Chapter 6 Employee / Occupational Health CIC Flashcards
The IP is assisting Employee Health with personnel tuberculosis (TB) skin testing. Which of the following represents a know tuberculin skin test (TST) conversion in a healthcare worker?
a. Prior tuberculin test results are not available, but the current result is 16 mm after 48 hours.
b. Tuberculin reaction 1 year ago was 9 mm, and the current results are 13 mm.
c. A prior tuberculin reaction was not measured, but the employee states it was dime-sized. The current result is 11 mm.
d. Tuberculin reaction 1 year ago was 3 mm, and the current result is 18 mm
Tuberculin reaction 1 year ago was 3 mm, and the current result is 18 mm.
Interpretation of the TST depends on measured TST induration in millimeters, the person’s risk for being infected with M. tuberculosis, and risk for progression to active TB if infected. The TST test should be interpreted according to the CDC guidelines. A healthcare worker without known exposure who demonstrates an increase of =/> 10 mm is considered a positive result.
A food service worker is diagnosed with Hepatitis A. How long should this employee be on work restrictions?
a. Until 14 days after symptoms resolve
b. Until 7 days after onset of jaundice
c. Until 14 days after onset of jaundice
d. until 10 days after symptoms resolve
until 7 days after onset of jaundice
According to the ACIP, food service workers who are diagnosed with Hepatitis A must be restricted from food handling until 7 days after the onset of jaundice.
Because there is no vaccine for Hepatitis C, there have been national recommendations for prevention and control of Hepatitis C (HCV) infections. These include all but which recommendation
a. Screening and testing of blood donors.
b. Risk-reduction counseling and screening of persons at risk for Hepatitis C infection.
c. A national registry for all healthcare personnel to be Hepatitis C antibody positive.
d. Adherence to Standard Precautions and safe work practices in healthcare settings.
A national registry for all healthcare personnel to be Hepatitis C antibody positive.
APIC Occupational Exposure to Blood-borne Pathogens
The U.S. Public Health Service’s Advisory Committee on Immunization Practices (ACIP) recommends all of the following immunizations be provided to healthcare personnel EXCEPT:
a. Hepatitis A and B vaccines
b. Influenza vaccine
c. Measles, mumps, and rubella (MMR) and varicella-zoster vaccines (if not immune)
d. Bacillus Calmette-Guerin (BCG)
Bacillus Calmette-Guerin (BCG)
Immunization programs provide protection from vaccine-preventable diseases for both the workers and those under their care.
Vaccines for pre-exposure are:
Hepatitis A and B, influenza, measles, mumps, rubella, tetanus, pertussis, and varicella-zoster (chicken pox)
Which of the following statements is TRUE regarding storage of vaccines?
a. Vaccines should be taken out of the original packaging.
b. Vaccines should be stored in a labeled container/bin on the middle shelf a few inches from the wall
c. Vaccines should be packed tightly into the fridge
d. Vaccines should be stored in the top of the refrigerator
Vaccines should be stored in a labeled container/bin on the middle shelf a few inches from the wall.
Vaccine storage and handling errors can reduce vaccine potency and result in inadequate immune responses and protection against disease. The CDC recommends the following:
Vaccines need to be placed in the central area of the unit away from walls, vents and coils.
Avoid placing vaccines on the top shelf
There must be enough room to store the year’s largest inventory without crowding
A calibrated thermometer should be placed inside each unit
The unit must be dedicated to the storage of vaccines
An employee is exposed to a patient known to have chronic Hepatitis B. The employee is a known responder to the Hepatitis B vaccine, which was given to him as a student 5 years ago. What is the recommended post exposure treatment for the employee?
a. Test the employee and all close personal contacts for Hepatitis B
b. Start the Hepatitis B series on the employee because of the length of time since vaccination
c. No treatment is recommended for a known responder
d. Recommend giving the employee the Hepatitis A vaccine
No treatment is recommended for a known responder
According to the CDC guidelines, when the employee is known to have responded to positive Hepatitis B antibody following immunization series, no treatment is recommended.
An employee who is not immune to varicella-zoster was exposed to a patient with active chickenpox. How long must the employee remain on work restrictions?
a. Until evaluated by a physician
b. From day 10 after exposure to day 21 after exposure
c. No work restriction is necessary if no signs and symptoms are present
d. At the discretion of the hospital infectious disease physician
From day 10 after exposure to day 21 after exposure.
According to the ACIP guidelines, a non-immune healthcare worker who has direct contact with a patient with varicella zoster should be excluded from work duty from the 10th day after the first day of exposure through the 21st days after the last exposure.
Which of the following are acceptable methods for follow-up testing among healthcare personnel with unprotected exposure to TB?
- QuantiFERON-TB Gold testing (QFT-G) of sputum at the time of exposure and 12 weeks after exposure.
- QFT-G testing of blood at the time of exposure and 12 weeks after exposure.
- TST via tine tests at the time of exposure and 12 weeks after exposure.
- TST via the intradermal method at the time of exposure and 12 weeks after exposure.
- Chest radiograph for personnel with prior positive TST or QFT-G results
- Chest radiograph for symptomatic personnel with positive TST or QFT-G results
a. 1,3,6
b. 2,3,5
c. 1,4,6
d. 2,4,6
QFT-G testing of blood at the time of exposure and 12 weeks after exposure.
TST via the intradermal method at the time of exposure and 12 weeks after exposure.
Chest radiograph for symptomatic personnel with positive TST or QFT-G results
What is the appropriate temperature for vaccines that require refrigeration?
a. 46 F to 55 F (8 C to 13 C)
b. 25 F to 35 F (-4 C to 2 C)
c. 25 F to 45 F ( -4 C to 7 C)
d. 35 F to 46 F (-2 C to 8 C)
35 F to 46 F (-2 C to 8 C)
Most routinely recommended vaccines should be stored in refrigerator 35 F - 46 F (2 C - 8 C), with a desired average temperature of 40 F (5 C). Exposure to temperatures outside this range may result in reduced vaccine potency and increased risk of vaccine-preventable diseases.
The IP is reviewing the immunization records of healthcare personnel at their facility and discovers that employees born before 1957 do not have any record of receiving MMR vaccine. What should she recommend to the Human Resources Director regarding employees born before 1957?
a. They are considered immune and do not require follow up.
b. They should receive two doses of the vaccine 4 weeks apart.
c. They are only required to provide proof of immunity to measles.
d. They are required to provide proof of immunity to measles, mumps and rubella.
They are required to provide proof of immunity to measles, mumps and rubella.
All persons working in healthcare facilities should be immune to measles, mumps, and rubella. It is reasonable to require proof of immunization.
Staff assisting with bronchoscopy must wear which type of respiratory protection?
a. Surgical / procedure mask
b. Face shield
c. Protection not required
d. A fit-tested respirator or powered air purifying respirator (PAPR)
A fit-tested respirator or powered air purifying respirator (PAPR)
Healthcare personnel assisting with bronchoscopy should wear appropriate personal protective equipment including a fit-tested respirator or a PAPR.
An employee has sustained a needle stick injury from a blood-contaminated needle. The source patient was Hepatitis B virus (HBV) positive, and the employee had completed one of the three vaccinations in the Hepatitis B series. Which of the following is the correct post-exposure prophylaxis (PEP) for this patient?
a. Complete the Hepatitis B vaccine series
b. Complete the Hepatitis B vaccine series and provide Hepatitis B immunoglobulin
c. Provide Hepatitis B immunoglobulin and begin interferon therapy
d. No PEP is needed
Complete the Hepatitis B vaccine series and provide Hepatitis B immunoglobulin
HBV is transmitted by percutaneous or mucosal exposure to infectious blood or body fluids. The risk of HBV seroconversion after a percutaneous injury ranges from 23% - 63% depending on the Hepatitis B e antigen (HBeAG) status of the source person. For exposed persons who are in the process of being vaccinated but have not completed the vaccination series, vaccination should be completed as scheduled, and Hepatitis B immunoglobulin should be added as soon as possible after exposure.
The IP is developing a seasonal influenza immunization promotion program and decides to survey some healthcare personnel to determine their knowledge and attitude about influenza vaccines. Several healthcare personnel state that they do not want to be immunized because they believe that the vaccine can give them the flu. What is the best response the IP can give to alleviate this fear?
a. The symptoms of the flu from the vaccine are much milder than actually getting the flu, so they are better off being immunized
b. There are no known reactions or side effects to the flu vaccine
c. Any symptoms they experience are due to allergies to components of the vaccine, so they will not get the flu from the vaccine
d. They might experience symptoms that are due to the immune response to the vaccine, but they cannot get the flu from the vaccine.
They might experience symptoms that are due to the immune response to the vaccine, but they cannot get the flu from the vaccine.
Vaccination is the primary method for preventing influenza and its complications. Healthcare personnel compliance with annual influenza vaccination is an expected behavior to protect patients, staff and families. There are two forms of vaccination available: the inactivated, injectable vaccine and the live/attenuated, intranasal vaccine (LAIV). Inactivated influenza vaccine contains noninfectious viral components and cannot cause influenza. LAIV can cause nasal congestion, sore throat, and headache for a few days. Some mild symptoms such as nasal congestion, sore throat, and headache can occur as a result of the immune response to the vaccine but these are typically minor and short-lived.
Dialysis staff are most at risk for exposure to blood borne pathogens during:
1) . Initiation and termination of dialysis
2) . Reprocessing, cleaning, and disinfection procedures
3) . Medication administration.
4) . Vascular access hemorrhage.
a. 1,2
b. 2,3
c. 2,4
d. 1,3
Initiation and termination of dialysis
Reprocessing, cleaning, and disinfection procedures
Staff members must follow Standard Precautions when exposure to blood or other potentially infectious materials is anticipated or likely. Times during which exposure is most likely to occur include initiation and termination of dialysis and during reprocessing, cleaning, or disinfection procedures.
According to the CDC, which type of thermometer should be used in a vaccine storage unit?
a. Fluid-filled bio-safe liquid thermometer
b. Infrared thermometer
c. Cart recorder
d. Probe in a glycol-filled bottle with an external monitoring device.
Probe in a glycol-filled bottle with an external monitoring device.
The CDC recommends using a temperature probe in a bottle filled with a thermal buffer, like glycol, that connects to an external monitoring device. This allows for temperatures to be monitored without having to open the unit door. In addition, the CDC recommends the use of digital data loggers. The CDC does not recommend the use of fluid-filled bio-safe liquid thermometers, infrared thermometers, or chart recorders.
