Practice exam 1 Flashcards
The bacterium most likely to be transmitted from mother to infant during labor and cause neonatal sepsis is:
a. Escherichia coli
b. Staphylococcus aureus
c. Group B Streptococcus
d. Group A Streptococcus
Group B Streptococcus
Heavy maternal colonization is associated with an increased risk for preterm labor, which in turn is a significant risk factor for neonatal infection. Intrauterine infection of the fetus therefore likely occurs via ascending spread of GBS from vagina of a pregnant, symptomatically colonized woman and subsequent rupture of membranes before 37 weeks’ gestation.
APIC Streptococci
An IP is developing an education session related to sharp object injuries. She wants to target this session specifically to healthcare personnel at her facility.
What is the best way to prepare this session?
a. Gather data from occupational health reports on sharp object injuries in the facility.
b. Gather information on national data about sharp object injuries in HCP.
c. Hold forums in each unit to find out what HCP experiences have been with sharp object injuries.
d. Perform a literature search to research the topic of sharp object injuries in HCP
Gather data from occupational health reports on sharp object injuries in the facility.
HCP will be most persuaded by data that relate to them.
APIC Education and Training
The primary functions of an Infection prevention and control program should include all except:
a. To develop and recommend policies and procedures related to infection prevention and control.
b. To conduct surveillance for healthcare-associated infections (HAIs).
c. To decrease the length of stay for patients.
d. To educate HCP and patients in infection prevention practices.
To decrease the length of stay for patients
The principal functions of an Infection prevention and control program includes:
Obtaining and managing critical data and information, by surveillance for infections.
Developing and recommending policies and procedures.
Intervening directly to prevent infections
Educating and training HCP, patients, and non-medical care givers.
APIC Infection Prevention and Control Program
What type of meningitis would be most consistent with the following cerebrospinal fluid (CSF) report result:
- Glucose - decreased
- Protein - elevated
- WBC counts 1,00/mm 3
a. Bacterial
b. Viral
c. Fungal
d. Tuberculosis
Bacterial
Culture of blood and CSF are indicated for patients with suspected invasive meningococcal disease. The CSF of patients with untreated meningococcal meningitis is usually cloudy and has pleocytosis with a predominance of neutrophils, low glucose, and high protein levels. in most of the cases, the organisms are seen on Gram stain or can be identified using latex agglutination assays. The culture is almost invariably positive as long as the sample was obtained before the administration of antibiotics.
APIC Central Nervous System Infection
The following blood culture result should be considered a potential contaminant:
a. A positive result of coagulase-negative staphylococci from two sets, 2 days apart, without symptoms.
b. A positive result of S. aureus from one bottle in a patient with a temperature of 38.6 C
c. A positive result of E.coli from one bottle in an afebrile patient with diarrhea.
d. A positive result on Candida albicans in a fungal blood culture in a patient with a urinary tract infection.
A positive result of coagulase-negative staphylococci from two sets, 2 days apart, without symptoms.
CDC CLABSI criteria, common commensals (such as coagulase-negative staph) meet the criteria for a CLABSI if there are two positive cultures from two or more sets of blood cultures drawn less than 2 days apart and the patient has symptoms ( fever greater than 38 C, chills or hypotension).
Which of the following organisms have been associated with the transmission of infections after body piercing?
1) Atypical Mycobacterium species.
2) Staphylococcus species
3) Pseudomonas species
4. Haemophilus species
a. 1,2,3
b. 2,3,4
c. 1,3,4
d. 1,2,4
1,2,3
Atypical Mycobacterium species
Staphylococcus species
Pseudomonas species
Body piercing activities can transmit infectious disease. Bacterial infections may result from improper initial piercing technique or from poor hygiene.
APIC Body Piercing, tattoos and electrolysis
The Director of the Operating room (OR) requests that the OR surfaces be routinely environmentally cultured. The IP’s best response should be:
a. A schedule for routine culturing of the OR should be arranged so that each room is cultured at a set interval.
b. Routine culturing of the OR should be done in the absence of any epidemiological investigations in that area.
c. Routine culturing should not be done because it is too expensive.
d. Routine environmental culturing should not be considered unless an epidemiological investigation is being conducted.
Routine environmental culturing should not be considered unless an epidemiological investigation is being conducted.
Microbial environmental testing is not generally recommended.
APIC Microbiology Basics
All of the following may be indications of a heating, ventilation, and air conditioning (HVAC) malfunction except:
a. An increase in the postoperative surgical site infection (SSI) rates.
b. A single case of aspergillosis in a severely immunosuppressed patient.
c. Healthcare - associated varicella infections.
d. An outbreak of ventilator-associated Acinetobacter infections in the Intensive Care Unit (ICU).
An outbreak of ventilator-associated Acinetobacter infections in the Intensive Care Unit (ICU).
Detection and Identification of certain HAIs may suggest HVAC malfunction and are usually not the immediate cause of device-associated HAIs.
APIC - Heating, Ventilation, and Air Conditioning
A patient who underwent intraocular surgery was diagnosed with a noninfectious endopthalmitis after the procedure. The IP initiates an investigation to identify the possible cause. Which of the following factors should be considered?
1) Improper handling, cleaning and rinsing of the instruments.
2) Improper labeling of the solutions
3) Gloves and powder
4) Prophylactic antibiotics administered 2 hours before the procedure.
a. 1,3 b. 1,2 c. 3,4 d. 2,4
Improper handling, cleaning and rinsing of the instruments.
Gloves and powder
Endophtalmiitis is an inflammatory condition of the intraocular cavities usually caused by infection. Noninfectious endophthalmitis may result from various causes such as retained native lens material after an operation or from toxic agents. Improper cleaning and rinsing of surgical instruments can leave a residue, which can irritate the eye and cause inflammation of the eye during surgery
APIC Ophthalmology Services
Sensitivity may be defined as:
a. The ability of a test to detect true positive (person with the disease) when applied to a population with the disease.
b. The ability of a test to detect the true negatives (persons without the disease) when applied to a population without the disease.
c. The ability of a test to detect true positives (persons with disease) when applied to a population without the disease.
d. The percentage of persons with true positive results when the test is applied to persons without the disease.
The ability of a test to detect true positive (person with the disease) when applied to a population with the disease.
Sensitivity and specificity are common statistical measures to describe diagnostic tests or presence of disease. Sensitivity is the ability of a test to identify true cases or persons who have the disease or health condition of interest. In other words, it is the probability of getting positive test results among patients with disease. A high sensitivity test means that a negative result rules our the disease.
APIC Use of Statistics in Infection Prevention
The IP is monitoring blood work in order to differentiate between bacterial or viral infection in a newly admitted ICU patient. Which of the following components of a complete blood count (CBC) should the IP examine in order to determine this information?
a. Hematocrit
b. Whit blood cell count
c. Platelet (thrombocyte count)
d. Red blood cell indices
White blood cell count
A WBC count and differential provide information about the relative numbers of each type of WBC. Evaluation of WBC count can help to determine whether an illness has a bacterial or viral origin.
A nurse manager from a Rehabilitation Unit is requesting that aerators be installed on the sinks in the patients rooms on her unit. The IP should explain that:
a. Aerators should be placed on all sinks in the ICU only
b. Aerators are more effective when combined with an ultraviolet water disinfection method.
c. Aerators increase the risk of HAIs
d. Low-flow aerators are suitable for use with this population.
Aerators increase the risk of HAIs
Various types of equipment and fixtures can promote the growth of water-associated pathogens. Important water reservoirs for these organisms include potable water systems and cooling towers, flush sinks, faucet aerators, hoppers and toilets, eyewash/drench shower stations, chests /ice machines, water baths used to thaw or warm blood products and other liquids, and whirlpool or spa-like baths. Aerators are not recommended.
APIC Water systems issues and prevention of waterborne infectious diseases in Healthcare Facilities.
Herpes simplex virus (HSV) keratitis is suspected in an oncology patient. Aerobic eye cultures are negative to date. A single serum sample is sent for enzyme - linked immunosorbent assay (ELISA) antibody testing. The following titers are reported: HSV titer 1:128, cytomegalovirus (CMV) titer <1:8, Epstein-barr (EBC) titer< 1:*, these results indicate:
a. Immunity to HSV
b. Confirmation of acute HSV infection
c. Presumptive identification of HSV infection
d. Immunity to CMV and EBV
Presumptive identification of HSV infection
APIC Herpes Virus
The Nursing Supervisor calls the IP at home to inform him that a patient has presented to the ED with a fever and rash and has been diagnosed with measles. The IP’s first action should be:
a. Place the patient in Airborne Precautions
b. Contact the local public
c. Place the patient in Airborne and Contact Precautions
d. Check the immunization status of the ED staff
Place the patient in Airborne Precautions
Measles are transmitted by direct contact with infectious droplets. In addition to Standard precautions, Airborne Precautions are indicated in healthy patients for 4 days after the onset of rash. If the patient is immunocompromised, he or she must remain on precautions for the duration of illness.
A patient is admitted for a skin infection after swimming in the ocean. Which of the following organisms is the most likely cause?
A. Mycobacterium marinum
B. Mycobacterium avium
C. Mycobacterium leprae
D. Mycobacterium tuberculosis
Mycobacterium marinum
This organism causes cutaneous lesions after exposure to swimming pools, fish tanks, or other water sources. The organism may enter through previously unappreciated superficial nicks and abrasions. The lesions first appear as papules and later ulcerate. Because special culture conditions must be used to isolate the organism, the lab should be alerted if this is a diagnostic consideration.
APIC Tuberculosis and Other Mycobacteria
An ambulatory clinic will be transporting equipment to the local hospital for sterilization. The IP at the clinic has been asked to write a policy to ensure safe handling of the equipment by staff. The policy should include which of the following points on handling the instruments at the point of use?
1) Devices are to be cleaned before biofilm can form
2) Keep instrumentation moist to prevent bio burden from drying
3) Instruments with lumens should be flushed with saline
4) Contaminated devices are to be placed in a sealed container to prevent exposure to staff and patients.
A. 1,3,4. B. 2,3,4. C. 1,2,4. D. 1,2,3
Devices are to be cleaned before biofilm can form
keep instrumentation moist to prevent bio burden from drying
Contaminated devices are to be placed in a sealed container to prevent exposure to staff and patients.
What is the probability of committing a type 1 error if the p value is 0.10?
A. 1 in 10
B. 1 in 100
C. 1 in 5
D. 1 in 20
1 in 10
APIC use of Statistics in Infection Prevetion
Which of the following is an example of the principle of emergency management called “mitigation?”
a. Implementation of the hospital’s emergency management plan during a hurricane.
b. Recovery efforts after a major flood has subsided.
c. A facility-wide bio-terrorism disaster drill.
d. Funding a program that will provide ring vaccination of exposed people against smallpox during an outbreak.
Funding a program that will provide ring vaccination of exposed people against smallpox during an outbreak.
Disasters should be planned for and responded to using the principles of emergency management.
APIC Emergency Management
The purpose of the antibiogram is to:
a. Provide a monthly report on new and emerging antimicrobials.
b. Give IPs another metric to track
c. Provide information on antimicrobial usage and resistance patterns in the community.
d. Give hospitals information needed for reporting data through the National Healthcare Safety Network (NHSN)
Provide information on antimicrobial usage and resistance patterns in the community.
APIC Antimicrobials and Resistance
The most common organism associated with pneumonia in school-aged children and young adults is:
a. Neisseria meningitidis
b. Streptococcus pneumoniae
c. Staphylococcus aureus
d. Mycoplasma pneumoniae
Mycoplasma pneumoniae
Mycoplasma is uncommon under the age of 5 but is the leading cause of pneumonia in school-aged children and young adults. It can occur during any season and occurs throughout the world.
The purpose of a root cause analysis is to:
a. Determine which individual made an error so that the employee may be disciplined or terminated.
b. Review the basic processes that are in place and then turn that review over to a unit-specific team so that they can determine how they should modify their practices.
c. Provide a process that requires little time or training but allows employees to identify culpability after an adverse event.
d. Include participants from diverse areas of the organization to delve into the cause of an error or systems failure and identify changes in practice and /or policy that will prevent a repeat of that error or event.
Include participants from diverse areas of the organization to delve into the cause of an error or systems failure and identify changes in practice and /or policy that will prevent a repeat of that error or event.
APIC Quality Concepts
A pediatrics patient has been diagnosed with pediculosis. What is the most appropriate follow-up to prevent it from spreading to other patients or HCP?
a. Place the patient on Contact Precautions until 24 hours after appropriate treatment has been initiated.
b. Require all visitors and HCP who enter the room to wear a disposable scrub cap for any patient contact.
c. Use an insecticidal spray in the room after the patent is discharged.
d. Prophylactically treat all family members and anyone with close physical contact with the patient.
Place the patient on Contact Precautions until 24 hours after appropriate treatment has been initiated.
In addition to placing the patient on Contact precautions, patient bedding,clothing, and waterproof personal items should be washed at high temperature.
APIC Viral Hemorrhagic Fevers
An employee has experienced an accidental needle stick injury while providing care to a patient. All of the following lab test would be appropriate for the source patient except:
a. Human immunodeficiency virus (HIV)
b. Hepatitis B antibody
c. Hepatitis B surface antigen
d. Hepatitis C surface antigen
Hepatitis B antibody
A positive Hepatitis B antibody indicates past infection or immunity via vaccination. It does not indicate active infection.
APIC Occupational Exposure to Blood-borne pathogens.
The IP receives a call from a physician who is concerned that there is an outbreak of Acinetobacter baumannii, because he has cared for four patients in the past week who are infected with the organism. What is the IP’s first step in responding to this call?
a. Contact the lab to ask them to create an alert for any A. baumannii cases.
b. Contact hospital administration to request additional resources to investigate the outbreak.
c. Confirm that there is an outbreak by using her own surveillance data and lab records to compare the rates of Acinetobacter baumannii over the past year.
d. Initiate a case-control study to determine risk factors for A. baumannii infection.
Confirm that there is an outbreak by using her own surveillance data and lab records to compare the rates of Acinetobacter baumannii over the past year.
Confirming the presence of an outbreak is a key first step in an outbreak investigation
APIC Outbreak investigation
The IP receives a call from the Food and Drug Administration (FDA) with an official request for private health information (PHI) about a patient who was admitted to the facility with botulism. How should the IP respond to this call?
a. Tell the FDA officer that she cannot share PHI with the FDA due to Health Insurance Portability and Accountability Act (HIPAA) regulations.
b. Ask the FDA to contact the local health department to obtain information about the patient.
c. Provide the FDA officer with the minimum amount of information necessary related to the patient.
d. Transfer the call to the Risk Management Department.
Provide the FDA officer with the minimum amount of information necessary related to the patient.
The FDA is a public health authority. HIPAA regulations cover disclosure to the FDA of the minimum amount of information is necessary to prevent of control disease.
APIC - Legal Issues
A measles exposure from a patient in a clinic was identified and an exposure workup was initiated. A staff exposure was defined as “non-immune HCP with more than 5 minutes of same-room contact or face-to-face contact with the index patient.” Forty-eight HCP were identified as possible exposures. Of these, 44 had documented immunity to measles. Of the remaining HCP, three did to have the same room or fact-to-face contact. How many HCP were at risk of developing measles because of this exposure?
a. 4
b. 45
c. 1
d. 48
1
Measles is highly contagious febrile exanthem. According to the definition of staff exposure, only one healthcare worker was non-immune and had more than 5 minutes of same-room contact or face-to-face contact with the index patient. This HCP must be furloughed from the 5th to the 21st day after exposure, regardless of whether they had vaccines.
APIC Measles, mumps, rubella
A nurse working in the recovery room is pregnant and has told her manager that she cannot take care of patients with methicillin-resistant S. aureus (MRSA). The manager contacts the IP for a recommendation. The best response is to:
a. Tell the manager that the nurse will need to be assigned to patients without multi-drug - resistant organisms (MDROs) for the duration of her pregnancy.
b. Meet with the nurse and reassure her that she is at no greater risk of contracting MDROs as long as she practices Standard Precautions.
c. Contact the nurse’s healthcare provider and explain why he/she gave the wrong advice.
d. Agree with the nurse and ask the manger to put her on light duty.
Meet with the nurse and reassure her that she is at no greater risk of contracting MDROs as long as she practices Standard Precautions.
For practical purposes, immunologic function is normal during pregnancy, and an otherwise healthy woman is not considered to be an immunocompromised host. Pregnancy does not increase the risk of acquisition of infections, and for most infectious agents, clinical manifestations of infections are no more severe in pregnant women than in those who are not pregnant. As long as proper infection control practices are used, pregnant HCP are at no greater risk than non-pregnant HCP.
APIC Pregnant Healthcare Presonnel
Vaginal probes with probe covers require which type of disinfection:
a. Low-level disinfection
b. Intermediate-level disinfection
c. High-level disinfection
d. Sterilization
High-level disinfection
Vaginal probes are used in sonographic scanning. A vaginal probe and all endocavitary probes without a probe cover are semi-critical devices because they have direct contact with mucous membranes. It is recommended that a new probe cover should be used for each patient. These covers may fail or be compromised a high-level disinfection of the probe should also be performed.
APIC Cleaning, Disinfection, and sterilization
The IP is reviewing the facility’s performance measures, which are used to benchmark against national data. The IP ensures that each performance measure includes which of the following characteristics?
1) . Measure is reliable
2) . Measure targets improvement in a health population.
3) . Measure is defined according to physician preference
4) Measure can be easily interpreted by the users of the data.
a. 1,2,3 b. 1,2,4 c. 2,3,4 d. 1,3,4
Measure is reliable
Measure targets improvement in a health population.
Measure can be easily interpreted by the users of the data.
Performance measures focus on outcomes or processes.
APIC Performance Measures
A preliminary microbiology report states that a patient’s blood culture grew aerobic, gram-negative bacilli. Which of the following is the most likely genus and species of the organism?
a. Enterococcus faecalis
b. Bacterioides fragilis
c. Acinetobacter baumanii
d. Neisseria Meningitides
Acinetobacter baumanii
Acinetobacter baumannii is a gram-negative bacterium. It is typically short, almost round, and rod-shaped (coccobacillus). It can be an opportunistic pathogen in humans, affecting people with compromised immune systems and is becoming increasingly important as an HAI. It has also been isolated from soil and water samples in the environment.
APIC Environmental Gram-negative Bacilli
Urinary tract infections in the postpartum period have three important risk factors. Which of the following is NOT one of them?
a. Induction of labor
b. Tocolysis
c. Cesarean delivery
d. Twin births
Twin births
UTIs in the postpartum period have three important risk factors: cesarean delivery, tocolysis, and induction of labor. Twin births are NOT associated with an increased risk of UTI.
APIC Urinary tract infection
If chance is likely the explanation for the difference between a sample statistic and the corresponding null hypothesis population value, then:
a. The difference is not statistically significant.
b. The sample results are not compatible with the null hypothesis
c. The difference is statistically significant
d. the null hypothesis can be rejected.
The difference is not statistically significant.
A common use of statistics is hypothesis testing. A hypothesis is a statement of expected results. Hypothesis testing uses the distribution of a known area in the normal curve and estimates the likelihood that a result did not occur by chance.
APIC use of Statistics
Non-infectious postoperative endophthalmitis is most often associated with:
a. Wearing contact lens
b. Toxic anterior segment syndrome (TASS)
c. Conjunctivitis
d. Keratitis
Toxic anterior segment syndrome (TASS)
Outbreaks of TASS have been associated with breaches in handling, cleaning, and disinfecting surgical instruments; introduction of contaminated solutions, contaminated intraocular lenses, and toxic medications during surgery; powder from gloves; and irritants (dried blood, endotoxins, residual detergent) left on instruments.
APIC Ophthalmology Services
An acute care facility experiences an outbreak of Serratia marcescens bloodstream infections. After the outbreak is under control and no new cases are being reported, the IP wants to find the source of the outbreak. The most appropriate epidemiology study design to use is:
a. Retrospective cohort study
b. Prospective cohort study
c. Case-control study
d. Cross-sectional study
Case-control study
Case-control studies group people by disease status and then investigate past exposures with the objective of identifying exposures that are more common to cases than to controls. This is an appropriate study design for this example because there are existing cases, and the IP is trying to identify the exposure that are associated with bloodstream infections.
APIC General Principles of Epidemiology and Research Study Design
To calculate the CAUTI rate for a unit for 1 month, the denominator should be:
a. The number of patient days for the unit for the month.
b. The number of admissions for the unit for the month
c. The number of patients with urinary catheters for the month
d. The number of urinary catheter insertions for the month
The number of patients with urinary catheters for the month
- persons in the denominator must reflect the same population from which the numerator was taken.
- Counts in the numerator and denominator should cover the same time period.
- The persons in the denominator should have been at risk of the event or occurrence. (that is number of patients with urinary catheters)
APIC use of Statistics in Infection Prevention
Which of the following is an example of surveillance on a process indicator?
a. The incidence rate of Clostridium difficle in the Bone Marrow transplant Unit.
b. The rate of hand hygiene compliance in the Bone Marrow transplant Unit
c. The number of sharp object injuries in the month of May in the Bone Marrow Transplant Unit
d. The prevalence of vancomycin-resistant enterococci (VRE) in the Bone Marrow Transplant Unit
The rate of hand hygiene compliance int he Bone Marrow transplant Unit
This is a process measure because it is measuring whether an action has taken place but not whether there is any effect of this action on outcomes.
APIC Surveillance
The Director of Infection Prevention and Control has hired a novice IP who has a Master of Public Health degree and has worked in the Epidemiology Division of the local health department for 2 years. The IP’s academic training included core courses in epidemiology, bio-statistics, behavioral science, health policy, and environmental health, and he was in charge of disease surveillance and outbreak control activities at the health department. Of the following, which will be the first priority in his orientation to Infection Prevention and Control?
a. Have him review the Control of Communicable Diseases Manual and evaluate his knowledge with a written quiz.
b. Have him visit the different clinical practice areas to meet with managers, and ask him to summarize the infection control needs of each manager.
c. Have him attend an online class on the use of statistical software package like Excel or Epi Info.
d. Have him read the APIC text cover-to-cover before taking part in any applied orientation activities.
Have him visit the different clinical practice areas to meet with managers, and ask him to summarize the infection control needs of each manager.
The most basic goal of healthcare education and training is to improve job skills and cometetnce. Needs assessments will identify deficiencies in knowledge, skills, or attitude and serve as the basis for training. Given the lack of experience at a healthcare facility, the new IP should meet the different managers and gain an understanding of how each area relates to and interacts with the IP team.
APIC Education and Training; Competency and Certification of the IP
What is the range for the following numbers: 2,3,5,8,9,10,11,15,18.
a. 16
b. 18
c. 9
d. 2
16
The range provides a value that represents the difference between the highest and lowest values in a data set. Like the mode in the measures of central tendency, the range is the least number and lowest number is this data set is 18-2 = 16.
An IP has been asked to evaluate a new antimicrobial-impregnated dressing in order to reduce device-associated infections. The initial step in the product evaluation process is to establish whether:
a. The new product is cost effective
b. The product is safe
c. There is a need for the new product
d. The impact on clinical outcomes is positive
There is a need for the new product
A product evaluation process should always begin with the identification of a need.
APIC Product Evaluation
After reviewing the quarterly report, the manager of the adult ICU contacts the IP for assistance to create a plan to reduce central line infections. Which of the following should the IP recommend:
a. Wait for the next report to see if the rate has decreased.
b. Create an Intravascular Team
c. Develop a multidisciplinary team to review and implement best practices.
d. Send a referral to Medical Affairs for peer review
Develop a multidisciplinary team to review and implement best practices.
Multidisciplinary teams are a valuable tool in deploying a quality-focused culture or process.
APIC Quality Concepts
Important considerations regarding blood culture specimens include:
1) Collect prior to the initiation of antimicrobial therapy
2) Collect from a central venous catheter whenever possible
3) Ensure that the volume of the specimen collected is sufficient
4) Culture of specific sites is not recommended for surveillance
a. 1,3
b. 2,4
c. 1,4
d. 3,4
Collect prior to the initiation of antimicrobial therapy
Ensure that the volume of the specimen collected is sufficient
The accuracy of a blood culture can be impacted by a wide variety of factors, many of which pertain to skin antisepsis and/or specimen collection techniques.
APIC Microbiology Basics; Blood Cultures
An IP subscribes to several peer-reviewed journals. As she reviews published articles describing research findings, what question should she ask before incorporating the conclusions/findings of the article into the infection prevention program?
a. Was the appropriate study design used and are the conclusions reasonable?
b. Is the author well known and well published?
c. Does the article state how to contact the author(s) with questions?
d. Are the findings described in tables or graphs and easily understandable?
Was the appropriate study design used and are the conclusions reasonable?
Many study designs, observational or experimental, are available to investigators. Understanding the advantages and disadvantages of each study design should prepare the IP to critically evaluate published research studies so as to appropriately assign value to the findings.
APIC Research Study Design
A patient with suspected active tuberculosis has been admitted to an acute care facility. To date, two sputum samples have been tested for acid-fast bacilli (AFB) and both were negative. What type of isolation Precautions are now indicated for the patient?
a. Standard Precautions
b. Contact Precautions
c. Airborne Precautions
d. Droplet Precautions
Airborne Precautions
The patient should remain on Airborne Precautions until three sputum samples are AFB negative.
APIC Tuberculosis and Other Mycobacteria.
APIC Isolation Precautions
Which of the following scenarios would be most appropriate for immediate-use sterilization:
a. The vendor brings the instrument for the procedure with morning of the surgery, which does not allow for the full sterilization process.
b. The instrument used for the procedure is dropped on the floor of the operating room and another instrument is not available.
c. The turnaround time between procedures does not allow enough time for the full sterilization process.
d. The OR does not have the needed instruments to meet the demand of surgeries; therefore, the instruments are flashed between procedures.
The instrument used for the procedure is dropped on the floor of the operating room and another instrument is not available.
Flash sterilization is a quick-steam sterilization cycle that does not use the full sterilization cycle of exposure and dry times.
Chapter 68 - Surgical Services
The Director of the Infection Prevention and Control Department has assigned one of her IPs to co-facilitate in a root cause analysis of an adverse event in collaboration with the Performance Improvement team. The IP plans to use process improvement tolls and techniques during the analysis. Which of the following methods would best outline the possible causes the event?
a. Brainstorming
b. Affinity diagrams
c. Fish-bone diagram
d. Pareto chart
Fish-bone diagram
A fish-bone diagram (also called a tree diagram or Ishikawa) allows a team to identify, explore, and graphically display all of the possible causes related to a problem to discover the root cause.
APIC Quality Concepts
Which of the following is not an infection prevention objective of an occupational health program?
a. Contain costs to personnel for work-related illnesses or exposures.
b. Provide care to personnel for work-related illnesses or exposures.
c. Educate patients about the principles of infection prevention.
d. Collaborate with the Infection Prevention Department in monitoring and investigating potentially harmful infectious exposures and outbreaks.
Educate patients about the principles of infection prevention.
The healthcare organization’s administration, medical staff, and other HCP need to support the infection prevention objectives of an occupational health program.
APIC Occupational Health
An IP is presenting data on the rate of central line-associated bloodstream infections (CLABSI) in the ICU for the last month. Which graphic display is the most appropriate choice for this data?
a. A bar chart
b. An ogive
c. A frequency polygon
d. A frequency histogram
A bar chart
A bar chart is the best choice for displaying this data because this is discrete data that is mutually exclusive.
APIC Use of statistics in Infection Prevention
What action is indicated when the IP is asked to help determine if a worker has experienced occupational acquisition of an infectious agent or disease in order to receive worker’s compensation benefits?
a. Provide enough information to prove or disprove the employee’s claim.
b. Notify the facility’s attorney immediately
c. Review the worker’s compensation system in place
d. Perform a root cause analysis to investigate
Review the worker’s compensation system in place
Disease that results from occupational exposure usually is eligible for compensation if the occupational exposure is the sole cause of the disease; the occupational exposure aggravates a pre-existing disease; or the occupational exposure hastens the onset of disability. The burden of proving that disease was occupationally acquired lies with the workers. The IP’s expertise may be needed to help assess this situation. Risk Management and Occupational Health proved the necessary follow-up. IPs shold be familiar with the workers’ compensation system in place within their country.
APIC Employee/Occupational Health
The safe temperature range for cold food storage is:
a. 41 F/ 5 C or lower
b. 42 F /5.6 C to 10 C
c. 50 F / 10 C to 12.8 C
d. Less than 60 F / 15.6 C
41 F/ 5 C or lower
APIC Nutrition Services
A robust Performance Improvement team should perform all of the following EXCEPT:
a. Observational audits
b. Benchmark comparisons
c. Root cause analyses
d. House wide infection rates
House wide infection rates
A robust performance improvement program should include the following basic elements; measuring how a facility or organization controls or complies with policies; documenting results of observational audits; performing root cause analyses; reporting individual physician or unit infection rates; and bench-marking the organization’s infection rate against community, state, and national averages.
APIC Quality Concepts
Toys used for inpatient pediatric patients should ideally be all of the following EXCEPT:
a. new
b. nonporous
c. plush
d. single-patient use
plush
Implementation of a process for appropriate toy acquisition to ensure suitability for cleaning/disinfection; toys should be nonporous and able to withstand rigorous mechanical cleaning. Avoid toys that are water-retaining, plush, and stuffed (an exception is therapeutic dolls, which should be single-patient use); and those that are difficult to clean and dry.
APIC Pediatrics
Which of the following would be an appropriate method to evaluate the quality of an infection prevention program?
a. The total number of areas where surveillance was carried out in the past year.
b. The average amount of time that elapsed between receiving reports from the lab about patients with mulitdrug-resistant infections and placing those patient on appropriate Isolation Precautions.
c. The number of IPs in the program per the number of beds.
d. The average amount of money spent on isolation gowns this year as compared to last year.
The average amount of time that elapsed between receiving reports from the lab about patients with mulitdrug-resistant infections and placing those patient on appropriate Isolation Precautions.
The quality of the infection prevention program should be assessed routinely by evaluating customer satisfaction, appropriateness, efficacy, timeliness, availability, effectiveness and efficiency.
APIC Infection Prevention
On September 1, there were 30 surgical patients in the hospital. Two of these were post-op patients with SSIs. A total of 75 surgeries were performed in September. Six additional SSIs occurred in patients who had surgery in September. What was the numerator for an incidence rate in September?
a. 30
b. 6
c. 8
d. 75
6
An incidence rate is a measure of the frequency with which an event occurs in a population over a specified period of time. The numerator is the number of new cases of a disease during a specific time period. The denominator is the population over a period of time. The numerator is the number of new cases of a disease during a specific time period. The denominator is the population at risk for the same time period. The incidence rate is equal to the numerator divided by the denominator and multiplied by a constant. Because there were six new cases after Sept. 1, the numerator to calculate the incidence rate is this scenario is 6.
APIC Use of Statistics
An employee is exposed to blood and body fluids from a patient whose baseline testing revealed positive results in a rapid HIV test. The most appropriate follow-up test for the patient would be:
a. Western Blot
b. Viral Load
c. HIV polymerase chain reaction
d. CD 4
Western Blot
Rapid HIV tests can offer a result in 15 minutes.
APIC HIV/AIDS
