocols.

Option A (iodophor) is typically used for intermediate-level disinfection and skin antisepsis, but it is not sufficient for high-level disinfection of bronchoscopes unless specifically formulated and validated for this purpose, which is uncommon. Option B (alcohol) is effective against some pathogens but evaporates quickly, fails to penetrate organic material, and is not recommended for HLD of endoscopes due to potential damage to internal components and inadequate sporicidal activity. Option C (phenolic) is suitable for surface disinfection but lacks the efficacy required for high-level disinfection of semi-critical devices like bronchoscopes, as it does not reliably eliminate all microbial threats, including mycobacteria.

The selection of peracetic acid aligns with CBIC’s emphasis on evidence-based reprocessing practices to prevent healthcare-associated infections (HAIs) associated with endoscope use (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.4 - Implement environmental cleaning and disinfection protocols). This choice ensures patient safety by adhering to manufacturer and regulatory guidelines, such as those in AAMI ST91 (AAMI ST91:2015, Flexible and semi-rigid endoscope processing in health care facilities).

Hand hygiene is a cornerstone of infection prevention, and declining compliance rates pose a significant risk for healthcare-associated infections (HAIs). The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes improving hand hygiene adherence in the "Prevention and Control of Infectious Diseases" domain, aligning with the Centers for Disease Control and Prevention (CDC) "Guideline for Hand Hygiene in Healthcare Settings" (2002). The IP’s survey identifies hand dryness as the primary barrier, likely due to the frequent use of alcohol-based hand sanitizers or soap, which can dehydrate skin. The goal is to address this barrier effectively while maintaining infection control standards.

Option B, "Provide a compatible lotion in a convenient location," is the most appropriate step. The CDC and World Health Organization (WHO) recommend using moisturizers to mitigate skin irritation and dryness, which can improve hand hygiene compliance. However, the lotion must be compatible with alcohol-based hand rubs (e.g., free of petroleum-based products that can reduce sanitizer efficacy) and placed in accessible areas (e.g., near sinks or sanitizer dispensers) to encourage use without disrupting workflow. The WHO’s "Guidelines on Hand Hygiene in Health Care" (2009) suggest providing skin care products as part of a multimodal strategy to enhance adherence, making this a proactive, facility-supported solution that addresses the root cause.

Option A, "Provide staff lotion in every patient room," is a good intention but impractical and potentially risky. Placing lotion in patient rooms could lead to inconsistent use, contamination (e.g., from patient contact), or misuse (e.g., staff applying incompatible products), compromising infection control. The CDC advises against uncontrolled lotion distribution in patient care areas. Option C, "Allow staff to bring in lotion and carry it in their pockets," introduces variability in product quality and compatibility. Personal lotions may contain ingredients (e.g., oils) that inactivate alcohol-based sanitizers, and pocket storage increases the risk of contamination or cross-contamination, which the CDC cautions against. Option D, "Allow staff to bring in lotion for use at the nurses’ station and lounge," limits the intervention to non-patient care areas, reducing its impact on hand hygiene during patient interactions. It also shares the compatibility and contamination risks of Option C, making it less effective.

The CBIC Practice Analysis (2022) and CDC guidelines emphasize evidence-based interventions, such as providing approved skin care products in strategic locations to boost compliance. Option B balances accessibility, safety, and compatibility, making it the best step to address hand dryness and improve hand hygiene rates.