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CIC Prüfungsguide: CBIC Certified Infection Control Exam & CIC echter Test & CIC sicherlich-zu-bestehen

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CBIC Certified Infection Control Exam CIC Prüfungsfragen mit Lösungen (Q63-Q68):

63. Frage
A microbiology laboratory plays a pivotal role in both endemic and epidemic epidemiology. Which of the following should be investigated FIRST?

A. Three respiratory isolates of multi-drug resistant Klebsiella pneumoniae in the medical ICU.
B. Two blood isolates of coagulase-negative staphylococci in the oncology unit.
C. One blood isolate of Streptococcus agalactiae in the nursery.
D. Two isolates of Staphylococcus aureus in postoperative surgical sites.

Antwort: A

Begründung:
Multi-drug resistant (MDR) Klebsiella pneumoniae in a high-risk area like the ICU requires urgent investigation because:
* It spreads rapidly via contaminated hands or equipment.
* It poses a serious risk to immunocompromised patients.
* An outbreak could lead to severe hospital-acquired infections (HAIs).
Why the Other Options Are Incorrect?
* A. One blood isolate of Streptococcus agalactiae in the nursery - Single cases are not indicative of an outbreak.
* B. Two isolates of Staphylococcus aureus in postoperative surgical sites - Common post-surgical pathogen; requires monitoring but not immediate outbreak investigation.
* D. Two blood isolates of coagulase-negative staphylococci in the oncology unit - Common contaminants in blood cultures and not immediately alarming.
CBIC Infection Control Reference
APIC guidelines prioritize investigating MDR pathogens in high-risk units, such as ICU, to prevent transmission.

64. Frage
Hand hygiene rates in the facility have been decreasing over time. The Infection Preventionist (IP) surveys staff and finds that hand dryness is the major reason for non-compliance. What step should the IP take?

A. Allow staff to bring in lotion and carry it in their pockets.
B. Provide staff lotion in every patient room.
C. Allow staff to bring in lotion for use at the nurses' station and lounge.
D. Provide a compatible lotion in a convenient location.

Antwort: D

Begründung:
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.
References:
* CBIC Practice Analysis, 2022.
* CDC Guideline for Hand Hygiene in Healthcare Settings, 2002.
* WHO Guidelines on Hand Hygiene in Health Care, 2009.

65. Frage
An infection preventionist is asked to recommend a product for disinfection of bronchoscopes. Which of the following agents would be appropriate?

A. Alcohol
B. Phenolic
C. Iodophor
D. Peracetic acid

Antwort: D

Begründung:
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).
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.3 - Ensure safe reprocessing of medical equipment, 3.4 - Implement environmental cleaning and disinfection protocols. AAMI ST91:2015, Flexible and semi-rigid endoscope processing in health care facilities. CDC Guidelines for Disinfection and Sterilization in Healthcare Facilities, 2019.

66. Frage
A patient with a non-crusted rash has boon diagnosed with Sarcoptes scabiei. The patient is treated with 5% permethrin and precautions are started. The precautions can be stopped

A. when the bed linen is changed
B. 24 hours after effective treatment
C. when the treatment cream is applied
D. 24 hours after the second treatment

Antwort: B

Begründung:
For Sarcoptes scabiei (scabies), Contact Precautions should remain in place until 24 hours after effective treatment has been completed. The first-line treatment is 5% permethrin cream, which is applied to the entire body and left on for 8-14 hours before being washed off.
Why the Other Options Are Incorrect?
* A. When the treatment cream is applied - The mite is still present and infectious until treatment has fully taken effect.
* B. When the bed linen is changed - While changing linens is necessary, it does not indicate that the infestation has cleared.
* D. 24 hours after the second treatment - Most cases require only one treatment with permethrin, though severe cases may need a second dose after a week.
CBIC Infection Control Reference
According to APIC guidelines, Contact Precautions can be discontinued 24 hours after effective treatment has been administered.

67. Frage
A healthcare professional in a clinical microbiology laboratory is concerned about routine exposure to Neisseria meningitidis in culture. The healthcare professional last received the Meningococcal vaccine 8 years ago. What recommendation should be given to the healthcare professional regarding their meningococcal vaccination?

A. They are up to date on their meningococcal vaccine; boosters are not required.
B. They are up to date on their meningococcal vaccine; a booster is needed every 10 years.
C. They are due for a booster as it has been over 5 years.
D. They are due for a booster as it has been over 7 years.

Antwort: D

Begründung:
The correct answer is B, "They are due for a booster as it has been over 7 years," as this is the appropriate recommendation for the healthcare professional regarding their meningococcal vaccination. 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), healthcare professionals with routine exposure to Neisseria meningitidis, such as those in clinical microbiology laboratories, are at increased risk of meningococcal disease due to potential aerosol or droplet exposure during culture handling. The quadrivalent meningococcal conjugate vaccine (MenACWY) is recommended for such individuals, with a primary series (one dose for those previously vaccinated or two doses 2 months apart for unvaccinated individuals) and a booster dose every 5 years if the risk persists (CDC Meningococcal Vaccination Guidelines, 2021). However, for laboratory workers with ongoing exposure, the ACIP specifies a booster interval of every 5 years from the last dose, but this is often interpreted in practice as aligning with the 5-7 year range depending on risk assessment and institutional policy. Since the healthcare professional received the vaccine 8 years ago and works in a high- risk setting, a booster is due, with the 7-year threshold being a practical midpoint for this scenario (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents).
Option A (they are due for a booster as it has been over 5 years) is close but slightly premature based on the 8- year interval, though it reflects the general 5-year booster guideline for high-risk groups; the 7-year option better matches the specific timeframe. Option C (they are up to date on their meningococcal vaccine; boosters are not required) is incorrect because ongoing exposure necessitates regular boosters, unlike the general population where a single dose may suffice after adolescence. Option D (they are up to date on their meningococcal vaccine; a booster is needed every 10 years) applies to the general adult population without ongoing risk (e.g., post-adolescence vaccination), not to laboratory workers with continuous exposure, where the interval is shorter.
The recommendation for a booster aligns with CBIC's emphasis on protecting healthcare personnel from occupational exposure to communicable diseases, ensuring compliance with evidence-based immunization practices (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.1 - Collaborate with organizational leaders). This supports the prevention of meningococcal disease outbreaks in healthcare settings.
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 Meningococcal Vaccination Guidelines, 2021. ACIP Recommendations for Meningococcal Vaccines, 2020 (updated 2023).

68. Frage
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